Monday, March 18, 2013

Obamacare and a Doctor Shortage

Recently, with discussions over occupations and shortages, it is clear that our nation will need many primary care physicians to sustain a growing, and aging population. Forbes explains clearly, "About four percent of American medical graduates are choosing careers in primary care. As the number of primary care residents grow, this number will probably increase a bit, but I wouldn’t count on it. About eighty percent of the time, primary care residents choose to move on to a subspecialty. The reasons are complex, but not unknowable. PCPs tend to work longer hours and get paid less then their specialist colleagues, but their debt burden isn’t any less. With average medical school debt approaching $200,000 its no wonder doctors reach for higher-paying positions."
In negation to my recent post about the benefits of an individual health mandate, it appears that Obamacare will exacerbate the already growing problem of a doctor shortage in the U.S.       Expanding health insurance universally will overwhelmingly burden the capacity of the health care system. The U.S. would see a shortage of primary care physicians for a few reasons: First, the Annals of Family Medicine explains in December that a health insurance requirement would result in 20 million more primary care visits annually due to increased demand. The number of primary care physicians would not change though, placing stress on the system. Second, the Doctors Company, a physician research firm, notes in a February 2012 study that 43% of doctors are considering moving up their retirements five years early as a result of their dissatisfaction with health care expansion. Moreover, Forbes explains in August that 83% of doctors are considering quitting their jobs entirely. Even if just a fraction do decide to leave the profession, the shortage begins.  Third, the Doctors Company continues that 9 out of 10 physicians would not recommend becoming a part of the health care profession as a result of health car expansion. In fact, some doctors are actively dissuading prospective students from going into the medical field, lowering the number of primary care physicians for the future.

Put all of these situations together, and a primary care physician shortage is imminent. The Association of American Medical Colleges explains in 2010 that an American physicians shortage will be accelerated by five years as a result of health insurance requirements, lacking 63,000 physicians by 2015. This has negative implications: First, the Heartlander Institute explains that increased burdens on doctors will increase wait times, which not only lowers the quality of care provided, but also dissuades patients from even going to the doctor at all. If the purpose of health insurance requirements is to improve health care, it would be doing the opposite. Second, the American College of Physicians conducted a study and found that for every addition primary care physician among 10,000 people, 3.5 deaths were prevented. However, if millions more people are adding to the population while primary care physicians dwindle, we will see a marked increase in American mortality. 

Is it more important to address the issue of the doctor shortages when considering whether or not we should require our citizens with health care, or does the issue of rights/constituionality take precedent? Please comment your thoughts and weigh in your opinion weather you think an individual health mandate would be beneficial/harmful to the United States.


  1. Noah, I found this post very intriguing and some of the stats are completely staggering. I personally believe that healthcare is necessary, but should not be mandatory, especially if it leads to a decrease in doctors. If the numbers of doctors decreases, less people are going to receive healthcare anyway, negating the purpose of healthcare for all. Doctors work their butts off in both medical school and as professionals and many aren't willing to see more patients. In addition, if the doctors are receiving less money from the insurance companies of those patients, they have less incentive to see those patients and become a doctor in the first place. My parents happen to be doctors and although they do not see any Obamacare patients, they still know many doctors that are completely opposed to the healthcare bill. Citizens should have the right to decide whether they want to spend money on healthcare or not.

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