Friday, June 12, 2015

Repost: Obamacare's Token Attempt To Adjust Physician Levels

Originally posted to Facebook 2014-04-29, reposted here for the usual reasons.

Something that came out of a discussion elsewhere ... I have long said that Obamacare does nothing to actually reduce costs, because it does not attempt to increase the supply of providers, either through practice liberalization (as by allowing nurse practitioners to perform certain procedures now only permitted to physicians) or through licensing liberalization (increasing the number of physicians). Mary Cvetan sent me hither, a website (she, at least in part wrote) that makes mention of the following:
Training New Primary Care Providers: The Affordable Care Act invests in the training of new primary care providers, including providing nearly $230 million to increase the number of medical residents, as well as funding to increase the number of nurse practitioners and physician assistants trained in primary care.  With these investments, by 2015, more than 1,700 new primary care providers will have been trained and enter primary care practice. The Fiscal Year 2014 budget includes investments that will expand the capacity of institutions to train 2,800 additional primary care providers over five years.
Is this a significant number? Per the Henry J. Kaiser Family Foundation, the US has 24.2 physicians per 10,000 population, which means, rounding down to 300,000,000 population, that the physician population is 720,000 or so, of which 1,700 would amount to less than one percent (actually 0.2%). It's entirely possible that this actually represents a figure below retirement replacement. If Obamacare wishes to lay claim to fixing the supply side of things, it must needs do better. This, however, runs square against the AMA's interests, and so I have my doubts.

Update 4/30/2014: In a surprisingly candid blog post on Mother Jones, Kevin Drum late last year pointed out that the reason US physicians are paid so much is because there are so few of them relative to other nations; the US is in the bottom third of physicians to population. To get to the OECD mean of 30.6, you would have to increase the US physician population by a quarter. And that's just to arrive at average.

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