Doctors don't think of their practices as a business. But it is. I know this is a problem because my own doctor is struggling with the low payments from insurers. It makes him want to rethink his practice and its business model. My daughter, who lives in Massachusetts, has told me stories of the doctor shortages brought about by the universal coverage that state has instituted. In Massachusetts, you're fined if you don't have health insurance. People who can't afford insurance must apply for it from the state. (It's like Medicaid.) But my daughter's friends who wound up with Mass Health coverage can't find doctors who will take it. They are going without.
This same problem is likely to hit the whole country if we have universal coverage. Medical school is expensive, so there are fewer doctors who want to become primary physicians where the pay is lower than it is for specialists.
So what should we do? I believe our country should subsidize doctors who will become primary care physicians, particularly ones who go out to serve the under-served. We need something like the Teach for America plan, only for doctors. I'm also hoping that lower salaries and bonuses and fewer jobs in finance will draw the best and brightest into medicine and science. I was so sad to watch my kids' classmates who were brainiacs in math and science all flock to Wall Street instead of the sciences. (Although one went to Google in marketing after majoring in chemistry at an Ivy League School.) The financial incentives simply have to change, or we will be paying more and more for medical care and getting less and less.
From the New York Times -- Health / Health Care Policy
Shortage of Doctors an Obstacle to Obama Goals
One proposal -- to increase Medicare payments to general practitioners, at the expense of high-paid specialists -- has touched off a lobbying fight.