The following article is an except form pages 78-81 of my book The Conscience of a Young Conservative. If you enjoy, free PDF copies are available through Liberty.me, and print copies are available on Amazon. 

When the conditions that a doctor must work in worsen, it should come to no surprise that we see less doctors.

In the 1970’s, before Canada’s government takeover of medicine, they ranked second out of 28 countries on doctors per thousand people. Now, they rank 24th.[1] Even though Massachusetts attempted universal coverage just recently (in 2006), they are already experiencing doctor shortages in dermatology, general surgery, emergency medicine, and other areas.[2] All these problems have arisen despite Massachusetts ranking #1 in doctors per 100,000 residents, with 462 doctors per 100,000 in 2006.[3] While Massachusetts has retained its #1 ranking for now, their supply of doctors has now begun to lag behind demand. One hospital reported 1,600 people on their waiting list in 2008 and said it takes around 4 months for someone to have their first appointment.[4]

American programs that resemble socialized medicine in other countries – such as Medicare and Medicaid – already suffer from something similar to this problem of physician reduction. Since private insurers pay physicians more than Medicare and Medicaid, patients on these government programs have trouble finding physicians.. In Michigan, the number of doctors willing to see Medicaid patients has declined from 88 percent in 1999 to 64 percent in 2005. In Ohio, only 28 percent of doctors surveyed by the Ohio Coalition of Primary Care Physicians said they would continue to provide care to Medicaid patients on an unlimited basis without an increase in pay.[5] Like Michigan, Ohio also has followed a downward trend in doctors seeing Medicaid patients, with a decline from 93 percent in 1998 to 63 percent in 2002.[6]

Both programs cause doctors to work at a loss in some cases. One doctor at Hurley Medical Center named Dr. Mukkamala estimated that is cost him around $29 for every X-ray he takes. Medicaid pays him $20 per X-ray, Medicare pays $30, and insurers such as Blue Cross pay $33.[7] The Ohio Coalition study cited previously also found that 79 percent of doctors do not receive a large enough Medicaid reimbursement to cover their office overhead.[8]

Since many of the same health care “experts” that designed RomneyCare in Massachusetts also designed ObamaCare, there are more areas where these plans are similar than different. What has caused problems at a statewide level is bound to cause problems at the national level. Even prior to the passing of ObamaCare, many polls showed a reduction in the number of physicians to be inevitable. A survey of 270,000 primary care physicians in 2008 found that 76 percent already described themselves as “overextended or overworked.” Because of this, 13 percent plan to look for a job that does not involve patient care, 30 percent plan to work part time or see fewer patients, and 11 percent plan on retiring.[9]

A survey conducted by the Physicians’ Foundation nine months after ObamaCare was passed showed that 40 percent of physicians said they would drop out of patient care within the next 3 years by retiring, seeking a non-clinical job within healthcare, or seeking a job not related to healthcare. [10]  I seriously doubt that someone who spends nearly a decade of their life in university obtaining a medical degree would truly seek employment in a non-medical field, but it at least it shows ObamaCare to be widely unpopular among physicians.

A study by the Association of American Medical Colleges placed a number on the size of the predicted shortages. In summary, they found that by 2015 the predicted doctor shortage would be 50 percent worse with ObamaCare than without it.[11] People can rationally argue that many of these doctors are bluffing, but there are other fields that doctors can migrate to. These include specialties such as cosmetic surgery, Lasik, and others where the government does not involve itself. Since the ObamaCare bill would place a cap on reimbursements, doctors would rationally flee to these other specialties.[12]

In addition to physician reduction, many other problems exist. Fifty-nine percent said that ObamaCare would cause them to spend less time with patients, and 87 percent said they would have to close or restrict their practices to Medicare patients. Overall, 67 percent of physicians surveyed view the ObamaCare bill negatively.[13] ObamaCare is largely unpopular among physicians, who tend to know best what is in their best interests.

[1] Esmail, Nadeem, and Michael Walker. “How Good is Canadian Health Care? The Heartland Institute, 2004. <http://heartland.org/policy-documents/how-good-canadian-health-care?Email=yes>.

[2] Mitchell, Jennifer. “Doctor Shortage in Massachusetts, Some Wait 53 Days to See Doctor.” 29 Oct. 2010. <http://actionforbetterhealthcare.com/?p=1436>.

[3] “American Medical Association, Chicago, IL, Physicians Characteristics and Distribution in the U.S., annual (copyright).” Table 156, Statistical Abstract of the United States, 2009.

[4] Brown, Karen. “Mass. Health Care Reform Reveals Doctor Shortage.” NPR, 30 Nov. 2008.  <http://www.npr.org/templates/story/story.php?storyId=97620520>.

[5] “2002 Ohio Physician Medicaid Survey Key Findings.” The Ohio Coalition of Primary Care Physicians and the Ohio State Medical Association, Jan. 2003. <ohiomedicaidreform.gov/pdf/Brian_Bachelder_PartI.pdf>.

[6] Ibid

[7] Fuhrmans, Vanessa. “Note to Medicaid Patients: The Doctor Won’t See You.” 19 July 2007. <http://mlyon01.wordpress.com/2007/07/19/note-to-medicaid-patients-the-doctor-wont-see-you/>.

[8] “2002 Ohio Physician Medicaid Survey Key Findings.”

[9] “Obamacare Won’t Survive Coming Doctor Shortage.” The Washington Examiner, 28 June 2009. <http://washingtonexaminer.com/editorials/2009/06/obamacare-wont-survive-coming-doctor-shortage>.

[10] “Nation’s Frontline Physicians Unhappy With Health Care Reform Measures.” Physicians’ Foundation, 18 Nov. 2010.  <http://www.physiciansfoundations.org/PressReleaseDetails.aspx?id=250>.

[11] “Health Reform to Worsen Doctor Shortage: Group.” Ed. Peter Cooney. 30 Sept. 2010. <http://www.reuters.com/article/2010/09/30/us-usa-healthcare-doctors-idUSTRE68T67120100930>.

[12] Morrissey, Ed. “Study: ObamaCare Will Make Doctor Shortage 50% Worse by 2015.” HotAir, 1 Oct. 2010.  <http://hotair.com/archives/2010/10/01/study-obamacare-will-make-doctor-shortage-50-worse-by-2015/>.

[13] Nations Frontline Physicians Unhappy With Health Care Reform Measures.