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Collected Articles on Culture & Politics
The Future Under Obamacare 
31st-May-2009 07:34 am
From a letter by a cancer specialist:

Every analysis of oncology suggests that we have a 10-30% deficit of trained physicians staring us in the face by 2020. Every academic analysis suggests one or another program, and bemoans the difficulty in attracting qualified medical students and residents to oncology. It's quite simple, really: very hard work, and declining income. Private practice physicians have seen a fall of approximately 30% since 2004. Worsening economics are right around the corner. Given the extraordinary expense of chemotherapy and supportive therapies, combined with reimbursements that just exceed a wash, it will become impossible to deliver outpatient care in more than half the venues in the United States quite soon. And then, simply put, the senior physicians will quit....

I could go on, but this note is far too long already. Specialists, and underpaid generalists will hang it up years ahead of their planned exit from medicine in just about any system that the Obama administration is likely to devise. They'll scarcely need to ration care: there just won't be anyone around to deliver it. Government will kill the golden goose, and then blame it upon everyone and anyone else. As usual.

Name me happy workers whose wages have fallen 30% in the past five years. Actually, name me anyone else whose wages have fallen 30% and who still thinks they're going to not take early retirement where they can. And we are about to have the largest cohort enter the senior citizen ranks just in time for the system to fail them.

There are two fixes now, widely discussed everywhere but in the media:

1. Allow health insurance companies registered in any state to sell their policies in every state.

2. Require all insurers to offer plans to everyone as a condition of offering it to anyone.
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