One key to good health and a successful health care system for all is a sufficient pool of quality physicians.
Yet according to recent Congressional testimony by Dr. Jeffrey Harris, president of the American College of Physicians (ACP), we are facing a critical shortage. To quote his testimony, “The demand for primary care in the U.S. will grow exponentially as the nation’s supply of primary care dwindles.”
Doctors list a host of reasons for leaving medicine: Low reimbursement rates. Outrageous malpractice premiums to protect themselves from often-frivolous lawsuits. Escalating paperwork. The inability to make medical decisions in conjunction with patients without being overruled by bureaucrats.
So logic would have it that a Congress and president fixated on reforming America’s health care model would address the urgent concerns of those on the front lines of medicine, our 780,000 physicians.
Unfortunately, if we look at the current health care proposals in the House and Senate, that assumption would be flat wrong. For example:
— Civil justice reform. The proposed legislation does nothing to address our current system of health justice, which takes too long, rewards trial lawyers at the expense of victims and drives far too many good doctors out of practice. In various states, many obstetricians no longer deliver babies, others refuse to work in emergency medicine, surgeons have ceased performing high-risk surgeries and some have even stopped working in radiology. The risk of getting sued is too great.
In addition, the threat of frivolous lawsuits often leads to defensive medicine, which not only wastes the physician’s time but also is estimated to cost us as a country $100 billion to $200 billion a year.
— Payment reform. Creating another government-run program is destined to further decrease physician payments. Medicare, another government-run plan, has such poor reimbursement rates that many physicians refuse to accept it. In fact, recent reports indicate that 29 percent of Medicare recipients have difficulty finding a primary-care physician.
— Paperwork reduction. The House proposal alone is more than 1,000 pages, which gives us some indication of the mountain of paperwork and bureaucratic procedures with any expansion of government health care. The complexity of the current Medicare system, along with its massive paperwork, is another reason listed for physicians’ dissatisfaction.
— Ending fraud in Medicare and Medicaid. Despite the low reimbursement rates, Medicare is going broke. We at the Center for Health Transformation believe 10 percent of the money spent at Medicare and Medicaid is wasted on fraud. We’re not talking billing errors but outright theft of government benefits. Those inefficiencies frustrate physicians and drive many out of medicine. Addressing fraud is an issue glaringly absent from legislation pending before Congress.
— Putting the patient and his or her physician in the driver’s seat. Allowing Washington to expand its control over health care, as the current House bill would do, would lead to less decision-making by individuals and their doctors and put more control into the hands of a Washington bureaucracy. The result, based on what we’ve learned from Medicare and Medicaid, will be fewer physicians and more taxpayer money wasted on fraud. That translates into longer waits for treatment and less access to care — just when our aging population will be more in need of more care. The U.S. population is expected to grow by 50 million in the next 15 years and another estimated 51 million baby boomers will retire by 2019, creating more of a demand for physicians.
A 2008 survey conducted by The Physicians’ Foundation found that 49 percent of physicians or 150,000 doctors planned to reduce the number of patients they would see or stop practicing in the next three years. Eighty-two percent of the doctors said their practices would be “unsustainable” if there were cuts to Medicare. The survey of primary-care physicians was conducted prior to any discussion of cutting $500 billion from Medicare to pay for more government-run health care.
Meanwhile, we don’t have to go far to see what will be the result of having a government-run universal system on physician access.
Consider Canada where government-run, universal health care has prompted a doctor shortage. The average Canadian doctor earns 42 percent of what an American physician is paid, according to the Pacific Research Institute. Over the past decade, 11 percent of the doctors have crossed the border to practice in our country. The result for citizens is long waiting lines, rationing of health care and limited physician access.
Any reform Congress considers should focus on solutions that solve the challenges that doctors face, as they are critical to the future of health care. If we expand government control, history shows and our neighbors’ experiments illustrate, it would be a prescription for disaster for the medical profession and for each of us.
Newt Gingrich is a former U.S. House Speaker and founder of the Center for Health Transformation. Nancy Desmond is president and CEO of the center.