The US economy has lost 7.8 million jobs since the start of this recession, and jobs are not coming back. Obamacare will lead to the loss of millions of healthcare jobs before the end of the decade.
There is already a trend for doctors to opt out of government programs, which will accelerate as more people are covered under Obamacare. Doctors who remain in practice will be overburdened, much the same as Massachusetts doctors, where cardiologists see as many as 9 patients at one time; having them sign non disclosures to protect each other’s medical information.
Insurance plans, forced to lower deductibles and include pre-existing conditions, will increase demand for medical care. The combination of an increase in medical demand and a decrease in medical supply will drive up costs, ultimately raising premiums for everyone. The need to reduce costs has spurred the growth of the medical tourism industry. Medical tourism facilitators lure patients overseas for medical care based on perceived cost savings. Facilitators often mark up the price for overseas medical care by 20% to 80% and accept kickbacks from the hospitals. Because state medical licensing boards prohibit fee splitting, medical facilitators primarily send patients to overseas destinations. This effectively creates a subsidy for medical tourism which is denied to domestic providers, outsourcing healthcare jobs.
With a developing doctor shortage, and increased costs of medical care, insurance companies will be under pressure to slash costs elsewhere. Insurers have already started signing up overseas hospitals in an attempt to increase supply of medical providers. Deloitte, in 2008, estimated that between $228 billion, and $599.5 billion annually will be lost from the US medical economy by 2017. That will mean millions of lucrative medical jobs permanently lost.
Other ways Washington plans on reducing cost is through electronic health records and “cost effectiveness” initiatives. Bureaucrats in DC study patients’ electronic health records, and attempt to automate medicine. We might even have an overseas call center taking health calls with the assistance of computerized symptom checkers. Price controls are driving a move towards less costly nurse practitioners, and physician assistants rather than medical doctors to provide care. Is this consistent with the quality of care Americans demand?
How will the US cope with the loss of millions of lucrative healthcare jobs, especially just when baby boomers are retiring, becoming Medicare eligible and in need of more medical care?
Can we continue to prosper as bad policies send high end healthcare jobs overseas? In one generation, we have seen manufacturing, phone answering, and computer programming outsourced, leading to growing trade deficits. The country which no longer makes its own tanks and ships will never be powerful. The country which cannot take care if it’s sick, cannot remain a great nation.
The reimbursement rates of medical treatment are set by Medicare for 14,000+ procedures. This price fixing, along with perverse utilization incentives embedded in health plans has caused massive healthcare inflation for decades, while eroding the patient/physician relationship. Lowering reimbursement percentages for doctors has forced a reduction in the time given to each patient, thereby reducing the quality of care. Insurance plans with lower deductibles increase demand and when spending the insurance provider’s money rather than their own, patients continue to accept this type of treatment. The only way to bring down costs, while improving quality, is through competition. Just look at how much Lasik surgery has come down in price, while quality has increased due to competition. When doctors compete based on cost, quality and value, patients win. Often, simply crossing state lines for care can save a lot of money.
Rather than using government to drive healthcare jobs away, we should embrace prosperity by increasing meaningful healthcare competition
Continuing along the current path, doctors will be substituted by non-MD “medical providers,” who will become order takers. This current path of coercion, will lead to increased cost, and decreased quality. Allowing doctors to compete and bid on your care the way other American businesses do, is the only path to sustainable healthcare reform.
Ralph F Weber, CFP, CLU, ChFC, REBC is the President of MediBid.com (http://www.medibid.com/consumers), an internet portal for buying and selling medical goods and services without the intrusion of third-parties. After starting an international health insurance brokerage in Canada, he moved to California in 2005 out of concern for the healthcare needs of his family. He has a personal passion for helping patients obtain greater access to quality care after his son was hit by a car and never received anything more than an X-ray, watching his mother choose a radical mastectomy because she felt she had no other choice, and finally watching his wife slowly become more and more crippled after a two year wait for a bunionectomy all because healthcare in Canada was being rationed. He has since participated in several healthcare forums as a means of educating people on the differences between single-payer and free-market health care delivery and financing. He is a contributor to both New York Mayor Rudy Giuliani’s, and California State Assemblyman Mike Villines’ health care policies.
By Ralph F. Weber
