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What is up, docs?

September 02, 1997

I almost spit out my Hudson Meat Co. pure all pork sausage patty last Sunday morning when I saw the headline in the Washington Post: "U.S. Will Pay To Reduce Doctor Glut."

The lead went on to say, "The federal government has agreed to pay hospitals around the country hundreds of millions of dollars not to train doctors, in a highly unorthodox initiative aimed at alleviating a growing glut of physicians."

Well, why not? After all, it worked for cotton.

But it looks like I picked the wrong week to invest in doctor futures.

"This just in from Chicago, a nationwide doctor glut caused by ideal growing conditions in the Midwest has pushed price of physicians to a new low in heavy trading..."

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I'm not certain I'm terribly comfortable with treating doctors like a commodity. Just my luck, I'd get sick right about the time the Indian equivalent of the OPEC cartel would announce a worldwide doctor embargo and people with sore throat aches would line up 20-deep in emergency rooms waiting for care, unlike now, where ... where. Sorry, I seem to have forgotten my point.

It also confuses me how this supply-side doctornomics is supposed to work. If I understand the problem correctly, according to the National Department of Fretting, medical costs are too high.

All right. Anyone who's ever paid $12 for a glorified Aspirin knows that. But how's reducing the number of doctors going to help? I always thought that less of something made the price go up, not down. Doctors may like it, though. If there are only 10 doctors left, they'll get $62 million per appendectomy.

I, for one, have never begrudged doctors, dentists or anyone in the health care field their salaries. Not only because it's valuable work, but because I would not be able to do it no matter what the price. There are some things I will not do, and putting my hands anywhere near the pyretic, Slim Jim-flecked, snaggle-toothed maw of some creosote-plant worker is one of them.

I can't deal with other people's physical afflictions, and the people who can should earn whatever they can and they will hear no complaint from me.

Obviously, though, there's something fundamental I'm missing. Because, it turns out, the doctors don't like the idea. "I know of no other profession where there has been as much federal effort to regulate," Princeton health economist Uwe Reinhardt grumbled. "You don't do it for economists, for architects, for engineers."

No, but maybe you should.

Lawyers, anyone?

If there ever were a noble use of public funds, it would be to pay people not to be lawyers. You wouldn't hear one more peep out of me about the federal deficit if that's where the money was going.

Doctors and lawyers aren't the only ones contributing to high medical costs. I think the government needs to investigate paying people not to be insurance and pharmaceutical executives as well. And after we've paid people not to be lawyers, doctors, pharmacy and insurance executives we can pay people not to be lobbyists, computer programmers or Frank Gifford.

Or hey, I've got it - let's simply pay people not to make a profit. That sounds like a pretty typical government program.

Actually, I guess the hang-up with the physicians is that you're not paying the people not to be doctors, you're paying the hospitals not to produce them. After all, I could just say that I want to be a doctor just to get the cash. Once again though, I don't get it. Paying a hospital not to train doctors is like paying an airline not to train any pilots.

For a while it may be a pretty sweet deal for the airline - until it comes time to land a plane.

Tim Rowland is a Herald-Mail columnist.

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