Ezra Klein of the Washington Post recently wrote the biggest threat to The Unaffordable Care Act and health care reform was a shortage of 30,000 primary care doctors.  I find this very interesting for a number of reasons.  

If it is true that a shortage of 30,000 primary doctors exists or will exist shortly, why is that?  There aren’t shortages of plumbers or tomatoes.  What’s up?  Could it be that government intervention and that magical thing that Uncle Sam can’t seem to get enough of which causes shortages……price controls?  ”Wait!  There you go again you free market fundamentalist!”   There, I said it.  Can you allow for the possibility that the government price controls in Medicare and Medicaid and the hassles with these wonderful agencies could drive young physicians away from primary care?  The primary care physician would be filing 40 claims or more a day if he/she were really busy.  What a nightmare!  

Actually, this is a great time to pursue primary care, though, as a non-contracted physician.  No insurance of any kind accepted.  Patients pay a set fee when they come in.  Wow.  Talk about an independent, bullet-proof practice.  Very few worries and hassles.  The gross almost equals the net.  This is not what Uncle Obama has in mind, though.

And this.  Who decides how many primary care doctors are enough?  Who decides how many plumbers are enough?  This reminds me of Bastiat’s essay entitled “How Paris is Fed.”  It is one page and you can read it here.  How do we know that the number is 30,000?  If you said, “We don’t!” you go to the head of the class.  

What will our government do?  I think you know.  They will force a certain percentage of graduating medical students to pursue this path whether they want to or not.  This is what always happens.  And the number of physicians that they force into this or that field will be wrong.  And the doctor you see won’t want to see you.  See any problems with this so far?

The government is always wrong in this business of allocation of scarce resources and the market is almost always right, but corrects itself when it’s off a little.  Why would we think that health care is any different?

G. Keith Smith, M.D.