They’re stealing my health care!

John Goodman has an editorial in the WSJ that’s worth a read:

Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way.

Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans—and if the economic studies are correct, they will try to double their use of the health-care system.

Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to free breast and pelvic exams and even free contraceptives. Once ObamaCare fully takes effect, all of us will be entitled to a long list of preventive services—with no deductible or copayment.

Here is the problem: The health-care system can’t possibly deliver on the huge increase in demand for primary-care services. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be gridlock.

Look, there’s nothing inherently wrong with what he’s saying. The issue I take with the piece is that the problem he’s describing has absolutely, positively nothing to do with Obamacare.

We have a doctor shortage in the United States. There are too many people who want to see a doctor, and not enough doctors to see them. This means that sometimes people have to wait to see a physician. This happens now.

In the future, under Obamacare, more people will have insurance, and thus more people will try and see the doctor. But we will have the same number of doctors. So it will be harder to get an appointment, and people might have to wait longer.

But let’s say instead that we replace Obamacare with RomneyRyancare. It’s a conservative’s dream of market forces and consumer shopping and now 30 million more people can afford health care than can today. The exact same wait times will occur.

That’s because the wait times have nothing to do with how we get more people insurance. They have everything to do with how many people are trying to access the system and how many doctors can service them. Period.

John predicts that we will see more concierge medicine. In other words, doctors will allow people with money to get in line first, meaning that the people who were helped by Obamacare, and can’t afford the concierge costs, will be second tier. I hate to tell you, but that’s the system we have now. People who can afford care are far more likely to get it than people who can’t. Moreover, if we have RomneyRyancare, there will still be the same forces at work, the same shortages, and I bet that we will still find ourselves in a system where those who can pay more get serviced first.

This has nothing to do with the means by which we increase access. Unless you are willing to discuss a way to increase the number of physicians in this country, John’s argument is one against decreasing the number of uninsured at all.


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