For the last two years, Democrats and Republicans have drawn battle lines over health care reform. As a pre-med student, I look with dismay upon this current mess, but Tuesday’s State of the Union address offered an encouraging sign when Presdient Barack Obama indicated his willingness to consider the Republicans’ suggestion of medical malpractice reform.
The medical profession is bombarded continuously with malpractice lawsuits, decreasing compensation, and less job satisfaction. A recent Physician’s Foundation survey sent to the nation’s 300,000 medical doctors produced some distressing statistics about our country’s caregivers. Seventy-eight percent of physicians said medicine is either “no longer rewarding” or “less rewarding”, and 42 percent of physicians described the morale of their colleagues as “poor” or “very low.” Even more disturbing, 60 percent of physicians would not recommend medicine as a career, not an encouraging sign for the profession that I wish to enter.
While Obama’s pledge to reform medical malpractice lawsuits is a step in the right direction to control medical expenditures, we need to realize that there are real costs in reshaping how Americans are covered. As Milton Friedman once said, “There’s no such thing as a free lunch.” Clearly, we cannot cover an additional 50 million people and cut down the deficit at the same time. Democrats cite a recent study by the Congressional Budget Office which claims that over 10 years Obamacare will reduce the deficit by $230 billion. However, the CBO can only work with the data and assumptions given to it by Congress. Former CBO Director Douglas Holtz-Eakin estimated that health care reform will really add $562 billion to the deficit over the next 10 years, and he said that deceitful accounting tricks, such as excluding implementation costs in the analysis as well as assuming unrealistic cuts in Medicare, led to the faulty CBO report.
Universal coverage will cost money, and not all of the costs can be taken on by the wealthy as Obama has promised. Obamacare requires insurers to pay for 75 “preventative” procedures at no additional cost to the consumer. Mandating additional coverage in every plan will unavoidably raise costs. Furthermore, many insurers will withdraw from the market if some parts of Obamacare are implemented. In fact, many already have. Companies such as Wellpoint and Humana have withdrawn from the child insurance market because they cannot remain profitable once Obamacare takes effect.
So what should be done? First and foremost, Congress should address tort reform. If a doctor follows accepted standards of care, then he should be protected from claims of malpractice, with a definite cap on liability. Malpractice reform will allow doctors to only perform necessary procedures. A 1996 study by economists Daniel P. Kessler and Mark McClellan found that malpractice reform reduces health care costs by 5 to 9 percent in patients with severe heart disease. However, President Obama does not advocate liability caps for malpractice suits.
Second, it has been proven time and again that the free market represents the best way to keep down costs. In many states, only a handful of insurers offer coverage. Consumers need the option to buy insurance across state lines. Currently, insurers can only sell in states in which they are licensed; each state regulates insurance companies’ policies for that state. By transitioning regulation to the federal government and allowing health care plans to be sold nationally, costs can be decreased and consumers will have more inexpensive choices.
Thirdly, our country faces a serious and growing physician shortage, mainly in primary care. Obamacare started to address this issue by raising Medicare reimbursements for primary care physicians. However, even more can be done to help address this problem. Many students pass up primary care due to outstanding student loans and the relatively low pay that comes with the profession. Payscale.com places the median salary for a family physician at $134,251 per year. However, starting salaries are below that number, and medical school tuition costs approximately $70,000 each year (Georgetown’s medical school costs between $71,425 and $77,000, depending on one’s year). Primary care is just not an attractive specialty. Possible ways to address this shortage include federal tuition reimbursement for committing to primary care, tax breaks for primary care physicians, and shifting the current compensation system to reward preventative care and regular care by primary care physicians.
Obamacare begins to address some of the problems our country faces in health care, but it is far from perfect. Congress cannot avoid dealing with medical malpractice liability reform or the continuing physician shortage. While we need to help the vast numbers uninsured people, we also have to accept the costs that come with such coverage and stop hiding behind flawed accounting to blur the true costs. With the new Congress in session, both parties have the chance to start over on this issue and impart meaningful, lasting reform that will provide each citizen the coverage they deserve.
