Sally C. Pipes is one of my favorite health care policy analysts. She has written several books on topics like the Canadian health care system, the American health care system, and the Obamacare health care law. She has debated health care with that damnable leftist Paul Krugman, among others. She heads up a think tank based in San Francisco, CA called the Pacific Research Institute.
Here is her latest column in the Orange County Register.
Thanks to Obamacare, America’s corps of doctors appears to have a case of the blues.
The Physicians Foundation recently asked more than 13,000 doctors about their morale, their career plans, their practices and their views of the Affordable Care Act. The results were grim.
Nearly six in 10 doctors said that they are less positive about the future of health care in America under Obamacare. Almost two-thirds have a negative attitude toward their jobs – nearly twice as many as before the health law was passed in 2010.
As a result, many doctors are cutting back on their workload or shuttering their practices. Worse, their collective frustration is exacerbating our nation’s troubling doctor shortage.
More than three-fifths of doctors say they would retire today if they could, compared with 45 percent before Obamacare. Eighty-four percent say the medical profession is in decline. Fewer doctors say they would enter the profession today if they had it to do over again, and fewer would recommend it to their children.
This decline in doctors’ morale is taking a toll on Americans’ ability to access care. Physicians report working almost 6 percent fewer hours than they did four years ago. That’s about two and a half hours less per week per doctor. Add up all the hours, and it’s the equivalent of losing more than 44,000 full-time physicians.
Doctors also report seeing some 16 percent fewer patients than they did in 2008. That represents tens of millions fewer doctor-patient encounters each year.
More than half those surveyed say they plan to cut back further on the time they devote to patient care, to work part time, to retire or to switch to direct-pay “concierge”-type medical practices, which are beyond the reach of many of Obamacare’s rules and regulations.
Even before the law, America faced a chronic doctor shortage, with a gap of 14,000 physicians in 2010. And the problem will only grow worse.
According to the Association of American Medical Colleges, Obamacare will push the doctor shortage up to 63,000 by 2015 – and more than 91,000 by 2020. That’s in addition to the full-time-equivalent losses from doctors working fewer hours.
I have been talking to people in my office who voted for Obama all week to see why they did what they did. Surprisingly, not many people I talked to voted for him. But for those that did, a popular reason is that they wanted to tax the rich more. I asked them what would happen if you taxed the rich more. They told me that Obama can tax people who are “rich” more and more and that the “rich” will just keep paying those higher taxes while still continuing to work and work to provide the goods and services that we all use. I asked them about regulations, and they said that Obama can just keep heaping burdensome regulations on these “rich” people more and more, and they won’t mind at all. They’ll just keep working and hiring people and providing goods and services even if they make less money and have to work more to comply with regulations.
One of the Indian contractors who voted for Obama told me that rich people do what they do because they like it, and they will keep doing it no matter how much we tax and regulate them. “They will do it for love of fairness, and because Obama is such a good man – they will be inspired by him to pay the higher taxes and to fill in the extra paperwork”, he told me. For him, people just do whatever they like. The reason why some people work is because they like working, and the reason why some people don’t work is because they like not working. Another Obama-voter told me that people should be able to do whatever they like and everyone should end up equal in the end. Some people will work because they like to, and others won’t. Taxes don’t affect what a person does. Nor does the difficulty of the work. Nor does the exposure to malpractice lawsuits. Nor does the higher medical insurance premiums. Doctors do what they do because they like it, and the conditions and profit margins don’t matter. Rich people like doctors will keep working at whatever they do even if they are taxed so much that they earn the same amount of money as people who work at McDonald’s.
That’s the worldview of the people who voted for Obama. They don’t understand incentives at all. They don’t understand the profit motive. They think that people who go to medical school until they are 35, racking up tens of thousands of dollars in debt in the process, will be happy to work 80 hour weeks and to pay 50% of their income in taxes so that other people can have free contraceptives. That is the worldview of the left – they have no idea what the consequences are of raising taxes on “the rich”. They don’t think that there are any consequences.
If you would like to see Sally Pipes talk a bit more about Obamacare, you can watch her explain it here:
Eight minutes long.