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PeakTrader:

EMichael, what good is insurance when you can’t find a decent doctor willing to work for almost nothing?

I have HMO and PPO dental insurance. My HMO dentist told me he couldn’t save a tooth. I went to my PPO dentist and he saved it.

Sure, you can buy insurance cheaper, but what do you get for it?

And, I wonder how many of those six or seven million Obamacare sign-ups for 2014 have major health problems, including younger sign-ups.

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What about fewer doctors and hospitals to choose from, longer waiting times, or no new patients. Also:

Doctors Say Obamacare Rule Will Stick Them With Unpaid Bills
March 19, 2014
NPR

“Doctors worry they won’t get paid by some patients because of an unusual 90-day grace period for government-subsidized health plans.

So several professional groups for doctors are urging their members to check patients’ insurance status before every visit.

Consumer advocates say these checks could lead to treatment delays or denials for some patients.”

http://www.npr.org/blogs/health/2014/03/19/291413910/doctors-say-obamacare-rule-will-stick-them-with-unpaid-bills

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Joel, we can’t ignore supply and demand. What if someone buys health insurance and wants to use it, and then discovers, with millions of new users, doctors aren’t accepting new patients or there’s a long waiting list? They wouldn’t be too happy, would they? Particularly, since they fell behind on their bills, or stopped going to the Sizzler and Starbucks, because they were forced to buy health care insurance. And, they can’t find another job to pay the deductable anyway without next year’s tax credit

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Joel, getting health care insurance is not the same as getting health care, and you can’t go bankrupt waiting for health care. However, I agree, there will be winners and losers.

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It seems, Obamacare will increase shortages of MDs:

http://www.nytimes.com/2012/07/29/health/policy/too-few-doctors-in-many-us-communities.html?ref=health

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What worries me is the CBO says Obamacare will lose the equivalent of 2 million jobs, e.g. through working fewer hours, more health care will be consumed, and fewer other goods consumed (which will skew GDP towards health care consumption), while more time is wasted filling out forms and waiting in line.

I think, a competitive market with much less regulation would lower health care prices and raise real GDP. So, consumers receive more health care and the government can collect more taxes to pay for bigger safety nets, e.g. catastrophic and bankruptcy coverage.

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run75441, NPs were growing quickly before Obamacare and will continue to grow quickly, because of an aging population.

The difference is a market economy would meet demand much more efficiently, resulting in lower costs and lower prices, along with sufficient quantity and higher quality.

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If doctors and hospitals receive less payments from Medicare, that doesn’t mean more efficiency. It may just mean they’ll have to cut costs or limit Medicare patients.

Of course, fraud can be reduced, which may be rampant with Medicare. However, finding fraud can be costly, and make it even more difficult for honest doctors.

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Maggie, “tighten their belts” does not necessarily mean they “become more efficient.”

And, “ways for them to become less wasteful and more productive” may mean keeping and finding patients that pay more and reducing and discarding patients that pay less.

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“Free Trade in MDs.”

Yes, we need to increase the number or size of U.S. medical schools and import more foriegn MDs. Lowering standards will also increase the supply of MDs. However, how low do we go? For example, we don’t want to import leaded painted toys. India and China can produce all the MDs they want through much lower quality. Here’s a related article:

A College Education Without Job Prospects
November 30, 2006

“The job market for Indian college graduates is split sharply in two. With a robust handshake, a placeless accent and a confident walk, you can get a $300-a-month job with Citibank or Microsoft.

With a limp handshake and a thick accent, you might peddle credit cards door to door for $2 a day.

But the chance to learn such skills is still a prerogative reserved, for the most part, for the modern equivalent of India’s upper castes — the few thousand students who graduate each year from academies like the Indian Institutes of Management and the Indian Institutes of Technology.

Their alumni, mostly engineers, walk the hallways of Wall Street and Silicon Valley and are stewards for some of the largest companies.

In the shadow of those marquee institutions, most of the 11 million students in India’s 18,000 colleges and universities receive starkly inferior training, heavy on obedience and light on useful job skills.

But as graduates complain about a lack of jobs, companies across India see a lack of skilled applicants. The contradiction is explained, experts say, by the poor quality of undergraduate education.

Teaching emphasizes silent note-taking and discipline at the expense of analysis and debate.

“Out! Out! Close the door! Close the door!” a management professor barked at a student who entered his classroom at Hinduja two minutes late.

Soon after his departure, the door cracked open again, and the student asked if he could at least take his bag.

The reply: “Out! Out! Who said you could stand here?” A second student, caught whispering, was asked to stand up and cease taking notes.

“When we are raising our children,” said Sam Pitroda, a Chicago-based entrepreneur who is chairman of the Knowledge Commission and was an adviser to Prime Minister Rajiv Gandhi in the 1980s, “we constantly tell them: ‘Don’t do this, don’t do that. Stand here, stand there.’

It creates a feeling that if there is a boundary, you don’t cross it. You create boxes around people when we need people thinking outside the box.””

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