Death Panel by Proxy

October 1, 2010 | Posted in Miscellany | Tagged with: , | 26 Comments ↓

Ed Morrissey discovers the shocking news that adding 30+ million to the number of insured Americans may exacerbate a national physician shortage – except, for Ed, the problem isn’t more people visiting doctors about, say, that odd mole that grows and changes color, or the cough or rash that doesn’t seem to go away… It’s something called “ObamaCare” or “the bill” that “will make doctor shortage 50% worse by 2015.”

Ed conjures up a reason for the anticipated shortage not mentioned in the report he cites, and he doesn’t seem to have much interest in what Repealican/Replacelican proposals might do to cover the gap between demand for and availability of care.  This is the “let them drink tea” version of conservatism.  The way to get rid of a “supply” shortfall:  Deter and deny those who might like to see a doctor.  It’s death panel by proxy.

26 comments on “Death Panel by Proxy”

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  4. You would think a proper health plan, would incentivize doctors into
    accepting Medicare, and expand the pool of doctors, but this is the kind of plan, designed by the abbatoir builders in that Monty Python
    sketch

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  6. @ miguel cervantes: expanding the pool of doctors has been pretty well resisted by the AMA, miggy. that “artificial” constriction of supply might also help explain why US doctors make so much more money than doctors elsewhere.

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  7. @ miguel cervantes:
    IIRC, the plan includes measures to “expand the pool of doctors.” Those measures may be inadequately funded. A transition to near-universal coverage may involve difficulties and inefficiencies. The whole thing may turn into a war between public option or even single payer on one side, system collapse on the other.

    Without attempting a full-fledged discussion of the entirety of Obamacare, but just sticking to this single issue highlighted by Morrissey’s criticism, what is the Republican answer to the problem other than to refuse to acknowledge it? Without the plan, there is a doctor shortage. With the plan, the doctor shortage appears worse, even with a larger number of doctors.

    Under the current system, the shortage doesn’t show up as a supply-demand problem on the same level in the same category – i.e., number of practitioners relative to demand for their services – because potential demand is strangled in the cradle – that is, diverted to and exhausted in other forms… self-medication, implicit dependence on emergency services, immiseration prefatory to access of services for the poor. In short, instead of satisfying the demand through health services, we convert it into pain, fear, illness, poverty, and death. THAT is the current system, and, as far as I can tell, the greatness that conservatives hope to restore.

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  8. @ CK MacLeod:
    The shortage of MDs in the report is largely due to the fact that a great number of them, being “boomers”, are set to retire… at the same time that the boomers are going to require extra care.
    It’s not really hard to head off the shortfall, as there are many more qualified candidates for medical school than there are places. It’s not ultra-difficult to increase enrollments and schools.

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  9. The problem, really stems from the HMO bill authored by Ted Kennedy, and the ERISA that ratified it. The AMA like all guilds, like to restrict
    it’s membership, This plan was poorly designed, there was no Beveridge, there is only the Death Eater like IMAC, and the properly acronymed FCCER, those death panels; one wonders why this is so.

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  10. @ fuster:
    I was trying to stick to the argument as presented by the blogger. The other thing I didn’t bring up is that the study is funded by a group whose main reason for existence, as far as I can tell, is to advance the interests of some 100+ medical teaching colleges – including by pushing for greater support from the government. So a skeptical recipient of the info might wonder if the conclusion was kind of conveniently dramatic – unless his main desire was to propagandize against O-care.

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  11. I do’t know Ed Morrissey from a hole in a hot air balloon so I don’t know if he’s being conveniently obtuse or if he’s simply as simple as some of the other souls on the site, but the reporting in Modern Healthcare makes it clear that the shortage, even increased by that 50%, isn’t any big whoop.

    To ensure an adequate physician workforce, Congress needs to lift a 1997 freeze on Medicare supported residency positions, the AAMC recommended.

    On the other hand, maybe Morrissey isn’t really comfortable with the crud he’s trying to peddle here.
    He’s updated his post and now offers ….

    They’re blaming me for blaming it on ObamaCare, but the very first line in the Reuters report lays the blame on ObamaCare.

    … a disclaimer saying that Ed Morrissey doesn’t control what Ed Morrissey puts in his posts.

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  12. @ fuster:
    Obtuse? Gee, what makes you think that?

    Now, I think it’s likely that the provision of universal health coverage would certainly include some increase in unnecessary demand. I suspect it’s been studied to death, but no one really knows for sure what the exact increase would be because there are so many variables to consider, and because “necessary” is in the eye of the beholder.

    But, correct me if I’m wrong, isn’t it a fairly safe assumption that most of the increase in demand would be people seeking treatment for conditions that under current circumstances they tend to self-diagnose and live (occasionally die) with?

    So there is currently some amount of “latent demand” – some fraction of it frivolous demand, some fraction (one tends to presume much larger) of suppressed demand.

    And that is the issue that Morrissey, representatively, ignores.

    As for whether Morrissey controls what Morrissey writes… I’d say that his ideology or his perception of the ideology of the audience he’s anxious to serve controls what he writes a vast majority of the time. Just like with everyone else.

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  13. It’s not just the bad pay that’s causing Dr shortages.

    one of my favorite comments from the thread.

    JED has a pretty fine one as well.

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  14. fuster wrote:

    JED has a pretty fine one as well.

    You’ll have to share… Can’t bring myself to go searching. (You know how to link to a comment, right?) Plus, she’s your specialty now. If I were still a JED-scholar, I’d have wasted an afternoon replying to parts of the Pakistan piece that you linked, too.

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  15. Well, I’m awfully sweet on her, fersure, but sometimes it sounds like she’s seeing Obama’s Army marching with General Santa Anna.

    I just bet she looks super in a coonskin cap.

    Repeal, yes. But take our country back. There’s nowhere else to go. It’s here or nowhere that the stand is taken.

    J.E. Dyer

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  16. That’s not such a crazy thought, Sr. Rana, with every step forward, Santana, retreated two more steps, from the Alamo on, had he been
    in power a little longer, we would own Monterrey province by now.

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  17. @ miguel cervantes:
    According to some folks, we’re currently losing everything from Texas to California.

    Californians are a lot more worried about illegals who commit homicides and flee to Mexico than they are about Meg Whitman and her maid. They’re more concerned about the illegals driving around uninsured, running into them, destroying their property, and injuring their children. They’re considerably more concerned about the illegals swelling the welfare rolls and showing up for an ever-growing list of free medical benefits. They’re very, very concerned about the illegals in the drug trade turning parts of Los Angeles into a war zone – a pattern that falls hardest on the poor of every ethnic background – and the illegals-fueled spread of Latino gangs into the suburbs.

    Now, I know even less about California than I do about the US, but I find it hard to believe that it’s people sneaking up from south of the border that are coming here because it’s their dream to be career criminals.
    Doesn’t seem to fit with the way immigration into this country has gone.

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  18. Well there has always been a degree of this, I don’t have to remind you of the Five Points gangs, or Lasky and Luciano, to the Mexican
    Familia and the Maras (named after a particularly fierce type of fire ant)

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  19. @ fuster:

    Interestingly insistent repetition of the word “illegals” there. Spoken aloud, with the right wrong intonation, that could be one ugly paragraph.

    And makes for an odd comparison next to all of the other stuff about how every Californian depends on illegals to be housed, fed, landscaped, brought up, laundered, etc. Kinda might make some people wonder about the typical HotAirian attitude toward “Shamnesty.”

    @ miguel cervantes:
    As for Santana…

    But back on the main subject – they really do think that Obamacare is the end of the country as they know it. It’s enough to make you wish they were right.

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  20. @ miguel cervantes: and you don’t have to remind me that the Jews ran organized crime in the Bronx in the early 20s. Old Grampa Fuster met Dutch Schultz right soon after getting here from Russia.
    But my girl seems to be a little over the top and not too clear on understanding that poor people are risking their lives to sneak into this country because they want to be part of it. Instead she sounds like she thinks that they’re vampires bent on destroying America.

    Sounds sorta like what the native Californians were said to say and think about them dirty, poor, desperate, illiterate Okies of 75 years back.

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  23. Unlike my fellow Paisan, Rick Sanchez, I was particular not to focus on any one ethnicity, Lagushka, as your grandparents might have referred
    to you, We tried the amnesty solution in ’87, it just enbiggens the problem

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  24. @ miguel cervantes: My clumsy phrasing, miggy. Didn’t think that you meant to focus on anybody. I was trying to suggest that other folks along the rightwing are focusing, and not in a real nice way.

    The “problem” is always blown out of proportion.

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  25. @ miguel cervantes:
    The “amnesty solution” of ’87 was rather trivial compared to the reality of the “problem,” as we learned. The size of the problem – all those laundering, drywalling, lettuce-picking illegals – is what makes an approach of that sort more, not less, justified, because the alternative is an ever harsher, more inequitous and self-defeating status quo. Depending upon attrition – i.e., a harsher, more suspicious and oppressive, racially divided society, with a besieged under class – may tend to make the problems all worse.

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  26. Keeping with the Roman analogies, this looks like the seeds of another Social War, sometime in the near future, possibly arising out of a protracted military expedition, and some economic dislocation. And continuing in a sci fi vein, one can’t help think of the Bell Riots, on DS-9

    Reply
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