Need for more doctors part of solution
By Robert Gumbiner
South Florida Sun-Sentinel
August 15, 2007
Michael Moore’s film, Sicko, begins to expose the problem — the lack of available health care insurance in the U.S. — but does he go far enough? The number of people in the U.S. who lack health insurance is part of the problem. This number includes people who have no health insurance, people who are under insured and people who may be covered but don’t have access to health care because of the lack of available health care providers or providers who refuse to cooperate with government plans such as Medicare or Medicaid.
The real problem is the impending lack of available physicians as physicians retire and are not replaced. What good is being able to pay for health care if you can’t find anybody to provide that care?
Doctors seem to be limiting their practices or retiring as fast as new doctors are produced. Then there’s the bigger problem of doctors moving to sub-specialties and super specialties. As medicine becomes more complicated, we will lose available doctors in the future. Doctors are becoming hospitalists, procedurists, super specialists, oncologists who only treat one type of cancer, dermatologists who only inject Botox, or opthomologists who specialize in one part of the eye, i.e. glaucoma. The list goes on.
What facts did Moore’s film miss? How about the fact that the Cuban system works well because they produce four times the doctors they need. Or how the British system is struggling because they are running out of British doctors and importing heavily from third world countries.
Sicko missed that we are already paying enough to supply health care to everybody in the U.S. If we would remove insurance companies from the mix, use the employer/employee contributions and government support and revise the system, national universal health care would be what we pay now.
Moore also had the opportunity to debunk the false allegation that people are resistant to a universal health system provided through a single payer, the federal government. Does Moore realize that we already have a single payer system and that it’s one of the biggest in the world, covering 47 million people? It’s called Medicare.
So, what can we do? Many solutions are simple and they have been implemented before. We need to produce more health care providers, particularly doctors, by paying for their schooling, tuition, books and paying them a salary to go to school. This was done in World War II on a large scale by the military. Doctors who are trained by the government can be assigned to places where doctors are needed and in necessary specialties. We need to move away from the laissez-faire attitude that doctors can go into any specialty they want, charge what they want, or live anywhere in the country, whether they are needed or not. If they are trained by the government then they will be obligated to serve the citizens. Today they are partially trained by the government (through state medical schools and federal grants) but without obligation.
The solutions come down to three key changes. One, educate doctors, nurses, dentists and other health care providers at government expense and pay them a salary while they are in training. Two, devise a system that changes the incentives of our current fee-for-every-service system. Three, reorganize the system and redistribute the available health care so everybody has access to health care providers.
If Sicko had gone a little further and dealt with the impending lack of providers as well as the fact that we already have a national universal health system, the film would have moved us further toward the solution to this country’s health care crisis.