Andrew Langer

Health care in America is a basic macroeconomic problem: supply, demand, and price. As supply decreases and demand increases price naturally rises. And supply is declining—especially in areas of basic, primary diagnostic care (the most important part of a public health policy equation—ensuring that people have a general practitioner that they can see for their wellness exams).

The only way you can increase access to a good and drive down the price for that good is to increase the supply. Not of insurance, but of health care itself. As I said, health insurance is meaningless without the providers to back it up (kind of like currency not backed up by anything of real value). This means creating more providers: doctors, nurses, and physicians assistants.

But Obamacare doesn’t do that. It never did that. Instead it does two key things guaranteed to destroy the practice of medicine:

First, Obamacare drives up patient panels, exacerbating both quality of life issues and problems with liability that physicians face. This, too, is axiomatic. When you drive up demand in an era of declining supply, at supply is constrained. There are a limited number of hours in a day, a limited number of hours in a year. Since Obamacare’s goal was to insure uninsured Americans, this means that the goal of Obamacare was to drive up demand (by something on the order of 20%).

In an era in which medical practices are constrained by having to sandwich appointments into 20 minute increments, a 20% increase in the number of patients handled by a practice means that those appointment times are reduced by 20%--meaning that a 20 minute appointment is now limited to just over 15 minutes!

Second, and more problematic from a health policy standpoint, is the impact that this has on the ability to effectively practice medicine. As difficult as it is to assess a patient’s condition in the compressed appointments already being practiced, short-changing that patient on more appointment time means that the potential for something to be missed rises considerably. Not only does this drive up potential costs, but it opens the health care provider to greater malpractice liability.

So, as the risks of getting sued go up (with no liability reform for doctors thanks to Democrat stonewalling), and as doctors are under increased pressure from simply seeing more patients, you see major quality of life issues creating severe disincentives that serve to discourage young people from pursuing careers in medicine (especially in basic, primary diagnostic care, the core of our health care system), while at the same time you see doctors leaving medical care in ever-increasing numbers.

The decline in supply accelerates!

Now, in the real universe in which we all live, when supply declines and demand increases, the natural result is that prices rise. But since Obamacare’s supposed goal is to keep insurance prices down, the only way to do that is to drive down provider reimbursement rates.

Let me underscore this: you will have fewer doctors, seeing more patients, with increased professional risk (and increased practice costs thanks to other aspects of Obama’s legacy, but that’s a separate issue), and medical care providers are going to be paid less!

This effectively destroys health care in America, since very few people want to enter a profession where you work harder and at greater risk for ever-declining amounts of money. Even altruists won’t enter a profession where their fear of getting sued outweighs any sense of desire to help others.

The only way to do what the left wants: to increase access to health care while driving down the cost of care is to create more care. This means fixing the problems underlying the practice of medicine: who can practice, cost of medical education, regulatory burdens, paperwork costs, and liability reform. Reform those, and you’ll create more medical practitioners. By creating more medical practitioners, and you can have a competitive market in medical care. Have a competitive market in medical care and the price that people pay goes down.

But to offer people a piece of paper and claim that you’re giving them medical care when you aren’t is a lie. It is a fraud. It is, in other words, a scam.

The moral message isn’t that Obamacare is socialism or anti-freedom. It may be those things. But fundamentally, it is immoral to lie to the American people and claim that you’re solving a problem when you are, in fact, making that problem worse. It is immoral to commit a massive fraud on the American people in the name of politics.

That’s the message that policymakers ought to be using.


Andrew Langer

Andrew Langer is President of the Institute for Liberty, an organization that works to ensure that America stays both exceptional and strong.