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Doctors' Lobby Stifles Study to Examine Access to Care

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Wednesday, 29 June 2011 05:04

Doctors in the United States have enormous political power. They use it to limit the supply of doctors domestically both by restricting medical school enrollment and the number of foreign doctors who can enter the country. As a result of these protectionist measures, the United States pays more than twice as much for its doctors as other wealthy countries, costing it more than $90 billion a year.

The NYT reported on the successful effort by the doctors' lobby to stop the use of government testers to determine the ability of people with different types of insurance to get appointments. The plan was to have people call doctors' offices and ask for an appointment saying that they have various types of insurance (e.g. Medicare, Medicaid, private insurance). This would provide a basis for determining how easy it is for people get care.

The article should have pointed out that this use of anonymous testers is absolutely standard. It has been used to uncover discrimination in the issuing of loans by banks, in selling cars, and offering jobs. It would be irresponsible for the government to be spending hundreds of billions of dollars a year on programs like Medicare and Medicaid without knowing how effective they are in providing care.

Therefore when Senator Orin Hatch complained that the administration was "wasting taxpayer dollars to snoop into the care physicians are providing their patients", he was not saying anything that made sense. Presumably he was doing the bidding of the doctors' lobby.

Comments (11)Add Comment
Hatch Fig Leaf Protects Naked Americans From More Bare Snooping
written by izzatzo, June 29, 2011 7:36
"wasting taxpayer dollars to snoop into the care physicians are providing their patients,"


Exactly. Orin Hatch understands that the private lives of all Americans has already been been turned inside out by the saturated snooping of private corporations on behalf of the government like so many peeled pornographic onions into objectified layers there's nothing left to snoop on.

As a matter of efficiency further snooping should be ceased immediately since it's redundant and exceeds the point of diminishing returns for purposes of data mining, spying and titillation of pruient interests.

Stupid liberals.
Fortunately we do not need to be outraged
written by RR, June 29, 2011 8:56
While the political analysis presented as to how the survey was killed is probably right, we don't need to be outraged about that. There are lots and lots of studies that show very clearly the horrifying extent to which Americans with and without insurance have trouble getting medical care.

The second point of the article - that doctors have limited the supply of physicians - is probably much more germane to the chaotic scene in the United States that we call "the health care system."
Dean has the stiffles
written by frankenduf, June 29, 2011 9:09
they should make the calls entertaining and tape them- that way, they could literally market the idea to the public- this was already done effectively by the Jerky Boys- i advise anyone to listen to the one where they pretend a firecracker went off in their hand, and they call for medical advice- "ill come down and see you with my nub" is in the pantheon of great crank calls
physician supply
written by john, June 29, 2011 9:51
Dean,

I remember quite clearly as a medical student from 1991-1995 all of the economic "experts" predicting a physician specialist surplus due to the advent of managed care. I was told, in the NY TImes, that if I entered an ophthalmology residency I would likely be driving a cab ten years later. The economic experts urged residency directors to slash the number of positions in most of the surgical specialties to prevent the impending oversupply. The directors were loathe to do this because their power and prestige is related to the size of their training programs so not many were downsized.

How do you divine, Mr. Baker, the precise number of physicians we need in the future? Should we have completely open immigration for all physicians? What does this due to their home country's supply of physicians? Particularly since many of them are coming from places like India where their is a much more acute shortage of doctors? Explain to me exactly how the vaunted physician lobby restricts medical school enrollment. I am not aware of any physician group opposing the opening of any medical school in the last twenty years. Perhaps you could document specific cases of physician groups blocking medical school openings.



Doctors have worked hard to limit both med school enrollments and foreign medical doctors
written by Dean, June 29, 2011 10:08
John,

actually, there have been numerous accounts over the years of the A.M.A. and other doctors organizations lobbying Congress to limit foreign physicians entering the country and also support for medical school expansion. I have noted many of these in BTP over the years.
Here's a somewhat dated piece that came up on a quick Google http://www.nytimes.com/1986/06...ctors.html

and a Miami Herald piece from the 90s
http://www.google.com/url?sa=t&source=newssearch&cd=1&ved=0CCwQqQIwAA&url=http://docs.newsbank.com/g/GooglePM/MH/lib00256,0EB4D6E32A6237C3.html&rct=j&q=a.m.a limiting foreign physicians&tbm=nws&tbs=cdr:1,cd_min:1996,cd_max:1998&ei=SDELTvS3DKOw0AHkzfCYAQ&usg=AFQjCNEsDd_CTrDKqAsVKRDMpHGlxGqndg&sig2=-mTiYF3cgKBgWSAcmMbHog&cad=rja


btw, I don't know what makes you think I am trying to "divine" the number of physicians we will need in the future. I want it left to the market.

And, it is really easy (even for a policy wonk) to develop a compensation scheme that will ensure that India or whatever country sends doctors here has the ability to train 2 or 3 doctors for everyone that left. So, this is a complete non-issue -- we can do this and have everyone come out ahead.
...
written by LAS, June 29, 2011 10:27
Corporations are constantly paying for mystery shopping research. Why should not the government? It would be wasting money not to assess equal access.
Lying and snooping for any purpose is outrageous.
written by denim, June 29, 2011 10:38
These testers are liars at best. That is the outrage. Where is the sense of integrity? Has the media killed it all so that even a phone call may have a lying fraud on the other end totally wasting your time? Sure, stop discrimination, but don't be as dirty and lacking of integrity as they are.
...
written by Dick C, June 29, 2011 12:17
Even I can see how collecting this data is vital. To hear it referred to as "snooping" by the same people who brought us the Patriot act would be funny, if it wasn't so harmful to the governments ability to do it's job. If someone wants to characterize this collection method as "lying and snooping," it should be up to them to design an alternate system that works. I can easily come up with other methods, but they'd all be more onerous.
Doctors
written by Chris Dudley, June 29, 2011 7:46
Our country asks doctors to take on enormous debts and to work in for-profit businesses and then rewards them by conducting snooping operations and paying them relatively poorly. Blaming doctors for not wanting yet another intrusion and inevitable judgment without understanding the pressures they are working under is ill founded.
...
written by liberal, June 29, 2011 9:50
Chris Dudley wrote,
Our country asks doctors to take on enormous debts and to work in for-profit businesses and then rewards them by conducting snooping operations and paying them relatively poorly.


Relatively poorly? LOL.

As for enormous debts and for-profit business, where's all the doctors lobbying to be state employees, like those working for the NHS in Britain?
Speaking as a business owner,
written by S.D. Jeffries, June 30, 2011 1:40
since there seems to be an overwhelming desire in this country for government to be run like a business, I can tell you that in business a new procedure is NEVER introduced without also having designed metrics with which to measure the procedure's effectiveness, efficiency and cost. If doctors haven't had their effectiveness, efficiency and cost measured, it's way past time for such a program to be initiated. Doctors are assumed to be entrepreneurs in this country so it's time they were treated as business people as well as healers. They can't consider themselves businessmen and women without undergoing the same evaluations as other business entities

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About Beat the Press

Dean Baker is co-director of the Center for Economic and Policy Research in Washington, D.C. He is the author of several books, his latest being The End of Loser Liberalism: Making Markets Progressive. Read more about Dean.

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