One often repeated comment in the health care debate is that doctors/hospitals can't get by on Medicare's compensation rates. They argue, as reported in the Post today, that if a large public plan offered Medicare-type reimbursement rates, they would be forced to just abandon public sector programs and work for rich people. That should be a serious concern in the health care debate, if there were a lot of rich people who do not currently enjoy access to medical care. However, that does not seem likely. All the rich people I know are able to get all the health care they want. What this means is that if doctors in large numbers were to abandon their current hospitals to serve the rich, most would find themselves unemployed. The rich are already being served. While some doctors may have the connections or skills to find employment providing boutique treatment to the rich, for the most part they would be displacing doctors who already serve the rich. These displaced doctors would then have no choice but to work for inadequate pay in hospitals serving the public health care plans. (There is also the threat that doctors will leave medicine altogether for another profession, But since physicians are already the top paid profession, they can only go down from there. It is unlikely that many doctors want to become shoe salespeople.) In short, the scare story pushed by the hospitals and doctors might be useful to advance their ends (high public compensation for their services) but they have no basis in reality. Responsible reporting should point this fact out to readers.
--Dean Baker
