One of the most talked about features of the health care plan just unveiled by Senator Baucus is the ostensible relief it offers for the primary care shortage:
The Baucus plan would seek a continued focus on the high value of primary care-related services, with corresponding reductions in relative values for overvalued services.
This hook was no doubt added to co-opt a large part of the physician community. And, if last year’s Medicare Advantage debacle is any guide, this ploy will work.
Robert Centor is a case in point. He hopes that Obama will heed the Baucus proposal to “spread the wealth around” (i.e. cut specialist payments in order to increase those of PCPs).
I wish that we could fix this problem without having winners and losers, however, the reason that we have this problem is because we have already had winners and losers for 20 years.
Actually, the “reason we have this problem” is that bureaurats have been setting price ceilings based on the recommendations of a group of alleged “experts” (the RUC).
These price ceilings have accomplished the one thing that such controls always accomplish—-a shortage of the service on which the price ceiling has been placed (primary care).
The solution here isn’t a “better” set of price controls designed to short change a different set of docs. That will only shift the shortage from one specialty to another.
The solution is to get rid of the RUC and the price controls. The solution is to allow physicians to charge what the market will bear and allow the market to set the price for their services.
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