Aff solves doctor shortage

Sally Pipes (2019), writing for Fox News, predicts a MCA system will reduce physician’s incomes because Medicare’s payments are 40% lower than private insurances for the same treatment. She also predicts a reduction of students enrolling in medical schools, that many physicians will retire early, and many younger physicians will discontinue medicine for another field.

Ms. Pipes assumes the primary reason for choosing medicine, and remaining in the field, is for monetary gain. She offers no data in support this claim.

There is data suggesting a substantial number of physicians are concerned about their income. A Medicus surrey (Doyle, 2017) indicates for 30% of physicians making a career change, the primary factor is financial. When physicians are asked about satisfaction with their income, about a third are satisfied and another third are dissatisfied. Physician satisfaction-dissatisfaction, though, is often unrelated to income. For example, of the 22 specialties, psychiatrists have the third highest percentage (64%) of satisfaction with their income. Their average income is $235,000 annually. One of the least satisfied with their income of $489,000 annually is those in orthopedics, placing 19th among specialties. Only 48% of these physicians are satisfied with their income. How can the critic’s explain that orthopedic specialist’s make almost a half-a-million dollars a year, twice as much as psychiatrist, yet the difference in satisfaction with their income is 16% lower?

Annalisa Merelli (2017) reports a study of the average physicians’ income for nine first world countries. The U.S. ranks first, with an average income about 17% higher than the second ranked country (United Kingdom) and 41% higher than the ninth ranked country (France). All except the U.S. have some form of a MCA. If income is the critical factor in choosing to become a physician it is expected that all these other countries will have physician shortages. Squires and Anderson (2015) report the number of physicians per 1,000 persons in 11 first world counties. If income is the critical factor for entering the medical profession it is anticipated that the U.S. would have the highest per capita physicians and France would have one of the lowest. The U.S. ratio of 2.6 falls in ninth place, well below the median of 3.2. France is in seventh place with a ratio of 3.1, 18% higher than the ratio in the U.S.

In a recent survey (Miller, 2017) of over 1000 physicians, 56% are supportive of a MCA and 41% are opposed. The younger physicians are the most favorable of a MCA.

If MCA is viewed by young physicians as on horizon, and a decrease in income will follow, then, per Ms. Pipes’ argument, there should be a precipitous drop in applications to medical schools. Just the opposite is occurring—over the last 10 years there is a 25% increase in applications to medical schools. The Association of American Medical Colleges reports there is an increase of over 10,000 applicants to medical schools in 2018 - 2019 than 10 years earlier (Kowarski, 2018). For 2018 - 2019, 41% of applicants are accepted (The Princeton Review, 2019).

Further, there is a shortage of residency opening (Kowarski, 2018). Matthew Mintz, of George Washington University School of Medicine, claims “the only way to increase the number of practicing doctors is to increase Medicare funding” (Kowarski, 2018, Would New U.S. Medical Schools Solve U.S. Doctor Shortages? section, para. 8). This suggests that a MCA system would increase, not a decrease, the number of physicians in the U.S.

Those claiming a MCA system in the U.S. will create a physician shortage due to a reduced income provide little evidence in support of their claim and there is substantial data indicating the number of physicians would remain static or even increase.