We human beings have the tendency to forget that we exist within systems of relationships, which are themselves part of larger systems, and that anything we do causes ripple effects. The consequence of this is that we tend to assume that we can change this one thing over here without changing all the other parts of our lives, because everyone else’s behavior will remain the same. Life doesn’t work that way, but we never seem to remember that. This is, I think, the biggest single reason for the Law of Unintended Consequences (which states, in its simplest form, that whatever you do will always produce consequences which you neither intended nor foresaw; Murphy’s codicil to that is that those consequences will usually be negative): we fail to consider that other people will adjust to the changes we make, and thus don’t stop to think about how they are likely to do so.
This is, of course, true on a national and global scale as well as on a personal and local one; and we’ve just gotten a pretty big red flag regarding the possible unintended consequences if ObamaPelosiCare passes. To wit, a survey taken by a leading medical search and consulting firm and reported in the New England Journal of Medicine found this:
The poll finds 46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of a public option will either force them out of medicine or make them want to leave medicine.
Doctors also seem to understand the impact that will have as 72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat.”
Why would they feel this way? Consider:
62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.
The respected medical journal also found 41% of physicians feel that income and practice revenue will “decline or worsen dramatically” and 30% feel income will “decline or worsen somewhat” with a public option.
Just 28.7 percent of doctors support the pro-abortion health care bill pending in the House
The assumption tends to be that if doctors and others in health care don’t like the changes the government wants to make, they can just lump it; but that fails to take into account that they do in fact have another option: they can stop seeing patients. Or, alternatively, they can stop seeing some patients (as many doctors and hospitals already restrict the number of Medicare patients they’ll take on), or see them on a different basis.
If this bill passes, will it really mean that nearly half of our primary-care physicians will leave practice? I’m sure it won’t; but will it mean that some leave, and some work fewer hours, and some retire early, and that in general, the availability of doctors drops? For my part, I saw enough “reduced activity days” (read: one-day strikes) by doctors while we were in Canada that I have no doubt it will. How is that going to improve health care?
Proponents of socializing our medical system need to take this very seriously. As the managing partner of the firm that conducted the survey wrote,
Many physicians feel that they cannot continue to practice if patient loads increase while pay decreases. The overwhelming prediction from physicians is that health reform, if implemented inappropriately, could create a detrimental combination of circumstances, and result in an environment in which it is not possible for most physicians to continue practicing medicine.
Health-care reform and increasing government control of medicine may be the final straw that causes the physician workforce to break down.