More on the Big Lie

"We have to limit the liability of negligent health care providers because doctors are leaving medicine to work at Krystal (or whatever)."  That’s the non-stop babble we hear from lobbyists and pr flacks for the health care industry.

Then, there are the facts.

Consider this:  cardiac surgeons are looking for work.  According to this article from USA Today, "[t]he use of artery-opening stents has helped lead to a sharp drop in the number of patients having cardiac bypass surgery and contributed to a tight job market for cardiac surgeons and falling interest in the specialty by medical school graduates."

USA Today goes on to report that "[a] survey of 88 cardiothoracic residents finishing their training found that 12% received no job offers in 2004, according to a 2006 article in the Annals of Thoracic Surgery. At the same time, the number of applicants choosing to pursue one of the 140 training spots each year has also declined. In 2005, there were only 104 applicants filling 100 of the 139 available spots, according to the article."

Jee whiz, we can use those doctors in Tennessee.  The health care industry keeps telling us that the only reason doctors won’t move to rural areas is the threat of being held responsible if they make an error – as if they were truck drivers who ran a red light.  Imagine that!

So, to all you cardiac surgeons who read this I am happy to report my guess that there are dozens of Tennessee cities without cardiac surgeons so we have lots of jobs available.  Lynchburg doesn’t have a cardiac surgeon.  Oh, you’re concerned that there is no hospital in Lynchburg.  No problem – we’ll build one.  Ridgley doesn’t have a cardiac surgeon or hospital either, but we must need one and it is a great place to duck hunt. I could go on and on.

But won’t.

Folks, principles of economics apply to the health care industry.  Demand almost always drives supply.  (Of course – you can create demand  under some circumstances, e.g. plastic surgery ads and drug ads.  You don’t create demand for getting cancer or having a heart attack.)  Economic reality means that you can’t put high-paid specialists in every hamlet because there simply is not enough demand for their services.  You can’t put a hospital every 17.89 miles because you can’t fill the beds.  You can’t deliver babies in a hospital unless you have sufficient volume to justify the expense of staffing an OB unit 24/7/365.  So, you are not going to get neurosurgeons and OBs and oncologists to move to rural areas unless they have enough patients to make a decent living and a hospital capable of supporting their practices.

The health care industry knows this.  You don’t consume over 13% of our nation’s GNP and not understand economics.  But the industry continues to tell the world that they need limited responsibility for their actions because the rural areas are being deprived on convenient health care.

And that is why I call their argument "the Big Lie."