Care specialists overwhelmed

There have been recent letters to the editor complaining about some aspect of medical care in Yuma. One gentleman could not get his wife into an orthopaedic surgeon for her wrist fracture within five days, and the another letter complained about the lack of consumer friendly service in doctors' offices.
 
The problems outlined are a direct result of "universal health care" - government-funded, government-mandated Medicare. In a free market system, shortages create higher prices which then draw people to supply whatever is in short supply. Then prices come down as competition increases.
 
This is happening in areas of medicine not funded by insurance or the government. Unfortunately, 46 percent of all medical care in the U.S. is funded by government. As government payments to hospitals and physicians have declined, several things have happened.
 
In spite of an aging population and increasing demand, there are fewer specialists (such as orthopaedic surgeons or oncologists) to fill the need. We have been trying to recruit orthopaedic surgeons for over five years to no avail.
 
According to the Government Accounting Office, the average ortho surgeon nationwide cares for a population of 12,000 people. We in Yuma care for a population of over 52,000 each (and that is an outdated number before the last Yuma census).
 
The state of Arizona trains only 2-3 new ortho surgeons a year. Over 33 percent of ortho surgeons are over 55 years old, and most new surgeons do not want to locate to areas with a high percentage of Medicare patients.
 
It may be that sometimes people will have to go out of town for care - but physicians, who already work 7 days a week, often all night long, cannot be enslaved to provide care at the expense of our families, our health and our freedom.
 
Oncologists don't just live in their offices, they care for an ever-increasing and sicker population of people in the hospital as well. Yuma has a gross deficiency in terms of numbers of oncologists, and most are well over the age of 65. They too have been recruited for years to no avail. Medicare has made it very unprofitable to deliver chemotherapy, so young physicians are not choosing to enter oncology as a profession.
 
Additionally, with government money comes government strings. The 145,000 pages of Medicare regulations suck up staff time, costs untold dollars in overhead and exposes doctors and hospitals to further legal woes but does nothing to improve "service."
 
And, just as the Soviets could not predict through central planning how many tractors were needed, so too, government is incompetent to plan medical professional requirements. During the Clinton administration, Ira Magaziner determined that specialists cost money, so the answer was to decrease the number of specialists (without any regard to possible need for these doctors). He went to the American Board of Medical Subspecialities, and told them that funding would be cut to train specialists. It was. Now, 15 years later we are feeling the effects.
 
People can argue that doctors make too much money - so what is the gripe? But the reality is the reality. If someone doesn't feel the time and effort are worth the money, they simply will choose a different profession. The smart guys these days are not going into medicine, but are choosing business or computers - jobs where they are not expected to be up all night, nor work 100 hour weeks for peasant wages for five to 10 years of training during their most productive young adult life.
 
And those few who choose to spend extra years in training are going to places where they can make enough to pay their student loans, pay their malpractice insurance (mine is $62,000 a year) and feed their families.
 
In short, when you pay for a cheap buffet meal, you can't expect French restaurant service. When the government, and not you, is the customer, the government gets what it wants. You do not.
 
Consider that as our politicians suggest that everyone should be cared for by the government under the guise of "universal health care." For a taste of that future, try out the access to care and the customer service from the Veterans Administration!


----
Lee D. Hieb, M.D. is a Yuma orthopedic surgeon.