Wednesday, January 7, 2009

Doctor Shortage, physician recruitment - Canadians Fear Doctor Poaching

Canadians are worrying the U.S. will rob Canada of its primary care doctors. They may have good reason. In 2007 16% of U.S. family practice residency slots went unfilled, and foreign medical graduates took more than 50% of the slots.

The Canadian National Post quoted a U.S. primary care expert, “We draw from Canada, Great Britain, South Africa. These countries draw from other places. It becomes a chain of holes.”

A Wall Street Journal Health Blog, which reported on the Canadian fears, drew some of the following comments.

“Barak will make sure recruitment of physicians in U.S. will dry up quickly.”

“I suggest patients needing a PC doctors brush up on their Urdu and Tagalog quickly.”

“We will have to ration care.”

“ I have never met a board certified doctor who cannot speak fluent English. You have to pass the FMG and be board certified if you are a foreign medical graduate. Quit the immigrant badgering.”

“Why is it every civilized country in the world can manage universal coverage, but here in the U.S. we continue to see ogeymand and Communists palts behind every attempt to humanizd our bloated for-profit health care (non-system)."

“I say bring on the Canadians.”

As for me, I say superimposing universal coverage on the current U.S. system will drive costs to the sky and expose the primary care deficit – the experience of Massachusetts so far.

The primary care deficit boils down to a moral vs. an economic issue. Universal coverage without access is meaningless. If the government controls everything in the U.S. and forbids charging outside government system, it will drive 1/3 of doctors (the number now not accepting Medicare and Medicaid patients), exaggerate the already desperate primary care shortage, and crate a black market for private care.

On the other hand, if you depend solely on the market, you take the chance all will not be covered, and you take the chance doctors will do the right thing and patients will make the right choices - a scenario policy wonks, who think only they, with their divine wisdom to dictate what’s good for the public, dare not risk.

Oh, what a tangled web we weave when we conceive we can please all by dictating what and when and where and how much care patients may receive in a democratic society that believes its citizens are not only free to choose but health care is free.


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