When doctors become employees this is what happens. Doctors on strike. Their patients dying. Oh. That’s right. They aren’t their patients. That old concept of the doctor patient relationship that everyone in this country takes for granted doesn’t apply to these government-employed doctors. What can we learn from this?
Economically, the government has set the salaries of these guys below what our economic friends call the market-clearing price. The market clearing price is that perfect price where there is neither shortage or surplus. The buyer and seller of goods and services are both exactly as well off in any transaction as they can be. Price controls by governments are always wrong. If the price is set too low, shortages result. If the price is set too high, surpluses result. These Indian doctors basically have said,”I’m not working for that wage. It’s too low.” Governments (ours included) never seem to learn that there is no possible way that any bureaucrat (no matter how brilliant) can come up with a price that is right. It will be either too high or too low. Every time. This arrogant tendency has been referred to as “The Fatal Conceit,” by Friedrich Hayek.
Doctors would never strike in the old USA, would they? They already are on strike. Countless physicians have walked away from patients, the payment for whose care is set below the market clearing price. Medicare and Medicaid and Tricare are good examples of government health plans that are defined by price controls and prices that are so far below the market clearing price that most physicians are either not seeing these patients or are severely limiting their exposure to these patients. Here’s the crazy part: this is exactly what the government goons want! This limited access to care is basically rationing care and the physicians play the role of the bad guys, not the politicians or bureaucrats. A physician who says that Medicare doesn’t pay him enough sounds greedy, no? What a great way to maintain the solvency of the Medicare Ponzi scheme.
On the doctor patient relationship front we can learn that if the doctor isn’t working for the patient, the doctor is more likely to walk away from them during their care and let them die. These government doctors in India have no loyalty to these patients. They couldn’t care less. Doctors employed by the government, doctors employed by hospitals or corporations…what’s the difference? One thing these employed doctors have in common: they aren’t working for you, the patient. I believe that Osamacare takes us one more gigantic step closer to this situation in India.
G. Keith Smith, M.D.
