Resource for arguments on healthcare reform from the perspective of a physician?

[ThomasShelby]

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Hi all, I'm not sure if SDN has an anti-politics policy, but I am trying to educate myself about the pros and cons of all the proposed healthcare reforms, particularly as they pertain to the physician.

Some of the factors that I consider especially important are day-to-day changes in treating patients (think administrative), overall salaries, freedom/restriction on doctors, and any other hoops each reform would introduce.

If it is allowed to be talked about here, I would welcome it, or if there were any resources that clearly delineate what I'm looking for I would greatly appreciate it. I understand the different ideas such as a single-payer system vs. private insurance, but I am more interested in the real implications.

While it should go without saying, everyone here should be capable of maintaining an open mind that is able to consider ideas different than ones own.

 

[NickNaylor]

Health Policy is a fairly large journal focused on, as the name says, healthcare policy. If you check out the archives, you might find some articles on this topic. Other large, general medical journals like JAMA and NEJM will occasionally include policy-focused pieces.

It can be a challenging topic to learn about in detail. Getting a book from Amazon (e.g., The American Healthcare Paradox: Why Spending More is Getting Us Less) can provide you with a lay of the land about some of the larger issues and arguments so that discussion about specific issues in the above sources make more sense.

Predictions about specific policies are difficult because they're only predictions. Many of these things are common sense if you consider the factors that motivate systems: for example, it is likely that a single payer system, while probably good for society as a whole with respect to theoretically making coverage more accessible and universal, will not be "good" for physicians with respect to salaries and administrative work as the government is interested in providing a service as cheaply as possible. This will necessarily result in pressure being exerted on all parts of the system that are seen as costs, which includes physicians. The devil is in the details with these proposals. Some might argue that a single payer system will actually reduce administrative work, and ultimately be cheaper for physicians, since there's only one payer to deal with. Others may point to the administrative burdens of Medicare as a model for what single payer would look like and extrapolate the administrative barriers to a general single payer system. Neither argument is wrong in general, but being able to predict specific details like that requires a thorough understanding of the current system and proposals for change. In this example, I'm not trying to make an argument for or against a specific policy, just trying to illustrate how challenging looking at healthcare policy can be.