J.J. Goldberg July 29, 2012

Here’s an object lesson in the power of headlines to mislead: The lead headline in today’s Sunday New York Times, the paper’s most-read edition, warns: “Doctor Shortage Likely To Worsen With Health Law.” Sounds bad, right? Whatever you think of Obama and his Care, you can’t be happy if the reform results in fewer doctors providing the care we need.

Except that’s not what the story says. Once you’ve read a few paragraphs in, you realize that the problem is something quite different: We already have too few doctors doing primary care — because the current system pushes doctors into the better-paid specialties — and this shortage will be felt more intensely as the new system allows more people to seek the care they need.

The article goes on to explain the new law actually addresses the shortage, but not fast enough—it takes 10 years to train new doctors, and besides the fix in the new law isn’t strong enough. That is, the new law doesn’t create a doctor shortage — it fixes it, but not fast enough, and in the meantime the flaws in our current system will become more apparent. And, like the Bush economic disaster, it will appear to be Obama’s fault.

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Put differently, our current system of rationing medical care, namely by income, will be removed, but — particularly in primary care — there’s nothing there to replace it. The result will be longer waits for some while the providers figure out how to implement the obvious replacement: rationing by need.

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