Massachusetts has been walking down this exchange-and-public-program-expansion road for six years now, since Mitt Romney signed RomneyCare. Massachusetts has been vacuuming up doctors and nurses from Costa Rica and elsewhere and still has been finding that the cost of treating your state population is higher when 97% are insured than it was when 88% were insured. And there aren’t enough loose doctors and nurses in the rest of the world for the ACA to vacuum up enough of them to meet the needs of not 1 state but 50 states.
…What is your guess as to what will happen if the ACA works for access, works for quality, works for coverage–but the extra health-care workforce needed isn’t there, and the lines start to get longer?
Pointer from Tyler Cowen.
Until the election, this sort of question had only been asked by conservative economists.
Perhaps this is an early example of the pattern of self-examination that I thought might take place after the election. When it comes to their policy portfolios, the Republicans will be second-guessing themselves in terms of political positioning. Meanwhile, the Democrats may be second-guessing themselves in terms of feasibility.
I have been wondering about this ever since the ACA passed.
Do you suppose this can be used as a lever to break the stranglehold of occupational licensing in the healthcare field?
It might be possible to loosen some of the restrictions. Perhaps we could get a law change that allows for stuff that can legally only done by doctors to be done by nurses/physician assistants “under supervision from doctors”.
…except that here in the South there is a ‘first mover’ problem, for one skills redefinition (devaluation?) inevitably leads to others. One often sees healthcare providers firmly in the Republican camp. Consequently, Republicans may be unwilling to loosen the ‘ties that bind’, in terms of current healthcare valuations in payscales and job designations. What’s more, the economic benefits of a new oil surplus may make the South ‘dig in’ and refuse to consider structural changes in services offerings. Which is why I believe northern states may be the first to look towards licensing changes for solutions or at the very least, non-monetary solutions in volunteer skills structures.
I think we’re seeing some of that supply-side reaction right now, with the explosion in number of retail health clinics. Throw in some licensing reform, and that could help drive prices down even more.