Someone mentioned in one of my Public Health classes that to stay informed in the most basic level as a general practitioner, you would need to read 30 journals a month. That’s nearly impossible, and they don’t have time to really hash that out with patients anyway. That’s why it’s better to allow MDs to specialize, because it is easier to be fully immersed in the literature, the new techniques, new diseases, etc when one is specialized. (Should everyone pay a MD’s price to go see a doctor about 90% of things? Probably not)

In regards to businesses paying less for insurance, you can thank government tax structures and federal regulatory barriers for that!

I don’t know if the mechanism you propose explains increasing specialization: if there are a limited number of ’spots’ for radiologists, then increased competition for those spots will lead to better care (maybe). It could also lead to more radiologists.

But be careful before you say ‘the consumer wins’. We may have more and better-trained radiologists, but I am unlikely to need their services. Instead, I may be stuck with a higher bill from my too-dumb-to-be-a-radiologist GP.

President Obama had a town hall meeting a few months ago where he talked to a woman who had some ridiculous amount of debt from going to med school. Like $300,000. Which is ridiculous. Why go out-of-state and then complain about high tuition rates? I was a little peeved.

Anyway, this woman said that she wanted to be a general practitioner because they do the most good for the most number of people, but she would be forced into becoming a higher-paid but less-useful-to-society specialist in order to pay off her student loans. President Obama said something to the effect that if you agree to be a general practitioner for 5 years, the government will help you out.

Because subspecialties are more complicated and generate higher revenue for health care organizations than primary care, the best and brightest doctors will compete for these positions and beat out the less-talented doctors. A person doesn’t even need an MD degree to provide excellent primary care. If I were seeking the services of a subspecialist, however, I would pay extra for a more-talented one. Patients get better health care as a result. The consumer wins!

1. Markets in Everything…

“I read this and it made me think of another example of where Health Care Follows Market Mechanisms: increasing specialization of doctors. Who wants to be a general practitioner (snoooooze!) when you can be a radiologist/oncologist and make the big bucks?”

2. Other examples in health care of multiple-tiered pricing systems…

“Another kinda tangential example of a multiple-tiered pricing structure: the market for health insurance. Businesses pay lower rates than people looking for an individual policy. CHRISSY, THE MARKET IS ALL AROUND US!! What an interesting world we live in when we stop to look!”