The allocation of scare resources: Rationing.
There are a lot of ways of doing it; time, money, connections even luck.
Some of us think that rationing by money optimizes quality and supply. Others think that rationing by time does the same thing. I disagree:
SACRAMENTO — As the state moves to expand healthcare coverage to millions of Californians under President Obama’s healthcare law, it faces a major obstacle: There aren’t enough doctors to treat a crush of newly insured patients.
So, California is going to ration on time. And one of the metrics that time based rationing optimizes is – low quality:
Some lawmakers want to fill the gap by redefining who can provide healthcare.
They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.
Now, to be sure, allowing non-doctor health care providers could very well be positive; after all – why do we need an MD to refill a prescription for blood pressure medication? However, I’m sure that California isn’t embracing this is an open-market mindset. Rather, docs are just fleeing the medicaid business. In fact, in California, only 57% of doctors are accepting new medicaid patients.