Tuesday, November 18, 2008

Tax Credits to Help Society Balance the Physician Supply.

Here's to your health America. Tax credits were used to help spur Hybrid Car sales, but were limited to a specific amount per car model, so as not to just be a giveaway once that model's market was established. What does this have to do with health care? Or is this just another post about the bailout? I'll tell you, and no. We need more General Practicing Physicians and we need to slow the growth in specialists. So, once again, enter the tax credit. Every year, for 15 years from when a new physician would enter medicine, and of course they would have to verify they have remained a general practitioner, they would get a tax credit equal to 3.5% of what they paid for medical school. After 15 years they would have saved over half of what they paid. Practice generally for less than 5 years and owe back whatever credits they received. 5-10 years they owe back half of what they received. 10-15 years, they owe back a quarter of the benefit they received. Within a decade we should have corrected the imbalance. If after 2-3 years of the start of this program, we are finding the credits do not outweigh the perceived benefits of being a specialist, we can increase and accelerate the credits. Once we have the proper balance, we can use credits to address whatever new areas need to be adjusted, or to keep people continuing in those practice areas most beneficial to society. The risk of physicians who practiced 10-15 years wanting to then change course to pursue a specialty would be small.

6 comments:

Tina said...

Just wanted to say "Hi". Been a while since I commented. I like what you have to say, most of the time. I miss Satan though, and the funny stuff. It sure has been serious lately. A few jokes mixed in...but serious.

LHwrites said...

It has been serious lately. These have been serious times. I try to lighten the mood when I can, but maybe I need to try harder!! Nice to see you back for a comment!

Tina said...

This was an interesting post. I didn't know there was a problem with the ratio of general doctors to specialists.

Tina said...

This was an interesting post. I didn't know there was a problem with the ratio of general doctors to specialists.

Bruce said...

There is a very big problem with the ratio of specialist to generalists [family docs and internists].

But more importantly, consulting specialists costs more...and not only because they charge more, but because they impulsively order a large battery of tests, many of them unwarranted.

Tax credits are a nice idea. Financial incentives to medical schools whose graduates go into family or internal medicine in large numbers, is also a nice notion.

LHwrites said...

Specialists do charge more and the co-pays for the insured are higher. More tests are ordered, but of course, by the time you get to a specialist, this may seem warranted, even if they are all negative, because at this point you need to rule things out. In this blog and excerpts from my book, I have laid out the case why I believe community health centers run and staffed by hospitals offer the best solution, with an eye towards savings and good care.
http://heres-to-your-health-america.blogspot.com/2008/08/getting-back-to-how-to-reform-health.html
I am not sure what incentives to give to the schools because during your first round of med school you are all practicing generally. Specialization would begin in your Residency. I am sure they can help encourage their students in the early phases, but I am not sure if they should. I would like to see a study of the factors that go into the choice of specialization. A desire for a specialty should be followed. Financial incentives for choosing a specialty over general practice should be reduced.