Weber State College Comment, January 1988, Page9 Doctors about worried octors are worried, patients watch anxiously and no one knows yet whether the prognosis is good or bad. But one thing is certain, health care in the next 20 years is going to experience some deep-cutting changes. For decades the way doctors do business has remained relatively consistent, but events of the last few years are causing American medical providers to worry about the health of their business. According to Dr. Dan A. Fuller, an economist in the Weber State School of Business and Economics, the free market principles of supply and demand are catching up with an institution that has remained relatively immune to such pressures in the past. Health care has always been a kind of monopoly, Dr. Fuller said. Physicians could pretty much determine what happened and how much it cost. Now financial concerns have created a state of “forced competition,” he said. “Medicine is seeing change, and change is always painful, but one of the prices of freedom is that at times you have to enforce competition,” Dr. Fuller said. Burgeoning numbers of new doctors are entering the profession each year. A recent article in U.S. News and World Report noted that the ranks of the M.D.’s swelled more than 40 percent from 1975 to 1985 even though the market is getting tighter. While the number of operations in hospitals, for example, declined slightly from 1979 to 1985, the number of surgeons increased by 19 percent. Frank E. Samuel, Jr., president of the Health Industry Manufacturers Association, told members of that group that by the year 2000 the U.S. is expected to have 696,000 doctors, which is almost 50 percent more than in 1981. By the turn of the century there will be 260 doctors per 1000 people “or 78,000 more than we need,” he said. “With less patients per doctor there is less money and more competition amongst providers. That’s a real new thing in health care,” Dr. Fuller said. But the WSC professor explained that other forces are at work besides just an | The WSC Career Services center offers profession's practice insurance for a number of years after they retire to cover any delayed legal actions. In many cities general practice physicians will not deliver babies any- oversupply of doctors. “One of the big changes behind escalating medical costs is who pays,” he said. In the past insurance companies took all the risk in health care. The insurance companies would collect payments, and hope that the insured would require less over-all health care than what they had paid for. Doctors were relatively free to charge whatever they wanted, knowing that insurance would pay the bill. But the insurance companies are less willing to shoulder that risk alone, Dr. Fuller said, and are sharing with doctors. Now, in many cases, doctors receive a set amount for most treatments. If the actual care costs more than what the insurance pays the doctor is forced to cover the difference. “More and more there’s a shifting of financial risk,” Dr. Fuller said. “Third party providers are much more interested in doctors taking some of the financial risk.” The oversupply of doctors coupled with the unwillingness of insurance companies to take the total financial responsibility of health care results in downward pressure on the price of health care, but the cost of new medical technology, coupled with rising malpractice rates and insurance premiums for doctors pushes prices back up. “They're caught in a squeeze. There’s incredible pressure on doctors,” Dr. Fuller said. “You’re seeing a massive industry going through an incredible change,” he added. Ultrasound equipment, for example, more because of malpractice costs. Surgeons and baby doctors are the hardest hit for malpractice suits, but all doctors, and now also nurses and lab technicians, are being sued, said Dr. Reed M. Stringham, dean of the WSC School of Allied Health Sciences. “The result is defensive medicine,” Dr. Stringham said. In order to justify their actions in a court of law doctors have to show they did everything medically possible for the health of their patients. The result, in some cases, is that physicians order more diagnostic tests than are needed, he said. “In one sense the patient is probably better served. Things are searched out more thoroughly. In another sense, though, the patients’ privacy is invaded health more,” Dr. Stringham said. And, in the end, patients are the ones who bear the higher costs of the additional tests in the form of higher insurance premiums, Dr. Fuller said. In fact, from an economic point of view the end result of the health care crisis will be increased costs for the consumer and less profits for the physicians. “The consumer has more choice in health care now, and more choice means that people probably will get better health care. The consumer is also being asked to be a better informed consumer, to “shop around’ for health care,” Dr. Fuller said. “In terms of costs the consumer is not better off, but economists would say that consumers should pay for health care costs. I’m not alarmed that costs are rising,” he said. “The private part of the market is being very innovative to find ways to finance health care.” costs anywhere from $70,000 to $190,000 and other equipment has a similarly high price tag. While doctors do, over time, recover most of the initial start-up costs, the new technology is causing doctors to be concerned about the amount of capital on hand. More than equipment costs, however, are rising costs of malpractice insurance. Obstetricians and gynecologists are particularly hit. Annual insurance premiums Rising malpractice and other insurance costs are dramatically altering the way health care is administered in the United States. In many communities some physicians are retiring or eliminating services because of increasing insurance costs. "Baby doctors are particularly hit," said WSC economist Dr. Dan Fuller. in the $20,000 to $30,000 per year category are not uncommon, and most policies stipulate that physicians carry the mal- _ad sections of a number of major news- anumber of placement services for former _ papers across the country. Connie Smith, students as well as for studentfinding their career information specialist, noted that first job.— _ the National Ad Search is available in ‘many public libraries | The college operates a computerized job match lsearch ‘and in most college | placement centers. Career Services can program month a | he iss a with that ties's employ whetheropening major ment student away from graduation or finished his also keep an alumnus’ confidential place‘ment file, consisting of three letters of recommendation, active if a $10 fee is ago. Those _ paid. That fee covers five mailings of the education at WSC 10 years letters in the file. Alumni must have set wishing to make a job search can cal Career Services and for a $10 yearly fee _ up the file before leaving Weber State, but the placement center will match jot openings with the alumni’s college major can renew at almost any time. “We have s back to the 1960"s,” Smith said. | Available for national job listings is . National Ad Search publication that lists ope —* as- appear in the classifie director of purchasing (c) and Kent Randall, dean of the WSC School of Technology (I). College acquires equipment The U.S. government has given Weber State title to 11 pieces of milling equipment that have a combined acquisition value of $119,673. title The machinery, though outdated, is used in the beginning manufacturing courses. Having the equipment listed under ~~ | boring machines, grinders, lathes, and Weber State ownership will save the college a significant amount in insurance opportunities contact t WSC Career Serv- ~ | hand presses that were loaned to Weber costs, said Robert L. Nielsen, director of _| Statein the 1950’s under a special program purchasing. Congressman Jim Hansen presented the title to WSC officials during a recent visit to the college. | Most of the job listings, however, are fo ‘the Salt Lake City/Ogden area. Utah awe Jim Siseels 0 th ficially presented title to U.S. Government equipment to Robert Nielsen, ices at (801) 626-6393. The machine shop equipment includes | by the federal government. In today’s | dollars the tools would cost approximately $3 million to replace.