Dr. Mark Sklar, writing in the Wall Street Journal, argues that doctors should not be forced to participate in any government-run health plan because, among other things, "We have paid for our professional training."
That is what might politely be termed a bogus argument. Sure, a lot of doctors pay medical school tuition, and some even take out loans to cover it (subsidized by the federal tax deduction for student loan interest.) But a key part of professional training for doctors, residency, is heavily subsidized by the federal government. A 1995 study by the Congressional Budget Office found, "Through the Medicare program, the federal government subsidizes graduate medical education--the training of resident physicians--in amounts that approach $6 billion annually." A 1999 study by the National Bipartisan Commission on the Future of Medicare found "The largest single Medicare subsidy, $6.9 billion in 2000, is the one for GME [Graduate Medical Education] which supports the advanced training physicians receive, mainly in teaching hospitals, after they graduate from medical school." A report in the New England Journal of Medicine published in 2008 says, "In 2007, Medicare provided $8.8 billion to teaching hospitals in support of their GME programs and related patient-care activities."
Government money tends to come with government strings attached, whether it is in the form of stricter rules on bonuses at Wall Street firms that take bailout money or an emphasis on high-mileage cars at automakers taking federal cash. If doctors don't want to be forced by the government to treat patients in the government health plans, they may want to rethink whether they want to accept $8.8 billion a year in federal subsidies for their professional training. Regardless, it takes a certain amount of nerve to accept an $8.8 billion annual government subsidy and then boast, "We have paid for our professional training."
The broader point, which comes up again and again in considering the health "reform" issue, is that both defenders of the current system against a push for greater government involvement and critics of the flaws in the current system are often unwilling to face the fact that there is a great deal of government involvement in the system already, involvement that has significant ramifications.
