Obamacare is slowly taking hold.  Web sites are up and running and people are replacing their canceled policies with ones that run the gamut from cheaper to more expensive, from bare bones coverage to Cadillac coverage.    Whatever else we have learned it still looks like the program will cost much more in Federal funds than believed at first.

Higher cost was not what we expected, in fact the president said the program would stop the constant escalation in medical costs.  As I have stated repeatedly, the main reason our health care costs so much is our doctors.  The average income for a doctor in the USA is about  $300,000 per year.  The entry level for the top 1% incomes is $350,000 so most doctors are in the top 1% of income earners.  Take 1% of the maybe 180,000,000 in the work force and you get 1,800,000 in that bracket.  There are about one million medical  doctors in the USA so one sees that the largest group within the top 1% are doctors.

The only brake we have ever had are our HMOs.  These “managed” care givers fixed the fees they would pay doctors and thus had some control over their incomes.  But the hew and cry raised against HMOs, exemplified by the popular film, “As Good As It Gets,” stopped the rapid rise of HMOs.  However, one HMO that continues to grow well is Kaiser Permanente which is ubiquitous here in California.  Kaiser dispenses its health care in its own facilities with its own staffs and in the process offers quality medicine at reasonable prices.

But most Americans rebel against HMOs, they insist on being able to select their own doctor, what I call the “Good Ol’ Doc Sawbones” syndrome.   You know the drill, “I want to continue to see Doc Sawbones who has been tending me for these many years, so don’t tell me who to see.”  The result, doctors still lie at the root of our excessive health care costs.

There is another way to perhaps lower doctor fees.  I just saw a dental clinic in Los Angeles which had large signs on the building offering dental implants for $699 each when most charge $1000 and up.  Crowns go for $299 and full dentures at $499.  Why not have doctors compete?  Let them tell the patients up front what they charge for medical procedures.  More importantly with Obamacare plans now stating how much they will pay for these procedures, the client will be able to shop for the doctor who comes in at that allowance

Time to retire “Good Ol’ Doc Sawbones” and welcome in lower doctor costs through competition.