>>>So, what I want to know is if the doctors are going to flee the state in mass when single-payer kicks in?
And go where?
A licensed physician, alas, cannot simply move from Vermont and set up a new practice in, e.g., Texas, without retaking various licensing exams and fulfilling burdensome requirements. The purpose of these licensing restrictions was to limit the number of physicians that could legally practice in any particular state, thus keeping their rates higher than a true free market would have resulted in.
I feel sorry for the doctors, but the truth is that ever since the old Flexner Report, they have been a kind of protected guild. Naturally, all such protections are made with the excuse that “It’s for the good of the public,” but the truth is that it was done mainly for prestige/economic reasons.
I think what will happen in Vermont is what I see happening in general: the older physicians will retire a little sooner than they expected to; they will be very reluctant to recommend medicine as a good career to bright young high school and college students; and some of the younger doctors already in practice will branch out into other kinds of care that are not yet so highly regulated. For example, many dermatologists no longer rely only on their practice for an income, but carry their own unique line of skin products — their offices and waiting rooms look like the beauty and skin-care section of a major department store. Some physicians — internal medicine, mainly — give an afternoon or two per week at some of the health food stores, answering questions about food supplements, vitamins, etc. They usually run their own clinics where they practice “integrative medicine” or “complementary medicine” combining orthodox medical therapies with alternative practices. Nothing wrong, per se, with this, of course, but for me, it’s always interesting to see how people respond in whatever pockets of freedom remain during times of political restrictions on liberty.
“without retaking various licensing exams and fulfilling burdensome requirements. The purpose of these licensing restrictions was to limit the number of physicians that could legally practice in any particular state, thus keeping their rates higher than a true free market would have resulted in.”
The above and the rest of your whole post is complete nonsense. Physicians relocate to different states all the time. In most states, obtaining a license is primarily a function of the state performing an investigation to assure proper degrees, credentials, and past performance. In uncomplicated cases, this can take as little as 60 days in many states.
Some of them are young, more naive and inexperienced and in debt…they can't pick up and move as easily as those with grey hair, lots of experience in dealing with the licensing boards and regulators. Many doctors have already gotten their locum tenens licenses, have multiple state licenses. There will be states alert to the idiocy of Vermont and will be ready to receive fleeing physicians.
So, though you smirk more in sorrow rather than in anger, doctors are far better prepared for this than are patients. And those waxing smug after a lifetime of envying and resenting doctors.
Guild, my foot. It takes a multimillion dollar infrastructure to educate any kind of health pro…doc, dentist or nurse.
The "woe is me, the guild kept me out of medical school" ought to have studied harder for their organic chem exams.