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Lawson Mansell
@lawsonhmansell
I'm in
@TheArgumentMag
this morning! Here's my argument: Organized medicine has captured Medicare and since the 1970s, has made it harder and harder for doctors to choose primary care. But quietly, this administration is pushing back and we should all be rooting them on 🧵:
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David Watson 🥑
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Lawson Mansell
@lawsonhmansell
Like a lot of shortages in the US, we can look back to the 1970s for an idea as to how we got here. The AMA and other industry groups, over the course of a decade, forever altered the incentive structure for medical students, making specialties and subspecialties more attractive.
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Lawson Mansell
@lawsonhmansell
But why are payment rates for specialty care so much higher anyway? Again, capture. The AMA owns both the system we use for reimbursement and helps determine how much each service should cost. Because the org is dominated by specialists, it overvalues specialty care.
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Lawson Mansell
@lawsonhmansell
But this administration, with its MAHA-inspired goal of stamping out corporate capture, is proposing significant changes that would both increase primary care payments and further disconnect the AMA from the process.
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Lawson Mansell
@lawsonhmansell
This is not about being against specialists. Specialists are great and needed. But with a residency bottleneck, the primary care shortage is only going to get worse if we don't restore some balance. And the consequences are dire: Primary care simply saves more lives.
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