How much physicians are paid for the work they perform is a perennial problem for Maryland doctors and policymakers. While groups representing doctors claim low reimbursement rates contribute to doctor shortages in the state and jeopardize Marylanders' health care, there is no consensus on just how much doctors should be paid. In fact, there is no real way to tell how much a doctor should be paid, since there is no real market for health care service. With the state government and federal government paying for most health care services in the state and little competition in the private insurance market, physician services are not paid a market price. The lack of a real market for doctors' services is at the heart of this problem. Until market forces are brought to bear on this situation, doctors and legislators in Maryland will continue grappling with this issue.
The goal of any policy changes by state policymakers should not be merely to increase payment for doctors' services. While doctors may desire to be paid higher rates, if higher rates do not lead to better service to the taxpayers, health insurance companies, and consumers who are paying them, then any rate hike would be undeserved. Instead, policymakers should try and reform the health care marketplace in the state to allow doctors and those who pay them to determine a fair price for doctors' services.
Marc Kilmer is a Maryland Public Policy Institute senior fellow specializing in health care issues. Besides his work with MPPI, he also works with the Buckeye Institute for Public Policy Solutions, a free market think tank in Ohio. Kilmer has a Bachelor of Arts in history and political science from Hillsdale College in Michigan and lives in Salisbury, Maryland, with his wife and daughter.


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