The Doctor Cartel will see you now.

• Author: Glastris, Paul
• Position: Editor's Note - Editorial

Conservatives have long warned that government-mandated universal health care will lead to long wait times to see doctors, as in Canada and the United Kingdom. But the truth is that we already have long waits to see some kinds of doctors in the United States. It takes nearly a month (twenty-seven days) for the average new patient to see a family practitioner, according to data from a survey done in fifteen U.S. metro areas in 2009 (a year before Obamacare passed) by the health care consulting firm Merritt Hawkins. In some cities the wait is even worse: thirty days in Washington, D.C.; fifty-nine days in Los Angeles.

Instructively, however, the lines to see medical specialists are much shorter: twenty days on average for a dermatologist, seventeen days for an orthopedic surgeon. And you can see a cardiologist almost as quickly as Zappos delivers shoes; the average wait is only fifteen days, five if you live in Atlanta.

The big gap in wait times between specialists and primary care doctors is part of the general out-of-whackness of the American health care system and helps explain why ours costs so much more than those in other developed countries without producing better health outcomes. We have, on the one hand, an oversupply of specialists coming out of our graduate medical programs, and instead of driving costs down, these doctors drive costs up by performing unneeded surgeries and diagnostic procedures that don't make us healthier. On the other hand, we are producing way too few primary care doctors--a category that includes pediatricians, gerontologists, and others who treat the whole person and not just certain ailments or body parts. Nationwide, more than 40 percent of physicians are in primary care, but only 25 percent of new doctors emerging from residency programs are going into that field. And the need for primary care is set to explode because of a growing and aging population and the Affordable Care Act, which is about to add thirty million newly insured patients to the health care system. By 2025 we're likely to have tens of thousands fewer primary care doctors than we need, according to numerous studies. This undersupply will in turn undermine some of the most promising trends that are beginning to control health care costs and improve quality, such as the creation of "medical homes" where teams of nurses and doctors coordinate the care of patients with chronic conditions--teams that are supposed to be quarterbacked by primary...