my connection with the tea party

[kandrathe]

Temporary employees *increase* bureaucracy, they don't decrease it. Turnover is more work, not less, because hiring someone involves fixed costs, and a mess of paperwork.

Having run a consultancy, I understand the overhead involved. There are three main functions, hiring, placement, and administration of benefits. The ratio for the first two is about 1 per 20 employees, and the last is about 1 per 30. Assuming you could recruit 50,000 health care corps volunteers, that would equate to about 6500 government jobs managing the program (or about $650 million). By comparison, Americorps costs about $1 billion per year.

Why would doctors work there for cheaper? Civic duty? Doctors might be interested more than most, but then, they should already have factored that in to their choices of specialization. (Boob jobs, or family practice?) If they have debts to pay off, their goal would be revenue maximization, no?

But more importantly, how can you increase the number of physicians by hiring at lower than market wages? (Or, if you pay good wages, how can you reduce costs by paying out more money?)

I'm all for the idea. I just don't see where the savings are supposed to come from.

The doctors would get a fair market rate. Maybe just not as much as they could going into private practice, but that is a risk too. This way, they could negate a big part of their debt, get experience, and be altruistically contributing to society.

A company like Accountemps exists to make at least a 15% profit. They do this by charging a higher than normal hourly rate. Companies hire them because they are an expense, rather than on operational payroll. Also, the benefits are paid by the staffing company. The company who hires the temp is free to flex their workforce as needed without the expense of hiring and firing. When I said cost less 10 %, I expected the government to eat the 10% loss (about $500 million). I'm just throwing these % around though by gut feel based on experience, you might be able to create a system with less overhead, and tighter margins reducing the overall cost and achieving the same results.