The Affordable Care Act II - Because Mr. Obama Loves You All

[Tiberius]

You're a !@#$ing idiot.

Happy hour down at Charlie's Bar can't get here fast enough for someone I see...

Yes you can.

 

You drive the prices down the same way you do in every other industry. By letting the consumer price shop.

What if they can't afford anything?

[Chef Jim]

 

What if they can't afford anything?

 

They die?

[B-Man]

America’s million-doctor shortage is right around the corner

The doctor is disappearing in America.

 

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

 

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

 

(Excerpt) Read more at marketwatch.com ...

 

 

 

 

 

 

Popular HSA Plans Face An ObamaCare Death Sentence

(Excerpt) Read more at investors.com ...

 

[Magox]

 

Agreed. Though you can't drive down medical costs without massive reform in both the insurance and pharmaceutical industries. And considering those are two of the most powerful and influential lobbies in politics, the chances of that happening are slim to none unless you reform campaign finance first.

 

Pharmaceutical industries, yes. Insurers, not so much. When you strip out Insurers administrative, marketing and profit margins, you could shave off around 15-20% of the price. When you factor in Medicare's administrative costs, fraud and over payments, you are talking about 13-15%. So the difference between the two is roughly about 3-5%.

 

Steven Brill's 'Bitter Pill' is a great read.

[Tiberius]

 

They die?

Where? Like don't even let them in the hospital if they look poor or something?

[Magox]

except that doesn't work. many systems charge $50 or so for screening heart CT scans. sounds cheap right? but they do it for the expensive catheterizations, stress tests, echocardiograms, bypass surgeries and cancer work ups fopr incidentally found abnormalities that generate big bucks. where you start is usually not where you finish in healthcare. and you usually finish a whole lot poorer.

 

There is no perfect system. Having said that transparency would go a long way in helping contain/drive down costs.

[Tiberius]

America’s million-doctor shortage is right around the corner

 

The doctor is disappearing in America.

 

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025,

 

lol, that's one hundred thousand, dip schit, not a million

[Chef Jim]

Where? Like don't even let them in the hospital if they look poor or something?

 

No they are let into a hospital and you know that. And because you know that why did you ask "what if they can't afford anything?" The indigent will always be taken care of in this country.

[Tiberius]

America’s million-doctor shortage is right around the corner

 

The doctor is disappearing in America.

 

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

 

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

 

(Excerpt) Read more at marketwatch.com ...

 

 

 

 

 

 

Popular HSA Plans Face An ObamaCare Death Sentence

(Excerpt) Read more at investors.com ...

 

Our culture is also part of the problem, Raju said, since “it’s not very glamorous to [say] that I went to some primary-care doctor. It’s glamorous to say, ‘I went to a cardiologist.’ ”

 

[Magox]

America’s million-doctor shortage is right around the corner

 

The doctor is disappearing in America.

 

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

 

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

 

(Excerpt) Read more at marketwatch.com ...

 

 

 

 

 

 

Popular HSA Plans Face An ObamaCare Death Sentence

(Excerpt) Read more at investors.com ...

 

 

If you think we have a doctor shortage now with the ACA, it wouldn't be nothing compared to single payor "Medicare-for-all". You still have well over 70% of the insured public that is receiving health insurance through private plans not affiliated with the government, meaning that the vast majority of doctors/medical providers receive preferable negotiated reimbursement rates.

 

Primary care physicians make less money than their colleagues, hence the shortage. Applying simple logic dictates that the shortage has a lot to do with how much they are being paid, if they are being paid less and you cut their reimbursement rates another 15-35%, will more people want to be internists/family doctors or less?

[birdog1960]

America’s million-doctor shortage is right around the corner

 

The doctor is disappearing in America.

 

And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report.

 

Primary-care physicians will account for as much as one-third of that shortage, meaning the doctor you likely interact with most often is also becoming much more difficult to see.

 

(Excerpt) Read more at marketwatch.com ...

 

 

 

 

 

 

 

I saw this recently as well. my partners and I discuss this all the time. Who are we going to find to provide our own care? I guess we'll care for each other as long as we are able. most of the newly minted docs have neither the same work ethic nor the same sense of ownership over their patients' care that the older docs do...and there's even way too few of them coming out. it's really been at crisis stage for years and corporate medicine is just making it worse by forcing us to be clerks and robots for the insurers.

[Magox]

I saw this recently as well. my partners and I discuss this all the time. Who are we going to find to provide our own care? I guess we'll care for each other as long as we are able. most of the newly minted docs have neither the same work ethic nor the same sense of ownership over their patients' care that the older docs do...and there's even way too few of them coming out. it's really been at crisis stage for years and corporate medicine is just making it worse by forcing us to be clerks and robots for the insurers.

 

Yes, because cutting their reimbursement rates like you propose is really going to help out with that shortage. BRILLIANT!!!!!

[Deranged Rhino]

 

Pharmaceutical industries, yes. Insurers, not so much. When you strip out Insurers administrative, marketing and profit margins, you could shave off around 15-20% of the price. When you factor in Medicare's administrative costs, fraud and over payments, you are talking about 13-15%. So the difference between the two is roughly about 3-5%.

 

Steven Brill's 'Bitter Pill' is a great read.

 

Good stuff.

 

Brill's article should be a must read for everyone of voting age, I agree.

 

 

 

There is no perfect system. Having said that transparency would go a long way in helping contain/drive down costs.

 

Also agree.

[birdog1960]

 

Yes, because cutting their reimbursement rates like you propose is really going to help out with that shortage. BRILLIANT!!!!!

medicare has actually been more proactive than anyone in cutting specialist fees and reimbursing better for nonprocedural work done by primary care. it's not enough by a long shot but they been more responsive to the problem than the private insurers. medicare is the entit6y that can effectively remove us from fee for service which rewards doing more of everything over quality. I like my odds at better pay in a well designed pay for outcomes system.

[Magox]

medicare has actually been more proactive than anyone in cutting specialist fees and reimbursing better for nonprocedural work done by primary care. it's not enough by a long shot but they been more responsive to the problem than the private insurers. medicare is the entit6y that can effectively remove us from fee for service which rewards doing more of everything over quality. I like my odds at better pay in a well designed pay for outcomes system.

 

Nothing you mentioned addressed how drastically reduced reimbursement rates would alleviate primary doctor shortages.

[Tiberius]

 

Good stuff.

 

Brill's article should be a must read for everyone of voting age, I agree.

 

 

 

Also agree.

That Brill article is amazing. I was just at Vanderbilt University Medical Center and was just blown away by how wealthy it all looked. Sounds just like the Houston's MD Anderson. Got good care though

[birdog1960]

 

Nothing you mentioned addressed how drastically reduced reimbursement rates would alleviate primary doctor shortages.

umm... you cut the specialist pay while simultaneously increasing the primary care pay and the incentive to do a low paying fellowship for 2-5 years becomes much less. hence, more people choose primary care. if you look at any of the high quality, low cost single payer systems in the world, the discrepancy between specialist and primary care pay is much less. most have 50% or more of their docs practicing primary care. it's a key element.

 

prestige is also directly effected by the pay differential. you are clearly aware of the emphasis put on earnings in determining ones value in this country.

[Tiberius]

umm... you cut the specialist pay while simultaneously increasing the primary care pay and the incentive to do a low paying fellowship for 2-5 years becomes much less. hence, more people choose primary care. if you look at any of the high quality, low cost single payer systems in the world, the discrepancy between specialist and primary care pay is much less. most have 50% or more of their docs practicing primary care. it's a key element.

 

prestige is also directly effected by the pay differential. you are clearly aware of the emphasis put on earnings in determining ones value in this country.

Didn't you post a link before to a private insurer who was training medical professionals and doctors? Opening up a school in California to train medical professionals?

 

And isn't the doctor shortage being addressed by other medical professionals that can handle much of the stuff doctors do?

[birdog1960]

Didn't you post a link before to a private insurer who was training medical professionals and doctors? Opening up a school in California to train medical professionals?

 

And isn't the doctor shortage being addressed by other medical professionals that can handle much of the stuff doctors do?

yes, Kaiser permanente. that's not a good thing, believe me.

 

you mean mid levels? even they are going into specialties most often. they make more. but I have a real problem with referring to a neurosurgeon and the first visit being done by a midlevel.

 

we don't currently employ any. over the years, 1 out of 4 passed the mommy test: would I send my mom to him/her. perhaps we had too small a sample or were just unlucky.

Edited April 8, 2016 by birdog1960

[Pine Barrens Mafia]

 

Pharmaceutical industries, yes. Insurers, not so much. When you strip out Insurers administrative, marketing and profit margins, you could shave off around 15-20% of the price. When you factor in Medicare's administrative costs, fraud and over payments, you are talking about 13-15%. So the difference between the two is roughly about 3-5%.

 

Steven Brill's 'Bitter Pill' is a great read.

 

That lays out a pretty strong argument for the nationalization of the health system.