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Taco John
02-01-2013, 11:15 PM
Comprehensive Survey of 13,575 U.S. Physicians Points Toward Substantial Challenges

Research Commissioned by The Physicians Foundation Also Examines Physician Morale and Perspectives on Current / Future State of U.S. Healthcare System

Boston, MA, September 24, 2012— American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians. One of the largest physician surveys ever undertaken in the U.S., the research was commissioned by The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients.

Physicians are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment, according to the research, titled “A Survey of America’s Physicians: Practice Patterns and Perspectives.” The research estimates that if these patterns continue, 44,250 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. The survey also found that over the next one to three years, more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access. In addition, should 100,000 physicians transition from practice-owner to employed status over the next four years (such as working in a hospital setting), the survey indicates that this will lead to 91 million fewer patient encounters.

“It is clear that the introduction of nearly 30 million new patients into the U.S. healthcare system through healthcare reform, added to the already growing physician shortage, will have profound implications for patient access to medical care,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “The rate of private practice physicians leaving the medical field, as well as changes in practice patterns that reduce the number of hours spent seeing and treating patients, is alarming. When these lost hours are added up, we get a much fuller and more ominous picture of the kind of access crisis that patients may soon face.”

More than half of physicians (52 percent) have limited the access of Medicare patients to their practices or are planning to do so, while one out of four physicians (26 percent) have already closed their practices altogether to Medicaid patients, the survey shows. Physicians cited rising operating costs, time constraints and diminishing reimbursement as the primary reasons why they are unable to accept additional Medicare and Medicaid patients.

The survey, fielded online from late March to early June 2012 by Merritt Hawkins for The Physicians Foundation, is based on responses from 13,575 physicians across the U.S. The overall margin of error (MOE) for the entire survey is (μ ± 0.998 percent), which indicates a “low to very low” sampling error for a survey designed to draw opinions and beliefs from a large population. Generally, an overall MOE at 99 percent confidence is considered highly trustworthy at +/- 2 percent or less, and all questions within the survey met this criterion.


Physician Morale

An overwhelming 80 percent of physicians cited “patient relationships” as the No. 1 most satisfying part of their job. Yet the survey also found an overwhelming majority of physicians, 77 percent, are pessimistic about the future of medicine. Eighty-two percent believe they have little ability to change the healthcare system.

Multiple factors were cited as driving widespread feelings of discontent among the nation’s physicians. “Liability / defensive medicine pressures” (related to potential malpractice lawsuits) was cited first, followed by “Medicare / Medicaid / government regulations,” “reimbursement issues” and “uncertainty / changes of health reform.” These issues and others cited throughout the study tend to distract or interfere with the time physicians spend with their patients, according to survey respondents.

“The level of pessimism among America’s physicians is very troubling,” said Lou Goodman, Ph.D., president of The Physicians Foundation and CEO of the Texas Medical Association. “More than 84 percent of physicians feel that the medical profession is in decline and nearly 58 percent are reluctant to recommend medicine as a career to their children. That means we need to make significant changes to ensure that we preserve the patient-physician relationship and continue to have the brightest minds going into medicine.”

Healthcare Cost Drivers

When asked about the factors driving increases in healthcare costs, “defensive medicine” was cited as the No. 1 cause for 69 percent of physicians, followed by an “aging population” (65 percent). On average, older patients visit physicians three times as often compared to younger patients. Other factors ranked included “cost of pharmaceuticals,” “advances in technology / treatment” and “social conditions.”

Additional survey findings of note include:

• Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now
• More than 62 percent of physicians said Accountable Care Organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs, or that any quality / cost gains will not be worth the effort
• Physicians are divided on the efficacy of the “medical homes” concept, and many (37.9 percent) remain uncertain about their structure and purpose
• While close to 70 percent of physicians have implemented electronic medical records (EMR), 47.4 percent have significant concerns that EMR poses a risk to patient privacy

“The 13,000 plus physicians who participated in this landmark survey, which included nearly 8,000 open-ended responses, strongly demonstrates the overwhelming desire of America’s physicians to share their perspectives and concerns about the current state of medicine,” said Tim Norbeck, CEO of The Physicians Foundation. “The accuracy, rigor and sheer scope of this survey should make it an invaluable piece of research to policy makers, healthcare providers, media and other stakeholders that truly want to understand the challenges that face America’s healthcare system.”

http://www.physiciansfoundation.org/news/comprehensive-survey-of-13575-us-physicians-points-toward-substantial-challenges/

Taco John
02-01-2013, 11:16 PM
Going to be interesting to see how this works out as more physicians limit their hours at the same time that they system is flooded with every sniffle and sore.

La literatura
02-01-2013, 11:25 PM
Going to be interesting to see how this works out as more physicians limit their hours at the same time that they system is flooded with every sniffle and sore.

What does your understanding of economics tell you about what happens when the demand for something rises?

Taco John
02-01-2013, 11:37 PM
What does your understanding of economics tell you about what happens when the demand for something rises?

You understand that demand interacts with supply, no? Your question doesn't seem to understand that. To answer the question, that would depend on the supply and the supplier. In this case it appears that as demand is increasing, supply is decreasing - which means higher prices.

Personally, I think we'll get to a place where we see more doctors refusing to accept insurance (http://www.nytimes.com/2012/11/24/your-money/dealing-with-doctors-who-accept-only-cash.html?pagewanted=all) and dealing with patients on a cash only basis.

At this point, I expect the government to move to "increase supply" in order to control costs and meet the needs of the market. What happens after that depends on how the physicians react.

Iowanian
02-02-2013, 12:05 AM
Exactly what I think will happen, said as much before it passed.

Health care will take a dive, doctors will retire instead of doing this crap.

listopencil
02-02-2013, 12:10 AM
What does your understanding of economics tell you about what happens when the demand for something rises?

What happens when the demand for something rises in an industry that is going through a transition to more and more government involvement and control? Also consider that supply is bottle necked by a substantial certification process, and that the product can not be manufactured.

La literatura
02-02-2013, 01:49 PM
There's never been a better time to join the healthcare industry. It's booming. The industry doesn't need a doctor to check out every sore and sniffle. The medical profession has nurses for that. We certainly need more doctors, but those with nursing degrees are going to be very valuable when 30 million more people with insurance go to a hospital for a problem.

More states may grant Osteopathic degrees the same leverage as MD degrees, like Iowa and New Jersey, which opens up the door to more people.

This gloom and doom from a professional doctor's association is a little short-sighted. "More people have access to health care, I'm pissed!"

tiptap
02-02-2013, 02:03 PM
Why don't you put up the age demographics of practicing physicians and note the number reaching retirement. That would have nothing to do with cutting back hours.

Cephalic Trauma
02-02-2013, 06:22 PM
There's never been a better time to join the healthcare industry. It's booming. The industry doesn't need a doctor to check out every sore and sniffle. The medical profession has nurses for that. We certainly need more doctors, but those with nursing degrees are going to be very valuable when 30 million more people with insurance go to a hospital for a problem.

More states may grant Osteopathic degrees the same leverage as MD degrees, like Iowa and New Jersey, which opens up the door to more people.

This gloom and doom from a professional doctor's association is a little short-sighted. "More people who can't payhave access to health care, I'm pissed!"

FYP.

theelusiveeightrop
02-03-2013, 08:19 AM
Physicians and Dentists who see only cash patients are doing quite well. We will see more of this.

ThatRaceCardGuy
02-03-2013, 10:31 AM
There's never been a better time to join the healthcare industry. It's booming. The industry doesn't need a doctor to check out every sore and sniffle. The medical profession has nurses for that. We certainly need more doctors, but those with nursing degrees are going to be very valuable when 30 million more people with insurance go to a hospital for a problem.

More states may grant Osteopathic degrees the same leverage as MD degrees, like Iowa and New Jersey, which opens up the door to more people.

This gloom and doom from a professional doctor's association is a little short-sighted. "More people have access to health care, I'm pissed!"

:spock: You're close to being logical in the DC area. Logical thinking is not allowed. Unless your post supports some far right agenda or way of thinking you're a socialist anti American scum bag per 90% of DC posters.

Cephalic Trauma
02-04-2013, 01:06 PM
:spock: You're close to being logical in the DC area. Logical thinking is not allowed. Unless your post supports some far right agenda or way of thinking you're a socialist anti American scum bag per 90% of DC posters.

What if your employer told you that they wanted you to work harder (see more patients), work longer hours (see more patients), and pay you less(cut medicare, which insurance compensation rates are based on)? Would you agree to that?

Not many would. So why would you do it to some of the brightest minds in one of the most important fields?

King_Chief_Fan
02-04-2013, 01:12 PM
What if your employer told you that they wanted you to work harder (see more patients), work longer hours (see more patients), and pay you less(cut medicare, which insurance compensation rates are based on)? Would you agree to that?

Not many would. So why would you do it to some of the brightest minds in one of the most important fields?
whaaat? You mean they are cutting teachers salaries?

loochy
02-04-2013, 01:12 PM
What if your employer told you that they wanted you to work harder (see more patients), work longer hours (see more patients), and pay you less(cut medicare, which insurance compensation rates are based on)? Would you agree to that?

Not many would. So why would you do it to some of the brightest minds in one of the most important fields?

Join a union and throw a hissy fit?

Saul Good
02-04-2013, 01:13 PM
What does your understanding of economics tell you about what happens when the demand for something rises?

Prices increase.

Source: I have a degree in Finance.

Cephalic Trauma
02-04-2013, 01:17 PM
whaaat? You mean they are cutting teachers salaries?

Did you miss the brightest minds part?

Cephalic Trauma
02-04-2013, 01:18 PM
Join a union and throw a hissy fit?

Meh. We're better than that. We strike (which will never happen), people die.

Cephalic Trauma
02-04-2013, 01:19 PM
Prices increase.

Source: I have a degree in Finance.

What if compensation is fixed? Or, in this case, decreased?

King_Chief_Fan
02-04-2013, 01:24 PM
Did you miss the brightest minds part? no, I was thinking teachers as soon as you said it. Someone had to take your little brain and feed it.
(and no, I am not a teacher)

Cephalic Trauma
02-04-2013, 01:25 PM
Dear teachers,

I love you and you made me smart. But there are far too many of you to compensate you fairly, and it sucks.:(

Edit: I would also like to pledge 50% of my future salary spread evenly to every teacher that 'fed my little brain' from K-12. I am not worthy of the salary that I will "earn" during college, graduate, and residency. I will also wait to pay off my six figure debt in order to pay you for the work you've done.

Thanks,
Cephalic "Forever in Debt" Trauma

Saul Good
02-04-2013, 01:27 PM
What if compensation is fixed? Or, in this case, decreased?

Then the laws of free market supply/demand no longer apply. Supply will continue to drop while demand increases.

The wealthy will be able to go outside the "system", and the rest will get rationed care.

Cephalic Trauma
02-04-2013, 01:28 PM
Then the laws of free market supply/demand no longer apply. Supply will continue to drop while demand increases.

The wealthy will be able to go outside the "system", and the rest will get rationed care.

Bingo.

BucEyedPea
02-04-2013, 01:28 PM
Then the laws of free market supply/demand no longer apply. Supply will continue to drop while demand increases.

The wealthy will be able to go outside the "system", and the rest will get rationed care.

That is the law of supply and demand still working. Just like black markets were a market response to soviet socialism.

BucEyedPea
02-04-2013, 01:29 PM
Prices increase.

Source: I have a degree in Finance.

Finance is not economics....but I'm sure you covered economics as part of it.

Taco John
02-04-2013, 01:31 PM
:spock: You're close to being logical in the DC area. Logical thinking is not allowed. Unless your post supports some far right agenda or way of thinking you're a socialist anti American scum bag per 90% of DC posters.

What's so logical about his post? He's provided some optimistic conjecture, but none of it addresses the facts of the survey.

In every case:
Facts > Conjecture

Saul Good
02-04-2013, 01:31 PM
That is the law of supply and demand still working. Just like black markets were a market response to soviet socialism.

You'll notice the "free market" qualifier in my post...

BucEyedPea
02-04-2013, 01:34 PM
You'll notice the "free market" qualifier in my post...

What ever market is there?

La literatura
02-04-2013, 01:35 PM
What's so logical about his post? He's provided some optimistic conjecture, but none of it addresses the facts of the survey.

In every case:
Facts > Conjecture

Your facts are physicians conjectures. Which is great if our primary concern about public health is related to how physicians think about future events. Is that your concern? Or is a good, affordable health care system your concern?

BucEyedPea
02-04-2013, 01:36 PM
The market always has the last say—even in a socialism.It just goes underground to operate freely.

Saul Good
02-04-2013, 01:37 PM
Your facts are physicians conjectures. Which is great if our primary concern about public health is related to how physicians think about future events. Is that your concern? Or is a good, affordable health care system your concern?

Quality
Affordability
Accessibility

Pick two

La literatura
02-04-2013, 01:37 PM
Then the laws of free market supply/demand no longer apply. Supply will continue to drop while demand increases.

The wealthy will be able to go outside the "system", and the rest will get rationed care.

The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

Saul Good
02-04-2013, 01:42 PM
The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

Hooray. This line for free bread.

Cephalic Trauma
02-04-2013, 01:49 PM
Quality
Affordability
Accessibility

Pick two

Hooray. This line for free bread.

This. Exactly.

Cephalic Trauma
02-04-2013, 01:51 PM
The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

La literatura
02-04-2013, 02:03 PM
Hooray. This line for free bread.

Yeah, these right-wing scare tactics were tried two years ago when the ACA was attempting to get passed. Maybe you should start referencing death panels for grandma.

La literatura
02-04-2013, 02:04 PM
Quality
Affordability
Accessibility

Pick two

I miss the days when health care was abundant, nearly free, and top quality for everyone, said no one ever.

La literatura
02-04-2013, 02:07 PM
Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

This isn't analogous to the position physicians, "the medical staff" that is contracted out by hospitals, find themselves in.

I think we can all appreciate the fact that ACA creates a higher demand for more doctors (and nurses). You'll have to connect the dots for me about how it also makes doctors professional lives look like Thomas Hobbes' state of nature.

Cave Johnson
02-04-2013, 02:11 PM
So you can't buy the best doctors available with what Medicare reimburses? So, so shocking!

King_Chief_Fan
02-04-2013, 02:18 PM
Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

wait...you mean when an appointment can't be had past 2:00 p.m. that you aren't on the golf course?

Taco John
02-04-2013, 02:23 PM
Your facts are physicians conjectures. Which is great if our primary concern about public health is related to how physicians think about future events. Is that your concern? Or is a good, affordable health care system your concern?


I think it's clear that the concern is for good, affordable health care. The survey shows that physicians are planning on limiting their access, which puts the healthcare system under some strain. When a system is under strain, it's because it lacks resources to operate without strain. In this case the math is simple:

(More patients) + (Less Physicians) = (Higher Costs)

Unfortunately for your argument (and for us all), you can't pave over these concerns with happy thoughts and sunshine.

La literatura
02-04-2013, 02:46 PM
I think it's clear that the concern is for good, affordable health care. The survey shows that physicians are planning on limiting their access, which puts the healthcare system under some strain. When a system is under strain, it's because it lacks resources to operate without strain. In this case the math is simple:

(More patients) + (Less Physicians) = (Higher Costs)

Unfortunately for your argument (and for us all), you can't pave over these concerns with happy thoughts and sunshine.

Having a good, affordable health care system isn't as deceptively simple as you make it out to be. There is, of course, a huge barrier between patients and physicians, and that is the health insurance industry, or medicare/medicaid. And physicians are one element of a vast industry of medical providers, which include nurses. Nobody has protected doctors better than themselves with their professional association, so we can expect regulations and standards of entering the profession to remain sufficiently high. Assuming that is so (and as I say that, I also think DOs would be on par to MDs in most states in the next few years) this may open the door for more nurses, and particularly nurse practitioners, to move ahead in the medical profession.

I'm supposed to be worried because doctors are unsure of where their place in the field is going to be in 10 years? I got other things to think about.

loochy
02-04-2013, 02:46 PM
wait...you mean when an appointment can't be had past 2:00 p.m. that you aren't on the golf course?

Are you joking? Do you even know any doctors?

Taco John
02-04-2013, 02:51 PM
Having a good, affordable health care system isn't as deceptively simple as you make it out to be.


I've never made it out to be simple. I think that's the point. It's not.

The rest of your post is difficult to address, because of how much you've misinterpreted on you way to trying to make a point.

Cephalic Trauma
02-04-2013, 02:52 PM
This isn't analogous to the position physicians, "the medical staff" that is contracted out by hospitals, find themselves in.

I think we can all appreciate the fact that ACA creates a higher demand for more doctors (and nurses). You'll have to connect the dots for me about how it also makes doctors professional lives look like Thomas Hobbes' state of nature.

Higher demand, less compensation. Do the math.

Dots connected.

Taco John
02-04-2013, 02:53 PM
From the survey:
American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians.

Jensen17:
I got other things to think about.


Fine by me, what are you doing in this thread then?

La literatura
02-04-2013, 02:55 PM
I've never made it out to be simple. I think that's the point. It's not.

The rest of your post is difficult to address, because of how much you've misinterpreted on you way to trying to make a point.

Are you kidding? You even stated: "In this case the math is simple:" and then proceeded with a simplistic formula showcasing your spin on the medical industry.

Taco John
02-04-2013, 02:57 PM
Are you kidding? You even stated: "In this case the math is simple:" and then proceeded with a simplistic formula showcasing your spin on the medical industry.

In that case, the math is very simple. But to project that and say "Having a good, affordable health care system isn't as deceptively simple as you make it out to be. "

There's more to the health care system than just physicians. They're a key piece though. Nothing a physician does is cheap as it is - and virtually EVERYTHING they do is important.

Cephalic Trauma
02-04-2013, 02:57 PM
Are you joking? Do you even know any doctors?

Apparently not. Are there some that don't see as many patients and are compensated well? Yes, but that is a very small minority. The norm is 50 hours or more.

Not to mention the 80 hour time limit they had to put on resident (first 3-7 years after med school, for those who don't know) work schedules because they were too tired. Does he know anything about that? Probably not.

patteeu
02-04-2013, 02:59 PM
What does your understanding of economics tell you about what happens when the demand for something rises?

Prices go up?

La literatura
02-04-2013, 03:00 PM
Higher demand, less compensation. Do the math.

Dots connected.

? That's completely unhelpful.

King_Chief_Fan
02-04-2013, 03:01 PM
Apparently not. Are there some that don't see as many patients and are compensated well? Yes, but that is a very small minority. The norm is 50 hours or more.

Not to mention the 80 hour time limit they had to put on resident (first 3-7 years after med school, for those who don't know) work schedules because they were too tired. Does he know anything about that? Probably not.

lighten up Lucy...it was a joke

La literatura
02-04-2013, 03:04 PM
Prices go up?

Possibly. Here's what I'm thinking: Supply rushes in to meet the demand. Yeah, if there's no supply, then prices will go up. If there's no way we can take care of 300 million people, but only 270 million, then there will be a fight. But the United States doesn't have a short supply of human capital and medical brilliance.

Cephalic Trauma
02-04-2013, 03:06 PM
? That's completely unhelpful.

How so?

You are increasing accessibility to physicians (increasing patient load, more work), while decreasing how much they are compensated. How is that so hard to understand?

I'm dumbing it down as best I can, but until you grasp that simple concept, I don't know much else I can say.

patteeu
02-04-2013, 03:06 PM
Possibly. Here's what I'm thinking: Supply rushes in to meet the demand. Yeah, if there's no supply, then prices will go up. If there's no way we can take care of 300 million people, but only 270 million, then there will be a fight. But the United States doesn't have a short supply of human capital and medical brilliance.

If we didn't already have a short supply (relative to the demand created by our third party payment system), we wouldn't have the high prices we already have. Where is this extra supply going to rush in from?

Cephalic Trauma
02-04-2013, 03:07 PM
lighten up Lucy...it was a joke

Fine.

You go play in the yard while the adults discuss business.

King_Chief_Fan
02-04-2013, 03:08 PM
Fine.

You go play in the yard while the adults discuss business.

ROFL

La literatura
02-04-2013, 03:09 PM
How so?

You are increasing accessibility to physicians (increasing patient load, more work), while decreasing how much they are compensated. How is that so hard to understand?

I'm dumbing it down as best I can, but until you grasp that simple concept, I don't know much else I can say.

Particularly the part about doctors getting paid less. Where is that? Also, the part about increasing accessibility to physicians is odd. The health insurance industry is still the barrier. More people are getting access to physicians through health insurance, but I don't think it's the case that insurance companies are lowering the bar for access to a physician.

La literatura
02-04-2013, 03:11 PM
If we didn't already have a short supply (relative to the demand created by our third party payment system), we wouldn't have the high prices we already have. Where is this extra supply going to rush in from?

I suspect Osteopathic schools and an increased graduate rate of nurses, particularly nurse practitioners.

Cephalic Trauma
02-04-2013, 03:14 PM
Particularly the part about doctors getting paid less. Where is that? Also, the part about increasing accessibility to physicians is odd. The health insurance industry is still the barrier. More people are getting access to physicians through health insurance, but I don't think it's the case that insurance companies are lowering the bar for access to a physician.

What do insurance companies base their compensation on? Medicare. Company A will pay 300% of medicare, Company B 200%, etc etc. Cut medicare in half, cut compensation for physicians by even more (overhead, cost of procedures stays the same).

How is the accessibility part odd? That is the basis of the ACA. Individuals who didn't have health insurance before have it now.

Cephalic Trauma
02-04-2013, 03:15 PM
ROFL

You have not made a single valid point since joining the thread.

patteeu
02-04-2013, 03:15 PM
I suspect Osteopathic schools and an increased graduate rate of nurses, particularly nurse practitioners.

Perfect. Our young people can rush to take out bigger loans to pay for a more costly education so they can end up stuggling to pay off their debt with lower paying jobs delivering a lesser quality healthcare product. That's an Obama plan if I ever heard one. Wonderful.

Cephalic Trauma
02-04-2013, 03:17 PM
I suspect Osteopathic schools and an increased graduate rate of nurses, particularly nurse practitioners.

MD's are not superior to DO's, and this is coming from an MD student. They get compensated the same.

La literatura
02-04-2013, 03:19 PM
What do insurance companies base their compensation on? Medicare. Company A will pay 300% of medicare, Company B 200%, etc etc. Cut medicare in half, cut compensation for physicians by even more (overhead, cost of procedures stays the same).

How is the accessibility part odd? That is the basis of the ACA. Individuals who didn't have health insurance before have it now.

Are you referring to the fiscal cliff measures related to medicare payouts?

La literatura
02-04-2013, 03:20 PM
Perfect. Our young people can rush to take out bigger loans to pay for a more costly education so they can end up stuggling to pay off their debt with lower paying jobs delivering a lesser quality healthcare product. That's an Obama plan if I ever heard one. Wonderful.

No, rather than art history, women's studies, and history, more people graduate with degrees in nursing.

King_Chief_Fan
02-04-2013, 03:21 PM
You have not made a single valid point since joining the thread.
nor do I intend to.... watching the grown ups talk business is enough for me.

seriously, the part about Dr.'s getting paid less needs more explanation.

I don't know how the medical profession establishes the charges for services which in turn pays for the salaries of their team or themselves not to mention all the other expenses involved.
Or, how the Insurance companies, Medicare, Medicade or Obamacare determines the worth and pays a reduced % accordingly.

I do admire your willingness and your passion to go to the medical field. I wish you luck

La literatura
02-04-2013, 03:23 PM
MD's are not superior to DO's, and this is coming from an MD student. They get compensated the same.

I'm not saying anything related to the comparative quality, only that historically, state MD boards wanted nothing to do with having DOs around. Like physical therapists and chiropractors today.

Cephalic Trauma
02-04-2013, 03:42 PM
Are you referring to the fiscal cliff measures related to medicare payouts?

I'm referring to the way physicians are compensated by third-party payers. It's relative. Cut medicare, third-party insurance companies cut compensation because they base their compensation on medicare.

Cephalic Trauma
02-04-2013, 03:45 PM
I'm not saying anything related to the comparative quality, only that historically, state MD boards wanted nothing to do with having DOs around. Like physical therapists and chiropractors today.

No, it's nothing like that. They take the same boards now. MD and DO are essentially synonymous, and for our purposes in this discussion, are pretty much the same. The only difference is their access to competitive specialties.

Physical therapy is evidence-based, the practice of chiropractic "medicine" is based on voodoo. Like homeopaths (gag).

KILLER_CLOWN
02-04-2013, 03:48 PM
Note to self: Stay healthy and *hope the govt stays as far out of my business as possible.

* Denotes faith in something never seen nor heard before..ie hopey change.

Cephalic Trauma
02-04-2013, 03:49 PM
I'm bowing out. I have a lot of work to do, and not enough time.

But I get the absolute privilege of serving people who don't know the amount of work that I'm putting in to get this degree. Yay!!!

KILLER_CLOWN
02-04-2013, 03:50 PM
I'm bowing out. I have a lot of work to do, and not enough time.

But I get the absolute privilege of serving people who don't know the amount of work that I'm putting in to get this degree. Yay!!!

Enjoy being in debt for a good long time, it's the American Dream ya know?

La literatura
02-04-2013, 03:55 PM
No, it's nothing like that. They take the same boards now. MD and DO are essentially synonymous, and for our purposes in this discussion, are pretty much the same. The only difference is their access to competitive specialties.

Physical therapy is evidence-based, the practice of chiropractic "medicine" is based on voodoo. Like homeopaths (gag).

Cmon man! Again, I'm not saying that DOs are like chiropractors. I'm saying that historically, until really very recently, MDs held the monopoly on physician care in states, shutting out osteopathy. Now, of course, we view them all as doctors. But that's now.

HonestChieffan
02-04-2013, 06:19 PM
That is the law of supply and demand still working. Just like black markets were a market response to soviet socialism.

There is no such thing as the law of supply and demand. There are two laws. The law of supply and the law of demand.

In the example where price (compensation) is fixed by the government as in reimbursements, the law of supply explains why fewer doctors will continue in the profession or will reduce hours and patient load. In essence as price decreases or is not allowed to rise, supply (doctors/HC professionals) will fall.

What does wrong in classic economic models is that when price is set artificially, the market is no longer allowed to respond with greater supply. Demand will grow and as a result lower quality care will be delivered. It will be slower, longer waits, and reflect the same quality of almost all situations where government is involved.

It is easy to see how a secondary market could develop for those who can afford better care for cash.

chiefzilla1501
02-04-2013, 06:38 PM
Possibly. Here's what I'm thinking: Supply rushes in to meet the demand. Yeah, if there's no supply, then prices will go up. If there's no way we can take care of 300 million people, but only 270 million, then there will be a fight. But the United States doesn't have a short supply of human capital and medical brilliance.

Umm... what? America is absolutely short-staffed on doctors, and the attractiveness of getting into the medical profession is going to drop significantly as long as school is a gazillion dollars to afford and overall medical income is dropping like a rock. Doctors will have to work more hours to take care of more people and get reimbursed less. That's what happens when you create a medical system that incentivizes people to go to a doctor because their tummy hurts vs. when you have an actual emergency. They are going to have spend a GINORMOUS amount of cost to just comply with the insane government bureaucratic bullshit. They are going to continue to pay an ungodly amount of malpractice insurance. They are going to have to invest a shitload of their hard-earned money on new electronic records capability. And all the while, they are going to have to provide lesser quality care and be exposed to a lot more liability, because the government is telling them how to treat their patients.

Health care reform is absolutely needed. That means insurance reform. Pricing reform. Better electronic systems. And yes, something has to be done to demand non-insureds or illegal immigrants pick up health insurance. I don't like how they did it, but it has to be done. But reform could have been achieved without the ridiculous micromanagement of doctors. And it scares the shit out of me, because we decided that in order to reform health care, we are going to make our medical field a hell of a lot worse. I want my doctor taking care of me, not some government bureaucrat.

Brock
02-04-2013, 06:44 PM
There is no such thing as the law of supply and demand. There are two laws. The law of supply and the law of demand.



Nonsense. There are not only one, but four laws of supply and demand.

mlyonsd
02-04-2013, 06:47 PM
Yeah, these right-wing scare tactics were tried two years ago when the ACA was attempting to get passed. Maybe you should start referencing death panels for grandma.
You realize ACA already implemented them, right?

mlyonsd
02-04-2013, 06:50 PM
No, rather than art history, women's studies, and history, more people graduate with degrees in nursing.
So this is your grand ideology you thought I wouldn't understand?

More demand doesn't mean reduced total cost in health care. It might mean a procedure will cost less than today but if you increase the number of procedures you're losing ground. More demand means more cost insurance for providers and the government, thus the rest of us.

La literatura
02-04-2013, 07:34 PM
Umm... what? America is absolutely short-staffed on doctors, and the attractiveness of getting into the medical profession is going to drop significantly as long as school is a gazillion dollars to afford and overall medical income is dropping like a rock. Doctors will have to work more hours to take care of more people and get reimbursed less. That's what happens when you create a medical system that incentivizes people to go to a doctor because their tummy hurts vs. when you have an actual emergency. They are going to have spend a GINORMOUS amount of cost to just comply with the insane government bureaucratic bullshit. They are going to continue to pay an ungodly amount of malpractice insurance. They are going to have to invest a shitload of their hard-earned money on new electronic records capability. And all the while, they are going to have to provide lesser quality care and be exposed to a lot more liability, because the government is telling them how to treat their patients.

Health care reform is absolutely needed. That means insurance reform. Pricing reform. Better electronic systems. And yes, something has to be done to demand non-insureds or illegal immigrants pick up health insurance. I don't like how they did it, but it has to be done. But reform could have been achieved without the ridiculous micromanagement of doctors. And it scares the shit out of me, because we decided that in order to reform health care, we are going to make our medical field a hell of a lot worse. I want my doctor taking care of me, not some government bureaucrat.

Your doctor still takes care of you. There's not a government bureaucrat unless you're talking about medicare or mediacaid. If you have insurance, your doctor gets to work with the insurance bureaucrat, which only in the insurance world is better than a government bureaucrat.

La literatura
02-04-2013, 07:38 PM
You realize ACA already implemented them, right?

Were you hauled into the government bureaucrat court to decide if you could get some meds?

La literatura
02-04-2013, 07:40 PM
So this is your grand ideology you thought I wouldn't understand?

More demand doesn't mean reduced total cost in health care. It might mean a procedure will cost less than today but if you increase the number of procedures you're losing ground. More demand means more cost insurance for providers and the government, thus the rest of us.

I'm not sure what you're talking about with your first statement. I take it I said something to you a while ago about something.

mlyonsd
02-04-2013, 07:41 PM
Were you hauled into the government bureaucrat court to decide if you could get some meds?I'm not sure what that means.

La literatura
02-04-2013, 07:44 PM
I'm not sure what that means.

The death panels you think have been implemented by ACA. Can you explain that?

mlyonsd
02-04-2013, 07:44 PM
I'm not sure what you're talking about with your first statement. I take it I said something to you a while ago about something.We were discussing why adding 30 million people into the healthcare system would/would not raise the costs to the consumer/taxpayer.

mlyonsd
02-04-2013, 07:47 PM
The death panels you think have been implemented by ACA. Can you explain that?

When I say death panels I mean government bureaucratic's deciding who does and does not receive health care. Do you agree or disagree with that definition of 'death panels'?

La literatura
02-04-2013, 07:58 PM
When I say death panels I mean government bureaucratic's deciding who does and does not receive health care. Do you agree or disagree with that definition of 'death panels'?

Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?

patteeu
02-04-2013, 08:13 PM
Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?

As long as it doesn't meet Sarah Palin's definition of a death panel it isn't a death panel? If you get to sit down during the process, no death panel, right?

mlyonsd
02-04-2013, 08:16 PM
Death panels, as the former Republican vice-presidential nominee wrote, was where: "[Elderly] or [people with mental diseases] will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

It's not just rationing. Rationing has always existed in the health care system. Is there government rationing today? With medicare and medicaid, sure. Has there been increased rationing since ACA?I consider my definition of death panels more accurate in present terms although I do believe Palin's definition could happen once health care is turned over to politicians.

And the answer to your second question is yes, without a doubt. Hospitals can now be penalized for readmitting Medicare patients. All because of a provision of the ACA. To me that is rationing.

La literatura
02-04-2013, 08:24 PM
As long as it doesn't meet Sarah Palin's definition of a death panel it isn't a death panel? If you get to sit down during the process, no death panel, right?

That was the general idea. You basically had to plead your case to some government stooge who would then decide if you were worthy of care. Old people, mentally retarded people, conservatives, evangelicals need not apply. This was the New World Order, ushered in by an African Adolf Hitler.

That was the key Republican scare tactic of summer 2009 with all those townhall debates.

La literatura
02-04-2013, 08:30 PM
I consider my definition of death panels more accurate in present terms although I do believe Palin's definition could happen once health care is turned over to politicians.

And the answer to your second question is yes, without a doubt. Hospitals can now be penalized for readmitting Medicare patients. All because of a provision of the ACA. To me that is rationing.

And others consider it sensible cost-control measures that are necessary for government-funded health care.

mlyonsd
02-04-2013, 08:34 PM
That was the general idea. You basically had to plead your case to some government stooge who would then decide if you were worthy of care. Old people, mentally retarded people, conservatives, evangelicals need not apply. This was the New World Order, ushered in by an African Adolf Hitler.

That was the key Republican scare tactic of summer 2009 with all those townhall debates.

The MSM is proud you're paying attention to them.

La literatura
02-04-2013, 08:35 PM
The MSM is proud you're paying attention to them.

You don't remember the death panel controversy? Surely that wasn't a minor glib on the political radar.

mlyonsd
02-04-2013, 08:48 PM
And others consider it sensible cost-control measures that are necessary for government-funded health care.
You realize you're describing decreased benefits. AKA death panel.

Maybe once you're receiving Medicare it should only pay for antibiotics. That would solve a lot of those pesky old people problems.

Taco John
02-04-2013, 09:01 PM
You don't remember the death panel controversy? Surely that wasn't a minor glib on the political radar.

blip

La literatura
02-04-2013, 09:03 PM
You realize you're describing decreased benefits. AKA death panel.

Maybe once you're receiving Medicare it should only pay for antibiotics. That would solve a lot of those pesky old people problems.

Yes, but the opposing argument is that there was too much lingering on, and hospitals would just bill medicare when it wasn't needed. Certainly there needs to be an appropriate balance.

La literatura
02-04-2013, 09:04 PM
blip

Just a blip? Hmm. I thought it could be a glib. Is glib a word? I should look it up I guess.

patteeu
02-04-2013, 10:17 PM
That was the general idea. You basically had to plead your case to some government stooge who would then decide if you were worthy of care. Old people, mentally retarded people, conservatives, evangelicals need not apply. This was the New World Order, ushered in by an African Adolf Hitler.

That was the key Republican scare tactic of summer 2009 with all those townhall debates.

It sounds to me like you've turned it into a strawman so you don't have to deal with the reality.

patteeu
02-04-2013, 10:18 PM
Yes, but the opposing argument is that there was too much lingering on, and hospitals would just bill medicare when it wasn't needed. Certainly there needs to be an appropriate balance.

Why should a government overlord (if you don't like calling it a death panel) decide these things?

La literatura
02-04-2013, 10:27 PM
It sounds to me like you've turned it into a strawman so you don't have to deal with the reality.

Yeah, the Republicans did create a strawman with the death panel rhetoric. Worked pretty well for them.

La literatura
02-04-2013, 10:32 PM
Why should a government overlord (if you don't like calling it a death panel) decide these things?

By "these things," do you mean deciding which cost-cutting measures for Medicare? Or do you mean something else?

patteeu
02-05-2013, 07:44 AM
By "these things," do you mean deciding which cost-cutting measures for Medicare? Or do you mean something else?

Whether we call it death panels or cost control, we're still all talking about government bureaucrats deciding which medical services real people will have covered. Your euphemism doesn't change that.

patteeu
02-05-2013, 07:45 AM
Yeah, the Republicans did create a strawman with the death panel rhetoric. Worked pretty well for them.

Is that why you're doing it?

La literatura
02-05-2013, 07:58 AM
Whether we call it death panels or cost control, we're still all talking about government bureaucrats deciding which medical services real people will have covered. Your euphemism doesn't change that.

Who should decide how to cut costs on Medicare? Anyone? No cutting costs? Full buffet?

patteeu
02-05-2013, 08:00 AM
Who should decide how to cut costs on Medicare? Anyone? No cutting costs? Full buffet?

We're not talking about just Medicare alone. We're talking about the entire scope of Obamacare.

La literatura
02-05-2013, 08:02 AM
Is that why you're doing it?

Critics (mylonsd) now want to say that the ACA has started to implement death panels, using a term that Republican fear-mongers used in 2009 to attempt to derail the bill. (The proposal, as you may recall, involved end-of-life counseling). What am I doing that you find so objectionable?

La literatura
02-05-2013, 08:04 AM
We're not talking about just Medicare alone. We're talking about the entire scope of Obamacare.

Mylonsd and I were talking about medicare cost-cutting measures, but I'm open to expanding the discussion. Is it your argument that government bureaucrats are mandating that insurance companies cut certain benefits?

King_Chief_Fan
02-05-2013, 08:08 AM
And others consider it sensible cost-control measures that are necessary for government-funded health care.

I am sure you wouldn't feel that way about your grandma.
Sorry granny, you had your turn in the hospital and you don't get another one.
On second thought you would prostitute yourself and your family

La literatura
02-05-2013, 08:12 AM
I am sure you wouldn't feel that way about your grandma.
Sorry granny, you had your turn in the hospital and you don't get another one.
On second thought you would prostitute yourself and your family

We just can't design a public-funded program based on what our wishes for our own grandma's healthcare are.

patteeu
02-05-2013, 08:35 AM
Critics (mylonsd) now want to say that the ACA has started to implement death panels, using a term that Republican fear-mongers used in 2009 to attempt to derail the bill. (The proposal, as you may recall, involved end-of-life counseling). What am I doing that you find so objectionable?

Denying that they exist.

patteeu
02-05-2013, 08:42 AM
Mylonsd and I were talking about medicare cost-cutting measures, but I'm open to expanding the discussion. Is it your argument that government bureaucrats are mandating that insurance companies cut certain benefits?

You brought "death panels" up by mentioning something you called ACA, which I take to mean "Affordable Care Act" which I further assume is what you're calling Obamacare.

La literatura
02-05-2013, 08:53 AM
Denying that they exist.

Yes, I deny that death panels, as it was used in the Republican smear campaign's attempt to derail the ACA, exist. In fact, the provision that began the whole death panel smear (relating to end-of-life counseling) was taken out.

La literatura
02-05-2013, 08:55 AM
You brought "death panels" up by mentioning something you called ACA, which I take to mean "Affordable Care Act" which I further assume is what you're calling Obamacare.

Okay. Go on.

King_Chief_Fan
02-05-2013, 09:02 AM
We just can't design a public-funded program based on what our wishes for our own grandma's healthcare are.

I think your own grandma just flipped you off.
Funny that you can design one that excludes people.
So Palin was right? Call it what you want, but changing the name doesn't make it any better.

patteeu
02-05-2013, 09:14 AM
Yes, I deny that death panels, as it was used in the Republican smear campaign's attempt to derail the ACA, exist. In fact, the provision that began the whole death panel smear (relating to end-of-life counseling) was taken out.

Nonetheless, they exist in the form mlyonsd mentioned and you chose to battle your strawman instead. And you apparently can't stop.

La literatura
02-05-2013, 09:19 AM
Nonetheless, they exist in the form mlyonsd mentioned and you chose to battle your strawman instead. And you apparently can't stop.

No, death panels do not exist in any form. It's unreasonable to call a penalty issued to a hospital for 30-day returning medicare patients a death panel. It was unreasonable to call end-of-life counseling a death panel. A death panel, at the bare minimum, consists of a group of people who alone decide to effectively shut off aid to a person because they are deemed to be less valuable to society and okay to die.

I'm not going to agree that everything some critics dislike about the legislation is a death panel. Not everything short of a full healthcare buffet is a death panel. I don't consider insurance benefit limitations a death panel either, though, so maybe I'm the crazy one.

La literatura
02-05-2013, 09:22 AM
I think your own grandma just flipped you off.
Funny that you can design one that excludes people.
So Palin was right? Call it what you want, but changing the name doesn't make it any better.

No, Palin wasn't right. There are no death panels as a result of Obamacare. Also, there never was a proposal to have death panels.

Medicaid and medicare both exclude people who don't meet the eligibility criteria. I didn't design it.

Velvet_Jones
02-05-2013, 10:59 AM
I'm referring to the way physicians are compensated by third-party payers. It's relative. Cut medicare, third-party insurance companies cut compensation because they base their compensation on medicare.

You are incorrect on this. Most insurance companies pay at a contractual rate that has nothing to do with medicare. If the contractual rate is not available, Usual and Customary costs are used that are not based on Medicare either. It is the percentile representation of billed amount that is broken down by service and geographical area for NON-MEDICARE billing. Lastly, there is a relative value calculation that can be used to attempt to discount a claim. This is based on Medicare reimbursement schedules but you will routinely get told to fuck off if you attempt to base some negotiation on relative value.

patteeu
02-05-2013, 11:12 AM
No, death panels do not exist in any form. It's unreasonable to call a penalty issued to a hospital for 30-day returning medicare patients a death panel. It was unreasonable to call end-of-life counseling a death panel. A death panel, at the bare minimum, consists of a group of people who alone decide to effectively shut off aid to a person because they are deemed to be less valuable to society and okay to die.

I'm not going to agree that everything some critics dislike about the legislation is a death panel. Not everything short of a full healthcare buffet is a death panel. I don't consider insurance benefit limitations a death panel either, though, so maybe I'm the crazy one.

Yes, maybe you are.

La literatura
02-05-2013, 12:16 PM
Yes, maybe you are.

I went to wikipedia to check the consensus of the "death panel" allegation. What does this tell you?



For 2009, "death panel" was named as PolitiFact's "Lie of the Year", one of FactCheck's "whoppers", and the most outrageous term by the American Dialect Society.

. . . .

Media
The Economist said the phrase was used as an "outrageous allegation" to confront politicians at town hall meetings during the August 2009 congressional recess.[56] The New York Times said the term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul.[22] Former Newsweek editor Jon Meacham said it was "a lie crafted to foment opposition to the president's push for reform"[57] and Fox News analyst Juan Williams said "of course there is no such thing as any death panel."[58] The Christian Science Monitor reported that some Republicans used the term as a "jumping-off point" to discuss government rationing of health care services, while some liberal groups applied the term to private health insurance companies.[59] Journalist Paul Waldman of The American Prospect called the "death panel" charge a consequential policy lie, a falsehood about a policy that had definite effects on the policy, a type of lie that is not as condemned in the media as personal lies.[60]
The Daily Telegraph noted that some critics of the U.S. reform used the United Kingdom's National Institute for Health and Clinical Excellence (NICE)—"as an example of [doing] the sort of drug rationing that amounted to a 'death panel'". NICE, as one of its functions, uses cost-effectiveness analysis to determine whether new treatments and drugs should be available to those covered by Britain's National Health Service.[61] The Sunday Times wrote that Sarah Palin's use of the "death panels" term was a reference to NICE.[62]

Physicians
C. Porter Storey Jr. said the term represents fear that due to financial pressure "some mechanical, governmental method will be used to determine how much of our scarce health care resources will be applied to their situation."[63] Atul Gawande, a surgeon and writer, said that fear of missing out on an expensive life-extending treatment is behind the phrase, but he thought that framing the issue in this way was completely mistaken. "[T]he trouble is not whether we're going to offer a $100,000 drug to help someone get 3 or 4 months"; our big trouble is that patients receive a $100,000 drug that not only yields no benefit—it also causes major side effects that shortens their lives", he said.[64] Gawande said doctor's schedules of 20 minute appointments, a lack of payments and the emotional difficulty of conversations about mortality were barriers to the doctor-patient discussions about end-of-life care issues, which can take about an hour.[65]
Geriatric psychiatrist Paul Kettl said his experience in a geriatric unit showed end-of-life discussions and reimbursements were "desperately needed" as these hour long conversations are "ignored in the crush of medication and disease management."[66] In the Journal of the American Medical Association, Kettl wrote he was in favor of the "death panels that were originally proposed ... periodic discussions about advance directives that Medicare would pay for as medical visits."[66] Kettl noted that the attention-catching phrase "death panels" became "a lightning rod for objections to a series of ideas about health care besides" end-of-life discussions, and that somehow, "the concept of physicians being paid for time to talk with patients and their families about advance directives ... generated into the fear of decisions about life and death being controlled by the government."[66] Kettl also wrote that, "We can expect more good medical ideas to be destroyed by sound bytes and needless concerns that will be exaggerated. It makes for good television, but bad medicine."[66]
The American Society of Clinical Oncology (ASCO) published a statement in January 2011 advocating an individualized approach to treatment and supportive care for patients with advanced cancer. They said there was a
need to recognize the value of these conversations to both our patients and society and the effort such care requires in our reimbursement systems. Currently, our system highly incentivizes delivery of cancer-directed interventions (chemotherapy, targeted therapy, and so on) over conversations that are critical to establishing a patient’s goals and preferences and providing individualized care. Efforts to compensate oncologists and others for delivering this important aspect of cancer care were unfortunately politicized in the recent health care reform debates, but these efforts had at their core a critical patient-centered societal interest and should be revisited.[67]

Benjamin W. Corn, a cancer specialist, wrote in the New England Journal of Medicine that the "death panels" controversy showed Americans were uneasy discussing topics related to the dying process. Corn said the end-of-life care conversations can have an important positive effect on patients, although some patients may not ever welcome them. Corn also said that certain issues, such as whether experimental therapies should be reimbursed, the possible expansion of hospices, restoring dignity to the process of dying, and guidelines for physician assisted suicide, need to be addressed directly.[21] David Kibbe, a physician, and Brian Klepper, a health care analyst and consultant, wrote, "One of American politics' most disingenuous conceits is that health care must cost what we currently pay. Another is that the only way to make it cost less is to deny care. It has been in industry executives' financial interests to perpetuate these myths".[68]

Politicians
Sen. Lisa Murkowski (R-AK) stated that "death panels" were a baseless charge that unnecessarily incited fear and detracted from real problems in the proposed legislation. She said the proposed legislation was "bad enough that we don't need to be making things up."[69] Sen. Johnny Isakson (R-GA), thought there was illogical confusion over "death panels"; he said advance directives put "authority in the individual rather than the government."[70] In July 2010 Rep. Bob Inglis, (R-SC) said that he thought it was counterproductive for the conservative movement for some to promote misinformation about death panels when they do not exist.[71] Rep. Darrell Issa (R-CA) endorsed Rep. Charles Boustany's statement that "medical panels of people who care about what's best for their patients ... is good science and good medicine."[72] Speaking for himself, Issa said "Republicans have to step back from the words 'death panels'."[72] Michael F. Cannon, a former domestic policy analyst for the U.S. Senate Republican Policy Committee and a member of the Cato Institute, wrote that "[p]aying doctors to help seniors sort out their preferences for end-of-life care is consumer-directed rationing, not bureaucratic rationing."[73]
President Barack Obama cited the charge—along with the citizenship conspiracy theories and "job-killing" allegations—as demagogy against him.[74] In testimony before the United States Congress Joint Select Committee on Deficit Reduction, Erskine Bowles (D), co-chair of the National Commission on Fiscal Responsibility and Reform, called "death panels" "a kind of crazy stuff" and added that end-of-life care in the U.S. needed reform.[75] Rep. Earl Blumenauer (D-OR) called the references to "death panels" or euthanasia "mind-numbing" and "a terrible falsehood".[76] He thought that the news media contributed to the persistence of the myth by amplifying misinformation and extreme behavior.[77] When a regulation for reimbursing consultation payments was upcoming, Blumenauer cautioned supporters to keep things quiet, reasoning that Republican leaders would attempt to continue the myth.[13]

patteeu
02-05-2013, 01:11 PM
I went to wikipedia to check the consensus of the "death panel" allegation. What does this tell you?

It tells me that you're clinging to your strawman for dear life.

La literatura
02-05-2013, 01:12 PM
It tells me that you're clinging to your strawman for dear life.

Not my strawman, man.

patteeu
02-05-2013, 01:16 PM
Not my strawman, man.

Is someone holding a gun to your head?

La literatura
02-05-2013, 01:16 PM
Is someone holding a gun to your head?

No, why?

tooge
02-05-2013, 01:18 PM
You understand that demand interacts with supply, no? Your question doesn't seem to understand that. To answer the question, that would depend on the supply and the supplier. In this case it appears that as demand is increasing, supply is decreasing - which means higher prices.

Personally, I think we'll get to a place where we see more doctors refusing to accept insurance (http://www.nytimes.com/2012/11/24/your-money/dealing-with-doctors-who-accept-only-cash.html?pagewanted=all) and dealing with patients on a cash only basis.

At this point, I expect the government to move to "increase supply" in order to control costs and meet the needs of the market. What happens after that depends on how the physicians react.

The wrench in your supply and demand theory as it relates to medicine is that there is a third party involved that regulates prices allowed by the "supplier" (insurance) and another regulatory influence (government) that effects the cost of business for the supplier (hippa, osha). These factors don't apply to most industries, and the algorhythms that would be required to figure out supply and demand based economies of medicine are impossible.

I wish it were as simple as a doctor charges so much for an office visit, the patient pays it, and everyone is happy due to supply and demand setting the fee for said office visit. Unfortunately, the doctor has to order extra tests because the patient is a smoking fatass with diabetes, and if the doctor doesn't cover every base possible, the insurance won't pay him a cent. On top of that, the patients family will sue the doctor when the patient loses foot due to diabetes from an infection.

Bottom line is this. Despite the fact that many people think the doctor is a wealthy money grabber, the truth is, the doctors are trying to help their patients, but most of them (just look around at people these days) are out of shape, don't eat well, and do things that they know will hurt them. Meanwhile, the amount of money that the insurance pays the doctor to treat these patients has gone down steadily for years.

I get reimbursed less for a crown today than I got in 2002. Imagine if everything else cost less than it did in 2002.

The medical professions are taking it in the shorts, have been for over a decade, and will continue to do so as long as big Pharm and insurance continue to rule the game.

tooge
02-05-2013, 01:41 PM
I suspect Osteopathic schools and an increased graduate rate of nurses, particularly nurse practitioners.

Hey there Florence Nightengale, I'm gonna let you in on a little secret. It's very difficult to get into medical and dental schools right now. It's relatively difficult for the nursing profession as well, if you are talking RN or nurse practitioner. You've got to be in the very top of your class and score very well on aptitude testing. You know how you increase the graduation rate to pump out more nurses and nurse practitioners? You dumb down the requirements. You lower the entrance bar. Guess what? You've just decreased the level of care. Is that what you want?

La literatura
02-05-2013, 01:46 PM
Hey there Florence Nightengale, I'm gonna let you in on a little secret. It's very difficult to get into medical and dental schools right now. It's relatively difficult for the nursing profession as well, if you are talking RN or nurse practitioner. You've got to be in the very top of your class and score very well on aptitude testing. You know how you increase the graduation rate to pump out more nurses and nurse practitioners? You dumb down the requirements. You lower the entrance bar. Guess what? You've just decreased the level of care. Is that what you want?

No, I just want more smart people to enter into nursing. Because there's a larger demand for it, I suspect that won't be a huge problem. There are plenty of people who will probably go forward with nursing than something like graphic design, art, interior design, real estate, etc.

mlyonsd
02-05-2013, 08:01 PM
No, why?
Reduced funds by the adoption of the ACA followed up with bureaucratic officials that aren't elected and subject to the wrath of the voter, is exactly the definition of what death panels were to anyone paying attention back in 2009.

Which is exactly what happened here by penalizing hospitals for return admissions. It will cause death.

The ACA already has implemented at least one death panel, more to follow as the funds dry up. There is little to argue here.

Ace Gunner
02-05-2013, 08:09 PM
No, I just want more smart people to enter into nursing. Because there's a larger demand for it, I suspect that won't be a huge problem. There are plenty of people who will probably go forward with nursing than something like graphic design, art, interior design, real estate, etc.

so, in your perfect lil world, it's all nurses and ambulance chasers :D

La literatura
02-19-2013, 09:30 PM
Interesting article from local paper today . . .

No, I just want more smart people to enter into nursing. Because there's a larger demand for it, I suspect that won't be a huge problem. There are plenty of people who will probably go forward with nursing than something like graphic design, art, interior design, real estate, etc.

Record enrollment reported for Allen's spring semester

WATERLOO --- A record 610 students are enrolled at Allen College for spring semester 2013, an 11 percent increase from a record enrollment of 551 students in fall semester 2012.

The college reports large growth in its graduate program, where 197 students are enrolled, a 19 percent increase from 166 students last fall. These students are enrolled in either the master of science in nursing, post-graduate certificate or doctor of nursing practice programs.

In response to increased enrollment, Winter Hall opened on the Allen College campus in August 2012. The 19,500-square-foot facility includes two 75-seat lecture halls, two 35-seat classrooms and faculty offices.

In addition to its graduate programs, Allen College offers bachelor of science in nursing, associate of science in radiography and bachelor of health sciences programs.

Applications are being accepted for all programs. To apply or for more information, call 226-2000 or visit allencollege.edu.

http://wcfcourier.com/news/local/record-enrollment-reported-for-allen-s-spring-semester/article_a7e0c373-871f-544d-b709-3ca7f96f3c67.html

Cephalic Trauma
02-20-2013, 12:21 AM
The wrench in your supply and demand theory as it relates to medicine is that there is a third party involved that regulates prices allowed by the "supplier" (insurance) and another regulatory influence (government) that effects the cost of business for the supplier (hippa, osha). These factors don't apply to most industries, and the algorhythms that would be required to figure out supply and demand based economies of medicine are impossible.

I wish it were as simple as a doctor charges so much for an office visit, the patient pays it, and everyone is happy due to supply and demand setting the fee for said office visit. Unfortunately, the doctor has to order extra tests because the patient is a smoking fatass with diabetes, and if the doctor doesn't cover every base possible, the insurance won't pay him a cent. On top of that, the patients family will sue the doctor when the patient loses foot due to diabetes from an infection.

Bottom line is this. Despite the fact that many people think the doctor is a wealthy money grabber, the truth is, the doctors are trying to help their patients, but most of them (just look around at people these days) are out of shape, don't eat well, and do things that they know will hurt them. Meanwhile, the amount of money that the insurance pays the doctor to treat these patients has gone down steadily for years.

I get reimbursed less for a crown today than I got in 2002. Imagine if everything else cost less than it did in 2002.

The medical professions are taking it in the shorts, have been for over a decade, and will continue to do so as long as big Pharm and insurance continue to rule the game.

Great post. But they are taking it in the shorts for two main reasons.

One thing I would like to add is one-third of US health care spending is on administration costs of this system.

Second, there is way too much variation by region in how much we pay per medicare enrollee. However, those regions who spend more do not have better outcomes. The weirdest trend is that more spending actually leads to worse outcomes.

Cephalic Trauma
02-20-2013, 12:25 AM
Interesting article from local paper today . . .



Record enrollment reported for Allen's spring semester

WATERLOO --- A record 610 students are enrolled at Allen College for spring semester 2013, an 11 percent increase from a record enrollment of 551 students in fall semester 2012.

The college reports large growth in its graduate program, where 197 students are enrolled, a 19 percent increase from 166 students last fall. These students are enrolled in either the master of science in nursing, post-graduate certificate or doctor of nursing practice programs.

In response to increased enrollment, Winter Hall opened on the Allen College campus in August 2012. The 19,500-square-foot facility includes two 75-seat lecture halls, two 35-seat classrooms and faculty offices.

In addition to its graduate programs, Allen College offers bachelor of science in nursing, associate of science in radiography and bachelor of health sciences programs.

Applications are being accepted for all programs. To apply or for more information, call 226-2000 or visit allencollege.edu.

http://wcfcourier.com/news/local/record-enrollment-reported-for-allen-s-spring-semester/article_a7e0c373-871f-544d-b709-3ca7f96f3c67.html

ROFL

Allen College: The answer to our broken healthcare system

La literatura
02-20-2013, 07:09 AM
ROFL

Allen College: The answer to our broken healthcare system

Just an example of the increase of supply going on to meet the increased demand. I'll refrain from posting news about the healthcare industry if you find it ridiculous.

La literatura
02-20-2013, 07:16 AM
On second thought, I guess I don't really care if you find the news ridiculous. I'll keep posting them because they should be posted.

Here's an interesting development:

New NCIN Project Will Encourage Doctoral Education Among Nurses

There is no question that our nation needs more nurses prepared with a doctorate degree. The aging baby boomer population, the dramatic projected increase in the number of people with access to health care through the Affordable Care Act and a rapidly changing and increasingly technologically advanced health care system are increasing the need not only for highly qualified nurses, but also for nursing researchers, nursing faculty and nurses who are prepared to shape public policy. The rapidly changing demographics of our nation also demand greater diversity in our nursing workforce –in practice, research and academia.
Now, NCIN is launching a project to identify and encourage nurses who are interested in pursuing doctoral degrees, and to support doctoral nursing students in their studies. The Doctoral Advancement in Nursing (DAN) project is currently collecting data – including hearing from nursing students, nursing school deans and faculty, and other health care professional education associations – to determine the best ways to increase the number of PhD and DNP prepared nurses in the U.S.

http://www.newcareersinnursing.org/current-programs/success-stories/new-ncin-project-will-encourage-doctoral-education-among-nurses

HonestChieffan
02-20-2013, 07:37 AM
On second thought, I guess I don't really care if you find the news ridiculous. I'll keep posting them because they should be posted.

Here's an interesting development:

New NCIN Project Will Encourage Doctoral Education Among Nurses



http://www.newcareersinnursing.org/current-programs/success-stories/new-ncin-project-will-encourage-doctoral-education-among-nurses


Great stuff. This means we can have Nurses called Doctor. That right there will calm the fears of many.

patteeu
02-20-2013, 08:18 AM
On second thought, I guess I don't really care if you find the news ridiculous. I'll keep posting them because they should be posted.

Here's an interesting development:

New NCIN Project Will Encourage Doctoral Education Among Nurses



http://www.newcareersinnursing.org/current-programs/success-stories/new-ncin-project-will-encourage-doctoral-education-among-nurses

So it sounds like what Obamacare is bringing us is healthcare delivered by nurses instead of more highly trained doctors. Is that supposed to be progress?

patteeu
02-20-2013, 08:18 AM
Great stuff. This means we can have Nurses called Doctor. That right there will calm the fears of many.

LMAO

La literatura
02-20-2013, 09:23 AM
So it sounds like what Obamacare is bringing us is healthcare delivered by nurses instead of more highly trained doctors. Is that supposed to be progress?

Yes, it is. Think of it like realtors doing semi-legal work at much less the cost than a lawyer. This doesn't mean that we're throwing nurses into surgical rooms to conduct triple-bypasses. It means the healthcare system is adapting to train more people to do more tasks, at less the cost of a traditional doctor (who retain their low number). When I have a physical, do I need a doctor to come talk to me about whether I smoke, drink, or have high blood pressure, diabetes, etc.? Not at all. Nurses are perfectly educated and trained to be able to know, diagnose, and educate me on that. And the more highly trained and educated nurses, the more they can do: write me a prescription for something or do follow-ups for surgeries.

We'll always need doctors, but it's okay to allow them to do the most important, intensive healthcare issues, while a hierarchy of nurses take care of 95% of health care issues.

By the way, most of our health care costs are relegated to a small percentage of the population (the elderly, and the chronically ill). Geriatric care is a nursing issue. Chronically ill is a nursing issue. Despite the naysaying and doomsday prophesies about the end of doctors, I think 1) that's ridiculous and 2) there is a lot of cause to be optimistic about the medical profession.

Cephalic Trauma
02-20-2013, 01:34 PM
On second thought, I guess I don't really care if you find the news ridiculous. I'll keep posting them because they should be posted.

Here's an interesting development:

New NCIN Project Will Encourage Doctoral Education Among Nurses



http://www.newcareersinnursing.org/current-programs/success-stories/new-ncin-project-will-encourage-doctoral-education-among-nurses

You have no idea what you are talking about.

Cephalic Trauma
02-20-2013, 01:40 PM
Yes, it is. Think of it like realtors doing semi-legal work at much less the cost than a lawyer. This doesn't mean that we're throwing nurses into surgical rooms to conduct triple-bypasses. It means the healthcare system is adapting to train more people to do more tasks, at less the cost of a traditional doctor (who retain their low number). When I have a physical, do I need a doctor to come talk to me about whether I smoke, drink, or have high blood pressure, diabetes, etc.? Not at all. Nurses are perfectly educated and trained to be able to know, diagnose, and educate me on that. And the more highly trained and educated nurses, the more they can do: write me a prescription for something or do follow-ups for surgeries.

We'll always need doctors, but it's okay to allow them to do the most important, intensive healthcare issues, while a hierarchy of nurses take care of 95% of health care issues.

By the way, most of our health care costs are relegated to a small percentage of the population (the elderly, and the chronically ill). Geriatric care is a nursing issue. Chronically ill is a nursing issue. Despite the naysaying and doomsday prophesies about the end of doctors, I think 1) that's ridiculous and 2) there is a lot of cause to be optimistic about the medical profession.

So, you're saying that nurses can help "diagnose" diseases when they know nothing about their pathophysiology?

Also, you are largely ignoring the fact that the salaries of doctors are a very small portion of the pie.

1. Administration costs
2. Unnecessary tests

Those are your two main culprits.

You can't simply water down the profession by "adding more nurses". You are, in effect, reducing the quality to account for increased costs.

La literatura
02-20-2013, 01:55 PM
You have no idea what you are talking about.

These are just small changes I've found that show a positive growth of the nursing education and training that I predict will occur because of ACA, and which will prevent the healthcare system from going off the cliff. If you don't think there is going to be measurable growth in their numbers and their responsibility, I'd like to know why.

La literatura
02-20-2013, 02:00 PM
So, you're saying that nurses can help "diagnose" diseases when they know nothing about their pathophysiology?

I don't know Cephalic Trauma. Is that what I'm saying? Does it make any logical sense to infer that from my post? [No it doesn't, unless you're entering your own assumptions and premises into this equation that I'm not. Feel free to explain those.]

Also, you are largely ignoring the fact that the salaries of doctors are a very small portion of the pie.

1. Administration costs
2. Unnecessary tests

Those are your two main culprits.

You can't simply water down the profession by "adding more nurses". You are, in effect, reducing the quality to account for increased costs.

It's not watering down the profession. In fact, with increased students and increased training at good schools, it's building up the profession.

I'm not ignoring administrative costs or unnecessary tests. That has little to do with my prediction that a stronger flow of nurses and increased responsibilities of nurses will help meet the demand made by ACA.

Cephalic Trauma
02-20-2013, 02:05 PM
These are just small changes I've found that show a positive growth of the nursing education and training that I predict will occur because of ACA, and which will prevent the healthcare system from going off the cliff. If you don't think there is going to be measurable growth in their numbers and their responsibility, I'd like to know why.

Read my post above.

There will be a measurable growth across the board. That's not being debated. But, to say that an increase in nurses will meet the demand is extremely simplistic and will not adress the problem.

The problem with healthcare is spending. Not the number of healthcare providers.

We have a shortage, yes, but that has many different factors contributing to it. Among those factors is an unwillingness of professionals to practice in rural areas and of decreased compensation(as stated in the OP).

Cephalic Trauma
02-20-2013, 02:08 PM
I don't know Cephalic Trauma. Is that what I'm saying? Does it make any logical sense to infer that from my post? [No it doesn't, unless you're entering your own assumptions and premises into this equation that I'm not. Feel free to explain those.]



It's not watering down the profession. In fact, with increased students and increased training at good schools, it's building up the profession.

I'm not ignoring administrative costs or unnecessary tests. That has little to do with my prediction that a stronger flow of nurses and increased responsibilities of nurses will help meet the demand made by ACA.

You said it explicitly by stating nurses are trained to diagnose. i did not assume that, you said it.

Nurses diagnosing anomalies they know nothing about is watering down the quality of care.

Cephalic Trauma
02-20-2013, 02:10 PM
Additionally, who's going to pay them? Medicare cuts are taking effect, and private insurers negotiate prices based on medicare.

Are these colleges providing us with volunteer nurses?

La literatura
02-20-2013, 02:49 PM
The problem with healthcare is spending. Not the number of healthcare providers.

We have a shortage, yes, but that has many different factors contributing to it. Among those factors is an unwillingness of professionals to practice in rural areas and of decreased compensation(as stated in the OP).

I think there are a few problems with healthcare. Obviously, I'm not in the industry and (in the vein of this thread) don't have my thumb on its pulse, but 30 million more people coming into a system means the jobs of those in the healthcare industry are very stable, they're in large demand. The better you are, the more wanted you will be. And that's why I believe, as I stated in my first post in this thread, that there's never been a better time to be in the profession.

Medicare (and Medicaid) made the healthcare industry rich. Anytime you have the full backing of the United States to support your paycheck because you are doing operations and checkups and testing, you're going to see a stable monetary benefit (not to mention, an increase in the amount of operations, checkups, and testing -- that age-old incentive issue).

Even supposing Medicare payments to doctors are cut, even drastically, my belief is that the healthcare system will be a well-compensated profession.

La literatura
02-20-2013, 02:52 PM
You said it explicitly by stating nurses are trained to diagnose. i did not assume that, you said it.

Nurses diagnosing anomalies they know nothing about is watering down the quality of care.

Here are some possible missing premises:

1) Nurses are currently trained to diagnose anything
2) Nurses can not take pathology courses

I'm not advocating that nurses diagnose anomalies they know nothing about.

La literatura
02-20-2013, 03:00 PM
Additionally, who's going to pay them? Medicare cuts are taking effect, and private insurers negotiate prices based on medicare.

Are these colleges providing us with volunteer nurses?

First, I think you are over-simplifying the way private insurers negotiate prices with providers. It's not as simple as "Well, what's the gov't paying? Okay, let's do that." If it were that simple, then all operations would cost the same everywhere.

Secondly, it's silly to think that if Medicare payments are reduced, there will be no way to pay nurses, including the nurses for the 30 million that are going to purchase private health insurance.

Cephalic Trauma
02-20-2013, 03:11 PM
I think there are a few problems with healthcare. Obviously, I'm not in the industry and (in the vein of this thread) don't have my thumb on its pulse, but 30 million more people coming into a system means the jobs of those in the healthcare industry are very stable, they're in large demand. The better you are, the more wanted you will be. And that's why I believe, as I stated in my first post in this thread, that there's never been a better time to be in the profession.

Medicare (and Medicaid) made the healthcare industry rich. Anytime you have the full backing of the United States to support your paycheck because you are doing operations and checkups and testing, you're going to see a stable monetary benefit (not to mention, an increase in the amount of operations, checkups, and testing -- that age-old incentive issue).

Even supposing Medicare payments to doctors are cut, even drastically, my belief is that the healthcare system will be a well-compensated profession.

Being in high demand and being compensated for being in high demand are two very different things. Like I said, we are cutting Medicare funding, yet treating more patients. So, I'll see more patients, but get paid less for each. How does that benefit me?

Hypothetically, because I don't have exact numbers, if I see 20 patients in a day, and get paid $50 for each pt, I make 1000 bucks (these are not real numbers). Now, with more people being insured, I will see 30 patients, AND my compensation will decrease to $30 a patient, and make 900 dollars a day. I'm essentially getting paid less to do more. Follow?

Cephalic Trauma
02-20-2013, 03:17 PM
First, I think you are over-simplifying the way private insurers negotiate prices with providers. It's not as simple as "Well, what's the gov't paying? Okay, let's do that." If it were that simple, then all operations would cost the same everywhere.

Secondly, it's silly to think that if Medicare payments are reduced, there will be no way to pay nurses, including the nurses for the 30 million that are going to purchase private health insurance.

That's exactly how it works. They take the government number, determine how much they will pay based on that figure (i.e. 120% of medicare), and pay it. I have physicians in my family, and I get lectures from physicians every day, so I'm sure they aren't lying.

And that's not what I'm saying. I'm saying if you increase the NUMBER of nurses, while decreasing the overall compensation then you will pay them all less. It's a simple math problem.

La literatura
02-20-2013, 03:27 PM
Being in high demand and being compensated for being in high demand are two very different things. Like I said, we are cutting Medicare funding, yet treating more patients. So, I'll see more patients, but get paid less for each. How does that benefit me?

Hypothetically, because I don't have exact numbers, if I see 20 patients in a day, and get paid $50 for each pt, I make 1000 bucks (these are not real numbers). Now, with more people being insured, I will see 30 patients, AND my compensation will decrease to $30 a patient, and make 900 dollars a day. I'm essentially getting paid less to do more. Follow?

What kind of Soviet-style system do you have built up in your mind for our healthcare system? You honestly don't have to see patients unless you want to. Also, these 10 extra patients are privately insured (not Medicare patients).

La literatura
02-20-2013, 03:31 PM
That's exactly how it works. They take the government number, determine how much they will pay based on that figure (i.e. 120% of medicare), and pay it. I have physicians in my family, and I get lectures from physicians every day, so I'm sure they aren't lying.

This doesn't make sense. Think about it: why are there differences between costs for similar operations, then? Under your theory, there should be a uniform cost in the healthcare system.

The reality is that hospitals and insurance companies negotiate on payment plans. I'm sure Medicare plays a role in it, but it's one of many roles.

La literatura
02-20-2013, 03:35 PM
That's exactly how it works. They take the government number, determine how much they will pay based on that figure (i.e. 120% of medicare), and pay it. I have physicians in my family, and I get lectures from physicians every day, so I'm sure they aren't lying.

This really cements in my mind, though, that Medicare is a great plan -- for doctors.

patteeu
02-20-2013, 03:37 PM
I think there are a few problems with healthcare. Obviously, I'm not in the industry and (in the vein of this thread) don't have my thumb on its pulse, but 30 million more people coming into a system means the jobs of those in the healthcare industry are very stable, they're in large demand. The better you are, the more wanted you will be. And that's why I believe, as I stated in my first post in this thread, that there's never been a better time to be in the profession.

Medicare (and Medicaid) made the healthcare industry rich. Anytime you have the full backing of the United States to support your paycheck because you are doing operations and checkups and testing, you're going to see a stable monetary benefit (not to mention, an increase in the amount of operations, checkups, and testing -- that age-old incentive issue).

Even supposing Medicare payments to doctors are cut, even drastically, my belief is that the healthcare system will be a well-compensated profession.

You shouldn't use your thumb to take a pulse.

Cephalic Trauma
02-20-2013, 03:39 PM
What kind of Soviet-style system do you have built up in your mind for our healthcare system? You honestly don't have to see patients unless you want to. Also, these 10 extra patients are privately insured (not Medicare patients).

I have to make a living. I will leave medical school with 200 grand in debt.

It comes down to one thing that you are ignoring. Everything revolves around medicare. Medicare sets the standard, and private companies set prices based on the standard.

There are multiple private insurance companies, and different companies will pay different rates for different procedures.

patteeu
02-20-2013, 03:41 PM
This really cements in my mind, though, that Medicare is a great plan -- for doctors.

Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.

Cephalic Trauma
02-20-2013, 03:44 PM
This doesn't make sense. Think about it: why are there differences between costs for similar operations, then? Under your theory, there should be a uniform cost in the healthcare system.

The reality is that hospitals and insurance companies negotiate on payment plans. I'm sure Medicare plays a role in it, but it's one of many roles.

Because different companies will pay different rates for similar procedures in order to make a profit.

Cephalic Trauma
02-20-2013, 03:45 PM
Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.

We had a lecture about this from the CEO of a major hospital associated with our school.

La literatura
02-20-2013, 03:47 PM
Your earlier statement about there never being a better time to be in healthcare seems out of touch in the context of what I hear from people actually in the field.

I think there's a lot of uncertainty in the field right now. After all, the regulations covering ACA haven't been completed yet. Everyday, who knows how many pages are printed detailing regulations.

I get that it's probably unnerving, especially for doctors who have been around for 25-35 years.

But I don't see the AMA running around acting crazy like a freshmen Republican Representative.

La literatura
02-20-2013, 03:49 PM
I have to make a living. I will leave medical school with 200 grand in debt.

It comes down to one thing that you are ignoring. Everything revolves around medicare. Medicare sets the standard, and private companies set prices based on the standard.

There are multiple private insurance companies, and different companies will pay different rates for different procedures.

And there are multiple hospitals, and different hospitals/doctors will get different rates.

Which goes to show you that it's not as simple as "What's 120% of Medicare? Okay. Done."

La literatura
02-20-2013, 03:50 PM
We had a lecture about this from the CEO of a major hospital associated with our school.

And he told you to drop out of school and get a degree in accounting.

Cephalic Trauma
02-20-2013, 03:56 PM
And there are multiple hospitals, and different hospitals/doctors will get different rates.

Which goes to show you that it's not as simple as "What's 120% of Medicare? Okay. Done."

The hospitals a patient has access to are limited by the provider. You can't stray out of your PPO, or you will pay higher rates.

Cephalic Trauma
02-20-2013, 03:57 PM
And he told you to drop out of school and get a degree in accounting.

I hope you aren't relying on one.

Fish
02-20-2013, 03:58 PM
You shouldn't use your thumb to take a pulse.

LMAO.... truth....

La literatura
02-20-2013, 04:00 PM
I hope you aren't relying on one.

Well, have you thought about quitting? Have other kids in your class dropped out because of ACA?

patteeu
02-20-2013, 04:10 PM
I think there's a lot of uncertainty in the field right now. After all, the regulations covering ACA haven't been completed yet. Everyday, who knows how many pages are printed detailing regulations.

I get that it's probably unnerving, especially for doctors who have been around for 25-35 years.

But I don't see the AMA running around acting crazy like a freshmen Republican Representative.

I'll pass your reassurances on to my acquaintances. I'm sure it will make them feel better to know that one of Obama's faithful is confident that their worries are unfounded.

Cephalic Trauma
02-20-2013, 04:11 PM
Well, have you thought about quitting? Have other kids in your class dropped out because of ACA?

No. I love the science of medicine. I can't see myself practicing anything else.

I assume my classmates feel the same way.

La literatura
02-20-2013, 04:12 PM
I'll pass your reassurances on to my acquaintances. I'm sure it will make them feel better to know that one of Obama's faithful is confident that their worries are unfounded.

Glad I could help them. If I'm wrong, they can yell at me when I meet them in the Obama Soup Kitchen line next year.

La literatura
02-20-2013, 04:13 PM
No. I love the science of medicine. I can't see myself practicing anything else.

I assume my classmates feel the same way.

Well, shit. Can we do more than 30% cut in Medicare payments?

La literatura
02-20-2013, 04:17 PM
No. I love the science of medicine. I can't see myself practicing anything else.

I assume my classmates feel the same way.

Your first rule as a doctor is to say, "I love medicine, but the current atmosphere is choking my love. With so many [regulations/lawyers/etc.], I can barely gone on as a free man in good conscience. My passion to help people is the only thing that is holding me on right now, but even that . . . ." and then drift off into silence and head shaking.

Cephalic Trauma
02-20-2013, 04:29 PM
Well, shit. Can we do more than 30% cut in Medicare payments?

Have a smarter populace that doesn't turn to a Chiefs board for their homework. That's a start.

La literatura
02-20-2013, 04:38 PM
Have a smarter populace that doesn't turn to a Chiefs board for their homework. That's a start.

You think they gave some bad advice in there?

Cephalic Trauma
02-20-2013, 04:40 PM
You think they gave some bad advice in there?

:drool: