Doctoral debt

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sicologia

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As a newly recognized doctoral candidate, I have been assessing my last year of training to see where I may end up finanicially by the time I graduate with my doctorate about this time next year. Since this is a real problem for some with our economy and somewhat lack of prolific positions immediately after graduation, I think it is important to share and even forewarn others of potential pitfalls that occur that further add to graduate student debt.

Also, since this is a mostly anonymous forum consisting mainly of like-minded and educated individuals in similar situations, I wonder if folks might want to share their own personal stories on how they accrued debt and what their plans are to pay it off. I, for one, have my own story which currently (and fortunately) only falls at about 30k of student loan debt over the past several years. My plans are to aggressively pay the loans off by 2015 since I have very little debt elsewhere. Anyone else care to share their story?
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You may want to reconsider an aggressive payoff, depending on your interest rate, gross income, tax write-offs, etc. A financial planner/accountant may be able to save you quite a bit of money.

I know people that have really good rates, and they pay what they are required, and instead invest their money elsewhere. The bottom line should be a comparison of payoff value v. minimum payment + investment value.

Basically if you can make more money elsewhere....why pay off the government and net less money? It can get a bit tricky with estimating ROI on certain investment tools, but even a simple CD through an internet bank can offer a greater interest rate than what you borrowed against. The real pro's manipulate cashflow to maximize their investments and minimize taxable income.....but that gets into much stickier territory if that isn't your thing. I'm looking to minimize payments (hopefully adding in a gov't repayment plan), maximize my pre-tax contributions, and funnel any side income through some more tax-friendly ventures. I'd rather not pay taxes, but since I can't do that....I'll try and minimize my exposure.

I'm far from an expert on this, so go with a pro, but it is something to think about.
 
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No debt, and no foreseeable debt.

I plan to buy a house in the country or maybe a loft after I graduate.
 
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I have no student loan debt, but I do have a good deal of consumer debt and home equity debt related to making ends meet while I've been in grad school and we've been living on one income. My situation is not typical. I have owned my own home for more than 20 yrs. I had some money saved and invested from my years of working in another career. However, I've blown through a lot of that money at this point and need to start replenishing. Fortunately I'm near the end now and have a decent-paying internship and a spouse who handles most of the home and child stuff when I'm not around, since he works from home.
 
I have about $100K in student loan debt. My loans are in deferment until January thankfully. Wooooo :rolleyes:

My plan is to approach this similar to a mortgage, which I also have. Basically paying more than the minimum to apply more toward the principle and reduce the amount of overall interest paid as much as I can. I plan on teaching 1-2 classes a semester during my post doc and taking that money to apply toward my loans as "extra." My post doc pays decently so I can afford the loan payments without teaching. I'm also married, and that certainly helps in being able to pay for everything.

For those looking at consolidation, it seems to be a bit more complicated than in the past with the current state of the banking system/economy. When I did my masters in 2001 I could easily consolidate those loans and lock in a good rate. Now it seems like you have to find your own lender and those are more difficult to come by. Anyone else run into this yet? I'm also reviewing the new loan forgiveness rules that were just passed by congress to see what other ways I can cut it down.
 
Married so there are two parts to this equation:

Me:
$20k Undergraduate debt (University of Texas, San Antonio)
$0k Graduate school debt (USUHS)

Current Tuition: $0k
Current Stipend/Salary: $89k/year (USUHS)
Internship Salary: ~$100k/year (Navy)

Wife

$20k Undergraduate Debt (Limestone College)
$30k Graduate Debt (M.S. in Engineering at Univ of Texas, Austin)

Current Tuition for JD: $40k/year (Georgetown Law)
Current Salary: $110k/year
Projected Debt: $210k with lawschool
Average Salary out of her law school: $160k (Median, Class of 2008)

So when she graduates we will have an approximately $230k in student debt between us (assuming I haven't paid anything off, which is not the case.) but a combined income somewhere around $250k. It's a reasonable amount of debt, and if it becomes too much I might have to just divorce her. ;) Unlike psychology (unless you work for CA DOC), Law pays much better and like medical school (until recently with Obamacare) makes sense to accrue more debt for a proportionally greater income in most cases.

So that's my story in a nutshell.

Mark
 
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Hey,

I posted this in another thread........

Check out the new loan forgiveness program that was passed by Congress. There are two parts to it -

(a) Income Based Repayment (IBR)
and
(b) Loan Forgiveness

(a)
IBR guarantees that loans never exceed 10% of total annual income (and is normally actually less, depending on # of dependants and what not)

(b)
Loan forgiveness kicks in when you make 120 consecutive re-payments (at that 10% 0f your annual salary). As long as you are working in non-profit or government institution (including as a researcher or academic in college/university, as a psychologist in a school or 501 (3c) , as a psych in the armed services/VA hospital, or in a non-profit where it can be documented, you are eligible for the forgiveness. You also have to consolidate your loans into the federal loan program.

Basically, this new legislation guarantees you pay no more than 10% per year of your salary for 10 years, and then everything is forgiven.

Here is information on the loan forgiveness & income based repayment:

http://www.ibrinfo.org/what.vp.html

or for q/a section

http://www.ibrinfo.org/faq.vp.html

This organization has live online question and answer sessions regarding all this on their facebook page (that links to the lecture/discussion). They also have several previously recorded lecture/discussions that are very informative that you can listen to at any time. Just facebook them at Project for Student Debt to join!




sicologia said:
As a newly recognized doctoral candidate, I have been assessing my last year of training to see where I may end up finanicially by the time I graduate with my doctorate about this time next year. Since this is a real problem for some with our economy and somewhat lack of prolific positions immediately after graduation, I think it is important to share and even forewarn others of potential pitfalls that occur that further add to graduate student debt.

Also, since this is a mostly anonymous forum consisting mainly of like-minded and educated individuals in similar situations, I wonder if folks might want to share their own personal stories on how they accrued debt and what their plans are to pay it off. I, for one, have my own story which currently (and fortunately) only falls at about 30k of student loan debt over the past several years. My plans are to aggressively pay the loans off by 2015 since I have very little debt elsewhere. Anyone else care to share their story?
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Wow, thanks for posting some of your own stories and plans. It seems there are many ways to overcome graduate school debt and reading actual stories about real people in the similar situations is very helpful!
 
Markp said:
Current Stipend/Salary: $89k/year (USUHS)
Internship Salary: ~$100k/year (Navy)
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Are you FREAKIN kidding me??

Suck it, classical liberalism and left-wing ideals! I'm going to work for the US military!
 
JockNerd said:
Are you FREAKIN kidding me??

Suck it, classical liberalism and left-wing ideals! I'm going to work for the US military!
Click to expand...

No, I am not kidding you. I did have 9 years of prior service which did increase my pay some, but there are people at USUHS who make more and others who make less than I do.

You don't have to give up your liberal beliefs of left-wing ideals. USUHS and the military in general still has a number of left leaning people, especially on the medical side of the house. I know both liberals and conservatives in the program. If you think about it, the military really operates much like socialism with a caste system. Perfect for lefties who want full medical care, housing provided, food provided, uniforms provided... it's all there. All you have to do is your part, unfortunately there are many left leaning people who cannot tolerate structure or have misgivings about being part of an organization where the overall all mission results in breaking things and hurting/killing people.

In my case, I had to agree to commit to 4 years in the program, and 7 years in service to pay back my commitment (as all USUHS students do.) In my case, with 9 years prior service, I also get a check for the rest of my life once my commitment is up because I will be eligible for retirement pay... Should I leave the service at that point I will get 50% of my base salary for the rest of my life and medical insurance will be covered as well. So it's really crazy, how could I turn that deal down?

Mark
 
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I was mostly kidding. It's moot anyway, since I (a) am not American, and (b) both ask and tell.
 
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JockNerd said:
I was mostly kidding. It's moot anyway, since I (a) am not American, and (b) both ask and tell.
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I knew (b), I didn't know (a). I don't know if you have to be an American, that's a good question, since plenty of foreign nationals do serve.

Navy website states "Be a U.S. citizen or a foreign citizen currently practicing in the U.S. (see a Medical Officer Recruiter for details.)" So that might not be a barrier... As far as don't ask, don't tell... I think we all expect congress or the President to "fix" that this year.... the question is will they replace this policy with something even more flawed.

Mark
 
Are there any jobs that assist you in clearing up your student loan debt?
I've heard that prison jobs can be very helpful with this. Any Advise?
Thanks!:xf:
 
The VA offers some loan repayment, though I believe it varies by site.
 
I believe I read an article within this forum about IHS. I believe many sites within IHS repay $20,000 per year of debt - so, if your looking to aggressively pay off debt, this could be a good way to go! Not all IHS sites have student loan repayment, though (my guess is that the tribes with casinos are the only ones able to afford to participate in the program). Good luck!

futureapppsy2 said:
You could look into IHS (Indian Health Service) or the National Health Corps (I'm blanking on the official name, sorry).
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i have tons and tons of debt, since i got no funding for my degree....before even going into this program my plan was that i would finish, get licensed and then ***** myself out to the govt and have them pay off a substantial chunk (if not the whole thing) of my student loan debt. i got out of undergrad with less than $10k and that was taken care of before i even started the doctoral program...
 
sicologia said:
I, for one, have my own story which currently (and fortunately) only falls at about 30k of student loan debt over the past several years. My plans are to aggressively pay the loans off by 2015 since I have very little debt elsewhere. Anyone else care to share their story?
Click to expand...

You're worried about 30k in debt? Lucky you. Mine and my colleagues' is more like 130k on the low end.
 
RGMSU said:
You're worried about 30k in debt? Lucky you. Mine and my colleagues' is more like 130k on the low end.
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Different ball of wax when you are getting paid $200k per year. Try managing that debt on 60k per year.

Mark
 
Markp said:
Different ball of wax when you are getting paid $200k per year. Try managing that debt on 60k per year.

Mark
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I assumed a PhD psychologist practicing clinically was closer to around 100k. And, we will see how much longer psychiatrists make 200k with healthcare reform around the bend.
 
RGMSU said:
I assumed a PhD psychologist practicing clinically was closer to around 100k. And, we will see how much longer psychiatrists make 200k with healthcare reform around the bend.
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There is a lot of variability in full v. part-time, academic v. non-academic....though unfortunately people are out there making $60k and being okay with it. The speciality areas tend to do much better, though like you said....let's see what healthcare "reform" does to our ability to make a livable wage.
 
Not to hijack the thread but it is interesting that psychology (due to non parity) has largely learned how to work around insurance. The medical profession is starting to to figure out how to work around it as well. With Obamacare likely to decimate insurance reimbursements, maybe we can help the MDs adjust with what we have learned from working with insurance (or actually most not working with it at all).

Most psychologists should be making at 100K a few years out of school. If you aren't you are likely in academia. If you are clinical and not making 100K you need to go and get good business training.

My plan to pay off debt. The military. After you graduate from school, you can apply for a direct officer commission into the military as a Captain. I sign some papers, take a physical and fitness test, do some other stuff, and then I am in. I serve 8 years of reserve (not all has to be active reserve) one weekend a month, 2 weeks a year, with the occasional deployment. I get $50K in student loan reimbursement, $45K for a "signing" bonus, and around $5K per year for my one weekend a month (plus an extra 2K per year when I am ABPP). But, even better, I get to serve the troops as I already specialize in PTSD/TBI. What a deal for me!!
 
hkusp said:
With Obamacare likely to decimate insurance reimbursements, maybe we can help the MDs adjust with what we have learned from working with insurance (or actually most not working with it at all).
Click to expand...

Why do you feel that healthcare reform would result in lower pay for doctors? I have never heard of that being in the works as long as providers are practicing efficient and empirically supported treatments (which we should all be doing ethically in the first place).

If Obama's plan would dramatically decrease wages, then the majority of doctors wouldn't be in support of it.
 
KillerDiller said:
Why do you feel that healthcare reform would result in lower pay for doctors? I have never heard of that being in the works as long as providers are practicing efficient and empirically supported treatments (which we should all be doing ethically in the first place).

If Obama's plan would dramatically decrease wages, then the majority of doctors wouldn't be in support of it.
Click to expand...

What makes you think the majority of Doctors do support it?!?
 
Markp said:
What makes you think the majority of Doctors do support it?!?
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Well, some doctors (and in training) do support it. The ones I know are primarily med students and residents. The older, more established doctors I know do not support it. This is both for physical and mental health doctors.
 
Markp said:
What makes you think the majority of Doctors do support it?!?
Click to expand...

A study published by the New England Journal of medicine found that 62% of AMA physicians supported a public health care option and 58% wanted to expand medicare options.

The AMA sent a letter to the Whitehouse supporting H.R. 3200.

A Reuters survey of 2000 physicians found 59% were in favor of a national health care plan.
 
The bill specifies equal wages for doctors, no matter what specialty. This will likely be a pay cut for many. Also, it is unlikely the government will be able to pay healthcare providers a large amount given that their funding will be limited. Finally, the lack of competition will likely drive wages down as well.

You're also assuming that all doctors support AMA. Many are angry at their decision to support healthcare "reform." A poll I saw, which was on a doctor website similar to this one, said that 80% opposed the plan.
 
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cara susanna said:
The bill specifies equal wages for doctors, no matter what specialty. This will likely be a pay cut for many. Also, it is unlikely the government will be able to pay healthcare providers a large amount given that their funding will be limited. Finally, the lack of competition will likely drive wages down as well.
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I have read the bill and I don't remember any mention of this. Could you point me to a page and paragraph #? Parts of the bill that are relevant to doctors salaries include

1) Reimbursement being tied to the quality and the specifics of the treatment provided. Now, this is admittedly vague, however, it is made clear that doctors will be expected to follow the most efficient and most empirically-supported treatments available. For example, government officials have pointed to the practices of doctors in certain regions of the country performing hysterectomies and back surgeries when less invasive options are readily available and effective. I'm sure we can all draw parallels to the psych community. The bill purports to attempt to cut down on these types of unnecessary procedures by cutting reimbursement rates to make these options less appealing to doctors than they currently are (but not refusing to reimburse them all together, by the way).

2) The bill will form anti-trust laws to prevent insurance companies from continuing to charge exorbitant fees for malpractice insurance.

3) The bill calls for more loan-reimbursement programs for physicians (and hopefully other doctoral level practitioners as well...that would be nice).

Doesn't sound too bad to me.
 
cara susanna said:
Finally, the lack of competition will likely drive wages down as well.
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How would adding a public option to the existing insurance options create less competition? Not that a public option is going to happen anyway.
 
KillerDiller said:
How would adding a public option to the existing insurance options create less competition? Not that a public option is going to happen anyway.
Click to expand...

In short, when the government can offer a plan of "full coverage" (no one reads the fine print) for less than 25% of what your employer's plan costs you every month for "full coverage" (no one reads the fine print on this, either) which will you choose? You can expand the syllogism from there. As a doctoral psychologist and a physician, I would say these things:

1. There is NO WAY to tell what will happen. I simply no longer trust the news, the AMA or APA or APA to explain things to me. Everyone has an agenda. And like most of my colleagues, I am too busy actually working to have the time to sit down and attend to the issue at the level of detail it deserves.

2. Psychologists are paid WAY too little. I fault the APA for spending more time diddling the RxP issue and too little time actually promoting/identifying psychologist's contribution to health care.
 
Pterion said:
In short, when the government can offer a plan of "full coverage" (no one reads the fine print) for less than 25% of what your employer's plan costs you every month for "full coverage" (no one reads the fine print on this, either) which will you choose? You can expand the syllogism from there.
Click to expand...

Well, the public option is off the table anyway, so I guess this line of discussion isn't really germane (although I would argue that having cheaper options would compel insurance companies to offer competing cheaper plans of their own).

Pterion said:
As a doctoral psychologist and a physician, I would say these things:

1. There is NO WAY to tell what will happen. I simply no longer trust the news, the AMA or APA or APA to explain things to me. Everyone has an agenda. And like most of my colleagues, I am too busy actually working to have the time to sit down and attend to the issue at the level of detail it deserves.

2. Psychologists are paid WAY too little. I fault the APA for spending more time diddling the RxP issue and too little time actually promoting/identifying psychologist's contribution to health care.
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Totally agree! With regard to your first point, I think health care reform is so necessary that this is worth the uncertainty and inevitable restructuring that will have to occur. It is definitely extremely hard finding unbiased information as to what it will eventually look like. It will be somewhere between the utopia that one side predicts and the utter chaos, economic despair, and rampant patient death the other side touts.
 
Pterion said:
2. Psychologists are paid WAY too little. I fault the APA for spending more time diddling the RxP issue and too little time actually promoting/identifying psychologist's contribution to health care.
Click to expand...
I agree that the APA is spending way too much time in certain areas...bu RxP isn' really one of them. Unfortunately the APA made mistakes decades ago that we are still paying for

1. Not allowing the degree to be granted until after internship, which makes our services unbillable and suppresses our internship salaries.

2. Poor representation for insurance issues, allowing shrinking reimbursements.

3. Proliferation of the profession without enough quality control.

4. Lethargy in regard to anything and everything requiring timely responses.

etc.
 
I have a WAIS-IV report to write so I can't keep debating, but here are the relevant parts of the bill:

(c) Payment Terms for Providers-
(1) PHYSICIANS- The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year, in one of 2 classes:
(A) PREFERRED PHYSICIANS- Those physicians who agree to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(B) PARTICIPATING, NON-PREFERRED PHYSICIANS- Those physicians who agree not to impose charges (in relation to the payment rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C) of the Social Security Act.
(2) OTHER PROVIDERS- The Secretary shall provide for the participation (on an annual or other basis specified by the Secretary) of health care providers (other than physicians) under the public health insurance option under which payment shall only be available if the provider agrees to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(d) Exclusion of Certain Providers- The Secretary shall exclude from participation under the public health insurance option a health care provider that is excluded from participation in a Federal health care program (as defined in section 1128B(f) of the Social Security Act).

Page 253 says that government will set the value of doctors' time.

Page 241 says that Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.

As for no competition:
Page 102 says Medicaid eligible persons will be automatically enrolled, page 145 says an employer must auto-enroll employees.
Page 149 says that any employer with a payroll above $400,000 (that is, 99.9999 percent of businesses in the US) that does not provide the public option pays an 8% payroll tax.
 
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cara susanna said:
I have a WAIS-IV report to write so I can't keep debating, but here are the relevant parts of the bill:

(c) Payment Terms for Providers-
(1) PHYSICIANS- The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year, in one of 2 classes:
(A) PREFERRED PHYSICIANS- Those physicians who agree to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(B) PARTICIPATING, NON-PREFERRED PHYSICIANS- Those physicians who agree not to impose charges (in relation to the payment rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C) of the Social Security Act.
(2) OTHER PROVIDERS- The Secretary shall provide for the participation (on an annual or other basis specified by the Secretary) of health care providers (other than physicians) under the public health insurance option under which payment shall only be available if the provider agrees to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(d) Exclusion of Certain Providers- The Secretary shall exclude from participation under the public health insurance option a health care provider that is excluded from participation in a Federal health care program (as defined in section 1128B(f) of the Social Security Act).

Page 253 says that government will set the value of doctors' time.

Page 241 says that Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.

As for no competition:
Page 102 says Medicaid eligible persons will be automatically enrolled, page 145 says an employer must auto-enroll employees.
Page 149 says that any employer with a payroll above $400,000 (that is, 99.9999 percent of businesses in the US) that does not provide the public option pays an 8% payroll tax.
Click to expand...

I'm afraid we must be looking at different things. Also, wasn't the public option taken off the table in July?
 
JockNerd said:
I was mostly kidding. It's moot anyway, since I (a) am not American, and (b) both ask and tell.
Click to expand...


I know this is like a week after the post, but I just started laughing out loud in a library after reading this. Love it!! :D
 
cara susanna said:
The bill specifies equal wages for doctors, no matter what specialty. This will likely be a pay cut for many.
Click to expand...

For surgeons, dermatologists and radiologists maybe--specialties that currently reimburse at a vastly higher rate, largely due to the number of billable procedures available to them which greatly affects insurance companies methods of calculating reimbursement, than others like general practice, gynecology, and wait for it...psych services. Psychiatrists and psychologists are on the lower half of pay scale and would BENEFIT from this sort of change, since the only ones making more than that tend to be those that do not accept insurance anyway.

Part of why that needs to happen is that if there is greater access to health care, more general practitioners will be needed, and currently there is a dearth of medical students willing to go that route. Just look at the links at the top of the SDN page, like "The Successful Match: Getting into Dermatology." Med students are drawn to the high paying specialties, understandably, and the others, some of which are much needed, are neglected. I used to work at a hospital in MA, and since the recent mandated insurance law went into place, there was a significant shortage of primary care providers, and MA has a much higher rate of primary care physicians per capita than almost any other state in the country. The same thing will be true if mental health coverage is actually available to people (which often right now it isn't, or it is only to a very limited extent). We will need more mental health care providers, and unless the reimbursement rates are made (more) comparable, that won't happen. That's going to apply to psychologists as well psychiatrists I imagine.

Opposing this sort of change is shooting yourself in the foot, but, hey, go ahead.
 
We were discussing MDs, so that's why I said a pay decrease for many. Psychologists it's obviously a different story.
 
Well again, it depends on the specialty. For a few, it will hurt them. For many it will not.
 
Cara Susanna,

As usual, your brilliance astounds me.

It would astound members of the US Senate as well, as there are currently 4 bills that have been passed by the US Senate that must still be re-reconciled into one bill. 3 of those 4 bills differ quite substantially from the most recent bill passed by the Finance committee, as 3 out of the 4 actually do contain a public option. Once these 4 bills are re-reconciled within the US Senate, they must be re-reconciled with the bill passed months ago by the House of Representatives. The House bill, like 3 out of the 4 Senate bills, has a strong public option.

The passages you excerpt are from 1 Senate bill (likely the most recent bill, passed by the Finance committee). Not the bill that has passed the Senate (since, again, no bill has been passed by whole senate yet).

You truly are a brilliant graduate student. You have no clue as to how doctors in general feel about a public option - citing a poll from a conservative pharmaceutical front organization means nothing, but again.........you do seem to know everything.

I find your certainty about everything so exciting. The public option and US healthcare overhaul have been discussed in several forums, with Cara Susanna and a few others presenting there usual, certain views. I recommend taking all such certain viewpoints with a grain of salt, in spite of (or perhaps due to) there brilliant certainty. My suggestion - stick to the supposed certainty (I know- I've used 'certainty' too many times) you have found regarding the cognitive functioning of your client (via use of a WAIS) and leave other matters to those who have actually taken some time to at least understand the healthcare situation from more than one pre-determined angle.



cara susanna said:
I have a WAIS-IV report to write so I can't keep debating, but here are the relevant parts of the bill:

(c) Payment Terms for Providers-
(1) PHYSICIANS- The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year, in one of 2 classes:
(A) PREFERRED PHYSICIANS- Those physicians who agree to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(B) PARTICIPATING, NON-PREFERRED PHYSICIANS- Those physicians who agree not to impose charges (in relation to the payment rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C) of the Social Security Act.
(2) OTHER PROVIDERS- The Secretary shall provide for the participation (on an annual or other basis specified by the Secretary) of health care providers (other than physicians) under the public health insurance option under which payment shall only be available if the provider agrees to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
(d) Exclusion of Certain Providers- The Secretary shall exclude from participation under the public health insurance option a health care provider that is excluded from participation in a Federal health care program (as defined in section 1128B(f) of the Social Security Act).

Page 253 says that government will set the value of doctors' time.

Page 241 says that Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.

As for no competition:
Page 102 says Medicaid eligible persons will be automatically enrolled, page 145 says an employer must auto-enroll employees.
Page 149 says that any employer with a payroll above $400,000 (that is, 99.9999 percent of businesses in the US) that does not provide the public option pays an 8% payroll tax.
Click to expand...
 
aagman01 said:
Cara Susanna,

As usual, your brilliance astounds me.

It would astound members of the US Senate as well, as there are currently 4 bills that have been passed by the US Senate that must still be re-reconciled into one bill. 3 of those 4 bills differ quite substantially from the most recent bill passed by the Finance committee, as 3 out of the 4 actually do contain a public option. Once these 4 bills are re-reconciled within the US Senate, they must be re-reconciled with the bill passed months ago by the House of Representatives. The House bill, like 3 out of the 4 Senate bills, has a strong public option.
Click to expand...

Cara and I may not have the same views on this issue, but your tone here is really condescending and that's not helping you get your point across in the slightest. Also, I think it's probably me you want to correct on the public option front, not her.
 
KillerDiller said:
Why do you feel that healthcare reform would result in lower pay for doctors? I have never heard of that being in the works as long as providers are practicing efficient and empirically supported treatments (which we should all be doing ethically in the first place).

If Obama's plan would dramatically decrease wages, then the majority of doctors wouldn't be in support of it.
Click to expand...

Doctors and medical students are just as mixed in their views toward healthcare reform as any other group. And, nobody really knows what will happen to salaries. What we do know is that salaries in some specialties cannot go lower (family med, psychiatry, obgyn, internal med, pediatrics). If these salaries go lower, we will experience major shortages in the physician workforce in these fields. The plans I have heard are to decrease reimbursement to the highly procedural, well-paid stuff (cardio for example), to level the playing field a bit.
 
RGMSU said:
The plans I have heard are to decrease reimbursement to the highly procedural, well-paid stuff (cardio for example), to level the playing field a bit.
Click to expand...

That is nice in theory, but it is worrisome that the focus is on reimbursement reduction. Middling through cuts simply reduces overall compensation, instead of redistributing the compensation. If the "realized" gain from the cuts is put towards higher reimbursements for generalists (physician and other clinical professionals), that would be something worth supporting.
 
As usual, aagman has killed any desire I had to argue this topic since, as much as I love debating, I will not engage with someone who feels the need to insult me personally.

Sorry, Killer, it seems we'll just have to agree to disagree or something like that.
 
Therapist4Chnge said:
That is nice in theory, but it is worrisome that the focus is on reimbursement reduction. Middling through cuts simply reduces overall compensation, instead of redistributing the compensation. If the "realized" gain from the cuts is put towards higher reimbursements for generalists (physician and other clinical professionals), that would be something worth supporting.
Click to expand...

Agreed. I merely was expounding on the realities of what I have heard proposed, not what should be. I have yet to hear anyone seriously proposing reimbursement increases. Good luck fighting for that one. The general consensus in the public is that we're all over-paid, and the public makes little distinction based on what the professional title is as long as your name starts with "Dr."
 
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