Nationalized Health Care = bad for doctors?

[usermike8500]

Greetings future doctors,

With both republicans and democrats in favor of nationalizing American health care at least to some extent, it is quite likely that the government will gain greater control over health care before any of us graduate from medical school and enter the work force.

Do you think this will have negative implications on the careers of physicians? With the taxpayers subsidizing health care, it is doubtful that physicians will be able to command as high of salaries as they currently do. I predict that we will see doctors' wages fall well below the $100,000 a year mark within the next few years. I know money isn't everything, but would you be willing to go through 8 years of additional training after college to earn, perhaps $65,000 a year?

Of course, I'm only speculating. However, in other nations that have predominately government-funded health care, physicians earn relatively low salaries. Again, money isn't everything and should never be the reason to choose medicine as your career... but 8 years of training and $200,000 of medical school expenses is large sacrifice to make for a lifestyle that may necessitate eating top ramen noodles for 3 meals a day.

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[Napoleown]

who are you to predict anything?

 

[DropkickMurphy]

Greetings future doctors,

With both republicans and democrats in favor of nationalizing American health care at least to some extent, it is quite likely that the government will gain greater control over health care before any of us graduate from medical school and enter the work force.

Do you think this will have negative implications on the careers of physicians? With the taxpayers subsidizing health care, it is doubtful that physicians will be able to command as high of salaries as they currently do. I predict that we will see doctors' wages fall well below the $100,000 a year mark within the next few years. I know money isn't everything, but would you be willing to go through 8 years of additional training after college to earn, perhaps $65,000 a year?

Of course, I'm only speculating. However, in other nations that have predominately government-funded health care, physicians earn relatively low salaries. Again, money isn't everything and should never be the reason to choose medicine as your career... but 8 years of training and $200,000 of medical school expenses is large sacrifice to make for a lifestyle that may necessitate eating top ramen noodles for 3 meals a day.

Thank you for the most unoriginal post of the day.

 

[Husky85]

Greetings future doctors,

With both republicans and democrats in favor of nationalizing American health care at least to some extent, it is quite likely that the government will gain greater control over health care before any of us graduate from medical school and enter the work force.

Do you think this will have negative implications on the careers of physicians? With the taxpayers subsidizing health care, it is doubtful that physicians will be able to command as high of salaries as they currently do. I predict that we will see doctors' wages fall well below the $100,000 a year mark within the next few years. I know money isn't everything, but would you be willing to go through 8 years of additional training after college to earn, perhaps $65,000 a year?

Of course, I'm only speculating. However, in other nations that have predominately government-funded health care, physicians earn relatively low salaries. Again, money isn't everything and should never be the reason to choose medicine as your career... but 8 years of training and $200,000 of medical school expenses is large sacrifice to make for a lifestyle that may necessitate eating top ramen noodles for 3 meals a day.

No politician has a problem with screwing the physicians. They're all pretty blunt about that point.

What they (and the mass media) don't tell you is that nationalized healthcare will screw the patients too. Imagine waiting in a DMV'esque setup for healthcare...more people would die in line than those who would actually receive treatment! But the masses don't see this...they just hear the words "free healthcare" and start salivating. It's not really free, but people aren't very smart. It will be paid for in American lives and American tax dollars.

What we need is to form a united front and tell the government that no, we will not work under a nationalized system...so if they want to nationalize healthcare then they better find a good way to train an entire country full of mindless zombie physicians because we won't tolerate it.

Imagine if the country said "free cars for all" and tried to nationalize the automobile industry and make assemblyline workers work for less money and under a bureocracy...the unions would burn Detroit to the ground.

 

[Bacchus]

You need to survive. For a physician to survive he (or she) needs to make substantial $$$ in order to pay off debts, secure retirement, and provide for the family. You can do a lot with 65,000 but not when you have a mortgage coupled with its bastard child (med school debt). If I wanted to earn 65,000 a year I'd go establish myself in pharmaceutics or some other lab.

 

[OCallag]

I predict that we will see doctors' wages fall well below the $100,000 a year mark within the next few years.

...no.

 

[OCallag]

No politician has a problem with screwing the physicians.

Ron Paul.

 

[usermike8500]

who are you to predict anything?

-Calm down, take a deep breath, and relax

Thank you for the most unoriginal post of the day.

Sorry, I don't spend a lot of time reading Internet forums. I should've searched for this topic before posting

Thanks Husky85 and ahaydt for your comments.

 

[DropkickMurphy]

I didn't mean to come across as nasty, just there have been four threads on this topic in the past two days that I'm aware of.

 

[artaxerxes]

No politician has a problem with screwing the physicians. They're all pretty blunt about that point.

What they (and the mass media) don't tell you is that nationalized healthcare will screw the patients too. Imagine waiting in a DMV'esque setup for healthcare...more people would die in line than those who would actually receive treatment! But the masses don't see this...they just hear the words "free healthcare" and start salivating. It's not really free, but people aren't very smart. It will be paid for in American lives and American tax dollars.

What we need is to form a united front and tell the government that no, we will not work under a nationalized system...so if they want to nationalize healthcare then they better find a good way to train an entire country full of mindless zombie physicians because we won't tolerate it.

Imagine if the country said "free cars for all" and tried to nationalize the automobile industry and make assemblyline workers work for less money and under a bureocracy...the unions would burn Detroit to the ground.

people die now due to the lack of access to healthcare for financial reasons...I think there is a legit case for nationalization, although what form it takes is still up to debate.
Your analogy with the assemblyman's union is frightening however, because they are losing the fight your talking about. Because of their need for healthcare benefits, better wages, American automakers are becoming less competitive, just look at ford. Eventually, I believe they will be supported by government substities. In a similar fashion, a "Doctor Union" might spell the total collapse of America healthcare system....and yes, you Doctors can be replaced, just like assembly line workers, with foreign nationals and outsourcing.

 

[thinkorswim]

With a universal health care system, the end result would be a homogeneous system of mediocrity (similar to what we have in Canada). The sad thing is, for most people, that system would be an upgrade to the quality of health care to which they presently have access.

That being said, I would expect taxes to increase rather than physician salaries to decrease. There is no way the average salary will go below $100,000.

 

[artaxerxes]

With a universal health care system, the end result would be a homogeneous system of mediocrity (similar to what we have in Canada). The sad thing is, for most people, that system would be an upgrade to the quality of health care to which they presently have access.

That being said, I would expect taxes to increase rather than physician salaries to decrease. There is no way the average salary will go below $100,000.

well said....considering how many doctors volunteered at homeless shelters, clinics for the poor, etc. during their premed years, its hard to believe that they would argue against some form reforms toward universal healthcare.

 

[maestro1625]

well said....considering how many doctors volunteered at homeless shelters, clinics for the poor, etc. during their premed years, its hard to believe that they would argue against some form reforms toward universal healthcare.

during the premed years students have a very poor grasp of their own future financial needs.

 

[DropkickMurphy]

during the premed years students have a very poor grasp of their own future financial needs.

Hell, most of the premeds I know (both on here and through the school I attend) barely have what one could call a grasp on reality, let alone any sort of foresight. This is attributable largely to the fact that most of them are too young to have ever had to be 100% self-reliant.

 

[artaxerxes]

during the premed years students have a very poor grasp of their own future financial needs.

to be honest though, national policies should not be geared toward what benefits doctors. If they decrease doctor salaries, feel free to enter investment banking. And of course we'll see a drop in medical school applications, but thats really okay, cause plenty of doctors from other countries will still flock to the US to make 60-80 grand a year.

I say, massively fund medical education so doctors aren't swimming in debt,
Nationalize health care for the poor through middle class.
Raise taxes on the rich (yeah!), lower physician salaries, import/outsourch healthcare jobs.

 

[TexMED]

Ron Paul.

,

that's Dr. Ron Paul

AMEN!

 

[Wanna_B_Scutty]

,

that's Dr. Ron Paul

AMEN!

Thirded. I'd recommend that all of you have a look at Dr. Ron Paul's recent Kaiser Family Foundation healthcare interview. It's available on MP3 or in transcript form:
http://www.kaisernetwork.org/health_cast/health2008hc.cfm?&hc=2258

(If you like what you see, his campaign site is at www.ronpaul2008.com )

 

[rich1234]

to be honest though, national policies should not be geared toward what benefits doctors. If they decrease doctor salaries, feel free to enter investment banking. And of course we'll see a drop in medical school applications, but thats really okay, cause plenty of doctors from other countries will still flock to the US to make 60-80 grand a year.

I say, massively fund medical education so doctors aren't swimming in debt,
Nationalize health care for the poor through middle class.
Raise taxes on the rich (yeah!), lower physician salaries, import/outsourch healthcare jobs.

How about we do none of the above, and you move to France?

Sounds good to me!

 

[Ofelia]

With a universal health care system, the end result would be a homogeneous system of mediocrity (similar to what we have in Canada). The sad thing is, for most people, that system would be an upgrade to the quality of health care to which they presently have access.

Actually, the United States is one of few developed countries that does not have a universal health care system. If you must insist that a nationalized system would inevitably produce "mediocre" doctors, then we are faced with two choices: either we all receive "mediocre" care or some of us receive no care. When faced with such a grim choice, it's not difficult to see which is the wiser decision. Of course, health care is not so black and white.

What we need is to form a united front and tell the government that no, we will not work under a nationalized system...so if they want to nationalize healthcare then they better find a good way to train an entire country full of mindless zombie physicians because we won't tolerate it.

Imagine if the country said "free cars for all" and tried to nationalize the automobile industry and make assemblyline workers work for less money and under a bureocracy...the unions would burn Detroit to the ground.

Cars and health care are entirely different matters, as I am sure you realize. 47 millions Americans do not have any health insurance and 82 million Americans lost coverage for a portion of either 2002 or 2003. As a premed, you know that illnesses can occur anytime, and if something serious happens when the patient has no healthcare coverage...well, it's almost certain that this person cannot afford the outrageous costs. That's 82 million people (nearly 1/3 of the American population!) at risk! Adequate health care is essential, much like food and shelter. One simply cannot compare an essential quality such as adequate health care to an nonessential item as a car.

You need to survive. For a physician to survive he (or she) needs to make substantial $$$ in order to pay off debts, secure retirement, and provide for the family. You can do a lot with 65,000 but not when you have a mortgage coupled with its bastard child (med school debt). If I wanted to earn 65,000 a year I'd go establish myself in pharmaceutics or some other lab.

It is true that doctors will not survive if they do not have high salaries to pay off their outrageous debts. Yet I think that the reason medical education is so expensive is precisely that doctors will eventually make more than enough to pay it. Premeds are quite willing to pay the high medical tuitions because they are confident that their future salaries will more than compensate for the temporary state of debt. If salaries do decrease in the future and medical education does not also relatively go down, then we will see less aspiring doctors (yes, I'm aware that we do not want to be doctors purely for their high pay, but most of us are also practical). This would cause a physician shortage; and just like any other shortages in the U.S., policies will change (e.g. the government may subsidize or force the tuition to go down) to ensure that there are enough doctors. So I should not think that we have the worry about this. After all, can anyone think of an occupation whose education is far more expensive than its salary (please do not say acting....).

 

[LifetimeDoc]

You need to survive. For a physician to survive he (or she) needs to make substantial $$$ in order to pay off debts, secure retirement, and provide for the family. You can do a lot with 65,000 but not when you have a mortgage coupled with its bastard child (med school debt). If I wanted to earn 65,000 a year I'd go establish myself in pharmaceutics or some other lab.

Well said!

Especially for those of us "non-traditional" older folks. I'll only be able to put in 20 years as a full-time physician before I'll have to start slowing down (I don't plan on retiring totally). At 42 I'll have $250k of debt, no retirement, and I already own a home with about 10 years left to pay off. Even making $150k a year for 20 years is less than $1.0m saved in the bank, roughly guesstimating. There is a lot of extended risk in becoming a physician, and if our salaries are less than a plumber...it'd be stupid to become one.

 

[mirakate]

Hell, most of the premeds I know (both on here and through the school I attend) barely have what one could call a grasp on reality, let alone any sort of foresight. This is attributable largely to the fact that most of them are too young to have ever had to be 100% self-reliant.

Change "premed" to "people" and you've tagged most of the world.... /cynical

Well said!

Especially for those of us "non-traditional" older folks. I'll only be able to put in 20 years as a full-time physician before I'll have to start slowing down (I don't plan on retiring totally). At 42 I'll have $250k of debt, no retirement, and I already own a home with about 10 years left to pay off. Even making $150k a year for 20 years is less than $1.0m saved in the bank, roughly guesstimating. There is a lot of extended risk in becoming a physician, and if our salaries are less than a plumber...it'd be stupid to become one.

for LifetimeDoc and DKM

 

[Gut Shot]

What they (and the mass media) don't tell you is that nationalized healthcare will screw the patients too. Imagine waiting in a DMV'esque setup for healthcare...more people would die in line than those who would actually receive treatment!

Nice to see fearmongering is making such a comeback.

Many nations, such as France, Germany, Switzerland and Japan, have universal healthcare, quick access to high end procedures, and low to non-existent wait times all while covering their entire populations for a fraction of what we spend. Our system will only become the DMV if we let it.

Speaking as a resident, I see many patients who would be better off, even under a strained system like Canada's. I have a young man who has let a mass in his posterior thorax grow for over a year now because he couldn't afford the workup. Now he's about to lose his house because he's in severe pain and can't work (P.S. It's probably malignant and may have been treatable even six months ago).

Thank God he didn't have to wait in some line, though. That would have been a real tragedy.

 

[Law2Doc]

Well said!

Especially for those of us "non-traditional" older folks. I'll only be able to put in 20 years as a full-time physician before I'll have to start slowing down (I don't plan on retiring totally). At 42 I'll have $250k of debt, no retirement, and I already own a home with about 10 years left to pay off. Even making $150k a year for 20 years is less than $1.0m saved in the bank, roughly guesstimating. There is a lot of extended risk in becoming a physician, and if our salaries are less than a plumber...it'd be stupid to become one.

If you are making this career change "needing" to make over $150k at the other end, you are taking a gamble. While average salaries are higher than this currently, we have seen physician salaries declining 7-10% over the last decade and quite a few of the primary care fields currently already do average under $150k.

As to the OP's initial question, I think most people contend that a nationalized health care will give more significant price control to non-physicians, which will inhibit what physicians can charge per visit/procedure and thus limit physician salaries. This is already coming into play with the reimbursement system we have today, which is forcing certain specialties to work longer hours to get more throughput or face a salary reduction. I seriously doubt this happens at once to put the salaries at a specific number -- rather, the screws would be tightened gradually, as is being seen now.

Moral of the story, is don't expect anything to be guaranteed in this route, and expect to have a comfortable life, but nothing comparable to the lifestyle of physicians of prior generations.

 

[LifetimeDoc]

If you are making this career change "needing" to make over $150k at the other end, you are taking a gamble. While average salaries are higher than this currently, we have seen physician salaries declining 7-10% over the last decade and quite a few of the primary care fields currently already do average under $150k.

No, my point was to illustrate how much you'd make, at least in my situation, over the next 20 years. I'd guesstimate that an average salary of $150k over 20 years (inflation and all) is on the lower end, maybe not the average today but the average over time. If our salaries go below what a plumber makes (or whatever middle-class job you want to come up with), then it's a big risk. Not that it's a big risk making the average physician salary today (which I always hear as around $140k), just that it's a risk if our salaries plummet.

 

[Captain Fantastic]

Adequate health care is essential, much like food and shelter.

What constitutes adequate health care?

 

[zeff]

Thirded. I'd recommend that all of you have a look at Dr. Ron Paul's recent Kaiser Family Foundation healthcare interview. It's available on MP3 or in transcript form:
http://www.kaisernetwork.org/health_cast/health2008hc.cfm?&hc=2258

(If you like what you see, his campaign site is at www.ronpaul2008.com )

Arrgh, enough with the Ron Paul worship; that guy gets more unearned mileage out of his medical degree than an intern talking up a girl in a bar. I know he is an appealing speaker, and makes valid points in debates, but please realize, he is free to say such things precisely because he has zero chance of actually being nominated. If he had even the smallest realistic shot at winning, he would pucker up and speak in focus-group-tested sound bites like any other candidate. He really does have nothing to lose, and your time is better spent on selecting and supporting the viable nominee who most closely reflects your views, not on some Dr. Quixote, tilting at every windmill he can find.

Another peeve, as long as I'm ranting: everybody please stop throwing around the phrase "nationalized healthcare" until you define what you mean by it--are you talking about a single, public payor, or about a legal mandate to buy insurance on the private market, or perhaps something in between? Please recognize, if Congress were to enact legislation mandating every American be covered, as we do with car insurance, physician and mid-level provider income would instantly rise.

P.S. Scutty, I've been meaning to say, I like your signature line, more lefties need to say that. Also, your avatar is sort of a turn-on--oh no, I've said too much....

 

[dochoov]

Ron Paul.

..is the man.

 

[GreenMudPhud]

Salaries will not be under $100,000 per year. We're talking between 150-175 for normal physicians.

 

[TheRealMD]

No, my point was to illustrate how much you'd make, at least in my situation, over the next 20 years. I'd guesstimate that an average salary of $150k over 20 years (inflation and all) is on the lower end, maybe not the average today but the average over time. If our salaries go below what a plumber makes (or whatever middle-class job you want to come up with), then it's a big risk. Not that it's a big risk making the average physician salary today (which I always hear as around $140k), just that it's a risk if our salaries plummet.

Truly, doctors expect to be paid enough to pay off our med school debts. If you start tinkering a lot with that equation, you will definitely see some angry doctors when they remind Congress that it took $100k-$200k and several YEARS of training just to get where they CAN be in a position to pay back loans.

In reality, we need to dispel the myth that doctors make a bunch of money. For the most part, we all know that's not true. But as with several other topics concerning us today, the public doesn't have a clue.

If physician's salaries go down, expect tuition to be subsidized otherwise you WILL have a real physician shortage. No one wants to go into a career where they will live with debt for the rest of their life.

 

[Wanna_B_Scutty]

Arrgh, enough with the Ron Paul worship; that guy gets more unearned mileage out of his medical degree than an intern talking up a girl in a bar. I know he is an appealing speaker, and makes valid points in debates, but please realize, he is free to say such things precisely because he has zero chance of actually being nominated. If he had even the smallest realistic shot at winning, he would pucker up and speak in focus-group-tested sound bites like any other candidate.

Dr. Paul has admitted in several interviews that he knows his odds of winning are... ahem... on the long side. But what he's also said is that he's running in an attempt to disseminate his message. So I don't see any problem at all in talking about his economic theories of health care in this forum. His longshot odds on winning don't preclude the rest of us from talking about and trying to understand his ideas.

He really does have nothing to lose, and your time is better spent on selecting and supporting the viable nominee who most closely reflects your views, not on some Dr. Quixote, tilting at every windmill he can find.

Well, that depends on what I'm trying to do, doesn't it? If I'm trying to get a Republic into office for the win, then yes, I would agree with you. But as the banner under my screen-name should suggest to you, I'm not interested in getting a Republican into the White House. Rather, I'm interested in hearing sustainable ideas for our healthcare system. Currently we have a debt load of 9 trillion, and we have promised a nausea-inducing 40 TRILLION in entitlements to the Baby Boomers. If we were to try to raise that money right now, every man, woman and child would have to pony up $157,000 in order to cover those costs. Both the Republicans and Democrats are to blame for this-- Reps for unsustainable War-state spending and Dems for unsustainable Welfare-state spending. But I just don't see how we can tack healthcare on top of all the rest of this without going totally broke. Thus, I really think we should at least listen to Dr. Paul, no matter where we come from on the political spectrum.

P.S. Scutty, I've been meaning to say, I like your signature line, more lefties need to say that. Also, your avatar is sort of a turn-on--oh no, I've said too much....

Thank you, zeff. Although I must admit I've been wondering how much longer I can be intellectually honest in keeping up the lefty ID. Dr. Paul's candidacy is starting to make me think I might have been a Libertarian all along...

 

[zeff]

Dr. Paul has admitted in several interviews that he knows his odds of winning are... ahem... on the long side. But what he's also said is that he's running in an attempt to disseminate his message. So I don't see any problem at all in talking about his economic theories of health care in this forum. His longshot odds on winning don't preclude the rest of us from talking about and trying to understand his ideas.

That's a fair point, I suppose I am carrying baggage from my former life, when I worked a congressional campaign and then in Washington, where the bottom line is a little more tangible (i.e., getting to 51%). But, an internet forum, of all places, is the right spot for a serious, if idle, discussion of longshots. Shouldn't have jumped on that point so hard.

Well, that depends on what I'm trying to do, doesn't it? If I'm trying to get a Republic into office for the win, then yes, I would agree with you. But as the banner under my screen-name should suggest to you, I'm not interested in getting a Republican into the White House. Rather, I'm interested in hearing sustainable ideas for our healthcare system. Currently we have a debt load of 9 trillion, and we have promised a nausea-inducing 40 TRILLION in entitlements to the Baby Boomers. If we were to try to raise that money right now, every man, woman and child would have to pony up $157,000 in order to cover those costs. Both the Republicans and Democrats are to blame for this-- Reps for unsustainable War-state spending and Dems for unsustainable Welfare-state spending. But I just don't see how we can tack healthcare on top of all the rest of this without going totally broke. Thus, I really think we should at least listen to Dr. Paul, no matter where we come from on the political spectrum.

The nominee of the party one doesn't support matters almost as much as the nominee of the party you plan to vote for in November. I am a liberal first, and I vote for/support/used to work for the Democratic Party secondarily, as a means to advance my views as a liberal. I am unlikely to see a policy I firmly support be advanced strictly by Democrats; progress is made when we bring the other side around on an issue, to reach a degree of harmony between left and right. This is why I care who the Republicans nominate; A nominee Guiliani would represent an important consolidation of ideological turf for my side.

Welfare reform was a GOP hopbbyhorse for decades, but could only be enacted when a Democratic president signed on; the Clean Air Act had to be signed by a moderate Republican president; Medicare Part D had to be pushed through by a Republican (can you imagine the uproar if a Democratic president had signed that bill? Rush Limbaugh's dittohead *****s would have been rioting in the streets, ranting about how American had become a socialist workers' paradise).

You only really win when you convert the other side. Abraham Lincoln once said something perfect along these lines, "I destroy my enemies--I make them my friends".

Thank you, zeff. Although I must admit I've been wondering how much longer I can be intellectually honest in keeping up the lefty ID. Dr. Paul's candidacy is starting to make me think I might have been a Libertarian all along...

I certainly hope we don't lose you to the wing-nuts, like I said above, I don't want us to be the "abortion party", we need all contrarian hands on deck. Just remember, the Libertarian crowd also thinks that if you want to drive somewhere, you should pay to pave a road there Libertarianism works if you are a farmer in 18th century rural England; in 21st century America, we are all irrevocably intertwined in each others' business, so we'd better figure out how to coexist as such without slugging each other.

 

[usermike8500]

What constitutes adequate health care?

Well, if nationalized health care is anything like government-funded dental insurance, cosmetic surgery will most likely fall under the "adequate health care" designation. This is great for me actually. Judging by my family pedigree, I'll be in need of a hair transplant in a few years... and the taxpayers will have to cover the tab.

 

[OCallag]

Arrgh, enough with the Ron Paul worship; that guy gets more unearned mileage out of his medical degree than an intern talking up a girl in a bar. I know he is an appealing speaker, and makes valid points in debates, but please realize, he is free to say such things precisely because he has zero chance of actually being nominated. If he had even the smallest realistic shot at winning, he would pucker up and speak in focus-group-tested sound bites like any other candidate. He really does have nothing to lose, and your time is better spent on selecting and supporting the viable nominee who most closely reflects your views, not on some Dr. Quixote, tilting at every windmill he can find.

ahhhh, i didn't mean to be the impetus for a ron paul love-/hate-fest. i was just pointing out that there is at least ONE politician that doesn't want to take money from doctors.

and, for the love of God, don't limit yourself to "viable" nominees.

 

[badasshairday]

Who cares? Universal healthcare will be good. Most of your premeds have been under your parents health plan and have no clue what its like. Doctors will be paid, maybe not a ****load like they were in the past, but still pretty handsomely. So Nationalized healtcare

 

[Law2Doc]

If physician's salaries go down, expect tuition to be subsidized otherwise you WILL have a real physician shortage. No one wants to go into a career where they will live with debt for the rest of their life.

Although this would be a good idea, you can pretty much expect this NOT to happen, at least in the near term. This is simply not a proposal anyone other than on SDN has made -- Wise or not, we are talking about cutting salaries without any tuition adjustment. Folks who would propose that physicians' salaries should be reduced aren't exactly going to be proposing ways for physicians to better get by. Additionally, this reduction isn't going to happen as a fell swoop -- it would happen gradually -- probably as a continued reduction of reimbursements. Until a problem filling med schools actually starts happenning, there will be no impetus to consider tuition subsidization or other pot sweetening measures.

There are already plenty of people who go into careers that are less lucrative than medicine (eg teaching), so it's not a fact that income is the sole driving force putting people into higher educational seats. Currently half the people who apply to med school don't get in and quite a few of those have reasonable qualifications and actually become physicians via other routes. Thus salaries would have to drop pretty substantially before any shortage would occur in terms of filling schools. So don't expect this to happen.

 

[badasshairday]

Although this would be a good idea, you can pretty much expect this NOT to happen, at least in the near term. This is simply not a proposal anyone other than on SDN has made -- Wise or not, we are talking about cutting salaries without any tuition adjustment. Folks who would propose that physicians' salaries should be reduced aren't exactly going to be proposing ways for physicians to better get by. Additionally, this reduction isn't going to happen as a fell swoop -- it would happen gradually -- probably as a continued reduction of reimbursements. Until a problem filling med schools actually starts happenning, there will be no impetus to consider tuition subsidization or other pot sweetening measures.

There are already plenty of people who go into careers that are less lucrative than medicine (eg teaching), so it's not a fact that income is the sole driving force putting people into higher educational seats. Currently half the people who apply to med school don't get in and quite a few of those have reasonable qualifications and actually become physicians via other routes. Thus salaries would have to drop pretty substantially before any shortage would occur in terms of filling schools. So don't expect this to happen.

I know you are just trying to be real. Bt I feel that you are just a bit too pessimistic.

 

[Law2Doc]

I know you are just trying to be real. Bt I feel that you are just a bit too pessimistic.

I don't think so. Folks on SDN always start saying "if they cut salaries they have to give tuition breaks, loan foregiveness, etc". The world doesn't usually work that equitably. Especially when there is a lot of give in the system (they can drop salaries a lot before it impacts care or the number of doctors).
I don't like the idea of declining salaries any better than anyone. But there is no proposal on the table to make debt easier to handle for professionals, and won't be. Didn't happen when law salaries declined significantly in the 80s (before the law boom) and it won't now in medicine.

 

[voirlesetoiles]

thread had 666 views so I HAD to click on it ... I'm starting to become superstitious... great.


... and nationalized healthcare... I vote yes.

 

[TheRealMD]

I don't think so. Folks on SDN always start saying "if they cut salaries they have to give tuition breaks, loan foregiveness, etc". The world doesn't usually work that equitably. Especially when there is a lot of give in the system (they can drop salaries a lot before it impacts care or the number of doctors).
I don't like the idea of declining salaries any better than anyone. But there is no proposal on the table to make debt easier to handle for professionals, and won't be. Didn't happen when law salaries declined significantly in the 80s (before the law boom) and it won't now in medicine.

From what I know, law students doesn't have an extended period of literally no pay like med students do. Comparing 3 years in law school to 7-11 years in med school+residency and maybe a fellowship if you choose; there's a world of differrnce there. Also, law doesn't have the cap where medicine does. The people that would complain and actually have an effect are the people at the top, and I don't think even with a "decrease in the 80s", they'd be living paycheck to paycheck like most residents do.

 

[novawildcat]

No politician has a problem with screwing the physicians. They're all pretty blunt about that point.

What they (and the mass media) don't tell you is that nationalized healthcare will screw the patients too. Imagine waiting in a DMV'esque setup for healthcare...more people would die in line than those who would actually receive treatment!

Typical argument against national healthcare. ::sigh:: do you mind telling me what the waiting time for health care is for the 40-50 million uninsured Americans? They are waiting an infinite amount time for health care because they have no insurance and can't afford it. It is obvious that you premeds who are still in school have no idea what it is like to live uninsured because you have lived under your parent's insurance plans your entire life. I lived for 1.5 years without insurance and went through the hell that 40+ million Americans are now suffering through. It is absolutely ridiculous.

 

[Law2Doc]

I lived for 1.5 years without insurance and went through the hell that 40+ million Americans are now suffering through. It is absolutely ridiculous.

Your perception will shift when it is coming out of your pocket as a doctor rather than going into your pocket as a patient.

 

[Law2Doc]

From what I know, law students doesn't have an extended period of literally no pay like med students do. Comparing 3 years in law school to 7-11 years in med school+residency and maybe a fellowship if you choose; there's a world of differrnce there. Also, law doesn't have the cap where medicine does. The people that would complain and actually have an effect are the people at the top, and I don't think even with a "decrease in the 80s", they'd be living paycheck to paycheck like most residents do.

Well, during the really bad years lots of law students came out of school to no jobs, so honestly "living paycheck to paycheck" wouldn't have been so bad. I wasn't particularly trying to compare law to medicine, just to suggest that just because salaries go drastically down doesn't mean anyone in power ever feels compassion in terms of tuition breaks. It simply doesn't happen. If you pick a field that suddenly doesn't let you pay your bills, you are SOL and nobody intervenes. There is no "so long as they change this" it's fair.

 

[novawildcat]

Your perception will shift when it is coming out of your pocket as a doctor rather than going into your pocket as a patient.

Maybe, maybe not. I don't feel like I would be one of those docs that has to drive a BMW and live in a 6 BR and 4 car garage house though.

 

[Law2Doc]

Maybe, maybe not. I don't feel like I would be one of those docs that has to drive a BMW and live in a 6 BR and 4 car garage house though.

Those days are largely over - there aren't many newly minted physicians getting mansion calliber salaries these days. The question is really whether you will still want to be one of those doctors driving an american car and living in a 2-3 bedroom two car garage house. With a big salary cut even that may no longer be the case, unless you marry or invest really well.

 

[badasshairday]

Those days are largely over - there aren't many newly minted physicians getting mansion calliber salaries these days. The question is really whether you will still want to be one of those doctors driving an american car and living in a 2-3 bedroom two car garage house. With a big salary cut even that may no longer be the case, unless you marry or invest really well.

So we are all screwed?

I don't think so. I know that Canadian physicians gross probably half of what American docs make, yet they still are paid well because malpractice kill them over there.

If or when huge reforms in healthcare occur, like a nationalized healthcare system, a malpractice reform will also occur. I see us following the Canadian system in the future.

 

[hye345]

I don't think so. Folks on SDN always start saying "if they cut salaries they have to give tuition breaks, loan foregiveness, etc". The world doesn't usually work that equitably. Especially when there is a lot of give in the system (they can drop salaries a lot before it impacts care or the number of doctors).
I don't like the idea of declining salaries any better than anyone. But there is no proposal on the table to make debt easier to handle for professionals, and won't be. Didn't happen when law salaries declined significantly in the 80s (before the law boom) and it won't now in medicine.

As far as I know (someone correct me if I'm wrong), lawyers are paid by clients directly; there is rarely a middleman (insurance company, Medicare, etc...). The pay for lawyers fell in the 80's because a)there were too many lawyers and b)at the time, the public had a certain distrust for lawyers, mostly because of the Watergate scandal. Since these problems weren't really the government's 'fault', the government wasn't really obligated to pass legislation that would reduce the debt load for law graduates.

 

[Law2Doc]

If or when huge reforms in healthcare occur, like a nationalized healthcare system, a malpractice reform will also occur. I see us following the Canadian system in the future.

See my discussion with TheRealMD above. There won't likely be a fix to go along with any salary cut -- there is no movement toward that. It is no more likely that you will have malpractice reform than tuition reform. While lots of people on SDN have great ideas of how you can fix the system such that it won't hurt so bad when the axe comes down, the rest of the world isn't thinking along those lines, and so it won't happen -- or if it does it will follow many years later (once the issue impacts or becomes obvious even outside the profession).

 

[limpkitty]

Those days are largely over - there aren't many newly minted physicians getting mansion calliber salaries these days. The question is really whether you will still want to be one of those doctors driving an american car and living in a 2-3 bedroom two car garage house. With a big salary cut even that may no longer be the case, unless you marry or invest really well.

First of all, you need to realize that doctors (especially specialists) make much more money than the typical person. FYI, the median salary per person in this country is 28 grand a year. And for the 150K that even primary care docs make, you can still get a pretty nice house.

And stop being so melodramitic about the healthcare situations for doctors. I haven't heard any politicians shouting that we need to stop paying doctors so much, michael moore never criticizes doctors in this country (only the system they work in), and a single payer system would save money by eliminating the middle man, not by screwing doctors.

 

[hye345]

First of all, you need to realize that doctors (especially specialists) make much more money than the typical person. FYI, the median salary per person in this country is 28 grand a year. And for the 150K that even primary care docs make, you can still get a pretty nice house.

And stop being so melodramitic about the healthcare situations for doctors. I haven't heard any politicians shouting that we need to stop paying doctors so much, michael moore never criticizes doctors in this country (only the system they work in), and a single payer system would save money by eliminating the middle man, not by screwing doctors.

With regards to the 28K that the average American makes: the average American has $0.00 debt, didn't go to school for 12+ years, and doesn't pay malpractice insurance. Don't compare apples to oranges.

 

[Law2Doc]

As far as I know (someone correct me if I'm wrong), lawyers are paid by clients directly; there is rarely a middleman (insurance company, Medicare, etc...). The pay for lawyers fell in the 80's because a)there were too many lawyers and b)at the time, the public had a certain distrust for lawyers, mostly because of the Watergate scandal. Since these problems weren't really the government's 'fault', the government wasn't really obligated to pass legislation that would reduce the debt load of law graduates.

Watergate? That was in 1972 -- and people didn't really blame lawyers for that but the administration. As for how lawyers are paid, you are generally correct, but I'm not sure that gets you to your conclusion (I think I muddied the waters bringing up lawyers but it made sense to me in response to a prior posters specific language).

Nobody in the public is going to have any problem if doctor's salaries get slashed, and they certainly aren't going to feel bad enough to give them a tuition break. My only point was that you shouldn't presume that just because X happens that Y can be expected. It cannot. If salaries get cut, then MAYBE years later if it has a negative impact someone will propose a fix. But I wouldn't go along thinking you can expect it.