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Obamacare and PT

Discussion in 'Physical Therapy' started by DancerFutureDPT, Mar 20, 2010.

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  1. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    Hi guys,

    I know this has been talked about before, but to be frank I'm really too lazy to search through all the forums (I'm in a very frustrated mood, ironically about health insurance since I was turned down today by Humana for being too "high risk" because I was in PT this year for a ballet hip tendonitis thing, so I'm not in the mood to do it). Plus, I think some things have changed since it was last discussed anyway.

    I watched a bit of the press conference thing today, but got bored because everytime I turned it on they weren't talking about health care but instead about each other and how much they love their jobs.

    I've read all the stuff on the blogs, on the APTA website, etc., and I've talked to PTs I work with, but no one seems to know for sure what the changes will mean for PT. I know it's hard to know for sure, but does anyone have any solid/pretty reliable predictions? Or, can someone give a Cliff's notes version of what's out there? Most of what is written is really hard for a non-political person to understand.

    One PT I know says it will be great and business will boom...another one from the same clinic says it's horrible and will cut everyone's salaries in half because insurance won't reimburse (a la California BCBS Anthem) and put caps on PT benefits because the insurance companies will have a financial strain from all the new insured people. Others are saying it will all depend on Medicare and whether Congress passes the exceptions bill at the end of the month. Some say it will force PTs to turn over more work to aides and assistants because they're cheaper to hire. Others say it'll push everything into managed care, which I've heard nothing but bad things about.

    I'm so confused. I've been starting to reconsider PT a bit (a little late since I've already sent in a deposit and have been accepted), because it's a lot of money and I'm completely financing it myself. I'm really terrified of getting into 100k+ of debt and not being able to find a job, or find a job but then not be able to pay back loans sufficiently/put a down payment on a house/get a car because of a drastic cut in salary. I really do love the profession, but I'm afraid of what is happening to it.

    Maybe I'll move to Canada? What is the PT situation there? I've heard that it's great and then I've also heard that PT is a joke up there. So very confused.
    Last edited: Mar 21, 2010
  2. PT Dad

    PT Dad

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    For those who wanted change, its coming and it won't be pretty.
  3. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    haha thanks...but care to elaborate on that a little?
  4. Lizarde

    Lizarde

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    For the reason you stated (denying coverage to a healthy young person with some tendonitis) we need healthcare reform. If reform passes, some of the chances MAY negatively affect certain aspects of care (caps/limitations) , but many others will undoubtedly improve (requiring everyone has coverage/not being denied coverage).

    The way I look see it: if healthcare reform is passed this year we will have 3 years to see how the PT profession is adapting to the changes. By graduation, we will know if certain settings are not financially viable and will not already be tied to any particular subset of the PT profession.

    Think back to the newspaper/internet problem. The students graduating from journalism schools where able to get jobs because they were learning about multimedia journalism when traditional print media was losing ground.
    Pinesfootball likes this.
  5. lee9786

    lee9786

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    You are not alone in your thoughts. I didn't even bother to apply this year albeit having everything done. I just couldn't bring myself to do it. I have also considered taking an ochem and biochem lab and put myself in a position to apply to PA schools. I would only need two credits to do so. I keep hanging on to PT, but I see drastic change in reimbursement structures ahead. While the reimbursement structure changes, the student loan debt remains the same or even increases.

    One can only look at the trends to see what the future might hold. Unfortunately the trends seem to be paying for less care and paying less for the care that is received. Since Medicare reimbursment is a large player in determining how much PTs get paid for treatment, what does its future hold? The can look at the trends in the American population as well. It's now the age of the baby boomers. So it seems as if the demand would be high due to the numbers alone. If you dig deeper though you start looking at the healthcare trends. Diabetes could pose to be a huge problem in the future and cost this system a lot of money. It could also pose to be an opportunity for PTs if they could demonstrate they were effective in decreasing the prevalence.

    PTs could have a bright future if the system moved more towards one in which the patient had to burden more of the medical costs and had more choice in which intervention they deemed successful. For example some of these back surgeries cost much much more than PT treatment. If the patient actually had to pay for the treatment in one way or the other there is a very good chance they would pick PT management first. The core problem right now is everyone else is paying for someone elses care. People don't care what it costs so why not.

    It does seem like the PT profession is headed toward unchartered territory. What you've seen this past decade and the decade before in PT could be something of the past. I have not seen one shred of evidence that suggests that PTs will get paid more in the future. If anything from what I see it's the opposite.
  6. lee9786

    lee9786

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    I think everyone can agree change was needed. Now whether or not that change was a massive stimulus bill, massive bailouts with taxpayer dollars, massive borrowing from other countries, and massive printing of our dollar; I'd can say that just about everyone in this country will agree ten years from now that is not the change we needed. The change this country ultimately needs is an introduction of new parties to our political system because the two we have right now is a joke. We will all be enslaved by our national debt for years. Some economists don't believe we can actually pay it off. So we've thus mortgage our country with China being the bank. If the bank comes to claim their foreclosure it won't be pretty.
  7. MotionDoc

    MotionDoc PT/PhD

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    PT has already proven itself to be as effective, if not more effective than costly surgeries and medical interventions (people forget how much their pharmaceuticals really cost cause they just shell out a copay) for a large number of common ailments...from hypertension and diabetes to chronic low back pain and ACL tears.

    In no likely scenario do I see a drop in PT salaries...in many likely scenarios (for many of the reasons you mentioned above) do I see a maintenance of current salaries if not an increase.

    There is something to be said for preparing for the worst, but undue pessimism is foolish. Is there a chance that the profession will collapse on itself? duh...nothing is impossible...but, call me an extreme optimist, but the profession is being pushed forward by the sort of visionaries that I think this is the perfect time (if there ever is a such time) to be faced with a "change or die" scenario where we I am confident we will adapt to the times.
  8. lee9786

    lee9786

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    I like to consider myself mostly an optimist. There's a certain risk one takes when they are taken by unbridled optimism without considering their bias. So you look at the information available, perceived facts, and trends. I'm under the impression there's fine line between optimism and idealism while the same can be said concerning pessimism and realism. This being said, being overtly pessimistic is destructive so an optimistic mindset is needed to be constructive.

    I've talked to a number of PTs and the one scenario that has shown a potential for economic growth is complete autonomy and cash-for-service only system. Now this system also comes with significant risk. Some PTs believe the dependence on the third-payer parties actually limits their salary potential. They also believe that the free market would help the profession advance quite rapidly. Reason being the PTs would be accountable directly to the patient for results. What this would end up doing is reward the good PTs and weed out the poor.

    The current system poses little reward to be a good or bad PT. The system is flawed. The system is driven soley by an innate desire of the PT to be good. Unfortunately this system hasn't delivered the best results. If an economic incentive was tied into a quality product, you'd see a rapid evolution of this profession.

    Unfortunately the DPT hasn't shown any increase in quality from a perspective of a number of seasoned PTs. Despite the change in degree, the change in practice hasn't occured. While newly graduating DPTs should be making a stand towards EBP many are falling into the oldschool Estim, Usound, treatment models. Basically if the new DPTs don't attempt to change their practice patterns, it will prove that this degree inflation is just that.

    I think most of the blame needs to be on the PT institutions. They should be providing a landscape for PTs to think critically. Unfortunately new research and theories on pain management and manipulation are being ignored by institutions.

    Not only is there a problem with the educational institutions, there is a significant divide in the profession. For example the recent implementation of "Malipalooza." Some PTs believe this is a move in the wrong direction. Some say they are blantantly embarassed. So while there is payment restructuring going on, there also is a confusion of identity in the PT profession.

    There is no doubt that right now is a scary time to be investing so heavily into this degree. All I can say for those that do, it will be an uphill battle. If the DPT shows no advancement in the profession, they will only prove that this was just an excellent example of degree inflation. Quality is not in the degree but the person, but the degree should adequately prepare the practitioner to think at the level of their education.

    I don't know the more I learn the more get get increasing frustrated with the profession. On a positive note PTs should be able to define themselves as the primary neuromuscularskeletal experts. Their success could mean the end of the Chiropractic profession. PTs also provide a low-cost alternative to treatment. So if they capitalize on this opportunity then things could evolve. It won't happen with sitting on the couch though. Many PTs chastize themselves for being overly passive. There will be a necessity to get involved politically or continously watch their reimbursement rates decrease.

    My biggest problem with the profession is the dependence on third party payers. I believe very much in the free market. I think it breeds quality and efficiency. Now PT in the free market is a new concept, at least in this country. Would the PT profession survive in the free market? From what I've researched yes it could do very well? Is this an idealistic viewpoint though? That I don't know.
  9. USCDPT

    USCDPT

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    There are a lot of PTs out there that are bitter toward the DPT degree. My guess is that the PTs you speak to that have informed you are as such or you have a limited view of the big picture. The DPT degree has shown vast improvements in patient outcomes since its inception. I will be more than happy to provide you with articles to back that up. As far as the original question goes, my opinion is that we will have to wait and see because a lot of details of obamacare are still unknown. The easiest way to put this is that if everything ends up being like medicare then it will mean less money for us PTs for the most part because of the low reimbursement. However there is money to be made depending on what setting occurs. Now as far as student loans goes, don't let that deter you. My student loan interest has actually dropped since Obama went into office. Tuition will always increase but he has and is still taking steps towards helping with that issue. I graduate in December and I am going to commission into the Army as a PT so I won't have to worry about this issue (at least for a while) but myself and the rest of my classmates are very optimistic about our future and no PTs that I work with are concerned. There is money to be made out there.
  10. MuscleHead

    MuscleHead

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    the way i look at it, there will always be a demand for pts. that simple fact makes me confident that i'll always have a job. the dpt degree will probably deter many students from pursuing the profession, so i dont think the market will ever get overly saturated with pt's. even with the government takeover, no one can ignore the importance of pt's in the health care community. and, as has been stated before, the dpt will hopefully minimize the amount physician involvement in treatment, thus cutting costs overall, and providing more billable work and autonomy to the pt.
  11. mtm34

    mtm34

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    I have done my best to follow this topic throughout the entire debate, but with that said the political jabber has it made it difficult for me to determine exactly how a practicing physical therapist (and other health care professionals) will be effected by the passing of this legislature. I would greatly appreciate to hear from anyone that has a better direct insight into our profession...
  12. lee9786

    lee9786

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    USCDPT if you have the articles I would like to read them. Musclehead wouldn't the supply of PTs to the workforce be determined by the number of seats in PT schools and not as much the DPT? From what I understand, there isn't a problem with filling seats. Thus the reason there is annual tuition increases. The programs are filling seats, they are just lowering their academic standards in order to do so. In the late ninties the average GPA of applicants was much higher than it is today because there was more competition for each seat.
  13. PT Dad

    PT Dad

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    Dancer,
    Our age difference may have something to do with you not understanding my wry sense of humor. The greatest leader of the 20th century, Winston Churchill once said, "If you are not a liberal at age 20 you don't have a heart. If you are not a conservative at age 40 you dont have a brain." Here's another, by another great leader, Ronald Reagan, "The nine most terrifying words in the English language are: I'm from the GOVERNMENT and I'm here to HELP."

    Or how abouth this little story:
    A young woman was about to finish her first year of college. Like so many others her age, she considered herself to be a very liberal Democrat, and was very much in favor of the redistribution of wealth. She was deeply ashamed that her father was a rather staunch Republican, a feeling she openly expressed. Based on the lectures that she had participated in, and the occasional chat with a professor, she felt that her father had for years harbored an evil, selfish desire to keep what he thought should be his.

    One day she was challenging her father on his opposition to higher taxes on the rich and the addition of more government welfare programs. The self-professed objectivity proclaimed by her professors had to be the truth and she indicated so to her father. He responded by asking how she was doing in school. Taken aback, she answered rather haughtily that she had a 4.0 GPA, and let him know that it was tough to maintain, insisting that she was taking a very difficult course load and was constantly studying, which left her no time to go out and party like other people she knew. She didn't even have time for a boyfriend, and didn't really have many college friends because she spent all her time studying.

    Her father listened and then asked, "How is you friend Audrey doing?" She replied, "Audrey is barely getting by. All she takes are easy classes, she never studies, and she barely has a 2.0 GPA. She is so popular on campus; college for her is a blast. She's always invited to all the parties, and lots of times she doesn't even show up for classes because she's too hung over."

    Her wise father asked his daughter, "Why don't you go to the Dean's office and ask him to deduct a 1.0 off your GPA and give it to your friend who only has a 2.0. That way you will both have a 3.0 GPA and certainly that would be a fair and equal distribution of GPA."

    The daughter, visibly shocked by her father's suggestion, angrily fired back, "That wouldn't be fair! I have worked really hard for my grades! I've invested a lot of time, and a lot of hard work! Audrey has done next to nothing toward her degree. She played while I worked my tail off!"

    The father slowly smiled, winked and said gently, "Welcome to the Republican Party."

    I hope you are understanding where I am leading. No one can say for sure how this government takeover will effect PTs and the entire health delivery system in general but be sure of this, it will cost much more than what Obama claims, it will be inefficient (as all government enterprises are) with rampant fraud, it will raise taxes on all form of income, and it will ration care. Based on past government programs you can count on that.
  14. MuscleHead

    MuscleHead

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    well said PT Dad.
  15. MuscleHead

    MuscleHead

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    i guess what im trying to say is there wont be a huge increase in seats. take nursing for example. nursing is not necessarily easy to get into but its a pretty quick fix (1year accelereated nursing programs). theyre all over the country. the spike in these programs have a caused such a massive wave of nurses flooding the market that the jobs are much more scarce then they used to be.
  16. truthseeker

    truthseeker Senior Member

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    Ditto
  17. hopingtobePT

    hopingtobePT

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    Call me crazy but paying 100k+ for the DPT seems ridiculous even if the pay stays the same. I'm crossing my fingers for a salary increase. How will the APTA continue to justify the DPT?! :eek:
  18. MuscleHead

    MuscleHead

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    i know, right? the cost:income ratio is insane. creates less of an incentive for talented people to pursue the degree.
  19. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    PT Dad,

    I get what you're saying completely...in your first post I just didn't know if you had more insight as to why it will potentially hurt the profession. Like I said, I find it very hard to actually follow everything that is going on, because the stacks of documents are way too heavy with political jargon to make sense to a normal person.

    And I like to think of myself as a libertarian (in ideology, anyway, not practicality)...I don't want the gov't telling me who I can or cannot marry, if I can/can't have an abortion, or whether or not I can put a Christmas tree up in my office at work, but I also don't want them taking my money to use on inefficient, fraudulent public programs that don't work. There are way too many people cheating the system (like my friend who is on food stamps because she had a baby at 21 and is technically single, even though she lives with her country club parents who make more money than I probably ever will....she uses the food stamps to buy groceries for her whole family, although they hardly need it). But in reality, I'm just jealous I haven't figured out a way to do it myself yet. haha.

    But I digress...but I agree with you completely. Given the whole history of gov't programs, I don't see this one panning out any better. It may be good in theory, but so was Communism. What sounds like a good idea is usually very hard to make it work. Just my opinion :)
  20. mtm34

    mtm34

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    okay lets try this out... your adding roughly 32 million american people to the health care system. Simple principle of supply and demand- I can't see how the professional outlook could look poorly for any one in health care, my fear is capitation- maybe instead of seeing 12 patients you have to see 15 or 16 because the reimbursement isn't high enough. Basically my question is what happens to reimbursement per patient?

    If it becomes lower as it looks like medicare is doing- In that case you are lowering quality of care by spending less time with patients or pawning them off to pta's and aides, whatchall think?
  21. MuscleHead

    MuscleHead

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    haha, you should give your friend a piece of your mind. people like that should be arrested, or fined. but definitely one or the other.
  22. PT Dad

    PT Dad

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    mtm34,
    It won't just be 32 million, I believe it will probably be double or triple that number. The reason is that the Democrats are now emboldened to pursue amnesty for illegal aliens. When that happens, the now legal aliens will by law be allowed to bring in their family members to the U.S. Our schools, health system, criminal justice system, etc. will then be overwhelmed and we could see the end of the U.S. as we currently know it. I know this sounds apocalyptic and you may think I'm nuts but the Democrats strategy is to maintain their power and by granting amnesty to illegals they will be in control for many generations. Yes, you can count on working harder and seeing more patients to maintain a certain income, but that will be for everyone in the healthcare field.
  23. truthseeker

    truthseeker Senior Member

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    Its about time for Atlas to shrug. When you have time read the book "Atlas Shrugged" by Ayn Rand. It is about 800 pages and a little slow at times but it just might be the future of America.
  24. lee9786

    lee9786

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    One would think that securing the borders would be of top priority with the emergence of the drug cartels. Instead of higher regulations on who comes in this country there is going to be less? Considering there is a good possibility the cartels are getting their heroin supply from Al queda, maybe a good strategy on fighting these threats would be to secure our borders. The reasoning why we haven't already eludes me. Now there's talk the cartels are actually obtaining a political influence. Yes very scary. I'm sure this corrupted nature will include both Republicans and Democrats. Time we start embracing other alternatives. Tea party?
  25. lee9786

    lee9786

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    http://en.wikipedia.org/wiki/Atlas_Shrugged
  26. GOBENGALS

    GOBENGALS

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    Agreed. I was thinking the same thing earlier today.
  27. lee9786

    lee9786

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    I think reimbursement will decrease per patient. The costs could be shifted more to the patient through higher copays. This could also decrease the demand for services. In all though it does look like patient-PT interaction will decrease while administrative tasks and paperwork increase. I do think the use of PTAs and PT aides will increase to help dilute the service.
  28. ksquared303

    ksquared303

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    I love how everyone on this page talks about their own interests. I know that I got it to PT not to make a big lump of money but to help people. How many people out there are going to be helped by this?

    Big government this and big government that, it's such a simple narrative to follow. The companies need restrictions to stop the atrocities that are occurring. Free market is great in some respects but when related to people's health, the only way to get money for your shareholders is to deny people coverage. Also, premiums have doubled in the last 10 years and that's not concurrent with inflation and rising health costs. It's just money taken from lack of coverage and placed into the retirement plans of the wealthy.

    If you want the the right information on dividends of the health bill go to factcheck.org. I know it's not specific to PT but its an unbiased, reliable source.
  29. mtm34

    mtm34

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    I didn't get into PT to make a bloody fortune friend but I'm about to start my DPT this summer which will run me about 70K+... I'm not trying to spend 7 years in school to spend 27 in debt? If that makes me a mongul then my apologies... I got interested in this field to help others and live comfortably.
    Last edited: Mar 22, 2010
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  30. ksquared303

    ksquared303

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    Average starting salary for PT before the bill is around 58K per year. You can't tell me that's going under 50K per year. Your in a profession that is making a true difference. How much monetary fullfillment do you need? You're student bills will be paid off easily if you don't intend to live like a rockstar.
  31. Sjohn106

    Sjohn106

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    In case anyone forgot Obama-care also includes obama-education reform...all the loans we are about to take out are straight from the government with many regulations to follow. I'm concerned about funding and government control while I'm trying to get my DPT degree, with apparently more worries with these reforms to follow. As someone who wasnt too work with an geriatric population medicare cuts are VERY concerning. I don't think I.O.U.'s from the government are going to help me pay them back for my loans...although if they're handing them out I guess they should be able to accept them...
  32. MuscleHead

    MuscleHead

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    easily? dude, my program will run 80k, plus living expenses. doesnt make much sense getting into a profession that pays sh*t, when you have to kill yourself in school for 3 years.

    and 60k/year is NOT a lot of money. i'm not expecting to become donald trump through PT, but id like to have an enjoyable life and have something nice to show for all of my hard labor. its called rewarding success...something barrack obama and company seem to not care about.
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  33. lee9786

    lee9786

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    The question you need to ask is why premiums have doubled in the past ten years. Is it due to lack of government intervention? Or could it be due to lack of competition? If you do your research, you'll find that the estimated Medicare fraud is ~ 60 billion annually. How's that for paying for retirement plans, and this is your tax payer dollars. Government promises sound good on paper but in practice don't deliver. Medicare and Medicaid relies on other people paying for care. When you don't pay you don't care how much it costs. It really comes down to that. Personal responsibility diminishes, and the system starts rewarding handouts. Because someone else pays, the services are more likely to be overutilized meaning more "wasted" care.

    I don't feel the least bit bad about doing a cost, benefit analysis regarding what this profession could offer me and my family. In fact I think everyone, including yourself, should be doing the same. A capitalistic system is supposed to encourage and reward hard work as opposed to rewarding handouts. In summary no system is going to be sustainable by sucking the resources out of the hard working to give to those that aren't. What you'll get is people that see no need in working hard and asking where their handout is.

    Medicare and Medicaid is a new socialized idea that is failing. Don't expect Medicare and social security to be there for you. So the youth in this country is being asked to pay for medicare, medicaid, social security as well as the national debt, increasing tuition rates, and increasing taxes. Add to this the increased cost of living, the devaluing of the dollar, a decrease in salary, and a mandate in purchasing health insurance. Basically while you are working hard to pay for everyone else's mistakes and their healthcare you will be struggling to take care of you and your family. We my friends are the generation of very little discretionary income. I surely wouldn't be comparing the salary to that of a rock star. How much really is your net discretionary income. Maybe it's time to check the math.
  34. PT Dad

    PT Dad

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    For all of you that are worried about tuition costs consider that the states are mandated to pay for certain costs under Obamacare. Now how do you think that the states will pay for these costs? Either they will have to raise taxes and fees (including higher education tuition) or cut services elsewhere. Has anyone noticed the recently proposed state tuition increases in California of over 30% that students are up in arms about? Well that will be happenning in every state unless this is stopped. I hear that 14 states will be filing lawsuits in federal court tomorrow challenging the constitutionality of the law once Obama signs it. To see what a disaster this will be one only needs to look at the universal health insurance system that Massachusetts has. Premiums have gone up across the board, services have been cut (the average wait to see a doctor is 42 days), and the system is in the red by at least $3 billion, necessitating an increase in taxes. I have family that lives in Massachusetts and that plan was crafted by a Republican governor at the time, Mitt Romney. The lesson is there is no free lunch and if you want to give a benefit to someone that means you have to take money from someone else. We already have government run health care, its called the Veterans Administration. I also have elderly relatives who have used the services of the VA health system and could relate some horror stories about the level of care they received, but that we'll save for another time. As to how this law will be enforced, the IRS will have the power to garnish your wages, withhold your refunds, and seize your property if all you good little comrades don't purchase your government dictated health insurance.
    Last edited: Mar 22, 2010
  35. ksiem

    ksiem

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    LoL Ksquared bro.. your making an illogical point. You can help people as an RN, LPN, pharmtech, pttech, PTA, etc... Don't bring some selfless attitude into this. No one goes to school for 7 difficult years for $58,000. Sure we all want to help people (hopefully) but our knowledge should be compensated appropriately. If you are able to overlook salary, fine. You are the type of person that promotes the status qou of PT. If you want to push for more AUTONOMY, KNOWLEDGE, RESPONSIBILITY, EFFICACY, etc then you also take on more stress and value which = more compensation. If a doc enters the med route to make good money he's crazy. Eight years + residency (2-4 years). Say a minimum of 10 years with little to no compensation (except for the small amount in residency) to make 150,000 as a GP or maybe more in a high stress position. That doesn't sound that fantastic to me. Their whole education should be figured into their salary and that's 8 years with no pay and 2 with very little. Does that mean their life is about money? Does it mean that the PT's who would like to have room for growth and perhaps a higher salary ceiling are selfish and disregard the American population? NO. Honestly, I have rehabilitated myself many times, and have figured out many things because I could never afford to see a health care provider (you can't do that with all things though). But, many of the population choose to be ignorant on some things and rely on another's expertise (not always a bad thing). At the end of the day it is still a service and PTs as well as other health care providers should love to help people but it doesn't mean we have to be stomped on by MDs, pharmacists, etc. who own the majority of the health care market share.

    Also I could spend 4 years of school getting my business degree, work for a couple years, go get my MBA and make more than a PT. Or I could go to school for 4 years and go to law school and get paid more than a PT. I could get to 2 years of school then 4 years of Pharm school and make on average $30,000 more than a PT. I could go to school for 4 years + 2 years and be a PA and make an average of $10,000 more than a PT. I'm sure that many people on this forum aren't money seeking, that doesn't mean we can't push for more. The DPT is inflated and it will either burst or it will fill in from the inside.. lets all hope it's the latter.
    Last edited: Mar 22, 2010
  36. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    well...this all sounds promising...my back up plan is to teach A&P at a community college...one by me pays $49,000 to their A&P profs that only teach 2-3 classes/week. Cake.

    ...so back to my other original question...how's life in Canada? I know their healthcare system isn't perfect either, but I'm guessing it's still better than ours? What is the PT situation up there? I've heard PTs are great up there, but I've also heard PTs are thought of as a joke up there (kinda like the stigma chiropractors have here).
  37. Yun

    Yun

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    Why would PT be in a better shape in Canada since Canada has a more government-controlled market and high income tax?

  38. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    Yun...that's what I'm not sure of and why I'm asking. I've heard that PT isn't very well respected in Canada, but I've also heard great things, who knows.

    I'm 99% sure though that there is no DPT in Canada...it's still a Master's. And it's probably a cheaper degree to obtain, and therefore if the salaries aren't as high, at least you're not in a crapload of debt.

    And if I move to Canada it isn't to be a PT...it's just Plan C for if/when this country loses control. No one messes with Canada, because Canada doesn't mess with anyone else. They're just up there chilling out. And I've taken 8 years of high school/college French, so I may as well put it to use :p
  39. MinnDasota

    MinnDasota

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    For those concerned about making only 60K as a PT, there are options to make more. Work per diem or home care on the side and you can easily jump up to 80-90K or even the sacred 100K. My father told me as a young physician, he did quite a bit of moonlighting to make ends meet to pay off loans. Point is, work hard in school to get the degree. Work harder after school to make the money you think you deserve. Our salaries are run by insurance reimbursements and will always be limited by these 3rd party payors.

    Dancer, in your original post, most of what you posted are all of the concerns I have with both the current healthcare system and the new system. The old system was broken and I can only hope for the best with the new system. Either way, I have a job to do as a PT and feel very fulfilled with my middle of the road income.

    ...and sorry that I have no input on Canadian PT.
  40. Cyres

    Cyres

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    1)
    My bitter take. You'll get to pay more taxes for the privilege of being overworked... and for less money. But wait, there's more! As an added benefit you get to experience the intrinsic joy that comes from working with those whose care is free (read: Medicaid patients and their notorious noncompliance issues)... only now it's with everybody. But wait, that's not all! Soon you'll be spending not 25% of your day documenting but 50% or more just to meet the minimum bureaucratic requirements.

    Silver lining: With tens of millions of new patients flooding the market and with less incentive for students to enter health care, there could be merit in the expanding scope of practice theory. Black cloud: Wasn't exactly the practice you wanted to be practicing. Bronze lining: eventually we'll have patient quotas like Great Britain's dentists and end up walking off the job and vacationing half the year once we meet them.
    And I which I could say I was being unrealistically grim...

    2)
    PT Dad - wonderful story.

    3)


    This morning I explained to a "seasoned" PT and two PTAs why we don't apply thermotherapy to a patient's insensate leg that has an infected tunneling wound. Yes, the negative opinions of salty veterans make me feel insecure... either that or it is projected emotion I'm feeling... Regardless, your comment/their opinion was good for a laugh on this otherwise dark day.
  41. JeeDot

    JeeDot

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    PT DAD, I understand your concerns with the healthcare bill. Anyone will admit that the bill is not perfect, but it is not nearly what you describe it to be.

    You Say:

    For all of you that are worried about tuition costs consider that the states are mandated to pay for certain costs under Obamacare. Now how do you think that the states will pay for these costs? Either they will have to raise taxes and fees (including higher education tuition) or cut services elsewhere.

    +++++++++++++++++++++++++++++++++++++++++
    I Say:

    States will receive federal funding to start healthcare exchanges with individuals between 133 and 400% the current poverty level. The Federal government is paying for the bill in mainly 3 ways:

    -increasing medicare tax for families making over $250,000/year. this tax will be expanded to include unearned income from investments.

    -insurance companies will pay an 'excise tax'. they will be forced to pay a 40% tax on plans provided to families worth over $27,500 or $10,200 for individuals. Dental and vision plans are exempt from this.

    -10% tax on indoor tanning services

    The CBO predicts that this plan will reduce the federal deficit by about 143 billion dollars in the first 10 years.

    Also, states will be required to include childless adults in medicaid starting in 2014. the government will pay 100% of costs for all newly eligible individuals through 2016.

    Additionally, states can choose whether or not to provide coverage for abortions in their health exchanges.

    The Federal government is providing these funds to give states time to accumulate funds to support this program. Inability to do so would require increases in taxes and fees and/or reductions in services elsewhere, but can you think of any other service that is more important than healthcare? What's more important than the health of you, your family, and others around you?
    +++++++++++++++++++++++++++++++
    You Say:

    Has anyone noticed the recently proposed state tuition increases in California of over 30% that students are up in arms about? Well that will be happenning in every state unless this is stopped. I hear that 14 states will be filing lawsuits in federal court tomorrow challenging the constitutionality of the law once Obama signs it.

    +++++++++++++++++++++++++++++++++++++++++++
    I Say:

    The student loan reform package that was wrapped into the healthcare bill was designed SPECIFICALLY to address the rising tuition costs. 36 billion dollars in new spending will go towards pell grants. Also, 1.5 billion will be used to make it easier for students to repay their loans.
    http://www.cbsnews.com/stories/2010/03/22/politics/main6321515.shtml

    ++++++++++++++++++++++++++++++++++++++++++++
    You Say:

    To see what a disaster this will be one only needs to look at the universal health insurance system that Massachusetts has. Premiums have gone up across the board, services have been cut (the average wait to see a doctor is 42 days), and the system is in the red by at least $3 billion, necessitating an increase in taxes. I have family that lives in Massachusetts and that plan was crafted by a Republican governor at the time, Mitt Romney.

    +++++++++++++++++++++++++++++++++++++++
    I Say:

    This is an interesting point to consider and you may have a point, although the overall theories are similar, the specifics of the Massachusetts plan and the Federal reform are not. It is impossible to predict precisely what will happen. This is an extremely complicated issue and the all of the effects of this, or any, bill would be impossible to predict. Fortunately, the current health care reform bill has provisions to help Massachusetts specifically.

    ++++++++++++++++++++++++++++++++++
    You Say:

    The lesson is there is no free lunch and if you want to give a benefit to someone that means you have to take money from someone else. We already have government run health care, its called the Veterans Administration. I also have elderly relatives who have used the services of the VA health system and could relate some horror stories about the level of care they received, but that we'll save for another time.

    +++++++++++++++++++++++++++++++++++++++++++++++
    I Say:

    I'm sorry to hear your relatives received poor care in the VA health system, but are you aware that the VA system is widely regarded as one of the best health care systems in the U.S.? In 2003 the New England Journal of Medicine conducted a study to compare the quality of healthcare in VA facilities with that of fee-for-service facilities. VA facilities were rated 'significantly better' in 11 out of 11 measures of quality. Also, the Annals of Internal Medicine conducted a study comparing the quality of treatment for diabetes patients in VA facilities and commercial managed-care systems. Again, VA systems ranked higher in quality of care in 7 out of 7 measures. Also, the VHA system outranks the highest ranked non-VHA hospitals in the National Committee for Quality Assurance's yearly performance measure. Also, about 80% of all VHA patients express satisfaction in the treatment they received.
    http://www.cbo.gov/ftpdocs/88xx/doc8892/MainText.3.1.shtml

    +++++++++++++++++++++++++++++++++++++++++++++++++++++
    You Say:

    As to how this law will be enforced, the IRS will have the power to garnish your wages, withhold your refunds, and seize your property if all you good little comrades don't purchase your government dictated health insurance.

    +++++++++++++++++++++++++++++++++
    I say:

    Are you talking about the individual mandate for health insurance? If so, individuals receive a maximum of a 695$ annual fine if they do not purchase healthcare. There are some exemptions for low-income people. However, I think everyone will agree that it is more expensive for everyone to have individuals NOT insured.

    As I stated before, you have the right to be worried about this bill. The bill is not perfect and your concerns and criticisms are understandable, but the cost of doing nothing is far too great. It costs us all more to have individuals uninsured. Something had to be done. Perhaps if Bush had made some moves during his term, he could have gotten a Republican version of a health care reform bill passed.

    I'm also confused as to why you continue to call this socialist. I would be interested if you could explain to me how providing a cheap, fair alternative to low-income individuals is a socialist idea? Individuals can keep their private insurance if they like it.

    Even if this is socialist (and I don't believe it is), is that really so bad? Did you go to public schools? That's a socialist idea. Have you ever called the police or fire department? Have you ever gone to a public library? Our society already has socialist services throughout it.

    I don't believe the private sector has our best interest when it comes to health care. The current system makes money by denying coverage. A fair, inexpensive government plan is required to keep these insurance companies honest and competitive.

    I apologize that my thoughts above may be a little bit disjointed, but having family members that have been fudged over by private insurance makes this a very personal matter for me.
  42. lee9786

    lee9786

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    So an increase in pell grants and implementation of IBR is going to decrease tuition rates? More funding and more perceived ability to pay down student loans only encourages institutions to increase tuition. Please refer to the video posted in "education reform" where Peter Schiff explains how government involvement in loans is the primary reason the costs have risen.

    There's even evidence showing a privitized primary school system would vastly improve this country's school system as well. Belgium's system of attaching the taxpayer dollars to the student as opposed to the institution gives the option of choice to the student's family which creates incentive for institutions to retain those students. The result is a better education for students and higher salaries for teachers.
  43. truthseeker

    truthseeker Senior Member

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    Jee Dot, you are a political operative. You have neglected a few details.

    Except for union jobs which have been exempted from the excise tax on "cadillac" insurance policies.

    That is everyone who pays taxes. Remember, we supply the money to the federal government. This is Marxism, nothing less.

    Again, I will be paying for other people's children to go to college while I will not be able to afford to send my own.

    That is absurd. Would you rather go to the VA or to the Mayo Clinic? The reason people in the VA system are satisfied is because it is free to them and they never go anywhere else to compare it to an efficient system.

    Ok, I will take a shot at it. Cheap and Fair it will not be. The mnedical decisions will be made by bureaucratic beancounters and no my doctor and me. Individuals can keep their private insurance, sure, but the ultimate goal is a single payer system and you know it. If you don't you are simply thick. With a fine that is lower than the cost of a modest premium for a private plan, the personal fiscally smart thing is to cancel your insurance, wait until you are sick or injured, pay the fine and then sign up for the government plan. viola, all private carriers go away because they can't hope to compete in that type of system. You see, the government doesn't have to balace its books, if runs in the red, it just raises our taxes. Or don't you believe that?
    It is socialist because it takes from those that do and give it to those that don't make good decisions in their lives, prioritize poorly etc. . . and/or choose not to purchase things that they need vs things that they want.

    And here you tip your hand. Not such a bad thing, socialism eh? Schools are a good idea but can you actually say that urban public schools are the best choice for at risk kids? Why is it that none of our politburo, I mean politicians chose to send their kids to the DC public schools? Sounds like some of our comrades are just a little bit more equal than the rest of us.

    As far as the police and fire department, those are hardly socialist. The constitution says that we should provide for the common defense, promote the general welfare and secure the blessings of liberty . . .

    I have had more denials from medicaid than from all of the other payers combined over the last 19 years of practice. Don't tell me who denies treatment to people. The government is already the biggest provider of health care coverage and is bloated, distant, and disorganized. You clearly are well versed in the talking points but just as clearly, don't know the first thing about how health care really works.

    You are part of a column of true believers and a political hack/troll. You do NOT have our best interests at heart and if this bill actually becomes the way things work and is not repealed, then our country will be ruined, bankrupt, and our way of life will be completely changed, for the worse, forever.
  44. JeeDot

    JeeDot

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    Political operative huh....no, try 22 year old student. To be honest, I have better things to do than spend an hour replying to your post. I still stand by every single that I said. All of your arguments take situations to the extreme and you back them up poorly. You neglect that year after year VA clinics ARE ranked higher in terms of quality of care.

    However, it would be impossible to change the minds of people like you. Let's face it, no matter what Obama came out with, a large number of people were going to be against it. I respect your right to have a different opinion, but I'm not going to be reading this thread anymore. Like I said before, it is a waste of my time and I'd be beating a dead horse.

  45. mtm34

    mtm34

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    alright alright everybody simmer down now...
    Try not to be too drastic... what kind of changes from the standpoint of quality of care, salary, patient load, ect. can you forsee changing in a PT's day to day work life under the new bill?
  46. PT Dad

    PT Dad

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    mtm34,
    No one knows until it happens but from recent experience we can assume that the work load will become greater, the paperwork more burdensome and the quality of care will suffer as a result. Case in point, my son in law is a civilain physician at Fort Bragg in North Carolina. The government refuses to hire more docs so they recently increased the patient quota per physician. In addition they now require any doctor who is on call after hours to come into the office and immediately fill out the paperwork even if its 3 AM. Some docs live 25 miles from the hospital so they are up in arms about this new policy. Just a peek at things to come when everyone will be under the jackboot of the feds.
  47. truthseeker

    truthseeker Senior Member

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    JeeDot
    Junior Member


    Status: Rehab Sci Student
    Join Date: Feb 2010
    Posts: 17



    --------------------------------------------------------------------------------

    That is what happened in the debate on healthcare reform. The left set out their talking points without detail. Had people vote on it without reading it. When they balked, they offer bribes and payoffs to those who were on the fence. When someone wanted to debate the issue on its merits they walk away and won't go back and forth to hear anything but what they want to hear. Jee dot did the exact same thing. Drive by posting from a troll who doesn't have a clue about how anything works.

    Name one government program that works as it is intended.

    Heck, I used to say the post office but even they are considering stoppage of Saturday delivery because they too are in the red.

    Pathetic
  48. PT Dad

    PT Dad

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    truthseeker,
    Don't be so hard on the youngster, he/she is only 22 years old, filled with idealism and good will towards all. Not enough life experience yet to think logically. I read somewhere that the frontal lobe is not fully developed until the mid 20's.
  49. truthseeker

    truthseeker Senior Member

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    True but its people like that that vote for this stuff and part of the reason why we are in the predicament we are in. I don't actually believe that he/she is 22 and involved in any way with healthcare. I suspect that he/she is simply someone put onto the blog/forum/chatroom circuit in order to spin the passage of what will be a disaster not just for healthcare in the best system in the world, but for the USA in general.
  50. Sjohn106

    Sjohn106

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    DPT / OTD
    I'm 23 and agree with everything you two are saying PTDAD & truthseeker. It's a battle over being informed, reading history, and actually LISTENING to what the politicians are saying, not what they want you to hear vs watching the news and listening to opinions of everyone around you. Know the values of your country then learn the values of your politicians. Common sense. It is my generation that votes for who is in office now, which is exactly what they're hoping for and who they aim at. It's terribly sad that other people my age don't appreciate the liberties and freedoms we've enjoyed , and are so willing to unknowingly throw them away due to only looking at things on the surface instead of digging a little deeper. I guess you can be happy that a least some of us know better, and a few more are waking up.

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