CNN article on doctors driven to bankruptcy

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Arbor Vitae

The North remembers
10+ Year Member
Joined
Sep 25, 2011
Messages
2,272
Reaction score
24
Last edited:
In the future, we'll all be hospital employees.
 
It seems there are obvious ways to make this system work for the patients and workers in the system if we change the structure of the industry and not allow profits to be sucked out of it.

It would seem so, but good luck getting the political capital to make it happen.
 
It seems there are obvious ways to make this system work for the patients and workers in the system if we change the structure of the industry and not allow profits to be sucked out of it.

Sorry, that's not capitalist.

....Which is the short way of saying "ain't gonna happen."
 
Sorry, that's not capitalist.

....Which is the short way of saying "ain't gonna happen."

But why does capitalist economy have to apply to healthcare? It should be treated differently than a normal industry. Read that article about medicare and see what happens when you let capitalism and federal oversight mix. Essentially our tax dollars go to medicare, which then goes to drug companies, etc. Right now there are laws saying that medicare can't look for lower pricing on drugs in their contracts with drug companies. Then drug companies overcharge ridiculously on the customers because it is illegal for medicare to seek lower pricing. Ain't no Obamacare or capitalism ever going to fix that.
 
Last edited:
But why does capitalist economy have to apply to healthcare? It should be treated differently than a normal industry. Read that article about medicare and see what happens when you let capitalism and federal oversight mix.

Agreed.
 
Doctors driven to bankruptcy on CNN

Don't read the reader comments, they will just annoy you as people start arguing about Obamacare. Just thought I'd share. What does the future hold?

Also found this article on the Pharma price scamming of medicare

It seems there are obvious ways to make this system work for the patients and workers in the system if we change the structure of the industry and not allow profits to be sucked out of it.

Interesting article. Ill share my thoughts tmw as I am currently struggling to stay awake. I hope you've sparked a nice discussion here.
 
Interesting article. Ill share my thoughts tmw as I am currently struggling to stay awake. I hope you've sparked a nice discussion here.

Yeah, the article definitely rustled my jimmies.

The main things that bother me are:

1. Allowing drug companies to overcharge medicare, and preventing medicare from changing suppliers

2. The companies say they need profit to research yet spend 19:1 on marketing over research
 
2. The companies say they need profit to research yet spend 19:1 on marketing over research

Gotta love tax dollars funding the 17 Cialis/Viagra ads I sit through every time I watch TV.

😎
 
But why does capitalist economy have to apply to healthcare?

Honestly, it doesn't.



But as long as there are billions of dollars being thrown around, some executives and stockholders will find a way to get their hands in the kitty.
 
But as long as there are billions of dollars being thrown around, some executives and stockholders will find a way to get their hands in the kitty.

When a hospital or doctor's office goes bankrupt, they could end up with a bankruptcy trustee in charge of all operations - main goal to satisfy creditors. A quick google search of "bankruptcy trustee hospital" will turn up some interesting articles.
 
Last edited:
I don't see why independently-run private practices are inherently necessary in providing medical care. Long gone are the days of the independent, "house call" doctor (well I guess there are "concierge" docs, but roll with me here) due to the changing nature and complexity of patient care, and new challenges will certainly necessitate new changes. Is it inherently bad that now doctors will group into larger practices/clinics, hospitals, HMO/ACOs, etc.? Or is it a good thing because it enables more socioeconomically-inclusive, preventive treatment for the people?

We have to re-think the way we provide healthcare in the United States. What we are currently doing is not cost effective and not socially inclusive enough to warrant resistance to reforms. We spend, by far, more than any other developed nation without the results (on average) to show for it. I say "on average" because US healthcare is phenomenal for those who can pay. I recommend reading about more efficient, outside-the-box structures of healthcare delivery, such as the Cleveland Clinic proposals for 21st century care.

Regarding the article, I think it rightly points out that the "great recession" we have been in for nearly a decade is a major cause (well we've technically been out of it, but the pain is still out there and residual effects on markets will take time to disappear). The root causes of the recession were in the investment banks' financial securities markets. Not welfare or taxes or whatever else people like to put in those comments sections.

Another big thing - declining reimbursements - has been occurring for decades due to unprecedented healthcare spending in the budget. These costs are largely driven by treatment of chronic illness. There are two options to reduce these costs -- stop treating expensive people altogether, or start preventing/treating them earlier before they get so expensive. CBO and economists estimate that Obamacare will save money in the budget, leaving the possibility (big maybe) for increased or at least static reimbursements to providers at some point. But the alternatives -- the status quo or letting poor/sick people die -- would certainly not increase reimbursement, or would do so at the cost of patient outcomes.

Malpractice, drugs, and other business costs are important hurdles to deal with. These frustrating restrictions and expensive requirements for providers are legislated by the companies themselves. I don't know how this can be fixed. One strategy in Obamacare is to limit insurance companies' price-gouging by imposing the 80/20 rule (80% of revenue must be spent on customer care). Perhaps similar stipulations can be applied to these other industries related to healthcare. I think the best strategy would be to change Washington culture itself to limit the power of such lobbying (campaign finance reform, congressional term limits, etc.), but that probably won't happen while things are so polarized and cutthroat.
 
Last edited:
business ownership=autonomy, power & status
if all the doctors become employees, the presence of doctors in health care policy-making will be further diminished. doctors will be no different from a regular white collar, aka Dilbert.

Not sure what you mean? If physicians are all employees, they are more easily able to form unions and be able to strike (I know the ethical implications of a strike but I just wanted to state this). This will cause government officials to take more notice of physicians' needs.
 
Last edited:
If anything, I think prominent voices in both the scientific and public policy realms of medicine come from academic institutions, hospitals, and clinics rather than individually-owned practices.
 
Medicine is part Science, part Art (patient care), and part Business. The Business side is very badly broken, and the Business dysfunctions are seriously damaging the Art. The whole system needs a dramatic overhaul. But the big money players (the drug companies, medical equipment makers, hospital companies and insurance companies) are not likely to let that happen because they realize their huge profits by gaming the existing system.

If we look at other countries with excellent healthcare, we could learn a lot about what might work here. But will we do it? No - because of two sacred cows:

- the deeply-ingrained belief in American exceptionalism, and
- the political axiom that Socialism is somehow evil and unAmerican.

Exactly how are we so exceptional? Once upon a time, perhaps, but much of western Europe and certainly Canada and Australia enjoy our political liberties and fundamental values. Yet we have the persistent belief that what works so well for them could not possibly work here. We're exceptional, don't you know...

And a single-payer medical system would somehow be Socialism, and every good American knows that socialism is evil. I'm not sure how our public schools, police force, libraries, and Medicare sneaked in -- but never let it be heard that anything government-run could possibly be in the public interest when private companies are screaming 'socialist.'

But despite all this, I don't actually fear for the country's future physicians.

They are an intelligent, hard-working group that Americans respect and admire. Even in the most virulent healthcare rants, it is not generally the physicians who are blamed. The politicians, drug companies, insurance companies -- fair game. The actual physicians are not. Can they continue to net $300K+ annual incomes? Maybe not. But will they be pulled into the sub-$150K category? Not in this century. Americans want our physicians to be well-compensated. That, and more cynically, the rich and powerful stick together; and that rich and powerful category includes physicians. They won't suffer too much --
 
Exactly how are we so exceptional? Once upon a time, perhaps, but much of western Europe and certainly Canada and Australia enjoy our political liberties and fundamental values. Yet we have the persistent belief that what works so well for them could not possibly work here. We're exceptional, don't you know...
--

Why do you believe that their medical systems are so far superior to ours? I have spent time in Canada and I can say that for individual patients there are some serious flaws in the Canadian health care system. A big part of which is the small profit margins for doctors/hospitals who become deinsentivized to invest in the latest technology or to have ample machines.
 
Why do you believe that their medical systems are so far superior to ours? I have spent time in Canada and I can say that for individual patients there are some serious flaws in the Canadian health care system. A big part of which is the small profit margins for doctors/hospitals who become deinsentivized to invest in the latest technology or to have ample machines.

Why do I believe their system is so much better? Because for the vast majority of people, it simply is. Comparing only to those US residents with the very best insurance, it may not be -- though I've seen studies showing that even for those Americans, most 'socialist' systems are better. But for the sake of argument, let's concede that at its very best, for well-insured Americans with diseases that require the highest tech. care, American healthcare is the best in the world.

But on average - NOT so good. Health crises are, by a wide margin, the number one cause of personal bankruptcies in the US. I would go as far as to say that no American under the age of 65 (Medicare) who does not own a major corporation (and thus cannot be fired) can have true financial security because we are all are vulnerable to enormous medical bills that, without employer-provided health insurance, could wipe out virtually anyone. You lose your job? You lost your health coverage. Over 50? - Good luck finding employment / insurance. Got a pre-existing condition? Something as mundane as high blood pressure or cholesterol can prevent you from even buying decent coverage. (Don't even get me started on individual policies.)

I'm not saying the Canadian system is without flaws. Just as no law can apply to every situation well, no system is without systemic flaws. Canada's medical system has some. Australia's has some. Japan's has some. Ours has many, deep, pervasive flaws.

I've also spent time in Canada and had an unexpected encounter with their medical system. It worked beautifully, efficiently, and inexpensively. What would have been a disaster in the U.S. was a minor inconvenience in Canada. Did it matter that the X-ray machine used to provide care was not the latest technology? Not in the slightest - it was certainly adequate to the task. Was it relevant that the hospital had fewer X-ray machines than its US counterpart might have? Not to me. The 5 hours saved waiting in the ER more than made up for an extra 5 minute wait for an X-ray.

A close family member lives in Australia. In addition to their national health system, which provides necessary and preventative care, people with the means to do so can purchase private supplemental care policies. Those policies get them 'better' hospitals, shorter wait times, single rooms, 'name brand' drugs instead of generic. There are plenty of physicians, and they make good money. But everybody gets the basic care they need.

We would certainly need to do something to keep our advanced research going -- IMO, that's the best thing about U.S. health care. But that challenge is not insurmountable. After all, Switzerland has big pharmaceutical companies AND a 'socialist' healthcare system. Other countries do too.
 
Why even waste your time arguing about this issue? If idiots want to drive doctors out of business, let them. They'll be the ones suffering and dying as a result of ****ty doc-in-a-box/Walmart PCP care.
 
DokterMom said:
But despite all this, I don't actually fear for the country's future physicians.

They are an intelligent, hard-working group that Americans respect and admire. Even in the most virulent healthcare rants, it is not generally the physicians who are blamed. The politicians, drug companies, insurance companies -- fair game. The actual physicians are not. Can they continue to net $300K+ annual incomes? Maybe not. But will they be pulled into the sub-$150K category? Not in this century. Americans want our physicians to be well-compensated. That, and more cynically, the rich and powerful stick together; and that rich and powerful category includes physicians. They won't suffer too much --

Physician reimbursement will never fall too low, because if it did, all the older docs would be living better off their retirement incomes, so they'll just quit. Which, of course, would end in disaster for the patients, especially in rural areas where there might just be one health practitioner to go to. The government wouldn't want that.

I don't know how bad things are going to get. But I remain somewhat optimistic in believing that it will be possible to make a 250-300K salary working in medicine.

If not, I'll just quit medicine, go to law school, and make living litigating physicians. 🙂
 
It would seem so, but good luck getting the political capital to make it happen.

If anyone really wanted to change things and was willing to put forth lots of time, effort, and personal sacrifice, they would then have to:

1. Know the issue, alternate "solutions," and their own proposed solution very well,

2. communicate it understandably and loudly,

3. gather lots of support (ideally diverse support including lawyers, government officials, media experts/journalists), and be in for constant debates.

I think it's possible for change to happen, but that it requires a big "to do." It's a matter of finding someone who cares enough to take it on and who is also capable of doing so. I guess this applies to a lot of things. There are certainly easier causes out there since this one will likely get the big bucks spin campaign.
 
Last edited:
If anyone really wanted to change things and was willing to put forth lots of time, effort, and personal sacrifice, they would then have to:

1. Know the issue, alternate "solutions," and their own proposed solution very well,

2. communicate it understandably and loudly,

3. gather lots of support (ideally diverse support including lawyers, government officials, media experts/journalists), and be in for constant debates.

I think it's possible for change to happen, but that it requires a big "to do." It's a matter of finding someone who cares enough to take it on and who is also capable of doing so. I guess this applies to a lot of things.

AKA run for president :laugh:
 
Physician reimbursement will never fall too low, because if it did, all the older docs would be living better off their retirement incomes, so they'll just quit. Which, of course, would end in disaster for the patients, especially in rural areas where there might just be one health practitioner to go to. The government wouldn't want that.

I don't know how bad things are going to get. But I remain somewhat optimistic in believing that it will be possible to make a 250-300K salary working in medicine.

If not, I'll just quit medicine, go to law school, and make living litigating physicians. 🙂

It has fallen too low already in some areas. The old docs will quit or they will move to an area where reimbursements are better.

PCPs in rural areas are netting around 100K in my home state for sometime now. It is only going to get worse from here on out. As to how much worse only time will tell.
 
Top