Congress puts off cuts to doctor Medicare payments

Elpenor

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this has been going on for a while, and will continue to.
 

Atlas Shrugged

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TWENTY-FIVE PERCENT?! From what I understand Medicare already pays next to nothing and they want to decrease pay that much? This is absurd; the future looks bleak.

Oh well, I' planning on the military so it's not like I was looking forward to huge paychecks anyway.
 

TooMuchResearch

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TWENTY-FIVE PERCENT?! From what I understand Medicare already pays next to nothing and they want to decrease pay that much? This is absurd; the future looks bleak.

Oh well, I' planning on the military so it's not like I was looking forward to huge paychecks anyway.
And what is your level of understanding?
 

Wolfman89

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Happens every year, no harm no foul. Nothing will end up happening to reimbursements.
That's my general understanding of politics and one reason why I got out. It's hard to fight for "change" when everyone wants it but no one wants it to effect them.
 

WellWornLad

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It's been happening ever since the cuts went into effect in 2002. The cuts were conceived in 1997 to tie medicare spending to economic growth. I'd love to talk to the genius who figured that economic growth was a great predictor of how much we should be spending on health care for people over 65, especially as baby boomers were just about to swamp the market.
 

WorldChanger36

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I don't think I will sweat the gov cutting into my bank a bit. Honestly as long as I can put food on the table, pay off my debt and practice medicine I will be happy. Simple life.
 

DoctwoB

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I don't think I will sweat the gov cutting into my bank a bit. Honestly as long as I can put food on the table, pay off my debt and practice medicine I will be happy. Simple life.
Ohh the naive pre-med. You do realize that practices have overhead that run in the 50-60% range right? That means that a 25% cut of Medicare (revenue) = a 50-70% cut in take home pay (profit) assuming a Medicare dependent practice (fair assumption for specialties dealing with elderly patients).

I love medicine, and would go to med school again even if salaries were cut. I understand that one can still enjoy being a doctor while making less than 100k. You need to understand that if an ESTABLISHED (e.g. the median salary) practice doctor makes 100k, then any doctor starting a practice will make far less, and likely will lose money for several years until their volume picks up to capacity. That would kill the private practice system as we know it, making salaried employment almost a requirement. Now you can argue whether this is a good thing or bad thing, but it will mean that doctor's will no longer be their own bosses, and will answer to administrators instead of patients.

Basically saying the top physician salary should be 100-200k is like saying that that Microsoft should only make 1M in profits. We can tax companies until they are just above the break even point, but this means that every less profitable company (e.g. starting practices) will be dead in the water, and that start ups could no longer happen. Think about it.
 
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Ohh the naive pre-med. You do realize that practices have overhead that run in the 50-60% range right? That means that a 25% cut of Medicare (revenue) = a 50-70% cut in take home pay (profit) assuming a Medicare dependent practice (fair assumption for specialties dealing with elderly patients).
I was just about to write this exact same thing. Have fun paying your mortgage or saving for your kids' college tuition when your pay drops from 150,000 to 75,000 pre-tax overnight.
 

WorldChanger36

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Ohh the naive pre-med. You do realize that practices have overhead that run in the 50-60% range right? That means that a 25% cut of Medicare (revenue) = a 50-70% cut in take home pay (profit) assuming a Medicare dependent practice (fair assumption for specialties dealing with elderly patients).

I love medicine, and would go to med school again even if salaries were cut. I understand that one can still enjoy being a doctor while making less than 100k. You need to understand that if an ESTABLISHED (e.g. the median salary) practice doctor makes 100k, then any doctor starting a practice will make far less, and likely will lose money for several years until their volume picks up to capacity. That would kill the private practice system as we know it, making salaried employment almost a requirement. Now you can argue whether this is a good thing or bad thing, but it will mean that doctor's will no longer be their own bosses, and will answer to administrators instead of patients.

Basically saying the top physician salary should be 100-200k is like saying that that Microsoft should only make 1M in profits. We can tax companies until they are just above the break even point, but this means that every less profitable company (e.g. starting practices) will be dead in the water, and that start ups could no longer happen. Think about it.

....And like I said as long as I can take care of my family, pay of my debt and practice medicine I will be happy. I am not interested in being my own boss or working out side of the hospital system. Nor do I care about making the big bucks, if in the end those on medicare get the care they need and I get the things I need, it is all good.
 

werd

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TWENTY-FIVE PERCENT?! From what I understand Medicare already pays next to nothing and they want to decrease pay that much? This is absurd; the future looks bleak.

Oh well, I' planning on the military so it's not like I was looking forward to huge paychecks anyway.
it's actually medicaid that has low low reimbursement. medicare is currently not too far off from private insurance in terms of most compensation. a lot of medical groups are advocating for a repeal of the growth formula that suggests these medicare cuts; it's something to follow closely.
 
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Ohh the naive pre-med. You do realize that practices have overhead that run in the 50-60% range right? That means that a 25% cut of Medicare (revenue) = a 50-70% cut in take home pay (profit) assuming a Medicare dependent practice (fair assumption for specialties dealing with elderly patients).

I love medicine, and would go to med school again even if salaries were cut. I understand that one can still enjoy being a doctor while making less than 100k. You need to understand that if an ESTABLISHED (e.g. the median salary) practice doctor makes 100k, then any doctor starting a practice will make far less, and likely will lose money for several years until their volume picks up to capacity. That would kill the private practice system as we know it, making salaried employment almost a requirement. Now you can argue whether this is a good thing or bad thing, but it will mean that doctor's will no longer be their own bosses, and will answer to administrators instead of patients.

Basically saying the top physician salary should be 100-200k is like saying that that Microsoft should only make 1M in profits. We can tax companies until they are just above the break even point, but this means that every less profitable company (e.g. starting practices) will be dead in the water, and that start ups could no longer happen. Think about it.
I was just about to write this exact same thing. Have fun paying your mortgage or saving for your kids' college tuition when your pay drops from 150,000 to 75,000 pre-tax overnight.
its not hard to see why he would say that, look at his name "Worldchanger" lol.
 

smq123

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....And like I said as long as I can take care of my family, pay of my debt and practice medicine I will be happy. I am not interested in being my own boss or working out side of the hospital system. Nor do I care about making the big bucks, if in the end those on medicare get the care they need and I get the things I need, it is all good.
Here's the thing. Medicare cuts will actually, most likely, affect your ability to practice good medicine.

Let's say that you work for a hospital system. If the Medicare cuts actually do go through, the hospital you work for will be forced to make some changes. They may have to lay off staff, making it take longer for patients to get the studies/care/tests/treatments that they need. You may also be "encouraged" to get your patients home faster than you would like, because the faster that patients get home, the more money the hospital makes, and the more patients they can get paid for per year.

Let's say that, instead, you work in an outpatient clinic. If you're a PCP, you will find it hard to get your Medicare patients the specialty care they need (eye exams, colonoscopies, etc), because many specialists will stop taking Medicare if they don't get paid for it. If you're a specialist, and you make the decision to still take Medicare, you will be overrun with patients, and will likely be swamped. To see them, and still be able to pay your office staff and keep the lights/electricity on, you'll have to either limit the number of Medicare patients you see (which is a step above not seeing any at all), or you'll have to see more and more patients each day, spending less quality time with them and being one of those doctors who zips in, spends 2 minutes, and then has to zip back out.

Medicare cuts hurt us all, no matter how philosophically blasé we may want to be.
 

WorldChanger36

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Here's the thing. Medicare cuts will actually, most likely, affect your ability to practice good medicine.

Let's say that you work for a hospital system. If the Medicare cuts actually do go through, the hospital you work for will be forced to make some changes. They may have to lay off staff, making it take longer for patients to get the studies/care/tests/treatments that they need. You may also be "encouraged" to get your patients home faster than you would like, because the faster that patients get home, the more money the hospital makes, and the more patients they can get paid for per year.

Let's say that, instead, you work in an outpatient clinic. If you're a PCP, you will find it hard to get your Medicare patients the specialty care they need (eye exams, colonoscopies, etc), because many specialists will stop taking Medicare if they don't get paid for it. If you're a specialist, and you make the decision to still take Medicare, you will be overrun with patients, and will likely be swamped. To see them, and still be able to pay your office staff and keep the lights/electricity on, you'll have to either limit the number of Medicare patients you see (which is a step above not seeing any at all), or you'll have to see more and more patients each day, spending less quality time with them and being one of those doctors who zips in, spends 2 minutes, and then has to zip back out.

Medicare cuts hurt us all, no matter how philosophically blasé we may want to be.

I know but we should not be relying on a government to take care of us now should we.
 

NickNaylor

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I know but we should not be relying on a government to take care of us now should we.
You confuse me. On the one hand you don't care if the government arbitrarily dictates your salary. On the other, you disparage reliance on the government. What?
 

WorldChanger36

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You confuse me. On the one hand you don't care if the government arbitrarily dictates your salary. On the other, you disparage reliance on the government. What?

Yes quite a conundrum from the outside view point. One of those things I looked at, scratch my head and said this is going to confuse somebody....crap....

I feel medicine should be for charity. Of course that is not super popular in this country. Practising medicine for profit feels unethical to me. So you can see why I personally am not bothered by pay cuts as long as my needs are met. Medicare needs to be free of the up and down shift of government, which is why I feel it should be run by private community charities.
Hope that clears some of the corn-fuse-in'...
 

Charles_Carmichael

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Yes quite a conundrum from the outside view point. One of those things I looked at, scratch my head and said this is going to confuse somebody....crap....

I feel medicine should be for charity. Of course that is not super popular in this country. Practising medicine for profit feels unethical to me. So you can see why I personally am not bothered by pay cuts as long as my needs are met. Medicare needs to be free of the up and down shift of government, which is why I feel it should be run by private community charities.
Hope that clears some of the corn-fuse-in'...
Wait what?!
 

WellWornLad

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I feel medicine should be for charity. Of course that is not super popular in this country. Practising medicine for profit feels unethical to me. So you can see why I personally am not bothered by pay cuts as long as my needs are met. Medicare needs to be free of the up and down shift of government, which is why I feel it should be run by private community charities.
Just...wow. You're basically advocating that medicine take up a model of voluntary slavery. That is not super popular anywhere.

This kind of nonsense is what gives liberalism a bad name.
 
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whoknows2012

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Yes quite a conundrum from the outside view point. One of those things I looked at, scratch my head and said this is going to confuse somebody....crap....

I feel medicine should be for charity. Of course that is not super popular in this country. Practising medicine for profit feels unethical to me. So you can see why I personally am not bothered by pay cuts as long as my needs are met. Medicare needs to be free of the up and down shift of government, which is why I feel it should be run by private community charities.
Hope that clears some of the corn-fuse-in'...
Unfortunately your naivety has clouded your mind and this is not a possibility....EVER. Who is going to pay for the education? You cannot tell me that medicine should be for charity, yet students should still have to pay their way through school...I'm assuming you'd think medical education should also be free so what you're REALLY saying is that anyone involved in the healthcare system should be working for free? GL with that...make sure you tell you interviewer when you apply to med school..automatic acceptance:thumbup:
 

NickNaylor

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Yes quite a conundrum from the outside view point. One of those things I looked at, scratch my head and said this is going to confuse somebody....crap....

I feel medicine should be for charity. Of course that is not super popular in this country. Practising medicine for profit feels unethical to me. So you can see why I personally am not bothered by pay cuts as long as my needs are met. Medicare needs to be free of the up and down shift of government, which is why I feel it should be run by private community charities.
Hope that clears some of the corn-fuse-in'...
Good idea in theory, no way in hell that's happening ever. There's no way that you're ever going to get someone to agree to train in a field for a minimum of 11 years (undergrad + med + residency) to work in charity. Not only is it not going to work under our given system, it's just not going to work EVER. You would really have to find some extremely altruistic people to agree to that. And while you might find some, you're not going to find enough to make an industry big enough to care for all people.

Probably the most naive thing I've ever read on SDN. In fact, good enough to be added to my signature hall of fame.
 

boggvir

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He probably phrased it wrong. Most industrialized countries except the US have a government healthcare system, which is probably what he means.
 

NickNaylor

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He probably phrased it wrong. Most industrialized countries except the US have a government healthcare system, which is probably what he means.
He said explicitly that he wants medicine to be "free of the up and down shift of government" and "should be run by private community charities." Don't think there's much of a way of misinterpreting that.
 

boggvir

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He said explicitly that he wants medicine to be "free of the up and down shift of government" and "should be run by private community charities." Don't think there's much of a way of misinterpreting that.
Missed that. Yea....it's ******ed.
 

chinocochino

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Cool. When you are making 50,000 gross after your 7+ years of post-college and loan payments, give me 20,000 gross since you don't need the extra money.


I don't think I will sweat the gov cutting into my bank a bit. Honestly as long as I can put food on the table, pay off my debt and practice medicine I will be happy. Simple life.
 
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WorldChanger36: you've managed to raise the ire of so many people. :p

I agree with you 100% (in theory), but our reasons might be different.

I like your idea because making medicine a charity should weed out all the students who mainly want to become doctors for the money.

It's another argument whether a physician's motivation affects his or her competence, but I think that it might.

After all, wouldn't a family doctor whose main goal is money spend less time with his patients and be more rushed than one who isn't as concerned about money?
 

gravitywave

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WorldChanger sounds like a communist. oh well, i suppose that's his perogative.

FWIW, i happen to believe that money has drawn a lot of people to medicine who ended up becoming good doctors in spite of their baser instincts :D it's not as saintly a profession as some would have you believe.

i'd happily surrender half of my future earnings if it meant zero debt. no foolin'.
 

Negrodamus

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WorldChanger36: you've managed to raise the ire of so many people. :p

I agree with you 100% (in theory), but our reasons might be different.

I like your idea because making medicine a charity should weed out all the students who mainly want to become doctors for the money.

It's another argument whether a physician's motivation affects his or her competence, but I think that it might.

After all, wouldn't a family doctor whose main goal is money spend less time with his patients and be more rushed than one who isn't as concerned about money?
I'm fairly sure most doctors are concerned about money.
 

gettheleadout

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WorldChanger sounds like a communist. oh well, i suppose that's his perogative.

FWIW, i happen to believe that money has drawn a lot of people to medicine who ended up becoming good doctors in spite of their baser instincts :D it's not as saintly a profession as some would have you believe.

i'd happily surrender half of my future earnings if it meant zero debt. no foolin'.
:eek: ...half still seems pretty high
 

smq123

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I know but we should not be relying on a government to take care of us now should we.
You are completely missing the point.

It is not about what "ought" to happen in an ideal world. It is about the way our healthcare system is structured NOW.

I like your idea because making medicine a charity should weed out all the students who mainly want to become doctors for the money.

After all, wouldn't a family doctor whose main goal is money spend less time with his patients and be more rushed than one who isn't as concerned about money?
Both of you need to take business classes before you're even allowed to set foot on a medical school campus.

I AM a Family Medicine resident. Do you honestly think that, even in a family medicine office, all the money that comes in gets put into the doctor's pocket? Do you have any idea how much it costs to keep an office running? Heck, do either of you have ANY idea of how many patients you MUST see just to break even??

As an example - a few years ago, in our office, a cleaning lady was vacuuming the floor. I guess she was too vigorous, and got the vacuum tangled up in the power cord to the vaccine refrigerator. (All vaccines have to be stored at a certain temperature, usually in a refrigerator). She yanked too hard and unplugged the vaccine fridge and the vaccines sat at room temp all night. The office, as a result of that one incident, lost $30,000 of vaccines. IN ONE NIGHT. That's almost as much as I paid for one year of medical school!!

Furthermore, if you run an office as a family doctor, you have no idea how many employees are relying on YOU, as the physician, to make money. If you lose money, if you can't keep your office afloat because you're not as "concerned" about money, you will have to lay off staff members - nurses, techs, front desk staff. Cutting them adrift because I was "not concerned about money" would just be plain irresponsible.

It's too simplistic to set it up as "altruistic and likes patients" vs. "greedy and just out to make a buck." You can still value good patient care and a) be vehemently against Medicare cuts, and b) be concerned about whether or not your office is making a decent amount of money. You can be the biggest patient advocate, but if your office is forced to close because you weren't fiscally responsible enough to keep the lights on, then your PATIENTS are the ones who suffer.
 

gravitywave

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:eek: ...half still seems pretty high
yeah, sounds drastic i know. not to mention the fact that it's a sure financial loser (provided the reimbursement model remains the same for the next thirty years, that's a laugh)

debt blows. even a moderate amount will make you second-guess yourself so much more than you deserve.

EDIT: forgot to mention that the tax regime will have to become more progressive in the next thirty years, so i would never see a lot of that money anyway :p
 

Charles_Carmichael

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I agree with you 100% (in theory), but our reasons might be different.

I like your idea because making medicine a charity should weed out all the students who mainly want to become doctors for the money.
Who's going into medicine these days with the primary purpose of making money? Reimbursements are steadily decreasing, the length and cost (both financial and emotional) of training is immense, etc. If your intent is to make bank, going down the route of medicine is kind of a silly thing to do.

You also can't really correlate someone's motivation to their competency.
 
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It's too simplistic to set it up as "altruistic and likes patients" vs. "greedy and just out to make a buck." You can still value good patient care and a) be vehemently against Medicare cuts, and b) be concerned about whether or not your office is making a decent amount of money. You can be the biggest patient advocate, but if your office is forced to close because you weren't fiscally responsible enough to keep the lights on, then your PATIENTS are the ones who suffer.
Let me make sure that we are on the same page -- what you are essentially saying is that there are a lot of costs associated with running a family practice (nurses, techs, front desk staff). These costs always need to be covered, so a GP is already somewhat restricted when it comes to deciding how much time to spend with patients and how much attention to give them (even before any personal preferences and greed come into the equation).

I agree with this, but I am talking about behavior that goes beyond simply covering overhead costs. I am talking about the GPs who rush through patients and miss symptoms.

The bottom line is that if all doctors were working for free under charities (WorldChanger's hypothetical scenario :p), then this type of behavior would be impossible. But, this scenario would never happen in real life. . .
 

smq123

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I agree with this, but I am talking about behavior that goes beyond simply covering overhead costs. I am talking about the GPs who rush through patients and miss symptoms.

The bottom line is that if all doctors were working for free under charities (WorldChanger's hypothetical scenario :p), then this type of behavior would be impossible. But, this scenario would never happen in real life. . .
<sigh> You're still missing my point.

Overhead costs are high. That's not a secret. A GP's office, in particular, has very high costs because you have to provide a wide range of equipment (equipment to help you take care of children, pregnant women, the elderly, the young, etc.) for a fairly large patient population. It's worse if you see Medicaid patients, because Medicaid does not reimburse well. But, in your scenario where the goal is "social justice," you have to see Medicaid, because they are the ones with less access to healthcare.

In order to just BREAK EVEN, you'd still have to see 20 patients a day, possibly more. How much time would you, even in an ideal world where you are not motivated by money, be able to give 20 patients a day? An hour each? That's 20 hours a day. That doesn't include the amount of time it takes for you to call their insurance companies, do their paperwork, etc. 45 minutes per patient? That's still 15 hours - again, without doing a lick of paperwork, not calling patients back to address their questions or their lab results, etc. 30 minutes each? That's slightly more feasible - 10 hours - but don't forget to tack on a lunch hour, which your employees will almost certainly demand. And then, since you're asking them to work 11 hours a day, you have to pay them overtime...which drives your costs up even further, requiring you to see more patients at a faster pace.

So....what's the solution? You have to see patients at 15 minute intervals. But by the time they sign in, have their vital signs taken, have their information taken, ~8 minute have elapsed. You now have 7 minutes to see that patient....but what other choice did you have?

NOW do you get it??

We're a residency program. But even with 4-5 residents a day seeing 10-14 patients a day (30 minutes each), we STILL do not break even. We were $15,000 in the red last month. Is it any wonder that GPs, even those not motivated by money, still have to see patients faster than they like?

Like I said, your idealism is nice, but so far removed from reality as to be painful. I'd highly recommend taking a business class (or 3) before even thinking about going to medical school.
 

WorldChanger36

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WorldChanger36: If you've got the time, take a look at this article and this person's viewpoint. It'll be an interesting view, if not anything else.

http://www.bdt.com/pages/Peikoff.html

I understand health care is not a right currently. I think it should be but I as I said earlier can not speak for others. I can only do my part and hope others follow and join in. I want to open free clinics where I can and help others get financing when I can. Just because the dream is an impossible utopia does not mean one should not reach for it. I don't think we should reily on the government to do it for us, I feel we should get together as a community and make sure everybody has there needs met. We wouldn't have a medicare problem if communities took care of each other. Health care is a right when we make it one. Besides it benefits the individual to benefit the community before the self.( Not neglect the self )
 

WorldChanger36

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Let me make sure that we are on the same page -- what you are essentially saying is that there are a lot of costs associated with running a family practice (nurses, techs, front desk staff). These costs always need to be covered, so a GP is already somewhat restricted when it comes to deciding how much time to spend with patients and how much attention to give them (even before any personal preferences and greed come into the equation).

I agree with this, but I am talking about behavior that goes beyond simply covering overhead costs. I am talking about the GPs who rush through patients and miss symptoms.

The bottom line is that if all doctors were working for free under charities (WorldChanger's hypothetical scenario :p), then this type of behavior would be impossible. But, this scenario would never happen in real life. . .
Free? Is that the only charity you can think of. Charities employ people all the time. I am not suggesting Doctors work for free because we all have needs. You are exaggerating my expression. I think Doctor should not work for profit, not for free. Charge what you need OR Donate what you don't need. Working for free? Priests don't even do that. My scenario maybe high reaching but it is far from impossible. I could open a few businesses and take the profits from that and use it to pay for a free clinic with other donations or I could use it to provide intrest free medical loan to people that need help paying for a procedure. Shoot I could start a medical version of KIVA to start clinics overseas. All is very possible, and what if every new medical student made a small commitment like this. Such as to provide a 1/6 of the funding needed to start and maintain a free clinic. Little things added up when properly directed. Isn't the point of going into this profession to help ease suffering, help patients make informed medical conditions and perform medical procedure with the intent of healing and improving the patients health and wellbeing?
 

DoctwoB

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Free? Is that the only charity you can think of. Charities employ people all the time. I am not suggesting Doctors work for free because we all have needs. You are exaggerating my expression. I think Doctor should not work for profit, not for free. Charge what you need OR Donate what you don't need. Working for free? Priests don't even do that. My scenario maybe high reaching but it is far from impossible. I could open a few businesses and take the profits from that and use it to pay for a free clinic with other donations or I could use it to provide intrest free medical loan to people that need help paying for a procedure. Shoot I could start a medical version of KIVA to start clinics overseas. All is very possible, and what if every new medical student made a small commitment like this. Such as to provide a 1/6 of the funding needed to start and maintain a free clinic. Little things added up when properly directed. Isn't the point of going into this profession to help ease suffering, help patients make informed medical conditions and perform medical procedure with the intent of healing and improving the patients health and wellbeing?
Healthcare is 17.3% of the US's 14 Trillion dollar economy. A little math tells you that this is over 2.4 trillion dollars. There is absolutely no way to pay for that with private charity. Physician services are 21% of healthcare costs. This includes office salaries, etc. so physician salaries are probably more like 10%. Even if doctors took a 75% paycut, we'd still be looking at 2.2 trillion PER YEAR to fund healthcare. It is simply impossible for private charity to raise this, even if doctors were willing to work for peanuts.

A tip. If you do want to be a worldchanger, don't set your sight on an absolutely impossible goal like reforming healthcare into a charity venture. There are lots of ways to do a lot of good witihin medicine's current framework. Set up a medicaid-only clinic in an underserved area. Work with the Indian health service. Go abroad and help the international health effort. If after going through medical school, racking up 200+k in debt, residency, fellowship, etc. you still want to do good works for peanuts, then more power to you. There are a lot of ways in which doctors who aren't focused on their bottom line or where they live can do great things. But don't expect a functional system based on charity and all healthcare workers being saints.
 
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WorldChanger36

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Healthcare is 17.3% of the US's 14 Trillion dollar economy. A little math tells you that this is over 2.4 trillion dollars. There is absolutely no way to pay for that with private charity. Physician services are 21% of healthcare costs. This includes office salaries, etc. so physician salaries are probably more like 10%. Even if doctors took a 75% paycut, we'd still be looking at 2.2 trillion PER YEAR to fund healthcare. It is simply impossible for private charity to raise this, even if doctors were willing to work for peanuts.

A tip. If you do want to be a worldchanger, don't set your sight on an absolutely impossible goal like reforming healthcare into a charity venture. There are lots of ways to do a lot of good witihin medicine's current framework. Set up a medicaid-only clinic in an underserved area. Work with the Indian health service. Go abroad and help the international health effort.

I respect that. Keep in mind though I didn't paint the seen as broad as you did there. I am thinking on the community level to supplement and assist programs like medicare. Would Charity cover all healthcare cost? No. Would Charity, other not for profit care and Government assistance cover the cost? Yes. Should medicine be done for profit? No. That is what I think. That is just how I want to work. I am sorry if my comments seem disrespectful to you or smq123 it was not my intent.
 

MDub1

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I respect that. Keep in mind though I didn't paint the seen as broad as you did there. I am thinking on the community level to supplement and assist programs like medicare. Would Charity cover all healthcare cost? No. Would Charity, other not for profit care and Government assistance cover the cost? Yes. Should medicine be done for profit? No. That is what I think. That is just how I want to work. I am sorry if my comments seem disrespectful to you or smq123 it was not my intent.
I respect your altruism, but have to disagree. Working for "profit" is not a bad thing. It's exactly what has driven the US economy to the state of prominence it's in. It motivates businesses (including physician-owners) to provide the very best services at the best cost so they get the most business. For-profit businesses accomplish a lot of altruistic motives where non-profit organizations fail. In fact, for-profit businesses might even be the answer to destroying poverty (check out the microfinance movement). There are a lot of problems with our system that warp these incentives and create conflicts-of-interest but the idea of working for profit is not the problem. Just my two cents. I really do admire your desire to help others, though :thumbup:.
 
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The cuts won't happen until we are thoroughly enslaved by the government (federal and state) sponsored monopolies of the INSURANCE COMPANIES over the healthcare field.

Does nobody else see why insurance companies and government are a terrible freakin idea? And then everyone wants to go even further in that direction with directly administrated government insurance?

Eliminate insurance-bargaining, eliminate government interference, improve efficiency, improve quality, lower costs without also killing people.
 

WorldChanger36

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I respect your altruism, but have to disagree. Working for "profit" is not a bad thing. It's exactly what has driven the US economy to the state of prominence it's in. It motivates businesses (including physician-owners) to provide the very best services at the best cost so they get the most business. For-profit businesses accomplish a lot of altruistic motives where non-profit organizations fail. In fact, for-profit businesses might even be the answer to destroying poverty (check out the microfinance movement). There are a lot of problems with our system that warp these incentives and create conflicts-of-interest but the idea of working for profit is not the problem. Just my two cents. I really do admire your desire to help others, though :thumbup:.
Cool beans. It is good to disagree and fight to defend what we think is correct. After all it is what make Democracy strong right? ( Wish congress would stand up for what it thinks is right we would get better results)
I feel medicine is one field where making as much money as possible isn't the best motivator. Perhaps I have just been tainted to the idea of profit because of all the ridiculous things I have seen it do to people. Just when we can exchange human life and the wellbeing of our planet to make a profit I have to draw the line. We all have seen examples of this in medicine today. I am open to the fact that I maybe wrong in my thinking, it happens. In a world without profit would people no long be able to find a reason to better themselves? Maybe, but I don't think so. Perhaps we need to uphold ethics standards to prevent people from getting run over by the juggernaught in the name of profits. It just seems like everyday we deregulate more and more and let profit deside what is right and wrong for us.
I love microlending. I have been a KIVA member for a few months now and wish I could do more. It is the only donation that comes back to benefit another person.
 

Lokhtar

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And then everyone wants to go even further in that direction with directly administrated government insurance?
Works fine enough in other countries that no one wants a return to a laissez-faire healthcare system.

Does nobody else see why insurance companies and government are a terrible freakin idea?
No, they are essential in health care.
 

WorldChanger36

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The cuts won't happen until we are thoroughly enslaved by the government (federal and state) sponsored monopolies of the INSURANCE COMPANIES over the healthcare field.

Does nobody else see why insurance companies and government are a terrible freakin idea? And then everyone wants to go even further in that direction with directly administrated government insurance?

Eliminate insurance-bargaining, eliminate government interference, improve efficiency, improve quality, lower costs without also killing people.
What about giant health saving account/investment pools? A person contributes pay paying into it monthly in exchange for healthcare benefit similar to that of insurance companies now. The more people that are a part of the pool the strong the pool is. No body can be denied coverage for pre-existings as long as the pay into the pool. The younger a person join the pool the less that persons premiums would be per month, so families still get their "discount". Medicare and insurance can then supplement cost. How does that sound? Any better....
 

MDub1

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Cool beans. It is good to disagree and fight to defend what we think is correct. After all it is what make Democracy strong right? ( Wish congress would stand up for what it thinks is right we would get better results)
I feel medicine is one field where making as much money as possible isn't the best motivator. Perhaps I have just been tainted to the idea of profit because of all the ridiculous things I have seen it do to people. Just when we can exchange human life and the wellbeing of our planet to make a profit I have to draw the line. We all have seen examples of this in medicine today. I am open to the fact that I maybe wrong in my thinking, it happens. In a world without profit would people no long be able to find a reason to better themselves? Maybe, but I don't think so. Perhaps we need to uphold ethics standards to prevent people from getting run over by the juggernaught in the name of profits. It just seems like everyday we deregulate more and more and let profit deside what is right and wrong for us.
I love microlending. I have been a KIVA member for a few months now and wish I could do more. It is the only donation that comes back to benefit another person.
You make some good points. I definitely agree that there needs to be some regulation (though I think it needs to be done in order to ensure financial incentives are properly aligned). I as well am open to the idea that I could be wrong.

Works fine enough in other countries that no one wants a return to a laissez-faire healthcare system.
This is not actually not technically true. A lot of countries with universal coverage (such as Japan or Germany) have a private health care system. I actually like this system quite a bit.
 

Lokhtar

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This is not actually not technically true. A lot of countries with universal coverage (such as Japan or Germany) have a private health care system. I actually like this system quite a bit.
It's not laissez-faire capitalism, which was the point (the person I was replying to was against both insurance companies and government). The private insurances are very very heavily regulated in terms of coverage, etc.
 

Longshanks

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Just...wow. You're basically advocating that medicine take up a model of voluntary slavery. That is not super popular anywhere.

This kind of nonsense is what gives liberalism a bad name.
That's not liberalism, that's stupidity and naivety that poster is espousing.
 

gravitywave

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What about giant health saving account/investment pools? A person contributes pay paying into it monthly in exchange for healthcare benefit similar to that of insurance companies now. The more people that are a part of the pool the strong the pool is. No body can be denied coverage for pre-existings as long as the pay into the pool. The younger a person join the pool the less that persons premiums would be per month, so families still get their "discount". Medicare and insurance can then supplement cost. How does that sound? Any better....
you just described Medicare/Medicaid :rolleyes:

i'd like to see what people think of running health insurance similar to the way utilities are run now: privately capitalized, but heavily regulated. this model keeps the lights on, why not your local ER?