Does anyone doubt if our gov't had a single payor system salaries would collapse

[RabbMD]

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I have only been practicing a few years, but from what I have learned about anesthesiology economics I find it hard to believe any anesthesiologist can conceivably doubt that our current government, under a true single payer government controlled system, would not drastically cut physician reimbursement. The reason I say that is just look at what the government in the form of medicare and medicaid rates pays anesthesiologist. Everyone who is honest has to agree our rates from these government programs are horrible.

This raises the question why are anesthesiologists medicare/caid rates so much worse than most other specialties (and primary care)? Although I was not around the profession when this rate disparity occurred, retrospectively the only conclusion I can come to is that anesthesiologists are paid so little by the government simply because the government can pay them that little. As a hospital based physician who does not bring their own patients with them, anesthesiologists can not "refuse" to see medicare or medicaid patients. To me this is a microcosim of what the government would do to all physicians once they had an effective monopoly.

There is plenty wrong with our healthcare system, and maybe reimbursement is part of the problem. But to me allowing the government to unilaterally decide what to pay physicians out of the goodness of their own hearts looks to be a losers game based on what the government has already done to anesthesiology. Thoughts?

 

[Dimoak]

I think it's pretty widely understood and accepted that if single-payor would be implemented, just about every healthcare practitioner's salary would decrease. It would even decrease with the institution of a government option, as a lot fewer people would have private insurance (especially those who get it from work) since many employers would drop their private group plan in favor of the cheaper government option, which there is little evidence to suggest would pay much better than Medicare and Medicaid.

 

[IN2B8R]

No, I do not doubt that the salaries will collapse. And with that, so will the standard of care...

I have only been practicing a few years, but from what I have learned about anesthesiology economics I find it hard to believe any anesthesiologist can conceivably doubt that our current government, under a true single payer government controlled system, would not drastically cut physician reimbursement. The reason I say that is just look at what the government in the form of medicare and medicaid rates pays anesthesiologist. Everyone who is honest has to agree our rates from these government programs are horrible.

This raises the question why are anesthesiologists medicare/caid rates so much worse than most other specialties (and primary care)? Although I was not around the profession when this rate disparity occurred, retrospectively the only conclusion I can come to is that anesthesiologists are paid so little by the government simply because the government can pay them that little. As a hospital based physician who does not bring their own patients with them, anesthesiologists can not "refuse" to see medicare or medicaid patients. To me this is a microcosim of what the government would do to all physicians once they had an effective monopoly.

There is plenty wrong with our healthcare system, and maybe reimbursement is part of the problem. But to me allowing the government to unilaterally decide what to pay physicians out of the goodness of their own hearts looks to be a losers game based on what the government has already done to anesthesiology. Thoughts?

 

[IlDestriero]

No, I do not doubt that the salaries will collapse. And with that, so will the standard of care...

And, around the same time, the quality of medicine will go up in Canada, Australia, Brazil, etc.😉

 

[IN2B8R]

And, around the same time, the quality of medicine will go up in Canada, Australia, Brazil, etc.😉

Damn, Brazil sounds nice....👍

 

[RedAnesthesia]

And, around the same time, the quality of medicine will go up in Canada, Australia, Brazil, etc.😉

No doubt in my mind. As somebody mentioned in an earlier thread, we would see a reverse brain drain as many physicians would leave the country for higher salaries.

 

[orangele]

Yes I firmly believe that under single payor, payments for anesthesiologists would continue to drop. Rather than pay for what is appropriate for physician care, the government would begin paying for what is appropriate for nursing care (CRNA). Indeed I think once virtually all anesthesiologists have left the profession, the government would then proceed to lower the compensation to CRNAs as well.

This country is no longer a capitalist society. It is no longer a free-market society where intelligence, work ethic, and skill compete to determine compensation. Today, it appears that government knows best who "deserves" compensation, and how much, influenced strongly by what politically active group you belong to.

Sorry I could go on and on about this......

 

[racerx]

And, around the same time, the quality of medicine will go up in Canada, Australia, Brazil, etc.😉

The quality of anesthesia care during tourist surgery in the Dominican Republic is gonna get alot better too!

 

[cfdavid]

The quality of anesthesia care during tourist surgery in the Dominican Republic is gonna get alot better too!

That's an interesting topic to keep an eye on. I guess it depends on where energy (i.e. fuel) costs go in the future. Seems hard to believe that they'll be lower though, over the long haul.

 

[DScully]

This country is no longer a capitalist society. It is no longer a free-market society where intelligence, work ethic, and skill compete to determine compensation. Today, it appears that government knows best who "deserves" compensation, and how much, influenced strongly by what politically active group you belong to.

Totally agree.

What frustrates me the most is that people (ex. government) want both quality and quantity. If you want the best, you need to pay for it. There is no free lunch and if you cannot afford it, someone else will and you will not be able to keep the smartest and brightest. If someone wants to "save the world", then the quality will have to suffer.

There is a reason why natural selection works.