Oct 2, 2012
99
43
Miami, FL
Status
Pre-Medical
Does anyone have a good website or documentary or anything of the sort where I can learn about our current health care system and about the Affordable Care Act and changes to come?

It is for interview prep and my general knowledge and I would like a neutral site if possible. Please no strong democratic or republican views on why its bad or good but rather just the facts.

Thank you!!!!
 
Apr 11, 2012
211
27
Status
Medical Student
Does anyone have a good website or documentary or anything of the sort where I can learn about our current health care system and about the Affordable Care Act and changes to come?

It is for interview prep and my general knowledge and I would like a neutral site if possible. Please no strong democratic or republican views on why its bad or good but rather just the facts.

Thank you!!!!

http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx


I used this to prep for my interviews. The poster provides citations so it's a reliable source. There is also a very interesting thread that addresses questions regarding doctor's pay and the quality of their care. You can read it here:

http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c537rqi
 

Bacchus

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HopefulSlav

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It encourages waste and physician autonomy goes out the window. It adds 400,000 (plus more with amnesty) people without adding a single doctor. Ah, what could have been.
 
Mar 2, 2012
147
1
It sure feels like the north pole...
Status
Medical Student
It encourages waste and physician autonomy goes out the window. It adds 400,000 (plus more with amnesty) people without adding a single doctor. Ah, what could have been.
I agree that the ACA is not even close to perfect. However, are you suggesting that 400,000 people are being added to the health care system? I would counter that these people are already utilizing the system and not very efficiently at that.
 

sinombre

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I agree that the ACA is not even close to perfect. However, are you suggesting that 400,000 people are being added to the health care system? I would counter that these people are already utilizing the system and not very efficiently at that.
Yep. In other words, these are the people that use ER physicians as their PCPs. Guess who's paying for it?
 

Omppu27

El Tiburon
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I agree that the ACA is not even close to perfect. However, are you suggesting that 400,000 people are being added to the health care system? I would counter that these people are already utilizing the system and not very efficiently at that.
Yep :thumbup:. Now with some coverage these people can get help earlier and won't have to run to the ER for everything...

EDIT: To answer the OPs question, you can go look around the ACA's site: http://www.healthcare.gov/law/

I also get e-mail from the Kaiser Family Foundation: http://www.kff.org/. It is pretty informative.
 

HughMyron

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Jul 15, 2012
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Expect high reimbursement and salary cuts across the board for physicians. Medicine's looking a lot worse now, but it will prob still make a middle class living.

Your friends on Wall Street will laugh at you though. At least mine are making fun of me haha.
 

sinombre

carboloading
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Expect high reimbursement and salary cuts across the board for physicians. Medicine's looking a lot worse now, but it will prob still make a middle class living.

Your friends on Wall Street will laugh at you though. At least mine are making fun of me haha.
There's no way reimbursement cuts will be that drastic.
 

lobo.solo

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May 4, 2011
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It encourages waste and physician autonomy goes out the window. It adds 400,000 (plus more with amnesty) people without adding a single doctor. Ah, what could have been.
OP didn't ask for our input on the matter, but resources so that he can read about it for interview. Don't hate on the not-perfect ACA, is a step forward IMO.
 

touchpause13

nolite te bastardes carborundorum
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OP didn't ask for our input on the matter, but resources so that he can read about it for interview. Don't hate on the not-perfect ACA, is a step forward IMO.
:thumbup:

Also OP I found the reddit thread mentioned earlier to be extremely helpful
 
May 11, 2012
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As a pre-med with no knowledge of health insurance policy or insurance companies in general I can tell you definitively that reimbursements will be slashed by 59.67%. Derms will have to work full time to pay the water bill and pediatricians will qualify for medicaid.
 
Nov 14, 2012
147
0
Status
Pre-Medical
As a pre-med with no knowledge of health insurance policy or insurance companies in general I can tell you definitively that reimbursements will be slashed by 59.67%. Derms will have to work full time to pay the water bill and pediatricians will qualify for medicaid.
:laugh:
 

HopefulSlav

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Jul 21, 2011
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The neurologist and orthopædic surgeon that I shadow are highly opposed to it. They both state that autonomy is going out the window. Example: there are only a few options for treating an ailment. A physician must pick from A,B, or C. If they pick D, they get fined. They both talk about primary care lines starting to pile up. A friend of said neurologist is primary care and had a three-month waiting list in May. I'm not sure of what it is now, it could be better for all I know. I'll ask him this Friday for an update.


Watch this: http://reason.com/reasontv/2012/03/29/remy-pizza
 

Renaissance Man

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Expect high reimbursement and salary cuts across the board for physicians. Medicine's looking a lot worse now, but it will prob still make a middle class living.

Your friends on Wall Street will laugh at you though. At least mine are making fun of me haha.
What exactly is your definition of "middle class"?
 

eleveneleven

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Aug 19, 2008
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For those that want a thorough look at this topic, an interesting option is here:
https://www.coursera.org/course/healthpolicy

It's a MOOC (Massive Open Online Course) called Health Policy and the Affordable Care Act. The start date has not yet been announced but I imagine this course will provide those interested with everything they wanted to know and more.
 
Nov 14, 2012
147
0
Status
Pre-Medical
Physician salaries will never fall to a level where it will no longer be attractive to go through medical training. Or, if it ever does, we're going to have a bigger problem on our hands.
 

Gut Shot

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The neurologist and orthopædic surgeon that I shadow are highly opposed to it. They both state that autonomy is going out the window. Example: there are only a few options for treating an ailment. A physician must pick from A,B, or C. If they pick D, they get fined.
They must have a good laugh after you leave the room.
 

CrimsonKing

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Hahahaha someone grew up in a rich household.

If a household is making over $250K, it's at the border of being upper-class.

Good lord, way too many pre-meds, med students, and physicians have been spoiled by their parents and fail to realize exactly how much money a physician makes compared to the average American, and even more compared to the average person in a developed nation.

Hearing Orthopedic Surgeons complain about salary cuts makes me laugh, especially when it's the spine guys who are already making nearly $1 million/year. Physicians complaining about income changes with the ACA are just upset that they won't be living as luxurious of a lifestyle any more, even though it means that more patients will actually receive coverage for their healthcare.
 

IslandStyle808

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Physician salaries will never fall to a level where it will no longer be attractive to go through medical training. Or, if it ever does, we're going to have a bigger problem on our hands.
It is getting there in some of the rural areas already.
 
Nov 14, 2012
147
0
Status
Pre-Medical
It is getting there in some of the rural areas already.
I thought salaries were higher in rural areas:confused: Unless you mean that there is a physician shortage there, which I thought had more to do with people being attracted to more urban areas.
 

IslandStyle808

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I thought salaries were higher in rural areas:confused: Unless you mean that there is a physician shortage there, which I thought had more to do with people being attracted to more urban areas.
This was actually true a while back. However, in my hometown Hilo on the Big Island of Hawaii, the cost of living is pretty high (around $50,000 a year) and reimbursements are decreasing drastically for physicians (especially PCPs). Thus a lot of them have been leaving the islands.
 
Nov 14, 2012
147
0
Status
Pre-Medical
This was actually true a while back. However, in my hometown Hilo on the Big Island of Hawaii, the cost of living is pretty high (around $50,000 a year) and reimbursements are decreasing drastically for physicians (especially PCPs). Thus a lot of them have been leaving the islands.
Ahh, I see. Is the reimbursement issue directly tied to the ACA, or are there other, region specific issues at play here?
 

IslandStyle808

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Ahh, I see. Is the reimbursement issue directly tied to the ACA, or are there other, region specific issues at play here?
It is more region specific issues actually. The system is currently set up here as well as every else to be pay-per-visit. There not too many people in the rural areas (can't see enough patients in some scenarios) and plus some can't afford insurance. The decline in reimbursements means that the physicians cannot stay in private practices any more thus need to move to hospitals which are located in bigger cities.

I have a family friend who is a cardiologist who had a private practice but could not sustain it and thus worked for Straub hospital.
 
Nov 14, 2012
147
0
Status
Pre-Medical
It is more region specific issues actually. The system is currently set up here as well as every else to be pay-per-visit. There not too many people in the rural areas (can't see enough patients in some scenarios) and plus some can't afford insurance. The decline in reimbursements means that the physicians cannot stay in private practices any more thus need to move to hospitals which are located in bigger cities.

I have a family friend who is a cardiologist who had a private practice but could not sustain it and thus worked for Straub hospital.
Darn, that's too bad :(
 

IslandStyle808

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Wow, I hope things get better eventually. That does look like a pretty rough situation for the PCPs.
Yeah I hope so too. A PCP making only a 100k a year is just ridiculous!
 

Gut Shot

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Ahh, I see. Is the reimbursement issue directly tied to the ACA, or are there other, region specific issues at play here?
Medicare is in the process of bumping reimbursement for primary care, and the ACA is designed to reduce the number of uninsured (which is a huge reason why rural PCPs in Hawai'i are losing their festive shirts). It's a lot easier to sustain a practice if the amount of charity care you are doing plummets.
 

notbobtrustme

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Expect high reimbursement and salary cuts across the board for physicians. Medicine's looking a lot worse now, but it will prob still make a middle class living.

Your friends on Wall Street will laugh at you though. At least mine are making fun of me haha.
[citation needed]

The ACA has no mechanism to reduce reimbursements. That's handled by CMS and that has been the case ever since Medicare was established.

Furthermore, anyone who claims they know what's going to happen to physician salaries is lying or ignorant. There are several mechanisms in the ACA to increase physician reimbursements and hospitals will be rewarded on patient outcomes rather procedures performed.

Moreover, algorithm/checklist medicine has been the case for the past 30 years because lawsuits will force providers into the standard of care lest they get sued for deviating from established guidelines. The ACA simply clarifies and rewards physicians who perform best according to those guidelines.

Finally, from a moral standpoint, increasing the access to healthcare should be a primary goal of any civilized nation. The ACA, while not perfect, is a step in the right direct, just as Medicare was a step in the right direction in the '60s. The US is the only developed nation where medical bankruptcy routinely affects our citizens. We are the only civilized nation that doesn't provide medical care to it's citizenry. For all the talk about rationed care, the US is the worst offender. People die because they don't have access to healthcare. We have invisible rationing, where we simply don't see the care being rationed because those people do not show up to doctors' at all. As Americans, you should be shamed that your neighbors, your friends and your family may be denied healthcare for any number of reasons, including congenital and inherited conditions. If the problem is that we cannot provide enough providers to meet the needs of the citizenry, we need to increase the number of residency and medical spots until that discrepancy is no longer there rather than buying another dozen stealth fighters for a phantom war against Communist Russia that will never happen. The total budget for residency funding is ~8 billion dollars. The cost of a single delivery of a weapon system runs in excess of 10 billion dollars. The failed F-22 program, which the military didn't even want to begin with, cost over 60 billion dollars. The money is absolutely there in the budget for expanding residency and medical school spots; it's a matter of will and perspective.

It boils down to a simple question, do we, as a nation, value our own citizenry?
 
Jun 4, 2012
68
0
Status
Pre-Medical
[citation needed]

The ACA has no mechanism to reduce reimbursements. That's handled by CMS and that has been the case ever since Medicare was established.

Furthermore, anyone who claims they know what's going to happen to physician salaries is lying or ignorant. There are several mechanisms in the ACA to increase physician reimbursements and hospitals will be rewarded on patient outcomes rather procedures performed.

Moreover, algorithm/checklist medicine has been the case for the past 30 years because lawsuits will force providers into the standard of care lest they get sued for deviating from established guidelines. The ACA simply clarifies and rewards physicians who perform best according to those guidelines.

Finally, from a moral standpoint, increasing the access to healthcare should be a primary goal of any civilized nation. The ACA, while not perfect, is a step in the right direct, just as Medicare was a step in the right direction in the '60s. The US is the only developed nation where medical bankruptcy routinely affects our citizens. We are the only civilized nation that doesn't provide medical care to it's citizenry. For all the talk about rationed care, the US is the worst offender. People die because they don't have access to healthcare. We have invisible rationing, where we simply don't see the care being rationed because those people do not show up to doctors' at all. As Americans, you should be shamed that your neighbors, your friends and your family may be denied healthcare for any number of reasons, including congenital and inherited conditions. If the problem is that we cannot provide enough providers to meet the needs of the citizenry, we need to increase the number of residency and medical spots until that discrepancy is no longer there rather than buying another dozen stealth fighters for a phantom war against Communist Russia that will never happen. The total budget for residency funding is ~8 billion dollars. The cost of a single delivery of a weapon system runs in excess of 10 billion dollars. The failed F-22 program, which the military didn't even want to begin with, cost over 60 billion dollars. The money is absolutely there in the budget for expanding residency and medical school spots; it's a matter of will and perspective.

It boils down to a simple question, do we, as a nation, value our own citizenry?
:thumbup: x 1000
 
OP
Papa Doc
Oct 2, 2012
99
43
Miami, FL
Status
Pre-Medical
Does anyone have a source for me to learn about our current health system as it regards to insurance companies, physicians, and hospitals? I have a general idea but no where near enough to hold a convo on the topic in an interview.

Thank you!