Health Insurance for everyone = more doctors?

[EMTB2MD]

What do you guys think? If 12 Million+ Americans are without coverage and we move to a national health care plan for all that means we are going to need more Physicians to service the need out there. This may equate to more applicants being accepted, and new medical schools.

What are some of the negative implications? Lower pay? Less reimbursement?

Love to hear what you guys have to say!

Ken

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[postbacker]

What do you guys think? If 12 Million+ Americans are without coverage and we move to a national health care plan for all that means we are going to need more Physicians to service the need out there. This may equate to more applicants being accepted, and new medical schools.

What are some of the negative implications? Lower pay? Less reimbursement?

Love to hear what you guys have to say!

Ken

That number is way too low - the number of uninsured is over 40 million (seems like I recently saw a figure of 46 million).

If everyone was insured, my guess is that primary care would have to grow substantially to take the load off of emergency rooms that are seeing way too many non-emergent patients...this would be a "good" thing.

 

[relentless11]

What do you guys think? If 12 Million+ Americans are without coverage and we move to a national health care plan for all that means we are going to need more Physicians to service the need out there. This may equate to more applicants being accepted, and new medical schools.

What are some of the negative implications? Lower pay? Less reimbursement?

Love to hear what you guys have to say!

Ken

Actually not quite. They can easily just increase the number of PA's for lower costs. Thats where its supposedly heading for Kaisers Healthcare and other healthcare programs out there. There will probably be more of those "clinics" based in Walmarts as well which take care of routine things. This is of course in addition to building bigger hospitals, and modernizing them. A lot of hospitals are still trying to modernized and just keep up, let alone deal with a larger patient volume. UCSF's main hospital on Parnassus is ANCIENT. They just gave up and have put in a 10-20 year plan to build a new hospital. Thats how long it takes to just get that going.

I believe Newsweek reported something how the PA's are the better jobs of the future. Better "bang for the buck".

I find it unlikely that they will build new schools and admit more students. We already have an overburdened healthcare system in the United States, and its even worse in California. None of the med schools are expanding by much. I think here at UC Davis, they added 2 new slots, but its for rural medicine or something. UC Riverside is toying around with the idea of making a med school, but thats been on the table for some time. The UC Regents will have to debate on the $$$ available, and so forth. Bureacracy, will ultimately prevail and at the very least delay any new med schools from being built anywhere.

As much as a national healthcare system would be great, it probably won't happen in our life times. Too many economic, socio-economic problems to overcome. Both in terms of hospitals, doctors, med schools, and how our economy works in the US. Gotta raise taxes at some point and really American's don't like to raise taxes. Hahah...

 

[njbmd]

Moving to Topics in Healthcare. People who wish to comment can follow and comment there.

 

[McDoctor]

I've always wondered where these figures come from regarding the number of uninsured americans. I always hear "close to 50 million", or something like that, but never hear a source that it is based on. If anyone can post some hard data, please do.

I also don't think we'll see national healthcare anytime soon. This majority democrat congress can't even manage to pass a bill allowing medicare to negoiate lower prices for prescription drugs. In this country, money trumps ideals, at least as far as politics is concerned.

If it did happen, you would see more doctors go into primary care. Demand would be higher, salaries would increase commensurately. PA's are not going to replace doctors. Nobody says "I'm getting frequent chest pain, I better go talk to my PA..." Fewer doctors would go into specialties, because the salary wouldn't be worth all the extra training. And the public would do just fine with fewer specialists. There is already data out there that shows more specialty care does not equal better outcomes.

 

[relentless11]

For whatever its worth, here's a link to my claim about PA's. http://www.boston.com/bostonworks/galleries/best_jobs?pg=7

Same reported on CNN MOney too. http://money.cnn.com/popups/2006/moneymag/bestjobs/frameset.1.exclude.html

Can scroll through the jobs. Apparently PA is #5. The 10-year growth rate of the profession is pretty high. Obviously physicians will never be replaced, but the amount of physicians to PA's may change drastically do to cost-effectiveness. Other issues include topics on decentralized diagnostics which I've actually published on. Might be the wave of the future...for better or for worse.

Another topic to consider is the increased frequency of unneccessary care or increase in high cost procedures if we implement a national healthcare system. Every problem that we have now, will be amplified on the same order of magnitude as the increase in "insured" patients. We will also inherit existing conditions which were left untreated pre-national healthcare. This would also increase the cost of such a system.

Like I said, I would love to see a system come in. It has certainly worked in other countries such as Australia, and a few others in Europe. Maybe someone can look at how Australia deals with their system, and the implications on their health care programs. Aus would probably serve as a decent model for the sake of this thread. However, I must conclude that increased med school admissions should be the least of our concerns..haha. More likely med school admissions would stay the same, as the demand on our healthcare system increases. The tipping point would be when we have some natural disaster/man-made disaster that overwhelms the already impacted healthcare systems in the US.

 

[Miami_med]

I suspect there would be fewer doctors and longer waits

 

[deleted87716]

They can easily just increase the number of PA's for lower costs...I find it unlikely that they will build new schools and admit more students.

Who is "they?"

 

[relentless11]

Who is "they?"

The powers that be that I mentioned in the later component of my post. Kaiser has been looking for more PA's in recent years for example as a cost-effective way to deal with a larger patient load. In regards to med schools, that would be the university administration, such as UC Regents, in the case of my University of California Riverside example.

 

[deleted87716]

The powers that be

Seriously, who?

My point is that there really isn't a mythical "They" in the U.S. healthcare "system." Nobody can simply push buttons and make things happen. It's not that simple.

 

[relentless11]

Seriously, who?

My point is that there really isn't a mythical "They" in the U.S. healthcare "system." Nobody can simply push buttons and make things happen. It's not that simple.

Oh I agree with that. This is more corporate. Kaiser Healthcare for example is huge over here on the west coast. They are a large hospital chain and insurance provider. Over the past few years they've been expanding heavily and thus hired more and more clinical staff including the PA's.

In terms of the US Healthcare System, I can't say, as you said there isn't a person or persons who push a single button. But med school admissions, and so forth are still managed by the school administration. The money needed to make new med schools and expand current med schools mainly lies with the university in question. That would usually fall under the chancellors, and sometimes the overall governing of the school system. I used the UC Regents example since UC Riverside has proposed to build a new med school, and it has been stuck due to costs reasons for a bit. Hence the difficulty in just building new med schools just for CA...a place that really does need more doctors.

Edit: Here's new information on the med school issue for those CA residents that are interested http://www.medschool.ucr.edu/

 

[QuikClot]

All the countries on this chart except us have some form of universal care. I don't see a strong trend towards a greater number of physicians. The UK and Canada, which are perhaps the closest to us culturally, have slightly fewer, despite covering everyone.

You would think more insured people would require more physicians, but if the population as a whole gets healthier, perhaps not.

 

[primadonna22274]

I would like to see it less painful for a practicing PA to become a physician (MD/DO, doesn't matter to me). This means: less expensive tuition, some integration of classes including credit for stuff I've already learned (physical exam, history taking comes to mind), accelerated learning. There is a sizeable ready-and-willing population of experienced PAs (and probably NPs too, but I don't speak for them) who would be up for this. As it stands now, it's very difficult to embrace the idea of giving up full-time work for four more years of medical school and then making a very modest living (about half of my salary or less now) as a resident for another 3-4 years, while incurring huge educational debt beyond the big debt I already took on to become a PA 8 yrs ago. I'll probably do it, eventually, but I wish there was a way around it. I know plenty of other PAs have done it before me, many on this forum, and I appreciate their insight and encouragement. But if we're talking about needing more primary care providers FAST, this would be the pool to tap.

 

[McDoctor]

All the countries on this chart except us have some form of universal care. I don't see a strong trend towards a greater number of physicians. The UK and Canada, which are perhaps the closest to us culturally, have slightly fewer, despite covering everyone.

You would think more insured people would require more physicians, but if the population as a whole gets healthier, perhaps not.

I agree and don't think you would need more physicians. You would need a shift away from specialty care and towards primary care. The most qualified candidates would have to have incentive to go into primary care, instead of the way it exists now.

The sky would not fall if there where 3 or more fewer cardiologists or gastroenterologists or pulmonologists in every market. Heart catherterizations, excessive endoscopies, and high resolution CT scans of the chest every 3-6 months for patients who smoke do not make people live longer. The excess of specialty care in this country arose out of consumer demand, not because it serves a vital public health service. Some specialty care is vital, just not the glut that exists now.

 

[McDoctor]

I would like to see it less painful for a practicing PA to become a physician (MD/DO, doesn't matter to me). This means: less expensive tuition, some integration of classes including credit for stuff I've already learned (physical exam, history taking comes to mind), accelerated learning. There is a sizeable ready-and-willing population of experienced PAs (and probably NPs too, but I don't speak for them) who would be up for this. As it stands now, it's very difficult to embrace the idea of giving up full-time work for four more years of medical school and then making a very modest living (about half of my salary or less now) as a resident for another 3-4 years, while incurring huge educational debt beyond the big debt I already took on to become a PA 8 yrs ago. I'll probably do it, eventually, but I wish there was a way around it. I know plenty of other PAs have done it before me, many on this forum, and I appreciate their insight and encouragement. But if we're talking about needing more primary care providers FAST, this would be the pool to tap.

This is actually not a bad idea, offering an accelerated track for PA's and CRNP's. But the culture of medicine that says "I suffered for 8 long sleep deprived years, therefore everyone that comes after me should as well" makes it unlikely to occur.

 

[primadonna22274]

Agreed...but hope springs eternal.
As for now I try to content myself with being a happy PA (a daily endeavor).
And appreciate time off to enjoy my days away from work....

This is actually not a bad idea, offering an accelerated track for PA's and CRNP's. But the culture of medicine that says "I suffered for 8 long sleep deprived years, therefore everyone that comes after me should as well" makes it unlikely to occur.