I hope you're being sarcastic about the government having superior administrative capabilities.
Definitely not sarcastic. Medicare administrative burden roughly 5%, computerized billing, timely payment, they are, by far, the single largest payer in the country with the BEST performance. Take 99% of the private insurers and you run into 20-30+% administrative burden, piece-meal effieciency, skewed non-standard policies, and WAY more red-tape then most people believe. When my staff communicates with these companies, I feel like we are talking to a crime syndicate, or the old corrupt soviet gov. In the meantime I get the shaft, but hey according to you all's fair, right. They must be doing something right, I mean their CEO's all seem to make six figures, score another victory for capitalism? I don't think so.
As for having the best intentions, you are naive. At the very best your elected representatives will vote more socialism into law in order to pander to their voters, many of whom believe in free lunches even though there is no such thing. It is all downhill from there.
I don't trust any politicians, anymore, and I have lost my faith in the people's voice. The only avenue that works is pouring money into "our" representatives coffers to buy their votes. It been going downhill for awhile, but hey its easier going downhill, much like turning your head and ignoring real problems (like healthcare, education) and pretending to worry about Wally's bottomline (who gives afu$k about that).
So are you for the government dictating your salary or are you against it? I'm not sure.
I've covered this? my salary is predetermined, for that matter as an ER doc yours probably is too, by the fees paid by the semi-socialist system we reside in. If you want to get specific, that is private ins vs government ins, I'd take gov hands down, they pay better, and are less of a hassle to deal with. Surprised? many people probably are, but that is the reality. So much for market-economics (at least for healthcare).
I most certainly am against socialized medicine including the quasi-socialistic system which we have today. You imply that somehow because I am forced to practice in it that I somehow approve. One of the reasons I like the idea of walk in clinics at Wal Mart is that, presumably, the patients will pay out of their own pockets and thus have a pretty good idea what their health care is costing them. This is not a bad thing and is the polar opposite of socialism.
OK, now we are getting somewhere. You agree this is "quasi-socialist" healthcare. That is step one. I know I'm off topic with the clinics (they will probably water-down the care americans receive, all in the name of the almighty dollar, score another for capitalism? I don't think so), but we are discussing the larger problem here. Step two is trying to figure a better way. Wallyworld isn't it, IMO.
I think the way we try to implement health insurance is crazy. Everybody wants an expensive policy that covers almost everything and masks the real cost from the consumer. I think it would be better if people were forced to pay out of pocket for their routine health care and only carried insurance for major medical conditions. When I was a resident at Duke, for example, health insurance for my family was around $1000 per month of which I paid about $250. There is no way in hell we used anything close to $12000 worth of health care. I went to the doctor once, my kids went several times and my wife had an annual exam. We have drug bill of about 100 per month for my ADHD son and that's about it. I would have rather been given the $12000 in salary and bought my own major medical insurance coverage for a lot less, paid for most things out of pocket, and probably have a good amount of money left at the end of the year. We did a variation of this when I was self-employed.
Exactly, your experience shows why this is already a socialist system. Yet, the blind lead the blind, when they tout the market economy, and the "positive" effects on the healthcare that our citizens receive. This isn't about a free lunch (were you looking for a free lunch when you paid for your insurance? does not sound that way to me). This is about people who already pay privately into the health insurance pool (to spread risk), and then turn around and pay again (with taxes) to support Wally's employees healthcare, just so he can keep the change. We get forced into the system, because most have no choice (unless you are otherwise wealthy) and that's the way it is. Wally is winning hands down, we are losing hands down, and the government has thus far done little to mitigate what is only going to be a larger and larger problem.
Health insurance is a business like any other. They also try to drive down their costs. Agreeing to a reimbursment schedule from a private health insurance company is not socialism. In other words, the fact that they aren't paying you what you want is just tough luck for you (and me) and life in the jungle among the predators. You don't have to take insurance. Some physicans do not and do pretty well. Some take insurance and make up for low reimbursement by high volume a la Wal Mart. Many, many physicians in my home state don't take medicaid because they lose money on it. With the exception of medicaid and medicare, market forces do determine what you will get paid. Unfortunately it doesn't always work in our favor.
You are countering your own statements here? First it is socialist, then it isn't, make up your mind. You were right the first time, it is socialist. It just isn't often portrayed that way because a private company is pulling the strings, by definition it would seem capitalist and for the CEO's, and stock holders, it is, but for the participants (consumer, provider, employee) it is socialist through and through. It's a clever guise, nothing more. It's true some physicians don't take insurance, they are the exception. In my neck of the woods 100% of the population is on some form of health insurance (unless they don't qualify for medicaid), so yes, the answer has been to increase volume, but that sucks for everyone (except for the millionare ceo, etc) and is only a short term solution.
On another note, why on earth do you want more money? Aren't you just stealing it from the needy? Why don't you work for the "living wage" and refund the rest.
P. Bear, MD
Emergency Medicine Resident
eek: ) walmart having to provide healthcare, or at least some form of contribution to the greater good (employing the local high school dropouts does not count). Or would you rather have just yourself (doctor?) providing help to those that need it?
