If Obama wins...

[dr aaron]

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If this idiot wins, how much of a hit do you guys think the salaray of a FP will take?..and please only attendings or residents reply, i'm not interested in what a med student or pre med have to say...thanks!

 

[MOHS_01]

If this idiot wins, how much of a hit do you guys think the salaray of a FP will take?..and please only attendings or residents reply, i'm not interested in what a med student or pre med have to say...thanks!

Fairly conservative estimate would be a 15-20% revenue loss... which translates into a significantly higher loss in income.

For most docs, the term "salary" is exceedingly inaccurate.... you are paid on a per work basis.

We're all f*****.

 

[lowbudget]

No effect. But as everyone knows from undergrad economics, the answer is always "it depends."

Generally, FP compensation depends on your negotiated contract (salary vs. "eat-what-you-kill"). Salaried contracts are more "sticky" while production contracts will vary depending on your business. Secondly, it'll depend on your payer mix: government vs. commercial insurance vs. self/cash pay. Thirdly, it'll depend on your payer contract, i.e. discounted-fee-for-service (PPO) or capitation (which are rare in some practice areas).

If the economy stagflates, self/cash pay FP's will take a hit. These are your community health centers (like some FP residency programs), your walk-in clinics, your urgent cares as well as your luxury clinics like concierge medicine, botox, and med-spas. Luxuries will take a hit, but the CHC's and walk-ins can go either way.

If the economy stagflates, the unemployment will push more people out of employer-based insurance into the government and self-pay category. Even if you got tax credits to buy your own insurance outside of employment, there's no risk-pooling or "community-rating" to make insurance cheaper. Healthy people will opt out of buying insurance, thus increasing insurance for everyone else.

Commercial insurance follows Medicare anyways. Expect Medicare to grow. Expect Medicaid to grow. And remember both Medicare/Medicaid compete with Afghanistan and Iraq for Congressional appropriations.

If the economy contracts, everyone will suffer, although doctors will suffer less (as usual). The Treasury bailout hopefully extend credit to businesses (large/small) so that unemployment won't be so sharp. The Fed's signaling a rate cut, which should help with some of that liquidity. But both are incredibly pro-inflationary in the long run.

So... I expect some FP's will do well, some worse. Average effect is no change. Long run, I think it'll appear as if salaries are going up... but because of inflation, it may not mean anything.

(But to answer your question, technically, Presidents have no control over the economy. I don't think it matters who's president. It depends on Congress, which controls fiscal policy. The Fed Reserve can lessen the short-term blow by controlling the monetary policy, but it'll depend on how the WORLD market receives it.)

 

[iatrosB]

No effect. But as everyone knows from undergrad economics, the answer is always "it depends."

Generally, FP compensation depends on your negotiated contract (salary vs. "eat-what-you-kill"). Salaried contracts are more "sticky" while production contracts will vary depending on your business. Secondly, it'll depend on your payer mix: government vs. commercial insurance vs. self/cash pay. Thirdly, it'll depend on your payer contract, i.e. discounted-fee-for-service (PPO) or capitation (which are rare in some practice areas).

If the economy stagflates, self/cash pay FP's will take a hit. These are your community health centers (like some FP residency programs), your walk-in clinics, your urgent cares as well as your luxury clinics like concierge medicine, botox, and med-spas. Luxuries will take a hit, but the CHC's and walk-ins can go either way.

If the economy stagflates, the unemployment will push more people out of employer-based insurance into the government and self-pay category. Even if you got tax credits to buy your own insurance outside of employment, there's no risk-pooling or "community-rating" to make insurance cheaper. Healthy people will opt out of buying insurance, thus increasing insurance for everyone else.

Commercial insurance follows Medicare anyways. Expect Medicare to grow. Expect Medicaid to grow. And remember both Medicare/Medicaid compete with Afghanistan and Iraq for Congressional appropriations.

If the economy contracts, everyone will suffer, although doctors will suffer less (as usual). The Treasury bailout hopefully extend credit to businesses (large/small) so that unemployment won't be so sharp. The Fed's signaling a rate cut, which should help with some of that liquidity. But both are incredibly pro-inflationary in the long run.

So... I expect some FP's will do well, some worse. Average effect is no change. Long run, I think it'll appear as if salaries are going up... but because of inflation, it may not mean anything.

(But to answer your question, technically, Presidents have no control over the economy. I don't think it matters who's president. It depends on Congress, which controls fiscal policy. The Fed Reserve can lessen the short-term blow by controlling the monetary policy, but it'll depend on how the WORLD market receives it.)

Well said and thought out 👍

 

[iatrosB]

Well said and thought out 👍

Oops, sorry, I'm not a resident or attending...for 8 more months anyway 😀

 

[hardknox]

If this idiot wins, how much of a hit do you guys think the salaray of a FP will take?..and please only attendings or residents reply, i'm not interested in what a med student or pre med have to say...thanks!

What idiot are we talking about here? I bet you are in the same league with McCain where you do not have the balls to call Obama by his name! It is such a sad reality to see that we want to impose our "democracy" and way of life in other nations but we have the most socially ignorant population on this part of the globe. I don't care who you are but all I know is that you are an educated fool! You make the rest of us look bad.

 

[MOHS_01]

Well said and thought out 👍

I disagree.

Obama's plan will create a shift from current traditional employer coverage pools to government sponsored pools. This alone is enough to decrease compensation. In addition to this, Medicare and Medicaid expenditures will continue to increase beyond fiscally allowed amounts, resulting in further fee schedule cuts. Taken in whole, the net effect will NOT be good for providers.

Salaried positions will not be immune to these changes either. Where do you think that the money for the salary comes from? Ultimately it is generated by services rendered. If you do not cover your nut, you will eventually be cut.

It is true that some docs will make out OK under his plan -- those who predominantly do not get paid for their labors currently because they treat a high percentage of un (or under-)insured individuals with unacceptable levels of bad debt. The vast, vast majority, however, will be sucking their meals through a straw after having our teeth kicked down our throats by the oppressive payer mix that we will be burdened with.

 

[dr aaron]

What idiot are we talking about here? I bet you are in the same league with McCain where you do not have the balls to call Obama by his name! It is such a sad reality to see that we want to impose our "democracy" and way of life in other nations but we have the most socially ignorant population on this part of the globe. I don't care who you are but all I know is that you are an educated fool! You make the rest of us look bad.

ok, Barak HUSSEIN Obama,,,is that better?

 

[H_Caulfield]

What idiot are we talking about here? I bet you are in the same league with McCain where you do not have the balls to call Obama by his name! It is such a sad reality to see that we want to impose our "democracy" and way of life in other nations but we have the most socially ignorant population on this part of the globe. I don't care who you are but all I know is that you are an educated fool! You make the rest of us look bad.

I'm having a hard time defining why, but it isn't surprising to me that "hardknox" is that full-blown socialist's biggest fan. It's plain and simple: Obama HATES America and what it stands for, the ability of some to succeed above others, and the very principles on which the country was formed. He ought to be the president of a European country, not this one. This election, frankly, IS Obama vs. America.

Once we become Europe, unfortunately, there doesn't seem to be another "new world" for us to go to for financial freedom.

 

[hardknox]

I'm having a hard time defining why, but it isn't surprising to me that "hardknox" is that full-blown socialist's biggest fan. It's plain and simple: Obama HATES America and what it stands for, the ability of some to succeed above others, and the very principles on which the country was formed. He ought to be the president of a European country, not this one. This election, frankly, IS Obama vs. America.

Once we become Europe, unfortunately, there doesn't seem to be another "new world" for us to go to for financial freedome.

Socialist or not, it does not negate the fact that many of us are not interested in the issues, all we see here is a non caucasian vs the establishment. We might use all the code words we want for expressing our innermost KKK views but the truth is that this country has many issues to address if we want to compete in the global scene which is gradually sliding away from us.

Hardwork definately has to be compensated appropriately, that is the core of our American dream but how far do we have to go to realise that greed is bringing us all down? McCain or That One might be president come next year but what does that mean to the average person on the street? That is the question we should be asking instead of trying to line our pockkets with green boys.

 

[dr aaron]

Socialist or not, it does not negate the fact that many of us are not interested in the issues, all we see here is a non caucasian vs the establishment. We might use all the code words we want for expressing our innermost KKK views but the truth is that this country has many issues to address if we want to compete in the global scene which is gradually sliding away from us.

Hardwork definately has to be compensated appropriately, that is the core of our American dream but how far do we have to go to realise that greed is bringing us all down? McCain or That One might be president come next year but what does that mean to the average person on the street? That is the question we should be asking instead of trying to line our pockkets with green boys.

kkk views? so therefore if i vote for Mccain instead of Obama that makes me a racist? now you have proven the fact that you are nothing more than a rambling idiot....i could care less what color he is, in less than 2 years I will be deciding on what field of medicine to go into and the outcome of this election will have a big impact on that decision...so when you are done using the ignorant race/Greed, Michael Moore 6th grade logic--then we can have an intelligent conversation, until then, go back to tying yourself to a tree at a construction site.

 

[MOHS_01]

Socialist or not, it does not negate the fact that many of us are not interested in the issues, all we see here is a non caucasian vs the establishment. We might use all the code words we want for expressing our innermost KKK views but the truth is that this country has many issues to address if we want to compete in the global scene which is gradually sliding away from us.

Hardwork definately has to be compensated appropriately, that is the core of our American dream but how far do we have to go to realise that greed is bringing us all down? McCain or That One might be president come next year but what does that mean to the average person on the street? That is the question we should be asking instead of trying to line our pockkets with green boys.

After that little insight I am floored...

Socialism does not work -- it rewards the elite and the lower class while punishing the vast majority of hard working, sacrificing, productive members of a society. To ignore this tried and true fact speaks to either a lack of appreciation for the country that we live in or willful ignorance, both of which disgusts me.

 

[sophiejane]

It's plain and simple: Obama HATES America and what it stands for, the ability of some to succeed above others, and the very principles on which the country was formed. He ought to be the president of a European country, not this one. This election, frankly, IS Obama vs. America.

Oh, please. Spare us the drama. Back that up with facts and see if you can do it without hyperbole, scare tactics, and misrepresentation of the truth.

By the way, keep the discussion to Family Medicine salaries specifically, or we'll move the thread to a forum that addresses more general issues.

 

[H_Caulfield]

Oh, please. Spare us the drama. Back that up with facts and see if you can do it without hyperbole, scare tactics, and misrepresentation of the truth.

By the way, keep the discussion to Family Medicine salaries specifically, or we'll move the thread to a forum that addresses more general issues.

Fact: He has the most liberal voting record in the senate....ever!

If you think that it's a "scare tactic" to point out that this country is slowly moving its way toward socialism, and that Obama will accelerate the process, you're rather naive.

He said something ridiculous at the last debate that nobody should even be allowed to say on American soil, let alone a presidential candidate. Something about how "the republicans are all about the free market, letting free enterprise run wild without regulations."

Durrh! That's what made the country great, and that's why your ancestors came here. That's capitalism, it's natural selection, it's the answer to how we went from bacteria into human beings.

Obama is inches from being a communist, and was in fact affiliated with several of them...something nobody will touch with a 10-foot pole, as nobody will say anything else about him, for fear of being called a racist (totally irrelevant, I know, but true).

Also, cute how you put in your own input before telling us we couldn't talk about this subject, Ms. Moderator.

 

[taXi]

Drama?
I suggest you listen carefully to Barack's economic policy, sophiejane (http://www.youtube.com/watch?v=wf_bOobOwaY This is simply Obama speaking. No spin.).

He explicitly states that "any company that can borrow from the fed should be subject to oversight." In the very next breath he immediately defines the U.S. population as an investment firm. Recall the simple fact that every U.S. dollar in circulation (paper or electronic) is borrowed from the fed. So technically, according to Barack: the way you spend any of your money should be subject to government oversight. So in four years, when I use U.S. currency to put gas in my car and drive to vote in the next presidential election, who under Barack's rule gets to decide my vote?

 

[sophiejane]

Fact: He has the most liberal voting record in the senate....ever!

That's why I'm voting for him.

If you think that it's a "scare tactic" to point out that this country is slowly moving its way toward socialism, and that Obama will accelerate the process, you're rather naive.

No, I think that's hyperbole and that you have no idea what socialism means.

He said something ridiculous at the last debate that nobody should even be allowed to say on American soil, let alone a presidential candidate. Something about how "the republicans are all about the free market, letting free enterprise run wild without regulations."

Look where they and their aversion to deregulation got us. Enough said. See you on election day.

Durrh! That's what made the country great, and that's why your ancestors came here. That's capitalism, it's natural selection, it's the answer to how we went from bacteria into human beings.

Right. Our forefathers stole from the Native Americans, now it's fine and dandy for big corporations and sleazy loan officers to steal from the middle class. Not if I have anything to do with it, which I do with my vote.

Obama is inches from being a communist, and was in fact affiliated with several of them...something nobody will touch with a 10-foot pole, as nobody will say anything else about him, for fear of being called a racist (totally irrelevant, I know, but true).

Again, you have no idea what communism means.

Also, cute how you put in your own input before telling us we couldn't talk about this subject, Ms. Moderator.

True, and I am unapologetic about it. It's my very small reward for my volunteer efforts here.

Now, about Family Medicine...

Obama supports:
1. investing in preventive care
2. investing in electronic medical records

Both of those can have a direct impact on our practices and therefore salaries if done right.

 

[AFSmiley]

Look where they and their aversion to deregulation got us. Enough said. See you on election day.

I'm no expert, maybe I'm wrong, but I think they were pretty big fans of deregulation...

...Not if I have anything to do with it, which I do with my vote.

Ya, umm...I dunno how often you've voted before in recent presidential elections, but Texas isn't exactly on Obama's "swing radar". Unless you're a transplant...I don't see Texas going Democrat anytime soon.

Obama supports:
1. investing in preventive care
2. investing in electronic medical records

So does McCain:

"By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs."

I know I'm not allowed to post on this thread because I'm a lowly medical student and all, but what the hell, I'll take a stab. I believe the healthcare debate boils down to this statement: "People generally agree that the healthcare system in this country does not match our values as a nation, and we want to change the system so that it more closely resembles our values system." Here's my simple-stupified summary of the candidate's proposals:

• If you think it will require more Federal requirements and regulation to more closely align with your values, vote Obama.
• If you think it will require more market forces and less Federal intervention, vote McCain.

As always, input, corrections, and criticism from my fellow SDNers is always welcome.

 

[sophiejane]

I know I'm not allowed to post on this thread because I'm a lowly medical student and all, but what the hell, I'll take a stab.

Of course you are allowed to post! There are no rules about status here, or anywhere on SDN. All we ask is that you keep it civil and collegial, which you are doing so far. So post away!

🙂

 

[iatrosB]

Of course you are allowed to post! There are no rules about status here, or anywhere on SDN. All we ask is that you keep it civil and collegial, which you are doing so far. So post away!

🙂

I believe AFsmiley is referencing the OP's disclaimer to have "only residents or attendings" post in this thread.

 

[iatrosB]

I believe AFsmiley is referencing the OP's disclaimer to have "only residents or attendings" post in this thread.

Oops, another pesky med student post!😱

 

[sophiejane]

I believe AFsmiley is referencing the OP's disclaimer to have "only residents or attendings" post in this thread.

oh. well. party pooper. 😉

 

[Leukocyte]

If Hilary was still in the game, I would have voted democrat. There is NO WAY IN HELL i am giving my vote to this Obama dude.

Go McCain, and his hot lady vice president!👍

 

[yumita]

Wow, who woulda thought that docs, especially FP's were so $ focused and so not concerned about their PATIENTS! McCain's health pan is a hoax, Obama's falls very short but is an improvement. As FP's we really know how lack of insurance equates poor health for individuals, for our nation, and it's economy. Socialized medicine is NOT socialism, it's taking care of each other because even if you don't care about your neighbor's health, it affects you in the long run.

 

[deleted87716]

Socialized medicine is NOT socialism

Sure it is.

It's not the only option, however. There are plenty of other ways to provide for universal coverage without resorting to full-blown government-run healthcare.

The government can't do anything else very well, so why would anyone believe that they can successfully take over healthcare? Look at their recent experiments. Medicare Part D looks like it was crafted after an all-night drinking binge. There are nearly 80 different Part D drug plans in my state alone, and their formularies change constantly. And, worst of all, it prohibits the government from negotiating with big pharma for lower drug prices.

And, Medicare Advantage? There's no "advantage" to doctors or patients that I can see. More money for insurance companies, though.

Paying for Zostavax under Part D was another brilliant move. Right, your local drug store is the best place to get your shots, not your doctor's (part B) office. Yeah, that makes sense.

Don't even get me started on the RUC and the medicare payment formula.

 

[yumita]

Most of the newer gov't changes to Medicare have to do with the big pharma and insurance companies' lobbies that have WAY too much influence on our legislative and executive branches.

And do you really think that the gov't can't do anything well? While there are flaws in all big systems, look at the IRS, they take our money well, look at the fire depts, police depts, public works (on local levels but through a federal structuring that stipulates for them), the armed forces, the FBI, etc...

The main advantage to one insurer for all citizens is that there is accountability on the financial side and a big picture view of healthcare with most money spent on what will help most people (primary care, prenatal, well baby check-ups, management of chronic disease, etc...) and less spent on high-tech, obscure stuff. And of course no money spent on trying to weezle their way out of paying for sick peoples' medical bills, and much less spent on admin.

I know that "government control" is a scary buzzword, but c'mon, look at real numbers. DOn't be afraid to look at other countries' systems and take the good ideas and leave the bad ones behind.

 

[Joe Richards]

That's why I'm voting for him.



No, I think that's hyperbole and that you have no idea what socialism means.



Look where they and their aversion to deregulation got us. Enough said. See you on election day.



Right. Our forefathers stole from the Native Americans, now it's fine and dandy for big corporations and sleazy loan officers to steal from the middle class. Not if I have anything to do with it, which I do with my vote.



Again, you have no idea what communism means.



True, and I am unapologetic about it. It's my very small reward for my volunteer efforts here.

Now, about Family Medicine...

Obama supports:
1. investing in preventive care
2. investing in electronic medical records

Both of those can have a direct impact on our practices and therefore salaries if done right.

I agree with most of what you say excpet the last part about the electronic records issues.

Even if we started the whole country and every office on electronic records, it would not have an impact for at least 10-15 years.

As far as healthcare is concerned neither one of the candidates have a real solution and neither one addresses the physician payscale issues.

In fact both will reduce payment in someway.

McCains idea that somehow giving tax breaks to buy health insurance could backfire when insurance premiums go beyond the tax breaks.

Obamas idea of universal govt. insurance to those who's employers don't offer insurance can also backfire because more companies would rather pay into the govt. system and let the govt. handle the headache of giving their employees insurance. Over time the insurance rates will rise and govt. will have more control to reduce physician pay.

The best solution for physician pay to keep up with inflation and for primary care to be able to maintain a competitive edge is for all insurance companies including any govt. run company to allow balance billing.

For example: Pt. walks in to see doctor for a 99213 visit. If I charge $100 for that visit and insurance pays $50 of that, then I get to collect $50 on the spot from the patient and I can raise my fees by 3-4% every year or so to keep up with inflation.

Simple, easy to implement and the insurance companies can do whatever they want. We would still get paid.

 

[BabyPsychDoc]

I would not make any overly enthusiastic comments about socialized medicine if you have not worked in that environment.

I have worked in two socialized healthcare systems - ex-communist block and the British NHS.

I personally cannot understand how you can be so excited about it, and expect it to become a magical fix for the ailing US healthcare system.

Granted, the US healthcare system needs SOMETHING to be done about it, but it is naive to assume that a) you can replace it with a socialized healthcare model without wasting a ton of money on the process of re-organization and re-structuring and b) that the product of the heroic effort will be worth the trouble.

In my view, the US and the UK healthcare systems will converge one day, figurally speaking. US will introduce some universal coverage with private insurance-based top-ups and the UK will start charging for some non-essential or not-cost-effective treatments (just give the poor socialists some time to get over the idea of two-tiered NHS, and they will come round to it).

Importantly, seeing what ****hole the world have driven themselves into, where on earth would Obama get money to finance his fancy ideas?

 

[deleted87716]

And do you really think that the gov't can't do anything well?... look at the IRS, they take our money well

Indeed. You've got me there.

 

[sophiejane]

I'm no expert, maybe I'm wrong, but I think they were pretty big fans of deregulation...

You're right....what I meant to say was "their aversion to regulation."

{Tired resident trying to make sense...}

 

[lowbudget]

So who the hell is this Joe the Plumber?

 

[deleted87716]

So who the hell is this Joe the Plumber?

Not this guy: 😉

A pipe burst in a doctor's house. He called a plumber. The plumber arrived, unpacked his tools, did mysterious plumber-type things for a while, and handed the doctor a bill for $600.

The doctor exclaimed, "This is ridiculous! I don't even make that much as a doctor!"

The plumber waited for him to finish and quietly said, "Neither did I when I was a doctor."

 

[lowbudget]

Not this guy: 😉

Wait until the HMO's get you, Joe. Curse you, Joe the Plumber. CURSE. YOU!!!

 

[iatrosB]

So who the hell is this Joe the Plumber?

I don't know, but obviously he's important.

 

[alibai3ah]

ok, Barak HUSSEIN Obama,,,is that better?

Lets not bring race into it.....

 

[sophiejane]

I don't know, but McCain's blinking and jaw clenching and nervous laughter and bitter sarcasm distracted me so much, I barely heard what he was trying to say...

And that whole middle section where they bickered about who ran the dirtiest campaign. Please. Spare us...

I was underwhelmed with the substance or lack thereof from both of them, but I do think Obama looked and acted more "presidential."

 

[AFSmiley]

So who the hell is this Joe the Plumber?

My hero. Second only to Chuck Norris.

 

[AFSmiley]

...but I do think Obama looked and acted more "presidential."

I think this video is vitally important to this discussion.

[YOUTUBE]65I0HNvTDH4[/YOUTUBE]

 

[iatrosB]

I don't know, but McCain's blinking and jaw clenching and nervous laughter and bitter sarcasm distracted me so much, I barely heard what he was trying to say...

Agreed, I'm not a supporter of either candidate, but McCain has a serious lack of public speaking/debate skills. It was almost laughable watching him "debate"...the republicans would have been better off sending Joe in to debate.

 

[iatrosB]

Joe responds!!

http://cosmos.bcst.yahoo.com/up/player/popup/?cl=10234011

 

[deleted87716]

I think both of them should give up politics and go into stand-up comedy. 😉

http://filmgordon.wordpress.com/2008/10/17/the-obamamccain-comedy-roast/

 

[bkpa2med]

Steve Obama was great and so was George Bush lmao

 

[djnels01]

I think this video is vitally important to this discussion.

[YOUTUBE]65I0HNvTDH4[/YOUTUBE]

Wow, I just got Barack-rolled...

 

[MaximusD]

Fairly conservative estimate would be a 15-20% revenue loss... which translates into a significantly higher loss in income.

For most docs, the term "salary" is exceedingly inaccurate.... you are paid on a per work basis.

We're all f*****.

Have you read his healthcare plan? I doubt it.

EDIT// and you better have a citation or a calculation for that 15-20% number you're throwing out there or you've already lost credibility before this debate even starts.

 

[AFSmiley]

Have you read his healthcare plan? I doubt it.

 

[iatrosB]

Judging by the latest poll data, the title of the thread should be changed to "WHEN Obama wins..."

 

[Joe Richards]

Not to be be confused with Joe Richards...🙂

Wait until the HMO's get you, Joe. Curse you, Joe the Plumber. CURSE. YOU!!!

 

[MOHS_01]

.

 

[Joe Richards]

Discussions with some medical students are all too often like giving instruction to teenage children (they are often quite bright, intelligent, and educated, but lack the experience necessary to form meaningful opinions), but here we go all the same....

Yes, I have read Obama's health plan... even more importantly, I have an intimate knowledge and understanding of how things work currently... something that many students, residents, and even employed physicians alike lack.

Regarding the 15-20% revenue loss:

Obama's plan actually is not as radical as McCain's, but since we are not speaking on McCain's plan...

Obama's plan will create essentially another large payer class; the fee schedule for this payer class will likely be in line with current MC fee schedule (as TriCare and federal employees currently have very similar fee schedules, at least here in KY). This new payer class will do two things: 1. bring current un- and underinsured people into the mix and 2. siphon off from traditional insurance coverage plans. (Hang with me on this one, I'll get to explaining it shortly).

Current employer sponsored plans typically pay better than MC for services provided (and this varies greatly with geographic locale, and on average has been widely quoted as 15-20%, with many areas being much higher). The margins realized on providing these services are much higher when compared to providing the same services on a MC/MA patient. Every specialty, and even every practice will have varying impact from these changes... but only those who currently carry large loads of bad debt hold any chance of seeing a zero-sum change; the vast majority of us will see a decrease in revenues corresponding to our current payer mix.

When Obama says that those currently enrolled in insurance plans through their employer can keep their current plans, he is being a bit of an idealist... for when companies have an option of dumping their expensive, ongoing and escalating costs associated with health benefits, they will do so as soon as their accountants tell them that it is a cost savings event. That is the way that business works...

So yes, those of us working, seeing patients, and on the hook for expenses will see a loss that correlates quite well with our current payor mix.

I agree. And I'm really not a McCain supporter for different reasons. But putting that aside for now.

I agree that as fewer people are insured by private insurance companies, the private companies will have to either raise their premiums or go out of business. That means the individual consumer will have to take the burden of the costs and as you mentioned the employer will have to take the hit as well.

When the employer drops the individual insurance company, then there is no one to to sell insurance to. Therefore the individual insurance company will go out of business (the collapse of the US medical system as we know it).

What will all those people without insurance do?

They will buy the same insurance that Obama and McCain have.

What does that mean?

A SINGLE payer system.

Who will cover the cost?

The tax payer.

But what if McCain win? How will his plan save us?

It won't. Because the rising cost of medicine will force the individual and the employer out of the market. This is taking place right now. Many companies no longer offer health insurance to their employees.

Once this problems get big enough the system will collapse and the Govt. will attempt to fix it. (just like they spent 700 billion to fix the market)

There you have it, a Single payer system again.

That is why I say it does not matter who wins the election as far as health care is concerned.

 

[AFSmiley]

So I've heard and read plenty on this site about both candidate's healthcare plans. Has anyone read the AMA's proposal? Thoughts on it?

Here are the main points:

1. Subsidies for those who most need financial assistance obtaining health insurance
2. Choice for individuals and families in what health plan to join.
3. Fair rules of the game that include protections for
   high-risk patients and greater individual responsibility.

I for one think physicians need to take more of a leading role in the public's view for fixing this mess. I think the AMA stands the best chance for docs to organize and mobilize and get something done that benefits our patients and our practices.

 

[Joe Richards]

So I've heard and read plenty on this site about both candidate's healthcare plans. Has anyone read the AMA's proposal? Thoughts on it?

Here are the main points:

1. Subsidies for those who most need financial assistance obtaining health insurance
2. Choice for individuals and families in what health plan to join.
3. Fair rules of the game that include protections for
   high-risk patients and greater individual responsibility.

I for one think physicians need to take more of a leading role in the public's view for fixing this mess. I think the AMA stands the best chance for docs to organize and mobilize and get something done that benefits our patients and our practices.

# 3 sound very ambiguous. Greater individual responsibility??? Our own govt. can't even take responsibility for much how can we expect ALL the individuals take individual responsibility.

#2 Choice is not the only issue. Cost, access, etc.