Interviewing: current state of health care/obamacare?

[clutch21]

Hey guys,

So I read it is necessary, for interviews (and being an individual who is entering health care) to have a good understanding of the current status of US healthcare and what impact obamacare has had/will have on the this situation. My question is- what constitutes as a "good understanding"? There are so many complexities to the new health care bill making it hard to grasp all the relevant changes.

Does anyone have any advice, as far as how and where to research the new health care bill? Also how much depth about the health care bill is expected to be common knowledge for the interviewee?

Thanks!

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[CuttingCorneas]

This sums it up pretty well. Would recommend even if you're NOT interviewing this cycle.

Also, keep in mind that if Romney is elected, the ACA will still stay in effect. He can't just get rid of it immediately like he says he's going to. That vote is up to the soon-to-be-elected Congress.

Edit: Be sure to read the comments. A lot of good insight there too.

 

[HughMyron]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

 

[Bacchus]

This sums it up pretty well. Would recommend even if you're NOT interviewing this cycle.

Also, keep in mind that if Romney is elected, the ACA will still stay in effect. He can't just get rid of it immediately like he says he's going to. That vote is up to the soon-to-be-elected Congress.

Edit: Be sure to read the comments. A lot of good insight there too.

Now if you could convey to the general public all the blame is not supposed to be put on any president I would offer you some type of Nobel prize.

 

[clutch21]

Thanks guys, Good advice! I will definitely read that link.

 

[desphil]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

.... not sure if srs

 

[HughMyron]

.... not sure if srs

I don't get it

I know Law school is meh because a lot of those schools blow, and unless you go to a great school you probably won't work as a lawyer.

But let's be honest: anyone good enough to get into medical school would def be able to make associate at a law firm. And it only goes up from there.

 

[Bacchus]

I don't get it

I know Law school is meh because a lot of those schools blow, and unless you go to a great school you probably won't work as a lawyer.

But let's be honest: anyone good enough to get into medical school would def be able to make associate at a law firm. And it only goes up from there.

You realize the law market is so oversaturated and most grads, if they even find a job, aren't pulling in 100's of thousands of dollars, right?

Unless you got to tier-1 schools, you're going to be pulling in an upper-middle class salary... if you're lucky.

 

[Sophocles]

This sums it up pretty well. Would recommend even if you're NOT interviewing this cycle.

Also, keep in mind that if Romney is elected, the ACA will still stay in effect. He can't just get rid of it immediately like he says he's going to. That vote is up to the soon-to-be-elected Congress.

Edit: Be sure to read the comments. A lot of good insight there too.

As of right now, congress is leaning way right and the trend seems to be getting stronger. Also, the next president will have to elect one maybe two chief justices, which will also help Romney's plan to amend the ACA.

I say amend because the last time Romney spoke he said that he didn't want to repeal it anymore, just amend certain things, but who knows, this guy changes his mind consistently.

 

[desphil]

You realize the law market is so oversaturated and most grads, if they even find a job, aren't pulling in 100's of thousands of dollars, right?

Unless you got to tier-1 schools, you're going to be pulling in an upper-middle class salary... if you're lucky.

This is what I was referring to. http://www.marketplace.org/topics/economy/education/job-prospects-getting-worse-law-school-graduates

Also, it's a pretty blanket statement to make that the ACA is going to decrease pay rates for physicians. I can appreciate the concerns associated with the IPAB for Medicare, but the truth is nobody can really say how the law is going to fully affect physicians until it does... which won't be until 2014 at the earliest.

 

[Bacchus]

As of right now, congress is leaning way right and the trend seems to be getting stronger. Also, the next president will have to elect one maybe two chief justices, which will also help Romney's plan to amend the ACA.

I say amend because the last time Romney spoke he said that he didn't want to repeal it anymore, just amend certain things, but who knows, this guy changes his mind consistently.

I pity his bagger at the grocery store. Can't predict if he's gonna want paper, plastic, paper in plastic, or reusable canvas.

 

[FrontierPsych]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

lol

 

[KnuxNole]

I would never consider law at all. I would be bored, miserable since I don't care about that profession at ALL, and schooling will be torture. Not to mention, I would hate my career lol

 

[annonymous819]

Hey guys,

So I read it is necessary, for interviews (and being an individual who is entering health care) to have a good understanding of the current status of US healthcare and what impact obamacare has had/will have on the this situation. My question is- what constitutes as a "good understanding"? There are so many complexities to the new health care bill making it hard to grasp all the relevant changes.

Does anyone have any advice, as far as how and where to research the new health care bill? Also how much depth about the health care bill is expected to be common knowledge for the interviewee?

Thanks!

No the gist of it, the pros/cons of the bill and have a logical (read:your own) opinion not some regurgitated msnbc/fox news punch line.

Be prepared for the inevitable "how would you fix it then?" question that follows. Have a logical idea on what you would change to improve hc.

 

[FrontierPsych]

As of right now, congress is leaning way right and the trend seems to be getting stronger. Also, the next president will have to elect one maybe two chief justices, which will also help Romney's plan to amend the ACA.

I say amend because the last time Romney spoke he said that he didn't want to repeal it anymore, just amend certain things, but who knows, this guy changes his mind consistently.

I don't really see how ACA could come to the Supreme Court again, and if it did I doubt Romney could appoint a justice that would shift the ideological balance of the court. What Romney passed in Massachusetts is basically what ACA is, so who knows what he would "replace" it with. It is just absurd pandering.

 

[CuttingCorneas]

Now if you could convey to the general public all the blame is not supposed to be put on any president I would offer you some type of Nobel prize.

Forget Nobel Prize. I think that qualifies for canonization.

 

[CuttingCorneas]

I pity his bagger at the grocery store. Can't predict if he's gonna want paper, plastic, paper in plastic, or reusable canvas.

It depends...what do you want him to want? http://www.roboromney.com

 

[occams_razor]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

haha you must be kidding right?

"being a doctor will become a financial death sentence" = most ridiculous thing i've read all day

"you shoulda gone into Law" - more students are graduating from law school each year than there are jobs available. the legal market is completely oversaturated. my cousin graduated from law school, passed the bar and is currently unemployed (with $140k in debt, by the way).
in contrast, employment of physicians is expected to grow by 24 percent from 2010 to 2020, faster than the average for all occupations (source: bureau of labor statistics)

 

[cbrons]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

\\

Yeah you are a cynic.

At these interviews, try not to get too political. If you are interviewed by an administrator, these people tend to be leftist hacks, so any sane points you might make will not help you out. Usually physician interviewers are less crazy, but this is not universally the case.

Better get used to keeping your mouth shut, because most medical schools (especially at large public universities) are very politically correct places with protocols in place for people who don't pander a different ideological line. It's okay to have opinions, but unless they are decidedly left-wing, trust me you will want to keep your mouth shut.

 

[KnuxNole]

What's wrong with being left-winged?

I don't think I would ever be right-winged in my life haha

 

[cbrons]

What's wrong with being left-winged?

I don't think I would ever be right-winged in my life haha

 

[OCDOCDOCD]

Basically, its going to mean more patients and lower pay for doctors.

If you thought medical school was a financially responsible decision...well, its not anymore, being a doctor will become a financial death sentence.

Do it because you love patients or because you want prestige or whatever. Otherwise, well, you shoulda gone into Law.

I keep hearing people say this, and I've yet to see it backed up by anything. The "more patients" part seems to be coming from the massive increase in insured patients, but that doesn't mean you have to see more patients. The "lower pay" part seems to be stemming from reduced reimbursement rates for health care providers of medicare patients...but that's only medicare patients who many docs don't even treat to begin with.

Really the only people who seem to have a reason to hate ACA are primary care docs who have to worry about mid-level providers encroaching on their territory, and who are also butthurt about the ACA forcing them to keep much more detailed records such that there's more paperwork and they're less autonomous than before (which isn't necessarily a bad thing tbh; as much as doctors like to think they're infallible gods, the reality is that even surgeons have dramatic decreases in mistakes when they're forced to follow a checklist).

Maybe I'm missing something here, but the ACA doesn't seem to be nearly as bad as people make it out to be. And even if it is, what's the alternative? Government provided health care which would devastate physician salaries? Or should we go back to the old system where 1/3rd of the country had no access to healthcare, and the other 2/3rds had to worry about their insurer refusing coverage the second they got an expensive/chronic illness?

 

[cbrons]

I keep hearing people say this, and I've yet to see it backed up by anything. The "more patients" part seems to be coming from the massive increase in insured patients, but that doesn't mean you have to see more patients. The "lower pay" part seems to be stemming from reduced reimbursement rates for health care providers of medicare patients...but that's only medicare patients who many docs don't even treat to begin with.

Really the only people who seem to have a reason to hate ACA are primary care docs who have to worry about mid-level providers encroaching on their territory, and who are also butthurt about the ACA forcing them to keep much more detailed records such that there's more paperwork and they're less autonomous than before (which isn't necessarily a bad thing tbh; as much as doctors like to think they're infallible gods, the reality is that even surgeons have dramatic decreases in mistakes when they're forced to follow a checklist).

Maybe I'm missing something here, but the ACA doesn't seem to be nearly as bad as people make it out to be. And even if it is, what's the alternative? Government provided health care which would devastate physician salaries? Or should we go back to the old system where 1/3rd of the country had no access to healthcare, and the other 2/3rds had to worry about their insurer refusing coverage the second they got an expensive/chronic illness?

Aside from attacking "primary care docs", the main thing you are missing is that you just don't know what the hell you're talking about.

 

[KnuxNole]

I'd rather play with that kitty than be a conservative

 

[cbrons]

I'd rather play with that kitty than be a conservative

My wife and I are getting a kitty tomorrow

 

[KnuxNole]

My wife and I are getting a kitty tomorrow

ooh sweet! Kitties are cute and playful. Until they turn into adult cats and sleep all day.

 

[CuttingCorneas]

Or should we go back to the old system where 1/3rd of the country had no access to healthcare, and the other 2/3rds had to worry about their insurer refusing coverage the second they got an expensive/chronic illness?

The number of people without health care is often grossly misquoted. Yes, many people are unable to get insurance due to pre-existing conditions or an inability to pay, but a significant amount of those without insurance are people in their 20's and 30's who think they're invincible and don't need to purchase health insurance.

That being said, I believe the ACA is more of a way to keep the insurance companies in check than anything else.

 

[CuttingCorneas]

Aside from attacking "primary care docs", the main thing you are missing is that you just don't know what the hell you're talking about.

x1000000

 

[Bacchus]

The number of people without health care is often grossly misquoted. Yes, many people are unable to get insurance due to pre-existing conditions or an inability to pay, but a significant amount of those without insurance are people in their 20's and 30's who think they're invincible and don't need to purchase health insurance.

That being said, I believe the ACA is more of a way to keep the insurance companies in check than anything else.

Until they end up in an accident and get the $250,000 ICU stay bill. Sigh. At the minimum everyone should have catastrophic coverage. I lose my insurance in December (yay 26). Sure I could wait until residency (7 months later) to reenroll. The fact is, its the most stupid idea in the world considering the financial ruin I could bring upon myself in the blink of an eye.

 

[CuttingCorneas]

Until they end up in an accident and get the $250,000 ICU stay bill. Sigh. At the minimum everyone should have catastrophic coverage. I lose my insurance in December (yay 26). Sure I could wait until residency (7 months later) to reenroll. The fact is, its the most stupid idea in the world considering the financial ruin I could bring upon myself in the blink of an eye.

Exactly. It's the "why pay for something I don't need?" mindset. Even though $200 a month is a paltry sum in the grand scheme of things (i.e. financial ruin if something bad were to occur).

 

[cbrons]

Until they end up in an accident and get the $250,000 ICU stay bill. Sigh. At the minimum everyone should have catastrophic coverage. I lose my insurance in December (yay 26). Sure I could wait until residency (7 months later) to reenroll. The fact is, its the most stupid idea in the world considering the financial ruin I could bring upon myself in the blink of an eye.

I don't understand... how the heck did you finish all your rotations by October? So you'll be doing nothing until July?

Some school schedules seem crazy to me, even for 4th years.

 

[OCDOCDOCD]

Aside from attacking "primary care docs", the main thing you are missing is that you just don't know what the hell you're talking about.

x1000000

Well then enlighten me. Links are fine.

 

[HughMyron]

\\

Yeah you are a cynic.

At these interviews, try not to get too political. If you are interviewed by an administrator, these people tend to be leftist hacks, so any sane points you might make will not help you out. Usually physician interviewers are less crazy, but this is not universally the case.

Better get used to keeping your mouth shut, because most medical schools (especially at large public universities) are very politically correct places with protocols in place for people who don't pander a different ideological line. It's okay to have opinions, but unless they are decidedly left-wing, trust me you will want to keep your mouth shut.

Yeah, I try to keep my politics just on the internet haha.

I would have thought that most physicians would be a pretty conservative bunch though.

 

[bluecalx]

Aside from attacking "primary care docs", the main thing you are missing is that you just don't know what the hell you're talking about.

yes, i'd like to be enlightened as well

 

[cbrons]

Well then enlighten me. Links are fine.

A link isn't going to fix your poor attitude. You are pre-med applying to medical school, and you are already showing a resentment toward a very important subset of medicine (primary care) and want to push this line of bull about there being not enough paperwork in outpatient, primary care medicine?

Don't go running your mouth about what primary care physicians are "butthurt" about when you don't know what you're talking about.

 

[alanwatts]

A link isn't going to fix your poor attitude. You are pre-med applying to medical school, and you are already showing a resentment toward a very important subset of medicine (primary care) and want to push this line of bull about there being not enough paperwork in outpatient, primary care medicine?

Don't go running your mouth about what primary care physicians are "butthurt" about when you don't know what you're talking about.

if you think ocdocdocd has a poor attitude, then ignore him and respond to me and the rest of the readers of this thread. tell us why you think the ACA will be bad for the profession. because ocdocdocd made some good points and is just curious about what some responses would be.
by the way, i'm not so concerned about ocdocdocd being a pre-med with a "resentment" towards primary care as much as I am about a med student calling medical school administrators "leftist hacks."

 

[NeuroSpeare]

if you think ocdocdocd has a poor attitude, then ignore him and respond to me and the rest of the readers of this thread. tell us why you think the ACA will be bad for the profession. because ocdocdocd made some good points and is just curious about what some responses would be.
by the way, i'm not so concerned about ocdocdocd being a pre-med with a "resentment" towards primary care as much as I am about a med student calling medical school administrators "leftist hacks."

+1

I'd love to hear some fact-based responses as to why the ACA is bad news.

 

[OCDOCDOCD]

A link isn't going to fix your poor attitude. You are pre-med applying to medical school, and you are already showing a resentment toward a very important subset of medicine (primary care) and want to push this line of bull about there being not enough paperwork in outpatient, primary care medicine?

Don't go running your mouth about what primary care physicians are "butthurt" about when you don't know what you're talking about.

I don't have a resentment towards PCPs. I have a resentment towards doctors with god complexes who view increased oversight and standardization as a personal insult. Most PCPs aren't like that though, and from what I've read many are actually happy about ACA for the most part.

Since you didn't answer the main issue though and instead tried to sidetrack the conversation with a strawman and ad homs I'm going to go ahead and assume you don't have anything to back up your position on the ACA. Maybe someone else does though and I'm still interested in hearing the other side so long as they actually explain themselves.

 

[cbrons]

if you think ocdocdocd has a poor attitude, then ignore him andrespond to meand the rest of the readers of this thread. tell us why you think the ACA will be bad for the profession. because ocdocdocd made some good points and is just curious about what some responses would be.
by the way, i'm not so concerned about ocdocdocd being a pre-med with a "resentment" towards primary care as much as I am about a med student calling medical school administrators "leftist hacks."

Who cares what you're concerned about? Who are you?

 

[cbrons]

I don't have a resentment towards PCPs. I have a resentment towards doctors with god complexes who view increased oversight and standardization as a personal insult. Most PCPs aren't like that though, and from what I've read many are actually happy about ACA for the most part.

Since you didn't answer the main issue though and instead tried to sidetrack the conversation with a strawman and ad homs I'm going to go ahead and assume you don't have anything to back up your position on the ACA. Maybe someone else does though and I'm still interested in hearing the other side so long as they actually explain themselves.

"Ad homs"? You previously stated, like you were some kind of authority, that primary care doctors are "butthurt" about a no-big-deal-get-over-it pile of paperwork they have to maneuver around daily. Do you have any idea what a day in the life of your average overworked PCP is? Particularly in a large, urban area?

I don't care to discuss the healthcare bill, my point was to warn the people interviewing that they'd better not get overly political in their interviews, because there is a way that the people at med schools lean and it's almost universally one way. That is the topic of this discussion, right? Advice for people interviewing?

 

[lobo.solo]

"Ad homs"? You previously stated, like you were some kind of authority, that primary care doctors are "butthurt" about a no-big-deal-get-over-it pile of paperwork they have to maneuver around daily. Do you have any idea what a day in the life of your average overworked PCP is? Particularly in a large, urban area?

I don't care to discuss the healthcare bill, my point was to warn the people interviewing that they'd better not get overly political in their interviews, because there is a way that the people at med schools lean and it's almost universally one way. That is the topic of this discussion, right? Advice for people interviewing?

This is a fair advise. I don't think I want to share my politics in an interview, cause it could hurt my chances.

 

[clutch21]

Just want to follow up and say that the initial link provided by cuttingcorneas was very insightful. Thanks again for the help!

 

[OCDOCDOCD]

Who cares what you're concerned about? Who are you?

"Ad homs"? You previously stated, like you were some kind of authority, that primary care doctors are "butthurt" about a no-big-deal-get-over-it pile of paperwork they have to maneuver around daily. Do you have any idea what a day in the life of your average overworked PCP is? Particularly in a large, urban area?

I don't care to discuss the healthcare bill, my point was to warn the people interviewing that they'd better not get overly political in their interviews, because there is a way that the people at med schools lean and it's almost universally one way. That is the topic of this discussion, right? Advice for people interviewing?

So in other words you can't counter anything I said about ACA despite accusing me of knowing nothing about it.

Gotcha.

 

[cbrons]

So in other words

So in other words, as a pompous undergrad interested in MD/PhD programs, who knows absolutely nothing about the real-world practice of medicine, I can't say that you'll do so well at your interviews unless you at least get some shadowing experience first. I'd tone down the rhetoric on what primary care doctors do and don't get upset about until then.

<--- me laughing at you because you think I'll waste my time do an e-debate with you on the "ACA." If you want to debate poly-tics, you can have your go at the people in the "Sociopolitical" forum. My entire involvement in this thread has been about interview advice, so I hope you received mine.

 

[Bacchus]

I don't understand... how the heck did you finish all your rotations by October? So you'll be doing nothing until July?

Some school schedules seem crazy to me, even for 4th years.

The way my schedule was set up, I got my Step 2 boards done in June/Early July. Since I passed, there are no outstanding requirements with them. I had my Sub-I exam already. That's the only exam I take 4th year from a rotation standpoint.

I'm not done with rotations but I'm done with the "hard" requirements. I just have to pass rotations, interview, and match.

 

[KnuxNole]

I wanna hear more kitty talk

 

[alanwatts]

Who cares what you're concerned about? Who are you?

you have a really nasty, bitter attitude. i hope you're only like this on sdn, and not in person.

I don't care to discuss the healthcare bill, my point was to warn the people interviewing that they'd better not get overly political in their interviews, because there is a way that the people at med schools lean and it's almost universally one way. That is the topic of this discussion, right? Advice for people interviewing?

no, the topic of the discussion is how the ACA will affect the medical profession, so that those of us who are interviewing have a clearer understanding of varying opinions in case it comes up. this thread would be history if the premise was simply: should I get political during my interview?
so don't pretend to take the high road after you've already insulted and degraded those who have a different opinion than yours.

 

[OCDOCDOCD]

So in other words, as a pompous undergrad interested in MD/PhD programs, who knows absolutely nothing about the real-world practice of medicine, I can't say that you'll do so well at your interviews unless you at least get some shadowing experience first. I'd tone down the rhetoric on what primary care doctors do and don't get upset about until then.

<--- me laughing at you because you think I'll waste my time do an e-debate with you on the "ACA." If you want to debate poly-tics, you can have your go at the people in the "Sociopolitical" forum. My entire involvement in this thread has been about interview advice, so I hope you received mine.

I've already explained my previous statement, which you ignored. I'll grant you that my wording could have been better, however my point was that the real issues that I've seen either only affect PCPs (encroachment of territory by midlevels) or are relatively trivial things to get upset about (oversight and paperwork) when the argument I keep seeing repeated is "OMG ACA IS GONNA DESTROY MEDICINE AS A CAREER ITS ALL OVER MED SCHOOL IS SUCH A BAD CHOICE NOW" (notice also I said that PCPs do have reasons to be upset; however PCPs =/= all of medicine).

Anyway, I'm not trying to argue about ACA. I fully admitted in my first post I may be unaware of important details that others are privy to. Each time in this thread I've invited people who disagree with me to tell me why, because I honestly want to know if I'm wrong, and if so, why. However, I've yet to receive a response that isn't you throwing a tantrum.

Here's why I know you don't actually have anything: If I'm so painfully, obviously ignorant about this topic, it should be utterly trivial to put me in my place. Anyone should be able to come in here and quickly list off some (not even all) of the specific things that are bad for physicians in ACA. At the very least it shouldn't be much of an issue to at least find a reputable source (ie not an overtly politically biased blog/news site) that points these things out, talks about repercussions, etc., link it here, and simply say "now shut up". And yet you haven't done this. Instead all you keep doing is say "no no no, I never wanted to get into a discussion about ACA in a thread devoted to discussion about ACA" followed by some kind of condescending remark.

What's most telling though is that I already outright told you that you don't know **** about this topic and you've yet to prove me wrong. If we're to believe your assessment of me, that's one hell of an insult isn't it? I mean, here I am, the pompous undergrad ignorant of all things medicine, and comically ignorant about ACA, and I'm telling you, a medical student, that you don't know anything about the very topic I know nothing about. It says a lot that your response was essentially "I could totally prove you wrong!...but I don't feel like it".

While you may not be of any use in this thread, I'm still hopeful someone else will be, assuming I am in fact wrong about all of this. Notice how this whole time I've freely admitted I could very well be wrong and encouraged people to correct me if that is the case. This should have been your first clue I'm not here to argue about politics.

 

[impact2d]

I've already explained my previous statement, which you ignored. I'll grant you that my wording could have been better, however my point was that the real issues that I've seen either only affect PCPs (encroachment of territory by midlevels) or are relatively trivial things to get upset about (oversight and paperwork) when the argument I keep seeing repeated is "OMG ACA IS GONNA DESTROY MEDICINE AS A CAREER ITS ALL OVER MED SCHOOL IS SUCH A BAD CHOICE NOW" (notice also I said that PCPs do have reasons to be upset; however PCPs =/= all of medicine).

Anyway, I'm not trying to argue about ACA. I fully admitted in my first post I may be unaware of important details that others are privy to. Each time in this thread I've invited people who disagree with me to tell me why, because I honestly want to know if I'm wrong, and if so, why. However, I've yet to receive a response that isn't you throwing a tantrum.

Here's why I know you don't actually have anything: If I'm so painfully, obviously ignorant about this topic, it should be utterly trivial to put me in my place. Anyone should be able to come in here and quickly list off some (not even all) of the specific things that are bad for physicians in ACA. At the very least it shouldn't be much of an issue to at least find a reputable source (ie not an overtly politically biased blog/news site) that points these things out, talks about repercussions, etc., link it here, and simply say "now shut up". And yet you haven't done this. Instead all you keep doing is say "no no no, I never wanted to get into a discussion about ACA in a thread devoted to discussion about ACA" followed by some kind of condescending remark.

What's most telling though is that I already outright told you that you don't know **** about this topic and you've yet to prove me wrong. If we're to believe your assessment of me, that's one hell of an insult isn't it? I mean, here I am, the pompous undergrad ignorant of all things medicine, and comically ignorant about ACA, and I'm telling you, a medical student, that you don't know anything about the very topic I know nothing about. It says a lot that your response was essentially "I could totally prove you wrong!...but I don't feel like it".

While you may not be of any use in this thread, I'm still hopeful someone else will be, assuming I am in fact wrong about all of this. Notice how this whole time I've freely admitted I could very well be wrong and encouraged people to correct me if that is the case. This should have been your first clue I'm not here to argue about politics.

I don't think you came across terribly, but working in primary care I can assure you they rarely ever have god complexes and already face more paperwork and scrutiny than most other physicians for the least amount of compensation. A patient walks in with complex conditions and they are paid one small sum for all of the management and follow up, including insurance pre-authorization, record requests that happen often, and coordination of care with specialists. The last thing we need in primary care is more regulation and more paperwork, this reduces quality of care because it takes away from patient care and management time. When one only gets paid $45 dollars for an E&M visit that is supposed to include all coordination of care, paperwork, insurance BS, and patient phone calls, and you throw more regulation into the mix-the time has to come from somewhere. Sadly, the time is often taken from time spent with the patient, and this is why over-regulation is a bad thing in Primary Care. I agree the systems need improvement, but you just can't add new regulation on top of defunct systems. Either fix the old system or create a new one, but this Jenga style of healthcare reform is worrisome.

The only other thing I'd point out (again I worked as an health admin in a PCP group) is that the idea that only medicare is effected is a misunderstanding of how insurance works. All private insurance trends after medicare. If medicare gives them an excuse to not reimburse a service or to reduce reimbursement, they will. They won't pay as little, but their precent reduction will trend similarly (e.g. if medicare reduces by 30%, Private insurance will often do the same). They quote medicare guidelines as reasons for not reimbursing all of the time. Also, the idea the most physicians don't accept medicare is wrong as well, especially hospital based physicians. You are thinking of Medicaid. The largest population demographic in america are all on medicare now or arriving shortly.

Hopefully that provides a slightly different perspective.

One misunderstanding in your quote

 

[Gut Shot]

Each time in this thread I've invited people who disagree with me to tell me why, because I honestly want to know if I'm wrong, and if so, why. However, I've yet to receive a response that isn't you throwing a tantrum.

You should know better than to hope for a discussion centered in the frontal lobes. This one always cuts straight to the limbic system.

Few people know a great deal about health policy, and virtually none of them post on this board. If you ask for insight you will meet little more than emotionally laced responses from individuals who think they know more than they do.

At this stage in your career the only viable strategies you have to develop a genuine level of foundational knowledge in this arena are 1.) a health policy class, and 2.) self-education. For the latter, I would recommend picking up Understanding Health Policy, 6th ed. by Dr. Thomas Bodenheimer, and Landmark: The Inside Story of America's New Health Care Law and What It Means for All Of Us. Both are available on Amazon.