Is it possible physicans would make more in a single payer system?

[osumc2014]

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Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

 

[Isoprop]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

My head just exploded.

 

[insane]

Nope they would still be suing the physicians. Physicians wouldn't be government employees, still independent contractors, just like physicians who accept medicaid/medicare aren't government employees, or physicians that accept payment from Blue Cross or various other insurance companies aren't employees of that company. Physicians or their companies/groups/hospitals would still be responsible for malpractice insurance, and we live in a country where there is like 1 lawyer for every 250ish people, we need serious tort reform, in any health care package.

EDIT: Not to mention in a single payer market, the government would fix the prices and be inclined to pay doctors way less, since there isn't another payer, doctors would be forced to accept.

 

[caniac]

My head just exploded.

I'm impressed you could type so well considering.

Obama is never going to do tort reform. if i remember correctly, he was actually booed when he said that at the AMA

 

[BBender716]

I'm impressed you could type so well considering.

Obama is never going to do tort reform. if i remember correctly, he was actually booed when he said that at the AMA

I remember that as well. Difficult when it's mostly lawyers that run the country.

 

[Law2Doc]

I remember that as well. Difficult when it's mostly lawyers that run the country.

Nah, it has nothing to do with law. The folks are politicians first, and their former career a distant second. As politicians, they have to answer to constituents. And far far far more constituents are going to picture themselves as the patient wronged by a rich evil doctor, than they are going to picture themselves as a physician. Doctors have no voice in the government compared to potential patients. So politicians will go to where the votes are and that's the users of medical services, not the medical providers. And for these people, tort reform is a bad thing. It protects doctors from THEM. It's thus naive to think the law background has anything to do with it. The public distrusts doctors, thinks they earn too much, etc, and politicians always will court the public's vote. Plain and simple.

 

[Law2Doc]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

You are wrong. A single payor means a single pair of hands able to have a grapple-hold over the purse strings. Means they can pay out whatever they want, which can be squat if they need the funds for something else (and they always do (see eg. what happened to social security). And single payor has nothing to do with med mal, which still will continue. That's the doctor's liability, not the payor's.

 

[osumc2014]

You are wrong. A single payor means a single pair of hands able to have a grapple-hold over the purse strings. Means they can pay out whatever they want, which can be squat if they need the funds for something else (and they always do (see eg. what happened to social security). And single payor has nothing to do with med mal, which still will continue. That's the doctor's liability, not the payor's.

Ok thanks...I just had no idea. So is single payer what obama is trying to get passed or is his bill a modified version

 

[BlueElmo]

Ok thanks...I just had no idea. So is single payer what obama is trying to get passed or is his bill a modified version

No, Obama is not trying to get a single payer passed. He just wants to pass a government- run insurance program to compete with private insurers to "keep the private insurance companies honest."

Also, I don't see Obama supporting any form of tort reform, unfortunate situation. Remember, he was a lawyer before he became a president.

 

[osumc2014]

No, Obama is not trying to get a single payer passed. He just wants to pass a government- run insurance program to compete with private insurers to "keep the private insurance companies honest."

Also, I don't see Obama supporting any form of tort reform, unfortunate situation. Remember, he was a lawyer before he became a president.

So adding more fragments to the system...

 

[kia ora]

Also, I don't see Obama supporting any form of tort reform, unfortunate situation. Remember, he was a lawyer before he became a president.

I agree that it is unlikely he will support tort reform, however I disagree that this is because he is/was a lawyer. that is way too simplistic a statement. not all lawyers are med mal lawyers. not all lawyers oppose tort reform.

 

[cardinal2010]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

Single Payer = Monopsony!

A monopsonistic employer (only hirer of labor in an industry), will invariably hire less labor and at a lower wage than is socially optimal. Based on the assumption that in the long term, physician labor supply is an upward sloping curve (higher salary = more people wanting to be physicians = more physicians working). This is because, when the monopsonist wants to hire one more physician, he has to raise wages for all physicians, meaning his marginal labor cost != the cost of the last physician, it equals the cost of the last physician + the cost of higher wages to the previously hired physicians. Thus the intersection of marginal labor cost and labor demand comes at a lower level of physician supply, leading to fewer physicians and lower wages than a free market would allow for where any given employer have less power over physician wages (not that our current medical system is a free market though).

 

[JJMrK]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

Whoever is doing the paying can dictate the reimbursement. In this case, if the government pays for all care, physicians are left in a "take-it-or-leave-it" situation.

What makes you think malpractice would go away?

 

[osumc2014]

Whoever is doing the paying can dictate the reimbursement. In this case, if the government pays for all care, physicians are left in a "take-it-or-leave-it" situation.

What makes you think malpractice would go away?

I was just thinking that the goverment would actually cover that if it is publicly funded, like how some hospitals would cover some physician's malpractice insurance if they need them in trauma or something

 

[Mellymel09]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

Ok so I'm from Canada, and as I'm sure you already know, we have public health care service. Let me start off by saying that our physicians make a lot less than in the US, in fact, many of our Canadian trained physicians end up going to work in the US because of the huge salary difference. You see what happens when the government runs the show is that they start implementing rules and lots of them. For instance, the reason why our med schools are so hard to get into is because we have very limited seats. Why? Because the education is largely funded by our government and so while tuition is ridiculously cheaper than that of the US, there is a limit to the number of physicians our nation can form per year, because you have to keep in mind that the Nation, then has to pay all of its physicians which it formed. You can't form more than what you can pay for and that's the main idea of it all... Of course, I just gave a brief outline, and even I myself, have not looked at all the little details and implications involved, because it is a very complicated system... but I hope this served to give you an idea.

Also, I'm not sure about the whole malpractice thing, but even if malpractice fees would no longer apply, the salary restrictions put in place by the government would most likely lower the current salaries.

 

[CoolWhipp]

No way.

 

[MegaProjectile]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

Canada has a single-payor system. The doctors make somewhat less the Americans but if you factor in:
low malpractice premium; Canandian doctors are far less sued and the same can be found in other single payor countries.
low tution; same in most other single payor countries.
and speedy reimburesment.

If you add all these factors, doctors in Canada come out even or slightly ahead depending on specialty. Below is the link for the take home income of doctors in different specialties and geographic regions in Canada. As you can see, they are doing well.

http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/MedStudentCentre/Medicine/income.pdf

 

[Optimalsauce]

Canada has a single-payor system. The doctors make somewhat less the Americans but if you factor in:
low malpractice premium; Canandian doctors are far less sued and the same can be found in other single payor countries.
low tution; same in most other single payor countries.
and speedy reimburesment.

If you add all these factors, doctors in Canada come out even or slightly ahead depending on specialty. Below is the link for the take home income of doctors in different specialties and geographic regions in Canada. As you can see, they are doing well.

http://www.cma.ca/multimedia/staticContent/HTML/N0/l2/MedStudentCentre/Medicine/income.pdf

Figures are in CAD$, and are not adjusted for higher taxes.

Also, way to equate low malpractice premium to single payer, and not laws or culture.

 

[Law2Doc]

I was just thinking that the goverment would actually cover that if it is publicly funded, like how some hospitals would cover some physician's malpractice insurance if they need them in trauma or something

Um no. You wouldn't be an employee of the government, they would simply be a payor for the customer. If you commit malpractice, they don't have your back, they have the payee's back. The hospital scenario is different because the hospital is itself on the firing line for lawsuits -- for negligent supervision of employees, etc so it backs doctors because that is an extension of their own liability.

 

[amakhosidlo]

I was just thinking that the goverment would actually cover that if it is publicly funded

I'd think that nationalized health care would accomplish this. UK docs, for example, are essentially government employees, and patients sue the NHS when something goes awry.

 

[Mellymel09]

Figures are in CAD$, and are not adjusted for higher taxes.

Also, way to equate low malpractice premium to single payer, and not laws or culture.

OH yeah, thx for reminding me, forgot to add that to the argument, yup, our taxes are sky high compared to yours... consider yourselves lucky 😉

 

[TopSecret]

Correct me if I'm wrong, but wouldn't physicians be able to make more money if healthcare was run by the government strictly on the fact that physicians would no longer have to pay malpractice, and people are less inclined to sue the government due to fear of all the red tape they have to go through, thus compensating the salary decrease due to socialized healthcare.

Oh hell no.

Single payer = no payer = happy taxpayer

 

[ajkby52]

But wouldn't this also get rid of the large amount of administrative costs if the government would be paying for it.
A more unified system would decrease the amount of work the individuals from different institutions (say physicians from different hospitals or different specialties) would need to perform and decrease the amount of paperwork.
Also there would be less ridiculous salaries for those at the top.

 

[TopSecret]

But wouldn't this also get rid of the large amount of administrative costs if the government would be paying for it.
A more unified system would decrease the amount of work the individuals from different institutions (say physicians from different hospitals or different specialties) would need to perform and decrease the amount of paperwork.
Also there would be less ridiculous salaries for those at the top.

Medicare will be insolvent in 2018 (Medicare apocalypse) and this factors in a 21% across the board cut in physician reimbursement. The government is not immune to high administrative costs. This country has a shortage of skilled and educated workers but has a surplus of administrators. It's just the way things are because the quality of US education is poor.

[FONT=times new roman,helvetica]The corporate boat race.

[FONT=times new roman,helvetica]An American automobile company and a Japanese auto company decided to have a competitive boat race on the Detroit River. Both teams practiced hard and long to reach their peak performance. On the big day, they were as ready as they could be.

The Japanese team won by a mile.

Afterwards, the American team became discouraged by the loss and their morale sagged. Corporate management decided that the reason for the crushing defeat had to be found. A Continuous Measurable Improvement Team of "Executives" was set up to investigate the problem and to recommend appropriate corrective action.

Their conclusion: The problem was that the Japanese team had 8 people rowing and 1 person steering, whereas the American team had 1 person rowing and 8 people steering. The American Corporate Steering Committee immediately hired a consulting firm to do a study on the management structure.

After some time and billions of dollars, the consulting firm concluded that "too many people were steering and not enough rowing." To prevent losing to the Japanese again next year, the management structure was changed to "4 Steering Managers, 3 Area Steering Managers, and 1 Staff Steering Manager" and a new performance system for the person rowing the boat to give more incentive to work harder and become a six sigma performer. "We must give him empowerment and enrichment." That ought to do it.

The next year the Japanese team won by two miles.

The American Corporation laid off the rower for poor performance, sold all of the paddles, cancelled all capital investments for new equipment, halted development of a new canoe, awarded high performance awards to the consulting firm, and distributed the money saved as bonuses to the senior executives..

 

[Mellymel09]

But wouldn't this also get rid of the large amount of administrative costs if the government would be paying for it.
A more unified system would decrease the amount of work the individuals from different institutions (say physicians from different hospitals or different specialties) would need to perform and decrease the amount of paperwork.
Also there would be less ridiculous salaries for those at the top.

If the government pays for it, then it indirectly comes out of your wallet 😉

 

[Simplify]

As soon as you remove free market principles from the equation, governments can pay doctors whatever they would like. It can happen slowly by failing to make cost of living adjustments over a long period or it can happen in one fell swoop. If we transition to a socialized system I can guarantee that Canadian doctors will see their reimbursements drop. Canadian doctors are being paid as well as they are because of their proximity to the United States.

Changing us to universal healthcare under a Medicare model doesn't solve the underlying problems. Many physicians are compensated only on the volume of care they provide and that is definitely unsustainable in the long term.

 

[sfwusc]

The patient is the one that is going to get screwed. The waiting on service or denial of service is going to be awful for them. (If you don't believe this, then think about who is going to handle all this extra care... we don't have providers sitting around on their hands now. Also, you need beds, ORs, and so on as well) The supply of service is way less than the demand for the services, which is why it is expensive. If no one wanted healthcare, then the price would be a lot lower. (Congressmen/Sentators/President didn't take economics it seems)

When these lines or denials happen, then the rich and upper middle class are going to say screw it. There will be hospitals build in the Caribbean/Mexico to handle this demand... and they will want to hire doctors from the USA. Those doctors are going to make mega bucks (which is going to leave even less doctors for those force to deal with the single care system). (See Canadians coming to the USA for treatment)

Also, I am pretty sure you can op out of Medicaid or Medicare along with not taking X insurance plan... so you can always say I am just going to deal with those that can pay outside the single payer system. Bring Cash... No Waiting on procedures!!! Again, the less rich are screwed when currently they would be covered.

It is the middle and lower income classes that are currently covered that can't afford the work arounds that will be screwed here.... not the ones providing the service or the rich.

If all you care about is making money, then you will be fine. If you care about actually helping people's quality of life, then we are ones that are going to get screwed along with those patients.


This is a bad plan and citizens are the ones that are going to get screwed! Yet, they elected the idiots to office, so let them reap what they sowed.

 

[sfwusc]

Medicare will be insolvent in 2018 (Medicare apocalypse) and this factors in a 21% across the board cut in physician reimbursement. The government is not immune to high administrative costs. This country has a shortage of skilled and educated workers but has a surplus of administrators. It's just the way things are because the quality of US education is poor.

[FONT=times new roman,helvetica]The corporate boat race.

[FONT=times new roman,helvetica]An American automobile company and a Japanese auto company decided to have a competitive boat race on the Detroit River. Both teams practiced hard and long to reach their peak performance. On the big day, they were as ready as they could be.

The Japanese team won by a mile.

Afterwards, the American team became discouraged by the loss and their morale sagged. Corporate management decided that the reason for the crushing defeat had to be found. A Continuous Measurable Improvement Team of "Executives" was set up to investigate the problem and to recommend appropriate corrective action.

Their conclusion: The problem was that the Japanese team had 8 people rowing and 1 person steering, whereas the American team had 1 person rowing and 8 people steering. The American Corporate Steering Committee immediately hired a consulting firm to do a study on the management structure.

After some time and billions of dollars, the consulting firm concluded that "too many people were steering and not enough rowing." To prevent losing to the Japanese again next year, the management structure was changed to "4 Steering Managers, 3 Area Steering Managers, and 1 Staff Steering Manager" and a new performance system for the person rowing the boat to give more incentive to work harder and become a six sigma performer. "We must give him empowerment and enrichment." That ought to do it.

The next year the Japanese team won by two miles.

The American Corporation laid off the rower for poor performance, sold all of the paddles, cancelled all capital investments for new equipment, halted development of a new canoe, awarded high performance awards to the consulting firm, and distributed the money saved as bonuses to the senior executives..

Sadly, this is pretty true. I don't see how letting the king of red tape handle it is going to lower the cost though.

There are a lot of waste in the admin side of things, but the shortage of providers is a major problem too. That problem is going to be very hard to fix as it take a long time to get a student to a practicing physician, and you are going to need more schools to increase the output.

 

[TopSecret]

Sadly, this is pretty true. I don't see how letting the king of red tape handle it is going to lower the cost though.

There are a lot of waste in the admin side of things, but the shortage of providers is a major problem too. That problem is going to be very hard to fix as it take a long time to get a student to a practicing physician, and you are going to need more schools to increase the output.

People who also think that a uniform salary would be more lucrative should think again.

These are the military pays for newly board-certified doctors without dependents.

Neurosurgeon $117,690.
Radiologist $117,690.
Dermatologist $101,690.
Internist $101,690.
Family Practice $101,690.
Emergency Medicine $107,690.

These doctors also deploy 6-12 months or more in combat zones. As you can imagine, the military has problems retaining physicians.

*The pays do not include base allowance for housing which is tax-free. The military pays about $15,000-$25,000 per year or about a 2 bedroom apartment rate depending on location. They also pay about $2300 for food. This is also tax-free.