Medicare, budget woes, and your future

[Nilf]

That's an almost weekly thing. It's not going to go through this time either.



That's not anywhere in the bill.

It's not EXPLICITLY stated in the bill... however... when you are hospital employee, and your hospital accepts Medicare, then you are going to eat up any Medicare cuts that WILL happen... And the federal bureaucrats will make sure that you cannot OWN your hospital or practice... This is what overregulation is all about.

On a related note, the number of private medical practices have been dropping sharply over the past decade.

Besides, the precedence for forcing doctors to accept government-sponsored insurance plans has already been made. Massachussetts have introduced a bill which states that if you want to be licensed in Massachussetts, you HAVE TO accept their reimbusement. This is really old story, and I am not sure what happened to the bill, but consider it a handwriting on the wall...

Read here on the MA bills:
http://www.kevinmd.com/blog/2010/05/doctors-forced-accept-medicare-rates-stay-licensed.html

You have to understand that it's the COMBINATION of all these developments that will push doctors salaries into 100K range.

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[gettheleadout]

It's not EXPLICITLY stated in the bill... however... when you are hospital employee, and your hospital accepts Medicare, then you are going to eat up any Medicare cuts that WILL happen... And the federal bureaucrats will make sure that you cannot OWN your hospital or practice... This is what overregulation is all about.

On a related low, the number of private medical practices have been dropping sharply over the past decade.

Besides, the precedence for forcing doctors to accept government-sponsored insurance plans has already been made. Massachussetts have introduced a bill which states that if you want to be licensed in Massachussetts, you HAVE TO accept their reimbusement. This is really old story, and I am not sure what happened to the bill, but consider it a handwriting on the wall...

Read here on the MA bills:
http://www.kevinmd.com/blog/2010/05/doctors-forced-accept-medicare-rates-stay-licensed.html

You have to understand that it's the COMBINATION of all these developments that will push doctors salaries into 100K range.

I wouldn't really consider the precedent set until that is put into law somewhere, bills for all sorts of crazy stuff have been introduced before, much of it never coming to fruition.

Also, I feel like if doctors' salaries get pushed into the 100k range, one of two things must happen: The number of doctors being minted in the country will fall sharply, or the cost of medical school for the student will have to be lessened somehow.

 

[Nilf]

I wouldn't really consider the precedent set until that is put into law somewhere, bills for all sorts of crazy stuff have been introduced before, much of it never coming to fruition.

Also, I feel like if doctors' salaries get pushed into the 100k range, one of two things must happen: The number of doctors being minted in the country will fall sharply, or the cost of medical school for the student will have to be lessened somehow.

This Massachussetts bill is a canary in a landmine... even if it's not going to become law, it highlights the trends that will be dominant in next several decades in US medical industry... Ignore these trends to your own detriment.

Cost of medical school brings up another interesting point: I predict that the next step of the big gubmint will be to take over the medical education system... 'TO KEEP IT AFFORDABLE... Sounds familiar?

I've seen these 'affordable' medical schools on the other side of Atlantic Ocean... trust me... they are much much worse than in US.



Your argument about 'falling number of doctors'... Do you know what liberals, AKA socialists, have been saying about doctors threatening to quit? They said:"And what are they going to do? Go to the business school?' As much as I hate to admit this, they are right... Once you sunk in 10+ of years into medical education, there is very little else you can do with your life. It's not easy to change careers.


Young people like yourself don't understand the challenges facing US medicine, and unless someone educates them, they will continue to apply to medical schools. This is why I keep posting on this forum.

 

[Lokhtar]

It's not EXPLICITLY stated in the bill... however... when you are hospital employee, and your hospital accepts Medicare, then you are going to eat up any Medicare cuts that WILL happen... And the federal bureaucrats will make sure that you cannot OWN your hospital or practice... This is what overregulation is all about.

Then ObamaCare would be the best thing to happen to doctors since it's an expansion of the private insurance system rather than medicare....

 

[Nilf]

Then ObamaCare would be the best thing to happen to doctors since it's an expansion of the private insurance system rather than medicare....

No it is not expansion of private insurance system. You completely mistuderstood the new laws.

It is about REGULATION of private insurance and private medical industry. Insurance companies will be heavily regulated... Some will go out of business, others will shrink their market.

 

[SamuelTesla]

It's certainly extremely competitive in the European countries. And Canada. Unbelievably competitive in India.

I don't know about the other countries, but in India kids become doctors to get the respect that comes with that position. Doctors in India are pretty much treated like kings, and with good reason, as many of them are thousand times better than any md in U.S. I once went to a family physician in India. His fee? $10 (and that's without insurance)

Does that mean I'll accept < 100k? Hell no!!

 

[Lokhtar]

No it is not expansion of private insurance system. You completely mistuderstood the new laws.

It is about REGULATION of private insurance and private medical industry. Insurance companies will be heavily regulated... Some will go out of business, others will shrink their market.

What regulation does it place except making everyone pay private insurance for their coverage? E.g, expansion of private medical insurance?

 

[Musclemass]

This Massachussetts bill is a canary in a landmine...

You've got a mixed metaphor here.

Either:
A canary in a mine,
or
A landmine

I think you mean the second - an unseen danger that causes havoc.

Much as you try, you won't get a canary into a landmine.

 

[Lokhtar]

I don't know about the other countries, but in India kids become doctors to get the respect that comes with that position. Doctors in India are pretty much treated like kings, and with good reason, as many of them are thousand times better than any md in U.S. I once went to a family physician in India. His fee? $10 (and that's without insurance)

Does that mean I'll accept < 100k? Hell no!!

This is flat out untrue. I'm from India. Yes, you have elite physicians doing really really well, and in the past, being a physician was seen a great way to get out of poverty and still carries an amazing amount of prestige but unless you can find work at a great private hospital that caters to the upper middle class or the rich, or are able to get the hell out of the country, the situation is terrible.

You can't judge a boutique operation that serves the rich and charges $10 per visit.

The majority of doctors have patients who barely make $10 in a week. That type of practice is simply not possible for most physicians in India considering the level of income of most patients.

 

[Cleavername]

lol it seems almost universal that physicians use to do really well financially. now they are just shadows of their former selves.

 

[Nilf]

What regulation does it place except making everyone pay private insurance for their coverage? E.g, expansion of private medical insurance?

There are lots and lots of regulations. For instance, it forces insurance companies to spend 85% on medically related expenses. If you want to participate in exchanges, your product (insurance) have to meet certain criteria. It also puts restrictions on doctors' ownership of hospitals (though i'm not certain of details). That's just a handful that I remember. Read 1200 pages of it, and you'll find many many more.

Obamacare is so sweeping that noone really knows the extent of it, and how it will play out. The law of unintended consequences will be on prominent display.

 

[Musclemass]

.. many of them are thousand times better than any md in U.S...

Yeah, I guess this is why there has been such a large migration of Americans to India, and especially to attend med school there.

 

[Lokhtar]

There are lots and lots of regulations. For instance, it forces insurance companies to spend 85% on medically related expenses.

I've read every page. It is true that they must spend 85% of medically related expenses, and it's a figure that insurance companies don't have a big problem with (it was 90% on earlier drafts before insurance companies got it revised). After the pre-existing conditions law kicks in, insurance companies will be able to close down their departments that they spend tens of millions on (e.g, denial of claims due to pre-existing conditions and screening applicants). That condition is not that bad.

If you want to participate in exchanges, your product (insurance) have to meet certain criteria.

That's common sense though, right? If you're going to participate in a government subsidized program, obviously you're going to have to agree to certain criteria.

 

[Lokhtar]

And yes, there will certainly be unintended consequences - there already are (the subsidized state run high risk pools are being utilized far less than predicted).

With that said, I will certainly agree that physician salaries will, without a doubt, go down. You can't keep increasing healthcare costs that much faster than inflation for all that very much longer, and while physicians are not the culprits, they'll be one of the ones that pays.

The smarter solution would be to fix the over-utilization of services for medicare patients in their final year of life, but no politician of either stripe is brave enough to bring that up.

 

[gettheleadout]

This Massachussetts bill is a canary in a landmine... even if it's not going to become law, it highlights the trends that will be dominant in next several decades in US medical industry... Ignore these trends to your own detriment.

Cost of medical school brings up another interesting point: I predict that the next step of the big gubmint will be to take over the medical education system... 'TO KEEP IT AFFORDABLE... Sounds familiar?

I've seen these 'affordable' medical schools on the other side of Atlantic Ocean... trust me... they are much much worse than in US.



Your argument about 'falling number of doctors'... Do you know what liberals, AKA socialists, have been saying about doctors threatening to quit? They said:"And what are they going to do? Go to the business school?' As much as I hate to admit this, they are right... Once you sunk in 10+ of years into medical education, there is very little else you can do with your life. It's not easy to change careers.


Young people like yourself don't understand the challenges facing US medicine, and unless someone educates them, they will continue to apply to medical schools. This is why I keep posting on this forum.

Or what, take note of them and do what?

Second, I said number being minted would fall. Current ones would of course have little choice otherwise.

Third, so your purpose here is to discourage pre-med students from becoming doctors?

 

[cliffhuxtableDO]

Or what, take note of them and do what?

Second, I said number being minted would fall. Current ones would of course have little choice otherwise.

Third, so your purpose here is to discourage pre-med students from becoming doctors?

yes, nilf has said this explicitly in other threads.

 

[gettheleadout]

yes, nilf has said this explicitly in other threads.

My apologies, I was unaware of that. I will say it seems to make it hard not to give off the "disillusioned, bitter attending" vibe...

 

[SamuelTesla]

This is flat out untrue. I'm from India. Yes, you have elite physicians doing really really well, and in the past, being a physician was seen a great way to get out of poverty and still carries an amazing amount of prestige but unless you can find work at a great private hospital that caters to the upper middle class or the rich, or are able to get the hell out of the country, the situation is terrible.

You can't judge a boutique operation that serves the rich and charges $10 per visit.

The majority of doctors have patients who barely make $10 in a week. That type of practice is simply not possible for most physicians in India considering the level of income of most patients.

dude - regardless if they make money or no money, they earn respect like no other - that's my point. You're right - private hospital doctors make more - but India's middle class is rising too fast for the situation to remain all that "terrible" - $10 is nothing in India nowadays - the physician's office i visited was the size of a living room - and that was it - he had 1 staff - so he wasn't serving the "rich"

 

[Lokhtar]

dude - regardless if they make money or no money, they earn respect like no other - that's my point.

Yes, well I'll be paying my bills with 'respect' from now on.

You're right - private hospital doctors make more - but India's middle class is rising too fast for the situation to remain all that "terrible" - $10 is nothing in India nowadays - the physician's office i visited was the size of a living room - and that was it - he had 1 staff - so he wasn't serving the "rich"

Yes, middle class is rising. So? The average Indian still doesn't finish high school. You have a billion people, the majority of medical care is still going to people who cannot afford to pay $10 per visit. That's about 450 rupees. I grew up there, and my friend there is a driver and makes 1600 rupees a month in a small city.

You think he can afford that $10? Forget the cost of medicine, or surgeries, or procedures. A large percentage of doctors still need to service patients and populations such as him.


You are making up imaginary scenarios without actual data. There is a reason that if you polled all of the AIIMS graduates, 90% of them would want to come to the US.

 

[SamuelTesla]

Yes, well I'll be paying my bills with 'respect' from now on.

Yes, middle class is rising. So? The average Indian still doesn't finish high school. You have a billion people, the majority of medical care is still going to people who cannot afford to pay $10 per visit. That's about 450 rupees. I grew up there, and my friend there is a driver and makes 1600 rupees a month in a small city.

You think he can afford that $10? Forget the cost of medicine, or surgeries, or procedures. A large percentage of doctors still need to service patients and populations such as him.


You are making up imaginary scenarios without actual data. There is a reason that if you polled all of the AIIMS graduates, 90% of them would want to come to the US.

If your friend can't afford the $10, he can go to one of the thousands of free public hospitals that are available in India. That is what they are there for.

 

[Lokhtar]

If your friend can't afford the $10, he can go to one of the thousands of free public hospitals that are available in India. That is what they are there for.

Thanks for proving my point. How much do you think the doctors there make?

Also, you may not say that after you've visited one of those (its not the fault of the physicians, they are just absolutely under staffed and resourced - as in 200 patients per doctor type under staffed).

 

[AgentBlue]

This Massachussetts bill is a canary in a landmine... even if it's not going to become law, it highlights the trends that will be dominant in next several decades in US medical industry... Ignore these trends to your own detriment.

Cost of medical school brings up another interesting point: I predict that the next step of the big gubmint will be to take over the medical education system... 'TO KEEP IT AFFORDABLE... Sounds familiar?

I've seen these 'affordable' medical schools on the other side of Atlantic Ocean... trust me... they are much much worse than in US.



Your argument about 'falling number of doctors'... Do you know what liberals, AKA socialists, have been saying about doctors threatening to quit? They said:"And what are they going to do? Go to the business school?' As much as I hate to admit this, they are right... Once you sunk in 10+ of years into medical education, there is very little else you can do with your life. It's not easy to change careers.


Young people like yourself don't understand the challenges facing US medicine, and unless someone educates them, they will continue to apply to medical schools. This is why I keep posting on this forum.

Exactly, I agree with this 100%. Pre-meds these days are so deluded with thinking that docotors still make the same amount of money and have the same amount of prestige that doctors in the old days had. Most pre-meds don't even keep up with the news and are completely clueless about things such as the 21% medicare cuts and the future of medicine.

For those of you who say Obamacare will be good for physicians, just look at the socialized care in other countries and see how poorly they are paid in comparison to US docs. Why are so many doctors then from Canada and Europe coming to US instead of vice versa???? Sadly in the future this trend will stop since the US will have the same crappy socialized system as these countries.

 

[IvyHopeful20]

Haha, obamacare is socialized medicine?

What color is the sky in your world?

 

[AgentBlue]

Haha, obamacare is socialized medicine?

What color is the sky in your world?

When you are forced to buy health insurance or else you will have to pay a fine <---- This not socialism to you???

 

[osteohopeful09]

This thread is depressing. Why are we voiceless victims in this?

Groups like PAs and NPs are gaining in power because they have a VOICE.

What do we get with the AMA? a bunch of paid-off, sponsored, spineless wall flowers.

OK, things might suck for a few years, but sooner or later, Doctors will HAVE to speak up. They can never leave the scene entirely, so I fear that things are going to get VERY bad (in terms of salary), before things get better.

At the end of the day, all this **** is cyclical. Doctors have always ridden the wave between a "necessary evil", and the best-paid and respected members of society.

So, hopefully you all are going into medicine because you love the idea of practicing. If you end up not being able to pay your school debts, no worries. Our economy will be collapsed by the time they're due, and society might very well be in chaos What a better skillset to have, than to cure people! You'll be able to barter your services for all the rat meat and canned spam people can scavenge!!!!

 

[AgentBlue]

This thread is depressing. Why are we voiceless victims in this?

Groups like PAs and NPs are gaining in power because they have a VOICE.

What do we get with the AMA? a bunch of paid-off, sponsored, spineless wall flowers.

OK, things might suck for a few years, but sooner or later, Doctors will HAVE to speak up. They can never leave the scene entirely, so I fear that things are going to get VERY bad (in terms of salary), before things get better.

At the end of the day, all this **** is cyclical. Doctors have always ridden the wave between a "necessary evil", and the best-paid and respected members of society.

So, hopefully you all are going into medicine because you love the idea of practicing. If you end up not being able to pay your school debts, no worries. Our economy will be collapsed by the time they're due, and society might very well be in chaos What a better skillset to have, than to cure people! You'll be able to barter your services for all the rat meat and canned spam people can scavenge!!!!

lol, I guess I am not crazy for being the only person who thinks about this

But yeah, I am really surprised that doctors don't have a vocal voice in all of this. I mean look at the nurses unions and how they are lobying like crazy to be on par with doctos with this whole DNP bull

 

[Lokhtar]

When you are forced to buy health insurance or else you will have to pay a fine <---- This not socialism to you???

No.

It's a tax and it's written as such in the bill. Can you opt out of paying for farm subsidies because you disagree with them?

If you end up not being able to pay your school debts, no worries.

That won't happen.

 

[musafirah]

I've read every page. It is true that they must spend 85% of medically related expenses, and it's a figure that insurance companies don't have a big problem with (it was 90% on earlier drafts before insurance companies got it revised). After the pre-existing conditions law kicks in, insurance companies will be able to close down their departments that they spend tens of millions on (e.g, denial of claims due to pre-existing conditions and screening applicants). That condition is not that bad.

..um, isn't all of that going to increase the cost of medical care? insurance companies claim that they can't make any money if they don't reject certain applicants.. to compensate for the pre-existing conditions law, they will raise premiums to even atrociously higher amounts.. health care costs will go up and nothing about this stupid system will get better.

@ closing down departments they spend millions on.. i donno where you get that idea that they are going to save millions of dollars when they start being forced to 'insure' more people...

lokhtar, you are way too positive about obamacare and readily defend it to no end.. are you being paid by obama or some sht? would make sense since u "read every page" of the bill.


FTR i don't think socialism is the worst thing ever, i'm not republican or democrat, i just think the problem is this country is being run by big corporations/special interests/and lobbies and until that isn't fixed nothing will be. insurance companies practically wrote the bill.. how is that ok? how can anything about healthcare be made better when third parties are using it as their playing field to make tons of profits off of the misfortune of illness while adding nothing to the care itself. we need dramatic changes in how this country works. things will only get worse. osteohopeful is right, why keep being voiceless victims??

all this uncertainty after working so hard for so long to attain a dream/goal sucks ass.

 

[Lokhtar]

..um, isn't all of that going to increase the cost of medical care? insurance companies claim that they can't make any money if they don't reject certain applicants.. to compensate for the pre-existing conditions law, they will raise premiums to even atrociously higher amounts.. health care costs will go up and nothing about this stupid system will get better.

@ closing down departments they spend millions on.. i donno where you get that idea that they are going to save millions of dollars when they start being forced to 'insure' more people...

Save millions because there will be a lot more people paying into the system because everyone is required to buy insurance...the young and healthy mainly, who subsidize care for others.

If on the other hand, the individual mandate is overturned, then of course the premiums will shoot up and most likely the insurance companies would go bankrupt in many cases.

lokhtar, you are way too positive about obamacare and readily defend it to no end.. are you being paid by obama or some sht? would make sense since u "read every page" of the bill.

I wish . Unfortunately not though.

In any case, I've discussed in other threads (when the bill was being debated/passed) how I am not a big fan of huge parts of the bill and there are a lot of problems with it.

I have a problem though when people debate the fake bill. Meaning, the fictious made up bill where Obama personally comes in and kills your grandmother.

There are very legitimate concerns and issues with this bill, and of course, it's possible to oppose much of it on principle. But make sure you're opposing what's actually in the bill rather than a caricature created by Glenn Beck.

 

[Parts Unknown]

For those of you who say Obamacare will be good for physicians, just look at the socialized care in other countries and see how poorly they are paid in comparison to US docs. Why are so many doctors then from Canada and Europe coming to US instead of vice versa????

So-called socialization comes in several flavors, but few people bother to make the distinction. There is the hardcore brand of socialized medicine, of the sort made famous by the NHS in Britain and practiced by the VA system here in the US. Under this model the government directly employs and pays the physicians and other providers. Doctor = Federal Employee.

One might complain about earnings, but if you look at the perks of working for the VA in this country (lower work hours, 300 sanctioned holidays per year, excellent protection from malpractice suits), one can see the trade-off.

Another model is that of socialized insurance, which retains privately operating providers. This is the basis in Canada and many other nations, as well as Medicare in this country. Here Doctor = employee or small business owner, providing care and billing whatever entity is responsible for coverage.

Hopefully you can appreciate that there is a big, big difference between these two scenarios.

Also, your statement about physicians leaving Canada for the US is outdated. See this very recent article Physician Drain Turns To Gain. In some fields, particularly primary care, one can end up financially ahead by practicing up North. Jobs in my field (pathology) were more than competitive last year when I was looking.

 

[pancakesyrup]

It's not EXPLICITLY stated in the bill... however... when you are hospital employee, and your hospital accepts Medicare, then you are going to eat up any Medicare cuts that WILL happen... And the federal bureaucrats will make sure that you cannot OWN your hospital or practice... This is what overregulation is all about.

On a related note, the number of private medical practices have been dropping sharply over the past decade.

Besides, the precedence for forcing doctors to accept government-sponsored insurance plans has already been made. Massachussetts have introduced a bill which states that if you want to be licensed in Massachussetts, you HAVE TO accept their reimbusement. This is really old story, and I am not sure what happened to the bill, but consider it a handwriting on the wall...

Read here on the MA bills:
http://www.kevinmd.com/blog/2010/05/doctors-forced-accept-medicare-rates-stay-licensed.html

You have to understand that it's the COMBINATION of all these developments that will push doctors salaries into 100K range.

A lot of people propose stupid bills, and this Massachusetts bill has no chance of passing. Please stop your doom and gloom posts. They are annoying, ignorant, and unhelpful. Typical of an SDN troll.

 

[Geekchick921]

A lot of people propose stupid bills, and this Massachusetts bill has no chance of passing. Please stop your doom and gloom posts. They are annoying, ignorant, and unhelpful. Typical of an SDN troll.

You know what would have been better than calling out Nilf on his OMG ONOZ! posts? Not bumping a thread that's been dead for 5 months.

 

[mauberley]

You know what would have been better than calling out Nilf on his OMG ONOZ! posts? Not bumping a thread that's been dead for 5 months.

Geeks, since most of the trolls have been banned, how else are we supposed to get our lulz?

 

[slatermd]

You know what would have been better than calling out Nilf on his OMG ONOZ! posts? Not bumping a thread that's been dead for 5 months.

Yes.

Wait, new healthcare legislation may be proposed?

I ask myself, how could this necrobump be anything besides an attempt to provoke a flamewar?

Ironic Easter threadsurrection is ironic.

 

[Wolfman89]

Yes.

Wait, new healthcare legislation may be proposed?

I ask myself, how could this necrobump be anything besides an attempt to provoke a flamewar?

Ironic Easter threadsurrection is ironic.

Medz wins the thread!

 

[Geekchick921]

Geeks, since most of the trolls have been banned, how else are we supposed to get our lulz?

Don't worry, the troll population always goes up during school breaks, so within a month we'll have a new group of them, I'm sure.

Medz, I posted an alnost identical gif in a Nilf thread before, and I am dead at ironic Easter threadresurrection...

 

[slatermd]

Don't worry, the troll population always goes up during school breaks, so within a month we'll have a new group of them, I'm sure.

Medz, I posted an alnost identical gif in a Nilf thread before, and I am dead at ironic Easter threadresurrection...

Tell me how you feel on the third day

 

[Lokhtar]

A lot of people propose stupid bills, and this Massachusetts bill has no chance of passing. Please stop your doom and gloom posts. They are annoying, ignorant, and unhelpful. Typical of an SDN troll.

It makes sense though right? Medicare spends between $300,000 to $700,000 training every doctor (about half goes to the resident salary, the other half to the hospital training them...regardless of whether residents are underpaid that's still hundreds of thousands of tax payer dollars going to train), and then if they don't accept medicare, it gets nothing back. Maybe they should just make it so that you have to pay back medicare for the cost of training if you don't want to accept medicare.


Note: I don't necessarily think everyone should be forced to accept medicare - just pointing out the logic there.

 

[gettheleadout]

Tell me how you feel on the third day

Still going strong!

It makes sense though right? Medicare spends between $300,000 to $700,000 training every doctor (about half goes to the resident salary, the other half to the hospital training them...regardless of whether residents are underpaid that's still hundreds of thousands of tax payer dollars going to train), and then if they don't accept medicare, it gets nothing back. Maybe they should just make it so that you have to pay back medicare for the cost of training if you don't want to accept medicare.


Note: I don't necessarily think everyone should be forced to accept medicare - just pointing out the logic there.

The system gets another practicing physician providing care to the population, and wasn't that the idea in the first place?

I duly noted your note, however.

 

[mido1765]

wait i have a question. if salaries go down for doctors, does this mean, med school fees will go down as well? i think that would be reasonable. if we get out of med school with a 200,000 dollar debt, at least cut it in half if you are paying us less.

also, how is bringing doctor salary down will improve healthcare lol .. i would say it would do the opposite.

i think lots of people will still go to medicine because its a very enjoyable field, im just worried about my debt.

 

[WeAreNotRobots]

wait i have a question. if salaries go down for doctors, does this mean, med school fees will go down as well? i think that would be reasonable. if we get out of med school with a 200,000 dollar debt, at least cut it in half if you are paying us less.

In an ideal world with rational people in leadership positions, something like that might happen. but what makes you think med schools would be okay with getting lower incomes themselves? You would have to subsidize them somehow...probably with federal money. But what money does the gov have to do this? Gotta raise taxes. But what makes you think the general public wants higher taxes, and in effect, lower incomes?

All these policy battles are just going to be swaying back and forth for the next 10 to 100 years, or until America collapses and humans destroy themselves (only half serious). Each idealogical party will make small gains, then the opposing side gains momentum and fights back, like a pendulum. Swinging back and forth but never actually going anywhere.

 

[mauberley]

and I am dead at ironic Easter threadresurrection...

I just wanted a flimsy excuse to use this photo. Carry on.

 

[pancakesyrup]

It makes sense though right? Medicare spends between $300,000 to $700,000 training every doctor (about half goes to the resident salary, the other half to the hospital training them...regardless of whether residents are underpaid that's still hundreds of thousands of tax payer dollars going to train), and then if they don't accept medicare, it gets nothing back. Maybe they should just make it so that you have to pay back medicare for the cost of training if you don't want to accept medicare.


Note: I don't necessarily think everyone should be forced to accept medicare - just pointing out the logic there.

Your logic is flawed. Medicare doesn't gain anything from doctors who accept its payments. Every taxpaying citizen funds the program.

This bill is utter nonsense, and I doubt that most single payer advocates would support this. I actually hope it becomes law. It will be hilarious to see doctors leave the state in droves, and discredit this stupid idea forever.

 

[Lokhtar]

Your logic is flawed. Medicare doesn't gain anything from doctors who accept its payments. Every taxpaying citizen funds the program.

This bill is utter nonsense, and I doubt that most single payer advocates would support this. I actually hope it becomes law. It will be hilarious to see doctors leave the state in droves, and discredit this stupid idea forever.

Your logic is flawed. Medicare doesn't gain anything from doctors who accept its payments. Every taxpaying citizen funds the program.

?? Of course it does. Medicare spends money on training, in hopes of increasing access to the medicare population. Why would it spend money on training doctors who then don't accept its own payment?

This bill is utter nonsense, and I doubt that most single payer advocates would support this. I actually hope it becomes law. It will be hilarious to see doctors leave the state in droves, and discredit this stupid idea forever.

The fix then is to make it a national law .


And I'm an advocate of single payer, and I don't really support this.

 

[iqe2010]

Wait, so some docs won't be making 400k anymore? How terrible, everyone needs a summer house and a maid!

 

[RelicLTD]

Wait, so some docs won't be making 400k anymore? How terrible, everyone needs a summer house and a maid!

I have a great idea. How about all the doctors who DON'T care about their salary going down take the hit, and subsidize those who DO care.

 

[Frazier]

i have a great idea. How about all the doctors who don't care about their salary going down take the hit, and subsidize those who do care.

+1

 

[munchymanRX]

Recently, a bi-partisan Presidential commission suggested paying physicians less as ways of balancing the federal budget.

For healthcare, the commission suggested:
--pay doctors, other health providers and drug companies less and improve efficiency and quality;
--replace cuts required by SGR through 2015 with modest reductions while directing Medicare to create a new system;
--require rebates for brand-name drugs as a condition of participating in Medicare Part D;
--increase cost-sharing in Medicare; and
--enact comprehensive medical malpractice liability reform to cap non-economic and punitive damages and make other changes in tort law

Go to page 31 of the following document:
http://www.fiscalcommission.gov/sites/fiscalcommission.gov/files/documents/CoChair_Draft.pdf


My commentary:

IMO the budgetary situation is still not dire enough that any substantial budget-reducing legislation can make it through the congress. I don't expect it to occur before 2012. There will, be however, a lot of posturing on both sides of the isle as everybody is trying to portray themselves as fiscally responsible.


Because of utter lack of political muscle and our spineless leaders, there is a good chance that eventually the budget will be balanced on doctors' backs. The CUTS WILL COME... IT'S ONLY A MATTER OF WHEN. And not they WILL NOT be accompanied by any meaningful tort reform... The lawyer lobby owns the DC and will never let that happen.

So, here is the handwriting on the wall for you. Keep in mind that these 200K+ salaries that you are drooling about while attending orgo, will likely NEVER MATERIALIZE. Not in inflation adjusted dollars. Not unless you do plastics...

They already never materialize for most doctors. The average physician yearly net in the US is somewhere around $160k. I don't use the term salary because most docs in the country aren't salaried.

As for what will happen to the medical landscape in our future, I think a couple things will happen:

1) Midlevel providers will be empowered to take on more and more responsibilities traditionally handled by physicians--at a fraction of the cost. This is probably the best reason to not go into primary care. It has nothing to do with how much pay you're going to receive and everything to do with whether or not you want a job in 20 years.

2) Medicare is going to be slashed, and payout from that pot accordingly.


Private practice will go the way of the dinosaur as more and more docs will be unable to meet soaring overhead costs in the face of decreasing reimbursements. We're fast moving towards more institutionalized medicine, and that's not really a good thing...

 

[SoundofSilver]

wait i have a question. if salaries go down for doctors, does this mean, med school fees will go down as well? i think that would be reasonable. if we get out of med school with a 200,000 dollar debt, at least cut it in half if you are paying us less.

also, how is bringing doctor salary down will improve healthcare lol .. i would say it would do the opposite.

i think lots of people will still go to medicine because its a very enjoyable field, im just worried about my debt.

This would be nice, but medical school tuition will most likely keep going up (especially at state schools due to state budget cuts) while physician income continues to stagnate/decrease.

On the other hand, the student loan bubble is likely to burst relatively soon as the amount of defaults is expected to increase (due to lack of jobs and outrageous tuition prices). I'm not sure what effect this will have on the price of tuition. College is a pretty terrible investment nowadays for people who aren't set on a technical field where they'll at least have a chance of securing employment.

It's definitely a scary time in this country's history. Unfortunately, not a lot of people seem to care or are aware of this.