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I don’t at all understand where the comments about mcat and admission committees came in
I was just replying to your remarks about "capitalism should be in medicine". A primary argument I have seen in this thread as to why aspects of medicine should be driven by the principles of capitalism is for its ability to recruit the brightest and most motivated individuals through monetary incentives. I think its important to realize there's many areas in our higher education that filter out those who are not prepared or unmotivated.
 

sb247

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I was just replying to your remarks about "capitalism should be in medicine". A primary argument I have seen in this thread as to why aspects of medicine should be driven by the principles of capitalism is for its ability to recruit the brightest and most motivated individuals through monetary incentives. I think its important to realize there's many areas in our higher education that filter out those who are not prepared or unmotivated.
I think weeding out the uncompetitive is pretty capitalistic
 
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I think weeding out the uncompetitive is pretty capitalistic
And I’m saying there’s a system in place that does independent of capitalism when it comes to medicine....
 
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We’re talking past each other or I cannot get what you are trying to say. I’m not even arguing with your point, I don’t know what it is

Sorry
Lol
 

Stagg737

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I’m not so sure...money talks....and I do believe there are other viable options. Look at Japan and Germany ghat still have private insurers with regulation. That could be the compromise that takes place in the end. I however, do support Medicare for all, but it is important we maintain what works while discarding what doesnt.
Japan is not the model we want to emulate. One of my co-interns (in another field) moved from Japan 3 weeks before intern year started a and we had a long conversation about their system. It's a complete nightmare.

Germany would potentially be something to shoot for, but the foundation of their current system has existed for 80+ years so they've literally had decades to figure it out. Not something the US could reasonably implement in the next 20 years.

If you're talking about a two-tier system, Australia is the most reasonable model for the US to try and adopt imo. Basically Medicare for all for basic services with separate wrap-around coverage for catastrophic care. Not an ideal system by any means, but one which could be passed here without destroying the current system.
 

Gyuji

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Try selling that to voters. People already compromised with corporate politicians and HMOs with the Obamacare, aka Romneycare, aka Newtcare, aka Nixoncare, aka the individual healthcare mandate aka the conservative approach on healthcare reform created by the right-wing The Heritage Foundation. Currently, Obamacare pulls 50% of support. I think the People already made up their minds and will go all-in with universal healthcare. They have become aware and demanding and will soon demand it from both Senate and House during Bernie Sanders' presidency or just be simply voted out and replace by Millennial DSA-associated politicians like Ocasio-Cortez.
 
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All I’m saying is there are viable options and no one has spoken about any except Medicare for all, mainly because sanders was the only one willing to take it there. Once politicians realize our healthcare system will change, you can bet they’ll be spinning their heads, along with their donors, on how to reconcile capitalism with a universal healthcare system. Bernie is Bernie. AOC, Ro Khana, Omar, and a few others are in his camp, but for the legislation to have any real chance to pass as-is, the majority of the senate and House will have to be turned inside out and replaced with true progressives WHILE a progressive holds the White House..... I don’t see that happening...look what they did in California when a similar bill had very strong support actually within the state legislature....
 
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dnyal

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Maybe all of the docs in support of MFA can just offer free or vastly reduced prices for their services to those that need them. That way they can feel charitable and give up most of their salary without advocating for the destruction of the profession for everyone else.
Wow...
I know this is a relatively old post, but as a pre-health I wonder if these kind of responses would sit well with medical schools’ admission committees. Is really getting an already high salary halved the ‘destruction of the profession for everyone’? I also wonder what the patients of many of these ‘doctors’ here would say if they knew that these beacons of medical service here consider a lower salary the destruction of their profession. I mean, isn’t that what American doctors are supposed to be: the cream of the crop? The professional beacons of the world?

Someone else here also mentioned that pretty much American doctors are the best because America entices bright minds into medicine with high salaries. Isn’t that counterproductive, though? That other person said, too, that doctors elsewhere but in the US are "shady" and unethical. Yet the reasoning is that you only get good doctors if you give them real good money. People, honey mostly attracts ants and flies, not so much bees themselves.

I mean, I know vocation alone doesn’t pay the bills, but spare me your politics and selfish reasoning: halving doctors’ salaries (if that ever happens) would not destroy the medical profession; you’ve already destroyed its soul with comments like those. Your medical schools have failed miserably in their supposed rigorous selection process to only yield the candidates most committed to serving the community.

If you would like to be of real service for once in your careers, please all the money doctors here tell me your med schools, so the rest of us ‘idealist millennials’ know where not to apply. Oh, and btw, I’ve seen more brilliant minds among the non-medical STEM majors than in the field of medicine. And and they didn’t need money to lure them into those fields.

Gosh, the shamelessness of most of you. Your doctor title and fancy houses went straight to your heads, didn’t they?
 

dohopeful13

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Wow...
I know this is a relatively old post, but as a pre-health I wonder if these kind of responses would sit well with medical schools’ admission committees. Is really getting an already high salary halved the ‘destruction of the profession for everyone’? I also wonder what the patients of many of these ‘doctors’ here would say if they knew that these beacons of medical service here consider a lower salary the destruction of their profession. I mean, isn’t that what American doctors are supposed to be: the cream of the crop? The professional beacons of the world?

Someone else here also mentioned that pretty much American doctors are the best because America entices bright minds into medicine with high salaries. Isn’t that counterproductive, though? That other person said, too, that doctors elsewhere but in the US are "shady" and unethical. Yet the reasoning is that you only get good doctors if you give them real good money. People, honey mostly attracts ants and flies, not so much bees themselves.

I mean, I know vocation alone doesn’t pay the bills, but spare me your politics and selfish reasoning: halving doctors’ salaries (if that ever happens) would not destroy the medical profession; you’ve already destroyed its soul with comments like those. Your medical schools have failed miserably in their supposed rigorous selection process to only yield the candidates most committed to serving the community.

If you would like to be of real service for once in your careers, please all the money doctors here tell me your med schools, so the rest of us ‘idealist millennials’ know where not to apply. Oh, and btw, I’ve seen more brilliant minds among the non-medical STEM majors than in the field of medicine. And and they didn’t need money to lure them into those fields.

Gosh, the shamelessness of most of you. Your doctor title and fancy houses went straight to your heads, didn’t they?
Your virtue has been signaled and your moral superiority is well established. Thank you.
 

dohopeful13

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And honestly, doctors and med students are allowed to be concerned about single payer and its consequences. You sacrifice your youth, hundreds of thousands of dollars in loans, and years of opportunity cost. It doesn’t mean I don’t love the field or i’m evil because I would be unhappy with having my salary cut from 200+k to sub 100k while owing 400k to the same government that just screwed me. I’m sorry if that offends your narrow world view.

Are you the same type of guy that tells teachers to be happy making 35k a year or they don’t love the field? Or does your self-righteousness only extend to medicine?

And that’s not to say healthcare doesn’t need reform btw. It absolutely does. No one you should go broke trying to afford medical bills. But that said, if an option comes at cost of destroying my financial future, then I don't want to be a martyr for it. Medicine is a noble job, but it’s still a job. Jobs are to be compensated fairly. If it offends your sensibilities that doctors dare care about their financial futures, then I don’t know what to tell you.
 
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Gyuji

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Don't worry. There's Kamala Harris. She's turning out to be a good "politician." Meaning she knows how to talk to people with the right words and saying what's popular like supporting Medicare-4-All but in reality she's not. Same goes to Elizabeth Warren as everyone knows she'll compromise all the way through her term which Bernie Sanders will not compromise. Corporate media is already prop-ing Harris at the moment. It all depends on the ballot. Sanders needs huge voter-turnout to wallop the competition and resistance.

The only thing is we're in the anti-establishment era.
 

sunshinefl

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Wow...
I know this is a relatively old post, but as a pre-health I wonder if these kind of responses would sit well with medical schools’ admission committees. Is really getting an already high salary halved the ‘destruction of the profession for everyone’? I also wonder what the patients of many of these ‘doctors’ here would say if they knew that these beacons of medical service here consider a lower salary the destruction of their profession. I mean, isn’t that what American doctors are supposed to be: the cream of the crop? The professional beacons of the world?

Someone else here also mentioned that pretty much American doctors are the best because America entices bright minds into medicine with high salaries. Isn’t that counterproductive, though? That other person said, too, that doctors elsewhere but in the US are "shady" and unethical. Yet the reasoning is that you only get good doctors if you give them real good money. People, honey mostly attracts ants and flies, not so much bees themselves.

I mean, I know vocation alone doesn’t pay the bills, but spare me your politics and selfish reasoning: halving doctors’ salaries (if that ever happens) would not destroy the medical profession; you’ve already destroyed its soul with comments like those. Your medical schools have failed miserably in their supposed rigorous selection process to only yield the candidates most committed to serving the community.

If you would like to be of real service for once in your careers, please all the money doctors here tell me your med schools, so the rest of us ‘idealist millennials’ know where not to apply. Oh, and btw, I’ve seen more brilliant minds among the non-medical STEM majors than in the field of medicine. And and they didn’t need money to lure them into those fields.

Gosh, the shamelessness of most of you. Your doctor title and fancy houses went straight to your heads, didn’t they?
Yikes. I’m literally gagging on this post. I would like to be compensated fairly for my education, training, sacrifice, blood, sweat, and tears. Cutting salaries in half isn’t going to do that.
 

sb247

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Wow...
I know this is a relatively old post, but as a pre-health I wonder if these kind of responses would sit well with medical schools’ admission committees. Is really getting an already high salary halved the ‘destruction of the profession for everyone’? I also wonder what the patients of many of these ‘doctors’ here would say if they knew that these beacons of medical service here consider a lower salary the destruction of their profession. I mean, isn’t that what American doctors are supposed to be: the cream of the crop? The professional beacons of the world?

Someone else here also mentioned that pretty much American doctors are the best because America entices bright minds into medicine with high salaries. Isn’t that counterproductive, though? That other person said, too, that doctors elsewhere but in the US are "shady" and unethical. Yet the reasoning is that you only get good doctors if you give them real good money. People, honey mostly attracts ants and flies, not so much bees themselves.

I mean, I know vocation alone doesn’t pay the bills, but spare me your politics and selfish reasoning: halving doctors’ salaries (if that ever happens) would not destroy the medical profession; you’ve already destroyed its soul with comments like those. Your medical schools have failed miserably in their supposed rigorous selection process to only yield the candidates most committed to serving the community.

If you would like to be of real service for once in your careers, please all the money doctors here tell me your med schools, so the rest of us ‘idealist millennials’ know where not to apply. Oh, and btw, I’ve seen more brilliant minds among the non-medical STEM majors than in the field of medicine. And and they didn’t need money to lure them into those fields.

Gosh, the shamelessness of most of you. Your doctor title and fancy houses went straight to your heads, didn’t they?
Get through residency and then tell us how your skillset is only worth $80k and you think high end intelligence candidates would still go that route
 

doctalaughs

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The idea that it's either tens of thousands of people die because they don't have healthcare, OR salaries go from 300,000-400,000+ to 80,000 seems a bit much.
“Covering everyone” in universal healthcare I think is a nebulous term.

I do think a few basic things should be universally “free” - ie vaccines, birth control, perhaps a few basic medications which are very cheap and proven.

Beyond that you could argue we can tax for catastrophic universal coverage - ie car accident, gunshot, ruptured appy etc.

Beyond that you need to pay for what you get. Sounds harsh but we can’t bankrupt the country or massively redistribute wealth (which in turn would destroy the wealth creation mechanism in the first place!) to keep grandma on the vent for weeks, or give out stem-cell transplants like candy etc.

The people that decide not to pay more for insurance won’t get the super-expensive treatments.... but they will get basic, evidence-based cost-effective care.

Two tier system? Yes. Sorry ALL healthcare can’t be a “right” because demand for healthcare (and increasingly expensive care) is infinite when it’s free. If you want to split hairs, sure we could say “basic” healthcare is covered as a society but that doesn’t sounds as righteous.
 
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I think that demand for healthcare is infinite when you're sick or going to lose your life, it's just that the current system "conveniently" lets these people die, go bankrupt, or both. If everyone has healthcare and uses it when they need it, then yes either people are going to have to wait longer (only so many physicians available) or we make more physicians or a combination of both.

It seems like to me the best system would be one where if someone feels sick, or there's something wrong, they can go see a doctor and the doctor will make the decision regarding what a reasonable plan is. Of course you would need some oversight (hopefully by other physicians) to make sure there's no funny business going on, but I think that in the vast majority of cases there would be a reasonable plan of care for a patient.

I hear a lot of philosophical reasons for why healthcare shouldn't be a right (you don't have a "right" to labor, etc) but I wonder how much of it truly comes down to "as a physician I will do well under the status quo and thus I will fight any attempts to change it because I am afraid my compensation will go down, so damn the shortcomings now"
 

Cryc_to_the_point

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It seems like to me the best system would be one where if someone feels sick, or there's something wrong, they can go see a doctor and the doctor will make the decision regarding what a reasonable plan is. Of course you would need some oversight (hopefully by other physicians) to make sure there's no funny business going on, but I think that in the vast majority of cases there would be a reasonable plan of care for a patient.

I hear a lot of philosophical reasons for why healthcare shouldn't be a right (you don't have a "right" to labor, etc) but I wonder how much of it truly comes down to "as a physician I will do well under the status quo and thus I will fight any attempts to change it because I am afraid my compensation will go down, so damn the shortcomings now"
I think this occurs but is actually a very small part of the argument. Its overblown by naive socialists that think we can just redistribute our way to a health utopia.
 

drtribbiani

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I think this occurs but is actually a very small part of the argument. Its overblown by naive socialists that think we can just redistribute our way to a health utopia.
Gonna preface my question with this: not taking any political stances here, cause I still don't know which side I lean with respect to healthcare. I'm just here to learn.

What about countries like Canada and Denmark that have universal health care and have reportedly been doing really well in that sector (according to some news I've seen, which I understand could very well be bs as well).
 

medschoolzombie

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Gonna preface my question with this: not taking any political stances here, cause I still don't know which side I lean with respect to healthcare. I'm just here to learn.

What about countries like Canada and Denmark that have universal health care and have reportedly been doing really well in that sector (according to some news I've seen, which I understand could very well be bs as well).
From my understanding, Canada’s system isn’t a federal one, it’s on the province level. So everyone in a province is on the same system and each province has their own. That’s different than what the US is proposing to do which is a nationalized system

Denmark’s system likely works because they limit the number of people on it. The population is already really small in comparison to the US, but they also vastly limit immigration into the country which keeps the number of people getting healthcare stable at any time. There’s also the fact that they’re a much healthier population to begin with than people here which probably makes it cheaper to insure them
 

drtribbiani

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From my understanding, Canada’s system isn’t a federal one, it’s on the province level. So everyone in a province is on the same system and each province has their own. That’s different than what the US is proposing to do which is a nationalized system

Denmark’s system likely works because they limit the number of people on it. The population is already really small in comparison to the US, but they also vastly limit immigration into the country which keeps the number of people getting healthcare stable at any time. There’s also the fact that they’re a much healthier population to begin with than people here which probably makes it cheaper to insure them
Thank you for clearing this up for me!
 
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Hey all!
First, I am going to bow away from the political side of this discussion (I have read almost every post haha). I am just curious if some people with more knowledge/experience could enlighten me on their opinions....

I’m an incoming M1. I was ecstatic to get into school and was even happier that I got into the same school as my spouse (who will also be an M1). However, I’m now terrified. Neither of us are wealthy, and although we got some scholarships, we expect to enter residency with ~500 k total debt (Includes living expenses and compounded interest). Are we being dumb for going into medicine with this level of debt? Haha, I know this is a loaded question but we both love medicine. However, the fear of paying off the equivalent of a large mortgage (especially with the prospects of physician salaries being halved) is keeping me up at night (literally have not been able to sleep all night)....

I would call my standard of living as modest (spouse and I are happy with a small condo, and my 10 year old Nissan), so we don’t need much. I just am worried that we might be putting ourselves at risk of becoming indefinite indentured servants (thanks to the student loan industry).

I for one don’t really care what my future salary is (not trying to start something here, I think we each are entitled to our views of what we are worth) but I don’t want to live in debt my whole life....

Any perspective? What have other countries done during this transition (loan forgiveness, etc)? Should I take a scholarship like HSPS? (I am interested in a competitive surgical specialty though, so that another thing).

Thanks so much!

Edited for grammar (typing at midnight is hard)
 

sb247

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Hey all!
First, I am going to bow away from the political side of this discussion (I have read almost every post haha). I am just curious if some people with more knowledge/experience could enlighten me on their opinions....

I’m an incoming M1. I was ecstatic to get into school and was even happier that I got into the same school as my spouse (who will also be an M1). However, I’m now terrified. Neither of us are wealthy, and although we got some scholarships, we expect to enter residency with ~500 k total debt (Includes living expenses and compounded interest). Are we being dumb for going into medicine with this level of debt? Haha, I know this is a loaded question but we both love medicine. However, the fear of paying off the equivalent of a large mortgage (especially with the prospects of physician salaries being halved) is keeping me up at night (literally have not been able to sleep all night)....

I would call my standard of living as modest (spouse and I are happy with a small condo, and my 10 year old Nissan), so we don’t need much. I just am worried that we might be putting ourselves at risk of becoming indefinite indentured servants (thanks to the student loan industry).

I for one don’t really care what my future salary is (not trying to start something here, I think we each are entitled to our views of what we are worth) but I don’t want to live in debt my whole life....

Any perspective? What have other countries done during this transition (loan forgiveness, etc)? Should I take a scholarship like HSPS? (I am interested in a competitive surgical specialty though, so that another thing).

Thanks so much!

Edited for grammar (typing at midnight is hard)
A two doc family can pay that off
 

KeikoTanaka

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Which country do we move to if salaries tank?
Probably Australia. Or you go to an even more socialized northern country where despite having a lower income, your kids healthcare and education will be paid for with amazing schools and infrastructure lol. Unlike in the US where we'll attempt to have a socialized healthcare but other costs in life will be so high still it'll just be oppressive
 
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Probably Australia. Or you go to an even more socialized northern country where despite having a lower income, your kids healthcare and education will be paid for with amazing schools and infrastructure lol. Unlike in the US where we'll attempt to have a socialized healthcare but other costs in life will be so high still it'll just be oppressive

The US really is the last bastion man. After that the other countries are sort of a joke. Although they I do agree about Australia by just wait until the next recession hits there.
 
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Have you talked to people in other countries? Most of them think the US is a joke. Yes, probably the best for the very wealthiest in the world, but for everyone else (including doctors) it’s not that great. Even taking into account differences in tax rates, after you subtract your schooling expenses (and your kids?), healthcare costs, money to save for retirement... we ain’t doing that great here. Everyone seems to see the big salaries that physicians pull in and completely ignore how much more they work here, how much unreimbursed care there is, and a million other things that those in other countries don’t worry about. Death by a thousand cuts...
 
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Have you talked to people in other countries? Most of them think the US is a joke. Yes, probably the best for the very wealthiest in the world, but for everyone else (including doctors) it’s not that great. Even taking into account differences in tax rates, after you subtract your schooling expenses (and your kids?), healthcare costs, money to save for retirement... we ain’t doing that great here. Everyone seems to see the big salaries that physicians pull in and completely ignore how much more they work here, how much unreimbursed care there is, and a million other things that those in other countries don’t worry about. Death by a thousand cuts...
Student loans are paid off at most in 10 years. So for the average career that's 20 years where education doesn't matter.

I think you underestimate a) just how much more we make compared to most other places and b) just how much they are taxed to pay for all those things.
 
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True that it’s paid off, but in that case we should actually compare them opportunity cost vs. invested in the market. This is more reasonable because it’s actually money you have and could invest, rather than pretending that you would have access to the hundreds of thousands in loan money that people pretend when they talk about the opportunity cost of paying for medical school over doing something else.

Also, again, I’m not sure how much higher our taxes are than in places like Australia or Canada. And what is our effective tax rate if you inClyde paying for healthcare, malpractice, and our loans + potentially college for kids. Because we can’t ignore these things are appreciably lower in those countries as well.
 
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Honestly, unfortunately, socialism and socialized health care is an eventuality. America is essentially socialist already and it's only a matter of time until it's full tilt. It's the natural cycle of things.

I'm reading through this thread (and others) a second time now.

I've wanted to be a doctor and am working extremely hard to get there. As a nontraditional student I have some years of perspective re: history and the status quo locally and around the world. Not seeing this through rose colored glasses..

I absolutely do not want to be completely beholden to government and its malevolent bureaucratic processes. I do not want a full load of med school debt PLUS drastically slashed compensation PLUS (further) exorbitant future taxes.

Will direct primary care/concierge practice even be possible under draconian socialist government?

I imagine feds yanking credentials and licenses for people operating outside of the system in the future. Possibly worse.

I considered physical therapy, but after some research it seems like all the same hassles for nearly the same commitments and responsibilities.

I have to sort out my life (and next semester) so I'd really appreciate input.
 
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Would you feel more comfortable working in to be completely beholden corporations and their malevolent bureacratic practices? Because that’s the reality as it is.. as private equity and hospital systems consolidate power they will do whatever they can to reduce physician salaries and skim more off the top. This is the current reality.

Answering your question, even the Sanders plan allows you to do whatever you want if you do not accept ANY money from the gov as far as insurance payments, etc. So essentially if you want to completely opt out to do your own thing, you can do that.

Also, keep in mind that the individuals you are talking about also want to cancel all student debt and make colleges tuition free and cap educational loans at 2% interest, not 7-8%. In addition, if salaries were “slashed”, then you wouldn’t be affected by the higher taxes on wealthier individuals.
 
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Would you feel more comfortable working in to be completely beholden corporations and their malevolent bureacratic practices? Because that’s the reality as it is.. as private equity and hospital systems consolidate power they will do whatever they can to reduce physician salaries and skim more off the top. This is the current reality.

Answering your question, even the Sanders plan allows you to do whatever you want if you do not accept ANY money from the gov as far as insurance payments, etc. So essentially if you want to completely opt out to do your own thing, you can do that.

Also, keep in mind that the individuals you are talking about also want to cancel all student debt and make colleges tuition free and cap educational loans at 2% interest, not 7-8%. In addition, if salaries were “slashed”, then you wouldn’t be affected by the higher taxes on wealthier individuals.
The opt out thing will never work for the majority of physicians. Even if they do, the government would put a kabosh on it either they making clear that they can charge no more for the service than those who charge the govt for the service or making licensure contingent on accepting it.

This whole opt out thing provides the illusion of a viable Choice which in truth it is not.

Corporate shill or govt employee, medicine in the 21st century isn’t about being a good doctor or clinching the diagnosis it’s about working as cheaply as possible for the sake of the larger system whatever that may be. Your compensation, professional fulfillment are irrelevant.

The public simply doesn’t care how miserable you are or how much work you had to put in to get to this point in your career. The only question they have is “can you do it for less doc?” Hence the barrage of legislation to knock down salaries from M4A and balance billing to NP independence.

This is quite possibly one of these most uncertain and unfathomably crappy times to be in the medical field.
 
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I mean if you look at the bill and you say no actually that's not what it says I don't know what to tell you... from what I understand it's written into the bill as it is now. If we take your approach then you can't look at the bill as it's written now at all because it could always theoretically change.

And yes, I agree with you about working as cheaply as possible, etc... I'm glad you acknowledge that it will be that way in our current system as well. If it makes you feel any better, look at threads pre-obamacare and you'll hear the sky is falling talk, and things are pretty ok today for doctors at least.
 
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I mean if you look at the bill and you say no actually that's not what it says I don't know what to tell you... from what I understand it's written into the bill as it is now. If we take your approach then you can't look at the bill as it's written now at all because it could always theoretically change.

And yes, I agree with you about working as cheaply as possible, etc... I'm glad you acknowledge that it will be that way in our current system as well. If it makes you feel any better, look at threads pre-obamacare and you'll hear the sky is falling talk, and things are pretty ok today for doctors at least.

It’s gonna be a slow but noticeable decline. Everything is ok until it’s not and by then it’s too late.

By working as cheaply as possible, I really meant you will likely be doing things that benefit the system rather than the patient.