Most docs seem to be against Obamacare, while most premeds are in favor of it

[jdlykins91]

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What provision in the PPACA prevented your father from seeing a cardiologist for 6 months?

I was not intending to claim that the Act, itself, prevented my father from seeing his cardiologist. That would be silly, and if that was the impression that I gave, I apologize. I was merely pointing out that the notion that now, currently, pre-existing conditions cannot prevent access to insurance and, by extension, health care is not accurate. As another poster pointed out, apparently this aspect of the bill does not go into effect until 2014. However, the general impression of the bill does not actually equate with the realities under the law.

 

[TipToad]

So you're basically arguing that this act is faulty because it didn't do everything that it said it was going to do the exact moment it became law.

I don't know what else to say besides "Wait and be patient."

 

[deleted103644]

Attending support varies from state to state.

It also varies across specialties, practice settings, etc.

 

[pseudosquam]

Earlier I spoke about higher ideals about taxation and autonomy.

Speaking directly to the Accountable Care Act - the reason I don't support it is because I don't want to see another profession, a noble profession, become another public-sector-cog-machine. The less government involved in medicine the better. We are all going into medical school so that we can learn medicine and practice to the best of our abilities to serve our patients. I believe that will be increasing difficult as more government becomes involved.

The Federal Gov. has a strong interest in who is treated, how much, and what type of treatment you give.

Think about the draconian-rigid-teaching objectives public school teachers must meet. All for the useless metric tests the federal government has pushed on them. If they don't meet these goals they don't get federal money. They have very little autonomy and their funding is used as a political football. See the similarities between public education and where health care may be headed? I don't want to go there. I don't want to be a cog in the federal machine and be looked at as a tax payer subsidized employee. I want to create my own wealth by providing a valued service in the private sector.

I don't know about you guys but I dream of someday running a private practice. Treating thankful patients who have an interest in their own health and being able to treat them with the best medicine that I can offer. I'm competitive. I want to be better than any of the other doctors in town and as a result be able to charge more and live better. The last thing I want is some worthless fed. gov. official telling me how to practice medicine and titrating my reimbursement so my success doesn't eat up too much tax payer money so they can be reelected.

Do not vote democrat.

 

[jdlykins91]

So you're basically arguing that this act is faulty because it didn't do everything that it said it was going to do the exact moment it became law.

Not at all!!! I am arguing that those who emphasize all of the wonderful things that the law is going to do are not seeing it from the perspective of the average person who is suffering just as much after the law as before it.

 

[Gut Shot]

I was not intending to claim that the Act, itself, prevented my father from seeing his cardiologist. That would be silly, and if that was the impression that I gave, I apologize. I was merely pointing out that the notion that now, currently, pre-existing conditions cannot prevent access to insurance and, by extension, health care is not accurate. As another poster pointed out, apparently this aspect of the bill does not go into effect until 2014. However, the general impression of the bill does not actually equate with the realities under the law.

I don't think there is a "general impression" of the bill. Public polling is divided (unless the major individual provisions are polled individually). A portion of the public is rabidly opposed. A portion is still bitter that a public option wasn't included. Most people don't seem well educated on its contents. Methinks you are overreacting to the perceived exuberance of a small minority.

 

[Gut Shot]

Treating thankful patients who have an interest in their own health and being able to treat with the best that I can offer.

 

[TipToad]

Not at all!!! I am arguing that those who emphasize all of the wonderful things that the law is going to do are not seeing it from the perspective of the average person who is suffering just as much after the law as before it.

I see suffering just fine. I see their perspective just fine. My boyfriend's mother is uninsured. All of my community service and volunteer work have been with people living under poverty-level without insurance. Still, I support the Act.

 

[jdlykins91]

I see suffering just fine. My boyfriend's mother is uninsured. All of my community service and volunteer work have been with people living under poverty-level without insurance. Still, I support the Act.

I assure you that it is not only liberals who do volunteer work with the uninsured. However, I feel no need to demonstrate how caring I am by talking about the free clinics in which I spend my free time. We all want to see the best for patients and ourselves. There are just two completely distinct underlying philosophies with respect to how that might be accomplished.

 

[deleted103644]

Earlier I spoke about higher ideals about taxation and autonomy.

Speaking directly to the Accountable Care Act - the reason I don't support it is because I don't want to see another profession, a noble profession, become another public-sector-cog-machine. The less government involved in medicine the better. We are all going into medical school so that we can learn medicine and practice to the best of our abilities to serve our patients. I believe that will be increasing difficult as more government becomes involved.

The Federal Gov. has a strong interest in who is treated, how much, and what type of treatment you give.

Think about the draconian-rigid-teaching objectives public school teachers must meet. All for the useless metric tests the federal government has pushed on them. If they don't meet these goals they don't get federal money. They have very little autonomy and their funding is used as a political football. See the similarities between public education and where health care may be headed? I don't want to go there. I don't want to be a cog in the federal machine and be looked at as a tax payer subsidized employee. I want to create my own wealth by providing a valued service in the public sector.

I don't know about you guys but I dream of someday having a private practice. Treating thankful patients who have an interest in their own health and being able to treat them with the best medicine that I can offer. I'm competitive. I want to be better than any of the other doctors in town and as a result be able to charge more and live better. The last thing I want is some worthless fed. gov. official telling me how to practice medicine and titrating my reimbursement so my success doesn't eat up too much tax payer money so they can be reelected.

Do not vote democrat.

Nothing in the bill will do this, if you're as good as you think you are.

If you can command your own rates due to reputation, you can simple get all of your patients to pay out of pocket. Insurance isn't an issue there.

Good luck with that.

 

[jdlykins91]

I don't think there is a "general impression" of the bill. Public polling is divided (unless the major individual provisions are polled individually). A portion of the public is rabidly opposed. A portion is still bitter that a public option wasn't included. Most people don't seem well educated on its contents. Methinks you are overreacting to the perceived exuberance of a small minority.

Perhaps you are correct. Perhaps I am overreacting. We will see how things play out. I am just apprehensive about the future both for physicians and their patients.

 

[deleted103644]

I assure you that it is not only liberals who do volunteer work with the uninsured. However, I feel no need to demonstrate how caring I am by talking about the free clinics in which I spend my free time. We all want to see the best for patients and ourselves. There are just two completely distinct underlying philosophies with respect to how that might be accomplished.

And how do you propose to insure everyone? I dislike the ACA, but probably for different reasons than you do.

 

[TipToad]

Perhaps you are correct. Perhaps I am overreacting. We will see how things play out. I am just apprehensive about the future both for physicians and their patients.

I think to a certain extent everybody is apprehensive. Personally for me, I feel that our current system is flawed. I support this bill because we're moving. As you've said earlier, the direction in which we're moving can be debated, but at least we're moving rather than staying in a flawed system.

 

[pseudosquam]

Democrats are actually the least caring. Not only do they donate the least amount to charity every year; but, they also tend to favor programs that keep people in poverty for generations to buy votes. Effectively trading public funds for their own political gain.

Johnny, as good as I may or may not be, I cannot fathom why anyone would be for the federal take over of health care - another line on the budget that needs to get cut. Public funds are drying up yet private industry thrives. What side of the fence do you want to be on?

 

[jdlykins91]

I think to a certain extent everybody is apprehensive. Personally for me, I feel that our current system is flawed. I support this bill because we're moving. As you've said earlier, the direction in which we're moving can be debated, but at least we're moving rather than staying in a flawed system.

No doubt. We are moving. I don't think anyone is satisfied about the system as it is. And working together, there are ways to continue to improve things. As to the above poster who asked for my own suggestions, I don't know how to fix things completely. There are people who are better qualified, have more real-world experience in the system, and have actually treated patients. I think that going to actual doctors, rather than special interest groups, is the first step. I recognize that medical malpractice is not that substantial of a driver of costs, but if doctors did not have to practice defensive medicine by ordering unnecessary testing to protect themselves, it would reduce costs slightly. It is a start. How about allowing for insurance companies nationwide to actively compete with one another for business. Prices will go down as the insurance companies attempt to provide the best product for the lowest price. Allow people to determine who succeeds with their dollars, rather than through governmental intrusion. Again, I don't know what the answer is, and I would welcome comments or suggestions. The thing is, working together properly, rather than through the use of divisive rhetoric (which both sides are guilty of!!!), we could do something that worked for patients and physicians.

 

[jdlykins91]

Democrats are actually the least caring. Not only do they donate the least amount to charity every year; but, they also tend to favor programs that keep people in poverty for generations to buy votes. Effectively trading public funds for their own political gain.

I don't know that Democrats are less caring. There are just different approaches to fixing problems in some cases. We all want problems to be fixed, we just want to go about fixing them in different ways. I think that people ought to actually spend their time, rather than their money, to help fix these kinds of problems. For example, here in the Portland-metro area, touted for its Progressivism, I can count, probably on one hand, the number of actual free clinics. In Oklahoma, where I attend school, there are many free clinics and quite a few that are available for reduced rates. Which is really backwards? Allow people's generosity to help with the problem as well!!!

 

[calvnandhobbs68]

Medicine is an art, it requires a natural bond and intuition between doctor and patient. There is a lot more unknown about the human body than known, and in that VERY large realm of uncertainty, a doctor must be able to have autonomy and ability to use their intuition and skills to pursue both the conventional and unconventional styles of treatment for their patients.

Says the premed.

Take a quality and safety course to see just how far from assembly line checklisty most things in a hospital are. There's a difference between requiring doctors to stick to a checklist when deciding treatment for some diagnosis (which seems to be what you're referring to) and making sure everyone washes their hands before they go into patient rooms. This kind of "medicine is an art" thinking is what gets patients hurt by doctors who don't want to stick to a standardized protocol for anything.

Physicians are subject to the same biases everyone else is...go ask any surgeon how their complication rates are and they'll all say below average. Many of them will also think that it's due to the particular way they do surgeries. There is no incentive on the part of most doctors individually to change practice because they all think they're doing a great job.

 

[deleted103644]

Democrats are actually the least caring. Not only do they donate the least amount to charity every year; but, they also tend to favor programs that keep people in poverty for generations to buy votes. Effectively trading public funds for their own political gain.

Johnny, as good as I may or may not be, I cannot fathom why anyone would be for the federal take over of health care - another line on the budget that needs to get cut. Public funds are drying up yet private industry thrives. What side of the fence do you want to be on?

Your arguments don't make any sense. Public funds are drying up because of spending cuts at the federal and local level. What are you talking about?

And you didn't directly answer my point that you could always accept cash and avoid all insurance issues.

 

[Catman21]

Sure the increase in patients (although many of them had been getting treatment for serious stuff for free already) will be an issue in the short-term, but it is one that is easily addressable by increasing the number of physicians as well as other health care positions. Is increased employment such a bad thing?

lolwhat??

Increasing number of physicians how?? I'm not saying its a bad thing for wide spectrum health coverage. But I am saying is that there is a shortage of physicians, and the reason being is because physicians are not people who you can mass produce in a factory. You cant just simply "make more." There is a growth in medical institutions opening across the united states, but that will never come close to covering the United States' 350+ million people.

You should really think about what you say before you just start posting all willy nilly.

 

[DietSexy5000]

Earlier I spoke about higher ideals about taxation and autonomy.

Speaking directly to the Accountable Care Act - the reason I don't support it is because I don't want to see another profession, a noble profession, become another public-sector-cog-machine. The less government involved in medicine the better. We are all going into medical school so that we can learn medicine and practice to the best of our abilities to serve our patients. I believe that will be increasing difficult as more government becomes involved.

The Federal Gov. has a strong interest in who is treated, how much, and what type of treatment you give.

Think about the draconian-rigid-teaching objectives public school teachers must meet. All for the useless metric tests the federal government has pushed on them. If they don't meet these goals they don't get federal money. They have very little autonomy and their funding is used as a political football. See the similarities between public education and where health care may be headed? I don't want to go there. I don't want to be a cog in the federal machine and be looked at as a tax payer subsidized employee. I want to create my own wealth by providing a valued service in the private sector.

I don't know about you guys but I dream of someday running a private practice. Treating thankful patients who have an interest in their own health and being able to treat them with the best medicine that I can offer. I'm competitive. I want to be better than any of the other doctors in town and as a result be able to charge more and live better. The last thing I want is some worthless fed. gov. official telling me how to practice medicine and titrating my reimbursement so my success doesn't eat up too much tax payer money so they can be reelected.

Do not vote democrat.

Yes. Not really looking to find myself in a doctors' union twenty years from now because some demigods (read: dip dunk politicians) feel they know best about medicine. Additionally, medicine is a lucrative field for those that offer the best service. Unless I stay in academia to continue research, I fully plan to be the top dog at my private practice where patients pay out of pocket, no insurance accepted. The entire capitalistic side of medicine is severely threatened with this legislation all for the idealism of some people. Bottom line is medical care requires real resources like people, facilities and capital. Passing a law doesn't magically make these appear no matter how hard Washington tries.

 

[bob99]

I, who was always interested in economics, and my father who was an economics major an now a dentist have spent many many hours discussing the PPACA. The one thing that neither of us understand is who will be paying for the 30M or so new patients on insurance. Medical care costs A LOT of money, and someone has to pay for it. The same goes for people with pre existing conditions. If its too expensive for them to purchase insurance for themselves who's going to pay for their insurance. The insurance companies will not stand by and just lose money. There are only 2 options and thats the government paying more for coverage or hospitals, physician, nurses, and pharmaceutical companies taking less for services.

If the latter takes place it will surely mean a deterioration of medical care accross the board for everyone, even privately paying individuals, purely because it will create a shortage of doctors, underfunded hospitals, and less money for R and D. If the former would occur then we would be shifting to a government run healthcare system. Yes, that will result in people getting healthcare, but the healthcare cannot be better than what we currently have. How can the government make something cheaper? Never have we found that government intervention has increased quality while cutting costs. The most successful industries in this country are the privately run industries, ones where competition has caused companes to provide the best possible product at the least expensive price. Look at the advances made by the computer industry, the cell phone companies, and internet retailers. The service and products have improved exponentionally when someone stands to make a dollar. Once you remove this competition, why would anyone spend their time and effort to improve a product if they won't be benifiting from it. It may seem unethical and wrong but the facts are facts. PEOPLE RESPOND TO INCENTIVES. Yes we want compasionate doctors but how can we improve a healthcare system when our smartest and most talented students are not going to medical school. Why would anyone spend 8 years in shcool, 5 years in residency, and put themselves hundreds of thousands of dollars in debt, when they can make more money and spend less time working in a different field. You want to know why the smartest people go work as financial analysts and investment bankers, ITS BECAUSE THEY PAY MORE. As long as people keep on saying that people shouldnt care about money we will have major issues in this country. Once the government recognizes that people will be innovative and work hard for money we can start to right the ship and fix the broken healthcare system.

 

[calvnandhobbs68]

Once you remove this competition, why would anyone spend their time and effort to improve a product if they won't be benifiting from it. It may seem unethical and wrong but the facts are facts. PEOPLE RESPOND TO INCENTIVES. Yes we want compasionate doctors but how can we improve a healthcare system when our smartest and most talented students are not going to medical school. Why would anyone spend 8 years in shcool, 5 years in residency, and put themselves hundreds of thousands of dollars in debt, when they can make more money and spend less time working in a different field. You want to know why the smartest people go work as financial analysts and investment bankers, ITS BECAUSE THEY PAY MORE. As long as people keep on saying that people shouldnt care about money we will have major issues in this country. Once the government recognizes that people will be innovative and work hard for money we can start to right the ship and fix the broken healthcare system.

People always say this but we forget that back before the expansion of Blue Cross/Blue Shield and Medicare physicians actually weren't paid that much. You went into the field basically because of the respect others had for medicine and the sense of importance you had to the community.

I think if we still retained that level of respect people might be more willing to be paid less but at this point no family doc wants to be making even less than he is now while patients charge in demanding the latest drug they've seen on TV or telling their doctor Judy next door heard from her "alternative medicine" friend that eating frog toes 3 times a week will cure her diabetes so she thinks she'll do that instead.

 

[Gut Shot]

The one thing that neither of us understand is who will be paying for the 30M or so new patients on insurance.

Try WIki-freakin-pedia under "Summary of funding."

 

[bob99]

Try WIki-freakin-pedia under "Summary of funding."

Maybe you should read the whole post before you comment. I wasn't saying that i can't be funded, I'm saying what the implications of funding are. Additionally if you think that the government projections for funding a program are accurate then maybe you should research the ACTUAL costs of medicaid, medicare, and social security. Not once has the government been even close to accurately predicting the costs and funding for a government program. And if you think we can always fund programs by taxing people, maybe you should stop and think what 35% of your income is. Imagine for every hour you work, you have to go and work another 21 minutes for someone else. Government providing aid and help, breeds government dependency, which is a never ending sinkhole.

 

[TipToad]

Maybe you should read the whole post before you comment. I wasn't saying that i can't be funded, I'm saying what the implications of funding are. Additionally if you think that the government projections for funding a program are accurate then maybe you should research the ACTUAL costs of medicaid, medicare, and social security. Not once has the government been even close to accurately predicting the costs and funding for a government program. And if you think we can always fund programs by taxing people, maybe you should stop and think what 35% of your income is. Imagine for every hour you work, you have to go and work another 21 minutes for someone else. Government providing aid and help, breeds government dependency, which is a never ending sinkhole.

Please elaborate further (because what you're saying sounds like you'd rather not have any taxes at all)

 

[Gut Shot]

Maybe you should read the whole post before you comment.

I did, I was simply replying to the only intelligible part.

 

[Mjolner]

Important qualifier: most premeds are dumb as rocks.

This.

 

[Praefectus]

The government has screwed up in the vast majority of its pursuits (over budget, over time, terrible service, etc.) because of its lack of competitors. Why would anyone trust the feds to get it right this time?

Also, pre-meds don't know jack **** about healthcare. Doctors are against the ACA because they're affected by it every single day. For us, medicine is just some theoretical fantasy land that is several years away. I've yet to meet an attending that supports this crappy law.

 

[deleted103644]

The government has screwed up in the vast majority of its pursuits (over budget, over time, terrible service, etc.) because of its lack of competitors. Why would anyone trust the feds to get it right this time?

Also, pre-meds don't know jack **** about healthcare. Doctors are against the ACA because they're affected by it every single day. For us, medicine is just some theoretical fantasy land that is several years away. I've yet to meet an attending that supports this crappy law.

There are plenty of attendings that support the law. I'd wager the majority in my state, easily.

You are correct in your assessment of your knowledge about healthcare, pre-med.

 

[pseudosquam]

Your questions suggest to me that you lack an understanding of macroeconomics & fail to see the difference between revenue and subsidies. Unfortunately I do not have the time to get your knowledge level from where it is presently to where it needs to be to discuss these topics.

But do not fret. Once you're finished with residency I'm sure you'll find more time to pursue other academic disciplines if you desire.

To your question - concierge seems like a good option if you can limit overhead. With government intrusion that may be difficult in several medical fields. Though, some do seem like they may lend themselves to that arrangement.

Your arguments don't make any sense. Public funds are drying up because of spending cuts at the federal and local level. What are you talking about?

And you didn't directly answer my point that you could always accept cash and avoid all insurance issues.

 

[bob99]

Please elaborate further (because what you're saying sounds like you'd rather not have any taxes at all)

You are right I would rather pay 0 in taxes. I havent met anyone who didn't. I as a citizen do recognize that a government would not be able to function and do what it's supposed to do without any taxes, especially not federal taxes. The Articles of Confederation failed due to lack of ability to tax. However there is a certain reasonable amount that you can expect people to A) pay B) be willing to pay. People throw around numbers like 250k and say these people dont pay their fair share. I can say for myself (who grew up with a household income above that amount) that its not an exorbitant amount of money. Yes you can live nicely, but by no means can you live super luxuriously. Just as an example if you make 300K and you pay 35% to federal income tax (and YES, most people in that bracket besides the ones living off of investments actually pay the full amount) and then you pay state and local taxes you are left with around 150-170K. If you want to provide private schools for your kids, or dirve a decent car, your not left with much more. Just in case you don't know a 750,000 dollar mortgage at 4% is close to 70,000 dollars. And in NY where i live thats not considered a lot for a house. Don't forget about student loans. You will be able to live comfortably but by no means are your rich; at no point can you sit back and relax. This notion that by taxing the"rich" we can save healthcare is so far from the truth.

I suggest reading a great book called "Basic Economics" by the great man Thomas Sowell, he really explains things in a way that makes perfect sense.

With regard to the question about the expansion of blue cross and blue shield, true doctors did not get paid much beforehand, but they also did not make as many strides and accomplishments in medicine as they did after they got paid more.

I'm sorry for ranting but its just that I feel that people seem to forget reality when they are trying to help others out. NEVER has the government been able to step in and make something better and cheaper. In all of this i forgot to mention the #1 reason why healthcare is going up in price. People are living longer and there are more options available to help them. All of these innovations and medical procedures cost lots of money, and prices will go up in response. Forcing insurance companies to provide the best and most updated healthcare will surely cause prices for plans to increase, not lower the costs like the government wants.

 

[deleted103644]

Your questions suggest to me you lack an understanding of macro-econ & fail to see the difference between creating revenue vs. subsidies. Unfortunately I do not have the time to get your knowledge level from where it is at presently to where it needs to be to discuss these topics.

But do not fret. Once you're finished with residency I'm sure you'll find more time to pursue other academic disciplines if you desire.

To your question - concierge seems like a good option if you can limit overhead. With government intrusion that may be difficult in several medical fields. Though, some do seem like they may lend themselves to that arrangement.

What government intervention?

If you do not accept Medicare or Medicaid, the government will have very little direct influence over your practice (aside from licensing issues).

 

[calvnandhobbs68]

Your questions suggest to me that you lack an understanding of macroeconomics & fail to see the difference between revenue and subsidies. Unfortunately I do not have the time to get your knowledge level from where it is presently to where it needs to be to discuss these topics.

But do not fret. Once you're finished with residency I'm sure you'll find more time to pursue other academic disciplines if you desire.

To your question - concierge seems like a good option if you can limit overhead. With government intrusion that may be difficult in several medical fields. Though, some do seem like they may lend themselves to that arrangement.

UR SO SMART DOOD

About your earlier comment, your reimbursement will already be titrated. See insurance companies and Medicare already do that for you. When Blue Cross or Aetna readjusts their reimbursement rates and you tell them to screw off, they say "f*ck you" because there's 100 other doctors who will take it. It doesn't matter if it's private insurance or public, the companies dictate the rates (public just pays less because they have to cover more people with less money).

Guess what then? Those patients just don't come to you. They aren't gonna go "wow old pseudosquam is the best doc in town, I don't care if he's not in-network I'm gonna go to him and pay out of pocket". No, they want to find the cheapest doctor they can so they can have some extra money in their pocket for that pack of cigs they smoke a day or new flatscreen. Medicine hasn't been anything close to a free market for about 60 years now so I'd get used to it.

 

[kpcrew]

The amount of pay cut is still up for debate, though. How large will the cut actually be? If specialists go from making 400k to 300k (pulled numbers out of my a**), what's the big deal? How much of a luxury are you living in when you're b******* about making 300k a year, when the median income in the USA is MUCH MUCH MUCH less than that?

Perfect example of why a premed's opinion is irrelevant. It's easy to talk about cutting salaries when it's not your money. Try earning a pay check instead of sitting at your computer in your cozy little dorm room with no real life experience. There's no reason why people shouldn't be compensated for the effort that they put in and the time that they sacrificed in gaining that expertise. How much money a median income actually entails is irrelevant, especially since none of those people have made anything close to the same effort. Also, during the time that they're in school, they're racking up 6 figure loans that they have to pay off. You'll be in the upper class but by then you're in your 30s or 40s while your peers have been making money and furthering their careers for at least a decade while you'll still be paying off your loans. If you want to attract the smartest people to the field of medicine, then you offer high salaries. There's a reason for why so many top students are going into finance.

 

[pseudosquam]

EMR, building codes, mandatory equipment, building and payroll taxes, insurances, etc. mandates that have been placed on medical establishments that raise financial barriers. I had a discussion with a retired physician once who described to me his increasing difficulties through the years in establishing medical offices do to state and federal mandates that he viewed as non-essential to him practicing medicine. One example he cited was hallway width. He had to spend thousands of dollars increasing the width of a hallway to fit an existing building for medical use. He said that when he was young it was much easier for a group of doctors to get together and make something happen.

What government intervention?

If you do not accept Medicare or Medicaid, the government will have very little direct influence over your practice (aside from licensing issues).

Calvn. I think a case could be made for setting up a cash office that services a certain type of health care consumer. One that is frustrated about not having access to their doctor and doesn't see the value in purchasing anything greater than major medical ins. By marketing to these consumers, and doing some leg work via finding them affordable major medical plans, they may be more open to paying cash for their PCP visit if they realize the added value. Maybe even offer some free wellness services or low cost cosmetic stuff like botox for free to bring them in.

EDIT: I see this model becoming more accepted in the future as less employers are providing ins. Consumers will be looking around for choices. Not everyone wants the NP or the 5 min visit or both...

 

[TipToad]

Perfect example of why a premed's opinion is irrelevant. It's easy to talk about cutting salaries when it's not your money. Try earning a pay check instead of sitting at your computer in your cozy little dorm room with no real life experience. There's no reason why people shouldn't be compensated for the effort that they put in and the time that they sacrificed in gaining that expertise. How much money a median income actually entails is irrelevant, especially since none of those people have made anything close to the same effort. Also, during the time that they're in school, they're racking up 6 figure loans that they have to pay off. You'll be in the upper class but by then you're in your 30s or 40s while your peers have been making money and furthering their careers for at least a decade while you'll still be paying off your loans. If you want to attract the smartest people to the field of medicine, then you offer high salaries. There's a reason for why so many top students are going into finance.

Being pre-med doesn't make my opinion irrelevant. Having an opinion that's different from YOURS does. Physicians are compensated rather well. I believe that they will still be compensated well in the future. Yes, doctors do put in a lot of time and effort, and they are compensated for it. I'm not saying pay physicians the same as you pay every body else. I have no way to prove it to you, but if I was making 400k a year, I would still be okay with a paycut and end up with 300k/year. Again, no way to prove it to anybody. But then, I'm not going into medicine for the money. At all.

I'd like to quote this from the Anesthesiology thread, for anybody that believes the government doesn't do anything:

"The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government."

 

[kpcrew]

Having no real world experience does make your opinion irrelevant. Have you earned a paycheck? Have you paid bills? Have you looked at a loan statement with large amounts of interest being compounded on a regular basis? I doubt it. Physicians are compensated for their time and effort. You don't know what $300,000 means. Why should people get a 25% paycut for no reason? Where would that extra money go? You will have many obligations in paying for your car, mortgage, and children while servicing your loan. Also, the government takes a huge chunk out of your money before you even see a cent. No one cares that you're pretending to be altruistic by using a hypothetical situation in an attempt to somehow prove that money doesn't motivate you. Go through medical school and residency before you decide to opine about some people's supposedly bad motivations.

 

[TipToad]

Having no real world experience does make your opinion irrelevant. Have you earned a paycheck? Have you paid bills? Have you looked at a loan statement with large amounts of interest being compounded on a regular basis? I doubt it. Physicians are compensated for their time and effort. You don't know what $300,000 means. Why should people get a 25% paycut for no reason? Where would that extra money go? You will have many obligations in paying for your car, mortgage, and children while servicing your loan. Also, the government takes a huge chunk out of your money before you even see a cent. No one cares that you're pretending to be altruistic by using a hypothetical situation in an attempt to somehow prove that money doesn't motivate you. Go through medical school and residency before you decide to opine about some people's supposedly bad motivations.

Paycheck: Yes, I've had three jobs.
Bills: Pay all of my bills by myself.
Loans: I've been fortunate enough to not have to take out any loans.

Again, I pulled the original numbers out of my a**. If the large numbers upset you that much, how about this? A 300k salary dropping to 295k? Or 500k dropping to 490k? What about 150k jumping to 170k? NOBODY knows what the numbers are going to be like. You're freaking out over random guesses.

 

[jojoflynmonky]

We live in a real world with real costs. Our economy can't support Obamacare. It's not the the idea of medical treatment for everyone would not be a good thing. It's that there aren't enough resources to go around. If you are the government and have to pay for 30 surgeries, but only have 3000 dollars to spend on those thirty people, then you only pay a surgeon $100 for each surgery. Sugeries can last hours. This is a simplictic example, but I feel it illustrates the problem well.

 

[Dave89]

Being pre-med doesn't make my opinion irrelevant. Having an opinion that's different from YOURS does. Physicians are compensated rather well. I believe that they will still be compensated well in the future. Yes, doctors do put in a lot of time and effort, and they are compensated for it. I'm not saying pay physicians the same as you pay every body else. I have no way to prove it to you, but if I was making 400k a year, I would still be okay with a paycut and end up with 300k/year. Again, no way to prove it to anybody. But then, I'm not going into medicine for the money. At all.

I'd like to quote this from the Anesthesiology thread, for anybody that believes the government doesn't do anything:

"The government has created a licensing system for your profession that allows your private trade organization to artifically limit the supply of your skillset, and which makes it a felony for anyone to work outside of that system. That's an enormous favor. If your profession was subject to true free market forces your salary (and the salaries of all physicians) would be in the toilet right next to lawyers and computer programers as half trained technicians and foreign nationals flooded in to do your job for pennies on the dollar.

I've always been torn about libertarianism. On the one hand I think its whats best for America, and really for mankind. On the other hand I think it would be the end of physicians as a profession: like New Jersey gas station attendants we survive almost entirely through government protectionism. You can go back and look up the salary that physicians made back before the dawn on big government insurance in the 60s: it sucked, and there was a significant unemployment rate besides. Physician salaries back in the dark ages before licensing don't even bear contemplating. Don't pretend you're not getting anything from the government."

But consider the trade-off. Due to government involvement in large part, tuition for medical school has risen from a sum that could be made by working summers to up to ~55,000/year. Were doctors rich as hell 100 years ago? No, but it was comfortable, and more about the medicine than the paperwork. Frankly, I'd vastly prefer that kind of practice to the nonsense doctors must deal with today. It's not black-and-white.

 

[TipToad]

But consider the trade-off. Due to government involvement in large part, tuition for medical school has risen from a sum that could be made by working summers to up to ~55,000/year. Were doctors rich as hell 100 years ago? No, but it was comfortable, and more about the medicine than the paperwork. Frankly, I'd vastly prefer that kind of practice to the nonsense doctors must deal with today. It's not black-and-white.

I agree with you. It'd be nice if the job was more about the medicine rather than the paperwork. But as others stated earlier, not many people want that because not having a high salary means we wouldn't attract the best students into the profession.

 

[kpcrew]

Paycheck: Yes, I've had three jobs.
Bills: Pay all of my bills by myself.
Loans: I've been fortunate enough to not have to take out any loans.

Again, I pulled the original numbers out of my a**. If the large numbers upset you that much, how about this? A 300k salary dropping to 295k? Or 500k dropping to 490k? What about 150k jumping to 170k? NOBODY knows what the numbers are going to be like. You're freaking out over random guesses.

Yes, I'm upset and freaking out about your oh so large numbers. Yes, I'm impressed by your part time summer jobs because that definitely gives you the proper perspective from which to make judgment calls on other people's motivations.

 

[TipToad]

We probably aren't going to agree on anything so I'm just going to call it quits.

 

[Minininja]

I like the bill I just don't approve of the guy who passed it.

 

[Gut Shot]

Just as an example if you make 300K and you pay 35% to federal income tax (and YES, most people in that bracket besides the ones living off of investments actually pay the full amount) and then you pay state and local taxes you are left with around 150-170K.

You do understand how marginal tax rates work, right? In Virginia a married person with no children making 300K will clear ~202K without taking a single deduction.

 

[OCDOCDOCD]

We live in a real world with real costs. Our economy can't support Obamacare. It's not the the idea of medical treatment for everyone would not be a good thing. It's that there aren't enough resources to go around. If you are the government and have to pay for 30 surgeries, but only have 3000 dollars to spend on those thirty people, then you only pay a surgeon $100 for each surgery. Sugeries can last hours. This is a simplictic example, but I feel it illustrates the problem well.

You are aware that Obamacare isn't government-run healthcare, right? The main thing it does is mandate private health insurance coverage and make it much easier for people to get said private health insurance. So nothing has changed about the market other than that now we don't have something like 25-35% of the population not participating until they get seriously ill or injured at which point they require expensive treatment be given to them for free.

 

[deleted103644]

You do understand how marginal tax rates work, right? In Virginia a married person with no children making 300K will clear ~202K without taking a single deduction.

It's amazing how many people don't understand this.

Even people who I assume must be paying taxes...

 

[NickNaylor]

It's amazing how many people don't understand this.

Even people who I assume must be paying taxes...

But Obamer is taking all mah moneh!

(sent from my phone)

 

[Dave89]

But Obamer is taking all mah moneh!

(sent from my phone)

I'm amazed that you fellows haven't run out of hay yet, what with the prolific straw man construction that goes on around here.

 

[NickNaylor]

I'm amazed that you fellows haven't run out of hay yet, what with the prolific straw man construction that goes on around here.

Lighten up, dude.

(sent from my phone)