Politics and Medicine

[Tawantinsuyu]

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I don't really know much about politics/policies/economy stuff. Can someone briefly explain to me the political/economic situation for physicians of today and the future? Someone I talked to today said that the future of human general practitioners is going downhill. Granted, he is a Republican, so I'm assuming it has something to do with Obamacare, which I know nothing about.

 

[manofmen]

my .02. don't expect much substantive discussion coming out of forums. the signal to noise ratio on places like sdn, i've found, is too low for my liking. follow the online news, read stuff like time and newsweek, be wary of news media biases, read books. your question about the future of human gp's is really vague, but even if you asked for something specific it would take time for you to develop true expertise in that subject, and sdn conversations are not the place for that and 'brief' answers should be taken with a grain of salt.

few people, myself included, really know much about the economy/politics, but that is no excuse for not making an effort it's encouraging that you're interested. good luck!

 

[mik30102]

*Disclaimer on this issue I am strongly left*

So more or less during the past few decades medicine has moved from a free for all fee for service model (where physicians simply billed for what they did) to a model with lump payments. By lump payment I mean physicians are often now payed a flat fee. For example say a physician see someone who has diabetes, they get a flat fee for seeing them no matter what tests they ordered or what they actually did. Sometimes they will break even, take a loss, or make a profit. Increasingly physicians are also being controlled by outside forces. Insurance companies try to limit the services provided as much as possible to pay out as little as possible. Contrary to popular belief the affordable care act is really just a law to regulate insurance companies, with little direct government control. I expect insurance company interference to increase over time since they really only care about their bottom $. Medicaid/medicare are also always trying to cut reimbursement. In my opinion these are unstable government systems due to the patients they cover, either the elderly, the disabled, or the extremely poor. This makes their costs very high and our government always tries to limit their total costs by dropping reimbursement. I also expect these fights over reimbursement to continue to occur. Physicians could avoid these headaches by doing cash only practice, but it is not very realistic to do so. The only physicians I am aware of who do so regularly are psychiatrists. There is also the moral issue of only seeing well off patients. Overall I think it is safe to expect reimbursement to drop as a net, with primary care maybe going up a tad.

 

[TheWeeIceMan]

lol "briefly."

 

[fellowstudent92]

lol there's one of these every week. I've never made a separate thread about this. I took the time to sift through all the PAST THREADS on this topic. You should do the same. 🙂 Just a suggestion. Not trying to be an ass.

 

[Osteoth]

I know alot of other threads have said that overall, reimbursement rates are going to decrease, but to me on the surface it seems like ACA -> more people insured (insurance companies can't deny based on pre-existing conditions) -> more money made by physicians.

Unless for some reason there's only a finite amount of money, then the situation would be just more patients for less money for physicians.

 

[fellowstudent92]

I know alot of other threads have said that overall, reimbursement rates are going to decrease, but to me on the surface it seems like ACA -> more people insured (insurance companies can't deny based on pre-existing conditions) -> more money made by physicians.

Unless for some reason there's only a finite amount of money, then the situation would be just more patients for less money for physicians.

Someone correct me if I'm wrong. But I think the consensus is that overall there is now more work (more patients) to be done for less money. Insurance companies are in general reimbursing less for each procedure/exam so you'll definitely be making less money. I guess yea if you want to continue making the same amount, you would just have to fit in more patients in your schedule, which also implies less time spent with each patient. Insurance companies, furthermore, will dictate which treatments are proper and which are not according to their financial model. This will curtail your independence to practice as a physician. Let's also not forget that this increases the vulnerability of malpractice lawsuits for physicians (despite the tort reforms, which are honestly in the phases of debate, not even a real thing. I think that speaks for itself).

Someone else, add more stuff 🙂