What so you think about what California is doing?

[hye345]

BTW, while doctors shouldn't be in it only for the money, they aren't in it to lose money either.

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[MattD]

It's interesting that Arnie is going to tax doctors to pay for their own reimbursement (basically redistributing income from higher paid specialists to primary care docs), rather than tax the entertainment industry to pay for it, therefore actually injecting money into the healthcare industry instead of just stirring it around. Bias maybe? But really, instead of a rediculous tax me so you can pay me plan, why are they not just adjusting reimbursement schedules so that the state can afford to offer a low cost insurance plan to those working uninsured. Sure, it'll still lower specialist salaries to pay for more primary care, but at least then they'd be honest about it. In addition, is this going to be FREE insurance for the working uninsured? Why do I have to pay for my company plan, but they will get free insurance just because their company doesn't have a plan? Seems like a disincentive for those companies to shell out for a group plan to me. The solution is for the lawmakers to realize that healthcare is an expense that people have to pay for. It can't just be free. Sure, it's a necessity and everyone should have access to it, but food is necessary too and nobody's dropped a free Big Mac on my doorstep lately. This socialism will ultimately fail just like socialism did in the east. Remember bread lines? That's what free food did in Russia. I think I've heard it can be up to a 6 month wait for a CT scan in Canada? Arnie, you lived in Hollywood for too long. Even ignoring the doctor's loss, I hope this doesn't happen bc of the effect it will have on PATIENTS.

 

[Misfit!]

I've got it! We round up the illegals, rent them out to Halliburton to help rebuild Iraq and use that money to raise physician salaries. No....wait. I mean "provide healthcare access for all the currently uninsured". Yeah.....that's what I meant.

Not to mention, for those that survive their stint in Iraq, and somehow find a way home, will suddenly have a new appreciation for Mexico not being so bad after all. I mean when was the last time an IED exploded in Guadelajara?

shh...careful with your jest...you may be giving some of the fools here ideas!

 

[maestro1625]

re: hye's post:

true, but the reason that people are bashing dutchman isn't to defend the program that we know nothing about detail-wise, it's the complete overreaction involved. Everyone here knows that doctor salaries are going to continue to slide, for more reasons than just "socialized medicine". Idiots like dutchman simply chalk that fact up to single causes.

 

[maestro1625]

It's interesting that Arnie is going to tax doctors to pay for their own reimbursement (basically redistributing income from higher paid specialists to primary care docs), rather than tax the entertainment industry to pay for it, therefore actually injecting money into the healthcare industry instead of just stirring it around. Bias maybe? But really, instead of a rediculous tax me so you can pay me plan, why are they not just adjusting reimbursement schedules so that the state can afford to offer a low cost insurance plan to those working uninsured. Sure, it'll still lower specialist salaries to pay for more primary care, but at least then they'd be honest about it. In addition, is this going to be FREE insurance for the working uninsured? Why do I have to pay for my company plan, but they will get free insurance just because their company doesn't have a plan? Seems like a disincentive for those companies to shell out for a group plan to me. The solution is for the lawmakers to realize that healthcare is an expense that people have to pay for. It can't just be free. Sure, it's a necessity and everyone should have access to it, but food is necessary too and nobody's dropped a free Big Mac on my doorstep lately. This socialism will ultimately fail just like socialism did in the east. Remember bread lines? That's what free food did in Russia. I think I've heard it can be up to a 6 month wait for a CT scan in Canada? Arnie, you lived in Hollywood for too long. Even ignoring the doctor's loss, I hope this doesn't happen bc of the effect it will have on PATIENTS.

of course this program doesnt even have the same economic skeleton as Canada's system, but hey, let's make generalizations about socialist bread lines... that'll lead to intelligent debate.

the sad thing is that no one here has even brought up the fact that CA isnt the first state to develop such a system.

 

[Tired]

re: hye's post:

true, but the reason that people are bashing dutchman isn't to defend the program that we know nothing about detail-wise, it's the complete overreaction involved. Everyone here knows that doctor salaries are going to continue to slide, for more reasons than just "socialized medicine". Idiots like dutchman simply chalk that fact up to single causes.

Thank you. I get so tired (hence the name) of folks assuming that when you disagree with the reactionary nutjobs, you must agree with the other side.

 

[DropkickMurphy]

No actually he says that it is meant to cover EVERYONE...that is one of the controversial components of his plan!!

I know, but I was speaking about who they were going to be billing for all of this.

 

[DropkickMurphy]

shh...careful with your jest...you may be giving some of the fools here ideas!

Actually I was only slightly joking about that. I think we could "enlist" a bunch of those illegals and reinstitute the policy of human wave attacks to deal with insurgents in Iraq. Think about it.....they are already good at running long distances, in large groups, clearing obstructions, etc. They'd be naturals......just think of it as a Mexican version of the banzai charge.....we could call it the "Charge of the Burrito Brigade".

Somewhere.....probably in England.....Alfred Lord Tennyson is spinning in his grave.

 

[MattD]

of course this program doesnt even have the same economic skeleton as Canada's system, but hey, let's make generalizations about socialist bread lines... that'll lead to intelligent debate.

the sad thing is that no one here has even brought up the fact that CA isnt the first state to develop such a system.

I wasn't claiming to be comparing apples to apples there. I do however think that the slippery slope possibility is at least worth looking at. If we have a free insurance program funded by the providers, what will happen? Everyone who doesn't feel like paying for their own insurance, even if they could afford it, will enroll. Demand will increase while supply will stay the same (more ppl wanting to use their insurance to see the same number of providers). Since prices are effectively controlled by the government, there can be no free market increase in the price of services rendered to bring the system into equilibrium. Providers are only willing to work so many hours per day, and will only compromise on quality of care so far (out of professionalism, as well as fear of the inevitable lawsuit), so what happens? Possibility 1 is that more supply (providers) will be brought in to handle the increased demand. This possibility isn't reasonable, because no new resources are being put into the system to pay for this supply. The providers moving into the state would be accepting a lower level of pay and a higher cost of living to boot. So possibility 2 is a shortage. Supply cannot meet demand. The free insurance is useless because people cannot treatment in a reasonable time frame. In order to remain viable, private insurance companies will increase reimbursements (and premiums) in return for an agreement from contracted providers to prioritize their subscribers. (or perhaps they'll rely on sheep to be sheep and keep paying the same premium while getting less bang from their buck....) Providers will also prioritize patients who will pay cash at an level above that of the government plan. So yes, I think this is analogous to a bread line situation. Only instead of standing outside the doctor's office, people just won't go. Unless they're rich.

Another interesting point is the way the program will be sustained financially. Every year they take 2% of revenue to fund the program. A portion of that is eaten up in administration costs, and the rest is returned to the healthcare system. Then they take 2% of that revenue, burn some, and put it back in. How does this not dwindle to 0? Because of cash coming in from other sources making up the difference. The private insurers. How do they get that money? They take it away from the physician's income. They COULD just as easily tax the private insurers. Of course the insurers would have to make up the cost somehow, but at least then the option would be there to pass the cost along to the consumer, rather than the provider. Which would be much more likely to happen, as physicians could group negotiate with the insurers to make it happen. Another way to fund it would be to just tax the citizenry. This makes the most sense, is most just, but also would not work politically. There are more non-healthcare provider voters than there are providers. So not only will it fail per paragraph 1, it is unjust and is fundamentally a government run redistribution of wealth targeted against physicians to pay for healthcare for the unemployed.

Maestro, if you think my scenario is implausible feel free to point out the flaws and propose your own scenario, but don't smugly disregard the conclusions out of hand just because I didn't write an economic treatise to support them.

 

[hye345]

dutchman, are you currently a physician? Because if you are, Im surprised that you didn't quit long ago with that kind of attitude.

 

[sirus_virus]

When you guys understand the full implications of this program you will shut up about all these positives you are advertising.

 

[sirus_virus]

and somehow you'll still live comfortably. If you're in this for the money, you're gonna get a wakeup call eventually.

Blah blah blah!! Wether you are in it for the money or not, you are still
going to have to pay back you medschool loans, buy malpractice insurance,take care of your family, and if you are in pivate practice pay your staff. So dont decieve yourself that your glorious "monk" approach will carry you through either.

 

[Instatewaiter]

When someone doesnt have the money to pay for a lawyer who ends up footing the bill? Does the gov't charge each lawyer 2% and the lawfirms 4%?


As to the person who was saying that the US has the highest rate of uninsured there is a reason for that. These countries generally charge a lot higher rate of income tax. The US's highest bracket is 35% and begins at $336,000. The UK's highest rate is 40% but that beings at 32,000 pounds (around $50,000). France is even worse. Their highest tax bracket is 58% and that begins at 77,000 euro (a bit over 110,000) I did the math and if we have a person making $336,000 they will get taxed 97,000 in the us, 125,000 in the UK and 175,000 in france!

I don't think anyone is saying that people shouldnt have access to health care but when the burden of that is placed on the provider it does not bode well for the system.

 

[em783]

Well according to Conan, California's healthcare costs will be paid by the Blue Cross of Mexico. So looks like we don't have to worry.

 

[notdeadyet]

Good lord, if you have a problem with California's immigration policies or universal health care proposal, feel free to move. This will just serve to drive up physician salaries for the rest of us.

 

[dutchman]

Good lord, if you have a problem with California's immigration policies or universal health care proposal, feel free to move. This will just serve to drive up physician salaries for the rest of us.

The words "up" and "physician salaries" will never go together in California after this.

 

[Towelie]

When someone doesnt have the money to pay for a lawyer who ends up footing the bill? Does the gov't charge each lawyer 2% and the lawfirms 4%?


As to the person who was saying that the US has the highest rate of uninsured there is a reason for that. These countries generally charge a lot higher rate of income tax. The US's highest bracket is 35% and begins at $336,000. The UK's highest rate is 40% but that beings at 32,000 pounds (around $50,000). France is even worse. Their highest tax bracket is 58% and that begins at 77,000 euro (a bit over 110,000) I did the math and if we have a person making $336,000 they will get taxed 97,000 in the us, 125,000 in the UK and 175,000 in france!

I don't think anyone is saying that people shouldnt have access to health care but when the burden of that is placed on the provider it does not bode well for the system.

Bad argument. The US spends MORE per capita on healthcare than France or the UK, and yet those countries have universal healthcare. We could get a more adequate system by restructuring, rather than raising income tax.

 

[Towelie]

Blah blah blah!! Wether you are in it for the money or not, you are still
going to have to pay back you medschool loans, buy malpractice insurance,take care of your family, and if you are in pivate practice pay your staff. So dont decieve yourself that your glorious "monk" approach will carry you through either.

Even though salaries are decreasing, physicians still make very good money, and will continue to do so. Even if you subtract loan payback, malpractice, and paying staff members, the average physician is still well in the top 5% of earners.

 

[dutchman]

When someone doesnt have the money to pay for a lawyer who ends up footing the bill? Does the gov't charge each lawyer 2% and the lawfirms 4%?
As to the person who was saying that the US has the highest rate of uninsured there is a reason for that. These countries generally charge a lot higher rate of income tax. The US's highest bracket is 35% and begins at $336,000. The UK's highest rate is 40% but that beings at 32,000 pounds (around $50,000). France is even worse. Their highest tax bracket is 58% and that begins at 77,000 euro (a bit over 110,000) I did the math and if we have a person making $336,000 they will get taxed 97,000 in the us, 125,000 in the UK and 175,000 in france!

I don't think anyone is saying that people shouldnt have access to health care but when the burden of that is placed on the provider it does not bode well for the system.

Do you know why? because lawyers are not jellyfishes like a lot of the people on this thread. They actually protect their turf instead of hidding behind some idealist demeanor.

 

[GoodDoctor]

Can someone explain this from the NYTimes article:

"On the provider side, the governor’s plan contains privileges and responsibilities. Doctors and hospitals, which have long complained about Medi-Cal’s low reimbursement rates, would benefit from a $4 billion increase in annual reimbursement. But the state would tax doctors 2 percent of their total revenues, and hospitals 4 percent, to help pay for the greater reimbursement."

Tax me more so you can pay me more? Why not just leave me alone and save yourself the trouble? It says "to help pay for the greater reimbursement", making it sound like the doctors give the govt., say, $40,000 but get $60,000 in reimbursement. I think in light of what a previous poster explained, it sounds like if you don't have medi-cal patients, all you do is pay. If you have only medi-cal patients, you just got a big pay raise.

 

[Ryo-Ohki]

Bad argument. The US spends MORE per capita on healthcare than France or the UK, and yet those countries have universal healthcare. We could get a more adequate system by restructuring, rather than raising income tax.

Thank end of life Medicare spending for our exorbitant costs. The socialist countries practice euthanasia on their senior citizens to control their costs.

 

[GoodDoctor]

Choosing to tax doctors is just as arbitrary as choosing to tax construction workers more. It just happens that doctors are in the field so it somehow feels less arbitrary. I don't hear construction workers saying, "Ya, my taxes went up, but I know the gov't. will put it to a good cause." Seriously, why focus arbitrarily on doctors? Ave salary is ~140-200k for docs, so why not just put an extra 0.1% tax on all earners who make this much in order to pay for healthcare, rather than focusing uniquely and arbitrarily on docs?

And why are so many of you happy about getting a pay cut? On lots of threads talking about money, I see people saying "Ya, but you'll still be so rich as a doctor". Why would you want to make less money than you can? Why would you want to be forced to work for free? A 2% tax on REVENUE is roughly equivalant to working one week for free. Why not just require all doctors to dedicate one week of service to uninsured folk, rotating through different docs throughout the year? All of you who like giving away free service and handing paychecks over to the gov't. could volunteer for a month. Heck, you could donate half a year of free service and still make more money than most people and live comfortably (of course, while working 60 hr/wk). Why not do this?

 

[em783]

Thank end of life Medicare spending for our exorbitant costs. The socialist countries practice euthanasia on their senior citizens to control their costs.

Wait, is this a fact? Or some sort of a joke that I can't pick up on? I should probably know this kind of information...

 

[nicksain]

to those talking about paycuts:

wouldn't this bill actually result in doctors making more money?

If more people have insurance, more people see doctors, and hence more doctors get paid more money from having a boost of patients.

I think the bill would increase patient load for most physicians by more than 5-10%, thus more than making up for the 2% increase in taxes...

I think it might hurt small business alot more than it hurts doctors.....

 

[notdeadyet]

The words "up" and "physician salaries" will never go together in California after this.

Folks complain about one thing or another in California, yet stil lthey come. Physicians will keep doing the same.

 

[sirus_virus]

to those talking about paycuts:

wouldn't this bill actually result in doctors making more money?

If more people have insurance, more people see doctors, and hence more doctors get paid more money from having a boost of patients.

I think the bill would increase patient load for most physicians by more than 5-10%, thus more than making up for the 2% increase in taxes...

I think it might hurt small business alot more than it hurts doctors.....

Dream dream dream.

 

[ClockworkDoc]

Politically, this is a great move by the Governator. There are diverse benefits with concentrated costs. Yeah, the doctors of CA will suffer, but everyone else potentially benefits. Being a minority, doctors will only be able challenge this law if they can get support from others. Although with everyone's perception that doctors make SOOOO MUCH MONEY, I think that it would be difficult to garner much support unless they can prove that this will somehow hurt the uninsured (which is unlikely).

Unfortunately, when people think about physician's salaries they do not take into account the cost of loan, long workweeks, stress, continued training, and time/opportunities forfeited during schooling.

 

[MattD]

to those talking about paycuts:

wouldn't this bill actually result in doctors making more money?

If more people have insurance, more people see doctors, and hence more doctors get paid more money from having a boost of patients.

I think the bill would increase patient load for most physicians by more than 5-10%, thus more than making up for the 2% increase in taxes...

I think it might hurt small business alot more than it hurts doctors.....

um, the program doesn't cost small business anything.

Physicians will not make money on the increased patient load. Let's say the program starts in 2008. In 2007, you bring in 1,000,000 in revenue, with overhead of 700,000. That leaves 300,000 for you. This has been status quo for years for you. But this year, you have to pay out 2% of revenues. So you pay your tax of 20,000 and now your take home is only 280,000. That's about a 7% takehome pay cut. Now, it's 2008 and the mighty insurance program is funded. Your patient load increases by 2%, perhaps. Yay, right! Now your revenue this year is 1,020,000, and your overhead 714,000, leaving a take home of 306,000. But, you have to pay the tax again. This time it's 20,400, leaving you with 285,600. Now it's 2009. 1,020,000 - 714,000 = 306,000 - 20,400 = 285,600. So guess what. You have taken a 14,400 pay cut and agreed to work more for the privilege. This is a rather idealized scenario too. Notice I didn't take any money out for administration costs. Notice I assumed that every dollar you were taxed came back to you as revenue, rather than being redispursed to a different physician. There is no way that physicians will make more money under this system because no new money is entering the system! Basically what it amounts to is you provide your services for free to the people in this plan, you pay for the additional support and lab expense, etc. for their care out of your own pocket, AND you donate some money to a bean pusher in the capital to make sure things run smoothly. Yeah, great plan.

 

[narretgrez]

Looks bleak. But on the upside, more people will be insured. A step toward universal healthcare must be a good thing for the US, even if it is not good for physicians?

 

[dutchman]

um, the program doesn't cost small business anything.

Physicians will not make money on the increased patient load. Let's say the program starts in 2008. In 2007, you bring in 1,000,000 in revenue, with overhead of 700,000. That leaves 300,000 for you. This has been status quo for years for you. But this year, you have to pay out 2% of revenues. So you pay your tax of 20,000 and now your take home is only 280,000. That's about a 7% takehome pay cut. Now, it's 2008 and the mighty insurance program is funded. Your patient load increases by 2%, perhaps. Yay, right! Now your revenue this year is 1,020,000, and your overhead 714,000, leaving a take home of 306,000. But, you have to pay the tax again. This time it's 20,400, leaving you with 285,600. Now it's 2009. 1,020,000 - 714,000 = 306,000 - 20,400 = 285,600. So guess what. You have taken a 14,400 pay cut and agreed to work more for the privilege. This is a rather idealized scenario too. Notice I didn't take any money out for administration costs. Notice I assumed that every dollar you were taxed came back to you as revenue, rather than being redispursed to a different physician. There is no way that physicians will make more money under this system because no new money is entering the system! Basically what it amounts to is you provide your services for free to the people in this plan, you pay for the additional support and lab expense, etc. for their care out of your own pocket, AND you donate some money to a bean pusher in the capital to make sure things run smoothly. Yeah, great plan.

Good point.
And it come down to the simple question--Why do doctors have to ****ing pay for people's healthcare? The *******es on this thread that are jubilating think this brings finality to the issue without recognizing that this is a test to see how far they can push it. Even the Airline industry which was virtually bankrupt could not cut pilots' salaries at will because the pilots can hold their own. After 14+ years of higher education doctors get outsmarted by a supposedly dumb bodybuilder. Who's the fool?

 

[maestro1625]

again, this has been far from a solo project of Arnold. But you knew about chapter 58, right? of course you did.

 

[cgscribe]

I've asked several practicing docs about this, and all agreed it would result in lower physician pay (obviously, won't destroy their pay, but still not good). While I like the idea of universal healthcare, and think it's only a matter of time before somebody actually does it in Washington, taxing physicians isn't the way to go. If you're going to make a program UNIVERSAL, then the tax should be UNIVERSAL.

 

[viper2fast505]

What is chapter 58?

 

[maestro1625]

http://en.wikipedia.org/wiki/Chapter_58

I expect California's system to look a lot more like it by the time it gets thru. Until then I'll reserve my decision on the good/bad and avoid the "ZOMG!!!!! Teh DOCTORS ARE gonna GET ASSRAPED!!!1!!111" reactions.

(I do agree with cgscribe, btw)

 

[MattD]

again, this has been far from a solo project of Arnold. But you knew about chapter 58, right? of course you did.

Chapter 58 isn't funded by a tax on healthcare providers. There is probably a form of universal health care that could work wonderfully. Perhaps Mass. does. I've been responding solely to the plan as described by the OP. That plan is ******ed.

 

[maestro1625]

Chapter 58 isn't funded by a tax on healthcare providers. There is probably a form of universal health care that could work wonderfully. Perhaps Mass. does. I've been responding solely to the plan as described by the OP. That plan is ******ed.

while I dont really disagree with you on that point, having people compare universal healthcare to soviet breadlines is hardly befitting of good discussion.

 

[Tyronebiggums]

It is informative to look at what happens in other countries that have socialized medicine to see what we can expect from California's program. First, countries like Japan want to get out of socialized medicine because it creates the incentive to see lots of patients for small periods of time. Doctors are paid per visit their so of course they see more patients and do not devote much time to them. In addition because going to the doctor entails no economic cost to the patient, patients are overusing the service. Therefore, a substantial black market has arisen in Japan for bribing doctors to get in to see them. The so-called "rich" still benefit in socialized medicine more than the poor because they can afford these bribes. Socialized medicine in California will not be much different if at all. Hospitals will be overcrowded because anytime 6.5 million people are put into the patient pull with unlimited access to doctors and the number of doctors staying the same, things will get busy. A universal healthcare plan was proposed before in California that called for a gradual implementation so the number of doctors could be increased enough to meet the demand. Furthermore, socialized medicine will most likely decrease doctor's salaries thereby creating a disincentive for the brightest minds to enter the profession. Socialized medicine also could have profoundly negative affects on health science innovations. The US is the world leader and we need an open healthcare system to stay on top. Remember anytime the government attempts to control prices a shortage always occurs and the quality of the product goes down. Healthcare is no exception. Basic economics still applies. Read the chapter on the economics of health care in Thomas Sowell's great book "Applied Economics". Many people on this thread in support of socialized medicine may change their minds.

 

[Hallm_7]

This sounds like a GREAT reason to stay out of California for residency and practice.

I don't see this going through all the way without doctors throwing a fit.....and they'll win in the end. Physicians hold the ultimate trump card in this game, and that's a work stoppage (or strike if you want to call it that). I doubt they'll ever get to that point b/c if this program hurts docs' pocketbooks enough then they'll just move to other states creating a de facto work stoppage through a physician shortage.

You shouldn't go into medicine for money, but that doesn't mean physicians shouldn't be well paid and shouldn't resist pay cuts.

 

[sdn1977]

Honestly!!!! I've responded to about 4 different threads in sdn on this same topic!

Isn't there any way these could all be combined???

Is there any physician or provider (since this bill is not physician specific) in CA who is posting here????

I'm a pharmacist in CA - also a resident - obviously.

No one (except perhaps the most vehement about this plan) expect it to go thru the legislature as written. In fact, in my state right now, there are about 20 different plans on the table & this is one of the LEAST offensive plans there.

One of the points of this plan was to bring ALL participants who are in healthcare together.

You all talk about physicians being the sole underwriters of this plan - they are NOT!

Providers (not just physicians) are proposed to be taxed. Likewise, hospitals are taxed. Likewise (contrary to a previous poster!!!) small business is obligated (those who employ greater than 10 employees) to provide health insurance or to pay into a pool which will. Likewise, insurance companies are required to spend 85 cents out of every $1 of premium paid on a patient's behalf on healthcare reimbursement (you'd be surprised at how little they do spend!). Likewise, the poor really do pay - there is a limit on how long an adult can be on public assistance (however there is no limit on children) - UNLESS the adult is enrolled in a job education and placement program. Likewise, the counties, which are the current "safety net" for the poor - have to relinquish their monies to the plan.

So - everyone - from the users to the providers NOW all have a reason to come to the table to talk.

Previous to this, everyone wanted to pass the responsibility off to the other group - the providers to the hospitals to the poor to the immigrant to the insuerers - it never ended.

I'm no Schwarnegger supporter - but he has done, in one fell swoop, what others have not been able to do & that is bring everyone who is a player in our state's healthcare to the table to talk about a system which is severly broken.

You can all stay away from coming to medical/professional schools or residencies/fellowships or private practices in CA. I doubt that the schools in my state will be avoided just because of this. But, schools are being burdened because of the LACK of reimbursement right now. However - remember - this same governor defied his own party & the President's veto to find state funding for stem cell funding. You may not agree with it, but this guy is definitely supportive of progressive medical care.

CA is a state which suffers from severe social problems - immigration, underpaid workers, high cost of living, too many people needing healthcare & not enough people to provide it nor education, social services, good roads, etc.....but - for now....the governor has brought productive discourse to the issue within this state.

Your own states may not suffer from these problems. If that is the case, and you choose to view life from your own small, and in my mind, narrow viewpoint - disagree all you want. But....this bill is NOT directed at physicians alone. Those of you who have read it as such have not read the whole bill. It will not become a template for healthcare across the country, but it may indeed be a format border states with severe poor/immigrant populations might follow.

This will not pass the way it was written & probably was never intended to. But.....it does bring all the players to the table to have a dialog - which, in and of itself, is a positive step! Hopefully, it will foster a full and complete dialog from all participants and we will come to a solution which will be, not perfect for all parties, but at least acceptable. It won't be this term.....it may not be for years...but at least the dialog has begun!

 

[dynx]

second of all, people will likely be visiting doctors more frequently for preventative care/mental health care as they will now have the means to pay for it.

where is the "i just pissed myself Im laughing so hard" smilie? This is truely a comment by someone that is NOT yet in the medical field.

 

[EctopicFetus]

where is the "i just pissed myself Im laughing so hard" smilie? This is truely a comment by someone that is NOT yet in the medical field.

Agreed!!! I cant tell you how many people I see in the ED who are unemployed and missed 3 meetings with their doc and are now out of 17 different meds. Hmm what big important thing could they be doing.. Oh yeah... the DEA and ATF come to mind..

 

[supercut]

The day I have to pay to take care of patients is the day I quit. Doctors are supposed to get paid for the care they provide, not pay to provide care.

 

[dilated]

It's interesting that Arnie is going to tax doctors to pay for their own reimbursement (basically redistributing income from higher paid specialists to primary care docs), rather than tax the entertainment industry to pay for it, therefore actually injecting money into the healthcare industry instead of just stirring it around.

Because the goal is to not allow physicians a choice as to whether to participate in MediCal. Lots of physicians would like to tell MediCal to **** off for all the hassle it causes and just work at ASCs (for example) and never take call or see uninsured pts. The goal of this is to take money from physicians who dare to not see MediCal patients and redistribute their money to the ones that do. I'm waiting for the day when all lawyers are taxed and that money distributed to pro bono people and legal support groups (how DARE you only do corporate law??), but I'm not really holding my breath.

 

[MacGyver]

You Arnold apologists are incredibly naive. This is a classic example of a bait and switch.

Arnie promises you increases in revenues as a result of this tax. But lets get real. The govt wont let this turn into a cost-positive or even cost-neutral program. Because if it did, it would mean they wouldnt be able to fund the uninsured costs.

Cali is going to work this as a cost-negative, meaning thta the taxes they get by doctors are going to be greater than teh increased reimbursement they give to docs.

So how do they pull this off? Bait and switch. Hoping that its passed by the legislature, they OK the increased rates. But the very next year (you do know that Medical rates are reviewed on a year by year basis right?) they will of course cut the reimbursement back to its pre-law levels. That means docs will take at least a 2% cut in gross revenues, translating to even larger losses on salary.

So yes, everybody in Cali will be covered by Medical or some other insurance, meaning that 100% of your patients will be paying customers. But that doesnt help much when the individual Medical reimbursement PER PATIENT is going to be slashed to pay for this program. Before everybody jumps for joy at hte prospect of having 100% paying customers remember the govt is going to pull a bait/switch and drastically cut the per-patient reimbursemnt levels to compensate for hte extra money they are spending.

Take a look at pediatrics for example. Their salaries have been falling forever, yet their patient base is almost 100% insured because of programs like CHIP. The reason why is because the state CHIP programs slash individual reimbursement fees every year.

Dont fall into the trap of assuming that 100% paying customers = more money for doctors. Thats fools gold you are chasing.

 

[RuNnR]

dutchman and dropkick are premeds/med students.

 

[mig2k]

6.5 people who couldn't previously afford it will now have access to healthcare.

They have access because I'm paying for it. The burden is on me because I chose to work hard and not sit around cranking out kids (who will probably end up robbing me) collecting welfare. Fair deal AMIRITE?