Why would anyone go into primary care nowadays?

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sb247 said:
if they aren't paying what I'm charging....then at least some of it is free
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You know what else is funny with insurance companies these days? Not only can they pay you a lot less than you're charging and you can do nothing, they can also come back a year or two later and decide they paid you too much and demand the difference back. If you don't pay, they'll just withhold it from future payments. Yes, this is true.
 
jonnythan said:
You also don't care if someone does because they can't afford basic health care. I don't think that's right.
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It's not that I don't care. It's that I don't want to be forced to care. There's a big difference you see?

People are dying due to lack of basic healthcare all over the world, every minute. What are you doing about that? Do you not care? Or you only care when it's Americans? Others aren't human to you?
 
tdram said:
You know what else is funny with insurance companies these days? Not only can they pay you a lot less than you're charging and you can do nothing, they can also come back a year or two later and decide they paid you too much and demand the difference back. If you don't pay, they'll just withhold it from future payments. Yes, this is true.
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insurance can't force me to take less than I charge because I can decide not to take that insurance

I'm arguing against the proposed insanity of requiring doctors to take medicare/aid and the subpar payments that come with it
 
@jonnythan Isn't it pathetic how Americans have so much excess when so many millions don't have proper homes, clean water, food, or any healthcare? How does that not bother you? Shouldn't we all take a massive standard of living cut so we can help out those that have absolutely nothing and are living in the midst of disease, filth and squalor? Why can't we all live in a studio apartment and eat ramen noodles for the rest of our lives so others can move out of the slums and get their basic human rights met?

I think it's pathetic and disgusting that you're going to make a 6 figure income when so many millions live on less than a dollar a day, starving and dying for lack of food and medicine.
 
sb247 said:
insurance can't force me to take less than I charge because I can decide not to take that insurance

I'm arguing against the proposed insanity of requiring doctors to take medicare/aid and the subpar payments that come with it
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Dude, they all do the same thing. You'd have to take no insurance at all if you want to get paid what you want. Plus, they hold the customers. If you opt out, you lose a potentially massive number of customers who you cannot get any other way.
 
tdram said:
@jonnythan Isn't it pathetic how Americans have so much excess when so many millions don't have proper homes, clean water, food, or any healthcare? How does that not bother you? Shouldn't we all take a massive standard of living cut so we can help out those that have absolutely nothing and are living in the midst of disease, filth and squalor? Why can't we all live in a studio apartment and eat ramen noodles for the rest of our lives so others can move out of the slums and get their basic human rights met?

I think it's pathetic and disgusting that you're going to make a 6 figure income when so many millions live on less than a dollar a day, starving and dying for lack of food and medicine.
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You guys keep trying to shove me into your neat little ideological boxes that you think I belong in. It doesn't work that way.
 
tdram said:
Dude, they all do the same thing. You'd have to take no insurance at all if you want to get paid what you want. Plus, they hold the customers. If you opt out, you lose a potentially massive number of customers who you cannot get any other way.
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they are just a company negotiating...just like I negotiate on lots of the services I use. I'm cool with it

and primary care (fm/psych/peds) does not remotely need to take insurance. cash pay has proven to be a workable solution.
 
jonnythan said:
You guys keep trying to shove me into your neat little ideological boxes that you think I belong in. It doesn't work that way.
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Yup, much easier to say that rather than answer his question and admit you're being a hypocrite.
 
jonnythan said:
You guys keep trying to shove me into your neat little ideological boxes that you think I belong in. It doesn't work that way.
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That's not the point at all. I was just trying to get you to understand the foolishness behind your argument.
 
sb247 said:
they are just a company negotiating...just like I negotiate on lots of the services I use. I'm cool with it

and primary care (fm/psych/peds) does not remotely need to take insurance. cash pay has proven to be a workable solution.
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Cash pay is the way to go if you can get it. It's an incredibly competitive area, and of course the NPs and PAs are in the arena too. Everyone wants a bite of the cash-only market.
 
tdram said:
That's not the point at all. I was just trying to get you to understand the foolishness behind your argument.
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I'm not arguing for some communistic world where everyone has the same stuff.

Everyone in America is already guaranteed certain things such as police protection, an attorney, an education, etc. from the government/society. I think basic medical care should be another one of those things. Other countries have accomplished this to some degree. We could too if we wanted to. We don't want to, though.
 
jonnythan said:
I'm not arguing for some communistic world where everyone has the same stuff.

Everyone in America is already guaranteed certain things such as police protection, an attorney, an education, etc. from the government/society. I think basic medical care should be another one of those things. Other countries have accomplished this to some degree. We could too if we wanted to. We don't want to, though.
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supreme court actually stated that police aren't bound to protect us....you only have a right to a provided defense attny in a criminal trial because the govt is creating the situation by charging you......and public education via the federal is not a recognized right, it's just something that all the states happen to do
 
jonnythan said:
I'm not arguing for some communistic world where everyone has the same stuff.

Everyone in America is already guaranteed certain things such as police protection, an attorney, an education, etc. from the government/society. I think basic medical care should be another one of those things. Other countries have accomplished this to some degree. We could too if we wanted to. We don't want to, though.
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We're not the same as those countries, though. We have a lot of fundamental differences that make what you're asking for very difficult to achieve here, if not impossible. For example, our culture is just not going to accept rationing of care. (and shouldn't, in my opinion)

And even if we could, my argument is that we shouldn't, at least not via increasing taxation, because that is the wrong way to solve the healthcare problem. I'd rather make healthcare cheaper so everyone could actually afford to buy it themselves without government assistance. We could do it cheaper, as many other countries do, if we backed off on a lot of uneccessary regulation and let the free-market work a bit more.
 
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jonnythan said:
I'm not arguing for some communistic world where everyone has the same stuff.

Everyone in America is already guaranteed certain things such as police protection, an attorney, an education, etc. from the government/society. I think basic medical care should be another one of those things. Other countries have accomplished this to some degree. We could too if we wanted to. We don't want to, though.
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What is your actual factual basis of this statement though? Like what about our system is bad, explain in specifics. You can't just say " people don't get decent care." What does that mean? We could do what if we wanted to? What is your gripe? If you want something accomplished, you have to make a concrete goal. After talking about this for hours, I still have no idea what actual problem you have with our system other than " people don't get decent care." What does that mean?
 
tdram said:
We're not the same as those countries, though. We have a lot of fundamental differences that make what you're asking for very difficult to achieve here, if not impossible. For example, our culture is just not going to accept rationing of care. (and shouldn't, in my opinion)

And even if we could, my argument is that we shouldn't, at least not via increasing taxation, because that is the wrong way to solve the healthcare problem. I'd rather make healthcare cheaper so everyone could actually afford to buy it themselves without government assistance.
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No, we're not the same. I think you're right that our culture won't accept rationing of care.
 
sb247 said:
they are just a company negotiating...just like I negotiate on lots of the services I use. I'm cool with it

and primary care (fm/psych/peds) does not remotely need to take insurance. cash pay has proven to be a workable solution.
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Yes but the capitalist in me says that they are given unfair leverage due to government regulations that allow them an effective monopoly as I'm not sure about the validity of cash pay for areas all over America, vs a few regions.
 
RJGOP said:
I just remember my mom (who is a surgeon) working with this Russian anesthesiologist who always said Russia had better physician training and healthcare. He quickly lost his license to practice medicine because of so many malpractice lawsuits. I just thought it was ironic.
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lmfao Russia admits 80% of students to med school based on who their parents know or how much they pay the adcoms. One of their urologists argued vociferously that their educational system/residency training was much better because it was less specialized but admitted that he could never pass any of the Steps but would move to the US if he had the option.
 
jonnythan said:
You guys keep trying to shove me into your neat little ideological boxes that you think I belong in. It doesn't work that way.
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If you end up practicing as a physician in the US you'll represent the scenario he's describing.
 
tdram said:
We're not the same as those countries, though. We have a lot of fundamental differences that make what you're asking for very difficult to achieve here, if not impossible. For example, our culture is just not going to accept rationing of care. (and shouldn't, in my opinion)

And even if we could, my argument is that we shouldn't, at least not via increasing taxation, because that is the wrong way to solve the healthcare problem. I'd rather make healthcare cheaper so everyone could actually afford to buy it themselves without government assistance. We could do it cheaper, as many other countries do, if we backed off on a lot of uneccessary regulation and let the free-market work a bit more.
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Of course not. We're willing to accept the possibly 10s, 100s, or thousands of small losses for that one huge win (person comes out of a coma and leaves the hospital). This is what makes the system here exceptional. I once read a fantastic article from an Arab seeking care here who described the US healthcare system placing an extraordinary value on human life, more than any material costs. This idea is completely foreign to the majority of healthcare providers around the world.
 
jonnythan said:
No, we're not the same. I think you're right that our culture won't accept rationing of care.
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For good reason. Most people, unlike yourself, don't accept govt. bureaucrats doing the rationing.
 
PL198 said:
Yes but the capitalist in me says that they are given unfair leverage due to government regulations that allow them an effective monopoly as I'm not sure about the validity of cash pay for areas all over America, vs a few regions.
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$30, 10-15m visit.
$30x4.5/hour (avg)= $135
$135x45 hours/week =$6075
$6075 x 48 week/year (4 weeks vac) = $291,600 pre overhead, then pre-tax a year.

Not sure if approx 300k is enough to run the place, but if you're taking cash your overhead drops tremendously.
I feel like most people could shell out $30 to see a doctor when they are actually sick?
Who knows. I don't, but I'd like to think this is a possibility.

Edit: this does not cover tests or procedures done in office, that's what insurance would be for.

I'm just throwing this out there, really haven't thought through this entirely.
 
tdram said:
I agree. The govenrment paints physicians out to be these money hungry people and uses that to specifically assault physicians with public support. The public isn't going to complain because the "overpaid" physician got a pay cut.

.
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physicians are money hungry rich evil villains who are 1%ers. I mean, they make so much money.

screw the fact that they went to YEARS of schooling that people cannot even fathom. Screw the medical malpractice insurance. Screw mountain of debt they have to go into because of schooling. Screwing the stress that they have to deal with. Screw the fact that they are serving other people and making huge sacrifices. All I care is that they are making more money than me, and are, therefore, evil.
 
jonnythan said:
Yes, this is true. There's a place for buying a higher level of care if you have the money though.
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That place is currently an academic medical center in the United States of America. What's that place gonna be under single payer? Are you going to come up to big name physicians and stuff money into their front pocket?
 
jonnythan said:
You are truly unbound by any rules of logic or decorum to conclude that someone has no conscience and is a hypocrite because they think universal health care is a good idea.
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Nope. It's bc you believe that the government should ration medical care for the good of the collective. I'd have more choice words about how I feel about people like you who believe that, but you're not worth getting banned over.
 
WhippleWhileWeWork said:
$30, 10-15m visit.
$30x4.5/hour (avg)= $135
$135x45 hours/week =$6075
$6075 x 48 week/year (4 weeks vac) = $291,600 pre overhead, then pre-tax a year.

Not sure if approx 300k is enough to run the place, but if you're taking cash your overhead drops tremendously.
I feel like most people could shell out $30 to see a doctor when they are actually sick?
Who knows. I don't, but I'd like to think this is a possibility.

Edit: this does not cover tests or procedures done in office, that's what insurance would be for.

I'm just throwing this out there, really haven't thought through this entirely.
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What would the benefit be of them going to your cash only practice if they still need to also pay for insurance for tests or procedures?
 
KanyeWes said:
physicians are money hungry rich evil villains who are 1%ers. I mean, they make so much money.

screw the fact that they went to YEARS of schooling that people cannot even fathom. Screw the medical malpractice insurance. Screw mountain of debt they have to go into because of schooling. Screwing the stress that they have to deal with. Screw the fact that they are serving other people and making huge sacrifices. All I care is that they are making more money than me, and are, therefore, evil.
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Yes, screw the evil physicians. At the same time, reality stars make several times the average physician's income yet provide no benefit to society whatsoever and that's totally fine, because I'm being entertained!! But screw the doctor who wants more money out of me, greedy bastard.
 
DermViser said:
Nope. It's bc you believe that the government should ration medical care for the good of the collective. I'd have more choice words about how I feel about people like you who believe that, but you're not worth getting banned over.
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If you want exceptional care, then pay for it.
 
tdram said:
What would the benefit be of them going to your cash only practice if they still need to also pay for insurance for tests or procedures?
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Basic diagnosis (flu, cold, inflammation, etc), in other words rule out life threatening stuff.
Prescriptions
Physicals
Wellness check ups for babies/ladies
Maybe really cheap tests that can be done in office would be cash, what I had in mind when I said tests were expensive things like x-rays, mri's etc that need to be done somewhere else besides the PCP's clinic.
If he needs to inject your joint with steroids, you'd pay for the shot. Sew up a gash, pay a little extra. Lance a boil, pay a little extra.
?
Good exercise, let's figure this out.
 
If government starts rationing care in this country, there will be a large market for offshore medical tourism. Who's in to start up a hospital out in the Carribean and fly in rich Americans?
 
tdram said:
If government starts rationing care in this country, there will be a large market for offshore medical tourism. Who's in to start up a hospital out in the Carribean and fly in rich Americans?
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Cash only, right?
 
jonnythan said:
If you want exceptional care, then pay for it.
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Yeah, and your goal is to take money from those who are able to pay for their OWN care to pay for everyone else's care. And who is to to determine what is "exceptional" care? A govt. bureaucrat?
 
DermViser said:
Yeah, and your goal is to take money from those who are able to pay for their OWN care to pay for everyone else's care. And who is to to determine what is "exceptional" care? A govt. bureaucrat?
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Probably, yeah. Maybe some independent body made up of people appointed by the industry. I don't know.
 
tdram said:
Wouldn't that lead to a two-tiered health system, which I've heard plenty of liberals complaining about the unfairness of?
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Probably. I don't really care what "liberals" have to say on the subject, or what the party line of a party I don't belong to is. I'm not a Democrat and I don't think I've ever voted for a Democrat. I actually vote mostly Libertarian whenever possible.

I don't especially care if the system is "unfair." Life is unfair. There are things we should do to equalize opportunity and make things fair, to some degree, but life will always be very unfair and I'm comfortable with that.
 
tdram said:
Yes, screw the evil physicians. At the same time, reality stars make several times the average physician's income yet provide no benefit to society whatsoever and that's totally fine, because I'm being entertained!! But screw the doctor who wants more money out of me, greedy bastard.
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yeah! med students deserve to get kicked in the balls.
 
jonnythan said:
Probably. I don't really care what "liberals" have to say on the subject, or what the party line of a party I don't belong to is.

I don't especially care if the system is "unfair."
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Well if you want Universal healthcare, they're the party that's gonna get it for you. So it's worth paying attention to what they have to say.
 
tdram said:
Well if you want Universal healthcare, they're the party that's gonna get it for you. So it's worth paying attention to what they have to say.
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I edited the post to add some content. You guys move too fast.

I purposefully haven't considered the political reality in the country. I know that what I want is impossible right now. I think we are kinda sorta moving in that sort of direction, but in a weird piecemeal way that might or might not work out. Don't mistake my opinions as me advocating for a massive shift in health care in that way.
 
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