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post #16 of 60 (permalink) Old 03-07-2017, 07:48 PM
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Re: Finally

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This is an interesting idea. But what about the problem with Drs. not wanting to take medicaid patients because they payout doesn't cover their costs? I know people on medicaid and they have a lot of trouble getting in to see a Dr. So yes, they have "coverage" but it doesn't cover a lot of things and isn't timely. Though I guess it would let us say "look, there is a safety net for everyone and if you want something more, go buy it."
Medicare, not Medicaid.

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post #17 of 60 (permalink) Old 03-07-2017, 09:15 PM
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Re: Finally

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If it is the only thing in town along with supplementary insurance then I say, let them turn it down and take only cash patients.
OK, but how does that solve the problem of getting medical care to all Americans? If the government makes it unprofitable and less desirable to be a Dr. it seems we could go from having medical care be expensive to simply not having Drs. available in many places.
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post #18 of 60 (permalink) Old 03-07-2017, 09:28 PM
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Re: Finally

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After almost 8 years of non-stop whining, crying and throwing tantrums, after over 60 votes to repeal ACA (aka Obamacare fka RomneyCare) the GOP announced their much ballyhooed replacement. Strangely enough the "conservatives" have yet to comment. So what say you?
I read some more about it today and I feel more optimistic, though not thrilled. I think this will be better than Obamacare, but not as good as before the govt. started screwing things up. One thing I'm disappointed in is that apparently they originally had language where insurers did not have to cover things that people don't want - like maternity care for people not having babies, but they took that out, so they still have to provide coverage for certain things. So that will keep premium costs higher. But other changes sound somewhat promising.
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post #19 of 60 (permalink) Old 03-07-2017, 09:34 PM
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Re: Finally

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OK, but how does that solve the problem of getting medical care to all Americans? If the government makes it unprofitable and less desirable to be a Dr. it seems we could go from having medical care be expensive to simply not having Drs. available in many places.
My daughter starts medical school in the fall. It's still very desirable and immensely profitable. Not as profitable as ten years ago but still...
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post #20 of 60 (permalink) Old 03-07-2017, 10:06 PM
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Re: Finally

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Medicare, not Medicaid.
I understand. I said the wrong word, but my concerns apply to Medicare too if expanded.
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post #21 of 60 (permalink) Old 03-07-2017, 10:11 PM
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Re: Finally

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It doesn't have to bankrupt us. I'm not even convinced it has to require exorbitant taxes, provided we make some tough choices between guns or butter.
I think it is evident with who is in charge as to which of these will be chosen. Even if we did go with butter over guns, we are still an unhealthy society, not sure if any part of the budget (where ever it comes from) can continue to bear the cost of our chronic disease management system.
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post #22 of 60 (permalink) Old 03-07-2017, 10:13 PM
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Re: Finally

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OK, but how does that solve the problem of getting medical care to all Americans? If the government makes it unprofitable and less desirable to be a Dr. it seems we could go from having medical care be expensive to simply not having Drs. available in many places.
I don't think this puts physicians out of business. It may cut their pay a bit and we may have to further subsidize medical school expenses. However it does mean the incentive to be a physician is founded on the correct principles.
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post #23 of 60 (permalink) Old 03-07-2017, 10:16 PM
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Re: Finally

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I don't think this puts physicians out of business. It may cut their pay a bit and we may have to further subsidize medical school expenses. However it does mean the incentive to be a physician is founded on the correct principles.
If the only people who applied to medical school were those that did so because of the "correct principles" and not because they wanted a respectable doctor's salary then there would be an epidemic shortage of qualified physicians.

Last edited by browser; 03-08-2017 at 10:15 AM. Reason: typo
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post #24 of 60 (permalink) Old 03-07-2017, 10:16 PM
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Re: Finally

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My daughter starts medical school in the fall. It's still very desirable and immensely profitable. Not as profitable as ten years ago but still...
That is good to hear. I was talking with someone else who has a daughter just out of med school who is very excited about being a Dr. and happy with her starting salary ($60K in CA.) But I also personally know several Drs. who hate being Drs. since the changes. They feel the only viable option anymore is to work for a hospital as an employee. And to specialize. Private practice simply is not sustainable anymore. What Medicare will reimburses literally does not cover their cost of doing business. And the younger ones have hundreds of thousands of dollars in med school debt. Plus I am reading about Dr. shortages and I have found for myself that it now takes months to get in to see a Dr. when it used to take a week or two.

My fear is that these changes will make the medical profession undesirable to a whole class of person - those who want to work for themselves - and we will end up with far fewer Drs. and a different personality type drawn to being Drs. No offense to your daughter, but people who are willing to give up their autonomy and let underwriters and administrators influence decision making that used to be strictly between Drs. and patients.
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post #25 of 60 (permalink) Old 03-07-2017, 10:17 PM
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Re: Finally

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I understand. I said the wrong word, but my concerns apply to Medicare too if expanded.
One way or another this will be paid by those who can... if we don't do Medicare for all, then we go to the ACA format that expands Medicaid along with subsidizing Health insurance for those who cannot afford it. Or, we go to the current GOP plan which still has an unfunded tax credit. Or we go back to the previous system in which some access health care and do not pay their way. In this final one, those who have insurance pay for those who don't along with subsidies from local and federal government.

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post #26 of 60 (permalink) Old 03-07-2017, 10:21 PM
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Re: Finally

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If the only people who applied to medical school were those that did so because of the "correct principles" and not because they wanted a respectable edoctor's salary then there would be an epidemic shortage of qualified physicians.
Most science PhD programs are completely subsidized by the federal government. The job does not pay all that well in academic circles, but this does not stop the large droves of PhD candidates looking to fill those low wage jobs in what is often a very competitive market. I'm not buying it.
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post #27 of 60 (permalink) Old 03-07-2017, 10:24 PM
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Re: Finally

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I don't think this puts physicians out of business. It may cut their pay a bit and we may have to further subsidize medical school expenses. However it does mean the incentive to be a physician is founded on the correct principles.
What are the "correct" principles for becoming a Dr.? And where do you get the moral authority to decide what they are?

And how do you explain to a sick person who can't get help that they are better off with no Dr. or waiting months for an available one than they would be getting immediate care from one who's principles you find objectionable?
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post #28 of 60 (permalink) Old 03-07-2017, 10:25 PM
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Re: Finally

Obamacare wasn't an entitlement; it was keeping people from having to declare bankruptcy (only in America) any time they get a real illness. I know of nobody who got 'better off' with Obamacare, but I know many many people who, for the first time, were able to go to a doctor.
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post #29 of 60 (permalink) Old 03-07-2017, 10:25 PM
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Re: Finally

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That is good to hear. I was talking with someone else who has a daughter just out of med school who is very excited about being a Dr. and happy with her starting salary ($60K in CA.) But I also personally know several Drs. who hate being Drs. since the changes. They feel the only viable option anymore is to work for a hospital as an employee. And to specialize. Private practice simply is not sustainable anymore. What Medicare will reimburses literally does not cover their cost of doing business. And the younger ones have hundreds of thousands of dollars in med school debt. Plus I am reading about Dr. shortages and I have found for myself that it now takes months to get in to see a Dr. when it used to take a week or two.

My fear is that these changes will make the medical profession undesirable to a whole class of person - those who want to work for themselves - and we will end up with far fewer Drs. and a different personality type drawn to being Drs. No offense to your daughter, but people who are willing to give up their autonomy and let underwriters and administrators influence decision making that used to be strictly between Drs. and patients.
Things change as they always do and even without the ACA, things were already changing for most physicians. A lot of insurance companies were already treating physicians more like employees than independent contractors. So, it makes no difference with a single payer system, ACA, the GOP plan or going back to the way things were, things in the medical community are not going to be sustainable in anything other than shared practice. No matter how you slice this one (taking on Health Care in America) there will be winners (not big ones) and losers (this can be minimized). So, one has to answer the first question: Is health care a right or a privilege?
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post #30 of 60 (permalink) Old 03-07-2017, 10:28 PM
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Re: Finally

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What are the "correct" principles for becoming a Dr.? And where do you get the moral authority to decide what they are?

And how do you explain to a sick person who can't get help that they are better off with no Dr. or waiting months for an available one than they would be getting immediate care from one who's principles you find objectionable?
It is not for me to decide why a person wants to pursue a career, that is something they will have to decide (my comment on the correct principles - not just for the money).

As for who most sick people see, in most states there is already a push to license NP and PA. In most cases now, your primary care "doctor" is likely one of these individuals. And as such cuts down on the need for physician having to fill a role that others can fill.
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