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The Shortage of Physicians Who’ll Accept Patients with Government Plans [Updates, Foreword by Larry Johnson]

By Bronwyn's Harbor on December 20, 2009 at 6:45 AM in Current Affairs

UPDATE: Do not miss today’s “A Nebraska doctor’s message for Ben Nelson.” Your blood will boil. (H/t to our reader sybilll for spotting this letter.)

Intro Comment by Larry Johnson, December 20, 2009 — Whether or not you believe in gravity, gravity exists. In fact, your belief does not mean a damn thing when it comes to gravity. If you doubt me then climb up to a tall building and jump. Unless you have a parachute you will probably kill yourself it you are jumping from a height of forty feet or more. Which brings me to Bronwyn’s firsthand account.

When you have a limited supply of something–in this case doctors, nurses, hospitals and pharmacies–and you significantly increase the demand for their services you can be guaranteed that one thing will result–THE PRICE OF THOSE SERVICES WILL GO UP. This is another immutable fact, like gravity, that will prevail for at least the next two years if this crazy bill goes thru. The utltimate irony is that this legislation, which is being touted as saving people from bankruptcy, will have the exact opposite effect. It will create more economic hardship. Heck of a job Harry!

Editor’s Note: Bumped up from October 21, 2009 because the latest version of the Senate’s Obamacare bill, reports the Christian Science Monitor, drops “provisions to increase payment rates to physicians treating Medicare patients.” This refusal to properly compensate doctors portends greater physician shortages, especially those willing to treat patients on state and federal aid programs, or those medical students interested in selecting family medicine as a career path.

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Original October 21st post: Fox News — especially commentator and columnist Charles Krauthammer — and a few other media outlets have pointed out that doctors cannot make ends meet if their patients are primarily on Medicare or Medicaid. A public health plan will add to the numbers of patients that physicians will not be eager to serve. From RealPolitics‘ “Some Inconvenient Truths About Medicare and the New ‘Public Plan’“:

The looming doctor shortage could become a national crisis as prospective physicians, whose education requires many to incur massive debt, would reluctantly opt for occupations where the government does not control their livelihoods.

My community faced the loss of its major health care clinic a few years ago, and its patients fought like crazy to get the county hospital to save the clinic. To make my case in a letter to the editor, I called every single general and family practitioner in a 50-mile radius, and asked each office if they were taking (1) new patients, (2) Medicare patients, or (3) Medicaid patients.

Guess what I found out:

Not ONE physician’s office — not one — was willing to take ANY Medicare or Medicaid patients. And very few had any openings for new patients with good health insurance.

I summed up my findings in my LTE, which was the top LTE in the Sunday newspaper. I wasn’t as pleased with the featured letter as I was terrified about the prospect of hundreds and hundreds of local citizens no longer being able to find a doctor.

Many local physicians have retired early because they can no longer make a decent living because Medicare and Medicaid do not reimburse them sufficiently to warrant their keeping their practices open.

Luckily for my area, the county hospital came through, but at enormous expense. The first action the hospital took was to spend millions to upgrade the clinic offices to comply with Medicare rules for hospital-grade clinics that enable the clinics to seek higher reimbursements from Medicare. (I am not sure how Obama’s plan will affect the set-up that the hospital achieved, and pray that there’s no “fine print” in the bill that will reduce the Medicare reimbursements for which the hospital paid a lot of money in order to receive.)

I do know that, as reported on Fox News yesterday, Harry Reid et al. hope to add a plan to reimburse doctors more, but instead of finding money within the scope of the plan, Reid says he’ll simply add the expense to the national debt. Smart, Harry. Smart.

From “Prognosis: Doctor shortage in the region” published at nwi.com (a Northwest Indiana media company), here’s a more detailed look at the doctor shortage issue and the very practical issue of how people are going to struggle to find a physician under Obamacare:

Dr. Alex Stemer, president and CEO of Medical Specialist Centers of Northwest Indiana, said doctors are getting paid less now than in the past because of low Medicare and Medicaid reimbursement rates that do not cover the cost of providing care. Stemer said this lower pay makes it harder for new doctors to pay off loans.

“You enter practice as a doctor with typically a quarter of million (dollars) in debt,” Stemer said. The Association of American Medical Colleges estimates most students left medical school last year with more than $150,000 in debt, an increase of 11 percent from the previous year.
With health care reform a possibility in Congress, the question for many health care providers is how many more physicians will be needed to care for the U.S. population.

“The fact is that if you do increase coverage, there is eventually going to be an increase in demand,” said Dr. Pat Bankston, director of Indiana University School of Medicine-Northwest. “Without an increase in health care providers, then you’re guaranteed to slow down care. This is the whole idea of waiting in line and rationing, because you don’t have the providers to take care of you.”

Stemer agreed, adding the current federal health care reform legislation increases access for Americans without increasing capacity.

“The president wants everyone to have an insurance card and make an appointment,” Stemer said. “The president is thinking they’ll go to the office instead of the emergency room when they need care. So now what is going to happen when the (doctors’) schedules fill up?”

Dvorscak and Van Roo said they know what they will face.

“I think in the past (medicine) was a well respected profession, and I hope it stays that way, because we’re really privileged to be able to do what we do,” Van Roo said. “I think it’s a hard job, but it’s a really good job.”

I hope their idealism holds true. But I’ve talked to enough doctors to know that most are bone-weary from having to deal with government health plans that don’t fairly compensate them for their services.

The subtitle of “Prognosis: Doctor shortage in the region“?

SIDE EFFECTS: LONG WAITS, CLINICS OVER CAPACITY, DOCTORS STRETCHED TOO THIN, CARE RATIONING, MORE PRESSURE ON NURSES

Craig Della Penna

This is a problem no matter what happens. Single payer, insurance stand-and-deliver, ‘private’ option – it doesn’t matter. If we have more people going to the doctor: we’ll need more doctors.

There are certainly some options:

Subsidize doctor training

Create and license “Advanced nurses”

Tax breaks for doctors who take medicare patients

The larger reality is that we need to reduce the profiteering on medical treatment at all levels:

Drug costs

Hospital costs

Insurance costs for doctors and hospitals

the list goes on and on, but it’s real and we will deal with it – one way or another.

lark

Subsidize doctor training

Subsidizing by accepting underachievers and paying them 100 dollars an hour to study or 5 thousand dollars per credit hour.

Create and license “Advanced nurses”

Women jails should be reorganized into nursing schools and once they pass their oral and multiple choice open book test they can be released with a promise the’ll fit some workdays in doctor’s offices if they can fit it in their busy schedules.

Craig Della Penna

Actually, offer to have the taxpayers pay off their school loans if they put in “X” years working for medicare patients…

Advanced nurses – kinda like the barefoot doctors the Chinese use: competent to handle most of the everyday needs – colds, cuts, checkups, prescribe drugs for the usual range of complaints. relieve doctors from these chores and might also reduce emergency room traffic.

Lana

I agree with you Craig. Good plan. Wonder why the White House hasn’t been able to think of it.

sowsear

For a long time, the military has been sending students to school for medical training. My GP is one who traded her schooling for a career in the military. One of my cousins had his dental training and one of his sons is now serving in the army after having had his training paid for by the government.

Clara

Advanced practice nurses are vital to any health care delivery system, but nurses have been in short supply for quite sometime. You don’t just crank out a new nurse every couple of years. Indeed, the shortage of PhD level faculty in nursing is one of the limiting factors to graduating more nurses. This is going to be a long, slow process to build up to a good level of skilled and knowledgeable nurses on any level of practice.

Shortages will be felt on many levels. Speaking from experience, the system will be stressed beyond anything we’ve known.

donjo

Here, they’re called Nurse Practicioners, and are a stone’s throw from being full-fledged doctors. It’s quite a burgeoning field with many opportunities; they “man” the clinics at various malls and even Walgreens.

nan

The PA craze has put the cart before the horse. Emergency or urgent patients currently see the PA while the MD is stuck doing scheduled exams.

It should be the other way around, with the experienced MD seeing the emergency patients with wounds, blood clots or infections while the PA does the regular exams.
Tammy

It’s already called, “Minute Clinic”

Look it up.
The Government needs to catch up!

Betty

Thank you CDP, your list indicates a thoughtful mind and that perhaps you have worked for health care reform for a long time.

Never mind what the ascending idiot says.
hokma

I agree with Subsidize doctor training (I have a son in medical school now). I would add that it should for primary care physicians only where thee is a great shortage.

Create and license “Advanced nurses” I would also incent the physicians assistant profession.

Tax breaks for doctors who take medicare patients – are you writing the legislation?

The larger reality is that we need to reduce the profiteering on medical treatment at all levels:
Drug costs
Hospital costs
Insurance costs for doctors and hospitals

EVERY doctor will tell you that the solution is reform malpractice tort – control the ambulance chasers.
Good list.

mountainaires

Not “every” doctor thinks “tort reform” is the answer. And certainly it isn’t the answer.

The medical profession better learn to police their own, and that will take care of “tort” reform–which is just another euphemism for doctors’ license to commit medical malpractice with impunity.

In my state, a patient cannot even bring a suit for medical malpractice without passing a board of physicians who screen cases; in other words, doctors decide which plaintiffs have “standing” and which don’t. Now, I’m not opposed to that in principle; but in action, I wonder how many of those doctors being sued for medical malpractice are protected from accountability by this medical “board.”

I haven’t researched the numbers, but my guess is, that not many patients get “standing” to sue. And, what does this board do with those doctors who get sued time and again, thereby creating a long record of malpractice complaints? Do they sanction them? Do they allow them to continue committing malpractice?

It’s not “tort reform” we need; it’s consumer advocacy and patients rights which will reform the need for “tort.” In states where “tort reform” has passed, doctors are not being held accountable.

hokma

How dare you!!!!

Doctors police their own? They do. What about flunky corrupt lawyers like John Edwards who convinced people to pile on and commit to unnecessary lawsuits – ruin doctor reputations – and abuse the legal system – ALL resulting in premiums skyrocketing.

You want REAL consumer advocacy? Go after the legal profession who, without question are THE most undereducated and overpaid profession there is.

A doctor is a person who gets onto this track not for a quick buck but because of a personal commitment – they are educated in medical school, residencies, and fellowships for over 10 years after a four year college degree. I’ll compare the ethics of the medical profession to any other profession – and they do police themselves extremely well.

http://firefox AnnieCarmel

You want REAL consumer advocacy? Go after the legal profession who, without question are THE most undereducated and overpaid profession there is.

Couldn’t agree more. They are also the most corrupt. Why do you think we have so many lawyers who upgrade their payscale to politicians? I think we have more lawyers than any other profession holding office right now.

Tammy

Learn about the Health Care before you spew about it,
My Dad worked for the Mayo Clinic for 40 years.

You are all spewing shit that you don’t know or don’t understand.

Tex-Mex Soup

Kinda like you spewing about the illegal mexicans ALL having stolen social secrity numbers Tammy when a good portion of them use IRS issued tax id numbers to work, pay taxes and have health insurance through their employers.

you are also spewing shit you don’t know or understand when it comes to that subject.

Sorry off topic and I am not picking an argument however I could not help but point that out.

Back to the subject about our screwed up health care system.

sjc-tx

Kinda like you spewing about the illegal mexicans ALL having stolen social security numbers Tammy when a good portion of them use IRS issued tax id numbers to work, pay taxes and have health insurance through their employers.

This is a contridiction in terms…. If they are “illegal“, how the hell do they get legal ID numbers??! If their employers are hiring them and they are ‘illegal‘, then how do all those “laws” about locating and prosecuting these employers work???

I think you have been misled tex-mex… Judging by your name, I;d say you are a bit biased as well as naive???

http://firefox AnnieCarmel

One of my relatives, who is very PC I might add, hires legal Latino workers…people who have been here for years, speak English, own homes, etc…in other words honor their culture but are assimilated. He was stopped in his tracks the other day when one of his Mexican workers was cursing an illegal (Blankedy blank M……) who was taking his time to fax back some papers needed to sign off on a job. “Mexican minutes, Amigo”, I believe was the excuse for the delay.

People who are here legally have almost a bigger issue that I do about people who sneak in. They don’t want their pay undercut by illegals. Even though my relative pays well and won’t hire illegals, they know the next guy will…especially in this economy.

mountainaires

Wow, Dad worked for the Mayo Clinic for 40 years! As what, Tammy, the janitor?

hokma

You are sick – get help.
http://firefox AnnieCarmel

Hey, stop with the personal attacks mountainaires.
http://firefox AnnieCarmel

Btw, that sort of comment smelled of the fecal material that was being smeared here the other day by your “friend” Suze. Or was that all you?

jangles

Health and wellness become more and more the most precious commodity.

BTW Fox appears to be the only network reporting the separate agreement on doctor reimbursement that is passing as separate legislation amounting to some 250 billion additional $$$. They pointed out that this was carved out of the Sen. Finance Bill Baucus and company so proudly tout as a bill that will reduce the deficit—nicely covering up the fact that a key cost is shifted to another corner.

Clara

The Doc Fix bill was defeated with the vote of 12 or 13 Democrats and all Republicans.

Bronwyn’s Harbor

Thanks for reporting this, Clara. I wonder how doctors are reacting.

Doc99

More upset that Harry Reid is blaming the AMA for his own failure to line up enough Democrats.

lark

The end result will be a whole lot of corruption and incompetent lackeys doing piecemeal duties and we will love it and cherish having full employment of every delinquent and criminal having the opportunity to be hired by the health care system to fill the needs of the medical services.

The best thing is to commit a crime early in high school. Apply for remedial or rehabilitation by being trained as a physician assistant and then work whatever hours fit your busy schedule.

Bronwyn’s Harbor

Just a note: Physician assistants are exceptionally well-trained, nearly as much as doctors. Their years and years at a university are very rigorous. My community has several, and every one of those I’ve seen has been top-notch — as good as the doctors they work for.

Peggy Sue

I agree, Bronwyn. I was treated recently by a PA at my local clinic [allergy complaint]. Absolutely professional. And my in-laws who have normal geriatric problems depend on their doctor’s PA as much as the doctor himself. I’ve found the PA service as good as a physician’s. For a really serious/critical condition, I’d want to see a regular MD. But in many, many instances, the PAs are just as good.
listingstarboard

Wow. Not sure I agree .Physician assistant is a four year undergrad degree. Medical Doctor is 4 year undergrad, then medical school then residency. P.A.’s are adequate at many things but the person putting me to sleep better be an M.D. and the surgeon better be an M.D.

Peggy Sue

I don’t think anyone’s suggesting that a PA whip out the surgical knife or pretend that they’re your friendly anesthesiologist :0).

But for routine matters, PA’s are perfectly suitable. Last month, the PA gave me a quick physical check, asked what my complaint was and wrote me a script for allergy medicine. I really didn’t need an MD for that.

Boxer Mum 06

I didn’t think PAs could write scripts. I thought only MDs could write scripts.

Peggy Sue

Nope, this PA wrote a script for Allegra and a Cortisone nasal spray.

Again, I really did not need a MD for this. Btw, this required no appointment, about ten minutes of my time [as opposed to an hour wait in a doctor's office] and was cheap: $35.

What’s not to like? Would I go to a PA for an amputation, a head injury, a heart attack? Noooo.

But for routine matters? It works. And it frees up MD’s for the really important stuff. Which fortunately, I don’t need right now.
http://firefox AnnieCarmel

Yes, that is normal procedure. I had an auto accident a few years back…whiplash, bruises, hematoma, etc., and my family physician’s PA did the exam, wrote scrips for pain killers, muscle relaxants and orders for x-rays, etc. I wind up seeing her more often than not. Only time I’ve seen my doctor in the past few years is when I needed a second opinion on a surgical procedure before deciding what to do. So far, I’m fine with this.

http://firefox AnnieCarmel

Sorry, all. I misspoke. My family physician has PA’s and and an NP. The NP is the one I usually see when she’s too busy. My family doctor is an (guessing 45 or so y/o) AA and is doing pretty well…new office, etc. I’ve been seeing her for the past 10 years and so far haven’t been told she won’t take Medicare, etc. She works hard though…calls back at 8pm sometimes.

Clara

Nurse anesthetists existed long before it was a specialty for doctors. My mother gave patients anesthesia for almost 50 years, and long before a doc was in the hospital to monitor her care. They are totally capable. As a nurse myself, working in a specialty that included OR, I’d personally take a nurse over a doctor in almost all cases. If there is a nurse doing the case, the docs don’t stay in the room – the nurses do.
http://www.aapa.org Lynn

I work for AAPA (American Academy of Physician Assistants) and I wanted to provide a little more specific information about PA training & practice:

The average PA program takes 26.5 months to complete. The first year generally is composed of classroom studies — the essential medical sciences such as microbiology, anatomy, and physiology — followed by a year of clinical rotations in private practice and institutional settings.

Currently, it is possible to obtain an associate, baccalaureate, or master’s degree [which 124 of the 140+ PA programs offer a Master's degree according to PAEA]. Regardless of the academic degree awarded, all graduates sit for the same national certifying exam.

Physician assistants have a long-standing tradition of serving in areas of need, providing care to those who might otherwise have little or no access to quality health care. PAs work everywhere, from remote rural settings to major urban centers, in doctors’ offices, hospitals, clinics, HMOs, the armed forces, and other federal government agencies. The PA’s responsibilities depend on the type of practice, his or her experience, the working relationship with physicians and other health care providers, and state laws.

PAs are health professionals licensed to practice medicine with physician supervision. PAs perform a comprehensive range of medical duties, from basic primary care to high-technology specialty procedures and often act as first or second assistants in major surgery and provide pre- and postoperative care.

In some rural areas where physicians are in short supply, PAs serve as the primary providers of health care, conferring with their supervising physicians and other medical professionals as needed and as required by law. PAs can be found in virtually every medical and surgical specialty.

Boxer Mum – All 50 states, the District of Columbia, and Guam and the Commonwealth of the Northern Mariana Islands have enacted laws that authorize PA prescribing.

Hope this information helps!
Bronwyn’s Harbor

Not where I live. It’s akin to more than a master’s degree — only about 2 years less than a doctor’s training. Perhaps there are different requirements at different universities.
Bronwyn’s Harbor

Clara, check Wikipedia’s entry. There are medical assistants — not the same thing. OF NOTE: MY DOCTOR’S P.A. CAN WRITE PRESCRIPTIONS. For ANY drug. No 4-yr. program would lead to that autonomy.

Wiki notes that the only difference is that most physicians must complete a residency program.

A quote from Wiki:

As of May 2008, there were 142 accredited PA programs in the United States [5]. The majority are graduate programs leading to the award of master’s degrees in either Physician Assistant Studies (MPAS), Health Science (MHS), or Medical Science (MMSc), and require a bachelor’s degree and GRE or MCAT scores for entry. Some PA programs are starting to offer a clinical doctorate degree (Doctor of Science Physician Assistant or DScPA), while a few still award an undergraduate bachelor’s or associate’s degree, but many of these are transitioning to graduate-level training. Professional licensure is regulated by the medical boards of the individual states.
Physician assistant education is based on the medical model [6] although unlike medical school which lasts four years plus a specialty-specific residency, PA training is usually 2 to 3 years in duration. However, most PA students start their medical education with a background of health care experience. The didactic training of PA education consists of classroom and laboratory instruction in medical and behavioral sciences, such as anatomy, microbiology, pharmacology, pathophysiology, hematology, pathology, clinical medicine, and physical diagnosis, followed by clinical rotations in internal medicine, family medicine, surgery, pediatrics, obstetrics and gynecology, oncology, emergency medicine, and geriatric medicine, as well as elective rotations.

Kim

I agree. I have been to physician’s assistants that were better than any doctor I’ve seen. They don’t have that God complex thing going on, either. I went to a female PA, at a local clinic, for several years that I just loved. When I was a military dependent I saw PA’s all the time, and they were very good.
sjc-tx

This isn’t quite right… A PA is just that… ‘assistant’. A Doctor is trained and EXPERIENCED, thru years and many hours. No disrespect intended, but I think it a bit naive (and insulting) to compare a PA to a full fledged MD…

Peggy Sue

Excuse me, no one is comparing a PA to a full-fledged doctor. At least, I’m not. But for routine complaints–nasty colds, minor sprains, gastrointestional infections, flu complaints, bee stings, allergy problems, vaccinations, etc., etc., etc. There’s absolutely no reason why I or anyone else needs an MD, let alone a specialist. The PA’s “do” have training and boots on the ground. It’s like demanding an architect when what you really need is a brick layer.

I also understand the comfort factor in being treated by a PA. They tend to be more down to earth and personable. Doctors, by and large, are overworked and stretched to the max. Yes, yes, I know we all have the stories of golf-addicted, vacation-prone MD’s. But I’m sorry, that is “not” my experience.

In the same way, I am reluctant to pop an antibiotic for every wince and ill is parallel to tapping the professional that meets my needs.

Right now, my health needs are minimal. But make no mistake, when one of my sons was critically injured with a TBI, I wanted the “best of the best.”

And maybe we were blessed. Because that’s exactly what we got.

hokma

“Physician assistants are exceptionally well-trained, nearly as much as doctors.”

I have a cousin who is a PA and is very competetent.

But there is no comparison or replacement for the education of a medical doctor. After they complete they have to go to medical school for four years in an extremely rigourous learning process – then spend a few years as a resident – then spend anywhere from 3-5 years in a fellowship of their choice.

When a patient is being examined by a doctor it is never routine and can never be taken for granted that something could be wrong that only a highly trained physician will spot.

However, under ObamaCare PA and certain nurses will have to replace primary care physicians because of more and more will opt for speciality areas that pay more.

Fredster

B.H.: Don’t forget you have p.a.’s and also nurse practitioners. Both are good and could triage in a doctor’s office.

Also, you cite the info on docs who can’t make it on medicare reimbursement rates. Do you have any info on the negotiated rates paid by PPO’s to doctors? They (PPO’s) are trying to low-ball as much as they can too.
SAINTIXE

For once I believe that my past experience as a medecin generaliste- general practice in France for 20ys then as a UK based GP can help in thise discussion. Strangely enough, shortage of doctors and nurses is international regardless of teh health care system
each country and you can add Canada to said description is running out of doctors.
US is poaching CANADA, UK is poaching India and Pakistan, with a fair sprinkling of spaniards , Germany is poaching Eastern Europe, France is poaching north Africa and Cntral Africa whilst New Zealand is poaching Ausralia and both are poaching the NHS. cLEARLY THERE IS A PROBLEM. wHY
- in the UK Uni is costly and getting admitted in Uni is hell- speaking as a parent, some freinds child ended up training …in Spain- where is the logic, but s France where it is cheaper, whilst getting admitted into the first year is easier, to survive said 1st yr is very hard- – at the end same result
when the babyboomers whether brits or gallic reach the famous 60-65ys Hell breaks loose. Some specialities as neurosurgery/neurology, rheumatology are simply deserted- in france as the obligation of gyn-obs is so demanding, they have come up with a new sort of consultant- who can attend your pregancy but heaven forbids you need a c-section as he/she will be clueless how to proceed
so why
after discussing with professional union members on both sides of the channel, it would seem that making/teaching/building up the exsperience of a doctor is expensive, so much expensive that – for the economist less is best- noyou will not hear that loud, you have to sail very close to the wind i.e. be a member yourself of said profession to know those facts. Nurses and nurses practitoners are cheaper, they prescribe in in Britain but again we reach the same problem
managers; administrative staff, bureaucrats, you name it dislike the autonomy of prescribers
what I do know is that there is no magic system and one of the problem is the huge cost of tort laws and lawyers
which we have here thanks to you , America
but also the management of the pharmaceutical companies who since at least the past 10years have been flooding our practices with dubious new drugs which are nothing but metoos-copycats and waste of time+space
but I am far from denying some doctors did see it coming and provided poor care to their patients and I cant deny any industry to try and make a living
as said above I am actually practising since 27years and met a few colleagues from different countris, we are all clueless as what is best, because it is costly which way you look at it

Docelder

pharmaceutical companies who since at least the past 10years have been flooding our practices with dubious new drugs which are nothing but metoos-copycats and waste of time+space

Exactly, the drugs exist just so as to be patentable and in many cases work no better than the ones they replace. Then we have the blends of the two generic non-patented drugs re-branded into a patented drug just to be able to have ex-cheerleaders come around and try to sell why it is better to take this one patented drug instead of the two generic ones it consists of.

sjc-tx

You are basing this statement on your education and professional research…? And just what is it you do for a living???

sowsear

Now that the family doctor no longer goes to the hospital, the person who manages medical care there is most likely a non-American hired by the hospital. Not only do these doctors not have any personal relationship to the patient, many are
culturally disparate from Americans and some have
language/communication problems as well.
I remember many years ago that the physician training schools in this country made a decision to cut the number of medical students they would accept. We are now seeing the results, and with increased coverage, we will be forced to expand the medical hierarchy from too few physcians downward to persons having decreased levels of medical competence.
I am not saying that the PAs and the NP I have used are not competent. They are well trained and patient oriented, but the point is I have chosen them (by their reputation). I have not been forced to accept someone who may not be of the same quality in the future.

http://www.madinthemiddle.blogspot.com churl

The medicos control the supply via the schools and thereby insure their high wages by constantly creating over-training accreditation and by limiting admissions and opportunities for training available to outsiders. Fewer medicos mean higher pay.
Fredster

Now that the family doctor no longer goes to the hospital, the person who manages medical care there is most likely a non-American hired by the hospital.

My mother had a hospitalization a number of months ago. Her internist/personal doctor did not do hospital visits so we were going to have to use a hospitalist. This was my first experience with one. I asked for a list of the ones on staff and by looking at the names I just said “I want one who clearly understands and speaks American English. I got one and did not have any problems with her at all.

norma

.23 on the dollar paid to the physician. Doesn’t pay well when you are forced to work 4 months out of the year to pay malpractice premiums.

Portia Elizabeth

Thank you! A voice of reason!

As the wife of a radiologist I can’t tell you how often I have to listen to people talk about how doctors are overpaid and are filthy rich. Well, let me lay out a few facts.

My husband’s college tuition cost ~ $80K. His med school was ~110K. Those amounts did not include the cost of textbooks and supplies. When he graduated, he started his internship at just over $30K. By the time he finished his residency and a year of fellowship which is recommended for his specialty, he was earning a whopping $50K per year.

Specialties like my husband’s require an outlay for equipment which as you can imagine for a radiology practice is incredibly expensive to keep up with the latest technology. In addition my husband’s group has to have radiology techs, an office manager, an insurance billing specialist, a receptionist and an accountant. The practice has to pay a retainer for an attorney. Then there’s malpractice insurance.

My husband works long hours and takes call once a week which requires him to be available for 24 hour stretches. He does not have “sick days” and holidays have to be covered, too. And FYI, radiologists do much more than read x-rays.

So I defy anyone who thinks doctors have it easy to come and tell me they don’t earn the money they make.

almaintx

My son is a doctor and was explaining to me last night why they are now limiting their Medicare patients. Just started doing this lately and he said it is so hard to tell a patient that they cannot have a procedure because of the limited reimbursement from Medicare. But they cannot stay in business with a large Medicare patient load. Overhead, medical school loans, etc. cut a huge chunk out of their income. And it will only get worse under Obamacare I’m sure.

SusDgs

I do understand. I am on medicaid. Medical care is non-existant, and that is because in my state medicaid pays the doctors the grand total of THREE dollars a month per patient.

We on medicaid do understand that doctors have huge expense and cannot accept medicaid. In my state, it is “all or nothing”, meaning any doctor cannot “just see a few”. If they see one, they have to see them all. How many can keep a practice going on three dollars a month per patient?

People who believe “government run insurance” is the answer is in for one big surprise if they get it.

http://firefox Martha Washington Collier

All of my doctors still accept me with Medicare and a supplemental plan which pays my yearly deductible and the 20% after Medicare. However, my premiums go up each year and I wonder if it will be a dramatic increase beginning with 2010. I am stretching my budget now…so don’t know what to expect.

I do know my Dermatologist (father and son practice) had $300K in billings hung up for almost a year before he was paid by Medicare. Doesn’t bode well.
Diana L. C.

I get so depressed by the healtch care issue that I keep returning to the same conclusion: Make sure I remain as healthy as possible. East right. Get rest. Don’t take physical chances. Do this as long as I can, and then figure out a way to die fast, with as little pain as possible. Leave enough money to help my kids pay some of their healthcare costs.

lark

All of this is about full employment; making health care grow in GDP percentage to 30, 35, 40, and up. Then employing millions in the system doing little idiotic chores as long as they can make a good salary so that they can pay lots of taxes to pay for all the deficit spending we are doing. Except in the process, liberty, freedom and happiness goes out the door. Not happiness, you can always find happiness popping up drugs.

But SAINTIXE says the story pretty good. Bureaucrats will enjoy being in command and the country will be turned over to foreigners who are better educated and prepared emotionally to steal the country away.

What’s important is that the government is in command of our lives and we will be put in a place where we work to pay taxes and pay foreigners for the quality education they received back in their own country.

Sassy

Bronwyn, you have addressed my greatest concern.
There are few, if any, physicians in our area who accept Medicaid. The health department calls around the entire region begging doctors to take a patient who is almost certainly facing a cancer diagnosis.
For Medicare, we are still doing okay. A nearby medical school provides interns for seniors. One never knows who they will see from one visit to the next though.
My own physician’s office was always full of older patients…no more, and I have concerns that he has only kept me because I have seen him for twenty years.
By the way, the doctor funding amendment failed in the Senate today.
tango

There is the National Health Service Corps loan repayment program where doctors can get $50,000 of medical loans paid by the government if they work two years in an underserved area.

I think a tuition assistance program might be a good idea but students won’t rush to apply if there are too many restrictions. I can’t see the majority of medical students wanting to be told by the government which medical specialty they must specialize in and/or where (geographically) they must practice in order to get free tuition. And even if some students agree to those conditions, then they could be like some of the doctors who participate in the NHSC program – after they’ve done their time, they move on leaving those areas and patients once again underserved.
MBC

I hope you don’t mind my posting a letter from an MD that was sent to me a few months back – A very good read.

Subject: An MD’s Opinion on the Healthcare Debate

> By Zane F Pollard, MD
>
>
> I have been sitting quietly on the sidelines watching this
> national debate on healthcare. It is time for me to bring some clarity to
> the table by explaining many of the problems from the perspective of a
> physician.
>
>
>
> First off, the government has involved very few physicians
> in the healthcare debate. Although the American Medical Association has
> come out in favor of the plan, it is vital to remember that the AMA
> represents only 17% of the American physician workforce.
>
>
>
> I have taken care of Medicaid patients for 35 years while
> representing the only pediatric ophthalmology group left in Atlanta,
> Georgia, that accepts Medicaid. For example, in the past 6 months I have
> cared for three young children on Medicaid who had corneal ulcers. This is
> a potentially blinding situation because if the infection causes corneal
> perforation, blindness will almost surely occur. In all three cases, the
> antibiotic needed for the eradication of the infection was not on the
> approved Medicaid list.
>
>
>
> Each time, I was told to fax Medicaid for the approval
> forms, which I did. Within 48 hours the form came back to me via fax, and
> I was told that I would have my answer in 10 days. Of course by then each
> child would have been blind in the infected eye.
>
>
>
> Each time the requests were denied. All three times I
> personally provided the antibiotic which was not on the Medicaid approved
> list. Get the point — rationing of care.
>
>
>
> Over the past 35 years I have cared for over 1000 children
> born with congenital cataracts. In older children and in adults, the
> vision is rehabilitated with an intraocular lens. In newborns, we use
> contact lenses which are very expensive. It takes Medicaid over one year
> to approve a contact lens post cataract surgery. By that time a
> successful anatomical operation is wasted as the child will be close to
> blind from the lack of focusing for so long a period of time.
>
>
>
> Again, extreme rationing. Solution: I have a foundation
> here in Atlanta supported 100% by private funds which supplies all of
> these contact lenses for my Medicaid and illegal immigrant children for
> free. Again, waiting for the government would be disastrous.
>
>
>
> Last week, a lady brought in her child. They are Americans
> who live in Sweden, as the father has a job with a big corporation. The
> child had the onset of double vision 3 months ago and has been unable to
> function normally because of this. They are people of means but are
> waiting 8 months to see the ophthalmologist in Sweden. Then, if the child
> needed surgery, they would be put on a 6 month waiting list. She called me
> and I saw her that day. It turned out that the child had accommodative
> esotropia (crossing of the eyes treated with glasses that correct for
> farsightedness) and responded to glasses within 4 days, so no surgery was
> needed. Again, rationing of care.
>
>
>
> Last month, I operated on a 70 year old lady with double
> vision present for 3 years. She responded quite nicely to her surgery and
> now is symptom free. I also operated on a 69 year old judge with vertical
> double vision. His surgery went very well and now he is happy as a lark. I
> have been told — but of course there is no healthcare bill that has been
> passed yet — that these 2 people, because of their age, would have been
> denied surgery and just told to wear a patch over one eye to alleviate the
> double vision. Obviously cheaper than surgery.
>
>
>
> I spent two years in the US Navy during the Viet Nam War
> and was well treated by the military. There was tremendous rationing of
> care and we were told specificially what things the military personnel and
> their dependents could have and which things they could not have. While I
> was in Viet Nam, my wife Nancy got sick and got essentially no care at
> the Naval Hospital in Oakland, California. She went home and went to her
> family’s private internist in Beverly Hills. While it was expensive, she
> received an immediate work up. Again, rationing of care.
>
>
>
> For those of you who are over 65, this bill in its present
> form might be lethal for you. People in England over 59 cannot receive
> stents for their coronary arteries. The government wants to mimic the
> British plan. For those of you younger, it will still mean restriction of
> the care that your children and you receive.
>
>
>
> While 99% of physicians went into medicine because of the
> love of medicine and the challenge of helping our fellow man, economics
> are still important. My office rent goes up 2% each year and the salaries
> of my employees go up 2% each year. Twenty years ago, ophthalmologists
> were paid $1800 for a cataract surgery and today $500. This is a 73%
> decrease in our fees. I do not know of many jobs in America that have seen
> this sort of lowering of fees.
>
>
>
> But there is more to the story than just the lower fees.
> When I came to Atlanta, there was a well known ophthalmologist that
> charged $2500 for a cataract surgery as he felt he was the best. He had a
> terrific reputation and in fact, I had my mother’s bilateral cataracts
> operated on by him with a wonderful result. She is now 94 and has 20/20
> vision in both eyes. People would pay his $2500 fee.
>
>
>
> However, then the government came in and said that any
> doctor that does medicare work cannot accept more than the going rate (now
> $500) or he or she would be severely fined. This put an end to his
> charging $2500. The government said it was illegal to accept more than
> the government-allowed rate. What I am driving at is that those of you
> who are well-off will not be able to go to the head of the line under
> this new healthcare plan, just because you have money, because no
> physician will be willing to go against the law to treat you.
>
>
>
> I trained for 10 years post-college to become a pediatric
> ophthalmologist. Add 2 years of my Navy service and that comes to 12
> years. A neurosurgeon spends 14 years post-college, and if he or she has
> to do military service, that would be 16 years of training before earning
> begins. I am not entitled to make what a neurosurgeon makes, but the new
> plan calls for all physicians to make the SAME amount. I assure you that
> medical students will NOT go into neurosurgery and we will have a
> tremendous shortage of neurosurgeons. Already, the top neurosurgeon at my
> hospital who is in good health and only 52 years old has just quit;
> forty-nine percent of children under the age of 16 in the state of Georgia
> are on Medicaid, so he felt he just could not stand working with the
> Government bureaucracy anymore.
>
>
>
> We are being lied to about the uninsured. They are getting
> care. I operate on at least 2 illegal immigrants each month who pay me
> nothing, and the children’s hospital at which I operate charges them
> nothing also. This is true not only of Atlanta, but of every community in
> America.
>
>
>
> The bottom line is that I urge all of you to contact your
> congresswomen and congressmen and senators to defeat this bill. I promise
> you that you will not like rationing of your own health.
>
>
>
> Furthermore, how can you trust a physician that works under
> these conditions knowing that he is controlled by the state? I certainly
> could not trust any doctor that would work under these Draconian
> conditions.
>
>
>
> One last thing: With this new healthcare plan, there will
> be a tremendous shortage of physicians. It has been estimated that
> approximately 5% of the current physician work force will quit under this
> new system. It is estimated that another 5% shortage will occur because of
> the decreased number of men and women wanting to go into medicine. The US
> government has mandated gender equity in medical school admissions. For
> the past 15 years, 49 – 51% of each entering class were females. This is
> true of private schools also, because all private schools receive federal
> funding.
>
>
>
> The average career of a woman in medicine now is only 8-10
> years and the average work week for a female in medicine is only 3-4 days.
> I have now trained 35 fellows in pediatric ophthalmology. Hands down the
> best was a female that I trained 4 years ago — she was head over heels
> above all others I have trained. She now practices only 3 days a week.
>
>
> Page Printed from: http://www.americanthinker.
> com/2009/08/obamacare_and_me. html at August 06, 2009 – 02:19:06 AM EDT
>
>
>

Sassy

Excellent read MBC! Thanks!
lark

Exactly. Yes we are being lied to left and right by almost everyone. The government wants to own you and do with you as they please. They now own the country but what they want is to own you and everything you have. Once that happens, nothing will work. It will be desperation and pain everywhere. Just like it has been in third world countries it will be with you and your children once Obama and his minions in the Democrat party finish off the Republican party and any kind of opposition that lurks its head through the media. The end is at hand. And the good thing is that we will be very happy living in servitude. God bless Americans, the servants, the service society, serving people whatever whatever whatever goes.
SusDgs

I have medicaid. I need neurosurgery but cannot get it. The surgeons at the medical school freely see me. They will see me with the students they are training. But actual treatment is denied.

They use us to train their neuro students.

This obamacare most likely will not effect me, but I will certainly get a bitter glee from watching all the people who demanded it, get what they asked for.

I don’t fault the doctors for denial of treatment. I fault this system that pays three dollars and allows the governor to claim “see how well we treat our poor”.

candymarl

I had an interesting experience in an emergency room a short while back. Although I have insurance after a cursory exam I was told my insurance was no good and they wanted cash.

This was not a young doctor still paying off student loans. This was an older doctor that would rather get cash than apply for my insurance.

I had a little talk with the head of the hospital and reminded him that an earlier faulty diagnosis nearly cost me my life. The problem was resolved.

But I don’t think this is simply about student loans and new doctors. I think even experienced physicians are unnerved by the currently proposed health care plan.

We’re in a lot of trouble here IMHO. My solution? Don’t have one. But if the government can spend billions bailing out Banks and Wall Street then they can pay doctors a competitive rate (perhaps not full) for care. They can negotiate with drug companies for medication pricing.

They are supposedly so smart and we’re supposedly so stupid. So where’s the super-smart plan?
elaine

There is no super-smart plan. Now how do you like your Hillary-ObamaCare? I live in a major city & I can assure you if you go on Medicare without already having a physican you’re not going to get one & even if you have a doctor don’t be surprised if he or she kicks you to the curb when you turn 65. Bear in mind doctors do retire. HIV/AIDS will still get care as research subjects are needed. Any plan will take a decade to enact. Baby Boomers will get screwed. Boomers will pay more & more & get less & less. EVERYTHING is going to be means tested to insure if you saved your money you’ll get it taxed away. Maybe medical tourism is the answer…3rd worlders come here & get it all for free & geezers with bucks can now fly to India & get affordable surgery + high cost air fare, while still paying for useless Medicare & private supplementals stateside.I guess that’s the plan.

candymarl

Umm the super-smart comment was snark. I don’t have all of the answers either. However, where I live, you can get a doctor with Medicare. The physicians here are not turning people away but the uninsured and under insured are having a tough time.

I agree that the boomers may get screwed but a good bill should have some kind of grandfather clause.

As a Vet I get my medical care. Perhaps we could follow the European/Israeli model an have everyone serve at least two years.

Hillary’s plan sounded good to me. She also pledged, if Congress refused to act, to get the American public the same health care package all of the Congresscritters have.

elaine

Correction: Romney-Hillary-ObamaCare
elaine

BTW The New York Times covered this story fairly well back in April. Google: Doctors Opting Out of Medicare+New York Times
Concerned

How about people just taking better care of themselves?

Like, eat less junk food, exercise more, don’t abuse substance, don’t drink, party till late and then take panadol because you think it’s your choice, etc etc. Let’s face it, alot of people with health issues weren’t born that way.

The reliance on pick me up drugs, fast food and soft drinks is undoubtedly a prime reason for this health care problem.

Until people actually address the cause and not the symptoms will this issue be resolved.

lark

You should get elected czar of nutrition for your neighborhood and go into each house with a couple of armed guards and take away any food and stuff that may harm them.

It so happens that the education of the children is mostly in the hands of the government and they hardly teach, just entertain. I think that when one is entertained, one’s develops an appetite for junk. The best thing is more entertainment and less education and import health care specialists from abroad to provide us with treatments.

Sassy

By strategy or clumsiness, I now believe the democrats will pass a public option.
The delays and revelations about penalties and fines have shifted more people to their side.
Those who will be forced to pay something will automatically go the cheapest route, and small businesses will be relieved to drop their coverage.
The House has the votes, and the Senate can garner at least 51.
So seniors, that’s the way the cookie crumbles!
As retirees, we now expect to lose our Health Savings Account, for we fully understand the need for the company to consider their current employees first.
Paco

Out of the way, Grandma!!!

I want my healthcare, free, and I want it now!!
Sassy

Hilarious Paco!
I may as well die laughing!
Sammie

I know my pediatrician’s office doesn’t accept medicaid and refers children with that coverage to nearby clinics …. wonder if we’ll see private doctor offices be replaced by clinics going forward.

This is off topic, but health related. This youtube was posted in the comments section of zerohedge. It’s a three part series of Gary Null speaking out against flu vaccines (apparently the science behind their safety testing isn’t good) at a NYS assembly meeting.

http://www.youtube.com/watch?v=y3XlJB7J5-o&NR=1

Peggy Sue

Sammie, where I live I have three clinics within 5 minutes. No appointment necessary, waiting times are usually short [I think the longest wait I had was 30 minutes] and cheaper than going to a private physician.

Now, to be perfectly fair, my medical needs are minimal. Basically, I have allergy complaints. One time I had a bee sting that turned my hand into a lobster claw. I get poison ivy every damn year. And I tend to have minor, ear and sinus infections.

For my needs, the clinics and Physician’s Assistents [although MDs are always on hand] are all I need.

My husband, however, has 4 physicians: primary, orthopedic [bad knees and ankles], blood [he has diabetes] and a gastrointestional specialist [he's prone to polyps in the gut].

There’s no such thing as a universal fix, not even for married people. I took my kids to a pediatric specialist because clinics didn’t exist in Pennsylvania [at least not at the time or in the area we were living].

My personal experience with clinics has been very good. But perhaps the quality of care at urban centers/clinics is far different. I simply don’t know. Right now, I live south of the Mason/Doxon line and in my area: clinics are popular.

PS: I have never had a flu shot and do not intend to get one this year. I had the Asian flu as a young child. Yeah, it was miserable. But I didn’t die nor was I left with any serious complications. I, for one, believe in leaving the big guns for the serious stuff. No antibiotics unless I need them; no additional vaccinations unless it’s the Black Plague.

Doc99

World’s Fastest Speed Reader Dissects Baucus.
Sassy

Bronwyn, I knew that TennCare had been a disaster for our state, but had forgotten the figures.
If you saw Brett Baier last night, they reported that 45% left their private coverage here to sign up for the public option.
Nice job on your research, and your letter!

Ferd Berfle

Spot on, Sassy. And Tennesseans tried to warn everyone, to no avail. I have excellent insurance but when I tried to go to a particular clinic in the area, I was told they only took TennCare.

I told them they had hitched their wagon to a falling star, laughed, and found a better clinic.

http://www.ecommunity.com/cardiovascular/ Cardiology Indianapolis

very nice about information for The Shortage of Physicians Who’ll Accept Patients with Government Plans
http://www.ecommunity.com/cardiovascular/ Cardiology Indianapolis

I know my pediatrician’s office doesn’t accept medicaid and refers children with that coverage to nearby clinics …. wonder if we’ll see private doctor offices be replaced by clinics going forward.

hokma

You will see exactly that. In addition primary care physicians will be replaced in many cases by Physician Assistants and Nurses.

WMCB

My husband is a doc, and the buzz among all the doctors at his hospital is “bug out plans”. Tons of them are fed up, unimpressed with this health care boondoggle, and sick and tired of it all.

The majority are planning on leaving the practice of medicine as soon as they can. They are tightening their belts, paying off debt, socking money away, and a large number have plans to WALK from the profession within 5 years.

There is going to be a massive shortage of doctors in this country down the road.

hokma

I am close to someone who is a medical school student and they are all concerned about the travesty going on in DC and want to know it it can be undone when Democrats are voted out of office.

THE most difficult, longest, and costliest graduate degree is a medical degree to be a physician. The easiest is a law degree and would challenge anyone on this. Isn’t it ironic that the large majority of the putzes in Congress are lawyers and with the lack of intelligence are setting on a path that will ruin our medical care in this country.

Seriously Sick of Obama

One of my Dr’s recently told me if the ObamaBS HEALTHCARE passes, he will only accept CASH or CREDIT CARDS! He refuses to deal with the politics of what this bill will do to the his practice. So, I have private insurance which I pay for and now I will be adding to my monthly debt with paying CASH for my Dr visit. Honestly, if I have to do that, I will die before I am fifty because I can’t afford both!!!

mountainaires

Thanks BH, for such a lively discussion on health care, medical care, the medical profession, and the effects of the ObamaCare Boondoggle to come.

I have always supported national health insurance because of all of the comments, many of which make perfect sense. It’s not a simple problem to solve, considering that we’re all held hostage by the real enemy to good health care in this country

INSURANCE COMPANIES.

http://makethemaccountable.com/myth/RisingCostOfMedicalMalpracticeInsurance.htm

Anyway, I’ve read through most of the comments, and there are some great ideas, and some interesting personal anecdotes regarding personal experiences, or state programs like TennCare, which Gov. Bredeson was forced to restructure due to costs.

The truth is, there’s no way around higher costs since technology and population growth virtually dictate more expense. Given that fundamental truth, why won’t people just admit that we could pay higher taxes and get good health care if we’d just stop wasting our taxpayer dollars on wars that have no purpose except to enrich Boeing and Halliburton?

We just passed a defense bill for nearly $700 billion. Think of what we could do with just a fraction of that money spent on the people of the United States?

HEP-T

I already have to travel across three counties to see a GP who will take medicare, then travel across two counties to get to a pharmacy that accepts the plan for medication.
I see a doc at 8:30 am and don’t get my called in prescriptions filled till 6:00 pm
Don’t even suggest going to the VA for my service connected problems. I must travel to the VAMC and stand in line just to make an appointment three months away.
This is the reality of government healthcare.
T

Medical schools work at producing doctor shortages. It protects the industry, keeps the pay high. Studies have shown that alternate students (ones put on the waiting list) perform just as well in med school as first picks. Remember that med schools have a very high level of nepotism and cronyism. The people who make the short list and get into med school aren’t necessarily the best of the applicant crop.

So med schools should open up more spots for enrollment….schools should cut funding to their far east humanities department or whatever, to make up for it. The fact that they don’t, not only complicates but IS the basic problem.
SantaFeK

When I moved to Santa Fe 10 years ago, I got rejection letters from doctors, as the excellent practices were closed. 10 years ago practices were refusing Medicare patients, and now, it’s all over the place in New Mexico. My physician, who wants a public option just started refusing Medicare (new) patients. She can’t afford to take them on. We asked her if she saw a disjoint in her politics and what she is doing. She just can take them on any more.

I too have physician friends who can’t wait to get out. And if you lve in New Mexico, the quality of medical care just isn’t top notch. 1/2 the population is not insured. Worse, even if you have top insurance, you still can’t get access to doctors. Scary.
Seymour

Be damned “Tort Reform” and “Interstate Competition”. That’s too easy as to be a small part of a cognoscente, cogent and logical part of this fix that doesn’t incorporate trillions of taxpayer dollars. The Repug’s whiffed this big time over and over as usual for years.

And finally, lest we not forget that Congress carved out of the bill itself $250,000,000,000 contracted to go to Medicare Physicians in a separate bill under the pillow.

I began with my own physician some 28 years ago when I started my first company Maui & Sons. He like I were green horns with him coming out his residency at the Institut de recherches cliniques, University of Montréal and finishing up his residency at University of Michigan.

I spoke to him about the healthcare bill and I couldn’t shut him up regarding the lack of vertical Canadian Healthcare and the lack of support that system has and if the U.S. adopts even a whiff of…..you know the rest. He and his colleagues know more about this than our representatives. He will only treat his current patient list of Medicare patients and has a 60 day window for his clinic to accept new Medicare Patients. If he is required to treat all under the program he’ll have no choice but defer these patients to other clinics.

It seems like yesterday that our careers began but now he and I have obviously grown older, he’s turned gray (I was at 28) and now walks with a bit of a stoop. But this man is a great friend as well as saved my life a couple of times. He’ll be retiring soon if the bill indeed manifest’s and I’m going to miss him.

Seymour
TeakWoodKite

“It’s very hard to merchandise healthcare until we have a bill,” Speaker Pelosi added Wednesday.

(From the CSM link above)

This comment is … an echo of Andy Card.

“From a marketing point of view, you don’t introduce new products in August.”

But it is also very very disturbing on SO MANY levels.
ziggy

Supply and demand works both ways. The supply of patients with the willingness to pay what doctors would like to be paid is also subject to decline, in an increasingly widespread system where payment schedules become a bit less prone to rapid escallation. How would doctors be expected to respond to such market pressures?

Last week I (and my insurance company) paid my doctor $120 for about 5 minutes of time–my own objective being nothing more than getting a daily prescription for HBP medicine renewed.

Ferd Berfle

Last week I (and my insurance company) paid my doctor $120 for about 5 minutes of time–my own objective being nothing more than getting a daily prescription for HBP medicine renewed.

That is the same I pay with my insurance company. However, I am certain it will be a much larger out-of-pocket expense under this fiasco of a bill.

One day it will be called the “Raw Deal” and no one will be praising it–not even you–mark my words.

TeakWoodKite

pay what doctors would like to be paid is also subject to decline.

Ain’t no time to wonder why
Whoopeee! We’re all gona die!

Momma don’t your babies grow up to be doctors, let ‘em grow up to be sheepel and such….

Ziggy, John Barley Corn is laughing at you, and that’s a difficult feat.

http://nyermd nyermd

Thank you for your article which points out an essential truth which has been lost on many in the mainstream media. As a physician who has worked in the public hospital system and in private practice, I can tell you that at this moment, many of my colleagues have opted out of Medicare and Medicaid because of low reimbursement rates. The plan to insure an additional 30 million people without any attempt to fix tort reform, improve reimbursement rates and address the basic problems with the current system will leave many more citizens without care as more and more doctors abandon government plans.

sybilll

TY for your honesty. My Internist, who stopped taking Medicare, was very candid with me about her new policy of no longer accepting Medicare. I cried, and I knew she felt my pain, but, I respect her decision to earn a decent living.

http://firefox AnnieCarmel

Until congress is willing to do unto itself what it is proposing to do unto us, they should stuff it.

This BS of their getting the creme de la creme while they offer us 3rd world care is going to lead to a revolution they won’t like.

http://strike120.ning.com
hokma

” . . significantly increase the demand for their services you can be guaranteed that one thing will result–THE PRICE OF THOSE SERVICES WILL GO UP”

It’s eco 101 and it is evident that either Obama/Pelosi/Reid have no comprehension of fundamental economics and/or the agenda is to socialize medicine which does has not worked anywhere.
Texas Playwright

Those crooks on the Hill need to give back the $500 Billion their sham bill plans to steal from Medicare. Crooks have been trying to rob Medicare and Social Security for at least a decade.
Pingback: Our Future Under Obamacare: “Mayo Clinic in Arizona to Stop Treating Some Medicare Patients” : NO QUARTER
http://qmsconsultants.com/NABH.html NABH

I really appreciate your post and you explain each and every point very well.Thanks for sharing this information.And I’ll love to read your next post too.
Regards:
NABH