Well, duh, we’re always discussing our various government programs, with some Opposition pols and pundits bitching about overspending but our system is not on the verge of collapse, nor are individual Canadians getting ass-fucked into bankruptcy, nor is there any serious hint we should stop what we’re doing and become more (chuckle, snort) American in our ways.
Anybody know who proposed this nonsense? Does it have any political support?
All this bill would do is get every competent primary care physician to become a specialist, or move to a different state.
Oh, God forbid. I mean, you can have Nazi-obsessed quasi-Stalinist Human Rights Comission, and that’s just quelle liberal’. But being American?! Ye-uch!
I won’t get into a large argument with you, because I don’t consider you worth it. However, I should note that trying to import a solution from another country doesn’t usually work very well.
Where the fuck is that coming from?
Hmmmmmmmm.
http://www.statemaster.com/graph/hea_tot_non_phy_percap-total-nonfederal-physicians-per-capita
Mass has one of the highest physicians per capital.
So? How does that disprove in any way that they benefit from license-based protectionism of their industry?
Um, have you taken a look in the mirror lately? we’re not exactly hot shit, either.
Are you at all willing to discuss the original subject of the proposed law?
Because, I really cannot fathom how your posts relate to the law.
It seems you have an ax to grind.
Which is fine, but , I won’t partake.
Thanks anyway.
Translation: We can’t let the fact that something works in another country get in the way of our insistence that it can never, ever work.
Isn’t that an element of American exceptionalism, i.e. if they don’t have it already, it’s not worth having because if it was worthwhile, some American would have invented it, dammit…
Sometimes. Sometimes it (probably unintentionally) amounts to “Americans just aren’t bright enough to make it work!” It depends on how the people making the excuse word things.
That would imply physicians in Mass. have been less successful at rent seeking than physicians in other states. Is that surprising in a state that’s now taking such a drastic step to limit the ROI physicians can expect on all their schooling and equipment?
Anyway you asked what Bill Door was talking about so I explained it to you. I assumed you were asking a sincere question and not a rhetorical one since you didn`t seem to make any other point in your post.
The U.K. is certainly having problems, but the NHS is not having similar problems. Per capita, we pay less than the U.S., and the admin overhead is about 3%. It’s Social Services that is the biggest expense over here. £127 Bn on non-pensioner benefits.
You’d have to study this. First of all medicine is more or less a calling rather than a way to make money. People like the idea of being a rich doctor but there are tons of other ways to make a buck that aren’t nearly as hard as the rigours you go through to become a doctor.
So money may force some out of the field but not most.
Let’s think about this, the bill doesn’t say the pay is regulated, it just says you have to take the medicare ones too.
This is merely an extension of other rules physicans have faced. I recall during the “AIDS days” of the 1980s many doctors were not seeing HIV+ people. They refused to do so. Of course this isn’t ethical or legal in some places (at least back then).
When I moved to the Florida Keys in the early 90s, I got my health provider plan and found only two doctors that would take new patients. You see doctors were getting aroudn the new law that said, you had to take HIV+ patients, by refusing ALL patients.
I soon learned if you knew someone, you could “get in under the table” very easily.
Now let’s think about this, if a physican has to see a medicare patient he will do so. He will just limit it to the minimum number. After all a physican can only see so many people per day. He will see just enough of the minimum paying ones to keep a license. He will also probably charge MORE to the others to make up for the minimum ones. So the income wouldn’t change at all.
You see when bills like these get floated and even passed into laws, they don’t cause as much harm as people make out. Where there’s a will there’s a way. You can always find creative ways to get around laws. And if the law passed it wouldn’t do any harm. OK you’d lose a few doctors, but most of the rest would simply cope by restricting patients and making up the cost of the medicare ones by passing it on to the ones with full insurance.
I can’t really fathom how your response to **Fuzzy ** is even pertinent, which is the response that I was responding to. Thanks anyway.
Do tell me more about these ways? I’ll note that like 10/10 highest paying occupations, according to the Dept of Labor, are all medical doctor specialties.
That pretty much answers your own question there. The only way to make the big money (avg. over 200k) really is to specialize.
It’s the generalists, the family practitioners, and general pediatricians and psychiatrists and such that tend to get the short end of the stick when it comes to wages. That’s why those areas tend to have the lowest growth, because it’s the specialties that tend to get the higher pay scales, and it’s the people who need generalized care who get stuck with the short end of things because the newly graduated doctors have a choice when facing around nearly a quarter-million dollar debt of loans and such to pay off- do they want to stay in a generalized field making 100k-200k for their lives, or to specialize and have the chance to make double or triple that amount easily for less work and stress. So the people at the top of the heap, the specialists and private practices certainly aren’t as worried about these things, it’s the general practitioners and basic generalized care field doctors that are going to really feel the brunt of these new practices.
Horrible idea. I am all for UHC, but this is like a chapter out of an Ayn Rand book. Really bad idea.
http://www.mass.gov/legis/bills/senate/186/st02pdf/st02170.pdf
Look at Line 26.
Does this say costs cannot be recouped by “passing it on to the ones with full insurance?”
Primary care is difficult, and stressful.
Primary care is where health care cost savings COULD occur.
Primary care involves a lot of listening, and a lot of teaching.
Both are time consuming.
Neither listening nor teaching is reimbursed.
What IS reimbursed is testing and procedures.
Any reduction in the number of primary care providers will increase costs.
Example:
A primary care provider who spends time teaching self care of diabetes to prevent future expensive medical costs related to long term poorly managed diabetes - not highly reimbursed.
A specialist who operates to amputate a foot of a long term poorly managed diabetic - very high rate of reimbursement.
Fewer primary care providers = increased need for more expensive specialists.
Passing laws that require primary care providers to accept low pay as a condition of licensure … Short sighted, at best.