Wouldn’t be all that surprised. For some, being an MD is their calling, for others, merely their profession. For some, the patient is a human being to be helped, for others, a problem to solve and a check to cash. And so it goes.
This is a bold and gutsy step, there are no guarantees. The whole single payer approach depends on the broadest possible demographic base to gain enough efficiency to make it viable. Vermont may be too small, or sick people may move in and burden the system. A lot of people are invested in seeing it fail, so this is not a slam dunk by any means.
My father owns a practice in VT (he’s for the law, FWIW) and I think people underestimate how much time, effort and money go towards dealing with patients that can’t afford to pay, haggling with all the different insurance companies over what gets paid for, trying to figure out the codes and such for all the different plans, etc. Assuming the State sets up a relatively simple system, I think the potential savings are fairly large.
I suspect some specialists will see a pay-cut, and a few might leave, but that most hospitals and practices in general will make out pretty well.
Also, most people that live in VT really like living in VT. So even if their bottom lines suffer, I doubt you’ll see that many specialists leave. After all, what’s the point in being rich (and specialists are rich) if you can’t live where you want.
Exactly. Just about anyone involved in the medical profession has to know the large percentage that goes into billing and receiving. If VT can truly reduce these costs then the reduction in compensation for anything but the highest-paid specialists should be small enough to be completely swamped by the benefits of living where you want.
We shall hopefully get some meaningful results in the next few years.
We already have Hawaii, it demonstrates that the right wing predicted high numbers of doctors that would “flee” an already expanded medicare did not materialize. The FUD numbers that the right wing sources like the Wall Street Journal predicted were indeed just Chicken little musings.
History shows that “states’ rights” were supposed to be about keeping slavery. Then about keeping Jim Crow. Then about keeping segregation. Today, about keeping blacks’ access to voting, among other things, limited.
But you won’t find this “social laboratories” stuff seriously presented as a central justification outside of recent revisionist screeds.
Terr’s probably right. There probably will be doctors who leave Vermont to seek more profitable practices elsewhere.
That’s pretty much the fundamental divide on this issue. Do we want a health care system that serves the best interests of special interests like doctors and insurers or do we want a health care system that serves the best interests of the general public?
Conveniently, our two major political parties have taken the two different sides on this issue. The Republicans generally favor the special interests and the Democrats generally favor the general public. So people can decide which position they support and vote accordingly.
It would be nice if all political issues offered such a clear choice.
The history of states rights also has legalized SSM, liberal drug laws, and the abolishing of the death penalty. We could also mention that slaves were first freed by states rights. States Rights is by itself neither a great evil or an undoubted good.
Fair points, but the states that have done so have still failed in getting those things established nationwide. The “experiments” have proven successful, but the other states have generally not used the results of the “laboratories”.
Not really. There was no abolition of slavery in any state after the Constitution was ratified, until the Civil War did it by force. The “free” states had abolished it beforehand, or as part of the constitutions they submitted to Congress as part of their statehood applications.
The problem is when its alleged goodness is used as an argument itself, as a cover for simple obstinacy - especially when accompanied by a demonstrated ignorance of the Constitution’s supremacy clause, as it so often is. Not only is the US not a confederation of states under the Constitution, as we are so often tiresomely told, it never was.
I will would also make the point also that many doctors in the long run will benefit, and as the case of Hawaii shows “Yes, some are [leaving]. Long answer: Not as many as you might have thought”.
As I have seen on discussions like this one, an important cost item that many miss is that savings for the doctors do happen when there is less private bureaucratic red tape to deal compared with the current system we have, doctors would actually benefit for having less overhead costs.
It’s true that nowhere it the world pays doctors anywhere near as much as the USA. Yet most countries in the West have more doctors per capita than America.
It is a fundamental divide - between people who think that if you reduce a doctor to a civil servant with a “reasonable” salary, you will get the same quality as you would in a high-income-for-doctors market system.