How does “doctors per capita” correlate to the quality of the health system, exactly?
Or between those who think that spending so much time and mental stamina wrangling with insurance companies, and therefore less with patients, actually reduces quality of care, and those who adhere to the quasi-religion of the Free Market and the artificially-propped-up incomes it permits in reality.
I am not in Vermont. But I packed up my bags and moved a dozen times, for economic reasons. Usually between the states in the US, but once country-to-country.
It already does, and I’m pretty happy with my career.
Why do you suppose it is that American doctors are paid more, yet like their jobs less, than doctors in other countries? My guess is that it is for the same reasons that about one in eight doctors think our health care system works well, and that a lot of them waste time trying to get care delivered to patients with poor coverage.
Cite for everything I said. Except for the “I get paid what the government tells me I can get paid” part.
According to this, New York abolished slavery in 1828, Indiana in 1820, and New Jersey in 1804.
We do, all the time. SSM is an example, surely the lack of moral breakdown and anarchy in states that have enacted it eased the way for other states to do so, and will eventually ease the way for federal change.
How doesn’t it?!
Some people like being a cog in the machine.
Belarus’ and Belgium have the same number of doctors per capita. Do you their health systems’ quality is comparable? Egypt has more doctors per capita than the US. Do you think Egypt’s health system is on the same level as the US? Lebanon’s number of doctors per capita is the same as Italy’s. Do you think that correlates to the health system’s quality in those two countries?
If it has no relation to the quality of the health care system, Vermont will still be in a great position if your predicted flight of doctors to Massachusetts actually comes to pass.
I like this, but I think you package it wrongly. It depends which method will result in the best healthcare system for the people. That includes things like, cost, accessibility, quality of care. But I do like being able to look at it as an experiment.
Hawaii really is a special case, given its remoteness. I used to live there, and it is unlike any other state in how people view things. And I’ve lived on the East Coast, West Coast, New England and the Midwest. Vermont probably isn’t the ideal testing ground, as it, too, is a special place in some ways, but probably good enough to use it as a testing ground, particularly if we get very clear information out of it.
I’d rather have 10 good doctors than 20 crappy ones in the system. In Vermont, the quality of the doctors won’t change (except maybe to the worse, since the good one will be the ones leaving, because it’s easier for them to find employment elsewhere). The quantity will.
So the ratio of doctors to patients doesn’t really mean much if you’re comparing Belarus to Belgium, but if you’re comparing socialist Vermont to anywhere else it is a BFD. Makes perfect sense!
Any ideas yet on why American doctors get paid so much yet like their jobs less than foreign counterparts? Maybe they are unhappy that there isn’t enough rugged individualism in our health care system?
Correction: the ratio of doctors to patients doesn’t mean much if you’re comparing Belarus to Belgium. The ratio of doctors to patients means a lot if you’re comparing Vermont today to Vermont 10 years from now.
Well, yeah 8% is a large percentage. You may remember large fights over much smaller tax increases in the not so distant past. And we constantly hear that malpractice insurance is a huge deal even though premiums are also around single-digit percentages of revenue. Are you thinking that VT will be cutting provider’s compensation by more than that?
Also, if I’m reading the cite correctly, 8% is roughly what a 3rd party billing service will charge. It doesn’t include the time the physician still has to spend considering insurance ramifications on treatment plans, coding, discussing with patients and families why certain things are or aren’t covered, etc. I’m not saying this would go to zero in single-payer, but there are significant quality of life improvements for a provider in a simpler system.
Finally an interesting point from your cite: the quoted average numbers for collections in using in-house or third-party billing range from 60% to 70%. It shouldn’t be hard to figure out why a physician might prefer an environment in which 100% of bills are paid compared to 60%, even if each bill is for a lower amount.
Please cite references to when this was true in previous instances of switching from nonSP to SP. I’m actually interested.
Most people like being a cog in the machine. If your job lets you get job satisfaction, but paid half of what is paid in another state, you’d probably stay there, despite the pay increase you could get by moving.
People become doctors more often for ideological goals, not cash goals. Most 6-18 year olds sit down and go “I want to HELP PEOPLE.” they don’t go “The best ROI between Investment Banker and Doctor is Doctor.” Thus, if they can live a comfortable life and get job satisfaction and feel like they are contributing to people’s well being, money becomes less of a factor.
On the other hand, if you make doctors deal separately with 100s of different insurance companies to come to a price that sorta kinda lets you break even (in some scenarios of patient distribution between insurers), you get ground down and feel a heck of a lot less job satisfaction.
Stop trying to drive the US like the only thing that matters is profit. That’s how 2007 and bull crap like the ACA will happen, again.
Sigh. Still no response as to why overpaid doctors aren’t as happy as others. I’m not sure if the lack of response is a form of denial evinced at unpleasant data, or if there’s a super-special ignore feature on this board that blocks out substantive yet inconvenient facts.
Even by exaggerating, the numbers of the doctors in Hawaii who left medicare does not reach even 4% during the last 5 years.
Incidentally that number is dealing with the doctors that **stay **in Hawaii they are only stopping taking Medicare/Universal covered patients, I think it is not much of a point to concentrate on the doctors that are completely leaving the state.
60%-70% is paid because insurance companies set those maximums - at 60-70% of what the physicians bill. Getting paid 100% of bills when the bills are 70% less after the switchover, rather than 60% of the bills before the switchover is still going to net you a lot less money.
You know what - put up a poll. Give the theoretical situation - you’re getting job satisfaction, but you are offered 100% more money in another state. For the sake of argument, make the standard-of-living levels the same in both states. What do you think will be the percentage of people that would move?
Another thing Vermont doctors will like is not having to pay health insurance premiums for their employees… That will save them many thousands of dollars.