Whither Obamacare in 2014

Well, they’re not exactly held captive. Some of the older ones will retire early. Others may go into another area of their expertise.

Such as?

Republican pundit/joke presidential candidate? Those fields are already pretty crowded.

The tone is mocking. But it’s a valid point that there are a number of more lucrative things a doctor can do with his education.

How can rates possibly go down? It seems the young are not interested in signing up, the ill are very interested in signing up, and the President has waived the penalty for those who lost insurance this year as well as allowing many people to sign up for catastrophic coverage. All of this seems to add up to significant rate hikes on policies in the short term.

I’m not here to play buffoon to your desire to poke at Republicans. If that’s all you want to do here, say so and I’ll stop contributing.

Here are a few areas that come to mind:

medical writing
consulting in medical device industry, pharmaceutical development, program planning for clinics
Entrepeneurship in any of the above.

How many doctors do you personally know and associate with regularly?

The current rates are based on worst-case scenarios, which is why some of them are high. Once it’s been established that those scenarios will not be the norm, they’ll naturally come down.

Leaving aside the entirely unsupported assertion that there will be pressure for physicians to stop practicing medicine - what makes you think that the financial rewards of any of these jobs will not go down commensurately?

ETA: You seem to be under the impression that we won’t have enough doctors because they won’t be paid enough. Nothing could be further from the truth. We already have a shortage of doctors because the AMA has artificially depressed the number of domestically trained physicians. As a hospital employee, you presumably knew that - as well as the fact that we’ve made up the difference by importing them.

Anything to keep from focusing on the content of my posts. Why the hostility? I’m not even Republican. But you really, if you want to discuss this, have to open your mind to alternate viewpoints.

I don’t know how many doctors I know. A lot. The bulk of my career experience was working in hospitals.

Do you have some kind of cite for the worst-case scenario claim? My understanding is the rates were set assuming around 7 million people would be signed up and that a significant number of young, healthy people would sign up due to individual plans being cancelled as well as the penalty. ISTM that the President has unilaterally taken a lot of the teeth out of his own law in such a way that will result in rate hikes.
(I see** Kantian** was banned for asking you for a cite so I pray the same fate does not await me :D)

There certainly are alternatives based on the fundamentals of universal health care at affordable prices which are more free market oriented and less based on government regulation.

However the Republicans have vitually no interest in these; instead they simply want to go back to the pre-Obamacare years where prices were doubling every few years and the working poor were increasingly priced out of the health care market and those with pre-existing conditions couldn’t get coverage–or only at sky-high prices.

With these the only two options I think the people will choose the Democratic/Obamacare option in the 2014 election…

Our American population of ill people is increasing. Boomers are at the age where we’ll need the lion’s share of health care and there are a lot of us.

Our immigrant population has much larger families and begin procreating at an earlier age. They come to us with a history of poor health care. There is tremendous work to be done there both in healing and prevention. It will take several generations of acculturation, I think.

The cost of medical supplies and devices continue to rise as well as building maintenance costs and the other non-medical costs of running a facility. For every doctor their is a small army of support people and they need to eat and feed their families. They are already working at skeleton crew levels.

Either less expensive services will have to be provided or staff salaries will have to be cut.

There has never been a magical lowering of prices that I know of even in groceries. Once it goes up, it generally stays up.

How do you see getting around this inevitability?

I’m puzzled because the doctors I know seem to have a calling for the job. It’s not all about the Benjamin$ for most of them. Also, many if not all doctors worth their salt are already actively involved in you list of things other than seeing patients. They collaborate on research projects, they publish things in medical journals, they participate in drug trials with pharmaceutical companies…

So I’m curious, what makes you think that doctors will leave practice in significant numbers?

What does any of this have to do with Obamacare? :confused:

The rates are set by individual insurers. I think you are confusing premiums with CBO scoring.

I was asking in response to your statement that costs would be high for a while and then go back to a norm. Considering what I’ve said I can’t see any way but that they will continue to rise.

There’s calling and then there’s feeding your family/paying for the lake cabin. These guys already enter the field with massive debt and a slow start in the money-making biz. They’re human and altruism doesn’t pay the rent.

Like I said, I know a lot of doctors. (And, yes, there will be others who stay true to their calling.)

I’m sure costs are going to continue to rise. I was referring to premiums (hence “rates”).

Incidentally, I apologize for my earlier snarky tone. That was unwarranted.

So you’re suggesting that the rising cost of medical care (overheads, etc) will cause a decline in available medical practitioners, doctors more specifically.

Do you make this claim based on some relationship to the emergence of the ACA or is this something you see evolving independent of the ACA?

And while medical costs have generally been rising along with most services, why are you forecasting the tipping point is coming soon, rather than 10 or 20 years ago?

No confusion here. I believe the rates were set with the presumption that many young and healthy people would be in the exchange. If that turns out not to be the case then rates will necessarily increase.