If anything, I would think they’d be all for some sort of single payer system. It would bring in more patients who wouldn’t otherwise be able to come in. And most importantly it would ensure that the doctors would recieve some sort of payment for treating those patients, rather than having to go through a collections agency when someone fails to pay their bill.
It would also remove a lot of the red tape involved in dealing with the private insurance industry (a hassle I hear most doctors hate).
So why then does the AMA, whenever anyone brings up the topic of healthcare reform, throw around the term “socialized medicine” like it’s some sort of evil plot to destroy all that’s good about America? Is it simply that rich doctors fear they’ll make less money? Do they just not want to handle the increased patient loads?
Also are there doctors out there who buck the AMA’s stance and want, or at the very least not worry much about a government-led overhaul of the healthcare industry?
It would also reduce their exorbitant pay. Now what lobby group doesn’t hate that?
This will veer quickly into GD, but it’s an observable fact that “government money” rarely comes without strings attached, as the banks have already found out. It’s clear that a “single payer” would set the prices for treatment and drugs, and some who favor an open market aren’t happy with that. Others say the open market is too Draconian an instrument to use for health care. But can you really be surprised that a previously unregulated market would resist heavy government intervention?
Or, they don’t think their pay is exorbitant vis a vis the investment of time, effort, and money it took to get to where they are, so they resist the efforts of those who don’t share this view to define their pay by bureaucratic fiat. That’s just my factual perception of what anti-socialized-medicine doctors are thinking. I’d imagine they also think, from their experience with HMOs/managed care, that adding a new layer of oversight and form-filling-out would make their lives even more miserable.
Being in a border area, I could attest to the high prevalence of Canadian doctors, nurses, and of all things, pharmacists on this side of the border. They don’t like Canadian pay. I imagine that our American-side doctors wouldn’t want Canadian pay, either.
Of course it may not be purely self-interest. Remember, “first, do no harm.” Perhaps they feel that Canadian-style rationing and waiting lists would ultimately “do harm” against their patients.
(Note: I’m not claiming that there’s anything wrong with the Canadian system, but only trying to describe what our doctors might perceive of as the Canadian system. Don’t feel obligated to “correct” me with all of the wonderful facts about Canadian health care.)
I don’t hear doctors in western Europe screaming “woe be unto me - i only make 180,000 a year”
they’re overpaid, they effectively have no cost containment measures outside of what they can privately selectively negotiate with an insurance company, and they know that people would give them every last penny they had in order to save their life.
but i wouldn’t necessarily mind making a quid pro quo where doctors can get by with slightly less training (like they don’t really need 2/3 of the liberal arts BA degree they have) and vocationalize the work a bit more - it would surely help the supply problems that have been artificially created by the AMA.
And it’s not bureaucratic fiat - no one in a single-payer system forces them to accept the government’s negotiated rates on services. it’s just that no one would do business with them if they don’t agree to take the government insurance. slightly different.
doctors would absolutely love dealing with one insurer and have a client book who are unquestionably covered by the insurer and an insurer who doesn’t have a profit-motive injecting a “delay delay delay” mentality into insurance reimbursements. if they would pay as much as the MDs rob today.
It’s not that they don’t like they pay. it’s that getting more pay comes at effectively zero cost to them - their labor services are in extremely high demand so they can work in the US, their skills are easily transferable (not as much a question that a canadian-certified doctor is able to provide “american level” medicine, whereas maybe a filipino-certified doctor may be a bit more questionable), and they don’t really have to move very far from their home and family in order to make alot more.
this isn’t proof of anything but greed.
Cite that that is what doctors make in Euro socialized regimes? What if it turns out that in reality it’s “only” $125k, or $80k, or $40k? Then would they scream, or at least be unhappy?
This is GQ.
Except that empirical evidence suggests, no, proves that not all doctors (or patients) “absolutely love” a single government payor system. Check out the thriving market for non-NHS doctors in the U.K. (and do a little looking into how many high-ranking left-wing politicians constrain themselves to exclusively NHS service). At least some doctors apparently think that there is government fiat that unreasonably restricts their compensation and way of practicing. And the fact that private practice doctors do not starve when they compete with the oh-so-more-reasonably-priced NHS, indicates that at least some patients, factually, do not find the single-government-payor system to be the most hassle-free or desirable one.
ETA: In most socialized medicine regimes, you also have socialized education. So doctors don’t in many cases have the crushing debt that grad school imposes in the U.S. Socializing medicine would almost inherently require socializing med school tuition. Maybe good, maybe bad, but big structural changes are rarely no-brainers and it’s hardly surprising that the ramifications trouble some stakeholders.
My wife. Over the New York Times this morning, I asked her, “Sweetie, you’re a member of the AMA, right?”
“Yes,” she replied.
“Why don’t you want government-sponsored health care?”
“I do want that,” she answered.
“Oh, OK then.”
In the Times, the AMA was quoted as saying that they didn’t want government making health care decisions. Having private insurance companies make health care decisions was, for some reason, perfectly acceptable.
No, they don’t love single payer at all because of the aformentioned reduction in income they’d receive. All I was suggesting is that they would love not having to deal with 100 different insurance companies and the corresponding overhead costs of employing a few staff people who exclusively fill out and file insurance reimbursement forms.
Again, the fact that rich people can afford to pay a lot more for medical services, and, gasp, that there are doctors who would take the increased fees these people would pay neither proves nor suggests much of anything. They’re not competing with the NHS in this instance, anyways.
so, some numbers:
http://www.docstoc.com/docs/1768416/How-Much-Money-Do-Doctors-Make
Average Income of Primary Care Doctors (03-04), British Medical Journal, Volume 334, Page 236
Reading the bar chart, in GBP
US: 95,000
UK: 82,500
Germany: 62,500
France: 47,500
I don’t know about doctors in Europe, but I can attest that my FIL, a psychiatrist, makes about 190K, possibly a little more, since that number comes from about 8 years back when my husband needed his father’s financial information to apply for something. He does work in a town with a bonus on his salary to try and attract doctors to that town, but this town is also in Québec, which is one of the provinces with the lowest doctor salaries.
His wife made about $90K as a hospital administrator (directeur des services professionnels). That job gave her steady hours while she was single and raising her two kids, but now that they are in college, she’s gone back to being a GP (she maintained her qualifications over the years). She has made comments to the effect of doubling her salary, but having crappier hours (she’s on call once every 4 weeks, for the whole week).
Bingo, and it’s not just that hypothetical government salaries would be lower than current private-sector salaries. In today’s world, doctor-entrepreneurs can make a ton of money by setting up all kinds of profit-making medical ventures – imaging centers, day-surgery centers, cardiac-diagnostic centers, etc. The real fear among doctors is that these plum opportunities to make money will be choked off.
Like I said, border zone. They don’t move at all. They cross the border every day.
That’s kind of a jealous statement? Am I greedy because I choose for work for non-bankrupt company F when I could with a little bit less effort work at underfunded company G for 25% less? If you think that all self-interest is greed, then I’m just going to treat you as a commie wacko.
I don’t care that they’re self interested, rather I’m trying to explain doctors’ aversions to a single-payer system - they wouldn’t make as much. they try to pawn it off as enhancing patient care, ensuring the best practitioners stay here, having to pay back their education costs, bla bla bla but at the end of they day they just want the money.
nothing wrong with it, but doctors are the only ones as a group that try to slap a deceptive veneer of humanity and caring on top of their rational economic desire to make as much money as possible.
I think some would argue with you. Teachers unions can’t talk enough about how “educators” live only to “teach our children.” That’s in the midst of strongly resisting merit pay and defending tenure for accused molesters. Politicians no wait “public servants” talk all day about their commitment to “serving the people,” while voting themselves pay raises and exempting themselves from laws they find inconvenient. Lawyers talk more about their commitment to justice than they do about profits, all the while maintaining licensure requirements whose effect and probably intent is to limit the amount of competition they face.
So doctors have a lot invested in their careers. So do most people. No one tells Greenday what they can or can’t charge for their next album, or some fop hairstylist that the government will now be providing all haircuts and oh by the way $200 is way “too much” for a haircut, we’re capping it at $25. Is it factually surprising (as opposed to “is it a good idea”) to learn that (some) doctors would rather be treated more like Greenday than like a rental car company forced to give a government rate to a traveling bureaucrat?
The government isn’t telling anyone that they can’t charge $200 for a haircut. If doctors want to charge exorbitant fees they should be allowed to do so. What a single payer system would do is give an affordable alternative to those who cannot shell out hundreds, if not thousands of dollars per month in insurance fees. There will still be practitioners who can charge whatever they want and accept whomever they want as their patient.
joebuck20, there are different expectations over what the government would and would not do.
Here is one. The government would tell doctors “We will only pay this much for this service.” “You cannot charge these patients more than our stated amount.” “You must accept these patients, you cannot deny them service because Health Care is a necessity.”
Then you very much do have a case of the government telling doctors who they must take as patients and how much they can charge. And if that is instituted, then many Americans will swap to this system rather than pay more (read exorbitant) fees to Insurance Companies, or worse, pay exorbitant fees to IC’s and then have to pay additional out of pocket money for the actual medical service itself (current situation). So unless the system itself is backlogged that people cannot get reasonable service in a timely manner, there isn’t incentive to stay out of that system.
Obama Reasserts Support For Public Plan While AMA Backtracks On Opposition | HuffPost Latest News This article says they have already backtracked. A lot of doctors would love to spend less time fighting with insurance companies.
Of course self-interest is greed. What do you think greed is? And what’s commie or wacko about recognizing that that’s what the word means? If anything looks “commie” here, it’s the assumption that greed is inherently bad.
I was going to post a version of the above.
If you work at place A because it pays more than place B…that is greed.
However, ‘greed’ is not always (or even usually) a bad thing.