Posted on 05/12/2009 5:10:11 AM PDT by reaganaut1
At the heart of President Barack Obama's health-care plan is an insurance program funded by taxpayers, administered by Washington, and open to everyone. Modeled on Medicare, this "public option" will soon become the single dominant health plan, which is its political purpose. It will restructure the practice of medicine in the process.
Republicans and Democrats agree that the government's Medicare scheme for compensating doctors is deeply flawed. Yet Mr. Obama's plan for a centrally managed government insurance program exacerbates Medicare's problems by redistributing even more income away from lower-paid primary care providers and misaligning doctors' financial incentives.
Like Medicare, the "public option" will control spending by using its purchasing clout and political leverage to dictate low prices to doctors. (Medicare pays doctors 20% to 30% less than private plans, on average.) While the public option is meant for the uninsured, employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage.
The Lewin Group, a health-care policy research and consulting firm, estimates that enrollment in the public option will reach 131 million people if it's open to everyone and pays Medicare rates, as many expect. Fully two-thirds of the privately insured will move out of or lose coverage. As patients shift to a lower-paying government plan, doctors' incomes will decline by as much as 15% to 20% depending on their specialty.
Physician income declines will be accompanied by regulations that will make practicing medicine more costly, creating a double whammy of lower revenue and higher practice costs, especially for primary-care doctors who generally operate busy practices and work on thinner margins. For example, doctors will face expenses to deploy pricey electronic prescribing tools and computerized health records that are mandated under the Obama plan.
(Excerpt) Read more at online.wsj.com ...
It already is in some cases. Fields like internal medicine (which I trained in) do not reimburse much. When I was a resident the best and the brightest competed for internal medicine residencies. Now it is difficult to fill programs, and many of the residents went to medical school out of the country. Those that are the best of the bunch use internal medicine as a stepping stone to the medical subspecialties, where they can make a better living. This is greatly impacting the care of patients.
Along with this, there is a growing trend of internists joining hospital only practice. I did this several years ago because the amount of work and the low compensation was not worth the time spent away from my family. I don’t make anymore now, but at least my days off are really off - no phone calls, lab results, prescription refills, etc to be dealt with. A large number of the people in my hospitalist group have left primary care for similar reasons.
It is difficult or impossible to find a primary care physician in some parts of the country, particularly one who is accepting medicare. This will only worsen, and the quality of the physicians going into primary care is diminishing rapidly. And if you think primary care is not as important as subspecialists, who is going to manage your blood pressure, diabetes, high cholesterol, etc. And who is going to listen to you and pick up the murmur of that defective heart valve that needs to be replaced before the damage to your heart is irreparable.? And when you have chest pain, would you like your physician to be skilled in diagnosing blood clot versus heart attack vs heartburn? Who determines when you need to see a specialist? usually the primary care physician.
Obama’s plan will drive medical care in this country to rival care in other 3rd world countries. Good luck!
/rant off
If you do not think care by extended providers (nurse practitioners and PA’s) will mean a reduction in quality, will you take your next commercial airline flight with a pilot rated on single engine planes?
And your source of this information is????
Yes there are bleeding heart leftists in the medical world. But in my experience of 25 years, there are just as many hard core conservatives practicing medicine. You are painting with an awfully broad brush there.
That’s because with TriCare it is at LEAST a 6 month ridiculous process for a dr to join and they do not always LET a dr join their network.
And a dr has to go thru the 6 month process as well just to SEE a TriCare patient OUT OF NETWORK....if they want to get paid that is....
It is a paperwork nightmare.
SZQ
BTTT!
The General Electric, GE, president and board have been in bed with the rats and 0b0z0 health care bed for a long time.
Thursday, GE will announce its 6 billion program which will push 0b0z0’s health care plan.
Of course, NBC, CNBC and MSNBC will provide “free advertising as they will push 0b0z0 care 24/7.
The link below sheds a little light on GE and 0b0z0 care.
GE may be the only good investment in the DOW.
One can only imagine the mediot uproar if Haliburton had planned something like this during GW’s presidency.
Excellent rant.
Unfortunately in Californicator, many of the conservative mds have retired or will be retiring. The liberal, “et tu Brutus MDs” will help 0b0z0 get his 0b0z0 care in.
Maybe some are, but look how many specialty doctors had to close their private practices because of the money lost due to medicare payments.
I think we may find a handful here & there that might be able to sway others of their type.
I’m hoping...
Yes, and the way I see it, they are going to begin with people in there mid-late forties, when they start denying cancer treatments. If I, or my child come down with cancer, and this Son of a Beeswax denies either of us treatment, I will have no choice but to pray to the God Almighty that he & his family suffer through illness as he is making the rest of us & our families suffer.
Do I sound a bit hostile? Look at how young the people are in Europe that are being refused the tests (ie paps) to discover cancer, or the treatments to cure it. I’ve seen everything from age 32 & up.
I wonder when his next POTUS medical check up is?
“I didn’t know until today that Medicare patients are not permitted to pay “over and above” to doctors, if those doctors don’t accept Medicare as payment in full.”
This is what i don’t understand, and i thought the law was that the doctor couldn’t charge the patient for what medicare didn’t cover. so WHY??? do all these elderly people on medicare have to have supplemental insurance??????????
“Their malpractice insurance is very costly.”
yes it is, that’s why so many gp’s no longer deliver babies, i understand it is almost impossible to find an ob/gyn who delivers in florida
I agree. First of all, ovarian cancer is a deadly form to begin with. But my father recently passed away from cancer after it went to his bones. He had medicare, plus Blue Cross, and he still went into debt with medical bills. Its going to happen to anyone who needs sustained care. But that doesn’t mean we should be denied the best quality care they can give us.
If they cost of treatment can be lowered, that would be great...but don’t take it away from us just because we might go into debt from it. Maybe Zero should regroup & consider this. His deep seeded hatred for this country is going to bring us all down.
My oncologist, as well as other specialty docs I deal with have said that they are not going to take this sitting down. I believe there are a lot of conservative physicians out there...I consider myself lucky to have found a few.
I am cancer free at this point, after surgical removal of a tumor (without chemo or rad). I asked my onco doc what is in my future if the cancer should come back. He said that the govt will attempt to tie his hands, as well as others.
I pray that the physicians of the country STAND & UNITE against the evil in the WH!
Actually, in some cases, I've had better care from extended providers than physicians because they could take more time to listen. I have had to fight tooth and nail to get past idiotic physician diagnostic work that placed my health in serious jeopardy upon more than one occasion and that of my children as well.
So it depends upon both the situation and the customer need, which is yet more justification for free markets in medical care.
In short - the future is a bunch of pissed off patients waiting forever to see an ever diminishing pool off pissed of doctors.
Liberals will love that...they are perennially pissed off about anything and everything. A miserable group of people who want to spread their misery to everyone else.
I also wonder, as many have on this thread, if we will end up with Obamacare, which will be “free” and of like quality (you gets what ya pays for) and Othercare, a separate market where subscribers pay for their own insurance and/or care to doctors that refuse Obamacare.
I am not in the medical field but I am VERY concerned about primary care! I am old enough to remember the old fashioned family doctors who made house calls. My mother was a nurse working in a nursing home most of her career but she started out working for one of those old primary care doctors. There are very few good general practitioners left in this area now and the situation is getting worse daily.
Back in the 80’s I saw two small town hospitals (in Central Cal)stop delivering babies because of all the illegals who could not, by law, be turned away for lack of funds.
One of them is now a nursing home and the other is a sad place that the paramedics try to by pass with anyone needing serious help.
So, I guess there are several reasons for the high cost of healthcare.
I notice that you are in France. You have first hand experience with the system. You should point that out in your posts. Liberals here get rosy descriptions of socialized medicine from some European tourists and think it’s great.
I saw what socialized medicine was like in Argentina and that was over 40 years ago before I left. They tell me it is much much worse now.
Consequences of the french socialized National Health Care on different levels are clearly bad.
1/On the economy. That very expensive mismanaged system can’t survive without taxes higher and higher weakening the national economy and increasing unemployment rates(France had the weakest economy and the higher unemployment in western Europe).
2/Hospitals are in a big jeopardy as everybody can come to “emergencies” for any kind of health problem to get “free” cares...As a consequence public hospitals are always missing money,doctors,nurses,paramedics and patients are also complaining of lack of cares.
3/Last but not least “private” doctors are “private” in name only when they are kept under the straight control of the administration . Their numbers are decreasing quickly because young physicians don’t want to work very hard with high responsability and a mediocre income...
The system have made illusion(for lunatics and ideologists) during years because he lived beyond its ressources
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