Posted on 12/04/2013 6:40:09 PM PST by Innovative
Well that seals the deal.
The very fact that they pub;ish an articel claiming there will not be a doctor shortage means that there actually will be...............
No shortage, because you won’t be able to see one unless you go through “team care” first and pass a political background check.
Medical care could be made more “affordable” without bleeding everyone if there was an intermediate level of care that was consistently available. Think PA, RN, or even paramedic type, who could get someone more serious seen at a full doctor but take off the load of the most basic cases like sprains, uncomplicated common infections, and sports physicals.
I think the issue here is that when people spend a lot of time becoming skilled at a very difficult profession like medicine, and then others see them at work, it looks fairly easy. They can only make it look easy because they have spent so much time practicing the skills.
Personally, I do not want my care delayed by having to go to someone who is not trained in diagnosis and treatment. Nurses, pharmacists, etc., all have valuable skill sets, but they cannot substitute for a physician.
What a denigration of the absolute best medical treatment that the world's rulers seek out when they are in trouble with their health. (Castro and Chavez excluded)
It only takes a few minutes for fools to destroy a beautiful home that took years to design and build to near perfection!!!
Here comes "the tragedy of the commons!"
Perhaps and that’s your choice to make.
I’d personally be fine with trusting my care to someone below a physician for a much smaller price tag. I refuse to mooch so I go without, as is, so for simple things a budget alternative would be good.
One caveat is that I’d NEVER want to see the NP/PA side be mandatory. You want to splash for the doc, you get the doc.
“Pharmacists will provide more counseling and urgent care.”
When will they have time and who is going to pay them? Someone doesn’t actually understand how this works! Besides the fact there is a shortage of pharmacists too.
Idiots running the asylum!.
I have a more fatalistic view of medical care. If I have something more serious than a simple infection or cut, I can’t afford to have to dealt with anyway, so I’d rather have access to what I can and if it doesn’t work, then I haven’t pissed away even more of the grocery or bills money just to be told “You’re screwed, best of luck!”.
I *refuse* to mooch.
Bingo.
Diagnosis, and analysis of what treatment is appropriate, can be highly complex. Moreover, doctors have already handed off all they can, probably too much, to lower level medical staff. A case in point follows, and I'll bet every FReeper can add similar stories of their own:
My Mom developed a rash on her face, but her doctor was out of town for a few days, so she saw the available Nurse Practitioner instead. The NP diagnosed shingles and prescribed a "package" of medications, at least one of which had significant negative side effects. At least one (I don't recall which) was fairly expensive, too. As you've probably figured out already, my Mom did not have shingles...
Saying we can get by with fewer doctors and replace them with lesser trained staff is like saying technicians can replace many engineers. Don't get me wrong, many techs are uber smart and probably could be engineers, or even "pick it up", but for whatever reasons, most do not go that route. The 4 years of TOUGH (at least for non-geniuses) study and training is required for engineers for good reasons. One is that often much money, or lives (sometimes many lives), are at stake. For physicians, the requirements are even tougher, as they should be.
If we wanted to lower health care costs, it would probably help to encourage MORE capable people to become (and stay) physicians, and enact reforms to make their practice less of a form of Russian roulette. And let them do what they do best -- "doctor" patients instead of piling on insane paperwork requirements. Who with an IQ over 10 thinks that as government becomes ever more involved with health care, the paperwork (be it electronic or on actual "paper") will do anything but grow exponentially?
Yes, it's true that the AMA, etc., would have to be "pushed" to accept the training of more doctors, but, it'd actually be better for individual doctors in the long run. ("Money is not everything".)
“Medical care could be made more “affordable” without bleeding everyone”
And how much will malpractice insurance cost these people to see patients and who do you think will pick up that tab, yet you think it will be more affordable this way? The bleeding is going on by the government that requires more paperwork from doctors than actual time with the patient.
And just in case you don’t know government reimbursement is crap and they are SLOW in paying their bills (& in many cases make excuses why they aren’t going to pay) and the doctor has to eat the losses!
Anyone who hasn’t had to deal with government reimbursement doesn’t have a clue. There is very little profit in Medicare & even less in Medicaid (welfare) paid to the doctor. And by the time you hire extra help to file all the paperwork it just isn’t worth it!
And that isn’t even considering lawsuits by the same leeches on the government dole who are just looking for a big pay day.
What?
Have these bozos even looked around? Almost any area with a significant population already has not only ER's available, but has clinics, usually multiple 24 hour clinics, and / or other walk-in medical facilities, where you mostly find said "intermediate level of care".
Ah, I see why everyone’s so pissed...no, I wasn’t saying the DOCTORS are the ones bleeding ppl. I meant the useless leeches!
I’m saying allow for a tier of ultra budget care to steer things back more towards ppl paying for THEIR OWN CARE. Not insurance, not welfare, not charity.
You’re twisting what I’m saying.
I’m suggesting a way to end the current screwed up system of using insurance for every tiny little thing, to stop bleeding taxpayers for enormous bills ran up by those who have no intent to pay them.
Pure cash and carry, doc in the box type stuff, just a tier below current doc in the box setups.
It's 2009, you've been laid off from the job you had for almost 20 years, the industry you worked in has imploded, none of the resume's and job apps you've sent off in the last several months have come back positive, most of your savings have gone into trying to start a business, and tonight your young daughter is having serious trouble breathing and her temperature is 102 & climbing despite all the Children's Tylenol she can handle.
You still *refuse* to "mooch"?
I still think most areas already have what you are suggesting and will accept “cash” (or at least a credit card or other proof of ability to pay) for payment if you come in with something that is “definitely” minor. It sort of parallels going to the dentist for a toothache — although even what you think is just a cavity needing filling might turn out to require a trip to an oral surgeon...
3rd party payment for mid and low level health issues is an unmitigated cost disaster.
Where we disagree is that I think we need more doctors to see patients on the front end, and then the doctors can "hand off" to less qualified staff when appropriate. Kick 50% more doctors into the system (along with some of the other ideas I posted earlier) and watch cost drop...
In the country area where I grew up, we had a retired doctor in his 80s that occaisonally still practiced medicine in his home and charged people little or nothing. He no longer carried insurance and his patients were mostly old folks who had seen him from long ago. I actually in passing saw him doing a minor operation on someones scalp once, to remove a skin cancer or something...very bloody, but patient awake under local anesthesia I presume.
That $10 he might charge IF he charged anything at all, was basically cost.
Yes. There is a name for this "it looks easy" business -- it's a recognized / well studied syndrome, but I can't remember the name. I think it starts with a "K". It often involves the not uncommon combination of incompetence and arrogance. (MY wording.)
Yes. I chose not to have kids to avoid that situation, but if I had, their life or death still doesn’t warrant taking so much as one single penny from another person by governmental force. Charity, perhaps for a child...for myself, again no.
WRT to your other posts, going to just address it in one post. It would be ideal if the gov just got out of the way, and there were ppl flocking to become doctors who had the brains, means, and desire to pull it off. That would bring down prices, but of course that means bringing down doctor salaries as well. At which point less go into it, and the cycle continues...anyway, back to the main point.
Even if Obamacare were abolished today, ppl will still be something of a limiting factor. You have to find folks who want to be doctors, either because they’re drawn to it, or they think the money is worth the work and sacrifices. Then, out of the ppl willing to think about it, only some will be smart enough to manage. Now out of those, they have to be able to afford the education.
I agree with the theory of your solution; I’m just less sure how likely it it to happen.
Hahaha, or in my case when I got my first job at a corporation, and even though part of my job was to help customers find cost effective options: “You are an engineer! You do NOT estimate pricing!”
As we head for a 2 tier system of the haves and the afraid to use, there may be a surplus of doctors as 90% of the population will be afraid to go for medical services unless they are dying.
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