If the healthcare bill passes.. what does it mean for doctors ?

[diego]

Originally Posted by JoRdAn fEtIsH

so many different answers

. i was talking to a friend (both parents are doctors) and they said that since everything is gonna be run by the goverenment, doctors are only gonna get paid around 80,000

They sound like Republicans who are giving misinformation in order to make people believe this reform is a bad thing.
Cant say Ive ever heard anyone do something like that.

 

[biggie62]

Originally Posted by Diego

Originally Posted by JoRdAn fEtIsH

so many different answers

. i was talking to a friend (both parents are doctors) and they said that since everything is gonna be run by the goverenment, doctors are only gonna get paid around 80,000

They sound like Republicans who are giving misinformation in order to make people believe this reform is a bad thing.
Cant say Ive ever heard anyone do something like that.

Agreed Diego.

 

[callhimar]

By simple logic, wouldn't the socialization of medicine lead to some type of compensation for med students as well? Such as higher financial aid so thatthere is more incentive to become a doctor because now it won't cost you as much money to get through school?

To me this would make sense and would silence this whole "We're going to run out of doctors!" smear campaign the Republicans have started.

 

[biggie62]

Originally Posted by CallHimAR

By simple logic, wouldn't the socialization of medicine lead to some type of compensation for med students as well? Such as higher financial aid so that there is more incentive to become a doctor because now it won't cost you as much money to get through school?

To me this would make sense and would silence this whole "We're going to run out of doctors!" smear campaign the Republicans have started.

Well the prices of school would have to be reduced yea. I mean look at the charts of school prices vs. inflation over the past 30 years. It's insane. Schools are way too expensive. And state schools have limited enrollment.

 

[jordan fetish]

Originally Posted by CallHimAR

By simple logic, wouldn't the socialization of medicine lead to some type of compensation for med students as well? Such as higher financial aid so that there is more incentive to become a doctor because now it won't cost you as much money to get through school?

To me this would make sense and would silence this whole "We're going to run out of doctors!" smear campaign the Republicans have started.

this would make a lot of sense.. and if doctors start getting paid "80000" , we really are gonna run out of doctors

 

[rexanglorum]

Right now no one knows what the final bill will look like, if one actually can get out the Senate and Reconciliation. Once on the President's desk, itwould be signed but likely take no major effects until 2013 and then triggers would have to be met for the public option and then States would deliberate andlegislate and implement the public option.

In health care you have the stock of physicians, all of those currently practicing and you have the flow and that would be new medical school students andgrads. Regardless of what is contained in the pending legislation, the cartel known as the American Medical Association (AMA) will have the ability to greatlyrestrict competition by not allowing new medical schools to be created or for existing ones to greatly expand capacity. More new doctors would mean morecompetition and lower income for them so they like to claim that they are protecting the public from "quacks" by making sure that the number of spotsat medical schools and hence the supply of new doctors is severely limited no mater how much market demand their is or how many more qualified applicants thereare relative to the number of spots available.

In a somewhat more competitive market, when prices go up the quantity supplied is expected to go up and when the price drops the quantity that is supplied willdrop. In the "market" for the doctor component for medical care, the "price" doctor's income will not have any effect on quantity atthe upper end and would probably only effect the quantity at the very low end. So if the government holds down physicians' wages so that the monthlypaycheck cannot even cover the monthly student loan bill, for instance, the number of applicants might shrink to less than the number of medical school spots.That is only at the extreme low end, even if doctor pay was reduced or if it is increased, the number of new physicians would be the same number as the AMAwill allow and the quality would be the what would change with price.

In every case, except for ones involving extreme doctor pay cuts, the changes would be over time because the stock of doctors would likely remain unchanged butthe flow of new graduates. Just like it would require a huge cut in doctor pay to reduce the quantity of the flow of new doctors, only an extreme cut in paywould quickly reduce the stock by sending many physicians into an early retirement and causing others to change professors or leave the country. That event isvery unlikely though.

Because the AMA only tightly controls the number of doctors and leaves the choice of specialization to private boards and the choice of the new med schoolgrad, the proportion of what types of medicine is practiced is much more fluid than the total number of doctors at a given time and that proportion is muchmore responsive to market demands than the number of doctors, in total. The biggest impact we might see from an expanded role for government health care is thebelief that surgeons and specialists are overpaid and that primary care physicians are underpaid, so they will probably try to push down surgeon and specialistwages and increase the relative pay of general practitioners and family doctors.

Med school grads choose specialization based on potential income and existing doctors can switch their type of practice and if government essentiallytaxes/penalties specialists (they are higher paid at least in part because patients are bidding for this limited number of doctors to do surgery or specialize)and that means that the demand for general practitioners is lower. Government, in its drive to "control costs" loves general practitioners becausethey can make it more difficult to see a specialist, they want ordinary people to always have to have to see a general practitioner (GP) no matter what becausethe general practitioner is the one can/will have to ration the inadequate budget that government allocates them and the GP can cause more waiting and delaysbecause everyone will always have to see a GP, there will be huge wait times just to see him and some people may finally just die while waiting months just tosee the GP to be referred to to wait more months to see the specialist, who will place you on a waiting list.

So because the GP is seen by government as the one who will do their dirty work of telling people to go and die, to save money, government will likelysubsidize GP and that will pull people away from practicing as specialists or as surgeons. So we will have some people who are skilled at doing the surgeries,that are in demand, becoming GP's because being a surgeon is penalized and being a GP is subsidized.

So in almost any situation getting into med school will be competitive but your future is uncertain. You may well be funneled into being the GP, who may gofrom being an occupation that is well liked today to being unfairly despised as the ones who bring about death and pain. You will be the ones who have toration the scraps you are given and for what, so that the political class (which will always have fine medical care) can pat itself on the backs on say that ithas finally whittled down the US share of GDP spending on health care to below 10% and for what. We let the weak die and the sick duffer in agony so that"society: can save money and spend it on more cars and big screen TV's. Have fun being a doctor in this brave new world, and try to keep a macabresense of humor, you will likely need it.

 

[sundoobie]

Funny to see all these forecasters predicting doom just because the Govt wants to mandate Healthcare. I prepare payroll for a medical group of about 12doctors. They get paid based on clicks, how many patients they see, and based on how much production dollars they bring in to the group. Each Doctor has beenmaking at an average around $250,000 annually and that is after they put in the max on their pension plan($49,000 for 2009)

You're trying to tell me this bill will dramatically affect how much they get paid? Bull CRAP!!! When this bill passes, at around this same time nextyear, I am betting payroll won't change much.

 

[38816]

OMG, HEALTHCARE WON'T BE RUN TO TURN PROFIT?

WHO WOULD WANT TO HELP PEOPLE LIVE IF THEY CAN'T TURN A PROFIT?!?

SMH.

ALL OUR GOOD DOCTORS ARE GONNA GO TO INDONESIA TO PRACTICE MEDICINE AND MAKE A FORTUNE

WOE IS US...

smh.

I'm glad the healthcare industry won't be run for-profit anymore..

it never should have in the first place.

nor should schools, either...(which is basically what no child left behind is)

but yall right, all these super great doctors will move under a rock in the desert because the USA is putting an end to this bs inflation of healthcare...yougot it..

-rolls eyes-

 

[diego]

Originally Posted by JoRdAn fEtIsH

Originally Posted by CallHimAR

By simple logic, wouldn't the socialization of medicine lead to some type of compensation for med students as well? Such as higher financial aid so that there is more incentive to become a doctor because now it won't cost you as much money to get through school?

To me this would make sense and would silence this whole "We're going to run out of doctors!" smear campaign the Republicans have started.

this would make a lot of sense.. and if doctors start getting paid "80000" , we really are gonna run out of doctors

You really gotta stop throwing that number around.

 

[bwood056]

its the private practices that will take a HUGE hit..

 

[rexanglorum]

SunDOOBIE wrote:

---

Funny to see all these forecasters predicting doom just because the Govt wants to mandate Healthcare. I prepare payroll for a medical group of about 12 doctors. They get paid based on clicks, how many patients they see, and based on how much production dollars they bring in to the group. Each Doctor has been making at an average around $250,000 annually and that is after they put in the max on their pension plan($49,000 for 2009)

You're trying to tell me this bill will dramatically affect how much they get paid? Bull CRAP!!! When this bill passes, at around this same time next year, I am betting payroll won't change much.





Can you just address me by name instead of saying forecasters. However many other pofessional economic researchers/analysts/econometricians havecommented on the thread.

I was commenting on what would happen if one way or another, government becomes so powerful that it can control the American Health Care Industry to such adegree that it can more or less dictate doctor compensation.

If you were addressing me (and correct if I am wrong here) your reply looks like you must not have read my reply, at least very thoroughly. You saw my name itseems, and took the line you seem to always take with, a gown versus town line of rhetoric. I have only researched this issue for about three years now (firsta student and now as an analyst) while you are in the trenches so any academic or professional research is moot compared to your experience of doing the booksfor a dozen physicians. You experience is valuable information, I am not disparingit but it seems like you have been using it to discredit my opinions onanything involving economics or policy in general, even something that has been the center piece of my academic and now professional research.

Maybe I am infering too much but you do seem to single me out, the one whose posts about policy are usually related to items that actually have researched andwhose sources I check meticulously and thoroughly.

 

[DownByLaw]

bwood056 wrote:

---

it means the money you will make will be the same across the board.. no means to prosper ... also means alot of doctors will practice overseas in diff countries.. also give the incentive to do the work in college non existent, and the people that usually strive to become doctors, will take their knowledge somewhere elsewhere.
Spoken like a true ignorant nter

 

[deuce king]

LOL at anyone who thinks a good portion of USA doctors will run overseas to practice due to this bill.

 

[craftsy21]

I have only researched this issue for about three years now

Rex, your insight is always appreciated - but I do think sometimes you pretend to be a lot less bias than you actually are. Even though you're probablymore researched than anybody on NT in this matter, there are plenty of people just as researched as you on the complete opposite side of the fence, who thinkthe net benefits from a "universal healthcare program" of some type outweigh the negatives.


What do you say to those analysts/researchers/etc?

 

[jinkazama]

You obviously know nothing of the healthcare system.
Yeah IN THEORY, it should be like that and I'm sure for everyone they believe in that. BUT at the same time we didn't go through 4 years of undergrad, 4 years of medical school and 3-5 years of Residency (Those 80 hour caps on a work week are a JOKE) not be compensated financially as well. No one wants to make less money than they already have been making. Get real kid.

You acting like somebody forced you to go into medicine...you knew what it was before you chose that path. Now because you CHOSE to go throughwhat you have to become an MD you are now entitled to a certain income? Get real homie...yeah nobody wants to take a pay cut but hey those are the breakssometimes MDs won't be the first or last profession who sees their compensation decline. You can either roll with it or choose to do something else.

As for what this bill means, read below for the simplest explanation I've seen so far. Remember this bill has a long way to go so don't think any ofthis is set in stone.

Legislative Brief

House Passes Health Care Bill:

The Affordable Health Care

For America Act

On November 7, 2009, the House of Representatives passed H.R. 3962, the Affordable Health Care for America Act, by a vote of 220-215. The vote is historic because no chamber of Congress has approved such a sweeping expansion of coverage since the passage of Medicare and Medicaid in 1965. Rep. Anh "Joseph" Cao (R- Louisiana) was the only Republican to vote in favor of the bill. Many Democrats were convinced to vote for the proposal after an amendment was adopted limiting the use of federal funds for abortion services. The Congressional Budget Office (CBO) estimated the cost of the bill at $1.05 trillion over 10 years.



Proponents of the bill are touting the legislation as a way to accomplish President Obama's goals for health care reform. They state that the bill will contain health care costs, keep coverage affordable and insurers accountable by introducing competition into the marketplace, protect people's choices of doctors and health plans and assure all Americans access to quality, stable, affordable health care. Opponents of the legislation argued that the bill would lead to the government takeover of the private health care system. They are also concerned that the legislation will increase families' health care costs, increase the deficit, increase taxes and cut Medicare.



Key Provisions

Key provisions of H.R. 3962 are outlined below. The bill provides that expansion of coverage would be funded through cuts to Medicare spending and a variety of new taxes, including a 5.4 percent tax on annual income over $500,000 for individuals and $1,000,000 for families.

Exchange - The proposed legislation would create a national "Health Insurance Exchange" to be effective in 2013. The Exchange would be operated by a new federal agency known as the "Health Choices Administration (HCA)." Individuals may use the exchange to purchase health insurance if they are not covered by employer-sponsored insurance, Medicare or Medicaid. Small employers may also purchase insurance through the exchange; within three years, the Exchange would be open to employers with up to 100 employees. Over time, the Exchange may be available to larger employers as well. States may opt out of the federal Exchange if they operate their own exchange that meets federal requirements.

Public Health Insurance Option - Unlike the bill that passed the Senate Finance Committee last month, the House bill contains a public health insurance option. The public option would compete with other plans in the Exchange. The Secretary of Health and Human Services will administer the public option and negotiate rates for providers that participate. Start-up funding will be provided for the public option, but the public option will be financed only by its premiums.

Benefit Plans - Individuals may keep their current coverage if they so choose, as long as there are no changes made to cost-sharing, contract terms, or benefit levels. However, a new Health Benefits Advisory Committee will be tasked with recommending an essential benefit package based on actuarial standards outlined in the bill. This benefit package will be the basic benefit package offered in the Exchange and would eventually become the minimum standard for employer plans. The Exchange would have four plan levels with the same essential benefits and various levels of cost-sharing.

Coverage Mandates - Beginning in 2013, individuals would be required to obtain health insurance coverage, either through their current plan, a government plan like Medicare or Medicaid, an employer-based plan or an individual or group plan that meets minimum benefit requirements. Those who choose not to obtain coverage would pay a penalty of 2.5 percent of their income. Certain exceptions are available, including an exception based on financial hardship. Employers with an annual payroll over $500,000 would also have to provide coverage with certain minimum benefits or face a penalty up to 8 percent of payroll tax. A tax credit will be available for certain small businesses that provide health coverage to employees.

Affordability Measures - To increase affordability of health coverage, the bill provides for affordability credits to some low- and moderate-income individuals and families. The credits are offered on a sliding scale through the Exchange. The bill also contains caps on out-of-pocket spending of $5,000 for individuals and $10,000 for families.

Insurance Market Reforms - The new legislation would implement various insurance market rules with effective dates ranging from 2010 to 2015. Changes would include government review of health plan premiums, enforcement of an 85 percent medical loss ratio, and coverage of children as dependents through age 26. The reforms would also prohibit lifetime benefit limits and insurance rating based on health status or pre-existing conditions, limit age rating to 2:1, and prohibit cancellation or rescission of coverage except in cases of fraud. States may also choose to permit the sale of health insurance across state lines.

Medicaid and Medicare - Under H.R. 3962, Medicaid would be expanded and improved. Additional individuals and families would be eligible for coverage. Medicare would also be improved with elimination of certain cost sharing provisions, increased primary care access and better coverage for prescription drugs.



What's Next?

The debate on health care reform next moves to the Senate. Despite a goal of bringing a proposal to the Senate floor by Thanksgiving, it is possible that a new proposal will not be ready before the end of the year. It is unlikely that any legislation that passes the Senate will mirror the bill passed by the House. Many Senators have expressed their plans to block legislation that includes a public option.

If the House and Senate both manage to pass health care overhaul bills, a conference committee then will negotiate a final version requiring approval from both chambers before going to President Obama for his signature.

ES 11/09

This [b_officialname] Legislative Brief is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.
Content copyright [emoji]169[/emoji] 2009 Zywave, Inc. Images copyright [emoji]169[/emoji] 2000-2004 Getty Images, Inc. All rights reserved.

 

[sundoobie]

Originally Posted by Rexanglorum

SunDOOBIE wrote:

---

Funny to see all these forecasters predicting doom just because the Govt wants to mandate Healthcare. I prepare payroll for a medical group of about 12 doctors. They get paid based on clicks, how many patients they see, and based on how much production dollars they bring in to the group. Each Doctor has been making at an average around $250,000 annually and that is after they put in the max on their pension plan($49,000 for 2009)

You're trying to tell me this bill will dramatically affect how much they get paid? Bull CRAP!!! When this bill passes, at around this same time next year, I am betting payroll won't change much.

Can you just address me by name instead of saying forecasters. However many other pofessional economic researchers/analysts/econometricians have commented on the thread.

I was commenting on what would happen if one way or another, government becomes so powerful that it can control the American Health Care Industry to such a degree that it can more or less dictate doctor compensation.

If you were addressing me (and correct if I am wrong here) your reply looks like you must not have read my reply, at least very thoroughly. You saw my name it seems, and took the line you seem to always take with, a gown versus town line of rhetoric. I have only researched this issue for about three years now (first a student and now as an analyst) while you are in the trenches so any academic or professional research is moot compared to your experience of doing the books for a dozen physicians. You experience is valuable information, I am not disparingit but it seems like you have been using it to discredit my opinions on anything involving economics or policy in general, even something that has been the center piece of my academic and now professional research.

Maybe I am infering too much but you do seem to single me out, the one whose posts about policy are usually related to items that actually have researched and whose sources I check meticulously and thoroughly.



Honestly I didn't even read your post till now and wasn't referring to you.

Now that I read your post, I can take it for it is which is your opinion. I can understand where you coming from because your post seems to be thoroughly puttogether but to be honest no one, not even you can PREDICT what will happen. I just don't see this bill dramatically affecting Doctor's pay as a wholeand even if it does, doctors, nurses, the health industry has to adjust to these changes when the time comes.

Let me ask you though, the tax cut bill that GW Bush signed into law back in 2001, the one that has cost over 1.3 Trillion dollars had the same type offorecasting. Economists predicted the same doom and gloom. I even remember economists posting advertisements in major newspapers condemning that bill. Noone back in 2001 could predict the outcome of that bill so my whole point is we can argue over this health care bill to death but no one and I mean no one hastraveled to the future and can predict what will truly happen. Maybe those forecasters were right, maybe they were wrong but the bottom line is we need tojust move on.

When the tax cut bill was signed back in June 01, did Bush knew of the economic collapse triggered by 9/11? Just like this health care bill, what if the Swineflu becomes a major epidemic? What if the population is sicken by a new type of disease and become zombies? Wouldn't those things affect the healthindustry?

No one knows what will or will not happen.

I guess my point is let Obama do what he promised he would do. Bush promised tax cuts during his campaign so he delivered. Obama is working on health carereform just as he pledge he would during his campaign so let him deliver on his promise.

 

[rexanglorum]

 

[craftsy21]

BTW, since you do not like profit in health care and education. Do you believe that there should be any for profit industries and do you think that anything good has ever come from a person or firm that was motivated by the profit motive.

So if you eliminate the AMA from bottle-necking the number of doctors and the cost to becoming a doctor, you handle the malpractice suit problems, what wouldbe so terrible about a public health option at that point? I feel like you're talking about two separate issues here - the problems you list are problemsno matter if a bill goes through or not. Are you suggesting that simply eliminating these two things would make solid private healthcare readily available toeveryone still?

What about incentives Rex? Could you not reward doctors still for performance within this type of proposed public health sector to still simulate a morefree-market like situation for doctors to have performance motives?

 

[grizzla1024]

over her we have the NHS but we also have private so if you don't want to join the waiting list for a operation you can go private and pay for it. A lot ofspecialist doctors will operate both for the NHS and also a private practice. My friends dad is an eye surgeon and does both, he gets a very decent pay packetfrom the NHS but also a lot more from the private work.

I dont see it being any different over there in America.

 

[rexmakesbeats]

+%*% doctors..

at the end of the day they exploit the sick for a quick buck

not saying they're all like that

but it happens everyday

 

[craftsy21]

Originally Posted by GriZZla1024

over her we have the NHS but we also have private so if you don't want to join the waiting list for a operation you can go private and pay for it. A lot of specialist doctors will operate both for the NHS and also a private practice. My friends dad is an eye surgeon and does both, he gets a very decent pay packet from the NHS but also a lot more from the private work.

I dont see it being any different over there in America.

no way dude - it'll never work over here, I mean it'll ruin our already superbly strong economy.

/sarcasm

seriously though - there are many examples of dual-systems working just as well or better than our current system, there's no reason to think we canestablish the same thing here or an even better hybrid.

 

[elgrenas]

well when did we have to be mandated buy something we didnt want. she doesnt even answer the question. i guess its going to be good to give to those lazy @@%people who depend on the government for everything. nany state here we come

http://www.youtube.com/watch?v=nUkzV8h3Wp0&feature=player_embedded

 

[duba169]

SunDOOBIE wrote:

I guess my point is let Obama do what he promised he would do. Obama is working on health care reform just as he pledge he would during his campaign so let him deliver on his promise.

get obamas @#+$ out of your mouth

you sound just as bad as a hardcore bush supporter. "he got voted in, let him do his thing, stop criticizing"

Like it's even just one man who wrote the bill. There are many obama fanswho don't like the way he is handling reform or think he has other things to focus on.

 

[38816]

if anything, yall doctors should be geeked to be rid of malpratice insurance fees/rates

I just don't think healthcare should be run for-profit....(by ins companies)

their overhead is so inflated, it literally bankrupts people

I can't afford health insurance and I work full time...

you pay health insurance and would still go broke if you got fatally sick...

sounds like rape to me.

 

[38816]

oh yeah

entertainment, food, almost every other type of goods or services,

for profit all day.....

educating and healing fellow human beings shouldn't be a corporate takeover...

why does it cost 60k to get a finger reattached?

because it actually costs that?

lol, WITH health insurance?

you make it seem like the health insurance industry is some competitive market with many companies competing to keep inflation and downright rape in check...

but there aren't...

you wanna talk about how small businesses are suffering and can't hire people because insurance and sick days are bogging them down?

you wanna complain about a "universal healthcare" but are quick to endorse vouchers?

when schools have their funding decided on how many kids pass or fail a test, they aren't being taught, they're being prepped for ONE test....

doctors will be fine. if anything, people looking to get in the field should be very excited because there with be many more job opportunities available foryou.....there should be, anyway...

after healthcare, I think education should be the next step. that or alternative energy.

what yall think?

(I can't wait for the right to start being "outraged" over alternative energy)