Possible Doctor Shortage with UHC Plan?

Possible Doctor Shortage with UHC Plan?

PostBy: Richard S. On: Thu Aug 13, 2009 2:31 am

Let's consider this for a moment hypothetically lets say all this goes through and there is 40 million new patients. Who's going to treat them?

Another point as well if doctors fees are to be controlled by the state and it isn't a lot how many kids are going to be willing to go into the field?
Richard S.
 
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: jpete On: Thu Aug 13, 2009 6:36 am

In the House "Discussion Draft" of the UHC bill that I have been reading, it says that for the first three years, doctors will be paid the same as Medicare pays for similar services.

It's my understanding that Medicare reimbursements as horrible. No doctor could live off of them. My wife is an EMT and says that her 2nd job after providing care is trying to get insurance information. Otherwise, the ambulance company gets paid from Medicare and that doesn't even begin to cover the cost.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: ErikLaurence On: Thu Aug 13, 2009 6:59 am

In college in the early 1980s I worked as an EMT-i summers and weekends.

One of the companies I worked for was Bay State Ambulance in Malden Massachusetts.

The owner of the company drove a Ferrari.

The EMTs made slightly better than minimum wage.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: jpete On: Thu Aug 13, 2009 8:36 am

Wow. Class warfare much? What does the owners vehicle have to do with how much Medicare pays? You haven't the faintest idea how that man made his money. Who's to say he didn't have several other companies or made some smart investments. The owner of a machine shop I used to work at drove a Testarossa. Hell I almost bought a Dino a few years back. It was only $6000. Another shop I worked at, the owner had 13 or 14 classic cars. I was making $9/hr to build machines he sold for six figures. After I left he hired me back to do restoration work on his cars and paid me $10/hr to do that! That's the point behind freedom and liberty. He offered a job for a price and I decided whether or not to take it. It just so happens that having his '67 SS/RS Camaro convertible restored was worth more to him than having a machine built.
jpete
 
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: samhill On: Thu Aug 13, 2009 9:09 am

My wife has been a RN for well over30 years & most of the Docs. she knows are for the HCR, it seems that they say medi-care payments aren`t that low. The Ins. cos. have so much paper work to do that most busy practices have to hire an office mananger just for that, then payments are cut & slow. Thats the reasoning behind a lot of doctors lowering their fees if you pay cash.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: billw On: Thu Aug 13, 2009 10:10 am

Since WW2 the US chose to have an employer based health system where Europe and Asia chose government run healthcare. From what I read neither is working very well. Employer's have hit the wall trying to maintain employee paid healthcare. At one point GM was paying more for healthcare than sheet metal. It's not sustainable and puts US companies at a competitive disadvantage with companies from other countries.

Here's a radical idea. Cancel every government health program including advanced disease research such as a cure for cancer, diabetese etc. No more medicare, VA healthcare, CHIPS, and every state and local healthcare program. If an employer provides healthcare insurance it's fully taxable as income to the employee and not deductible from a company's income. So the employer also pays tax on healthcare. Let's switch to every man for himself. If you can't afford it, to bad, go bankrupt or die. Within a year the cost of healthcare will be in balance with people's ability to pay.

As I said completely radical but I think something like this is going to be the ultimate solution. Companies can't afford it now, how long before governments can't afford it? Maybe 10 years.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: ErikLaurence On: Thu Aug 13, 2009 10:17 am

jpete wrote:Wow. Class warfare much? What does the owners vehicle have to do with how much Medicare pays? You haven't the faintest idea how that man made his money. Who's to say he didn't have several other companies or made some smart investments. The owner of a machine shop I used to work at drove a Testarossa. Hell I almost bought a Dino a few years back. It was only $6000. Another shop I worked at, the owner had 13 or 14 classic cars. I was making $9/hr to build machines he sold for six figures. After I left he hired me back to do restoration work on his cars and paid me $10/hr to do that! That's the point behind freedom and liberty. He offered a job for a price and I decided whether or not to take it. It just so happens that having his '67 SS/RS Camaro convertible restored was worth more to him than having a machine built.


I know how he made his money. You don't.

He was convicted of medicare fraud.

http://openjurist.org/874/f2d/20/united ... ervice-inc


As for class warfare? I went to MIT, built a tech company and sold it. I retired rich when I was 35. I work now when I feel like it and it is an interesting project.
ErikLaurence
 
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: Richard S. On: Thu Aug 13, 2009 10:51 am

samhill wrote: The Ins. cos. have so much paper work to do that most busy practices have to hire an office mananger just for that, then payments are cut & slow. Thats the reasoning behind a lot of doctors lowering their fees if you pay cash.


The administrative costs of the current system is one thing that is often cited for the escalating costs. It's like 25%.

Back to the topic at hand... lets say for arguments sake the this goes through and the doctors are happy with the payments. We still have an issue where you're going to be dumping millions of new patients into system seeking care they previously couldn't. If we have 40 million new people seeking services previously unavailable to them I'm sure anyone could agree it's going to strain a system that is already being stretched in a lot of places. Even if we have a whole new crop of people interested in going into the field it's not like they can be produced overnight.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: samhill On: Thu Aug 13, 2009 12:25 pm

Many of those millions of uninsured are the ones that use the ER for a primary care doc, call for an ambulance to get them there, alot of those live in areas where they won`t go without a police presents first so that sore throat ends up costing the tax payer a couple grand before its all over. Hospitals have to take care of the sick & injured, some can get away with shipping them to another hosipital after evaluation but they are all seen which drains the present system.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: Richard S. On: Thu Aug 13, 2009 12:52 pm

That's understood Sam and a lot of those people will be shifted from the ER to other treatment. I'm not talking about the costs here as two visits from one patient that prevents a situation from escalating is certainly cheaper than one very expensive visit to the the ER and preferable. My point is they will also be utilizing other benefits. For example sore throat guy without a plan may wait it out and the sore throat goes away by itself, If it gets worse he goes to the ER. With benefits he may be going to the doctor every time he gets a sore throat.

Keep in mind I'm not saying this is a bad thing cost wise, my point is if we have 40 million new people all making 3 or 4 trips to the doctor when their throat gets sore is there going to be enough doctors to take on this new workload? We only have X amount of doctors that can treat X amount of people and if my understanding is correct many of them are over worked now.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: Yanche On: Thu Aug 13, 2009 12:53 pm

The Medicare system made a lot of doctors rich. Unfortunately it made the wrong class of doctors rich, the specialist. The internist, the general practitioner, the doctor you see first is not doing very well. That's why there is a shortage of primary care doctors and the shortage is likely to grow. The reason the specialist can get rich is because he can structure his business model to get extra profit from things he orders. Yes, he is being paid the "average and customary" prices that Medicare pays but he also makes money on the related companies the specialist has set up to support his practice. That's why when you for example have surgery you get your rehab from the doctor recommended provider. Your surgeon has an interest in that company, either by ownership with other doctors or by finder fees. The doctor at the bottom of all this can't do much, perhaps he can setup a blood lab but he can't make money on the scale the specialist can. The insurance companies go along with it all because they get their cut.

The system has to have a reform which pays an incentive to the primary care doctor to keep you healthy. That's where the big savings are. Don't get sick. The other big savings would be in the administrative overhead. Ever wonder why there are so many paper pushers in doctors offices. It the burden imposed by insurance companies, in the belief that they can reduce claims by requiring pre-approval. It's an all paper based system. A doctor's office must replace a FAX machine every 6 months. :-) One of the early Obama administration bills tasked the National Institute of Standards and Technology to develop standards for electronic medical records. Using electronic records could greatly reduce the paper administration costs. But again there will be a lot of resistance to to status quo. Remember the CEO's make more money if their company has more employee's even it they are mindless paper pushers.
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Re: Possible Doctor Shortage with UHC Plan?

PostBy: Richard S. On: Thu Aug 13, 2009 3:49 pm

Electronic records discussion moved here: Electronic Medical Records
Richard S.
 
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