No problem. Take care.Quote:
Originally Posted by Tuttyd
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No problem. Take care.Quote:
Originally Posted by Tuttyd
Intended or unintended consequence of Obamacare?
“So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period." -Barack ObamaQuote:
Opinion - The Doctor Won't See You Now. He's Clocked Out
ObamaCare is pushing physicians into becoming hospital employees. The results aren't encouraging.
By SCOTT GOTTLIEB
Big government likes big providers. That's why ObamaCare is gradually making the local doctor-owned medical practice a relic. In the not too distant future, most physicians will be hourly wage earners, likely employed by a hospital chain.
Why? Because when doctors practice in small offices, it is hard for Washington to regulate what they do. There are too many of them, and the government is too remote. It is far easier for federal agencies to regulate physicians if they work for big hospitals. So ObamaCare shifts money to favor the delivery of outpatient care through hospital-owned networks.
The irony is that in the name of lowering costs, ObamaCare will almost certainly make the practice of medicine more expensive. It turns out that when doctors become salaried hospital employees, their overall productivity falls.
ObamaCare's main vehicle for ending the autonomous, private delivery of medicine is the hospital-owned "accountable care organization." The idea is to turn doctors into hospital employees and pay them flat rates that uncouple their income from how much care they deliver. (Ending the fee-for-service payment model is supposed to eliminate doctors' financial incentives to perform extraneous procedures.)The Obama administration also imposes new costs on physicians who remain independent—for example, mandating that all medical offices install expensive information-technology systems.
The result? It is estimated that by next year, about 50% of U.S. doctors will be working for a hospital or hospital-owned health system. A recent survey by the Medical Group Management Association shows a nearly 75% increase in the number of active doctors employed by hospitals or hospital systems since 2000, reflecting a trend that sharply accelerated around the time that ObamaCare was enacted. The biggest shifts are in specialties such as cardiology and oncology.
Estimates by hospitals that acquire medical practices and institutions that track these trends such as the Medical Group Management Association show that physician productivity falls under these arrangements, sometimes by more than 25% (more on this below). The lost productivity isn't just a measure of the fewer back surgeries or cardiac catheterizations performed once physicians are no longer paid per procedure, as ObamaCare envisions. Rather, the lost productivity is a consequence of the more fragmented, less accountable care that results from these schemes.
Unless he's off the clock...
Hello again, Steve:
While solving the only crisis that matters, RISING health care costs, there's going to be some disruptions. One of them may very well be the doctor who'll no longer be able to get obscenely rich. So, if your guy wants to go "off the clock" there'll be plenty of newcomers willing to fill his space.
The other thing you guys DON'T get is, the ACA is the law of the land. It'll NEVER get repealed... You LOST an election over it. What about that ISN'T sinking in?
excon
Most of the facts are correct but the concluson is not. Buying the "private practices" of doctors especially by not for profit hospitals has been going on for a while and is a lucrative revenue stream for the hopitals.
Bitter Pill: Why Medical Bills Are Killing Us - TIME
Why Medical Bills Are Killing Us | TIME.com
Its an eye opener.
Right, Obamacare will prevent doctors from getting obscenely rich and shift it to big health care corporations getting obscenely rich.Quote:
Originally Posted by excon
Ex,
First, hold off the rightwinger attack on me cause I ain't one.
I want Obamacare to work, but I try to base my predictions on facts, not hope.
When I questioned earlier where all the Dr's are coming from, you said that they will appear because of the demand. But the demand for Dr's in my region has been high for at least 7 years (and possibly longer, I base 7 years on when I needed one)--- and the Dr's haven't been magically arriving in droves around here.
Where are the Dr's who will "if you build it, they will come" come from? Have medical schools been training larger numbers of Dr's for the past 6 or 8 years, so that they will be arriving on the scene now and in the near future - or what?
You imply that they are waiting in the wings and that when a big need arises that they will come begging for the jobs. I haven't seen that happening so far.
Democrat policy is largely based on wishful thinking.
Hope is not a strategy.
No, it's a campaign slogan.
Hello again, wingers - and you too smear:
First off, Obamacare isn't even fully implemented yet. Secondly, it's only the FIRST attempt. It'll NEED revision. It doesn't address rising costs. We've ONLY just begun this process. It's going to take a few years to get it right.
It IS a bummer that we're in the middle of this upheaval, but I believe that we WILL solve it once and for all, and for all time.. The problem isn't Medicare. It's rising health care costs. If we FIX that, Medicare will be solvent, and I believe we WILL.
The difference between us, is I'm just looking wayyy down the pike.
What I DO know, is that we'll NEVER go back to a time when people died because they had no insurance and/or went bankrupt because they were sick.
excon
I did not know there was a surplus of doctors waiting in the wings for those lower incomes. What I do know is that doctors have to staff their offices like a corporation to handle the volumes of paper work required to service their patients. I also know that doctors have to have retainers for defense lawyers to deal with the tort. They also have to have fancy accountants if all they want to do is actually practice their profession ;that they went to expensive schools for years to earn.
Not only that.. already GP income does not cover ,or barely covers expenses... so while 17,364 new doctors emerged from the country's medical schools in 2011 ,only 5,746 went into GP... the rest opting for higher paying specialists .
And the demand of course is going to increase as the country ages . I've already heard people float the idea of non-physician medical professionals, such as nurse practitioners and physician assistants becoming the primary care providers . That will probably be the Obamacare way.
There will be other worse access issues due to service shortage.Quote:
What I DO know, is that we'll NEVER go back to a time when people died because they had no insurance and/or went bankrupt because they were sick.
Excon
Exactly, it pretty much doesn't do much of anything Obama said it would, especially bend the cost curve downward. But that's what you get when you have to pass legislation before knowing what's in it.Quote:
Originally Posted by excon
You righties act like there was no problem before Obama Care. There was, and nobody did anything about it. The gloom and doom you forecast is a bit premature.
Don't get on to us for publicizing the 'unintended' consequences that keep surfacing. People need to know what you've done to us.Quote:
Originally Posted by talaniman
You didn't give a rats patoot before Obama was elected? Now everything is wrong and its his fault.
On the contrary... I've been calling for tort reform for years.Quote:
Originally Posted by talaniman
Of course I did.Quote:
Originally Posted by talaniman
If the shoe fits.Quote:
Now everything is wrong and its his fault.
I like his idea better than yours. Oh that's right, you didn't have any ideas. None of your heroes had any either.
Your shoes fit really good.
I have also called for tort reform on these pages years back. That wasn't the question you asked. You asked, "You didn't give a rats patoot before Obama was elected?"Quote:
Originally Posted by talaniman
I answered what you asked. Try and keep up.
Hello again,
Tort reform is PERFECT for right wingers... It TAKES away rights, and doesn't fix the problem. Right wingers HATE rights, unless it's their 2nd Amendment rights...
What tort reform IS, in the final analysis, is PRICE CONTROLS - a very LIBERAL idea. I thought the right wing LIKED the free market. Instead, tort reform sets a LIMIT on how much money a VICTIM can receive, no matter HOW badly they were injured... That's price controls no matter how you slice it.
Now, everybody who lives on EARTH knows, that when THEY'RE injured or their child is injured, they'll change their tune. Look at Rob Portman - A STAUNCH defender of DOMA until something happened to HIS family.
FIXING our health care problems on the backs of INJURED people AIN'T going to work. To think it would is mean spirited, un American, short sighted, and won't work anyway.
excon
Tort reform doesn't stop your premiums from rising, but having the insurance companies return some of the money they didn't use for health care related expenses does and will.Quote:
Originally Posted by speechlesstx
I guess eliminating caps on coverage, and pre existing conditions doesn't help either. Or tax deductions for premiums that rise as the premiums rise was a lousy thing for consumers too.
My drug costs have come down the last year and so has my mom's on medicare. No more donut hole extra payments. That's a bad thing too huh?
Caught up yet?
In other words, profits and investing are evil. If you had the same attitude about government we might get somewhere. Government takes and takes and takes to feed its voracious appetite and you guys b!tch about an insignificant cut in spending increases.Quote:
Originally Posted by talaniman
Profits on the backs of the poor are evil, just ask the new pope. If you had the same concerns about businesses and corporations that take and take from the consumer as you do the government, which could be more efficient, we could get somewhere.
BWAHAHAHahahahahahah!!Quote:
Originally Posted by talaniman
Governments don't do efficient, ever. Have you never heard the old chestnut about an elephant being a mouse built to government specifications?
Governments (any of them) can SOMETIMES be more effective than private endeavors, but not more efficient.
Could be more efficient is an understatement.Quote:
Originally Posted by talaniman
I know! Finally we agree on a point. Watch out world!!Quote:
Originally Posted by speechlesstx
You may be right, so lets beat both their a$$e$ until they do what we want!!Quote:
Originally Posted by Catsmine
Tort reform was only one of my plans. One of the others that I have mentioned here before is Direct primary care(DPC) for the vast majority of health care needs ,and having insurance cover only catastrophic care.
Direct primary care - Wikipedia, the free encyclopedia
Well Tom you are getting closer but such a system doesn't solve the real problem, which is, where do you go when you don't have the moneyQuote:
Originally Posted by tomder55
There are already government programs to care for the poor. There are already charitable organizations to handle the heath care needs of the poor.
I don't think you have any idea about how many poor, that is, those unable to afford medical care there are, It isn't just the jobless, the unemployed, those on welfare, but poorly paid workers alsoQuote:
Originally Posted by tomder55
Yeah it sucks being poor.
Maybe we can seize everyone's bank accounts like the EU is doing to Cyprus ,so we can spread the wealth.
I think you miss the point of why that is being done, the Russians are using that country to launder money
And yes Tom it sucks being poor because the poor are more likely to need medical help and be less able to pay for it
But I already said there are provisions for the poor. That is not the problem. The real problem is that too many sheeple are used to suckling on the nanny-state teet.
You don't have nanny state, Tom
I wonder how much money is left in Cypriot banks today?Quote:
Originally Posted by tomder55
I know there was a run on the ATMs . Clete is wrong about Cyprus . It is the canary in the coal mine. If the EU gets away with it there ,then the PIGS are next . And then... (I see my 401-K threatened again)
He's just evolving like Obama, Bill and now Hillary.Quote:
Originally Posted by excon
Do you tell your gay friends that you haven't evolved yet? Do you even have any? Would you go to your best gay friends wedding?Quote:
Originally Posted by speechlesstx
Nice gotcha questions. The question you should be asking is why are Obama and the Clintoons pretending to endorse gay marriage to advance their political aspirations? Clinton signed DOMA, Obama was publicly against gay marriage until the last election and Hillary telegraphed her likely evolution months ago:Quote:
Originally Posted by talaniman
Yes, that sounds like the perfect time to have been convinced by your hubby and daughter to "emerge."Quote:
But according to two sources, Clinton’s aides have privately indicated to people that she will end up where her husband and daughter, Chelsea, have emerged on the issue – in favor of same-sex nuptials.
Her circle has “indicated privately that she feels like … because of her role as the country’s chief diplomat that it was appropriate for her to stay out of this” over the last two years, said one source, who added that the message was also that as soon as she’s left Foggy Bottom “and she’s given the right opportunity, that she will end up with the rest of her clan.”
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