[speechlesstx]

My apologies.

07 is not 70 or 71

Tut

No problem. Take care.

[speechlesstx]

Intended or unintended consequence of Obamacare?

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.

“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 Obama

Unless he's off the clock...

[excon]

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

[talaniman]

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.

[speechlesstx]

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

Right, Obamacare will prevent doctors from getting obscenely rich and shift it to big health care corporations getting obscenely rich.

[smearcase]

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.

[speechlesstx]

Democrat policy is largely based on wishful thinking.

[smearcase]

Hope is not a strategy.

[speechlesstx]

No, it's a campaign slogan.

[excon]

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

[tomder55]

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.

[tomder55]

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

There will be other worse access issues due to service shortage.

[speechlesstx]

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 gonna take a few years to get it right.

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.

[talaniman]

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.

[speechlesstx]

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.

[talaniman]

You didn't give a rats patoot before Obama was elected? Now everything is wrong and its his fault.

[tomder55]

You didn't give a rats patoot before Obama was elected? Now everything is wrong and it his fault.

On the contrary... I've been calling for tort reform for years.

[speechlesstx]

You didn't give a rats patoot before Obama was elected?

Of course I did.

Now everything is wrong and its his fault.

If the shoe fits.

[talaniman]

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.

[speechlesstx]

I like his idea better than yours. Oh thats 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?"

I answered what you asked. Try and keep up.