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Obamacare to make doctor shortage worse

cpwill

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....as predicted.




The Association of American Medical Colleges' Center for Workforce Studies released new estimates that showed shortages would be 50 percent worse in 2015 than forecast.

"While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025," the group said in a statement...

The AAMC projected a shortage of 33,100 physicians in specialties such as cardiology, oncology and emergency medicine in 2015... Other groups, such as the nonprofit Rand Corporation and the Institute of Medicine, have also projected various physician shortages.





as we pointed out at the beginning of his whole thing; price controls always backlash. and you can't increase demand, decrease supply, and expect prices to go down.
 
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cubbies2ws

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Yeah that's strange how the natural market forces aren't doing what Obama wants. It's difficult to control parts of the economy to get the exact results you want. I believe in light economic regulation (minimum wage, etc.) but it seems to me that the only options that work are to NOT control the economy (wtf?) or to COMPLETELY control the economy.
 

Aunt Spiker

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That's what happens when you turn a challenging and personally demanding career choice into something bad.

And now everyone has to suffer for it.
 
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reefedjib

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Way to Change, Obama!
 

1069

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....as predicted.




The Association of American Medical Colleges' Center for Workforce Studies released new estimates that showed shortages would be 50 percent worse in 2015 than forecast.

"While previous projections showed a baseline shortage of 39,600 doctors in 2015, current estimates bring that number closer to 63,000, with a worsening of shortages through 2025," the group said in a statement...

The AAMC projected a shortage of 33,100 physicians in specialties such as cardiology, oncology and emergency medicine in 2015... Other groups, such as the nonprofit Rand Corporation and the Institute of Medicine, have also projected various physician shortages.





as we pointed out at the beginning of his whole thing; price controls always backlash. and you can't increase demand, decrease supply, and expect prices to go down.
Oh well. Plenty of fine Indian, Chinese, and Middle Eastern doctors chomping at the bit to come to the US and replace them.
 

Orion

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Oh well. Plenty of fine Indian, Chinese, and Middle Eastern doctors chomping at the bit to come to the US and replace them.
Their re-certification on U.S. soil is not cheap. Fewer will come if the payoff is not worth it afterward.

The U.S. system has been a cash cow for private doctors for a long time now. It has been the bane of the Canadian medical system... students graduate using Canadian tuition fees, then go down to the U.S. and make big bucks.

This is good news for us. :)
 

Alvin T. Grey

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Their re-certification on U.S. soil is not cheap. Fewer will come if the payoff is not worth it afterward.

The U.S. system has been a cash cow for private doctors for a long time now. It has been the bane of the Canadian medical system... students graduate using Canadian tuition fees, then go down to the U.S. and make big bucks.

This is good news for us. :)
Blame the A.M.A. for that.
 

Diogenes

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It has been the bane of the Canadian medical system... students graduate using Canadian tuition fees, then go down to the U.S. and make big bucks.

This is good news for us. :)
Damn straight! Every Canadian health care professional who is good enough to compete comes down here to practice, and every Canadian wealthy enough to afford it comes down here for care.

And sometimes even the Canadian government sends them down here. Last year a woman in Calgary who had been taking fertility treatments came down with a case of quadruplets. Multiples are generally premature, and preemies need incubators. Calgary (pop. 1,000,000) did not have four incubators, so the Canadian health authorities sent her to Great Falls, MT (pop. 50,000) which did have the necessary equipment. I have also heard that the hospitals in Detroit and Buffalo do a booming business as subcontractors to the Canadian health system.
 

Orion

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Damn straight! Every Canadian health care professional who is good enough to compete comes down here to practice, and every Canadian wealthy enough to afford it comes down here for care.

And sometimes even the Canadian government sends them down here. Last year a woman in Calgary who had been taking fertility treatments came down with a case of quadruplets. Multiples are generally premature, and preemies need incubators. Calgary (pop. 1,000,000) did not have four incubators, so the Canadian health authorities sent her to Great Falls, MT (pop. 50,000) which did have the necessary equipment. I have also heard that the hospitals in Detroit and Buffalo do a booming business as subcontractors to the Canadian health system.
The myth that Canadians flock to the U.S. for proper care has been thoroughly debunked, although the American right-wing continues to perpetuate this lie. It's true that Canadians always have the choice to go south if they want, but they don't do it because of lack of facilities up here. The U.S. may have some of the most experienced doctors in the world in certain procedures, so people go to seek the best of the best. Canada also has doctors in specific fields who are considered the best at what they do, and Canadian hospitals host many foreigners who come from far and wide to get procedures done by the best doctors.

Just because wealthy people have money to travel and see the best of the best, that doesn't mean they always do. People who decide to stay in Canada can still get good treatment. It's not like the care isn't available.

As for the subcontractor comment... I would like to see proof of that.
 

Deuce

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Gee, if only there were some way to match the increase in demand for doctors. Like, some way for there to be more doctors. A supply of doctors, if you will.
 

Orion

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Gee, if only there were some way to match the increase in demand for doctors. Like, some way for there to be more doctors. A supply of doctors, if you will.
Ding ding ding :D
 

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Damn straight! Every Canadian health care professional who is good enough to compete comes down here to practice, and every Canadian wealthy enough to afford it comes down here for care.

And sometimes even the Canadian government sends them down here. Last year a woman in Calgary who had been taking fertility treatments came down with a case of quadruplets. Multiples are generally premature, and preemies need incubators. Calgary (pop. 1,000,000) did not have four incubators, so the Canadian health authorities sent her to Great Falls, MT (pop. 50,000) which did have the necessary equipment. I have also heard that the hospitals in Detroit and Buffalo do a booming business as subcontractors to the Canadian health system.
Maybe the problem isn't that we pay too much - maybe it's that Canada doesn't pay enough, then?

Just how much is *enough* for someone who is suppose to be perfect, never make mistakes, and save your life - at a moment's notice?
 

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Maybe the problem isn't that we pay too much - maybe it's that Canada doesn't pay enough, then?
It's not just spending, it's government monopoly control that's the problem. No government - anywhere on the planet, at any time in history - has ever demonstrated the slightest competence in delivering retail consumer goods and services.

In the production sector, governments are way too conservative, and spend their time protecting last year's jobs at the expense of next year's products. In the service sector (medicine, for example, or the DMV) the service providers work for a bureaucrat supervisor, *not* for the customer, and without the competition of a free market there is no way for the customer to hold the service provider accountable.

Government enterprises have no incentive to become efficient and they all respond to pressure the same way: hand over more money, or we'll cut back the service.
 

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Ding ding ding :D
It's crazy that I would even have to mention this. People are talking about an increase in demand for doctors as if that were a bad thing. What, like the solution to doctor shortages and long waits is to have people just not go to the doctor? Pretty sure we want that trend to go the other way, America!
 

Orion

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It's crazy that I would even have to mention this. People are talking about an increase in demand for doctors as if that were a bad thing. What, like the solution to doctor shortages and long waits is to have people just not go to the doctor? Pretty sure we want that trend to go the other way, America!
It's simpler to just call it socialism and move on.

Seriously... the number of medical schools in the U.S. has dropped by something like 75% in the past 80 years. The other way to decrease costs is to create more doctors, thus driving down the cost of care. There are many parts of the world where being a doctor is not a rich person's job. Iran is one example. The medical field has reached saturation. I don't see why we can't do that here.
 

cpwill

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Oh well. Plenty of fine Indian, Chinese, and Middle Eastern doctors chomping at the bit to come to the US and replace them.
just like they do in Britain already.


only problem; those medical schools don't always insist on the same standards and demanding curriculum as our own.


oh well. hopefully the ever-benificent-government will bless me with permanent social security after one of them accidentally cripples me


:)
 

cpwill

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Gee, if only there were some way to match the increase in demand for doctors. Like, some way for there to be more doctors. A supply of doctors, if you will.
see, usually supply rises to meet demand.... because demand is allowed to reflect in price.


but when you artifically depress price (or increase the likelihood that you will); then supply does not rise to meet demand.


because supply wasn't reacting to demand in the first place. it was reacting to price signals.
 

cpwill

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The myth that Canadians flock to the U.S. for proper care has been thoroughly debunked, although the American right-wing continues to perpetuate this lie. It's true that Canadians always have the choice to go south if they want, but they don't do it because of lack of facilities up here.
:lol: there are more MRI machines in the city of Atlanta, Georgia, than there are in all of Canada. the shortage in particular of OB/GYN's in Canada is legendary.

Just because wealthy people have money to travel and see the best of the best, that doesn't mean they always do. People who decide to stay in Canada can still get good treatment. It's not like the care isn't available.
what did the Canadian Supreme Court say about this?

oh yeah. Access to a Waiting List is not Access to Healthcare
 

cpwill

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It's simpler to just call it socialism and move on.

Seriously... the number of medical schools in the U.S. has dropped by something like 75% in the past 80 years. The other way to decrease costs is to create more doctors, thus driving down the cost of care. There are many parts of the world where being a doctor is not a rich person's job. Iran is one example. The medical field has reached saturation. I don't see why we can't do that here.
:) because our medical field is a guild; you could call it partial unionization, if you will. the number of doctors entering the system is controlled by the medical field, which seeks deliberately to keep a shortage of supply in order to keep price high.
 

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:) because our medical field is a guild; you could call it partial unionization, if you will. the number of doctors entering the system is controlled by the medical field, which seeks deliberately to keep a shortage of supply in order to keep price high.
Yes I know, and I disagree with this practice. Medicine is supposed to be about healing first, but the medical industry is now just about maximizing profits. There should be more doctors, period. I am willing to compromise by not raising the supply to much higher levels, but it still needs to be raised.

cpwill said:
only problem; those medical schools don't always insist on the same standards and demanding curriculum as our own.
They still have to go through re-certification in America, unless they come from a country whose standards are deemed acceptable. China and India usually don't qualify. And I don't know about the cost in the U.S., but in Canada it is typically tens of thousands of dollars to re-certify, and it takes years. A woman at my school who is from Iran, her husband is doing just that right now. It is costing them dearly, but the pay off (to them) is worth it.

The system should have quality control, but IMO it is currently overkill. It has become so elitist that they will do anything to limit supply, including creating high barriers to entry for foreigners as well. I also hate to break it them, but when it comes to chronic diseases, western medicine is not that special. The monopoly needs to be broken.
 

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The whole argument breaks down to quality vs. quantity. Here in America, we love(and rightly so IMO) our specialists. Specialized healthcare, also known as tertiary care, costs more and does so for a reason. It is advanced knowledge and skill that is specified. The general practitioner kind of gets the end around here in America, but that is because they are incapable of delivering the high level of care a specialist does. The downfall is that people could use GPs more efficiently to diagnose smaller issues. There is not really a need to see an orthopedist for a sprained ankle or sore knee. Going to a primary care facility is cheaper, and even using secondary care like therapy can help without incurring the increased cost of a specialists office visit. And those practitioners can recognize the signs and symptoms that is beyond their scope and refer them to the specialists.

The way things are set up, it is advantageous for any medical student to specialize. Institutions, private and government, will pay for their students to go specialize in return for so many years of employment. This is true even for some non-doctoral healthcare degrees like nursing, therapy, etc.... Having specialists on staff at a hospital is advantageous because you increase the level of care that a hospital can provide. If you have the right kind of specialists your hospital can become a high level trauma care, a burn center, a cancer center etc..... IMO it is better to have quality over quantity to a certain degree.

One of the popular arguments is to slash our military spending in half and use that money for healthcare. US military spending accounts for something like 12 or 16 percent of the budget and entitlement spending accounts for over 50%. Taking and adding 6-8% to our healthcare budget isn't going to change anything, its just going to throw more money down a black hole of bueracracy. What will have to change is people's desire for specialists, and the only way that will happen is if the government steps in and either severely limits specialists, or encourages an influx of GPs. I'd be against the former, but I could support the latter if only for the ability for early diagnosis and referral capability for situations beyond their control.
 
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Aunt Spiker

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It's not just spending, it's government monopoly control that's the problem. No government - anywhere on the planet, at any time in history - has ever demonstrated the slightest competence in delivering retail consumer goods and services.

In the production sector, governments are way too conservative, and spend their time protecting last year's jobs at the expense of next year's products. In the service sector (medicine, for example, or the DMV) the service providers work for a bureaucrat supervisor, *not* for the customer, and without the competition of a free market there is no way for the customer to hold the service provider accountable.

Government enterprises have no incentive to become efficient and they all respond to pressure the same way: hand over more money, or we'll cut back the service.
Maybe I just don't quite understand something, here - does the Canadian government provide for the Dr's pay? (I didn't think they did but your post now has me confused) - or are you refering to the government's deep involvement and continuing dictation and control over *how things work* (through legislation, etc?)

In the US we're privatized. The government does not cut the Dr's paycheck and the government has no right or control over anyone's pay *unless* they're government. The government can try to dictate (regulate, reform) - but they can't cap salaries unless there's a significant stake in the company (like - having given massive bailouts)
 

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In the US we're privatized. The government does not cut the Dr's paycheck and the government has no right or control over anyone's pay *unless* they're government. The government can try to dictate (regulate, reform) - but they can't cap salaries unless there's a significant stake in the company (like - having given massive bailouts)
Actually in the US, when it comes to "doctor's pay" its all handled much the same whether it is government run (Medicare) or pirvate(insurance). Doctors agree to a fee for services with whomever they do business with. So Medicare reimburses for a hip surgery the same for each surgery performed by that doctor. And each insurance company agrees to a contract with practitioners for whatever services they provide and it can vary based on whether the doctor is part of a PPO, HMO, or out of network. Now when you get into large corporate hospitals and all that, it complicates things as to how much a doctor gets paid as thats getting into more business side of things with regards to investments etc... but that's generally the basics of how people get paid in healthcare. The disadvantage of a single healthcare reimburser ala socialized healthcare, is that you are stuck with whatever fees that are decided upon. So when it comes time to talk fiscal responsibility and spending controls, you can get ****ed in the ass once they turn their sights to your practice and have no competition to turn to. At least with private insurance, you know that decisions are always made on the premise of maintaining profit. I'd hate to see all of our healthcare become a political issue that can sway in the wind with elections, ala Medicare.
 

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The myth that Canadians flock to the U.S. for proper care has been thoroughly debunked, although the American right-wing continues to perpetuate this lie. It's true that Canadians always have the choice to go south if they want, but they don't do it because of lack of facilities up here. The U.S. may have some of the most experienced doctors in the world in certain procedures, so people go to seek the best of the best. Canada also has doctors in specific fields who are considered the best at what they do, and Canadian hospitals host many foreigners who come from far and wide to get procedures done by the best doctors.

Just because wealthy people have money to travel and see the best of the best, that doesn't mean they always do. People who decide to stay in Canada can still get good treatment. It's not like the care isn't available.

As for the subcontractor comment... I would like to see proof of that.
Then it's a good thing we've eliminated the system that promotes the best of the best. And good news, our healthcare system is going to be just as crappy as yours in a few short years.
 
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