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Obamacare to make doctor shortage worse

WI Crippler said:
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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There's 'pay' as in = pay/reimbursement *to* the practice/hospital (etc) from patients/insurance/etc for the services/care provided.
And then there's their 'pay' - paycheck/salary.

When someone, in general, is talking about "how much Dr's are paid" - are they referring to "how much salary/weekly pay they get" Or are they referring to "how much the patient/insurance pays or reimburses for services/care provided.

Our government doesn't *pay Dr's directly* for their employment (paycheck wise).
 
Aunt Spiker said:
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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The Canadian government determines how much the doctor will be paid for a given medical service from the government-run insurance program, just like Medicare and Medicaid do here in the US. It was illegal in Canada to practice medicine outside the government system until their Supreme Court trashed that rule a few years ago, so now they are working toward two systems: those who can pay, and those who join the waiting line.

ObamaCare seeks to impose Medicare/Medicaid restrictions on the entire system. That way, Medicare and Medicaid don't look so bad by comparison with the free market system.
 
Diogenes said:
The Canadian government determines how much the doctor will be paid for a given medical service from the government-run insurance program, just like Medicare and Medicaid do here in the US. It was illegal in Canada to practice medicine outside the government system until their Supreme Court trashed that rule a few years ago, so now they are working toward two systems: those who can pay, and those who join the waiting line.

ObamaCare seeks to impose Medicare/Medicaid restrictions on the entire system. That way, Medicare and Medicaid don't look so bad by comparison with the free market system.
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Not the Canadian government but the various provincial governments.

Health care is a provincial issue in Canada. The provinces decide what medical treatments are covered by government (taxpayer) funding and which are not. If they are not covered the individual has the choice to pay for that treatment themselves.
 
1069 said:
Oh well. Plenty of fine Indian, Chinese, and Middle Eastern doctors chomping at the bit to come to the US and replace them.
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Maybe our home grown doctors have a better place to go, but I can't think of any....
 
mac said:
Then it's a good thing we've eliminated the system that promotes the best of the best.
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I don't think you understood my post. The U.S. medical system is not universally the best at everything, it is just the best at some things, just like Canada has its specialties, France, England, etc. I'm not saying Canadians went down there because it is the best; I am saying Canadians went down there because it is the best in certain procedures.

mac said:
And good news, our healthcare system is going to be just as crappy as yours in a few short years.
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Your system is already crappy, and debt-ridden to boot. You'll be lucky if in a few short years your stem is en par to Canada's, but it won't be.
 
Classic example of far-right partisan only reading half the article.

It calls for Congress to increase funding to train new doctors. "The number of medical school students continues to increase, adding 7,000 graduates every year over the next decade," the AAMC said.
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Sounds like the AAMC agenda is pretty clear.
 
Orion said:
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.

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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i think both problems could be solved by getting rid of the lisencing system we currently have in place, and instead instituting a 'bar' system similar to how we currently deal with those who are allowed to practice law.
 
The new right lies and lies and lies and lies and lies about everything but wing hen it comes to health care they exceed their normal pattern of lying. Why? When ever something seems not to make sense simply look to the money angle.

Fact time! Warning! Facts ahead! If you are a neo CON this may make your brain explode.

The highest paid MDs in the world are American.

Americans pay 3 times the world average for health care.

Currently there is no federal agency that regulates or oversees the actions of doctors and hospitals.

Over 100,000 Americans are killed each year my health care acquired infections and that is based only on what gets reported.

The leading cause of death and injury in the US is its health care system.

Given the above, the reason their is a doctor shortage as to do with money. We have IMO way too many foreign born MDs in the US and we are not graduating enough American born MDs. The shortage is artificial.
 
Mr Objective said:
The new right lies and lies and lies and lies and lies about everything but wing hen it comes to health care they exceed their normal pattern of lying. Why? When ever something seems not to make sense simply look to the money angle.

Fact time! Warning! Facts ahead! If you are a neo CON this may make your brain explode.

The highest paid MDs in the world are American.

Americans pay 3 times the world average for health care.

Currently there is no federal agency that regulates or oversees the actions of doctors and hospitals.

Over 100,000 Americans are killed each year my health care acquired infections and that is based only on what gets reported.

The leading cause of death and injury in the US is its health care system.

Given the above, the reason their is a doctor shortage as to do with money. We have IMO way too many foreign born MDs in the US and we are not graduating enough American born MDs. The shortage is artificial.
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Nope.

FASTSTATS - Leading Causes of Death
 
Diogenes said:
The Canadian government determines how much the doctor will be paid for a given medical service from the government-run insurance program, just like Medicare and Medicaid do here in the US. It was illegal in Canada to practice medicine outside the government system until their Supreme Court trashed that rule a few years ago, so now they are working toward two systems: those who can pay, and those who join the waiting line.

ObamaCare seeks to impose Medicare/Medicaid restrictions on the entire system. That way, Medicare and Medicaid don't look so bad by comparison with the free market system.
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Ok, I gotya - so in both countries the actually "salary pay" isn't determined by the government in a 'capped wage' measure.

Ok - I was thinking for some reason that Diogenes was suggesting a 'capped wage' measure which totally confused me. Thanks!
 
Orion said:
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.
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Nope nothing

The medical industry is the most powerful industry on the planet. Currently the medical industry is 20% of the US GDP and by 2020 it will be 25%. They are hiding the facts.

Here is the most comprehensive report on American Health Care. Medical Holocaust: US Health Care System is the Leading Cause of Death and Injury

Keep in mind this is all based on the self reporting of hospitals and clinics. The death toll is porbably much higher.

Infections caused by dirty and sloppy medical care kill a minimal of 100 Americans. The odds of getting a health care acquired infection today are 1 in 10.
Medical Holocaust

Doctors alone are the third leading cause of death.

Doctors are the Third Leading Cause of Death
 
Harry Guerrilla said:
Nope.

FASTSTATS - Leading Causes of Death
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These stats are a little confusing, as there's a lot of overlap.

Number of deaths for leading causes of death
Heart disease: 616,067
Cancer: 562,875
Stroke (cerebrovascular diseases): 135,952
Chronic lower respiratory diseases: 127,924
Accidents (unintentional injuries): 123,706
Alzheimer's disease: 74,632
Diabetes: 71,382
Influenza and Pneumonia: 52,717
Nephritis, nephrotic syndrome, and nephrosis: 46,448
Septicemia: 34,828
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People with diabetes die from kidney failure, heart attacks, and strokes. People with Alzheimer's die from pneumonia, nephritis, stroke. Septicemia can be caused by Cancer and Alzheimer's.

Just saying, people die because their heart stops pumping oxygen to their brain.
 
cpwill said:
i think both problems could be solved by getting rid of the lisencing system we currently have in place, and instead instituting a 'bar' system similar to how we currently deal with those who are allowed to practice law.
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What is the difference between a bar system and a licensing system?
 
Orion said:
What is the difference between a bar system and a licensing system?
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I don't think a bar system will work with doctors. An internship is a LONG term of supervised practice, to make sure that the doctors know their stuff. WE don't need any more quacks. It might be better, tho, to make lawyers serve an internship, to make sure they aren't too likely to become well educated crooks.
 
Ask and old time GP what's wrong with US health care and you will get a lot good answers.

Medicine went from a profession that regulated itself to and industry that is anarchy.
 
hazlnut said:
These stats are a little confusing, as there's a lot of overlap.

People with diabetes die from kidney failure, heart attacks, and strokes. People with Alzheimer's die from pneumonia, nephritis, stroke. Septicemia can be caused by Cancer and Alzheimer's.

Just saying, people die because their heart stops pumping oxygen to their brain.
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Those things are largely not the fault of a medical care system, unless you are demanding immediate perfection.
If that's the case, no one can help you.
 
Mr Objective said:
Nope nothing

The medical industry is the most powerful industry on the planet. Currently the medical industry is 20% of the US GDP and by 2020 it will be 25%. They are hiding the facts.

Here is the most comprehensive report on American Health Care. Medical Holocaust: US Health Care System is the Leading Cause of Death and Injury

Keep in mind this is all based on the self reporting of hospitals and clinics. The death toll is porbably much higher.

Infections caused by dirty and sloppy medical care kill a minimal of 100 Americans. The odds of getting a health care acquired infection today are 1 in 10.
Medical Holocaust

Doctors alone are the third leading cause of death.

Doctors are the Third Leading Cause of Death
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If you're only source of information is a blog website with a Nazi flag on it, I feel sorry for you.
 
Orion said:
What is the difference between a bar system and a licensing system?
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one "funnels" doctoral candidates through specific institutions which can be controlled; the size of the funnel can thus be enlargened or shrunk to fit the preferences of those who benefit from a (not too severe) doctor shortage.

a bar system, however, states that anybody who demonstrates the knowledge becomes a candidate. suddenly, you don't have to go through AMA "approved" schools who only take "the approved" number of students. you just have to actually know enough medicine to practice it effectively.



as for mr 'objective';

if you are worried about picking up infection from the medical establishment; then you need to be worried about increased socialization of healthcare, not reduced.
 
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Mr Objective said:
The new right lies and lies and lies and lies and lies about everything but wing hen it comes to health care they exceed their normal pattern of lying. Why? When ever something seems not to make sense simply look to the money angle.

Fact time! Warning! Facts ahead! If you are a neo CON this may make your brain explode.

A: The highest paid MDs in the world are American.

B: Americans pay 3 times the world average for health care.

C: Currently there is no federal agency that regulates or oversees the actions of doctors and hospitals.

D: Over 100,000 Americans are killed each year my health care acquired infections and that is based only on what gets reported.

E: The leading cause of death and injury in the US is its health care system.

Given the above, the reason their is a doctor shortage as to do with money. We have IMO way too many foreign born MDs in the US and we are not graduating enough American born MDs. The shortage is artificial.
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A: In general, yes, but not for specialists...
crsdoctors.jpg


B: Inncorrect. As a % of GPD, it's just over 2 times, not 3. LINK High, but not as high as you make it out to be.

C: True. This is handled at the state level. ALL states have regulatory boards that oversee the actions of doctors and hospitals.

D: Again, your 'estimate' is high. According to the CDC, 'The estimated deaths associated with HAIs in U.S. hospitals were 98,987' LINK Still way too high, but not as high as you imply. And again, still an 'estimate', not a hard number.

E: Simple nonsense. In 2009, data collected by the CDC attributes 616, 067 deaths to heart disease, NOT the U.S. healthcare system. LINK
 
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but the good news is, if you still live with your parents and aren't 26 yet, you can ride free on their insurance...
That might keep your kids at home longer, assuming any parent is wanting such a thing...:2razz:
 
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that is real world. Obamacarehas been tried before; with results that were the opposite of what was promised byits advocates.
 
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