USA's 1 million-doctor shortage upon us...

[Helix]

Thanks.. been there seen that.

Now. here is something for you to look at:

One-third of Americans -- or 78.6 million -- are classified as obese according to a paper published in 2014 in The Journal of the American Medical Association.
The average rate of obesity across Europe is one in six adults




Gee Helix could having DOUBLE the obesity rate of Europeans, and the resulting complication be the main factor in our costs?
Any objective person would realize that. but not you.. of course not.. its our system.. why it has to be.. even though there is wide variations within countries with the same system.

What about stress and work hours? any difference there?

America can learn from Europe on work-life balance - CNN.com

Gee what does working hours/stress have on health.

Forbes Welcome

How about a sedentary lifestyle?



Could that be contributing to our healthcare costs?

Of course not.. its got to be a system right Helix?

Come on.. be objective for once.

yes, because you've been the absolute image of objectivity during these past fifty threads, lol. have you considered for a moment that many people might actually be avoiding preventative care and regular checkups because of the potential cost? that they only get treatment when they have to for the same reason? my guess is that it hasn't, because you don't seem to live in that world. and, once again, it's job and location dependent. some people might have the whole thing covered. some might have insurance that is pretty much worthless. that's a dumb system, considering that we have to pay for primary care at emergency rooms once the illness becomes situation critical.

either way, we've been over all of this before five hundred times, so it's pointless by now. believe whatever you like.

 

[jaeger19]

yes, because you've been the absolute image of objectivity during these past fifty threads, lol. have you considered for a moment that many people might actually be avoiding preventative care and regular checkups because of the potential cost? that they only get treatment when they have to for the same reason? my guess is that it hasn't, because you don't seem to live in that world. and, once again, it's job and location dependent. some people might have the whole thing covered. some might have insurance that is pretty much worthless. that's a dumb system, considering that we have to pay for primary care at emergency rooms once the illness becomes situation critical.

either way, we've been over all of this before five hundred times, so it's pointless by now. believe whatever you like.

Actually yes, Helix I have been the absolute image of objectivity these past fifty threads.

Point of fact.. multiple times have I pointed out that I think America SUCKS when it comes to preventative medicine. Now ironically.. that's somewhat of a misnomer since we still score (using your data) higher on preventative medicine than most OECD countries..

that actually surprises me.

Now.. to point out.. the two worst insurances to have for preventative medicine are in general VA and Medicaid. Two government programs. With Medicare falling somewhere in the middle of the pack.

Yet you ignore this fact and think that if we simply went to a government system.. it will be great. So please explain to me.. why you think the government will be great at preventative medicine when two of its programs are terrible at preventative medicine?

See.. I live in the real world.. and apparently you don't. Its very frustrating to me, that almost every day.. I have a patient with Medicaid, that we could do a simple thing now.. that's much cheaper.. but instead.. Medicaid won't approve it until it gets so bad that they need a much more expensive procedure.

So while I live in the real world. You seem to believe that the same government that's screwing up when it comes to preventative medicine , is going to suddenly do a 180 and create a system that is great at preventative medicine.

And whats worse..you don't even understand WHY the government does this. It does this because its trying to REDUCE COSTS. It thinks by having these roadblocks to care.. its going to decrease costs.

And that's what you want right? Decreasing costs.

Either way.. we have been over all of this 5oo times.. so its pointless by now... you will believe what you want regardless of facts or logic..

 

[Helix]

Actually yes, Helix I have been the absolute image of objectivity these past fifty threads.

Point of fact.. multiple times have I pointed out that I think America SUCKS when it comes to preventative medicine. Now ironically.. that's somewhat of a misnomer since we still score (using your data) higher on preventative medicine than most OECD countries..

that actually surprises me.

Now.. to point out.. the two worst insurances to have for preventative medicine are in general VA and Medicaid. Two government programs. With Medicare falling somewhere in the middle of the pack.

Yet you ignore this fact and think that if we simply went to a government system.. it will be great. So please explain to me.. why you think the government will be great at preventative medicine when two of its programs are terrible at preventative medicine?

See.. I live in the real world.. and apparently you don't. Its very frustrating to me, that almost every day.. I have a patient with Medicaid, that we could do a simple thing now.. that's much cheaper.. but instead.. Medicaid won't approve it until it gets so bad that they need a much more expensive procedure.

So while I live in the real world. You seem to believe that the same government that's screwing up when it comes to preventative medicine , is going to suddenly do a 180 and create a system that is great at preventative medicine.

And whats worse..you don't even understand WHY the government does this. It does this because its trying to REDUCE COSTS. It thinks by having these roadblocks to care.. its going to decrease costs.

And that's what you want right? Decreasing costs.

Either way.. we have been over all of this 5oo times.. so its pointless by now... you will believe what you want regardless of facts or logic..

i'm arguing that we should enact a custom fit solution based on systems that are working more efficiently than ours, not that we should enact some half measure like medicaid or the ACA which can be choked to death depending on which way the state or nation leans at any given moment. the data shows that this strategy works better than our current hodgepodge system. i've posted that data over countless threads. however, you're still welcome to produce a Canadian who genuinely supports fully replacing the Canadian system with the American setup. that's about the only thing you could do at this point which would make our five hundredth regurgitation of the same topic interesting. i'm looking forward to explaining to that poster what he or she is signing up for.

 

[jaeger19]

i'm arguing that we should enact a custom fit solution based on systems that are working more efficiently than ours, not that we should enact some half measure like medicaid or the ACA which can be choked to death depending on which way the state or nation leans at any given moment. the data shows that this strategy works better than our current hodgepodge system. i've posted that data over countless threads. however, you're still welcome to produce a Canadian who genuinely supports fully replacing the Canadian system with the American setup. that's about the only thing you could do at this point which would make our five hundredth regurgitation of the same topic interesting. i'm looking forward to explaining to that poster what he or she is signing up for.

Yeah.. that's a nuanced position for you. up to know its been on your part.. "we need single payer like Canada/Europe".

Sure we can make a custom fit solution. I fully support that. However, to get where we need to be.. we don't have to end up with a single payer system that provides WORSE care than in the US.
Your numbers:
Quality of care : US higher than Canada
Effectiveness of care: US higher than Canada
Timeliness of care: US higher than Canada.;

You are still welcome to produce anything that suggests that americans want a single payer system that's worse than what they have now.

You have to convince the US people that your system is better.. not Canadians. There is a reason that a person lives in Canada and not the US. there is a reason that I and others live in the US and not Canada and that's because we like our systems better.

 

[Helix]

Yeah.. that's a nuanced position for you. up to know its been on your part.. "we need single payer like Canada/Europe".

that's my preference. however, i'd settle for a custom fit solution from the best parts of health care systems that don't produce metrics like this :

Sure we can make a custom fit solution. I fully support that. However, to get where we need to be.. we don't have to end up with a single payer system that provides WORSE care than in the US.

well, then perhaps there is room for compromise.

Your numbers:
Quality of care : US higher than Canada
Effectiveness of care: US higher than Canada
Timeliness of care: US higher than Canada.;

You are still welcome to produce anything that suggests that americans want a single payer system that's worse than what they have now.

so, i'll take that as an admission that you can't produce a Canadian who would agree to swap systems. which i already knew, because they are a rare breed.

You have to convince the US people that your system is better.. not Canadians. There is a reason that a person lives in Canada and not the US. there is a reason that I and others live in the US and not Canada and that's because we like our systems better.

some do. and once again, that depends on where you live, how much or little you earn, and where you work.

 

[jaeger19]

that's my preference. however, i'd settle for a custom fit solution from the best parts of health care systems that don't produce metrics like this :

The problem is that you aren't willing to realize that the metric that you are pointing out has more to do with the cultural demographics , than it does healthcare system. that's why there is differences, large differences between countries with the same type of systems.

so, i'll take that as an admission that you can't produce a Canadian who would agree to swap systems. which i already knew, because they are a rare breed.

No.. take it as I don't care. And neither do most americans. There is a reason that Canadian's live in Canada and Americans live in America. Because one country likes their system is not an indicator of how well it will be liked in the US. There are many differences between countries that individuals would not change.. that's why they live there in the first place. And the Canadians I have treated all like their system in general and can step out and get treated in the US when they want to avoid the time constraints or choose their doctor.
Like other countries healthcare systems where the wealthy and upper middle class can step out of the public system.

Just because Canadians like their system is no indication that its a good thing for the US.
Find me a Brit on the gun debate that would trade their firearms policy with ours. Would you claim that we should go the British system of gun control because as a country they like their system? Somehow I doubt it. And not its not an irrelevant question.. its relevant because its using the same rationale that you are using.

some do. and once again, that depends on where you live, how much or little you earn, and where you work

No not really. The vast majority don't want a Canadian like system, not "some". And that's because for the vast vast majority it works rather well.

 

[Helix]

The problem is that you aren't willing to realize that the metric that you are pointing out has more to do with the cultural demographics , than it does healthcare system. that's why there is differences, large differences between countries with the same type of systems.

then let's toss ours out in favor of a combination of what works in Canada and a few other nations. it will still be miles better than the employment / location / income specific inefficient hodgepodge that we have now.

No.. take it as I don't care. And neither do most americans. There is a reason that Canadian's live in Canada and Americans live in America. Because one country likes their system is not an indicator of how well it will be liked in the US. There are many differences between countries that individuals would not change.. that's why they live there in the first place. And the Canadians I have treated all like their system in general and can step out and get treated in the US when they want to avoid the time constraints or choose their doctor.
Like other countries healthcare systems where the wealthy and upper middle class can step out of the public system.

Just because Canadians like their system is no indication that its a good thing for the US.

not only would they not trade us, the average Canadian would probably consider cutting off a finger to avoid swapping systems. (for Canadians, an emergency room visit for a laceration on one of your digits can cost as much as $1,800 to $1,900 out of pocket. and that's with insurance. depending, of course, on where you live and where you work. if that sounds like a derp way of providing health care, well, ding ding ding!)

Find me a Brit on the gun debate that would trade their firearms policy with ours. Would you claim that we should go the British system of gun control because as a country they like their system? Somehow I doubt it. And not its not an irrelevant question.. its relevant because its using the same rationale that you are using.

not analogous. i can live without owning a gun just fine. the same cannot be said for health care. it is an essential service with inelastic demand.

No not really. The vast majority don't want a Canadian like system, not "some". And that's because for the vast vast majority it works rather well.

as evidenced by the charts and data i've posted, i'd have to disagree with a blanket statement like that. we can do better.

 

[jaeger19]

then let's toss ours out in favor of a combination of what works in Canada and a few other nations. it will still be miles better than the employment / location / income specific inefficient hodgepodge that we have now.
.

But your missing the point that considering our demographics.. that any system is not going to make improvements. You keep saying.. "it will be miles better"... but that's simply not rational based on the evidence.

With our demographics of obesity, stress, sedentary lifestyles and other cultural factors.. our system may actually be BETTER at handling our population demographics than another system.

Switching to other systems may actually make the problem worse. Not just because our government has not shown the propensity to be good at such things (considering the facts of Medicaid and VA). But also because these systems may simply getting "better results" than the US because their population is not as obese, etc.

not only would they not trade us, the average Canadian would probably consider cutting off a finger to avoid swapping systems. (for Canadians, an emergency room visit for a laceration on one of your digits can cost as much as $1,800 to $1,900 out of pocket. and that's with insurance. depending, of course, on where you live and where you work. if that sounds like a derp way of providing health care, well, ding ding ding!)

Again.. so? I would bet the Canadians would not swap most of their lifestyle with the US either. That's WHY THEY LIVE THERE and not the US. You have a non argument there Helix.

not analogous. i can live without owning a gun just fine. the same cannot be said for health care. it is an essential service with inelastic demand.

Sure it is. It illustrates the lack of validity in your argument that a system in another country is superior to the US because the people that live in that country like it.

Brits in general like their firearms laws in their country (surprise surprise since its their country). Just because they like that.. does not mean that we in America should adopt it.

You are making the argument that because another country likes their system.. its better than the US.

as evidenced by the charts and data i've posted, i'd have to disagree with a blanket statement like that. we can do better.

Based on the charts and data you've posted, if you are objective, you have to agree with that statement. America.. using YOUR OWN DATA and charts you have posted.. does very well when it comes to healthcare . We have better effective care, quality of care, timeliness of care so on and so forth. Where YOUR DATA.. points out where we do poorly are things which are effected by our uninsured population. Things like preventative medicine, and equity of care.
In other words.. for the vast majority of our population.. which is insured the system works pretty darn fine.

That's the facts. Can we do better? Absolutely. Largely in how we handle insurance so that we can make it affordable to the rest of the population and make it portable. But those are really relatively easy fixes (easy ideas.. though hard to get based the insurance lobby).

If we want improvement in the healthcare system.. we need people to really understand the healthcare system and insurance.. and not simply be guided as you have been.. purely by emotion and ideology. if we let emotion and ideology guide any changes.. we will certainly end up with a system that's worse for the majority of people.

 

[Helix]

But your missing the point that considering our demographics.. that any system is not going to make improvements. You keep saying.. "it will be miles better"... but that's simply not rational based on the evidence.

that's an utterly ridiculous claim. refer to the mountain of data that i've posted over the course of our long disagreement on this topic.

With our demographics of obesity, stress, sedentary lifestyles and other cultural factors.. our system may actually be BETTER at handling our population demographics than another system.

the entirety of the problems in our health care system cannot be boiled down to, "well, people are fat." our system is demonstrably inefficient, and can certainly be improved.

Switching to other systems may actually make the problem worse. Not just because our government has not shown the propensity to be good at such things (considering the facts of Medicaid and VA). But also because these systems may simply getting "better results" than the US because their population is not as obese, etc.

I'm willing to take the risk.

Again.. so? I would bet the Canadians would not swap most of their lifestyle with the US either. That's WHY THEY LIVE THERE and not the US. You have a non argument there Helix.

because you say so? well, i guess we'll just have to disagree on that point.

Sure it is. It illustrates the lack of validity in your argument that a system in another country is superior to the US because the people that live in that country like it.

no, it doesn't. refer to the charts and data that i've posted which more than defends my position.

Brits in general like their firearms laws in their country (surprise surprise since its their country). Just because they like that.. does not mean that we in America should adopt it.

already addressed in my previous post.

You are making the argument that because another country likes their system.. its better than the US.

also because it works better and more efficiently.

Based on the charts and data you've posted, if you are objective, you have to agree with that statement. America.. using YOUR OWN DATA and charts you have posted.. does very well when it comes to healthcare . We have better effective care, quality of care, timeliness of care so on and so forth. Where YOUR DATA.. points out where we do poorly are things which are effected by our uninsured population. Things like preventative medicine, and equity of care.
In other words.. for the vast majority of our population.. which is insured the system works pretty darn fine.

if by "fine," you mean that it's so ****ing expensive that they generally get care when there's no other option (unless they have a great job, are poor enough to qualify for Medicaid, etc.,) then sure. we are most certainly kicking ass.

That's the facts. Can we do better? Absolutely. Largely in how we handle insurance so that we can make it affordable to the rest of the population and make it portable. But those are really relatively easy fixes (easy ideas.. though hard to get based the insurance lobby).

i support handling the insurance issue by covering everyone by default so that they don't need to purchase private insurance unless they want to.

If we want improvement in the healthcare system.. we need people to really understand the healthcare system and insurance.. and not simply be guided as you have been.. purely by emotion and ideology. if we let emotion and ideology guide any changes.. we will certainly end up with a system that's worse for the majority of people.

i've supported my argument with facts, charts, and data. while it might be convenient for you to claim that my argument is solely emotional, that would be a strawman.

i'm willing to devote about one more post of my time to this utterly fruitless debate, and then you can respond and we'll leave it at that for good.

 

[jaeger19]

that's an utterly ridiculous claim. refer to the mountain of data that i've posted over the course of our long disagreement on this topic.

\

That's a completely valid claim. Refer to the mountain of data that you have posted. PLEASE.. PLEASE refer to your data and notice that countries with SIMILAR SYSTEMS vary widely in costs, health etc. A large portion of that is because of demographics, culture etc. And the US has some of the worst health demographics in the first world.

the entirety of the problems in our health care system cannot be boiled down to, "well, people are fat." our system is demonstrably inefficient, and can certainly be improved.

Well.. when you find someone who states that all our problems are well people are fat.. then I will disagree with them as well. I never stated that. However, the facts are that a lot of our costs and health determiners DO come from our demographics such as obesity, stress, work hours etc. You don't want to even recognize that fact. You even ignore your own evidence that shows that similar systems can have wide variations as well.

Can our system be improved? Certainly.. but by understanding what we can do and what we can't.

because you say so? well, i guess we'll just have to disagree on that point.
[/QUOTE
no because your rationale is not valid. You are arguing that because a country like their own system.. its proof that its superior to the US. that's not rationale.

also because it works better and more efficiently.

False.. refer back to your own data. On quality of care.. Canada is much WORSE than the US. On effectiveness of care.. Canada scores worse. On timeliness of care... Scores worse. Much worse.

And a few other categories as well.

if by "fine," you mean that it's so ****ing expensive that they generally get care when there's no other option (unless they have a great job, are poor enough to qualify for Medicaid, etc.,) then sure. we are most certainly kicking ass.

by fine I mean on most quality of care indicators we score very high.. using your data. Which is rather great considering our demographics that are worse than in the first world countries.
By fine it means that the vast majority of americans DO NOT want the system that you want.

Yes.. when it comes to healthcare.. we do kick a little ass. that's in part why we provide roughly half of the worlds medical research and development.

i support handling the insurance issue by covering everyone by default so that they don't need to purchase private insurance unless they want to.

You must work for an insurance company. Right into their hands. A public insurance that covers the poor which the private insurance companies administer for a fat fee.. for coverage that sucks. and then the upper middle class and rich have really expensive private policies to cover them,

What happens is you get basic Medicaid which is worse than what you probably have now. and the wealthy have great insurance. Like I said worse than what the poor and middle class have now.. which is that my employees, even the ones cleaning toilets.. have the same health insurance I have.

i've supported my argument with facts, charts, and data. while it might be convenient for you to claim that my argument is solely emotional, that would be a strawman

No Helix.. no strawman from me. I am spot on. You have not supported your argument with facts, charts and data. I have used YOUR DATA and explained to you.. over and over why the conclusions you are drawing from that data are incorrect. Yet when confronted with the facts.. you continue to argue emotion.

Remember your previous post. "they are better and more efficient"..

Canada scores lower on QUALITY. LOWER on EFFECTIVE CARE. LOWER ON TIMELINESS.

Sorry but that's not "better and more efficient"..

As far as strawman.. look to yourself... try and find where I ever summed up healthcare issues as "we are all fat"...

If you want to actually learn something about healthcare.. and have a logical discussion on fixes, and problems.. I am here.

 

[Helix]

\

That's a completely valid claim. Refer to the mountain of data that you have posted. PLEASE.. PLEASE refer to your data and notice that countries with SIMILAR SYSTEMS vary widely in costs, health etc. A large portion of that is because of demographics, culture etc. And the US has some of the worst health demographics in the first world.

if the rest of the first world can solve the problem, so can we.

Well.. when you find someone who states that all our problems are well people are fat.. then I will disagree with them as well. I never stated that. However, the facts are that a lot of our costs and health determiners DO come from our demographics such as obesity, stress, work hours etc. You don't want to even recognize that fact. You even ignore your own evidence that shows that similar systems can have wide variations as well.

Can our system be improved? Certainly.. but by understanding what we can do and what we can't.

we can provide universal health care without using our current stupid "primary care at emergency rooms for the uninsured" and "employer as health care provider" systems, and it would be a vast improvement.

no because your rationale is not valid. You are arguing that because a country like their own system.. its proof that its superior to the US. that's not rationale.

i already explained why the US health care delivery system isn't better, and provided a mountain of data to support that claim.

False.. refer back to your own data. On quality of care.. Canada is much WORSE than the US. On effectiveness of care.. Canada scores worse. On timeliness of care... Scores worse. Much worse.

if Canadian health care was the horror story that the right likes to pretend it is, there's no way that they wouldn't want to trade systems.

And a few other categories as well.

by fine I mean on most quality of care indicators we score very high.. using your data. Which is rather great considering our demographics that are worse than in the first world countries.

By fine it means that the vast majority of americans DO NOT want the system that you want.

that's changing. perhaps when enough people go broke or see their kids being offered safe auto health care plans at work, they'll wake up.

Yes.. when it comes to healthcare.. we do kick a little ass. that's in part why we provide roughly half of the worlds medical research and development.

there's a lot of money in the system. i'm actually part of that, you might be surprised to learn, though i'm not going into specifics. it's my bread and butter, too, and even i can see how poorly designed that the US system is.

You must work for an insurance company. Right into their hands. A public insurance that covers the poor which the private insurance companies administer for a fat fee.. for coverage that sucks. and then the upper middle class and rich have really expensive private policies to cover them,

i don't work for an insurance company. what i support would probably hurt my job security.

What happens is you get basic Medicaid which is worse than what you probably have now. and the wealthy have great insurance. Like I said worse than what the poor and middle class have now.. which is that my employees, even the ones cleaning toilets.. have the same health insurance I have.

i don't agree.

No Helix.. no strawman from me. I am spot on. You have not supported your argument with facts, charts and data. I have used YOUR DATA and explained to you.. over and over why the conclusions you are drawing from that data are incorrect. Yet when confronted with the facts.. you continue to argue emotion.

false.

Remember your previous post. "they are better and more efficient"..

Canada scores lower on QUALITY. LOWER on EFFECTIVE CARE. LOWER ON TIMELINESS.

Sorry but that's not "better and more efficient"..

see every chart that i've ever posted.

As far as strawman.. look to yourself... try and find where I ever summed up healthcare issues as "we are all fat"...

If you want to actually learn something about healthcare.. and have a logical discussion on fixes, and problems.. I am here.

lol.

as promised, you get the last post in our fifty thread, fruitless debate. goodbye.

 

[jaeger19]

if the rest of the first world can solve the problem, so can we.

but they haven't "solved it".

The data shows that there is wide variation even with similar systems:

we can provide universal health care without using our current stupid "primary care at emergency rooms for the uninsured" and "employer as health care provider" systems, and it would be a vast improvement.

Yep.. and we can do that without a single payer system that could very very easily be worse than what people with insurance have now.

i already explained why the US health care delivery system isn't better, and provided a mountain of data to support that claim.

No.. actually you did not explain WHY the US care delivery isn't better. You provided information that the US system scores lower than other countries in SOME categories. Mainly those categories are things that are influenced by our small percentage of uninsured.

You have assumed that the why of US healthcare deliver system scoring worse in some categories is because of our system not being single payer. Yet.. you ignore the data that shows that US demographics are different, that there is wide variation among even countries with single payer, etc.

You have made an assumption that is not supported by the evidence.

if Canadian health care was the horror story that the right likes to pretend it is, there's no way that they wouldn't want to trade systems.

that's an interesting statement. Of course its a strawman because I never made that argument.

However.. lets use that premise. the counter argument is that if the US healthcare system was the "horror" that the left likes to pretend it is... then we would have single payer socialized medicine just like Canada.

that's changing. perhaps when enough people go broke or see their kids being offered safe auto health care plans at work, they'll wake up.

Yeah.. don't think so. The evidence does not support that people want to ditch their current system for socialized single payer.

i don't work for an insurance company. what i support would probably hurt my job security.

Oh I know you don't work for an insurance company. that was tongue in cheek. Its because you are falling right into what the insurance companies WANT though. They want single payer in a big way. Its perfect. Administer the crappy public plan for a fee. (like they do Medicaid and medicare). then offer private policies to the wealthy and upper middle class and skim the cream of profit.

i don't agree.

I understand that but that's not based on facts, logic or even common sense.

see every chart that i've ever posted.

See every chart you ever posted and see my explanation of that chart.. not your assumptions. You simply have not been able to rebut any of the points I have made regarding those charts.

lol.

as promised, you get the last post in our fifty thread, fruitless debate. goodbye.

Goodbye to you. I don't consider it fruitless. I think you are thinking person that probably NEVER thought of ANY of the issues that I brought up before I brought them up. From our demographics, to how we actually score on certain things with Canada and other countries. To how costs are even tallied. (for example the cost of education is lumped in healthcare costs in this country where in other countries that pay for medical education.. it doesn't count in their cost of healthcare).
To our culture when it comes to work stress.. when we retire etc. And how a system will likely look given our political situation.

You obviously aren't in a place right now where you can accept the facts. that's cool. It takes time to think about what I presented. but I hope you do a little more thinking and research.. and maybe as the healthcare reform takes place.. you don't find yourself biting into a giant crap sandwhich that you thought was going to be a Canadian bacon on lettuce and tomato.

 

[WCH]

I read a good deal of MarketWatch material, but that is some questionable journalism right there.

"And by most projections, it’s only going to get worse — the U.S. could lose as many as 1 million doctors by 2025, according to a Association of American Medical Colleges report."

The link in that statement does not say that. (I've included it here below.) All it says is demand will not be fulfilled based on our aging trends.

https://www.aamc.org/download/426260/data/physiciansupplyanddemandthrough2025keyfindings.pdf

What it says is what we have known for sometime now about the strain on the current process to become a doctor and then the business model of a doctor's practice. We already know there is a shortage of doctors in the area of primary care and several specialty disciplines, and it is well covered material that the debt one needs to acquire just to become a doctor is absurd. Another factor is ACA greatly accelerated the mechanism between primary care doctors and Insurance Companies putting downward pressure on the fees for a doctor's practice. Basically, a demand issue is artificially coupled with a business model issue.

"The primary-care gap is particularly acute in about one-third of states, which have only half or less of their primary-care needs being met."

"We pay for procedures, drugs and expensive tests, but we don’t pay doctors to think and care and manage patient health-care problems."

With baby-boomers going into retirement, something like 12000 per day retire, will place upward strain on the system where we seemingly take the primary care physician and pay them less but expect them to care for more.

The issue at hand now is finding more doctors to get through a costly 7-8 year process, including internship, to then convince them go to into the lowest paid area of medicine... join (or start) a family practice as a primary care doctor. The government screwed around in this so much that everyone else got something but the very group we need to ensure we get more of.

On the lighter-side... Healthcare Insurance companies are showing record profits, and their CEOs are making a fortune. Check Anthem.

My Dad's long time GP has limited his practice to just cash- paying customers to avoid the pitfalls of.the ACA.

 

[OrphanSlug]

My Dad's long time GP has limited his practice to just cash- paying customers to avoid the pitfalls of.the ACA.

I see doctors going in two other directions because of ACA. Either selling the practice to a Hospital Group / Chain as a means to blend billing into one larger organization with presumably more influence on contractual negotiations with health insurance companies against the charge master max rates per service code. Or, charging a premium (usually in the form of a "preferred patient" fee) that could be as high as $1000-$2000 per year from patients to remain their doctor. Either way, ACA literally changed general practice offices into a new business model.

 

[WCH]

I see doctors going in two other directions because of ACA. Either selling the practice to a Hospital Group / Chain as a means to blend billing into one larger organization with presumably more influence on contractual negotiations with health insurance companies against the charge master max rates per service code. Or, charging a premium (usually in the form of a "preferred patient" fee) that could be as high as $1000-$2000 per year from patients to remain their doctor. Either way, ACA literally changed general practice offices into a new business model.

Apparently it changes many business models and not for the better.

The ACA is designed to self-destruct.

 

[jaeger19]

I see doctors going in two other directions because of ACA. Either selling the practice to a Hospital Group / Chain as a means to blend billing into one larger organization with presumably more influence on contractual negotiations with health insurance companies against the charge master max rates per service code. Or, charging a premium (usually in the form of a "preferred patient" fee) that could be as high as $1000-$2000 per year from patients to remain their doctor. Either way, ACA literally changed general practice offices into a new business model.

Just to point out.. the ACA didn't change general practice offices into a new business model.

It has accelerated that change... but consolidation to gain efficiency in the face of declining reimbursement, and management of patient caseload to maximize reimbursement has been going on for a least a decade.