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Posted: 9/17/2009 7:45:32 PM EST
[Last Edit: 9/17/2009 7:55:12 PM EST by ChinoUSMC]

45% Of Doctors Would Consider Quitting If Congress Passes Health Care Overhaul

By TERRY JONES, INVESTOR'S BUSINESS DAILY

Posted 09/15/2009 07:09 PM ET















Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors' own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors' positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.

Major findings included:

Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration's claims that doctors are part of an "unprecedented coalition" supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

Four of nine doctors, or 45%, said they "would consider leaving their practice or taking an early retirement" if Congress passes the plan the Democratic majority and White House have in mind.

More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll's finding onto that population, 360,000 doctors would consider quitting.

More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered "no" when asked if they believed "the government can cover 47 million more people and that it will cost less money and the quality of care will be better."




This response is consistent with critics who complain that the administration and congressional Democrats have yet to explain how, even with the current number of physicians and nurses, they can cover more people and lower the cost at the same time.

The only way, the critics contend, is by rationing care — giving it to some and denying it to others. That cuts against another claim by plan supporters — that care would be better.

IBD/TIPP's finding that many doctors could leave the business suggests that such rationing could be more severe than even critics believe. Rationing is one of the drawbacks associated with government plans in countries such as Canada and the U.K. Stories about growing waiting lists for badly needed care, horror stories of care gone wrong, babies born on sidewalks, and even people dying as a result of care delayed or denied are rife.

In this country, the number of doctors is already lagging population growth.

From 2003 to 2006, the number of active physicians in the U.S. grew by just 0.8% a year, adding a total of 25,700 doctors.

Recent population growth has been 1% a year. Patients, in short, are already being added faster than physicians, creating a medical bottleneck.

The great concern is that, with increased mandates, lower pay and less freedom to practice, doctors could abandon medicine in droves, as the IBD/TIPP Poll suggests. Under the proposed medical overhaul, an additional 47 million people would have to be cared for — an 18% increase in patient loads, without an equivalent increase in doctors. The actual effect could be somewhat less because a significant share of the uninsured already get care.

Even so, the government vows to cut hundreds of billions of dollars from health care spending to pay for reform, which would encourage a flight from the profession.

The U.S. today has just 2.4 physicians per 1,000 population — below the median of 3.1 for members of the Organization for Economic Cooperation and Development, the official club of wealthy nations.

Adding millions of patients to physicians' caseloads would threaten to overwhelm the system. Medical gatekeepers would have to deny care to large numbers of people. That means care would have to be rationed.

"It's like giving everyone free bus passes, but there are only two buses," Dr. Ted Epperly, president of the American Academy of Family Physicians, told the Associated Press.

Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.

The study found that, just with current patient demand, the U.S. will have 159,000 fewer doctors than it needs by 2025. Unless corrected, that would make some sort of medical rationing or long waiting lists almost mandatory.

Experiments at the state level show that an overhaul isn't likely to change much.

On Monday came word from the Massachusetts Medical Society — a group representing physicians in a state that has implemented an overhaul similar to that under consideration in Washington — that doctor shortages remain a growing problem.




Its 2009 Physician Workforce Study found that:

The primary care specialties of family medicine and internal medicine are in short supply for a fourth straight year.

The percentage of primary care practices closed to new patients is the highest ever recorded.

Seven of 18 specialties — dermatology, neurology, urology, vascular surgery and (for the first time) obstetrics-gynecology, in addition to family and internal medicine — are in short supply.

Recruitment and retention of physicians remains difficult, especially at community hospitals and with primary care.

A key reason for the doctor shortages, according to the study, is a "lingering poor practice environment in the state."

In 2006, Massachusetts passed its medical overhaul — minus a public option — similar to what's being proposed on a national scale now. It hasn't worked as expected. Costs are higher, with insurance premiums rising 22% faster than in the U.S. as a whole.

"Health spending in Massachusetts is higher than the United States on average and is growing at a faster rate," according to a recent report from the Urban Institute.

Other states with government-run or mandated health insurance systems, including Maine, Tennessee and Hawaii, have been forced to cut back services and coverage.

This experience has been repeated in other countries where a form of nationalized care is common. In particular, many nationalized health systems seem to have trouble finding enough doctors to meet demand.

In Britain, a lack of practicing physicians means the country has had to import thousands of foreign doctors to care for patients in the National Health Service.

"A third of (British) primary care trusts are flying in (general practitioners) from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland" because of a doctor shortage, a recent story in the British Daily Mail noted.

British doctors, demoralized by long hours and burdensome rules, simply refuse to see patients at nights and weekends.

Likewise, Canadian physicians who have to deal with the stringent rules and income limits imposed by that country's national health plan have emigrated in droves to other countries, including the U.S.

Tomorrow: Why most doctors oppose the government's plan — in their own words.

Link Posted: 9/17/2009 7:53:46 PM EST
Would quite what?

Did you mean quit? As in, give up?
Link Posted: 9/17/2009 7:55:23 PM EST
You know, I half way want the health care abortion to pass. I dated several female doctors in the past, I hate all of them now, and I would take great enjoyment from their suffering and the destruction of their careers.

Of course, the downside is the dying early because of crappy healthcare part.
Link Posted: 9/17/2009 7:55:37 PM EST

Originally Posted By Procyon:
Would quite what?

Did you mean quit? As in, give up?

Whoops... yeah, it's a typo... I'm tired.

Fixed... thanks.
Link Posted: 9/17/2009 7:56:08 PM EST
Originally Posted By Procyon:
Would quite what?

Did you mean quit? As in, give up?


It passes, I close my clinic. Not an MD; I just deal with hearing loss and hearing aids. I'll go back to doing something else.
Link Posted: 9/17/2009 8:23:34 PM EST
There is no such thing as a labor shortage, only a refusal to pay wages adequate to meet demand.
Link Posted: 9/17/2009 8:25:29 PM EST
I've worked with and personally known plenty of Physicians over the years.

They come in all types, I've seen my fair share of idiots, and I also seen a quite a few that were simply poor at business.

But I can guarantee you that if the money dries up worse than it already has –– and it will dry up significantly under obamacare –– every single one with even half a brain will jump ship and find another line of work. Or retire.

One thing they all have in common... They are well educated, well connected, and often have deep ties in their communities. It will not be hard for them to quickly find another another way to earn income.

Link Posted: 9/17/2009 8:25:50 PM EST
Sounds like BS. Quit and do what instead?
Link Posted: 9/17/2009 8:27:40 PM EST
[Last Edit: 9/17/2009 8:27:54 PM EST by clement]
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


Join the sex industry (for the females)? They have the outfits already.
Link Posted: 9/17/2009 8:30:08 PM EST
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.
Link Posted: 9/17/2009 8:30:58 PM EST
"$30,000 a year you say?? USA here I come!!"

Link Posted: 9/17/2009 8:34:56 PM EST
Originally Posted By happycynic:
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.


Unless they band together, gather up their resources, and create private clinics abroad, or even aboard ships just inside National waters. I'm betting on starting private, cash only clinics in medical friendly countries.

Link Posted: 9/17/2009 8:54:41 PM EST
[Last Edit: 9/17/2009 8:57:43 PM EST by nick89302]

I've posted before on this subject and I'll post it again:

I'm a volunteer FF/EMT-P. I'm in college working on my BS in Chemistry. I already have one BS. I'm a medic in the ARNG, and I'll be applying to med school within the year. I don't know that I'll go, even if I'm accepted. I may just go through the Army's Interservice Physician Assistant Program program and do my 20 years. By the time I finished with IPAP, I'd only have to work for another 13 years on active duty before I would be eligible for retirement at 45. I wouldn't have any school debt and I'd start earning as soon as I went to school.

If I have to face $200,000 in costs for four years of med school while looking forward to being worked like a dog during residency and making peanuts, postponing any sort of real earning potential another 8 possibly 9 years, when all the while facing a decline in earning potential, I'm going to say it isn't worth it.

I hope you like learning Spanish, Chinese, or Arabic so you can understand your third-world educated doctor.

Fuck you for wanting this.

Link Posted: 9/17/2009 8:58:01 PM EST
Originally Posted By Spook75A2:
Originally Posted By happycynic:
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.


Unless they band together, gather up their resources, and create private clinics abroad, or even aboard ships just inside National waters. I'm betting on starting private, cash only clinics in medical friendly countries.



Even under a single-payer system, they would be free to not accept the government insurance scheme and continue practicing privately.

However, most doctors would use the government "insurance" because few doctors have the kind of market power to attract people who are willing to pay a premium for healthcare (and can afford it). This is the way it is in Canada, which allows doctors to practice privately, under the condition that they cannot accept public money at all for any services rendered. It's not worth the hassle in most cases, as you shut out a large portion of the market. There are also even private hospitals in Canada.

People posting these unrealistic "rebel healthcare" scenarios are really ignorant of the fact that the vast majority of healthcare tourism is to places where healthcare is dramatically cheaper. India, Singapore, Thailand, etc. Seniors in America even go to Canada to buy drugs (blame Congress for preventing drug re-importation on that one) at the government's negotiated prices
Link Posted: 9/17/2009 8:58:03 PM EST
Does the proposed health care plan (Obamacare) force Physician to take Health insurance?? My wife's OBGYN just informed us (and all her patients) that she will no longer accept any insurance plan and run a direct payment cash for services business. The practice is called a medical boutique. Patients pay $2000.00 per year plus other fees. In return doctors will provide for the patients immediate care, house calls, ER visits etc.

If doctors opt for this practice then we will definitely have a two tier system. I believe that Congress would be hesitant to stop this type of business since many themselves are members of private Medical boutiques.
Link Posted: 9/17/2009 9:16:59 PM EST
Originally Posted By chunli:
Does the proposed health care plan (Obamacare) force Physician to take Health insurance?? My wife's OBGYN just informed us (and all her patients) that she will no longer accept any insurance plan and run a direct payment cash for services business. The practice is called a medical boutique. Patients pay $2000.00 per year plus other fees. In return doctors will provide for the patients immediate care, house calls, ER visits etc.

If doctors opt for this practice then we will definitely have a two tier system. I believe that Congress would be hesitant to stop this type of business since many themselves are members of private Medical boutiques.


That's what I'm talking about. Sign me up.
Link Posted: 9/17/2009 9:18:47 PM EST
Originally Posted By happycynic:
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.


Not too quick, are ya?
Link Posted: 9/17/2009 9:27:32 PM EST
Originally Posted By chunli:
Does the proposed health care plan (Obamacare) force Physician to take Health insurance??


No, Obamacare in a nutshell forces citizens to have health insurance, under threat of fines. You will have to either have private insurance that meets certain standards or they are making a public insurance option. If you cannot afford insurance (by the .gov's calculation), you will be given subsidies and a free choice of where to get insurance from. The public option will be revenue neutral, so it will not have any subsidies that the private companies cannot get

It's basically a handout to health insurance companies
Link Posted: 9/17/2009 9:41:36 PM EST
I know more than a few docs who simply will quit if this garbage becomes law. These are leading men and women in their respective fields, too.
Link Posted: 9/17/2009 9:48:19 PM EST
72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

Wow, 25% of doctors are dumbasses.
Link Posted: 9/17/2009 9:51:53 PM EST
Can't say I blame them.
Link Posted: 9/17/2009 10:00:31 PM EST
Originally Posted By Skillshot:
72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

Wow, 25% of doctors are dumbasses.


I'd love to see how that 25% breaks down in terms of specialty and function. Back when my dad was a chief resident, he had a resident under him who was insanely book smart, but inept with actual patients and lacking in common sense. So the guy became a research physician of some kind. So since 1982 the guy hasn't seen a single patient, but he's a "practicing doctor." He has no first hand experience with insurance reimbursement, malpractice insurance, etc. I can see how a man so divorced from the reality of medicine may be idealistically stupid.
Link Posted: 9/17/2009 10:00:55 PM EST
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.
Link Posted: 9/17/2009 10:05:28 PM EST
Originally Posted By BulletBait:
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.


Malpractice insurance rates going through the roof are already doing that in many states. A lot of Florida residents don't realize how close we were a few years ago to seeing a gigantic percentage of OB/GYNs pack up and leave the state. The state's largest group of OBs "took a coordinated time off" for about a month at one point just to offset the cost of insurance. One month taken off their insurance coverage cost the group less than one month of no income.
Link Posted: 9/17/2009 10:06:35 PM EST
Originally Posted By 103:
Originally Posted By BulletBait:
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.


Malpractice insurance rates going through the roof are already doing that in many states. A lot of Florida residents don't realize how close we were a few years ago to seeing a gigantic percentage of OB/GYNs pack up and leave the state. The state's largest group of OBs "took a coordinated time off" for about a month at one point just to offset the cost of insurance. One month taken off their insurance coverage cost the group less than one month of no income.


What the fuck...



Link Posted: 9/17/2009 10:18:01 PM EST

Originally Posted By 1Andy2:
Originally Posted By 103:
Originally Posted By BulletBait:
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.


Malpractice insurance rates going through the roof are already doing that in many states. A lot of Florida residents don't realize how close we were a few years ago to seeing a gigantic percentage of OB/GYNs pack up and leave the state. The state's largest group of OBs "took a coordinated time off" for about a month at one point just to offset the cost of insurance. One month taken off their insurance coverage cost the group less than one month of no income.


What the fuck...



I remember that.
It had to do with how the rates were actually lower for non-full time than full time practicioners.
Fucking nuts.

Link Posted: 9/17/2009 10:23:11 PM EST
[Last Edit: 9/17/2009 10:25:37 PM EST by polarbare]
Originally Posted By happycynic:
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.


The thing is, how many of your physicians are near/at/past retirement age? How many would just say "Screw this - it's not worth the effort. I can retire." The only physicians that will stay in are those that are fresh out, those that want to recoup (some of) their investment, those that can charge what the market will bear (e.g. fee for service), and those that simply love to teach. Note this last group is generally your older physicians, and if they aren't allowed to actually practice medicine due to rationing, they might just say "fuck it" as well, as their conscience won't let them continue on under that philosophy.

FYI - here is the census data from 2000

Age
25-34 35-44 45-54 55-64 (no data was given for those over 65, but they are likely dead or retired now)
19.0% 35.4% 31.2% 14.3%

So today, 9 years later, how many are nearing retirement? Notice the drop off in the number of people entering the field? How much worse will this shortage be when applicants see they can't possibly justify the cost and time of schooling? The only choice our government will have is to ease restrictions on FMG's, and even then state licensing has to follow suit. Good luck seeing a doctor in the future, esp, if this crap passes.

For what it's worth, I'm 38, and finished my fellowship 5 years ago. I plan on continuing to work. However, if they cut my salary, they will get a decrease in productiviity. If they want to fire me because I'm not meeting "quota" - fine, try to find a replacement, and see what kind of quality you get. The old adage still applies "cheap, good, or fast - pick two." When I first started on this path 20 years ago (yes, I knew I wanted to be a physician since my last year in high school), I could not even conceive of how much our gov't could fuck up my career. I busted my ass to get to where I am, and I believe I should enjoy the fruits of my labor. For those who think that doctors are overpaid/too concerned about money - think about what it takes to become one and what the job actually entails. During the course of your work day, how many times do you have a chance to kill someone because of a mistake?


Link Posted: 9/17/2009 10:24:18 PM EST
They are talking "unionizing" the health care workers..

I am considering going into anything besides what I do now..if this health care bill passes..
it is bad enough now with the way it is..Care is lacking under the private sector and will
be none-existant with gov in charge..

The VA is not the epitome of perfect health care, there are good people who work there, some of the finest, Vanderbilt Hospital is close to perfect health care.

If this health care bill passes everything is going to be the same..The Suck!

I have done quite a bit and have a DoD security clearance but I would have to think
long and hard before I went back into any kind of work that required me to have it..

Unless the money was right and I mean it would have to be Right..

I am thinking more along the lines of Pig and potato farmer but I'd be afraid they would
cut our water off..But I doubt that would happen in TN...

Link Posted: 9/17/2009 10:39:08 PM EST
Originally Posted By 103:
Originally Posted By Skillshot:
72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

Wow, 25% of doctors are dumbasses.


I'd love to see how that 25% breaks down in terms of specialty and function. Back when my dad was a chief resident, he had a resident under him who was insanely book smart, but inept with actual patients and lacking in common sense. So the guy became a research physician of some kind. So since 1982 the guy hasn't seen a single patient, but he's a "practicing doctor." He has no first hand experience with insurance reimbursement, malpractice insurance, etc. I can see how a man so divorced from the reality of medicine may be idealistically stupid.


Indeed.
Link Posted: 9/17/2009 10:43:45 PM EST
I recently had surgery for cancer and thankfully the surgeon was experienced and dedicated. At 61 years old, he is at the peak of his career.

When asked about ObamaCare, he said he would retire before he let the .gov interfere with his medical practice.

What a loss that would be.
Link Posted: 9/17/2009 10:50:26 PM EST
Originally Posted By BulletBait:
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.


It's always easy for the government to open the immigration window for doctors if we face a shortcoming. Tons of Indian, Chinese, and Latin American doctors would love to come up here and bring their families.

I'm fucking amazed that we haven't done this already. If doctors are really going to complain about government control, government can ease the artificial barriers it has set up for entering the medical field.
Link Posted: 9/17/2009 11:36:34 PM EST

Originally Posted By bear_grillz:
Originally Posted By BulletBait:
Simple math kids.
Make a job worth less than the hassle and people will walk away in droves.


It's always easy for the government to open the immigration window for doctors if we face a shortcoming. Tons of Indian, Chinese, and Latin American doctors would love to come up here and bring their families.

I'm fucking amazed that we haven't done this already. If doctors are really going to complain about government control, government can ease the artificial barriers it has set up for entering the medical field.

This will end real well...



"The red thing's connected to the...uh...I should know this..."
Link Posted: 9/17/2009 11:55:24 PM EST
Quit...and do what? Early retirement only works for older guys.
Link Posted: 9/18/2009 12:05:41 AM EST
Not a problem. SEIU would take over healthcare and assign you an ACORN worker as your new "physician." Bend over please ...
Link Posted: 9/18/2009 12:22:31 AM EST
Who is Dr. John Galt?
Link Posted: 9/18/2009 12:35:20 AM EST
Why not? This administration seems bent on removing from the economy as a whole about 50% of the jobs based on their present priorities, actions, and initiatives.
Link Posted: 9/18/2009 3:22:31 AM EST


I think this is my favorite quote:

"It's like giving everyone free bus passes, but there are only two buses."

For those that say "quit and do what?"... when the income stops being attractive, they will look for another job that will. My father has been practicing Anesthesia for 40+ years and continues to do so. He truly loves his profession. He said if Obama passes the Health Care reform, he will retire. Last I had checked, there were also a big shortage of anesthetists.


Which makes me wonder... will doctors have their unions IF this Health Care Overhaul passes?
Link Posted: 9/18/2009 3:25:09 AM EST
Get ready for 3rd world hack MD's.

I told you guys before that my Eye, Ear Nose & throat doc said he will give up his practice and do only nose jobs
when commycare shows up. He would not be able to profit under that plan.
Link Posted: 9/18/2009 3:30:49 AM EST
Originally Posted By MTUSA:
Get ready for 3rd world hack MD's.

I told you guys before that my Eye, Ear Nose & throat doc said he will give up his practice and do only nose jobs
when commycare shows up. He would not be able to profit under that plan.



Exactly


They will bring over any MD from any country that wants to come here.



Link Posted: 9/18/2009 3:46:45 AM EST
i will still practice...once I become a doc that is. They had better not get the equivalent of illegal immigrants to do the work
Link Posted: 9/18/2009 3:51:31 AM EST
ROFL...

I bet no more than 10% quit...if that many.

These are idle threats.
Link Posted: 9/18/2009 3:52:40 AM EST
Atlas will Shrug.
Link Posted: 9/18/2009 3:55:47 AM EST
Imagine the Government provided translators so you can communicate with your new, free of charge healthcare professional.

Good idea
Link Posted: 9/18/2009 4:00:09 AM EST
Originally Posted By dawgm:
i will still practice...once I become a doc that is. They had better not get the equivalent of illegal immigrants to do the work



They won't be illegal.

There are 10's of thousands of doctors in other 3 rd world countries where their degree is not valid here.

Obama will fix that



Link Posted: 9/18/2009 4:02:19 AM EST
Quitting <> Consider quitting. Misleading thread title.
Link Posted: 9/18/2009 4:04:52 AM EST
[Last Edit: 9/18/2009 4:10:02 AM EST by Bubbatheredneck]
Physicians wont quit. But they sure wont work as hard either. And what service is left will be gone. And anything that is difficulty, risky or time consuming will be shipped off at best or postponed as long as possible.

You are running late? No problem. Take your time. We have a spot waiting for you at the end of the line.

Appointment time? Hah! First come, first served. Need to be in line 30 minutes before we open the doors so we can see you today.

You need a CT scan? Take this paper to this office, have a seat, they will get to you in an hour or so to tell you when to come back to sit in line again to get your scan.

You need a revision surgery? Oh that is too hard for us to do here ( ie, not worth the hassle). You will need to drive to ______, 140 miles away, and have it done at the medical center. Better hurry, to beat the 6 month wait.





ETA
Also, when salaries are cut, many 'older' docs, about 55 or so and older, will suddenly have disabling back pain and cash in on their disability policy, and take home more than they would under Obamacare's payment scheme.

Plus, there are a hell of a lot of MDs that could retire tomorrow. The only reason they dont is most MDs actually enjoy practicing medicine. Obamacare gives them a reason to retire tomorrow.



Link Posted: 9/18/2009 4:07:40 AM EST

Originally Posted By happycynic:
There is no such thing as a labor shortage, only a refusal to pay wages adequate to meet demand.

Now you stop with all that Capitalist propaganda (reported to fishy@whitehouse.gov)




Link Posted: 9/18/2009 4:09:44 AM EST

Originally Posted By garwj:
Originally Posted By chunli:
Does the proposed health care plan (Obamacare) force Physician to take Health insurance?? My wife's OBGYN just informed us (and all her patients) that she will no longer accept any insurance plan and run a direct payment cash for services business. The practice is called a medical boutique. Patients pay $2000.00 per year plus other fees. In return doctors will provide for the patients immediate care, house calls, ER visits etc.

If doctors opt for this practice then we will definitely have a two tier system. I believe that Congress would be hesitant to stop this type of business since many themselves are members of private Medical boutiques.


That's what I'm talking about. Sign me up.

Don't forget the soon to be booming prescription drug smuggling business. Smuggle pot? Fuck that, Americans will be stocking up on Cipro and Amoxicillin.

Link Posted: 9/18/2009 5:41:30 AM EST
Originally Posted By VTHOKIESHOOTER:
Atlas will Shrug.



http://pajamasmedia.com/blog/is-your-doctor-getting-ready-to-shrug/



Is Your Doctor Getting Ready to Quit?
Posted By Paul Hsieh On September 18, 2009 @ 12:00 am In . Feature 01, Health, Legal, Money, Science & Technology, US News | 19 Comments

In a recent editorial [1] published by Investor’s Business Daily, associate editor (and PJTV.com [2] regular) Terry Jones revealed stunning poll data showing that 45 percent of American physicians “would consider leaving their practice or taking an early retirement” if Congress passed the proposed ObamaCare health legislation.

As a practicing physician, I’m not surprised. These numbers mirror the sentiments I’ve heard expressed by my professional colleagues. I’ve been in practice for over 15 years and I’ve never seen physician morale as low as it is today.

Older physicians have told me that they’re glad to be “getting out” and retiring soon. Medical students have asked me whether they should switch to engineering or pharmacology before it’s too late. Physicians in the middle of their careers are just hoping to survive any “reform.”

The same IBD poll also showed that an overwhelming majority (65 percent) of physicians were opposed to the proposed expansion of government in medicine. And they have every reason to be concerned, based on past experience.

One reason that many physicians are skeptical of the proposed “reform” is because they already know what government-run health care is like, in the form of Medicare. Medicare is “single-payer health care” for the elderly. Many proponents of universal health care want to create “Medicare for all,” claiming that it’s a model of efficient, compassionate care. But as the New York Times recently reported, more doctors are opting out of Medicare [3] (or limiting the number of Medicare patients they are willing to accept) for two simple reasons: “reimbursement rates are too low and paperwork too much of a hassle.”

Medicare reimbursements are so low that many physicians could not survive [4] if they relied solely on Medicare patients. Their patients with private insurance essentially subsidize their Medicare patients. Every time Congress passes another round of Medicare cuts, it merely worsens the problem as more doctors stop accepting new Medicare patients.

Physicians have also seen the problems in states such as Massachusetts that have attempted to implement universal health care, and the implications for the rest of the country.

The just-announced Baucus plan [5] is based closely on the Massachusetts plan, including mandatory insurance, subsidies for low-income residents, and strict new regulations on insurance companies specifying who they must cover, what benefits they must provide, and what prices they can charge. As a result, insurance costs have skyrocketed, raising the costs of the state subsidies. In response, the state government has cut back on its payments to physicians and hospitals.

Dr. Katherine Atkinson, a primary care physician practicing in Amherst, MA, told the New York Times [6]:

Every time I have a Medicaid patient, it’s like handing them a $20 bill when they leave. I never went into medicine to get rich, but I never expected to feel as disrespected as I feel. Where is the incentive for a practice like ours?

Because of perverse government incentives punishing physicians for taking patients covered by the state’s “public plan,” many patients face long waits for care — as much as a year for a routine physical exam in parts of Western Massachusetts. And this is despite the fact that Massachusetts “has the highest physician-to-population ratio of any state, in primary care as well as overall,” according to the New England Journal of Medicine [7]. Expanding the Massachusetts plan to the national level would merely multiply this problem by fifty.

Finally, physicians are concerned that universal health care will compromise their ability to practice according to their own best judgment and conscience.

President Obama’s “stimulus package” included $1 billion for “comparative effectiveness research” in health care. Writing in the Wall Street Journal, Harvard professor Martin Feldstein noted that the government’s eventual goal is to use this research to cut costs and ration medical care by “implementing a set of performance measures that all providers would adopt” and by “directly targeting individual providers … (and other) high-end outliers.”

In other words, your doctor would be rewarded if he practiced according to federal guidelines and punished if he strayed too far from them. Such guidelines must necessarily be based on statistical averages that cannot take into account specific facts of individual patients. But good physicians must consider precisely these specifics when treating their patients.

If you have abdominal pain due to gallstones, who should decide whether medication or surgery would be “most effective” for you? The doctor who felt your abdomen, heard your heart murmur, saw your ultrasound, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?

Most physicians I know aren’t in the field primarily for the money, although they do expect to be fairly compensated for a job that requires four years of college, four years of medical school, three to seven years of internship and residency, and often one (or more) years of additional specialty fellowship training.

They do it because they love their work, including the ability to apply those years of training to benefit their patients. They passionately want to use their skills according to their best medical conscience. To practice good medicine, a doctor must therefore be left free to use his reason, his experience, and his judgment — i.e., his mind. ObamaCare would destroy your physician’s willingness and ability to use his mind for your benefit.

If ObamaCare passes, some doctors will grit their teeth and still try to do their best for their patients. But they will have to waste hours arguing with bureaucrats, while their less conscientious colleagues can just punch a clock and go home. How long will the better doctors continue working under a system that constantly punishes them for their virtues? And when the good doctors finally retire or quit in frustration, what kind of doctors will remain?

In Ayn Rand’s classic novel Atlas Shrugged, one of the minor characters was surgeon Dr. Thomas Hendricks, who explained his reasons for “shrugging” and quitting medicine as follows:

I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind — yet what is it they expect to depend on, when they lie on an operating table under my hands? … Let them discover the kind of doctors that their system will now produce. Let them discover, in the operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man they have throttled. It is not safe, if he is the sort of man who resents it — and still less safe, if he is the sort who doesn’t.


The policies of our current president and Congress have turned too much of Atlas Shrugged from fiction into fact [9]. The government has already assumed unprecedented control over the banking and automotive sectors of our economy. Health care is next in its sights.

If ObamaCare passes, thousands of doctors will follow the fictional Dr. Hendricks and shrug.

Will your doctor be one of them?



Link Posted: 9/18/2009 6:25:34 AM EST
Originally Posted By happycynic:
Originally Posted By delacrue:
Sounds like BS. Quit and do what instead?


This. The desire to quit will end when they realize that $200k jobs don't grow on trees.


What you guys don't realize is that there are a substantial amount of physicians that are practicing well past retirement age. They practice because they love doing what they do , not because they have to. Take for example, my physician. He is 72, attended med school at Columbia, completed residencies at John Hopkins and Vanderbilt. I would hate to lose such a talented physician due to Obamacare, but I can't blame him one bit if he were to retire. The other side of the coin is that U.S. trained doctors are in high demand. My brother-in-law just finished a residency in ER medicine and was offered a position in UAE for $750k/year. I don't believe 45% will walk, but I wouldn't be surprised if 25% did. You think we have a shortage of docs now, just wait til Obamacare passes. Third world healthcare, coming to a city near you
Link Posted: 9/18/2009 6:38:34 AM EST
Health care is an industry.

Just like the American Automotive industry used to be.
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