Makes very valid and extremely scary points. Is this the crisis?
Bump.
Thank you.
Bump for later reading and posting elsewhere...
bttt
Excellent, my brother. Says it all. Wish I wrote it.
Your analysis is as cogent, as predictive, as anything I have read these several months. And I have gone back to read your previous posts. In a word, thank you, Doc, for all that you bring to this national discussion. I will send your post wherever I can.
Not this time.
This govt takover of so much of the US economy (artificial, unsustainable ecomomy) should finally topple our country into martial law and a police state. No elections, massive layoffs of govt workers that maintain the public infrastructure, empty professional and commercial real estate, empty homes as we move into cheap apartments and tents, no proper refuse handlling, widespread preventable illness, then desease...Well done, socialists.
Funny thing is, most of the voters that put these representatives that are trying to execute this govt takover into office are not really evil, just incredibly igonorant.
Some of us were warning of the dire consequences of government involvement in healthcare via the case of Terri Schiavo.
Perhaps you remember her government court ordered “murder/execution” via forced starvation and dehydration?
If anyone but “the government” did that to a death row inmate, a POW, or a stray dog or cat, they would have been charged with any number of “inhumane” anti-cruelety laws.
Lots of us folks with no monetary interest, fought hard to save her, and we lost.
I see you logged on here well after her death.
Just curious...what was your stand in her case?
Obviously you don't have to answer me.
Hopefully you will start thinking about it.
Her palliative health care expenses was supposed to have been “fully paid for” in advance, yet our entire health provider industry seemed almost to be frothing at the mouth,in thirsting for her death.
Pardon me if I have judged you as just some idiot, who only now that your own personal income is at risk, partially understands what is at stake with even more government control of healthcare.
“So to keep the boat afloat, the payouts by private insurers MUST increase to subsidize the ever increasing losses doctors incur by taking care of our government patients.”
About 15 years ago I had some surgery. I exclaimed to the Doc on how expensive it was. I guess this would have been right around the time of “Hillary Care”.
He told me “the U.S. already has socialized medicine”. Then went on to say the things in your post. I forget the actual numbers, but he said my minor surgery, which cost me (and my Insurance company) about $4,000 - was really worth about $2,000.
Just imagine what it will be after Obamacare. Except the doctors won’t get paid more. So why bother. Luckily the government will be there to solve the crisis. Probably using the General Motors plan.
I’ve tweeted it out — begging people to read it. Thank you. I completely agree with your assessment. I have such respect for doctors still working in the current environment, and you do not deserve a dramatic DOWNTURN in remuneration: you deserve an UPTURN, where the good docs can be plenty rewarded, and the not-so-good are left out. We need more of the real market in health care. More paying directly.
We are governed by economic morons.
Until that changes, not much else will.
I just have to ask you to explain one sentence that underscores your entire argument here:
“Most people can see how this bill will rapidly reduce private insurance plans and rapidly expand government plan patients.”
How exactly do the current house and senate bills do this?
The current and future uninsured will be purchasing private insurance via exchanges and these premiums will be subsidized by our tax dollars...but it is still private insurance (which will be expanded). There is no public option or new government run insurance plan. Yes, Medicaid will be expanded to cover those at 133% of the poverty line but that isn’t a very big percentage of the uninsured. Those poorer are already on Medicaid.
Mandating the uninsured to purchase private insurance with subsidies will actually expand greatly the private insurance market by forcing millions of new customers to into the private insurance market and increase the risk pool as a whole and therefore strengthen private insurance from a financial standpoint.
Yes, those making over $250,000 will take it in the gut with a .9% increase in their medicare tax on their paychecks and investments under either of the bills considered but I don’t quite see how “government patients” will increase as a result of this plan.
Government patients WILL increase due to a vast increase in Medicare patients (baby boomers) about to hit the government dole and/or a further increase in unemployment due to national and global economic conditions which results in more Medicaid patients. But neither of those scenarios have anything to do with the bills being considered by either the house or senate....at least directly.
Is there a new government insurance plan that I am not aware of in the bills?
With a 3-5% profit margin, the enterprise is an extremely high-risk enterprise as any profit margin is is only a hopeful guess these days. In the credit derivative world, currently sinking the Western World, a drop of 3-5% in collateral value sinks billions of tranches of credit derivatives. Private medicine cannot survive chronic sub-cost payment.
The public has no knowledge of the vast, draconian medicare cuts to MD reimbuirsement of surgical subspecialists in 1991, a result of the 1986 Budget Omnibus Reconciliation Bill. One specialty was cut 50% on its time reimbursement, and additional amounts varying with the service...some specialists were cut, measuring results at the end of their billing year...cut to the tune of 65% in income for services rendered equvalent to the previous year, 1991. These rates remained about the same to the present time. None of this has ever been disclosed. The break year was 1990/91....data is very hard to come by unless individual specialists have saved their records. One specialist reported in 2000 that by the minute, his time in the OR was 75% for Medicare and Medicaid, and that time only provided 15% of his income. Managed care and PPO discounted minutes provided 85% of his income and amounted to only 25% of his time. Medicare and Medicare reimbursements, 75% of his time, and only 15% of his income did not come close to meeting his practice overhead. His bills and living were all contained within his private, non-govt. practice. He has stated that the data in his practice is similar today.
The result is a dramatic slowdown in an economy that is already headed towards ruin.
I am absolutely certain, and horrified, that we are on a path toward civil unrest and bloodshed.
I think the mechanism’s a bit different than you forsee. The bill provides for control of premium hikes. They’ll use that to keep the insurers from offsetting the practitioners’ losses, thereby bankrupting the insurance companies while simultaneously forcing the practitioners to adopt higher volume, lower margin, lower quality of care operations. With the private insurers broke, we’ll all be on the government plan, and the practitioners will be scraping by doing 10 minute patient visits. They’ll then congratulate themselves for the new “efficiencies” they’ve created.
I was just chatting with a doc at work and he made some other interesting points. For those docs that decide they might want to refuse to take medicare/medicaid/public option patients, the next step for mugabeobami will be to “deem” their professional licenses null and void unless they comply. This country ain’t seen nothing yet if this passes.
I’ve read a couple of different articles stating that approx 47% of MDs will quit or retire if this bill becomes law. That’s a massive hit. Throw in all of the other medical jobs, nurses, techs of various sorts, etc. that will be reduced by the lack of MDs.
Buh bye U.S. health care, hello 3rd world.