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Doctors going broke
CNN Money ^ | 1/5/12 | Parija Kavilanz

Posted on 01/05/2012 9:43:56 PM PST by Nachum

New York - Doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet reality, which is spreading nationwide, is claiming a wide range of casualties, including family physicians, cardiologists and oncologists. Industry watchers say the trend is worrisome. Half of all doctors in the nation operate a private practice. So if a cash crunch forces the death of an independent practice, it robs a community of a vital health care resource. (Snip) Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat.

(Excerpt) Read more at money.cnn.com ...


TOPICS: Business/Economy; Government; News/Current Events
KEYWORDS: broke; doctors; going; obamacare
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To: DB

right, and so it will be expected that my older kids who are now entering the workforce will have to pick up the tab. It will be uncomfortable - but they’ll do it.

By the time their younger siblings enter the workforce, it will probably be downright mathematically impossible.

At some point -we simply become Greece.


101 posted on 01/06/2012 11:24:01 AM PST by Scotswife
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To: texican01
Sorry, that should have been "Those on the tail end get cheated."
102 posted on 01/06/2012 11:24:44 AM PST by DB
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To: Mom MD

Just like the UK system.

Remember those lovely terrorists who attempted to blow the subway - and wound up crashing at the airport in Scotland?

They were “doctors”


103 posted on 01/06/2012 11:26:11 AM PST by Scotswife
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To: Nachum

Bump


104 posted on 01/06/2012 11:43:29 AM PST by Incorrigible (If I lead, follow me; If I pause, push me; If I retreat, kill me.)
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To: Alberta's Child
I can sympathize with the doctors here, but this sort of thing was inevitable. It really has nothing to do with "ObamaCare," either.

Government is SOLELY responsible for destroying health care. If the market was truly allowed to work (without any state/federal interference) then the pricing mechanism of the marketplace would function properly.

Anyone who believes the market has somehow failed has NO understanding of Capitalism and Freedom. ALL that the government touches, it destroys.

105 posted on 01/06/2012 12:04:08 PM PST by sand88
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To: DB
We all got screwed in a Ponzi scheme.

Tellya what. THe government can pay me back, in land (with the mineral rights), only I get to pick where, easements granted, and no rules on how I use it. Same property value per section as any other similar undeveloped land in the area.

Such a deal I'll make them.

106 posted on 01/06/2012 12:12:53 PM PST by Smokin' Joe (How often God must weep at humans' folly. Stand fast. God knows what He is doing)
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To: jazzlite

That isn’t capitalism.


107 posted on 01/06/2012 12:56:27 PM PST by TigersEye (Life is about choices. Your choices. Make good ones.)
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To: vpintheak

If the cost of everything is higher in Alaska why would you expect doctors to work for lower rates?


108 posted on 01/06/2012 12:58:52 PM PST by TigersEye (Life is about choices. Your choices. Make good ones.)
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To: TigersEye

not 2.5x! Here is an example for you. I’ll spare the details. A worker of mine had back surgery a while back, he was getting bills saying he owed money and he started looking into it. A doctor he had never heard of before, who assisted in his surgery, charged $28,000 for his assistance during the surgery. $28,000! Think about that. The insurance company denied that charge but settled on $10,000 instead. This happens regularly. Fair is fair, and I’m glad we have good doctors, but rape is also rape.


109 posted on 01/06/2012 1:38:49 PM PST by vpintheak (Occupy your Brain!)
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To: vpintheak

The operating surgeon for any back case doesn’t charge $8k, much less $28k, and insurance pays about $3k, if that. The first assist fee insurance will pay is $1k, if that.

Could use some more details on your story of a $10k first assist fee paid by insurance.

Just sayin’


110 posted on 01/06/2012 2:01:35 PM PST by Jim Noble ("The Germans: At your feet, or at your throat" - Winston Churchill)
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To: sand88
Anyone who believes the market has somehow failed has NO understanding of Capitalism and Freedom. ALL that the government touches, it destroys.

That is true.

Of course, you were supposed to pay back those student loans. But the Won is fixing that.

111 posted on 01/06/2012 2:12:52 PM PST by cynwoody
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To: vpintheak

I guess I can’t speak to surgery charges since I’ve never had any surgery. It’s using kind of a broadbrush though to paint all doctors in AK as engaging in the same behavior as some surgeons have. What does a GP charge for the average office visit?


112 posted on 01/06/2012 2:15:23 PM PST by TigersEye (Life is about choices. Your choices. Make good ones.)
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To: Sgt_Schultze

There is already a military medical school, Uniformed Services University of the Health Sciences. I don’t know what the commitment of students is to serving after graduation, probably 5 years like the USNA, USMA, USAFA.

Yesterday I was trying to find an M.D. at Georgetown Hospital in DC. Couldn’t remember the name, so went thru the entire directory. About 1/15 names sounded like names that would have been at G’town 20-25 years ago. It seems American college grads are less inclined to continue on to medical school, whether because they’re not admitted or because they see the handwriting on the wall that it’s not being a great future relative to the cost of time and money to earn the M.D.


113 posted on 01/06/2012 2:23:56 PM PST by EDINVA
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To: Nachum
True. Also the vocation has no where near to respect or reverence it has here.

My son was born in a German hospital where I had private insurance. I had a big, giant room plus an adjoining room to myself while the German women were three to a room. Their rooms jam packed with visiting family, etc.

The nurses made it very clear I had "erste classe" (first class) accomodations.One actually told me it was unfair that I had such a large room to myself.

114 posted on 01/06/2012 3:19:09 PM PST by riri
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To: Silentgypsy

Keeping paper records as a backup does not have to mean using them as the core of your everyday office procedure. Why shouldn’t my medical records be held in servers online, like every other office I do business with, and available instantly when authorized people need them? Whenever we see a new doctor, we have to give them our whole medical history on a paper form, over and over and over again for each specialist. Eventually, you’re going to get fuzzy on how old you were when you had chicken pox. Vital information, which might at some point mean your life, is being lost.


115 posted on 01/07/2012 4:51:23 AM PST by BlazingArizona
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To: Silentgypsy

High-tech equipment runs on electronics anyway. If something gets hacked, it gets restored from an electronic backup. The problem is that the doctor’s own operations are not part of the electronic system. When you need to get that high-res digital EMR image to another specialist, I’ve seen them mail it and wait.


116 posted on 01/07/2012 4:55:29 AM PST by BlazingArizona
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To: sand88
I disagree with you 100%. Government's role in "destroying" this industry is really not much different than the role played by private insurance companies.

The problem isn't government, or private industry, or any other entity involved in the process. The problem is that any business sector built entirely on a third-party payment system is doomed to fail simply because there is no longer any "free market" involved at all. I apologize for the lengthy post, but if you have the patience to read through it I would highly recommend it (it's taken from a post I made on another thread on this same subject some time ago) . . .
___________________________________

The basic premise of any insurance policy is the transfer of risk from one person to another (or to a group of people). If I am concerned about wrecking my car, I buy an insurance policy on the car and pay my insurance company to agree to pay the costs of repair (or full replacement) in the event I get in an accident. Insurance companies make money by accumulating a large pool of clients, and essentially making the very good bet that the number of times they actually have to pay out on claims is very small in comparison to the total number of policies they have on their books. In other words, the risk of a single driver getting into an accident (or the cost to the individual driver) may be substantial, but the risk of more than, say, 1% of the drivers in a large group getting into an accident in any given year is actually small.

The key, of course, is that most forms of insurance "work" for society as a whole because the nature of these insurance policies is such that the frequency of claims for any individual policy holder is very low. Many property owners will insure their homes, for example, even if they know that there is a 99% chance that they will live there for 40 or more years without filing a single claim. They're paying for the peace of mind that comes with the knowledge that someone accepting the risk of a catastrophe.

Health insurance is the exact opposite, for it is the one type of insurance where everyone involved in the process (policy holders and insurance companies alike) know from Day 1 that claims are going to be filed with such boring regularity that it makes almost no sense to even call it "insurance" anymore. If you filed three or four claims every year on your auto insurance, then your insurance company would either dump you as a customer or decide that it's cheaper to buy you a car and hire a driver to get you around. But somehow we have such an entitlement-based mentality about medical insurance that we are appalled by the notion that an insurance company just might not want to do business with you, or might want to limit their financial exposure by refusing to pay the full price that doctors charge for their services. Government is no different than insurance companies in this regard. They both function the same way because they are third-party payers who are not directly involved in the delivery of the service in question.

Some other fatal flaws with medical insurance and government involvement are as follows:

1. Insurance claims don't adhere to typical economic principles of supply and demand because there are three parties to every transaction, not two. This is not a serious problem with something like life insurance because there a finality about death that makes the claims process and the aftermath much more clear, but for health and property/casualty insurance it introduces a potential flaw that often rears its ugly head. If I crash my car and file a claim, we have three parties to the transaction who operate under conditions that do not apply to a "pure" economic transaction . . . 1) I have already paid for the insurance, so I really don't care how much it costs to fix the car -- I want the best parts, best service, etc.; 2) the insurance company doesn't have to drive the car around, so it doesn't really care about the quality of the repair and is perfectly willing to accept something that is sub-standard by my standards; and 3) the body shop is dealing with two "customers" who have two different goals in mind in the transaction. This three-way dilemma also applies to medical insurance, and is why the problems in medical insurance are almost identical to the problems many states have encountered in auto insurance (including Mitt Romney's state of Massachusetts).

2. Medical insurance is the only type of insurance that is pretty much an open-ended financial commitment on the part of the insurance company or government agency. In agreeing to pay your medical bills, an insurance company or government agency has no control over how complex medical procedures will get over time, and how advanced technology will become in the future. So they always find themselves spending more and more money on what is "normal care" -- because the definition of "normal care" is always changing (upward, of course) and getting more expensive over time. Imagine how expensive your auto insurance would be if you drove a $10,000 sub-compact car, but had the ability to have it replaced by a $200,000 Rolls Royce. That's basically the way the medical industry works -- and why the whole system is falling apart.

3. All insurance carries what is called a "moral hazard," which means that people with some kind of coverage (government-paid or private insurance) will tend to behave in certain ways simply because they know that the insurance is there to protect them. A person with a brand-new car is likely to be a far more careful driver if he has no collision insurance, and a person with no medical insurance of any kind (even government-funded care) is more likely to keep himself in relatively good health (I'll leave hereditary/genetic conditions aside, since they aren't relevant to this point). It is no coincidence that the incidence of almost every physical and mental pathology has risen dramatically since people have been covered by medical insurance plans of one kind or another.

117 posted on 01/07/2012 7:36:50 AM PST by Alberta's Child ("If you touch my junk, I'm gonna have you arrested.")
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To: vpintheak
In a truly capitalist system you would have worked out the price for the surgery in advance and could have known the name, medical license number and prior work history of every person involved in the surgery.

See my last lengthy post . . . anytime you get a third party involved in paying the bills (no matter who that third party is), you can expect to have that sort of thing happen all the time.

118 posted on 01/07/2012 7:41:23 AM PST by Alberta's Child ("If you touch my junk, I'm gonna have you arrested.")
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To: Alberta's Child
I think you make several excellent points on the nature of insurance and how it drives (or crashes) health care delivery for both providers and consumers. Would you agree that HSAs are the best alternative to the pvt/public turd party payer schemes (excluding the indigent population)? And would a transitional period would be in order for the vast majority without one, so that people could fund their own care? It certainly redraws the model not only for the industry but of personal responsiblity. But as you point out people are far more likely to take better care of themselves, which will sharply drive down utilization. Perhaps in cases of prolonged or catastrophic illness insurance could be maintained in some way, and not necessarily publicly funded/administered, or people could be fast tracked into a safety net program.

Of course, none of this is feasible until the economy turns around, and that won't manifest until the Marxist is returned to Illinois or Hawaii or Indonesia or Kenya... whatever.

119 posted on 01/07/2012 8:44:25 AM PST by Dysart (#Changeitback)
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To: Alberta's Child
Thank you for your interesting and informative reply. I agree with most of what you have stated

The problem is that any business sector built entirely on a third-party payment system is doomed to fail simply because there is no longer any "free market" involved at all.

This is very true. This genesis of the explosion of third party payments in health care started in WWII. It was for employers to get around wage controls. Again, because of government, a cancer was allowed to evolve -- the third party payment system.

In a truly free market system, the third party payment system would never have evolved.

Here is an 5 minute video from Milton Friedman Milton Friedman on Market-Based Health Care

I come from the school of thought of our Founders -- "hostility towards government" I would rather have the flaws of the market system rather than the corroding and destructive solutions of arrogant elites in government.

Again, thank you for your interesting post. I think we mostly agree.

120 posted on 01/07/2012 9:26:07 AM PST by sand88
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