What's Your Doctor Worth?

American Thinker ^ | January 25, 2007 | Linda Halderman, MD

[Fairview]

The point I am trying to make is that the average person thinks that the average doctor is "rich," and has no idea that (a) most doctors these days are comfortable but far from being rich, and some have real financial problems, (b) the headaches and risks of practicing medicine in the present economic climate is making a lot of them consider leaving the practice of medicine altogether, and (c) their compassion is not in short supply, especially considering that all work done for elderly and Medicaid patients is charity care.

[DB]

It is a community hospital that gets public funds. I don't know the details of how that works though.

I spent 20+ hours with her in the room. That $500k bill would have more than paid for every piece of equipment in the room. It was mostly old equipment and they've recouped the cost many times over.

[Doghouse Riley]

This article is a well-written, eloquent plea for more of my tax money.

Forget it.

Unless we get a socialist program in which MD's are required to participate or face prosecution, Dr. Halderman is welcome to decline these patients.

As long as taxpayer money is funding Care/Caid I want the payments to providers set aggressively low.

[Kozak]

Clicking on the link shows that the good doctor is a California plastic surgeon: "offering Medical Spa Services, we provide a place to improve and maintain your appearance in a safe, professional environment."I doubt that we need to take up a collection.

And as a plastic surgeon she doesn't HAVE to work in a situation where she accepts Medicare or Medicaid. She can set it up to demand cash up front. Of course that means no mastectomy or reconstructive surgery for the Medicare or Medicaid patients. Does that situation make you happy?

[DB]

I should add, the truth is, she (and the insurance company) are paying for all the others who didn't pay - particularly the illegals. It isn't that her specific care cost $500k, it is her care in addition to the many before her that didn't pay their way.

That is wrong.

If the voters demand that hospitals take care of illegals and dead beats then it is the voters who should pay the cost directly. Not the next person that comes through the hospital door sick and who happens to have insurance or can otherwise pay.

And just perhaps if they started bearing the burden of their vote they'd vote differently.

[Doghouse Riley]

What we really need to move to is a two tier system where those who are getting their care on the taxpayers dime can get it in a clinic situation -- salaried MD's who have part/all of their educational expenses subsidized and have no malpractice worries.

Raising Care/Caid rates to the point where they are "profitable" for private MD's in boutique practices is not the solution, unless you want to see your taxes skyrocket.

[durasell]

Boutique or concierge practices usually don't accept insurance.

[Conservativegreatgrandma]

You're starting to catch on. People go to doctors far too much. They're just as capable of making matters worse as to making matters better. Doctors are very poor at treating chronic disease. They only treat symptoms, many times creating new symptoms in the process.

I've found a favorite new website: www.curezone.com

[Jim Noble]

If the voters demand that hospitals take care of illegals and dead beats then it is the voters who should pay the cost directly.

But they don't.

So, should the hospital, which maintains and provides for an ICU (and not just an ICU - an operating room, an emergency room, beds, a kitchen, heat, air conditioning, a staff of hundreds (at least) ready to care for you at the drop of a hat - should that hospital, which in all probability recieves ZERO of its operating overhead ($100 million/year, probably) from the taxpayers - should it close, or should it send bills?

Which is it?

[from occupied ga]

While I'm sympathetic to the writer of this article, someone is making money. A lot of money.

More like a lot of people are making a little money each. Take surgical billing at a large hospital. Lets start with 20 operations of $5000 professional fees each. First only 40% of these are ever collected because of insurance underpayment and the fact that a lot of people simply don't pay. so we're down to $40,000. The dean of the medical school now takes 16% off the top to support the medical school so now we're down to $33,600. The hospital charges the surgeon 60% of the collected bill for overhead - support staff OR supplies salaries for anesthesiologists, OR techs, etc. so thats another $24,000. If you subtract this from the 33,600 that's left after the med school gets theirs, then the surgeon gets $9600 for 20 operations or about $480 each. Now the surgeon has to have initial clinic, pre-op clinic, the operation itself, and followup care. Say 2 hours before the operation, 3 hours for the operation, and about 3 hours after the operation for followup the hourly rate that the surgeon gets is about $60/hour. Not a whole lot for the level of training and commitment that the job entails.

The biggest cost is the cost of treating non-payers, so when you see the ER crowded with people who only speak spanish, you can bask in the warm glow of knowing that your money that you're paying for your health care is actually paying for them too. (Thank you Jorje Bush for making the USA the welfare choice for Central America)

[CharacterCounts]

She did.

No. She did not!

She gave you an isolated example of one case.

A relevant answer would have been the income she reported on her federal tax return.

[DB]

"But they don't."

And there lies the problem.

It isn't a choice of "which is it". The whole thing is built on a series of bad choices - all stemming from government mandates/regulation. The only solution with any hope of actually making things better is getting the government out of health care. Not more of the same.

As it always is, the solution to the problems socialism causes is always more socialism... It never occurs to the bureaucrats that their "solution" is the actual source of the problem they're trying to fix.

[from occupied ga]

A lot of money.

One thing I forgot which is a large part of the hospital 60% overhead is that the hospital covers malpractice out of this overhead too.

[durasell]

Wow, so they'd actually make more working within a framework of socialized medicine! Amazing that the AMA isn't storming the steps of the Capitol demanding gubmint work.

[DB]

Wrong.

She took the example given knowing she wasn't going to be paid what her time was worth. In other words it was basically charity. She would have very likely made more money not accepting such patients. So who is going to care for these people if no one is willing to see them?

Most businesses can't afford to run their business as a part time charity. Nor should they be expected to.

[DB]

Yes - and in that case the people making "a lot of money" are the parasite lawyers...

I don't want to pay to make lawyers rich because I'm sick.

[Jim Noble]

The biggest cost is the cost of treating non-payers

The biggest cost is overhead.

The difference between the facilities and equipment that a hospital had to maintain in 1970 and now is staggering.

DB is complaining that her niece was in a modern ICU with pneumonia for two weeks (and presumably lived), and that it cost $500K.

The cost of having that ICU available 24/7/365, so that her niece, and everybody else's relatives, can drop in at 3:30AM critically ill and survive, is enormous.

And DB doesn't think her niece should have to pay for that cost (as opposed to her actual resource use).

But DB has not answered the question of who that hospital SHOULD send the bill to for weekly maintenance on the ventilators, or for the on-call respiratory therapy staff, or all the other stuff required to have that unit ready for her niece to drop in with pneumonia.

THAT'S the cost problem. It costs tens of millions of dollars to staff, equip, and maintain ICUs and ERs in a ready condition, and no one wants to pay.

[mo]

Follow the money...dollars are the corpuscles of the truth here....its is far, far cheaper for the insurance company and the payer of last resort, the Feds(you and me), when a patient succumbs to an intracerebral hemmorrhage than to go through apprpopriate, highly skilled and technical intervention resulting in several weeks of hospitalization and rehabilitation.

[durasell]

In my experience, doctors who are struggling are struggling because they're either in a market with little or no money or happen to be hacks.

You can still make a darned good living as a doctor.