Its all a deathpanel, the truth about osamacare

[tpaschal30]

As noted in your source, there were about 42000 applicants in 2008. That compares with 46000+ in 1996. The number of applications per applicant has increased.

The number of medical schools has been increasing annually, but the concerns about shortage are not equal across all specialties. The primary shortages are in primary care positions: GP's, family care specialists, internists, OG/GYN, etc. There are also clear shortages in more rural areas throughout the country. Simply increasing the number of physicians without addressing maldistribution geographically and by specialty would have little benefit. .

That is where a free market would work. With the new system they will have to entice or force doctors to live where they do not wish to.

[Buck Mann]

Why in the health care bill is there no plan to increase the amount of providers. Might be the reason the AMA is for the bill. They control who and how many can provide all in the name of supposedly benefiting the patient.

Interesting discussion with many good points. However, the AMA doesn't control anything. I think the most recent numbers show that the majority of physicians are not even members of the AMA and it's membership has declined. Historically they have been a totally ineffective lobby.

A big part of the problem is the cost of giving medical care to the aged in an aging population. Also, the acess that Americans are used to having to highly technical care is very expensive. So far, no country has come up with a model that works well. Time will tell if ours can. I think there are going to be too many concessions needed by the population to make it very palatable. There will have to be some sort of rationing to make health care for everyone financially viable. We'll see if the people are willing to accept that.

They way medicine is headed with continually decreasing reimbursements, increasing regulation and deteriorating satisfaction with the practice of medicine, I have a hard time recommending this profession to young people.

Buck

[Gerry Clinchy]

As an aside, there is a fair amount of evidence that medical service usage is driven more by the availability of services than it is by the need for services. As the number of providers goes up, visits go up with no obvious benefit in health outcomes. This pattern was first identified in a book titled Doctors, Patient and Health Care by Hermann Somers in the 1970's and has been repeatedly illustrated since then by health economists.

The stats may hold true under our present system, but if adding universal health care insurance to the picture, a new variable, those stats may, or may not, continue to hold true.

[YardleyLabs]

That is where a free market would work. With the new system they will have to entice or force doctors to live where they do not wish to.

If you want a free market in health care, get rid of health insurance altogether. Once you get past the transition period when tens of thousands die for lack of care, and many leave the industry for lack of revenue, those left who are able to pay anything asked will receive outstanding care. However, they will still have trouble getting that care in rural areas.

It's not clear, in fact, that there is a good answer for rural care. In truly rural areas, the infrastructure to support modern medicine is not readily available. As a consequence, the real answer may lie in more intense us of communication and transportation resources to support primary care providers in rural areas and move people to more urban areas for all other care. While I haven't seen recent data, when I was first involved in research on these issues the average compensation for rural GP's was actually higher than for urban GP's. Despite this, there were few takers because of the lack of hospitals and ancillary services in rural areas.

I think Buck Mann's comment that "They way medicine is headed with continually decreasing reimbursements, increasing regulation and deteriorating satisfaction with the practice of medicine, I have a hard time recommending this profession to young people." is very true. This is not the product of government run insurance, it is the product of private managed care plans and government run plans. The primary approach used for driving down costs has been to drive down physician compensation. What other professions have seen reduced income over the last decade? However, i suspect that the bigger problems have been related to the increased bureacratization of care and the pressure it has placed on physicians to perform more and more administrative activities that are not directly tied to patient care.

Having said that, I am extremely impressed by the University of Pennsylvania Medical Center group practice that I now use. They have put together administrative and computer resources that appear to work extremely well. My physician spends her time being a physician and loves the fact that she always as the chart at her fingertips, always has every lab test and xray at her fingertips, and can order whatever is needed in seconds and have the appointments be scheduled and printed out for me immediately, all with virtually no typing of her own. I have toured a lot of medical facilities and do not believe I have ever seen a better run clinic.

[road kill]

If you want a free market in health care, get rid of health insurance altogether. Once you get past the transition period when tens of thousands die for lack of care, and many leave the industry for lack of revenue, those left who are able to pay anything asked will receive outstanding care. However, they will still have trouble getting that care in rural areas.
It's not clear, in fact, that there is a good answer for rural care. In truly rural areas, the infrastructure to support modern medicine is not readily available. As a consequence, the real answer may lie in more intense us of communication and transportation resources to support primary care providers in rural areas and move people to more urban areas for all other care. While I haven't seen recent data, when I was first involved in research on these issues the average compensation for rural GP's was actually higher than for urban GP's. Despite this, there were few takers because of the lack of hospitals and ancillary services in rural areas.

I think Buck Mann's comment that "They way medicine is headed with continually decreasing reimbursements, increasing regulation and deteriorating satisfaction with the practice of medicine, I have a hard time recommending this profession to young people." is very true. This is not the product of government run insurance, it is the product of private managed care plans and government run plans. The primary approach used for driving down costs has been to drive down physician compensation. What other professions have seen reduced income over the last decade? However, i suspect that the bigger problems have been related to the increased bureacratization of care and the pressure it has placed on physicians to perform more and more administrative activities that are not directly tied to patient care.

Having said that, I am extremely impressed by the University of Pennsylvania Medical Center group practice that I now use. They have put together administrative and computer resources that appear to work extremely well. My physician spends her time being a physician and loves the fact that she always as the chart at her fingertips, always has every lab test and xray at her fingertips, and can order whatever is needed in seconds and have the appointments be scheduled and printed out for me immediately, all with virtually no typing of her own. I have toured a lot of medical facilities and do not believe I have ever seen a better run clinic.

Funny, that's exactly what we think will happen with socialized healthcare.

[M&K's Retrievers]

[that a real racist comment... I hope for your sake you never need a doctor to save your life in an emergency room situation because you dont get the chance to pick and choose based on their ethnic back ground[/QUOTE]

Careful now. DNF will get his feelings hurt

[dnf777]

[that a real racist comment... I hope for your sake you never need a doctor to save your life in an emergency room situation because you dont get the chance to pick and choose based on their ethnic back ground

Careful now. DNF will get his feelings hurt[/QUOTE]

If you think your comments can affect me like that, you have a really overinflated opinion of your self-importance!

What I take exception to is race-baiting comments like that. In no way did I refer to race. I pointed out that more and more voids in the healthcare workforce will be filled with people from other areas of the world that may or may not speak english. (England not being one of them, since I assume they still speak english there, albeit with an accent)

I think most reasonable people on this list, esp those who have had experince with poor-english-speaking doctors will sympathize, and not accuse that observation as being racist. There is a difference between race and one's first language or country of origin. Believe it or not MK, there are white people from other countries that are more difficult to understand than many of different races.

So get your racial-policing haclkes back down, nobody is violating your rules here. Relax, life's good.

Happy bumper regards,
dave

[Bob Gutermuth]

Dave, you are right on the money. I cannot think of many things that are scarier than going to the emergency room and being treated by an MD who has poor English skills. Being unable to communicate with the doctor is a major roadblock in getting the proper treatment. He/she may be a fine doctor, but not being able to understand one another is a major problem in getting a problem fixed. Been there done that.

[BonMallari]

Some of you are missing the point on foreign born doctors, whether they speak Farsi,Chinese,Vietnamese, these doctors are by and large the cream of the crop of there respective countries.Look at any large metropolitan city and pick any specialty and more than likely one of the pre eminent specialists is a foreign born doctor. They are not the folks you see at your local 7-11 or any motel near your favorite HT/FT

Even better yet take a look at this years National Spelling Bee finalists, most of the kids were either of Pakistani, Asian or Indian descent..coincidence..not hardly..These countries are beating us at a game the US invented

[dnf777]

Some of you are missing the point on foreign born doctors, whether they speak Farsi,Chinese,Vietnamese, these doctors are by and large the cream of the crop of there respective countries.Look at any large metropolitan city and pick any specialty and more than likely one of the pre eminent specialists is a foreign born doctor. They are not the folks you see at your local 7-11 or any motel near your favorite HT/FT

Even better yet take a look at this years National Spelling Bee finalists, most of the kids were either of Pakistani, Asian or Indian descent..coincidence..not hardly..These countries are beating us at a game the US invented

yeah, you're right, and its' a damn shame! Our kids are too busy eating microwave popcorn, juicyfruits, and playing wii to do anything like study! At least I was too busy playing football and stickball outside to study.....at least there's some exercise benefit there. We are turning into a fat, stupid lazy culture, that can't hold intelligent debate and engage in politics in a constructive way. (that's NOT aimed at anyone here!!) Even if I disagree some of the time, I take comfort in the fact there's so many here engaged in discussion, and researching, and being politically active, and I enjoy the hell out of it. Keeps rust out of the noggin.

I'm at work (lunch break) right now, but as I type, there are literally MILLIONS of americans watching Oprah or Jerry Springer, stuffing chips and soda down their gullet as fast as chubby arms will allow, whose ONLY fluid intake is soda, and the only thing they've read is the warming directions on a swanson box. Pretty ugly picture, but it explains why we're getting our butts whipped by many international measures, and why our life expectancy is decreasing.