The USA needs more doctors (bankrupt, debt, income, costs)

[rubber_factory]

This is just one piece of our overly-regulated, overly-litigated health system.

Miriam Harmatz, a lawyer in Miami, said: “My longtime primary care doctor left the practice of medicine five years ago because she could not make ends meet. The same thing happened a year later. Since then, many of the doctors I tried to see would not take my insurance because the payments were so low.”

How ironic. A lawyer is complaining because her primary care doctor "could not make ends meet."

I wonder if Mrs. Harmatz can connect the dots.

Doctors can't make ends meet because of malpractice premiums to insurance companies.
Insurance companies charge high malpractice premiums because of the high risk of litigation and the huge payouts.
These huge payouts and frequent lawsuits are the result of lobbying by the trial lawyers association.

[8 SNAKE]

Originally Posted by emilybh

What? Some states have TOO MANY doctors. Besides we'd all be better off if we kept our exposure to conventional medicne to a minimum. It turns out, medical errors is the leading cause of death in this country -- more than heart disease or cancer. 800,000 people die every year based on ony 5-20 percent of reported incidents die every year from this. LE Magazine, August 2006 - Report: Death by Medicine

Your supporting evidence comes from a web site geared entirely toward the marketing of vitamins and supplements (while talking down conventional medicine). Seems to be just a bit of a conflict of interest there.

[GregW]

Shortage of doctors & response to 8 snake

The biggest barriers to entry into the medical field is very high cost of education, excessive liability costs, AMA restrictions on supply, high costs of specialists and the need to operate your own business. These difficulties can be removed by:

Cost of education: Replace private loan funding with government loans that would be forgiven as a function of time spent in the needed medical areas and paid for by collecting a portion of the doctor's gross income.

Excessive liability: Liability costs can be reduces by having treatment of “mistakes” provided by the universal health care. Most “excessive” costs are attributable to life time care for severely disabled victims. In addition punitive damages must be eliminated. There should be no way a person, or his family, can become wealthy because of a physician’s mistake.

AMA restrictions: The AMA has had an effective monopoly on the supply of physicians in our system. This monopoly must be eliminated and control of the supply of medical students and doctors turned over to the demand.

Differential pay for specialists: the UHC can establish a payment scale proportional to the financial and time investment required to become a specialist. That way hard work would be rewarded while cost would be controlled.

Own business: At least one of my doctors would just like to care for people and not waste his time being a business manager, employer and insurance clerk. This waste can be eliminated by the UHC because the need for excessive managerial time is eliminated by the one payer system. Effectively a single practitioner become an employee of the UHC system and is free to practice medicine and not be hassled by the annoyances of running a business.

My over all recommendation is to remove conventional small and big business from the healthcare industry. Business has only added layers of management and profit expenses and I believe the services could be provided with greater rewards to the practitioners, fewer damages and much lower costs to the patients and lower cost to the economy by the adoption of a complete UHC system.

[8 SNAKE]

Originally Posted by GregW

Shortage of doctors & response to 8 snake

Very thoughtful response, Greg. I agree with many of your points, but also have a few other thoughts to add.

Originally Posted by GregW

The biggest barriers to entry into the medical field is very high cost of education, excessive liability costs, AMA restrictions on supply, high costs of specialists and the need to operate your own business.

Reimbursement (by the Government) for care to Medicare/Medicaid patients is also a major complaint from physicians that I have talked with. The amount that doctors are paid by those federal programs is laughable.

Originally Posted by GregW

These difficulties can be removed by:
Cost of education: Replace private loan funding with government loans that would be forgiven as a function of time spent in the needed medical areas and paid for by collecting a portion of the doctor's gross income.

I will say up front that I am opposed to Universal Health Care or any form of government run medicine. I'm not completely clear on the second portion of your statement about the collection of a portion of the doctor's gross income. Which doctors? How much income? Who decides?

Originally Posted by GregW

Excessive liability: Liability costs can be reduces by having treatment of “mistakes” provided by the universal health care. Most “excessive” costs are attributable to life time care for severely disabled victims. In addition punitive damages must be eliminated. There should be no way a person, or his family, can become wealthy because of a physician’s mistake.

I disagree with you here. Punitive damages have gotten way out of hand, but I would not eliminate them. Doctors need to have some accountability for the services that they provide. Figuring out how to draw the line between accountability and ridiculous compensation is very difficult and I won't pretend to know that answer.

Originally Posted by GregW

AMA restrictions: The AMA has had an effective monopoly on the supply of physicians in our system. This monopoly must be eliminated and control of the supply of medical students and doctors turned over to the demand.

I don't know a lot about the AMA, but I would agree with you based on what little info that I have.

Originally Posted by GregW

Differential pay for specialists: the UHC can establish a payment scale proportional to the financial and time investment required to become a specialist. That way hard work would be rewarded while cost would be controlled.

I revert back to my disdain for Universal Health Care. I do not want the government setting pay scales for physicians or any other business. Let the free market decide the value of services provided. I also believe that pay scales will have to be constantly changed. People will likely gravitate toward the higher paying options, which will eventually saturate those fields. Then the government will change the scales, infuriating people who lose money in the process.

Originally Posted by GregW

Own business: At least one of my doctors would just like to care for people and not waste his time being a business manager, employer and insurance clerk. This waste can be eliminated by the UHC because the need for excessive managerial time is eliminated by the one payer system. Effectively a single practitioner become an employee of the UHC system and is free to practice medicine and not be hassled by the annoyances of running a business.

Doctors are not forced to own a business if they don't want to. On the other hand, there are a lot of doctors who want to own and operate private practices. Taking that option away would likely have a crippling effect on medicine. I would also disagree about doctors being "free" to practice medicine under UHC. The government will set mandates on what can and can't be done. Those are decisions that should be made between the physician and the patient, based on a myriad of factors.

Originally Posted by GregW

My over all recommendation is to remove conventional small and big business from the healthcare industry. Business has only added layers of management and profit expenses and I believe the services could be provided with greater rewards to the practitioners, fewer damages and much lower costs to the patients and lower cost to the economy by the adoption of a complete UHC system.

I would again disagree with UHC being the answer. I see a flood of physicians leaving the market if the government dictates managed care, pay scales, tuition reimbursement, etc. I also see UHC as a hindrance to innovation and growth in the field of medicine. Why risk the time and resources necessary for innovation if the government is going to restrict/control the rewards? I know that I wouldn't.

[stan4]

Own business: At least one of my doctors would just like to care for people and not waste his time being a business manager, employer and insurance clerk. This waste can be eliminated by the UHC because the need for excessive managerial time is eliminated by the one payer system. Effectively a single practitioner become an employee of the UHC system and is free to practice medicine and not be hassled by the annoyances of running a business.

I'm sorry...I'm not about to go through 12 years of stress, competition, and crazy work so that some else (usually a stupid, untrained, business major) can be my boss. Talk about a no go.

[tallrick]

The very fact that anyone would be required to join the AMA is ridiculous. Also ridiculous is the current medical schooling system designed to funnel money into educational institutions. Anyone should be able to take the tests for a medical license, doctor or self-educated. Non-licensed medical staff are already assisting doctors, why cannot they use this experience to become medical professionals as well? A free market system with voluntary standards of accreditation would work a lot better than the monopoly we have now, or Government socialized medicine. Customers could choose the medical practice and accreditation that fits their needs best.

[oakparkdude]

Originally Posted by tallrick

The very fact that anyone would be required to join the AMA is ridiculous. Also ridiculous is the current medical schooling system designed to funnel money into educational institutions. Anyone should be able to take the tests for a medical license, doctor or self-educated. Non-licensed medical staff are already assisting doctors, why cannot they use this experience to become medical professionals as well? A free market system with voluntary standards of accreditation would work a lot better than the monopoly we have now, or Government socialized medicine. Customers could choose the medical practice and accreditation that fits their needs best.

No one is required to join the AMA. I quit after a few years because I wasn't getting much out of it.

[EnjoyTheSilence]

Originally Posted by 8 SNAKE

Please explain how you feel that universal health care would alleviate a shortage in physicians.

......because it'd push the insurance INDUSTRY out and would ultimately cut costs, just like it does in every other "developed" country on god's green earth.

[8 SNAKE]

Originally Posted by BCreass

......because it'd push the insurance INDUSTRY out and would ultimately cut costs, just like it does in every other "developed" country on god's green earth.

I fail to see a strong connection between the insurance industry and the number of physicians practicing medicine. Care to elaborate?

[PYT]

Originally Posted by tallrick

The very fact that anyone would be required to join the AMA is ridiculous. Also ridiculous is the current medical schooling system designed to funnel money into educational institutions. Anyone should be able to take the tests for a medical license, doctor or self-educated. Non-licensed medical staff are already assisting doctors, why cannot they use this experience to become medical professionals as well? A free market system with voluntary standards of accreditation would work a lot better than the monopoly we have now, or Government socialized medicine. Customers could choose the medical practice and accreditation that fits their needs best.

I highly doubt ANYONE can self-educate themselves to become a physician. The medical expertise involved is far too extensive. Honestly, how would you teach yourself to do a colonoscopy?

And I'm very curious, what type of "test" do you propose for non-licensed medical staff to take? Paper and pencil? A test surgery? I'm not too sure you understand what is involved in medical training. It'd be more accurate to consider licensing as the 3-5 years of residency rather than the medical boards.

When it comes down to it, No PhD, RN, or PA can ever replace a trained doctor.