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Average person simply cannot pay what doctors charge, period. It takes byzantine system involving insurance industry, large chunk of healthy population (to fleece) and controlled bankruptcies for doctors to get paid a small portion of what they think they are worth. And as screwed and unhealthier younger generations are, this system is full steam towards collapse.
Doctors are in unique position, they play with the most precious what people have - their life and thus charge unknown amount of "survival fear" and "emergency" premium. Believe me, I would sell a load of the junk food to starving doctors for quite a bit of $, much more than well fed doctors would be willing to pay. Plumbers and doctors benefit quite handsomely of emergencies when people have no choice but to come up with $ or else.
Here is a real solution. Different price scales for all goods and services for regular folks and medical&insurance professionals (I would add financial leeches there too). Regular pound of potatoes $1/lb, Financial wizards $10/lb, doctors & Insurance professionals price - $4/lb, nurses - $2/lb, nurse aids get regular price. Doctors should not object to different pricing since they charge uninsured triple and quadruple prices all the time. It would never work in the mega corporations controlled world, but that's what I would do.
Actually, uninsured pay full price and insured get a discount. A better comparison would be a store giving a discount to people who participate in a customer loyalty program. The price for the uninsured would go down if reimbursement from insurance companies went up. At the grocery store, the cost of the loyalty program is paid by those who choose not to participate. Why not insist that stores get rid of loyalty programs?
The majority of doctors provide some totally free medical care. Often that is done for patients who have been with a practice long term and have fallen on hard times. Sometimes it is by volunteering at free clinics for the indigent. Of interest is that participation in "managed" care plans results in doctors providing less free care. That is likely because the reimbursement from "managed" care is barely enough to keep the doors open.
I haven't seen a single illegal immigrant partaking of the supreme & free health care largess (as prepaid talk radio clowns claim), check emergency rooms for yourself once in a while. This issue of illegals getting free ride is pure propaganda. It's extremely difficult to get free (or reasonably priced) health care in USA. What illegals do? They have their own network of the unlicensed doctors and dentists taking care of their needs for the price they can afford. US and state governments spend lots of $ to hunt those unlicensed doctors down so "natives" would not get wrong ideas.
How much time do you spend in ERs?
In 2008, 1 in 12 births in the US were to illegal aliens. They all passed through the ER on the way to the delivery suite. After delivery, the mothers become eligible for emergency Medicaid and the child, an American citizen, becomes eligible for Medicaid and a whole list of taxpayer provided services.
Let's see what ER doctors say about illegal aliens:
"Q. How much does it cost U.S. taxpayers to provide health care for illegal immigrants?
A. Billions of dollars are estimated to be spent each year, although data are scarce on both the costs and use of health care. Transient living conditions, undercounting of migrant workers and desire to avoid contact with government agencies limit the nation's ability to accurately determine the costs of their medical care.
In some hospitals, as much as two-thirds of total operating costs are for uncompensated care for illegal aliens. As a result, hundreds of emergency departments have closed. In Los Angeles, for example, 10 hospitals have closed in the past five years because of uncompensated care.
Congress in 2005 authorized $1 billion in funding over four years to help physicians and hospitals recover costs of providing emergency care to illegal immigrants. This was a critical first step in recognizing the growing funding crisis in the nation's emergency departments, which affects everyone's access to emergency care."
Physicians are public servants, as they maintain health of the nation.
Or so they should be.
Physicians should become ones solely based on dedication and vocation, not based on monetary interest.
They should be on very decent state salary, and incentivised based EXCLUSIVELY on objective results of their treatments.
Same has to be for teachers, who prepair the future of a nation, and engineers, who make nation develop. Well, engineers and scientists, as back in times of nobility, engineer was a scientist in same person.
All of the above is not possible in privately owned for profit country. The rest is idle discussion. System needs etiological, not symptomatic treatment. Root of the problem is greed and profit, until they are rooted out, nothing will change.
Actually, uninsured pay full price and insured get a discount. A better comparison would be a store giving a discount to people who participate in a customer loyalty program.
Please, name me a single store offering a 200%-300% discount to people who participate in a customer loyalty programs? Some (if not most) practices don't take uninsured patients at all, and they manage to survive handsomely after insurance companies would cover 30% of their alleged "real" costs. You consistently try to rationalize highway robbery. Doctors and Hospitals can charge double and triple prices because they can, an armed men can ask for your wallet because he can, you can charge a man dying of thirst whatever arbitrary price would come to your mind. Your analogy doesn't make any sense.
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The majority of doctors provide some totally free medical care. Often that is done for patients who have been with a practice long term and have fallen on hard times.
It doesn't matter. Without byzantine insurance and government schemes health care is not affordable, period. Why stop on health care? Let's make all goods and services unaffordable and "invent" complex insurance schemes to pay for food, clothing & gas. I don't even talk "morals" and "philosophy" here, simple business aspect of it all is very weird. If an average income earner cannot afford a good or service, it's called a luxury item.
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In 2008, 1 in 12 births in the US were to illegal aliens. They all passed through the ER on the way to the delivery suite. After delivery, the mothers become eligible for emergency Medicaid and the child, an American citizen, becomes eligible for Medicaid and a whole list of taxpayer provided services.
I have a clue about dismal care ER provides at exuberant prices. They shrug you off, charge insane fees, shrug you off, charge insane fees, and then comes crisis, they don't know what to do and call for a helicopter. That's how I almost lost my son. There is no major presence of illegal Mexicans in my area (no work), prices are absolutely insane regardless. Besides, what sense does it make to crack down on the unlicensed doctors who serves illegals, if you don't want to pay for their ER visits?
Please, name me a single store offering a 200%-300% discount to people who participate in a customer loyalty programs? Some (if not most) practices don't take uninsured patients at all, and they manage to survive handsomely after insurance companies would cover 30% of their alleged "real" costs. You consistently try to rationalize highway robbery. Doctors and Hospitals can charge double and triple prices because they can, an armed men can ask for your wallet because he can, you can charge a man dying of thirst whatever arbitrary price would come to your mind. Your analogy doesn't make any sense.
It seems you do not understand basic math. A 100% discount would be free. Stores do that frequently. Kroger will send me a coupon for a free item. A 200% to 300% discount would be paying the customer. That makes no sense. Hospitals require doctors to see uninsured patients as a condition for having privileges to practice.
Insurance companies control the patients. They demand --- and get --- hefty discounts. If the insurance company wants a 50% discount and the office overhead is 50%, the doctor does not get paid anything at all.
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It doesn't matter. Without byzantine insurance and government schemes health care is not affordable, period. Why stop on health care? Let's make all goods and services unaffordable and "invent" complex insurance schemes to pay for food, clothing & gas. I don't even talk "morals" and "philosophy" here, simple business aspect of it all is very weird. If an average income earner cannot afford a good or service, it's called a luxury item.
Doctors do not make the insurance rules. You are demonizing the wrong people. The average American family does have health insurance, by the way. The biggest problem is for the working poor.
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I have a clue about dismal care ER provides at exuberant prices. They shrug you off, charge insane fees, shrug you off, charge insane fees, and then comes crisis, they don't know what to do and call for a helicopter. That's how I almost lost my son. There is no major presence of illegal Mexicans in my area (no work), prices are absolutely insane regardless. Besides, what sense does it make to crack down on the unlicensed doctors who serves illegals, if you don't want to pay for their ER visits?
So you based your opinion that there are no illegal aliens in emergency rooms on a geographical area with few illegal aliens. I see.
If there is no work in your area, then perhaps your hospital is seeing a large number of uninsured that happen to be citizens. If you want to know where your hospital's income comes from, ask it. You may be surprised.
A letter from Dr. Adam to his patients. I apologize for all the irrelevant comments:
I believe the corporatization of medicine is a big reason we pay more than the rest of the world. The doctor is paid, then overhead and profit is added. Overhead includes fabulously paid executives and advertising. If the company also owns a hospital, it makes sense to encourage a hospital stay for what could be done outpatient. Unnecessary treatment is encouraged. Of course the doctor is not permitted to waive the fee for someone who can't pay.
I haven't seen a single illegal immigrant partaking of the supreme & free health care largess (as prepaid talk radio clowns claim), check emergency rooms for yourself once in a while. This issue of illegals getting free ride is pure propaganda. It's extremely difficult to get free (or reasonably priced) health care in USA. What illegals do? They have their own network of the unlicensed doctors and dentists taking care of their needs for the price they can afford. US and state governments spend lots of $ to hunt those unlicensed doctors down so "natives" would not get wrong ideas.
Sorry, but I have sat in many ER's when my mother was alive and very elderly and watched many people who spoke almost no english in the ER's and I can almost bet they were not legal, however much you say so. They kids were because they were born here, which is another story.
Also, the private charities and sometimes gov sponsered have set up several clinics here in Central Fl where undocumented people go for graduated pymt services. If they need further treatment, they are sent to agreeable doctors. I know, I volunteered in one for a while. My daughter is also an RN in a level one trauma center and she sees it every day. So, know all your facts before you speak.
I know poor working people that could have benefited from these same kinds of treatment options before we were buried under immigrants and the need became so great. In my area, they helped to close the last charity hospital in the US, and was done within the last 20 years. I, and my brother, had our tonsils out there in the 1950's and was a godsend for us. It was originally set up for migrant workers but, thecounty just could not fund it any longer with the flood of legal and illegal immigrants seeking care. So, all were cut off.
The pay of doctors is a non-factor in the absurdly high prices of medical care in the country. A drop in the bucket.
Big Pharma and the insurance companies are the ones to blame if you're looking for someone to point the finger at.
It's them--not your doc--that charge you $12 for a Tylenol tablet while in the hospital.
The ER visit and follow-up care for a simple broken arm these days can cost up to $15,000. That's NOT because of your physician's paycheck!
There are many culprits in the high cost of health care. Arguing that the salaries of physicians plays no role though is both fallacious and ignorant. The truth is, its not just physicians. Its the salaries that all people working in the health care industry earn that is the single largest contributor to costs. Specialist physicians may earn $300,000 to $500,000 a year. A family doctor earns an average of about $150,000 per year. Critical Care and Emergency Room nurses may earn $80,000 to $100,000 a year. Than there are the administrators who run hospitals, HMO's, and the alphabet soup of organizations that deliver medical care in this country. Even surgical technicians and phlebotomists pull in comparatively high wages.
What do all these people have in common? What they have in common is that there is virtually no field outside of medical field that pays wages and salaries on this scale. If you open your eyes, you have to see these high salaries for what they are, THE major contributor to medical costs in this country. All the nurses, doctors, and executives can sit there all day long with a straight face and try to tell me that their high salary isn't part of the problem. It is. They just don't want to admit it. I challenge those who disagree to describe other sectors of the economy that have as many well-paying jobs.
Part of the solution to the high cost of health care in this country is to find ways to deliver quality services to consumers and reduce costs. Much primary care could be provided by Nurse Practitioners and Physician Assistants, as opposed to family doctors. Many procedures done by specialist physicians do not add years to a patient's life. Insurance reimbursement to specialist physicians is too high and should probably be revamped. When 80 out of 100 physicians graduating from medical school choose to go into a specialty instead of primary care, that's a pretty good indication that compensation for one group maybe too low and compensation for the other group maybe too high.
Salaries in the health care field tend to be high because there is little competition and few market forces that require health care organizations to keep costs down. Fee for service leads to more procedures being done. More employees means more ability to generate revenue. Many communities only have one hospital and anyone needing emergency care has to go there.
Its necessary to call things for what they are rather than look for "boogeymen".
The German system finances PRIVATE health coverage with a graduated income tax. Then doles the money out to independent provinces that provide the care.
Thus everyone that works pays for health insurance---just like everyone who works pays into social security here.
Since German care is considered superior to ours (it's not without some funding problems), it would appear that their system works well for them--and maybe would for us, too.
The biggest problem we have is that our politicians are owned, lock, stock, and barrel by the health industry and pharmaceuticals. And as a recent illustration of just how much power special interests in general have, the Affordable Care Act initially had a number of changes to "medi-gap" insurance. But AARP receives more funding from their commissions off the sale of medi-gap insurance than it does off selling memberships, so they successfully lobbied to withdraw any restrictions on medi-gap coverage.
Until all our nationally elected officials must depend entirely on public funds for obtaining political office, we will remain slaves to the corporations that rule our lives so thoroughly right now.
My very first job required extensive (and very expensive) academic and practical training. I couldn't afford to pay for it.
I was sponsored by a company which paid for my training and paid for my food and accommodation. The deal was that at the end of the initial formal training, the company would offer me a job at the 'going' rate. I could either take the job (and repay them a significant amount of money from my salary each year for 5 years) or I could go elsewhere and pay the whole lot up front. (As it happened, that company decided they had hired more personnel than they needed, so the contract was dissolved.)
My next employer (not dissimilar work) paid for my training, paid me a salary during training and required me to work for them for a rather long period.
If you want state-employed doctors (and there is precedent in a number of countries) then the answer is simple.
Let the state select suitable trainees, provide them with an employment contract which paid them a living salary during training, paid all the costs of that training and then required them to work at a pre-determined (and pre-agreed) salary for a minimum period of time in medical facilities (surgeries/hospitals) operated by the state and staffed with administrative and nursing staff employed by the state. (You could use the same scheme to train RN's.)
If the contract is seen as being equitable by both sides then there would be no shortage of suitable applicants.
The patient would pay the doctor the doctor's salary - not the doctor's training costs, the doctors malpractice insurance, the salaries of the doctor's staff, the operating/rental/purchase cost of the premises and equipment. The state could bill the patient for that separately. There would also be the costs of the bureaucracy [which would, of course, be passed directly to the patients.]... I wonder which would be more efficient? A doctor's surgery operated by a (group of) doctors who would have a clear incentive to be efficient or a state-run medical facility operated by salaried bureaucrats?
I understand that Obamacare is (in part) to be funded by money taken from medicare. (I'm not sure how you can take money from one medical pot, put it in another and [somehow] increase the amount of medical care you provide, but I'm not a politician and I've never understood how politicians can spend the same lot of money twice.)
I've been told by people who used to work as nurses in medicare that because the funding has been switched to Obamacare they have lost their jobs.
Reduced funding for medicare → fewer jobs in medicare → reduced health care provision in medicare. Seems logical.
How many of those people (front-line health car workers) who lost their jobs in medicare have been re-hired to provide Obamacare?
Where did the money go? How much has been diverted to cover 'administrative expenses'?
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