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250k is a lot of debt. $3k a month is a mortgage payment for a $400-450k home. $400k doesn't buy you much in a lot of urban areas in terms of housing. $150k-200k a year. Minus taxes and elective 401k deferrals. Doesn't leave much left over.
Most young docs don't want to live in the boonies to have those loans repaid.
You may be right. Wealthier kids may end up going to med school cause poorer students don't want to take in that debt.
I believe any young doc can pay off that kind of debt without a great deal of difficulty. Buying a new house on top of it does not sound smart. But I would think any doc already understands this by the time they are done with med school.
You know my dentist charges more because of the area we live in. He actually said that. Insurance won't pay for all his charges though because they think they are too high.
So does my dentist, given the relative affluence within my area. He has a mature practice of patients who are devoted to him. I am one of them.
He does not accept any dental insurance and requires payment in full, at the point of service.
His fees range 50-100% higher than what he would receive if he had PPO arrangements with insurers. I know because my husband sees a PPO dentist and I compare and contrast fees.
Healthcare providers who do not accept insurance and expect payment in full, at the point of service, are rarely competitive from a financial standpoint. They are being paid more than they would if they entered into contracts with insurers. On the other hand, their potential patient base is not nearly as deep as it would be if they were a part of an insurer's network. It all depends.....
I think this is a new part of the ACA. Doctors get a small tax credit to install an expensive system but it comes with lots of rules, like requiring the patient to check it a few times per year. My doctor friend was telling me about it the other day. He said it's cheaper to pay the penalty that to install the system and in his practice it would be hard to get enough patients to utilize it.
It probably exists to help monitor how doctors are performing and to help portability of health records. I think it is not a bad idea, though perhaps poorly implemented.
Private and public insurers have been trending towards Electronic Medical Records (EMR) since the late 60's. The greatest push for transitioning to EMR for public insurance began in 2004 +/-. Federal grants for subsidies were included in the 2009 stimulus package. I believe these grants include payments over 5 years with a cap of $65,000 +/-.
To the best of my knowledge, no MD is required to offer patients an electronic portal to their records.
Medical practice experiences with EMR seems highly variable, dependent on the system provider they choose and their ability to cope with change, over time. A small one man practice with minimal admin is going to be more challenged than say a practice with dozens of MDSs and a well trained admin staff to support them.
There's an old Help Desk diagnostic term called " PEBKAC", Problem Exists Between Keyboard and Chair". It continues to be as applicable today as when it was first coined.
250k is a lot of debt. $3k a month is a mortgage payment for a $400-450k home. $400k doesn't buy you much in a lot of urban areas in terms of housing. $150k-200k a year. Minus taxes and elective 401k deferrals. Doesn't leave much left over.
Most young docs don't want to live in the boonies to have those loans repaid.
You may be right. Wealthier kids may end up going to med school cause poorer students don't want to take in that debt.
I live in an area that has a substantial concentration of MDs at different stages of their careers, affiliated with a local hospital. Their student debt load has not prevented them from buying homes well in excess of $400-450K and having families. MDs tend to get the most favorable mortgage terms because they pay their bills and are amongst the least likely to become unemployed.
The more seasoned the MD, the more likely he/she has one or more secondary residences. In other words, the financial investment into their careers, student loan debt, seems to pay off.
It's unclear to me why MDs consistently bill insurers more than the amount they contracted to be paid by the insurer as it relates to in network services. And in my neck of the woods, they all do.
Docs will always bill the full non-discounted charge to everyone. If they do not, the insurer will discount its payments even more, because the lower amount becomes the "usual and customary charge".
That's why the explanation of benefits you receive will show the billed amount, the allowed amount after the discount given to the insurance company, how much the insurances covers, and the patient share (deductible and copayment).
And MDs are free to participate in the plan, or not.
Some MDs make the business decision to not participate in any insurance plan. Their patients know this going in and know they need to pay out of pocket at the point of service. If the patient is insured, they are free to submit a claim and their insurer will pay their customary rate for out of network providers, if their plan accommodates out of network providers.
An MD may chose to accept one BCBS plan and not another, or one insurer and not another.Some plans allow the MD to cap the number of patients it accepts.
Historically, those with the most affordable plans have had the fewest choices of MDs who will accept those plans. This was true before the ACA and nothing within the ACA changes this.
That some medical practices attempt to milk the claim is nothing new.
How this is news is beyond me.
"And MDs are free to participate in the plan, or not."
What do you mean "And"? This is exactly what I said.
Originally Posted by Dale Cooper View Post
0bamacare is going to destroy the medical profession. I can't imagine any young person wanting to be a doctor. The glory is gone.
The glory of being a doctor is gone for several reasons. Imagine taking on all that debt, giving up years of your personal life to go to school then when you get out you owes a huge school debt and the government wants a huge chunk of your money. What's the point.
I guess you are saying their crimes are OK, because they have an excuse you like?
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