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More testimony in today's NY Times regarding redundant doctors and unnecessary tests that together push up the costs to the overall health care system:
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“When I started in practice, I wanted to do the right thing,” he told me matter-of-factly. “A young woman would come in with palpitations. I’d tell her she was fine. But then I realized that she’d just go down the street to another physician and he’d order all the tests anyway: echocardiogram, stress test, Holter monitor — stuff she didn’t really need. Then she’d go around and tell her friends what a great doctor — a thorough doctor — the other cardiologist was.
“I tried to practice ethical medicine, but it didn’t help. It didn’t pay, both from a financial and a reputation standpoint.
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1. Medicare generally is about 40% of a physicians book of business.
so lets assume they can walk away from 40%.. guess what.. they can't get managed care contracts because the managed care companies won't deal with a provider that doesn't have a medicare ID.
So now.. the physicians are going to lose another lets say 30-35% of their business..
or they can play an out of network strategy which isn't a very good long term strategy.
They had better have some very very very good self pay patients to make up the difference (and a whole bunch of em')
Excellent post.. my endo did mention that 40% of his patients are Medicaid/medicare and he prefers it..
I stand corrected..I thought all employers had to give maternity leave (yes, without pay which stinks!!).
No, FMLA covers employers who have 50 or more employees and provides for 12 week unpaid leave for certain conditions including birth of a child, to care for a close relative or illness or injury of the emplyee.
There are no federal regs requireing employers to provide paid sick leave (or sick leave period other than FMLA), vacation or insurance.
No offense, but did you read what you wrote before you wrote that? 1. Osteopaths are D.O.'s, which you said should be removed from the role of PCP 1.a)
No offense taken. I recognized the error of my ways shortly afer my post, so I went back and edited it, even before you brought it to my attention. Thanks anyway for pointing it out. At times, my typing is faster than my brain!
The rules are still tight on who can be considered salaried, many lawsuits have been won for back overtime due to improper classification as salaried. I would suggest employees educate themselves before agreeing to a salary.
The US leaves paid leave up to employers, most companies do offer full time employees sick leave, vacations.... It doesn't compare to Europe, but a company needs to offer something to stay competitive.
Do you know how many workers get NO time off, NO vacations? It's tens of millions... and mostly low paid.
What happens if you "cross" your ill days? Can i choose how long i will be sick?
I've seen people BARELY walking going to job... in fear of being fired.
In my view laws have to protect ALL of workers, even the most vulnerable...
I think that this situation is quite sad.
If you ask doctors, they will tell you that American workers are extremely stressed out.
First off, the Government would not provide such things. The employer would. And, it would be a significant cost to the employer to provide your suggested mandates. This cost would of course have to be pass through to the consumers through higher prices for goods and services.
In effect, it would put tremendous inflationary pressure on the economy.
Then of course, you have the high percentage of independent contractors / self employed here in the United States - they would not have the benefit of all these "perks" you suggest.
So, the "employee" would then have an unfair advantage over those "non-employees" -
Sound fair?
Actually GreatDay.. as a self employed individual I already understand that I work more, however the more I work the more I make.. unlike a salaried position with a company where I could be as dedicatd as anything..work a lot of hours and my "salary" would stay the same.. I have NO incentive to put in those "extra" hours.
And.. while I expect my employees to do their work when they are with me adn care, I certainly do not expect them to put in as much as I do..simply becasuse it's not "their baby" so to speak so why should they care so much.. they do their work make their pay and go home.. and they are limited to that..
BUT. you also have to offer "perks" to motivate your staff. I'm already motivated by my self employed status becasue the better my businsess runs, the more I make.. THAT is my perk.. as for my employees..why should they care? BUT... if I"m able to offer "perks" they may be more loyal, may be more productive and may care more. For example, when we had employees (we've scaled down recently.. especially with a recession) my husband would treat everyone to lunch. This actually motivated them to WANT to work THROUGH their lunch (even though we kept telling them to STOP and ENJOY their lunch..LOL).. that's just a small example.. but you get my point.
How are the leaves and vacations paid for in Europe? Does the government help pay for it? It's very hard for a small company to pay these benefits and it isn't just about greed. If I hire one person, as much as I would want to provide him/her with the best of benefits, I would have a hard time affording it. That's why FMLA only applies to companies over 50 employees, it would pose a real hardship to small companies.
How are the leaves and vacations paid for in Europe? Does the government help pay for it? It's very hard for a small company to pay these benefits and it isn't just about greed. If I hire one person, as much as I would want to provide him/her with the best of benefits, I would have a hard time affording it.
And, in addition, if that employee is off for an extended period, and they are doing a vital job, you have the additional expense of replacing that employee, even for a temporary period
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