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Discussion in 'Politics, Religion, Social Issues' started by IgnatiusTheKing, Mar 16, 2010.
Those are some astounding numbers.
I thought this was interesting.
What a shockingly low number.
Lots of unhappy doctors out there.
If the senate's bill passes, it is a certainty that your primary care provided 5 years from now is more than likely going to be a Nurse Practitioner or a Physician Assistant. Those manpower shortages will become even more problematic in other specialties. Neither Nurse Practitioners nor Physician Assistants can take your appendix out.
Because that is how it is in Britain and Canada?
The spin and fear mongering has reached a fevered pitch.
Agreed. Total BS. The sky is falling, the sky is falling. Pay no attention to the man behind the curtain.
Whatever happened to this poll?
ironicly, the major reason in the first poll as to why the doctors who said they would quit if health care reformed passed was because of "increased traffic due to more people being covered"...
No, because there aren't enough physicians to go around. Physician "extenders" will be the only viable option to make up for the shortage.
I agree and doctor/health care provider shortage is something neither the Senate or House bill address...imagine your doctor office (and every doctor office) having 30 million new patients amid shortages of physicians? Chaos! RATIONED CARE! I posted this New England Journal of Medicine survey in the Health Care Reform thread but it seems relevant here too...
So your answer is to not treat those 30 million people? (p.s. all care is rationed. under every health system. It's a meaningless term and just empty politicking)
Perhaps it seems relevant to you because it's the same survey as in the OP.
All people need be treated. However, if neither the Senate or the House health reform bill address doctor/health care provider shortage solutions perhaps wise men/women in Washington will realize it is time to start over on health care reform rather than introduce laws that makes the problem WORSE!
1) This is INSURANCE reform, not HEALTHCARE reform. That said, as I feel access to a basic level of health care is a human right, I am all for more people being covered.
2) We do not have HEALTHCARE in the US, we have SICKCARE. This is the best nation in the world to have something go medically wrong with you (unless it is a psychiatric problem). We are lousy at curbing preventable/delayable illness. This has as much to do with societal values as the healthcare system. One gets far more return on investment in preventative care/primary care than in cutting-edge procedures. Unfortunately, current reimbursement is upside down. This is the paramount reason for shortages in primary care.
3) There does need to be "rationing" of care. There will never be enough money in ANY sector of the economy to give everyone what he or she WANTS. Healthcare should be about what people need, not what they want or think they need. I'd rather pay for univeral immunization and prenatal care than artificially delay the imminent inevitability of someone's death in the ICU. A very sticky wicket, I realize, but choices HAVE to be made.
The issue of healthcare is far more complex than can be hashed out in a forum such as this. Suffice it to say, the general public is woefully underinformed as to the true workings/economics of healthcare. Therefore, the masses have been easly herded by the politicians in the past several months. Tough, unpopular choices must be made. Unfortunately, no one in Washington has shown true leadership in advancing the real issues.
What does the current reform bill have regarding training of new doctors/health care providers?
IMO you are absolutely correct. With physician supply falling, expensive technology becoming increasingly part of the standards of care, and the population increasing (and the over-50 portion increasing even faster)...there is no possibility to avoid the rationing of healthcare.
I remember this from a couple of years ago (we may have even discussed it here) so it's worth putting this current survey in context. US doctors have been fed up for a while.
So...what's your solution? Let poor people die?
Honestly, I'm curious.
Those physician extenders aren't going to let people die. At least not intentionally. What a silly question.
Relative to preserving the supply of real doctors, improving physician satisfaction is the place to start. More money, less intrusive regulation, tort reform, less bureaucracy.
What is far more likely to happen is that those medical provider resources that DO exist will have to be utilized increasingly more efficiently. That means rationing of care. It's inevitable. If we're talking about letting people die, it's not going to be letting poor people die, it will probably be that we end up having to let old people die.
That will be part of the eventual evolution. In the short run rationing will take the form of the Canadian health care system. It doesn't matter how much your hernia hurts you, it won't kill you, so your operation will be in two years. Those thirty million people will be covered, but YOU will have to surrender your spot in the health care queu. The line for health care will be a lot longer....it will take you a lot longer to get to the front.
Your assumptions are showing. The insurance companies are already utilizing medical staff as efficiently as possible. Your doctor is on a treadmill to get you in and out the door in as few minutes as possible. They're timed. Of course, on the other hand, they have to spend half their time justifying procedures and filling out paperwork to get paid for the work they do. They are working incredibly efficiently, but towards the bottom line of the insurance companies, not towards better health care service.
This is why a lot of doctors have already been leaving the practice, or leaving medical groups and becoming totally private cash-on-the-barrelhead practices, and why existing doctors have been openly discouraging young people from entering the profession. Doctors have been abused as much as patients under the tyranny of the insurers.
If you really want more and more efficient doctors, you'd support a universal single-payer system such that a single especially clever trained monkey could fill out all the paperwork required to trigger payment. Track that data centrally to identify, for instance, a doctor who orders way more CT scans than his peers in similar practices in the region, but apart from that, let doctors be doctors full-time. You will already have nearly doubled the supply of medical services available in the United States.
Make medicine a tolerable and reasonably well-compensated profession again, and increase the demand for health services by offering them to more people, and it will be seen as a growth industry, luring in talented students. The number of medical practices will expand to fill the demand.
We have 30 million uninsured, ten percent of the population. Not counting the underinsured, offering those people health care will increase the demand for health services by 11%. Even if we assume the number of practicing physicians can never grow, I am really unclear about how my handful of days waiting to see the doctor, plus 11%, equals two years. There's no chance this is exaggerated scaremongering, is there?
Plus, the UK already gets around this issue by still offering private insurance. You can wait your turn in the NHS, or if you have one of a number of very affordable private insurance plans, you can jump the queue into a private facility, usually run by the same doctors you'd see on the NHS. It serves your need to be able to buy your way the front of the line, but doesn't let poor people die by depriving them of health care altogether.
I find it odd that people feel that a transition to some form of nationalization would "let people die". Most developed nations with some form of nationalized health care (that is, everyone else outside the US) have longer life expectancies than Americans.
BTW, wait times vary by province. For example, the majority of hernia patients in Nova Scotia are treated within two or three months.
My assumptions are based on direct observation over the 25 years that I've been practicing medicine.
Manpower issues are increasingly problematic. We are already seeing wait times increase as medical provider groups lose providers and are unable to recruit replacements. With increasing and more demanding population and incressingly decreasing supply, the end result is pretty obvious, at least to those of here in the trenches providing that care. As opposed to those of you whose expertise comes from reading about it.
Your assumption that a single-payer system would lead to any kind of increased efficiency is pretty funny.
Ok, let me see if I have this right.
Health care reform would lead to 30 MILLION new paying patients.
There will be a need for new doctors, nurses and health care providers.
The ONLY way to fill this need is for the Health Care Reform Bill to address doctor/health care provider shortage?
Ahhh, the irony.
I thought the free market would fill any gaps. I guess not. Are you really saying we need a bill to encourage people to go out and pick a career in which they are almost guaranteed to get a job?
I agree. I don't think many people think that the current system is good, the argument comes in figuring out how to fix it. I, too, was surprised how high the number was for doctors not recommending medicine as a career regardless.
You are really starting to show your colors.
The top 5 ranked health care systems in the world are single payer or close to it.
France is ranked #1 in health care in the world. I have had the pleasure of experiencing French health care for myself.
I have been to France on numerous occasions visiting family.
In the couple instances where I got sick, a doctor CAME to the house to see me personally. He was there in about an hour and a half, stayed for about 30 minutes and wrote me a prescription right there to take down to the corner pharmacy.
Total cost out of pocket for the doctor visit? $0
Total cost for the prescription? 5 Euro's.
And your evidence for this is? You may want to talk to our Canadian members, too.
No one has yet been able to explain to me why most of the world can make UHC work, but we can't.