Sunday, October 07, 2012

Scary Health Care Stuff

J.D. Tuccille has a piece up on Reason magazine about some aspects of health care to look forward to. They're based on a recent survey of physicians by The Physician's Foundation. Among the troubling statistics:
  • 60.6 percent of physicians say they would retire today if they could (up from 45 percent in 2008)
  • 33.5 percent of physicians say they wouldn't go into medicine if they had their careers to do over (up from 27 percent in 2008)
  • Physicians are seeing 16.6% fewer patients per day than they did in 2008, a decline that could lead to tens of millions of fewer patients seen per year.
  • Over 52 percent of physicians have limited the access Medicare patients have to their practices or are planning to do so.
  • Over 26 percent of physicians have closed their practices to Medicaid patients.
  • In the next one to three years, over 50 percent of physicians plan to cut back on patients, work part-time, switch to concierge medicine, retire or take other steps that would reduce patient access to their services.

I don't know about my current physician, Dr. Courtney Ladika. I haven't asked her. Then again, I didn't ask my last two doctors, either. They brought it up first.

They both volunteered that they thought health care should be a right and government should pay for it. This, despite the fact that doctors that accept MediCare and MediCal patients are increasingly hard to find, especially around here. Didn't make sense to me, but maybe that's why both of them recently retired?


At 9:07 AM, Anonymous Anonymous said...

Regulation, high costs, liability, at some point it's easier to go on "welfare", same, same, take away a man's incentive to work and why should he?

At 10:19 AM, Anonymous Charlie Bean said...

I can understand why less doctors are accepting MediCal (Medicaid) and Medicare, as noted above, over regulation. For "dual eligibles" one must bill Medicare first and then Medi-Cal, and as I understand, neither pays promptly or even reimburses fully the cost of the administration of the bill.

Take a look at what has been done recently in Congress, to cut back on expenses, they lowered the reimbursement rate to doctors for general service. When you go to the reimbursement for MediCal, imagine the reimbursement there; a doctor does a service and is often only reimbursed such a low amount for the service, it does not cover the cost to do business.

in creating a new Medical system, they need to address the cost to be a Doctor, not make it less attractive.

I understand, the new power chair I have will cost the normal Joe $21,000, the company selling it will get $9,000 reimbursed if by Medicare and $7,500 if by MediCal. Doing business, you do not make much after deducting your over-head and hoping to provide for your family.

At 11:30 AM, Anonymous Anonymous said...

Fred, there is no discrepancy. The sentiment that "health care should be a right and government should pay for it" is not being met today with MediCare and MediCal. Doctors are compensated exceedingly poorly through those programs. So, while a tiny portion of Americans are getting subsidized healthcare, doctors are not being compensated for it. MediCare/MediCal (some version of those ideas) should be expanded to cover all Americans and be fully funded. The examples where government run healthcare have succeeded are, well, all around us.

At 11:37 AM, Blogger Fred Mangels said...

Charlie wrote, " I understand, neither pays promptly or even reimburses fully the cost of the administration of the bill.".

Some years ago I was told MediCal pays fourteen cents on the dollar in reimbursement. Since then I believe they cut it even more.

Anon wrote, "MediCare/MediCal (some version of those ideas) should be expanded to cover all Americans and be fully funded..

As I wrote some time ago here, you have to wonder how much in the red Medicare would be now if they reimbursed at even the rate private insurance does?

At 8:15 AM, Blogger Stephen said...

The real problem is that we've allowed ourselves to believe in a very false social premise: namely that people who train as doctors and medical equipment manufacturers should be placed in a special category where they are to be treated as kings demanding a king's salary. Yes, medical care is critical to society's needs but so is in-home-healthcare, so is garbage collecting, so is fire protection. What would happen if we gave firemen the same type of salaries doctors demand? Who's to say a fireman is less important than a doctor to person's whose house is on fire? Even farmers growing our food are vital to our society's needs yet farm workers receive what in comparison to doctors. You will say, "oh, but doctors train so much longer" and I will say, work is work, and is the food on your table worth less worth to your body than the dentist or doctor needs for his huge house mortgage and three cars in the garage. We all work together to create community and when some in the community room take it as a right to charge outrageous fees for what is essentially a COMMON cause, we need to look at the way we teach our children to value members of society regardless of education. Work is work. A farm worker working in the fields doesn't deserve to be treated as a serf while the Lord has his castle. Basic communitarian values need to be instilled in us again as we have lost sight of true worth of each member of our community.

At 2:06 PM, Blogger Stephen said...

I will add here too that there's something weird going on with medical diagnostic equipment that could greatly reduce the doctor's patient load. Way back in 1965 or '66 one of my earlier inventions (have only been able to even do a patent search on one of them in my life of low income let alone filing a patent) was for using infrared technology to create a medical diagnostic machine. Where there is disease in the body there is almost always inflammation and a raising of temperature around the disease site. After running thousands of patients through an infrared scanner with different kinds of diseases I am of the opinion there will be distinctive infrared pattern showing up for each disease which can form a data base. Diagnosis then could be just a matter of being scanned by one of these machines. Save a lot of time and expense and I have wondered through the years why no such device or similar scanning technology has been developed and used in doctor's offices. It's been 47 years and I am wondering if this is another case of big companies squashing new inventions that would compete with their established markets.

At 8:36 AM, Anonymous Anonymous said...

"...namely that people who train as doctors and medical equipment manufacturers should be placed in a special category where they are to be treated as kings demanding a king's salary."

Sounds like you are talking about government workers. If healthcare and government job sector were subject to free market principles (eliminating union control and monopoly education requirements) then we would find an equilibrium where health care and government services would be affordable, like in the old days when you could go to emergency and pay the bill out out of pocket. It wasn't that long ago when prices were 1/8 of what they are today.

At 1:45 PM, Blogger Stephen said...

Healthcare should never be part of a market economy because then the rich have more healthcare than the poor which is what we have in America today while the great majority of the rich do not produce anything themselves to society, they are net takers while most of the poor have had to work years of their lives even if at low paying menial jobs. What you are missing in my argument is the communitarian factor that counters the alienation and artificial class divisions of free market economies which are really only a step away from feudalism where a Lord lords it over a feudal kingdom, e.g. your corporate capitalist system that is not subject to democratic oversight.

Skandinavians pay much higher taxes proportionately than Americans and they have the world's best healthcare delivery system. They still have a communitarian mindset while we have had centuries of capitalist propaganda telling us capitalism is the best system when it never ever was but one constantly prone to boom and bust cycles with only a change in the increasing list of 2% taking the profit made by workers for themselves alone instead of sharing it with the people who made it in the first place.

At 2:37 PM, Anonymous Anonymous said...

Your confusing the issue with your communist ideology. If government or medical services are not unionized/monopolized then the services will be cheaper. Bottom line. Communism doesn't work. Freedom does. Of course you must enforce anti-trust(corporation) laws to break up oligopolies/monopolies that control resources, dictate prices are practice price discrimination, that must be done to maintain a free market. No 2% taking advantage in a true free market with proper controls.

At 6:26 PM, Blogger Stephen said...

I'm a communitarian capitalist, not a communist and there is a difference. Capitalism is based on lying. Products are sold by liars selling mostly badly made products meant to break down and be replaced. All advertising is based on lying as are such "businesses" as real estate where the customer is never told that he can actually do a real estate deal very easily themselves by letting a title company handle all the transaction papers which realtors do but don't tell their clients. This type of deception runs capitalist businesses which have laws made to protect their scams, like all the credit card companies enjoy now. You see when money runs things the rich insure their riches any way they can and they have the means to buy protection for their wealth scams and do. Here and there, society reacts to the abuses of the wealthy few but in the main their wealth controls society through the election process where wealth buys the necessary liars and their lies to fool the public with these political circuses that only divert attention away from real social issues so that the wealthy chosen twiddle-dee candidate is elected instead of the wealthy's tweedle-dum.

I use the Skandinavian model because it works and the people are quite happy with it, high taxes and all. It's because they haven't lost their community spirit which is at the heart of communitarianism.

At 6:30 PM, Blogger Stephen said...

By "capitalism" I do mean free-market economic theory whereas when I use "communitarian capitalism" I mean community corporations, all employee owned and operated, like Winco.


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