You are confusing health care with insurance coverage. They are not the same...As for having a great Peds, that is awesome! I hope and pray that your kids do not need to have anything serious done - as in the hospital environment they are not even allowed to give advice to the providers.

More and more providers are going to the concierge model. It is the only way they can keep the lights on.

To keep with the theme of the service issue. The more we go to "big medicine" where your "Family Doctor" (MD/DO/NP) is one of fourty or fifty and you never see the same provider twice. The community systems can not keep qualified providers. Many families go to Quik Kare for medical things (school physicals). Then, wonder why there is no friendship/partnership/relationship with their healthcare provider(s)

 

My Audi TT caught fire while I was driving on a highway. The catalytic convertor was blamed by Audi.

Nothing to do with EV'S.

All this hysteria about EV'S by the Luddites. Technology changes. Adoption happens according to the benefits of the technology. Sometimes those deeply married to an old tech can't see past their blinkers what is changing and why. Millions of blackberry users swore they couldn't live without their keyboarda when iPhones first came out.

I also loved my blackberry as a communication device. But smart phones are computers for ecommerce, entertainment, photography and so much more than character based messages. We all came to understand that as blackberry's faded into memory.

The future may be hydrogen fuel cells, solid state batteries, sodium ion batteries and other energy storage evolutions. It just won't need combustion.

Just look to China. They can manufacture and retail an EV for $10k. ICE will eventuality get priced out of the market.

 

I'd be all for EVs if they had a decent 500+ mile range, and they charged from 0 to 100% in less than 10 minutes at convenient locations, like we have for ICE cars now.
Unfortunately, for now, this is not happening. You're lucky to get what, 400 miles out of a charge, under absolutely perfect, ideal conditions? Then, you have to plan your trip because there isn't a charger around every corner. When you do find a charger, you have to sit there for what, up to an hour, depending on the charging technology employed? Let's not talk about the utter failure of EV ranges when towing something behind an EV. I'll keep my loud, "polluting", high maintenance ICE for now.

 

I'm quite certain that the fire department was not afraid to approach your flaming Audi TT for over 4 hours. I'm also pretty certain that when your Audi burnt down it did not destroy the road surface underneath it causing them to need to redo the entire road to about 3 ft down

 

You would reply to and try and have a conversation with a bot lol.

Unfortunately most people don't have the luxury of not correlating health care to insurance coverage. What you are advocating is health care for the rich, most people struggle to get any health care. For most of them concerns about their PCP not managing their care in the hospital are way way down the list below being able to afford care without it bankrupting them in the first place.

PLENTY of providers out there keeping the lights on with insurance payment. If you want to offer a concierge model for rich people thats fine, but the business plight of the medical community doesn't move the needle for me lol. I know plenty of doctors and they make plenty of money.

 

I get the impression that some people know little to nothing about the medical profession. They get their ideas from biased “observing”. They see a duck cross a pond, and “observe” that the wind blew them over there. They don’t see how furiously the duck is paddling with his feet out of sight below the water.
There is no need to take doctors for granted. Unless you are one, you don’t know how hard they had to work, to study until their brains hurt, to sleep deprive until they are hallucinating. The dedication, discipline, the sacrifice. So at some point they can earn a living. Maybe they make good money, but they earned it to get there, and they earn it while they are there. No one is entitled to their care. The concierge trend, if fully realized, only returns them to the place they had 200 years ago, when they made house calls, and maybe had to take payments on account, or in chickens and other livestock.
So people who really know nothing of the profession, should maybe be a little graceful, and humble, and listen to people who are in the profession and might know a bit more than them.

 

My mother has managed medical practices for 30 years. I know plenty.

Everybody works hard. This has nothing to do with discounting the value of doctors, I believe everybody deserves to earn as much as they can make. BUT, if I have to choose between a Doctor being able to make $800,000+ a year and people being able to afford healthcare without it ruining them financially, I'm going to choose people having access to healthcare even if it means maybe that doctor can only earn $500,000 a year. Lets not be dramatic about "being entitled to earn a living", being a Doctor is very lucrative even today. Yes I believe EVERYONE in our country is ENTITLED to quality healthcare. If someone doesn't want to put providing care over their own best interests they shouldn't be a Doctor.

I would suggest that maybe you think about the benefit to the patient over the financial rewards to the doctor. The calling of medicine is supposed to be from a place of wanting to help and heal people.

 

The average gross income for PCPs nationwide is about $250,000. NOT $800,000. Your mama fooled you.

 

Never said the average was $800k, it was an example. PLENTY of Doctors make over $800k, I know many of them. The AVERAGE for a PCP is $250k, that's pretty darn healthy. Specialties have much higher averages as being a PCP is one of the lower paying medical specialties. Point is, being a doctor is very lucrative, I'm not moved by the plight of the doctor's income compared to people being financially ruined by getting sick. There is a happy medium here where Doctors can get paid very well AND we can provide healthcare to our citizens that they can afford.

 

How does your free medicine for everybody pay for 11 years of schooling and residency, and the average $250,000 medical debt after school?

 

Ask how it works in every other country.

Its also not free, its taxpayer funded healthcare. Literally everybody has it but us. "The average doctor only makes $250k" isn't an argument against this that is going to hold water for most people lol. Like I said before, good doctors want to be doctors not only for the money, they do it because its a calling to help and heal people. We don't need doctors who just want to be doctors for a paycheck. In any event the affordability issue is not because of doctors its because of insurance companies.

Reduced payments to providers is not because of the ACA, its private for profit insurance companies who are continually squeezing providers in the era of managed care. This has been going on for decades. Have you looked at the amount of profit insurance companies are making? Take that money out of their hands and put it in the hands of doctors. I'd MUCH rather see an incredible doctor earn that than an insurance company that is trying to dole out as little care as possible to maximize profit before death. Insurance companies are the enemy of doctors AND patients.

This doesn't trouble you all because you are all rich and you don't have to worry about the cost of healthcare. The vast majority of people in this country are not so fortunate.

 

I stayed at a Holiday Inn Express once....Oh, and I watched the first space shuttle (Columbia) launch...so, I am an astronaut too!'

And no - BILLER DO NOT UNDERSTAND HEALTHCARE. They understand billing codes and modifiers. They can run rings around Trauma Surgeons on if an ICD10 code or UB92 needs to be used. They certainly can not run a medical facility, nor do they know the current defensive aspect of treating patients.

Ask your mother (with all due respect) if she knows what her "RVU" is...and if she feels that figure is wrong.

 

That is NOTHING compared to the cost of MedMal. We had a guy who was shot and stabbed. His life was saved.

From prison he sued the MD for not re-aligning his gang tattoo as well as it might have been had the person "not been black"...the Jury did not get to hear that he was also shot. Did not get to hear he was in prison for 20+ years. Did not get to hear that when he was conscious his only words were "I am going to sue"....

A jury of 12 idiots awarded this guy near $100k....guess who has higher insurance premiums? Until the lawyers are under control, the prices will go higher and higher.

Note: If you drink two quarts of vodka a day while taking Celebrex you will die....just ask the makers of Vioxx.....

 

She manages practices, she does not just bill. She also absolutely believes providers are underpaid by insurance companies. Doctors aren't the issue here.

 

Horrible...

 

Oh Right - ever-increasing malpractice insurance.
Plus the cost of at least one extra back-office staff to file claims, refile and refile again. For limited "Usual and Customary" reimbursement.
A one person Doc needs three staff members, not just a receptionist/scheduler. And a rental NP or PA for continuing Ed and maybe a vacation.
Yep it'll be hard to recruit new Doctors in the future.

 

Instead of beating up doctors, for being compensated commensurate with their profession, maybe there are culprits in the health care industry that are more responsible for its costs.
Obviously bureaucracy and wild over regulation is a culprit. Also, HMOs have been a net expense not only to the patients and end consumer, but a major part in reducing physicians compensation, increasing their workload, and in the process, reducing patient care quality.
Perhaps the greatest culprit is the patient. Quite often, the non paying patient is the most demanding and the most conniving.
Example, in Saint Louis, a guy lived by a hospital, and worked at a hospital across town. When he needed to get to work, he called for an ambulance with a feigned condition that was best treated by the hospital he worked by. He would never give his name, so he remained anonymous as was his right by law. When he was ready to go home, he would call an ambulance and feign a condition best treated at the hospital close to his home. Transportation problem solved, and free as a bonus. That same ambulance ride would cost you and I between $2,000.00 and $6,000.00.
Those types of abusers of the system become well known to the ambulance staff. They don’t know their names, but they know their faces, and their scam. Nothing they can do about it though.
Then there is a vast majority of young people who do not have any interest in health insurance.
Then there is a large population of people who abuse their bodies in so many ways, and are uninsured, or underinsured.
Then there are people who probably could save money for HSAs, but instead, have plenty of money for tattoos, gold teeth, gold chains, 24’s with bling rims, weaves, nails, the latest iPhone, you know, all the essentials in life.
Then there is a very large population of illegals, who clog emergency rooms, and over time, force hospitals to close due to unreimbursed expenses.
I would have a lot more respect for a person pursuing health care expense reductions in these areas, over reducing what a doctor should make by 37%.

 

if you know of a PCP making $250,000 a year take home you know one of the one percenters. Average currently take home for a employed pcps part of a health system is generally under 150. A rural Health PCP is lucky to take home 60 to 80,000 at the end of the year. That is less than many RNs are making in a hospital environment. Then again, I have one PA who's making an excess of $800,000 a year because he is paid honey percentage of his production at a cancer facility

voice reply. Too lazy to type on my phone

 

Thats precisely what I said several times.

If we had universal healthcare there wouldn't be any such thing as a non paying patient.

This is all focusing on the minority and ignoring the majority. There will always be people who game the system and do crazy stuff to try and exact some benefit, but the vast majority of people out there are just trying to make ends meet and get the care for themselves and their families that they need.

The real problem is for profit insurance companies.

He said $250k gross. When people talk about incomes they talk about gross pay. I know a lot of doctors, I don't know one doctor who makes less than $250k. I have sold homes to a lot of doctors and have seen their incomes. Like everything else it sounds like in rural places people make less, employees make less than private business owners.

 

If we had universal healthcare, ALL patients would be non paying patients.
Also, my recounting of patients does not amount to a minority. Anyone who perceives something as being “free” Will tend to abuse it, and take it for granted. It’s human nature.
When you count illegals, immorals, uninsured, and underinsured who are mostly very young, you are meeting a 50% or more of the population threshold receiving health care.
That’s not nothing.

 

In Florida, the average salary for a primary care physician (PCP) ranges from $162,495 to $221,572 annually

Many people confuse the billed dollar figure with the take home....VASTLY different number for a small medical provider who is either an S-Corp or a PA.

For a one person provider his/her staff eats at that rapidly. I know quite a few PCP who are closer to 50 than 100...and this is with years of experience.

The REAL cost of medicine is the fact that everyone wants to be omnipotent and families will spend $40k on a test that might extend a life a week.

We have a Derm guy (former Trauma surgeon). He never, not ever does a biopsy on any mole on an 80 year old. Hell, the last thing an 80 year old needs to worry about (in general) is Melanoma. Why send the bill to Medicare? Not until there is legal reform, limits on liabilities and reasonable expectations will things change....

As for other nations? LOL LOL LOL LOL....everyone from every other nation with money come here for care.....Just ask the crew of MedJets Flight 056 (to Mexico).

 

Earth to you📣
We don't have universal healthcare.

 

Then how do doctors in every other civilized country get paid? Because they do. People pay taxes and healthcare is paid for with tax dollars.

50% or more of the population is not what you describe, its far far less. BUT, those people need healthcare too. Healthcare shouldn't be something just for people who can afford it.

You are conflating salary with gross practice revenue. If a doctor receives a salary then they are being paid regularly over W2. They have no expenses. They are working for a large practice or a hospital etc. Those averages are also the average, there are many many doctors making much more than that.

If somebody is operating a medical practice they are an independent businessperson. The average gross revenue for a medical practice is FAR more than those average salaries, and those people are being paid through S Corps etc. No different than any other business.

When its your life you will want that week.

Many doctors practice that way, but if the patient disagrees and wants the biopsy done the Dr needs to do it.

That just isn't true...but even if it were, people with money here will have access to better care too...at least in other countries everybody has access to a standard level of care.

Thats why I said "If we had", you should read more closely.

 

First, show me where the US Constitution guarantees free healthcare.

What other professions do you believe you are qualified to determine the appropriate pay rates for? A major airline Captain makes 400-500K per year while working 12 days a month. Do they need a pay cut to lower ticket prices? Should we set a maximum annual income and confiscate everything above that level?

Doctors have no more reason to sell their services for less than the market will support, than an auto mechanic does.

Of course if your politics lean more towards this, you would probably disagree

 

Well, let’s take Cuba for example. Often listed as a utopia of healthcare. When their healthcare became “free”, doctors were mandated to be paid the same salary as the rest of the proletariat. Before long, much fewer wanted to be a doctor.
In our country “free” healthcare will be foisted onto the tax paying populace. And since the top 50% of earners pay 100% of taxes, the bottom 50% will pay nothing. That leaves the producers paying for the freloaders. Not really a good system.
I just wonder if you have ever paid any attention to John Stossel, Dennis Prager, or Thomas Sowell, Milton Friedman et al.