ObamaCare Info

[A_Princess'_Daddy]

I didn't say that these problems were solely due to Obamacare, but they certainly were not addressed by it either. If anything, Obamacare has exacerbated those problems. Affordable healthcare is one thing. Accessibility is another problem. And on top of that, the quality of what we will be getting is also being called into question. The best of the best do not go into teaching math and science because they can make better money in industry. Do we really want the same to happen with medicine?

I cannot reply to your opinions on what the ACA was and is designed to do without violating board rules, but the brightest minds have been going into research for generations, and there is very little money in many aspects of that field. Brilliant people go on to pursue PhDs and teach or conduct research in Universities and there is little money in that. Brilliant people become investigative journalists, and there is little money in that. Other brilliant people have pursued lucrative careers and made lots of money. In other words, brilliant people are no different than any other subset of the population; some will pursue money, some will pursue knowledge, some will pursue a blend, some will go in an entirely different direction, just as some average people go on to pursue careers that generate wealth while others do not. The belief that people will flee the medical profession isn't new, and yet the medical schools have been consistently filled for generations and continue to be filled now.

When I was an undergraduate, at a university that sends many graduates on to medical school (as well as other graduate programs), my friends pursuing medicine talked about these same challenges at that time, and yet they all still wanted to be doctors because it was their dream. Most are now in specialties that I believe pay quite well, while one became a wonderful pediatrician and loves her life. As long as there are children who love science and dream of becoming doctors, I don't think that will change, and there is no empirical data to support that it has changed in the future to make me think differently.

Put another way, why isn't your daughter dropping out of medical school if things are so grim? Is it because she wants to be a doctor, has always dreamed of being a doctor, and nothing is going to dissuade her from that dream?

 

[AndyLL]

No, you only get the doctors WILLING to be part of one of those plans. Those would be the doctors willing to do the job for less money.

It works no different then before. Some insurance plans are HMOs (Kaiser) and you have to use their facilities. Some insurance plans are PPOs where you have to go to a 'network' of doctors. Some insurance plans to can go to any doctor you want but those are becoming rare these days.

I already know that if I end up in an exchange offered plan, I will be searching for a new doctor since mine will not participate.

This makes no sense which leads me to believe you're making it up. Doctors don't 'participate' in the exchanges. Insurance companies participate in the exchanges.

When you buy an insurance policy through the exchange it is no different then an insurance policy through work or on the open market.

And many posters are trying to point out the larger picture. Becoming a doctor requires years of intense and expensive training. Force them to take less money and the best and the brightest are gong to decide it's not worth it. So the pool of new doctors you get will of a lesser quality.

Doctors are not taking less money.

No, that's not true at all. You get the discounts associated the plan you are in, not company. You could have a plan through the VERY SAME insurance company you had before and the discounts could be substantially different.

In general the discounts are the same but different plans can cover different amounts of the remaining fee.

 

[Robbi]

It works no different then before. Some insurance plans are HMOs (Kaiser) and you have to use their facilities. Some insurance plans are PPOs where you have to go to a 'network' of doctors. Some insurance plans to can go to any doctor you want but those are becoming rare these days.



This makes no sense which leads me to believe you're making it up. Doctors don't 'participate' in the exchanges. Insurance companies participate in the exchanges.

When you buy an insurance policy through the exchange it is no different then an insurance policy through work or on the open market.



Doctors are not taking less money.



In general the discounts are the same but different plans can cover different amounts of the remaining fee.

http://www.forbes.com/sites/scottgo...-will-have-to-take-a-pay-cut-under-obamacare/

 

[Marionnette]

Put another way, why isn't your daughter dropping out of medical school if things are so grim? Is it because she wants to be a doctor, has always dreamed of being a doctor, and nothing is going to dissuade her from that dream?

She's under obligation to the Navy to complete her course of study and join the ranks of naval medical officers serving our country when she is finished. Her good fortune is that she will be graduating without the crushing debt of medical school. All for the price of 1 year of service for each year paid, which in her case will be 3 years of medical school tuition covered by the Navy because she put off entering the program until this year. What happens after she's completed her obligation is anyone's guess but ultimately her decision. She didn't enter medical school expecting to clear six figures as soon as she graduates but she also isn't going to school so that she can be among those who qualify for assistance under Obamacare.

 

[AndyLL]

http://www.forbes.com/sites/scottgo...-will-have-to-take-a-pay-cut-under-obamacare/

That's for medicare... not the policies on the exchange.

Ever since medicare was created doctors screamed they they couldn't survive any type of rate change and every time there is a rate change happens there are plenty of doctors that are more then willing to that the guaranteed payments from the government.

This has been happening well before Obamacare.

 

[A_Princess'_Daddy]

She's under obligation to the Navy to complete her course of study and join the ranks of naval medical officers serving our country when she is finished. Her good fortune is that she will be graduating without the crushing debt of medical school. All for the price of 1 year of service for each year paid, which in her case will be 3 years of medical school tuition covered by the Navy because she put off entering the program until this year. What happens after she's completed her obligation is anyone's guess but ultimately her decision. She didn't enter medical school expecting to clear six figures as soon as she graduates but she also isn't going to school so that she can be among those who qualify for assistance under Obamacare.

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession.

Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

 

[Robbi]

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession.

Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

Who would determine the sliding scale?

 

[manning]

Doctors and hospitals are already accepting huge deductions from insurance companies. I just pulled out an EOB for my DD. She had RSV a few months ago. The lab tests from the hospital were $850.00. Because we have a BC/BS PPO, the eligible charge amount was only $100. Insurance paid $80, we paid $20 and the hospital deducted $750. Because we have insurance, they were happy to discount the bill almost 90%

Charge. 850.00
Insurance. 100.00

Kind of makes you wonder. What does it really cost the hospital.

 

[Marionnette]

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession.

Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

It is an excellent deal that she has been offered by the Navy. However, it is not a subsidy. She will be repaying the taxpayers with her service and time. Subsidies, like those doled out through Obamacare, do not require any kind of repayment, although perhaps they should. Requiring a little sweat equity in the form of volunteerism in exchange for insurance premium assistance would not be such a bad idea...

As to why my daughter continues to pursue a career in medicine, well that's a question for her and not for me. She's an adult and makes her own decisions. The Navy was her idea and not mine. Becoming a doctor is her chosen career path, whether it be for altruistic reasons, the prestige of title or the income potential. I don't answer for her choices. I only related what she said was discussed in a recent class that addresses practice management. It didn't paint a rosy picture to current medical students.

 

[manning]

Well maybe it's time for us to offer some loan forgiveness in exchange for certain types of service?

I think there is a government program out there that does this. In return for the money they receive they must serve a certain number of years where it is difficult To get doctors.

The problem....a number of new doctors are not honoring their commitment and the government has not done a very good job going after them. I read an article about this a number of years ago. In this article a doctor was mentioned who went into plastic surgery and was making well over a million dollars a year and the the government let him slide.

 

[manning]

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession.

Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

The daughter comes out of this better off than most doctors do. No big college bills or big student loans. That may enter into the equation.

 

[johde]

Charge. 850.00
Insurance. 100.00

Kind of makes you wonder. What does it really cost the hospital.

I don't know what test the poster had but I looked up some information for a CMP (comprehensive metabolic panel). According to a local hospitals website they charge $168 + $17 collection charge. According to my insurance company website, their reimbursement rate is $138. If you go to an independent lab, the reimbursement rate is $8 according to the insurance company. The independent lab sends out the sample instead of doing it in house. So, they get some economies of scale. So, you're paying a huge premium for speed you may not need.

 

[mhsjax]

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession.

Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

deleted.

 

[A_Princess'_Daddy]

It is an excellent deal that she has been offered by the Navy. However, it is not a subsidy. She will be repaying the taxpayers with her service and time. Subsidies, like those doled out through Obamacare, do not require any kind of repayment, although perhaps they should. Requiring a little sweat equity in the form of volunteerism in exchange for insurance premium assistance would not be such a bad idea... As to why my daughter continues to pursue a career in medicine, well that's a question for her and not for me. She's an adult and makes her own decisions. The Navy was her idea and not mine. Becoming a doctor is her chosen career path, whether it be for altruistic reasons, the prestige of title or the income potential. I don't answer for her choices. I only related what she said was discussed in a recent class that addresses practice management. It didn't paint a rosy picture to current medical students.

Sure it's a subsidy. The value of three years of service, for which she is also being paid if my understanding of thing is correct, does not come close to covering the cost of her education. That's why our taxes are paying for it. It is a subsidy you and she value, and perhaps even one that is good for the nation (I'll leave my feelings out of that) but it is the very definition of an economic subsidy. Put another way, economists point out that the value of an insured work force exceeds that of an uninsured one, so those receiving subsidies for health insurance are in fact benefitting the nation's economy.

As to the "lack of a rosy picture," my point is that same picture has been painted for generations, so it's not new. And despite it, the bright people, like your daughter, are still flocking to the profession, even to the extent that she'll sacrifice three years of her life to become a doctor. It seems like the antithesis of a profession in crisis to me.

 

[jcamacam]

I think that is a very good deal that she has been given by the government. She is very fortunate to have her tuition subsidized by the taxpayers. But you didn't answer my question of why she still wants to be a doctor given the dire nature of the profession. Perhaps we as a country need to look at the government subsidizing the education of more physicians to reduce the issue of student loans, if it is really the issue many feel it is. Have a sliding scale so those who pursue family medicine, pediatrics, etc. receive more support than those pursuing lucrative specialties where they will still net good incomes. Throw in a bunch more well trained NPs and PAs and we could solve this apparent shortage very quickly.

I understand her tuition is being subsidized by the government but this woman is NOT getting something for nothing!! She will be serving our country not to mention go into a very respected profession. Why would you vilify someone for this? We NEED more people like her who are willing to WORK and not just take whatever they can with this "everyone owes me" mentality.

 

[AndyLL]

Sure it's a subsidy. The value of three years of service, for which she is also being paid if my understanding of thing is correct, does not come close to covering the cost of her education.

How are you calculating the the 'cost' of three years service?

How many of the doctors that take advantage of this program stay past the required years.

How much would it cost the government to have to overpay doctors to join if they didn't have this program?

A subsidy is when you get something of value for nothing.

In this case the military feels they are getting value for funding education.

You might feel that giving up 3 years of your life to the military (while we are at war no less) is not worth 3 years of education but plenty do. My bother had this opportunity when he couldn't get accepted to med school and turned it down even though at the time it looked like his last chance to go to med school.

Do you also feel that the USAF students and the Naval Academy students are receiving subsidies?

 

[Robbi]

Sure it's a subsidy. The value of three years of service, for which she is also being paid if my understanding of thing is correct, does not come close to covering the cost of her education. That's why our taxes are paying for it. It is a subsidy you and she value, and perhaps even one that is good for the nation (I'll leave my feelings out of that) but it is the very definition of an economic subsidy. Put another way, economists point out that the value of an insured work force exceeds that of an uninsured one, so those receiving subsidies for health insurance are in fact benefitting the nation's economy.

As to the "lack of a rosy picture," my point is that same picture has been painted for generations, so it's not new. And despite it, the bright people, like your daughter, are still flocking to the profession, even to the extent that she'll sacrifice three years of her life to become a doctor. It seems like the antithesis of a profession in crisis to me.

Perhaps, better stated, her daughter's tuition isn't a give me. She's serving our country and will repay her medical school bill with her service.

 

[robinb]

As to why my daughter continues to pursue a career in medicine, well that's a question for her and not for me. She's an adult and makes her own decisions. The Navy was her idea and not mine. Becoming a doctor is her chosen career path, whether it be for altruistic reasons, the prestige of title or the income potential. I don't answer for her choices. I only related what she said was discussed in a recent class that addresses practice management. It didn't paint a rosy picture to current medical students.

I haven't seen so much tap dancing since I last watched 42nd Street. She's YOUR daughter, not some stranger. I would think that you have have half a clue about why she selected her profession. My guess is that her reason doesn't fit your narrative.

 

[jcamacam]

As to the "lack of a rosy picture," my point is that same picture has been painted for generations, so it's not new. And despite it, the bright people, like your daughter, are still flocking to the profession, even to the extent that she'll sacrifice three years of her life to become a doctor. It seems like the antithesis of a profession in crisis to me.

Wow. If everyone shared this opinion, who would be left to take care of all of us??? I don't know about you but I don't want someone who graduated at the bottom of their class responsible for my healthcare. Aren't we lucky that the "bright people" are still "flocking to the profession"???

 

[jcamacam]

I haven't seen so much tap dancing since I last watched 42nd Street. She's YOUR daughter, not some stranger. I would think that you have have half a clue about why she selected her profession. My guess is that her reason doesn't fit your narrative.

And explain again why she needs to defend her daughter's decision to go into the medical profession? She's not becoming a meth dealer for goodness sakes!