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Thread: The Doctor Won't See You Now. He's Clocked Out

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    How's that Hopey Changey thing workin'? C.Puffs's Avatar
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    Default The Doctor Won't See You Now. He's Clocked Out

    "Big government likes big providers. That's why ObamaCare is gradually making the local doctor-owned medical practice a relic. In the not too distant future, most physicians will be hourly wage earners, likely employed by a hospital chain.

    Why? Because when doctors practice in small offices, it is hard for Washington to regulate what they do. There are too many of them, and the government is too remote. It is far easier for federal agencies to regulate physicians if they work for big hospitals. So ObamaCare shifts money to favor the delivery of outpatient care through hospital-owned networks.

    The irony is that in the name of lowering costs, ObamaCare will almost certainly make the practice of medicine more expensive. It turns out that when doctors become salaried hospital employees, their overall productivity falls.

    ObamaCare's main vehicle for ending the autonomous, private delivery of medicine is the hospital-owned "accountable care organization." The idea is to turn doctors into hospital employees and pay them flat rates that uncouple their income from how much care they deliver. (Ending the fee-for-service payment model is supposed to eliminate doctors' financial incentives to perform extraneous procedures.)The Obama administration also imposes new costs on physicians who remain independentófor example, mandating that all medical offices install expensive information-technology systems."

    http://online.wsj.com/article/SB1000...pinion_LEADTop

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    Senior Member [WDW]Megaraptor's Avatar
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    Oh boy am I going to be glad that my future health care decisions will be made by people trying to do the minimum amount of work they can still be paid for.

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    Member planb's Avatar
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    Already having problems finding a new doctor here,and this is going to get worse?

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    Senior Member Mu-Meson's Avatar
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    And any doctors not working in your local Big Health McHospital will be offering concierge service only. "Medicare? Insurance? Lol. Here's your bill. Cash please."

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    Pining for a custom title PEMM's Avatar
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    Interesting development.

    They don't allow private practices to run own? Even around here that sounds like socialism.

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    The member that no one remembers. IconOfEvi's Avatar
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    You get the society you deserve, that is all

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    Quote Originally Posted by Mu-Meson View Post
    And any doctors not working in your local Big Health McHospital will be offering concierge service only. "Medicare? Insurance? Lol. Here's your bill. Cash please."
    I know some docs in the US doing concierage servicd and offering proactive healthcare systems. spunds quite promising.

    I reckon what might be getting missed is the middle ground.

    Walmart and big box pharmacies are doing low level health care. Hospitals are taking the high end.

    There is huge scope for sorting out the middle ground via McSystems. Franchise/scale the middle ground with locally owned but jointly operated doctors offices.

    Doctors stay as owners or employees of local McDoctors, but with scaleable back office cost savings, efficiencies, and best practices.

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    Member The_Dispatcher's Avatar
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    Quote Originally Posted by PEMM View Post
    Interesting development.

    They don't allow private practices to run own? Even around here that sounds like socialism.
    My Doctor just sent me a piece of mail saying that he is on his way to Melbourne, Florida. It took me about five years to be a patient of this doctor. I can say that because, when my family moved to the US he just got out of Med School so he became our family doctor, some how then but we lost track of each other. When I did manage to score an appoinment I found out the this awesome doctor was a "consierge" doc, which means you pay his office "something" like $150 to see him and he would be available through email and cell calls 24 hrs. But should you need any tests, that would be on you. That's where private insurance comes in. They pay like half of your bill which isn't that much when you pay them $100 per month.

    I am not goining anywhere with this post, except that i am losing my doctor and that sucks.

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    Combat boots fetish gilgoul's Avatar
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    wanna see what this kind of medical (mal)practice does? Come to Israel, the king of underpayed overworked undermotivated MD's.
    Because of the HMO system here, it is like a lotery, you can have a decent doctor who will work overtime without pay just in order to treat his patients, or some time card puncher who in order to make a living will leave early to monlight at a private clinic, becaause at the end of the day, if you want decent treatment without having to wait for months for analysis or expert opinion, you eventually go private, at incredible costs.

    THis socialized medecine is great for preventive and prophylactic treatment of the masses, but when you are eventually sick, just hope you didn't miss a month payment on your private insurance, becaue it gonna cost you, a lot.


    My wife is a physical therapist, when she worked for an HMO, she had exactly 8 minutes per patient, so in order to treat or supervise rehab she had to keep 3 patients at a time in her office, think about that next time you go to your private doctor.

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    Senior Member PurpleCrow's Avatar
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    What's the problem with implementing the Canadian model for instance?

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    Senior Member [WDW]Megaraptor's Avatar
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    Quote Originally Posted by PurpleCrow View Post
    What's the problem with implementing the Canadian model for instance?
    Economies of scale for starters, since our population is 10X that of Canada.

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    Amiable Scoundrel Corrupt's Avatar
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    Quote Originally Posted by [WDW]Megaraptor View Post
    Economies of scale for starters, since our population is 10X that of Canada.
    Wouldn't that also mean 10x the people funding the system (either by tax or insurance payments)?

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    Pining for a custom title PEMM's Avatar
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    Quote Originally Posted by The_Dispatcher View Post
    My Doctor just sent me a piece of mail saying that he is on his way to Melbourne, Florida. It took me about five years to be a patient of this doctor. I can say that because, when my family moved to the US he just got out of Med School so he became our family doctor, some how then but we lost track of each other. When I did manage to score an appoinment I found out the this awesome doctor was a "consierge" doc, which means you pay his office "something" like $150 to see him and he would be available through email and cell calls 24 hrs. But should you need any tests, that would be on you. That's where private insurance comes in. They pay like half of your bill which isn't that much when you pay them $100 per month.

    I am not goining anywhere with this post, except that i am losing my doctor and that sucks.
    I checked for fun what it would cost me here if I wanted to use private practitioner, I've used them few times without insurance. Insurance from one company costed around 200€/year for one family, with deductible of 115€ (paying more you could get one without deductible, don't say how much though) and they would fund up to 60000€, paying even for the medicine. You would still get the aid from national health insurance which would pay 60% doctors bill and 35% of medicine. For anything bigger you would still want to go to public sector. Wonder why so few people apply for it.

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    Senior Member [WDW]Megaraptor's Avatar
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    Quote Originally Posted by Corrupt View Post
    Wouldn't that also mean 10x the people funding the system (either by tax or insurance payments)?
    Well, in the USA only 53% of the population makes enough money to pay federal taxes. Does anyone know what % of the Canadian population pays taxes?

    But it wasn't funding I was concerned with so much as the fact that some systems and organization can't be scaled up effectively without becoming inefficient.

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    Amiable Scoundrel Corrupt's Avatar
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    Quote Originally Posted by [WDW]Megaraptor View Post
    Well, in the USA only 53% of the population makes enough money to pay federal taxes. Does anyone know what % of the Canadian population pays taxes?
    Fair point, but then again I think most people would agree that the US needs tax reform just as much, if not more, than it needs healthcare and spending reforms.

    Quote Originally Posted by [WDW]Megaraptor View Post
    But it wasn't funding I was concerned with so much as the fact that some systems and organization can't be scaled up effectively without becoming inefficient.
    Fair points, I agree a simple transplantation of their system probably wouldn't work, given the differences between the US and Canada (or any other Western country you might wish to draw ideas from). However I think that a system sharing some of the principles could be made to work in the US. It could be administered on a state or country level for example, rather than a federal level.

    My main point is that socialised healthcare doesn't necessarily result in inefficiency, less dilligent doctors etc.

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