If the GOP Shut Down Govt Over ACA

[+DieChecker]

You are kidding yourself Q. I know a few of those docs and early retirement is all the rage these days. Medicine is in many ways a family tradition among them - or has been - but now the best and brightest will be looking to more stable earning potential. I have no doubt there will still be practitioners though the numbers of truly skilled specialists will never be enough. Medicine will go from being considered a "profession" to being seen as a technical specialty. There simply is no way the system is going to maintain even status quo when this law takes hold. And I'm not so sure those health insurers will be as happy to take on the new customers as you think. Their rates will be controlled at some point I believe. The government will start telling THEM what they can charge and when that happens they will just fold their tents and go into another way of profiting with fewer headaches. The effect of the law initially is going to be to attempt to drive down the earning capacity in healthcare. Anyone who doesn't expect real, organized resistance to that is kidding themselves.

I've heard that many General Practitioners are from Overseas now. American doctors tend to want to have careers as specialists, which have easier hours, less headaches and in which they can become experts. Few want the lower pay, longer hours and lots more paperwork that goes with being a general practitioner anymore.

http://www.newsmax.com/Newsfront/doctor-shortage-obamacare-health-insurance/2013/08/27/id/522431

The Association of American Medical Colleges projects the shortage will reach almost 30,000 in two years and will grow to about 66,000 in little more than a decade.

Eventually it will be like our public schools with 40 students in a class, instead of the recommended 30. Quality will quickly erode when each doctor has too many patients.

As it is, I can make an appointment for 9 AM and have to wait till 11 to get seen. And if I make an appointment for 2 or 3 PM, you might just as well forget it, because you'll either get bumped to the next day, rescheduled, or you'll see the doctor for 10 minutes for a 30 minute appointment. It already sucks and it's going to get worse.

Obamacare supposedly has almost a billion dollars for medical scholarships, but I'm not sure how many doctors that will create. at 150,000 dollars plus for a medical degree, 900 million is about 6000 doctors created. Not nearly enough to cover the 66,000 that will be missing soon. I suppose it is at least a help, even if it is just duct-taping the issue.

[+DieChecker]

Because save in former communist countries doctors are among the highest earners anywhere. In most countries with free healthcare they also have free university education meaning that they don't start their professional life with half a million in debt.

Which is not done in the USA. So, to pay for just the expected shortfall (66,000 in 10 years) in doctors that is expected we'd need to throw at least 10 billion at the education expenses of those doctors. About a billion a year. Which if the USA was ready for universal health-care, we might think about paying. But we're not ready and Congress would never pass a bill to give those with the best future earning potential a free ride to a PhD. It simply will not happen.

[+and-then]

Which is not done in the USA. So, to pay for just the expected shortfall (66,000 in 10 years) in doctors that is expected we'd need to throw at least 10 billion at the education expenses of those doctors. About a billion a year. Which if the USA was ready for universal health-care, we might think about paying. But we're not ready and Congress would never pass a bill to give those with the best future earning potential a free ride to a PhD. It simply will not happen.

I believe that the result will be a lower standard for completion of Medical school and Residency in a specialty. There are already "adjusted" standards for some minorities in medical schools. We are headed for a very separate and unequal system where the wealthy have competent specialists and the rest will have to get what's left.

[Frank Merton]

I think employer-provided health insurance should be outlawed, so everyone is on the same basis buying individual health insurance and group coverage is not allowed. This would greatly reduce the cost of individual coverage as the adverse selection they now present would be gone. Then create assigned risk plans for those no insurance company will cover.

Second, I think with such an arrangement coverage for the poor can be arranged as part of welfare systems, and middle and upper class people who don't buy insurance are out of pocket.

[Agent0range]

I believe that the result will be a lower standard for completion of Medical school and Residency in a specialty. There are already "adjusted" standards for some minorities in medical schools. We are headed for a very separate and unequal system where the wealthy have competent specialists and the rest will have to get what's left.

Please post the source for medical schools lowering standards for minorities. Last time I checked, the countries that many of our minority doctors come from are absolutely crushing us in math and science.

[Frank Merton]

It's interesting -- not that one system is better than another -- but if I get sick when I'm in the States I have to see a GP or maybe an Internist who then may or may not refer me to a specialist.

If I get sick in Vietnam I go to a clinic and there a triage nurse sends me to one or more specialists after having me take appropriate tests. The nurse is of course a lot cheaper way to enter the system than through a full MD, and if the err the specialists later can refer me to others. Family medicine and General Practice are almost unheard of here -- they are all specialists of some sort, and the equivalent of general medicine carries with it far less cost but also less education.

[Mac E]

I don't get all the poltics invovled. Can't we just try it, since the system is obviously broken and see if it works? If a part of it doesn't work, change it. Isn't that what our government system is for?

[questionmark]

I don't get all the poltics invovled. Can't we just try it, since the system is obviously broken and see if it works? If a part of it doesn't work, change it. Isn't that what our government system is for?

Yes, but since the 80s both sides of the house are so entrenched in claiming that the other side is Satan that they can't together anymore. Some new faces have to sent there as soon as possible.

[Leonardo]

Burt,

"On July 23, 2013, we held a joint hearing in which we heard from a witness responsible for implementing this mandate for a large company that employs 10,000 people Jamie Richardson, a vice president with the White Castle restaurant chain.

White Castle has offered their employees health insurance since before the Great Depression, and Mr. Richardson testified that this law and the uncertainty it creates is harming his company's employees, its ability to offer health insurance, and its capability to create jobs.

He said that White Castle's growth was directly and negatively impacted by this law. Richardson said, "I would like to tell you we've continued to open more restaurants in more neighborhoods, providing more jobs, and serving more customers. I'd like to tell you that, but I can't. In fact, White Castle's growth has halted."

And what is the evidence White Castle has that 'Obamacare' has negatively impacted their business? Or has the business simply stalled because of other reasons, and 'Obamacare' is a handy sacrificial goat to feed to the media as an excuse?

Does White Castle (and the American public/media) consider the ACA as "Republicare" rather than "Obamacare", as the Republicans had a large say in what finally made it through into law? Or is it better to smear Obama and the Dems alone for a Bill which both sides passed into law?

Edited September 24, 2013 by Leonardo

[+DieChecker]

I believe that the result will be a lower standard for completion of Medical school and Residency in a specialty. There are already "adjusted" standards for some minorities in medical schools. We are headed for a very separate and unequal system where the wealthy have competent specialists and the rest will have to get what's left.

I thought that was how it was already? The very best doctors go to work in the most expensive facilities, AFAIK.

It's interesting -- not that one system is better than another -- but if I get sick when I'm in the States I have to see a GP or maybe an Internist who then may or may not refer me to a specialist.

If I get sick in Vietnam I go to a clinic and there a triage nurse sends me to one or more specialists after having me take appropriate tests. The nurse is of course a lot cheaper way to enter the system than through a full MD, and if the err the specialists later can refer me to others. Family medicine and General Practice are almost unheard of here -- they are all specialists of some sort, and the equivalent of general medicine carries with it far less cost but also less education.

Not to mention that if you want to see a GP you need to schedule an appointment, and good luck getting in within two weeks time.

It is a LOT faster to go to a clinic and get a referal, but it is also more expensive. Not as expensive as going to an ER, but many times it is considered, "Out of Network", and so you end up paying like 10%-25%, instead of a $10-$100 co-payment.

[+joc]

This is my fear. If the Republicans in the House push this issue now and the government actually shuts down I see no benefit for anyone but the left. I think it will put the Speaker's gavel back in Pelosi's hand. In a way it will be fascinating - like watching a car wreck in slow motion - but I fear that neither the US nor world economies can survive the spending Obama and the Dems will do if completely unopposed.

What say you?

If the issue isn't pushed now...we are doomed...Capitalism dies on the vine...America becomes the largest Communist Police State in the history of the world.

[+DieChecker]

If the issue isn't pushed now...we are doomed...Capitalism dies on the vine...America becomes the largest Communist Police State in the history of the world.

Maybe not the largest (remember the Soviet Union?), but certainly the Most Powerful.

[Frank Merton]

If the issue isn't pushed now...we are doomed...Capitalism dies on the vine...America becomes the largest Communist Police State in the history of the world.

I dunno but that strikes me as silly. We all live in police states -- we can't do without police, bad as they sometimes are. I'm curious though what your image of a police state is that differs from the police in the States.

As far as Obamacare goes, that is hardly socialism, and to my mind is an unfortunate mix of private and state that is going to create bad consequences, and the state aspect will get the blame for the private parts of the mix's greed. The States does need a national health care system -- at the present time far too many people are doing without health treatments because costs in the States are entirely out of line with what they should be.

[Sir Wearer of Hats]

If the issue isn't pushed now...we are doomed...Capitalism dies on the vine...America becomes the largest Communist Police State in the history of the world.

It's not Communism - it's Fascism.

[+joc]

Yes, but since the 80s both sides of the house are so entrenched in claiming that the other side is Satan that they can't together anymore. Some new faces have to sent there as soon as possible.

Ah, but see...we did send knew faces there..in 2010...but what happened to all those Tea Party-ers? The truth is that both sides do claim the other is Satan...but the 'real' truth is...Washington D.C. is Satan. Only a handful of politicians in that town actually care about doing the 'work' of the people. The rest are just trying to keep their own personal sprocket turning. Republicans are played against Democrats and vice versa. The Rich are played against the Poor, Black against White, etc. It doesn't matter who we send to that town...the great Satan sucks them into his fiery hell of money and TV appearances. And it isn't just Dems. If you don't want to play on Boner's team with Boner's rules...Boner will set you down and read you the riot act. You will have no power, you won't get anything done and all of your high dreams were for nought. Play by my rules or we'll make sure in two years you will be gone for good. Same with the Dems.

So...we are doomed.

Edited October 7, 2013 by joc

[+DieChecker]

I think that joc is right in that once you get to DC you're told what to do by your Party, and no mavricks are allowed. Doubtless there are a few who will vote one way or the other on lesser issues and bills, but almost everyone toes the line when the Whips come around telling you how to vote. It is political suicide to be cut off from your parties reelection funds.

Edited October 8, 2013 by DieChecker

[Frank Merton]

A question: why do they call the ACA "Affordable" when it isn't?

[Gromdor]

Health insurance costs have risen 131% in the last ten years. http://business.time...last-ten-years/ Obamacare was implemented to force people who were using health care and not paying to buy insurance and in theory lower the rates. Hence the name.

Edited October 8, 2013 by Gromdor

[ninjadude]

A question: why do they call the ACA "Affordable" when it isn't?

It's the name of the law and for those uninsured, it certainly is.

[+DieChecker]

A question: why do they call the ACA "Affordable" when it isn't?

Exactly right. On the Sunday political shows they (mostly democrats) are still saying it is to allow for Affordable healthcare to the poor and other disadvantaged individuals. But from what I've read, it is not really affordable to the target groups.

[+DieChecker]

It's the name of the law and for those uninsured, it certainly is.

How is $300 to $500 a month affordable to someone/family living on 15000 a year ($1200 a month)??

They get part of that back at tax time, but they also have to pay Deducable, right? Which they don't get back....

Edited October 8, 2013 by DieChecker

[+joc]

I dunno but that strikes me as silly. We all live in police states -- we can't do without police, bad as they sometimes are. I'm curious though what your image of a police state is that differs from the police in the States.

As far as Obamacare goes, that is hardly socialism, and to my mind is an unfortunate mix of private and state that is going to create bad consequences, and the state aspect will get the blame for the private parts of the mix's greed. The States does need a national health care system -- at the present time far too many people are doing without health treatments because costs in the States are entirely out of line with what they should be.

We do not live in a Police State. In a Police State...the Government has all authority and the people have none. We live in a free society...which means that...as long as you obey the laws of the land...the Police cannot bother you. And remember that the only thing that seperates us is the Constitution of the United States of America...spelling out are Freedoms; Speech, Worship, Gun ownership, etc. When the Constitution has no more authority over the State, then the State will usurp all authority...whallaah...Police State.

[Frank Merton]

We do not live in a Police State. In a Police State...the Government has all authority and the people have none. We live in a free society...which means that...as long as you obey the laws of the land...the Police cannot bother you. And remember that the only thing that seperates us is the Constitution of the United States of America...spelling out are Freedoms; Speech, Worship, Gun ownership, etc. When the Constitution has no more authority over the State, then the State will usurp all authority...whallaah...Police State.

I think you have been indoctrinated into a myth. The police are just as powerful in the States as in Vietnam, and under a good deal less control.

[+joc]

I don't get all the poltics invovled. Can't we just try it, since the system is obviously broken and see if it works? If a part of it doesn't work, change it. Isn't that what our government system is for?

Rather than just 'try it'...let me 'try' to clue you in on the Politics of it. It isn't hard to understand once someone explains it:

1. Obama is on record several times before he became President stating that he wants a Single Payer System in America. Single Payer means that it is the government, rather than private insurers, that pays for all health care costs.

2. The way they get there is to mandate that YOU must buy a health insurance policy. YOU will buy one or THEY will fine YOU! You do the math and figure out quickly that it is cheaper for you to pay the fine. At the same time, they mandate to the Insurance Companies that they cannot deny YOU health coverage because of a pre-existing condition. You just found out you have cancer...the insurance companies now MUST sell you a policy...but you cannot afford it...so you pay the fine instead and still get treated for cancer. Sooner or later (probably sooner) the insurance companies will just go out of business because they will all be bankrupt. Then the government will be the sole provider of healthcare coverage...and we will all pay out the nose for FREE Healthcare.

3. And then there is the caviat...when YOU begin to understand that the way YOU vote affects YOUR ability to actually acquire the healthcare YOU need, then YOU will vote Democrat. That is the real Checkmate in all of this...consider the IRS is in charge of your health care now. Oh yeah! They are! Do you really want the IRS knowing that you were treated for Herpes last year? Or that you have been treated for schitzophrenia, or that you are being treated for aids? Do you really want the government to know every little health care private detail of your life?

If you are okay with that...then yeah...go ahead and try it!

But I have a few questions:

A. What happens when you do sign up and then don't make the premiums? Can you then just 'opt out'? Doubtful.

B. What if you don't make much money...haven't really contributed much to the program...and have a very expensive medical condition...and...you vote Republican? Will you be denied healthcare...will they lose your medical records or 'forget' to put you on the docket for that MRI that you need?

No offense, but you my friend are the end result of a dumbed down society. Don't know, don't care...just give it a shot and try it. Thinking is the key. Think!

shakes head and walks off the stage

Edited October 8, 2013 by joc

[+DieChecker]

I think you have been indoctrinated into a myth. The police are just as powerful in the States as in Vietnam, and under a good deal less control.

The police here (Oregon) are a joke. They sometime will not even give traffic tickets to ethnic minoritys because it looks bad in the yearly numbers in the newspapers. If too many Mexicans (A percentage greater then the population ratio) are arrested or ticketed, it turns into a real "Racism" fest around here. Usually resulting in a Police Commissionor, or Police Chief having to resign. And the police now fear to even pull their guns in self defense as so many of them in the past couple years have been let go for defending themselves against knife weilding homeless and mentally unbalanced individuals.

The police are only a little more powerful/feared then a security guard in a mall.

Edited October 8, 2013 by DieChecker