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Sun Nov 25, 2012, 11:33 AM

The REAL entitlement that nobody wants to talk about.

I was having an online conversation with a like-minded friend who was telling me she went to a conference where apparently they spent 20 minutes trashing Obamacare and said that 43% of Doctors were going to go out of business in the next 5 years BECAUSE of Obamacare.

Really?

Not because of the greed of the AMA and the Doctors that belong to that organization?

This particular "crisis" is one of an industry that has insulated and protected itself from competition by limiting the number of medical students, so now, a shortage of Doctors is imminent...but it has been predicted for over 30 years.

We have the perfect storm on us. Our aging Baby Boomer population that will need increased medical care combined with a large majority of physicians who will be retiring at the same time. But the AMA decided to protect the profits of the existing doctors by not increasing a pool of new doctors.

In this article, written in 2002, the very thing was being discussed. But instead, these assholes who were going to retire anyway are going to try to blame it on Obamacare instead of placing the blame squarely on themselves.
>>>snip
Viewed from within this recent historical context, the paper by Cooper and colleagues can be considered the first round of a renewed debate. The main premise of their piece is that demand for physician services will increase greatly as our nation’s health sector and overall economy expand in size. Whether this is due to the hand of Adam Smith, government planners, or coincidence, the paper documents that during the 1929–2000 period U.S. physician supply and gross domestic product (GDP) did track each other closely. The bottom line of their forecast is that they predict that the United States will have a “shortfall of substantial magnitude” (equivalent to about 200,000 physicians) by the year 2020. http://content.healthaffairs.org/conten

So, it appears that the REAL entitlement in this country is going to be healthcare. In a country that has upwards of 50 MILLION uninsured, I truly believe that THIS is the reason the republicans are fighting this law so hard. This is typical of the "I got mine" crowd. They do NOT want to share healthcare. There will NOT be enough physicians to take care of this population after the ones that have been predicted to leave their practices do. And of course, they want the blame to go somewhere else.

There will HAVE to be a restructuring in order to meet the needs of the country. Don't let people get by with blaming it on Obamacare. This has been in the works for a long time. Personally, I think the FEDERAL government needs to take over and increase medical school enrollment SUBSTANTIALLY and give us a national healthcare plan--but someone needs to shine the light on the actions that the AMA took to keep physicians wealthy and to artificially stifle competition.

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Arrow 22 replies Author Time Post
Reply The REAL entitlement that nobody wants to talk about. (Original post)
Horse with no Name Nov 2012 OP
brewens Nov 2012 #1
Horse with no Name Nov 2012 #3
brewens Nov 2012 #7
No Vested Interest Nov 2012 #18
underpants Nov 2012 #2
Horse with no Name Nov 2012 #4
underpants Nov 2012 #21
1StrongBlackMan Nov 2012 #5
Horse with no Name Nov 2012 #8
hfojvt Nov 2012 #6
Horse with no Name Nov 2012 #9
Egalitarian Thug Nov 2012 #10
freshwest Nov 2012 #11
Igel Nov 2012 #12
Horse with no Name Nov 2012 #13
99Forever Nov 2012 #14
RB TexLa Nov 2012 #15
rurallib Nov 2012 #16
libdem4life Nov 2012 #17
ChisolmTrailDem Nov 2012 #19
hue Nov 2012 #20
FrodosPet Nov 2012 #22

Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 11:45 AM

1. I'd say a lot of professions that are well respected like doctors, where that used to be a big part

of the incentive to be one, have also decided they need to be incredibly wealthy as well. We always expected doctors and CEO's to be well off, now they also want all the money.

You see that in many professions. Their status and the fact that they have relatively nice working conditions, mean nothing if they don't take most of the money. They expect people with the rougher jobs to risk their health for peanuts.

I've always been a little harsh on people with desk jobs whining about stress. Try doing concrete in the hot sun, under the gun to get the job finished on time, before you tell me about your stress!

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Response to brewens (Reply #1)

Sun Nov 25, 2012, 12:03 PM

3. I agree but the Public Health concerns with lack of physicians is going to make us a Third World

Country faster than any other industry.

This is truly a National Emergency. Maybe Cuba can send us some docs?

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Response to Horse with no Name (Reply #3)

Sun Nov 25, 2012, 12:14 PM

7. I think eventually, we'll see things shake out to where people are given medical care

for what they can afford to pay. If you want to be a doctor, you'll have to settle for a large, but not princely income. It will be the insurance companies that will be cut out.

The biggest threat to medical professionals are working class wages. If the workers don't make any money, how do they expect to get paid? Look at the big insurance companies. Where did they come from in the first place? Employers didn't want to give workers medical coverage. Unions made them want to. People in the health care insurance industry have been working against what created them in the first place.

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Response to Horse with no Name (Reply #3)

Sun Nov 25, 2012, 02:42 PM

18. So glad you brought up Cuba,

Known for the large number of physicians produced, who are sent worldwide to care for those suffering in emergencies.
If I remember correctly, Cuba offered to send doctors after Katrina, but, of course, the offer was refused.
I wouldn't be surprised if Cuba had offered to send doctors following Sandy, and we wouldn't have heard much about it.
Anyway, whenever I hear about the coming doctor shortage, I am reminded that Cuban doctors are plentiful and could help relieve our shortage very quickly.
(I am not Cuban nor Hispanic.)

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 11:46 AM

2. Excellent post

+

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Response to underpants (Reply #2)

Sun Nov 25, 2012, 12:04 PM

4. Thanks! Not getting a lot of response,lol. n/t

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Response to Horse with no Name (Reply #4)

Sun Nov 25, 2012, 05:12 PM

21. it is now

that's why I responded - not that it was me, any response gets people interested

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 12:09 PM

5. I've had several conversations ...

with anti-ObamaCare (actual, anti everything President Obama) folks that cited to these same figures.

My response has always been: Well ... Yes. Some aging physicians will retire ... and the ideological ones will blame it on ObamaCare. But how many non-aged physicians will be shuttering their practices because of their politics? What are they going to do ... open a plumbing or electrical contracting business?

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Response to 1StrongBlackMan (Reply #5)

Sun Nov 25, 2012, 12:19 PM

8. Yeah it is making the rounds

This percentage of loss was predicted long before Obama was even on the national radar.

The projected number of docs will retire. I HIGHLY doubt any more than that will. However, I do know one bastard that is an OB/GYN who retired under Bush and came out of retirement just so he could run his mouth about "quitting" because of Obamacare. I imagine the biggest number of physician detractors re: Obamacare come from those who have supported limiting the numbers in medical school for their own gain OR those physicians who work in the private sector (in the insurance industry, etc). THEIR jobs would just go away if we had a national healthcare plan.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 12:13 PM

6. the title confuses me. What the hell is an entitlement?

"The real entitlement in this country is going to be healthcare"

Okay, that means we will all be entitled to healthcare?

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Response to hfojvt (Reply #6)

Sun Nov 25, 2012, 12:22 PM

9. Healthcare is an entitlement for those that are insured

definition
to give (a person) the right to do or have something;

If a person does NOT have health insurance, they are generally NOT entitled to healthcare in this country.


Not sure why you aren't able to figure this out...

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 12:28 PM

10. K&R You are absolutely right. When these entitled people, doctors, lawyers, dentists, brokers,

 

the upper middle class in general, are hurt and feel the pain, that's when change will happen. And that's why their entitlements are ignored.

Reforming the ridiculous, antiquated weeding process of medical school is an excellent example, but is just one of the myriad artificial restrictions placed just to exclude the majority of Americans from participating in/entering the country club set.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 12:42 PM

11. What is already happening is that very good doctors from abroad who don't expect to become the new

landed gentry are moving in to take their place.

Where they come from, doctors were not regarded as gods surrounded by a group of worshippers. It's a profession, not the road to riches, hanging out on the golf course and living in luxury. They are barely in the middle class, and are willing to adapt.

Those who got into medicine to get rich are not going to fare well, squeezing the life blood out of the people they claim to care about. The discriminate in their practice based on the ability to pay now. The less complicated the processs, the less bias against patients, the better for people. Elitists of all kinds are squalling.

Let them retire, there is no shortage of doctors to replace them, people who believe in working in the field of healing and not sitting on their laurels.



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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 01:17 PM

12. Medical schools have been boosting enrollments.

They rely not just on tuition to fund the kids' educations. Research funds help. So do grants.

But once they're done, they have residencies. These are largely funded through teaching hospitals. The hospitals "make a profit" off of patients, some of the money going to the medical schools but a lot of it going to residents and fellows.

This is where the bottleneck is in training new doctors. This isn't an AMA "thing." It's a funding issue.


Please note that there's an odd distribution of doctors in the US. The more "red" a county is, the fewer doctors it'll have per capita.

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Response to Igel (Reply #12)

Sun Nov 25, 2012, 01:56 PM

13. Lately they have

but if you read the article, you will see that their has always been a gateway to the medical profession with a very strict gatekeeper.

And it is an AMA thing. It always has been. Why do you suppose there is a funding issue with it? Perhaps because there are no type of government grants available to those attending medical school--why do you suppose this is? Perhaps to keep poor kids out of their profession?

Granted, a few token poor kids with good stories will be allowed through the gates, but as a friend of mine who is a surgeon told me a few years ago....it is harder to get in medical school than medical school is.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 02:08 PM

14. The 1% will protect their own...

... regardless of who they kill and main in the process.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 02:10 PM

15. We've needed to remove the AMA from anything to do with medical schools and licensing


for a long time.

Vastly increase the medical school slots, open up visas for doctors.

When advertising for doctors surpasses advertising for attorneys on television we'll know we have a good start.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 02:24 PM

16. mark to come back to

some things need to be reread a couple of times to be digested thouroughly

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 02:40 PM

17. Another thought ... I notice that Physician's Assistants and RNs are taking up a lot of the minor

issues...that don't require an MD. They get very good pay, as well. Maybe they are like Medics in the military? Don't know, but think this is a good trend.

The Regional Medical Center here, which has a full hospital on site, has 5 names on the door...4 PAs or similar and a Doctor of Osteopathy. Seems the MDs are in the hospital setting. The PA can prescribe initial medications. Coughs and colds and the flu and physical exams and other minor illnesses, or initially reading test results, don't need the MD or DO until it becomes or shows itself to be serious. Also, they take Medicare patients, and the co pay is $11.

Not sure how this works in the overall medical system, but believe that it is a good trend. The old model of MDs who must support a practice, is overrated and overpaid...I believe it is the model that is failing. Independent physician's groups have tried to out-organize the newer HMO/Medicare model that does not pay nearly as well.

Young MDs are strapped with huge student loans. One niece is an MD and it takes both her and her husband's income to meet the loan payment, and as an irony, the other is a Marketing Specialist ... with just a BA ... for Nabisco/WalMart. I was shocked to discover their incomes are similar.

Just some observations.

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 02:59 PM

19. My gosh. This and so much more. We have so much work

that needs to be done. We need to find our lost identity and we're depending on the most disfunctional class of congressional and business "leaders" our history has known. Greed and childishness and malice and denial and apathy and outright sabotage are the rule of the day.

I watch an hour of "news" and it strikes me every single time how immature it all is, how profoundly childish and selfish. And it saddens me to know that all it will take to fix our problems is for our so-called leaders, both political and business, to just grow up and learn to share.

SMH

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 03:01 PM

20. One substitute or solution no one has added are the increase of Nurse Practioners.

There is a growing pool of Nurse Practitioners that are not physicians but are providing primary care for an increasing number of patients. Their scope of practice is widening and they are found in Quick Clinics (primarily to lessen the load in EDs and bring health care to the public) in shopping malls and street corners etc.
Keeping in mind they are the first to refute any one who claims they are practicing medicine they practice wellness in teaching wellness, doing physical assessments and screening, providing vaccinations and treating common afflictions while referring more complex cases to MDs and DOs (another group who is filling in the shortage of MDs.

http://www.pbs.org/newshour/bb/health/jan-june11/nurses_05-26.html

MDs from abroad bring quite a varied medical knowledge base. Some from India, for example, go directly into a pre-med or medical school secondary school (like a high school) after primary education. They do not have an undergraduate degree. Their medical school is much less expensive than med school in the U.S. and the Indian Gov. pays for many of the students. Entry to private med schools in some counties resort to corrupt practices such as wealthy families paying for their (usually) son's acceptance.
There are many new factors coming into play and some of them are quite welcome. Yes the AMA is another one of those "good ol' boys clubs" that are becoming obsolete. I'll end my post with an informative article with some good news:

"The nation’s universities are opening more medical schools as graduate medical education transforms to address the nation’s physician shortage.

The Association of American Medical Colleges (AAMC), which represents medical schools and teaching hospitals, said there are now 18 medical schools under development, which is the “largest number” of schools in various stages of development in decades. A dozen of them have preliminary accreditation or provisional accreditation, the association said."

http://www.forbes.com/sites/brucejapsen/2012/07/17/as-obamacare-looms-new-medical-schools-open-to-address-doctor-shortage/

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Response to Horse with no Name (Original post)

Sun Nov 25, 2012, 09:32 PM

22. The more I read

The more ready I am for the off switch.

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