Whiskey Fire: “One of the big advantages of universal healthcare — if not THE advantage — is supposed to be the public health and economic benefit of primary and preventive care. Get people covered, so they’re financially able to go see a doctor before a relatively minor medical problem becomes a serious illness and you both improve overall morbidity and save a sh*tload of money as well. All of which is a fine theory, and has some pretty impressive evidence to support it — just look where the US falls on the life expectancy charts compared to per capita spending on healthcare. But there’s one important ingredient missing from that equation — enough primary care doctors to take care of all these newly insured people.”
(via Mike the Mad Biologist)
Related posts:
- ER visits and health care costs rise in Massachusetts due to lack of primary care access
- Pre-paid primary care
- Will the lack of primary care doctors make universal coverage useless?
- Primary care docs "in the middle"
- Does nationalized care increase life expectancy?
- "It’s a miracle primary care docs make any money at all"
- Primary care and the elderly
{ 8 comments }
GREAT article. The Medicare RVU payment scam needs to be dismantled!! It will bankrupt the US. Pay physicians like they are paid in Canada or England and we will see primary care rebound. Only with primary care as the central hub (as they used to be) can the US reform health care. We have had a specialist-centric model now for 20 years and look what the results have been: 1. skyrocketing health care costs 2.. large segment of population with no or little coverage 3.. poorer outcomes compared to other western countries 4. over supply of “lifestyle docs” (how many dermato-pathologists, radiologists does one country really need) 5. medical errors rising at a huge rate………..Until the American people wake up and pressure their representatives to ABANDON this systems which has created the above problems, nothing will change. The specialist lobbyists are hard at work wining and dining those in DC to protect their income streams. A grass roots effort needs to happen whereby citizens begin demanding reform!! Americans are not stupid. They just do not understand the problem. Ask an average guy off the street what RVU means…you will get a blank stare. But, with proper education, the average guy off the street will easily see how and why this has ruined our health care. We need to get started and change this mess before it is too late.
I see this comment here all the time, i.e. that primary care physicians are poorly paid. However, one also sees frequently that the average primary care physician makes $150,00 per year after expenses. If you do the math (divide by month, week, etc.), one eventually reaches the figure of the doc being paid $19.53 per office visit. Figuring expenses per year as equal to pay, the total billed would be $39 per office visit. I don’t know about you but o.v.’s haven’t been under $40 for more than 20 years.
So what is really happening here? Are insurance payments really that low? Or are doctors exaggerating?
If insurance is paying so poorly, why are doctors signing contracts?
Would we be better off paying that $40 directly to the doctor? (This would also enable him/her to have a smaller staff and cut expenses.)
The health care industry is a mess and needs a lot of changes. However, I don’t think anything will happen in the near future as there are too many vested interests…..
Countries with universal healthcare in some sort of socialized system seem to pay the primary care docs very well.
Makes sense, in that the votes come from the majority of patients who remember their PAP smear was free, etc., as opposed to the tiny minority who remember their long wait for specialty care.
no one is gonna fix healthcare as long as the doctors stand on the sidelines and bitch & moan.
Educate the public? How about unify the physicians…and have them speak up and take their profession back (from the nurses, the CEOs, the governement…)
If doctors *really* decided ‘enough is enough’…and just stopped working, things would change very quickly. Just look at what they accomplished in Las Vegas when they all quit and walked off the job.
Sacrificing a few (i.e. walking off the job and leaving those few folks with ‘no physician’) to benefit the many (everyone else, patients and doctors alike), hardly seems like a far-fetched solution.
Doctors sold out their profession years ago…and the old bats that did it, aren’t even dealing with the repercussions of that mistake. We are, the new generation of physicians.
Until doctors are ready to ’say no’…nothing will improve for them…
…and why would they expect it to? Because ’society’ values us so much? If only we ‘educate’ them…things will get better for us??
Not!!
Well, currently the public thinks that all physicians are wealthy whiny p…ssys. Can’t live on 150k? Boo freakin hoo. Not a ton of good will at there in the real world. So, my comment about education is more to prepare the masses for the “physician strike”. If we cannot develop coalitions that support our cause, we will win NOThing. Ask George Bush about his Iraq war 2 coalition. Once the public understands how physicians are really paid and how the system is abused by some to the detriment of many, then we can all move forward. Right now, anon, if you walk off the job, you will likely be replaced by the next new MD grad or even better, the next new NP/PA grad.
I worked in primary care and I only made $125,000. Now I am a specialist looking at offers of $180,000-$200,000. How sweet it is.
JC MD has it all wrong.
The public is at NO point going to decide to get involved in the RVU problem.
There is only one solution– for large numbers of docs, acting individually and without collaboration–to decide that they are going to play and refuse to deal with any payor system that uses it.
Those who do not do so can only be presumed to like it and find it advantageous, griping notwithstanding.
JC MD
If you can be easily replaced without paying more, then you are not underpaid.
If you can be easily replaced by someone who is paid less, then you are overpaid even now.
Simple economics.
If you accept the deal, don’t gripe about it. If you don’t think it unfair enough for you to stick up for yourself and walk away from it, then NO ONE ELSE is sure as hell ever going to do so.
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