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View Diary: Durbin takes Social Security off the table (216 comments)

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  •  Then we will train doctors who will care (9+ / 0-)

    I don't want any doctors to be motivated only by their greed. It does not make them good doctors. We pay doctors far more in the US than anywhere else in the world. Insurers are cutting back on what they will pay just as Medicare and medicaid did. Still the doctors are extremely well paid.

    Yes, there is a shortage of doctors and it can be alleviated by changing immigration laws and by creating more medical schools and increasing the number of seats in the schools that exist now. The doctor shortage is purely a result of artificial limitations on the number of people allowed to be trained as doctors for practice in the United States. The AMA should be the leaders in reform, not the stumbling blocks for it.

    The GOP is the party of mammon. They mock what Jesus taught.

    by freelunch on Sun Nov 25, 2012 at 10:29:45 AM PST

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    •  And is that happening? (1+ / 0-)
      Recommended by:
      VClib

      I haven't seen it.

      •  yes; the ACA has all kinds of incentives (0+ / 0-)

        for people to go into medicine.  it's also true that nurse practitioners et al can do a lot.  i'm sorry, but one does not need a medical degree to take a throat culture and diagnose strep.

        those kinds of expansions are going to make a difference, and there are programs for doctors via PPACA as well.

        Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

        by Cedwyn on Sun Nov 25, 2012 at 07:00:13 PM PST

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    •  Training doctors to care won't help because (3+ / 0-)
      Recommended by:
      VClib, coffeetalk, greenbell

      the problem is simple math.  If the Medicaid payments are less than the actual costs of the treatment (and in most cases, that is true) then there is a hard limit on how many Medicaid patients they can accept without going bankrupt and no amount of training will change that fact.

      You have watched Faux News, now lose 2d10 SAN.

      by Throw The Bums Out on Sun Nov 25, 2012 at 12:00:07 PM PST

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      •  TTBO - I have several close frieds who are (2+ / 0-)

        primary care physicians and we talk about practice economics all the time. Given their overhead they lose money, even on a marginal cost basis, on all Medicare patients at current reimbursement rates. They have all stopped taking new Medicare patients. They will keep long term patients who turn 65 and start Medicare, but they won't take new ones. They have long ago stopped taking Medicaid patients where the reimbursement is even lower and the patients are the most expensive to serve.

        "let's talk about that"

        by VClib on Sun Nov 25, 2012 at 12:32:31 PM PST

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    •  freelunch - who is going to do that? (1+ / 0-)
      Recommended by:
      OleHippieChick

      I think one of the major failings of our political system is the lack of recognizing that we have a shortage of primary care clinicians. Where is the federal program to do many of the things you suggest, including expanding the number of primary care physicians, PAs, and nurse practitioners? Without it you will see the established medical practices just continue to eliminate Medicare and Medicaid patients. From what I see in my area that has been happening for five years and is accelerating. Any one physician can only treat a fixed number of patients and it makes economic sense for them to pick a patient population that provides the best income stream. There are consultants who run successful businesses just assisting physicians on exactly how to do this.  

      "let's talk about that"

      by VClib on Sun Nov 25, 2012 at 12:28:43 PM PST

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      •  Seems like a good subject to start turning screws (2+ / 0-)
        Recommended by:
        VClib, Kentucky DeanDemocrat

        for. Why not have the govt pay for med school in return for a number of years' domestic service. Powerful motivation.

        I ♥ President Obama. ~ Yes, we did. Again.
        NOW: Hands off SocSec, Medicare and Medicaid. NO Grand Bargain.
        Rich pay a bit more. DoD take a bit less. End war on Afghanistan sooner.

        by OleHippieChick on Sun Nov 25, 2012 at 01:38:50 PM PST

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        •  OHC - I think the key is to have the gov't (3+ / 0-)
          Recommended by:
          pistolSO, OleHippieChick, greenbell

          fund the expansion of slots in med school and primary care. I think we have plenty of qualified students. Some financial incentive to enter a primary care residency, rather than the higher paying specialties would also need to be a part of it as you suggest.

          "let's talk about that"

          by VClib on Sun Nov 25, 2012 at 01:52:46 PM PST

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          •  Well sure. I always simplify things, (1+ / 0-)
            Recommended by:
            VClib

            and there are parts I'm not thinking of like opening more med school/pc slots.
            I'm saying do whatever it takes to get this done in prep for the coming denial of service to the old and poor. I'ma drop a note to the President and will include what you said.

            I ♥ President Obama. ~ Yes, we did. Again.
            NOW: Hands off SocSec, Medicare and Medicaid. NO Grand Bargain.
            Rich pay a bit more. DoD take a bit less. End war on Afghanistan sooner.

            by OleHippieChick on Sun Nov 25, 2012 at 02:37:33 PM PST

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    •  With good qualifications for Med school, (1+ / 0-)
      Recommended by:
      Kentucky DeanDemocrat

      (iow, no fools), perhaps tuition costs could be guaranteed by a number of years' govt service, eg, a practice serving Medicare/Medicaid patients or VA patients in more local micro locations.

      I ♥ President Obama. ~ Yes, we did. Again.
      NOW: Hands off SocSec, Medicare and Medicaid. NO Grand Bargain.
      Rich pay a bit more. DoD take a bit less. End war on Afghanistan sooner.

      by OleHippieChick on Sun Nov 25, 2012 at 01:34:19 PM PST

      [ Parent ]

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