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View Diary: I feel sorry for health insurance companies. Yes, I said that. Why? This Time report must be read. (228 comments)

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  •  There is no competition.... (18+ / 0-)

    and that's a huge part of the problem.

    The USA has a shortage of tens of thousands of doctors, and it's going to get far worse as ACA kicks in and 30+ million people get insurance and can finally see a doctor.

    I read recently that something like 30% of all the doctors in California are at or near retirement age..... and that is a scary number, isn't it?

    As long as there is a doctor shortage, there cannot be any competition, leaving doctors, hospitals and insurance companies with a real 'monopoly' (there are other technical terms for this type of cornering the market that I can't remember).

    That's where the government is supposed to step in to regulate the market, like they do with electricity, water and other basic necessitites that are subject to monopolization.

    Unfortunately, the corporate interests don't want regulation, and in our wonderful new world, they are winning.

    So we suffer.


    Against stupidity the gods themselves contend in vain. Friedrich Schiller

    by databob on Thu Feb 21, 2013 at 08:59:43 AM PST

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    •  Medical Cruises To Taiwan? (8+ / 0-)

      An ex-pat went back for Lasic surgery, granted, he knew where the best doctor/facility in the country was, but $1800 later, his eyesight is as fine as it would have been for the $5000 stateside cost.

      My biggest rant is that we all know what a gallon of milk costs, a gallon of gas.  The insurance company negotiates rates for procedures, etc.  Why isn't there a uniform pricing clause in the ACA?  Now that I can see what my company pays for it, I for one would SERIOUSLY consider dropping my companies $1800 a month plan (and my massive bi-weekly contribution) and get catastrophic or high-deductible coverage only.  $20,000 a year can buy an awful lot of services if there were a uniform pricing,  but I'd be screwed into paying double the insurer's rate out of pocket.

      •  FWIW, I paid, ~$3k for PRK a couple years back (2+ / 0-)
        Recommended by:
        james321, ladybug53

        Way more than $1800, but not too bad, I think.

        "He who fights monsters should see to it that he himself does not become a monster. And if you gaze for long into an abyss, the abyss gazes also into you."

        by Hayate Yagami on Thu Feb 21, 2013 at 10:21:50 AM PST

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        •  Yes, all medical/dental pricing (3+ / 0-)
          Recommended by:
          james321, qofdisks, ladybug53

          Depends a great deal on where you live.

          If its a high cost area, it's going to cost a lot. There's a lot of overhead to a hospital or clinic, and if building costs, utilities, insurance, salaries, etc. are higher, your cost will be higher. Doesn't matter what the product is, really. Every business has that problem to some extent.

    •  I live in California (15+ / 0-)

      and it seems to me that most of the doctors in our area are foreign born/educated in foreign medical schools, or foreign born/educated to premed in foreign medical schools, then get final education in American schools.  

      We are filling the need for doctors from outside the country, and I am guessing that will continue when that 30 percent retire.  

      That folds into the other major problems our congress can't seem to deal with -- immigration reform, wage reform, costs/quality of higher education, unprepared high school students, as well as as destroying access to medical care in third world countries.  

      •  Hello (1+ / 0-)
        Recommended by:

        my dad is one of those foreign doctors. He graduated from Taipei Medical University's 7 year program. It cost him about $100 (USD back in that time period) per semester and like the spoiled brat he was, he drove to school. Everyone else took the bus. His medical education was CHEAP. Oh he served in the [foreign] military too lol.

        He came to the united states during the late 70's and got his greencard in early 80's... thanks to a nice man named Dr. Elmer Brown (God rest his soul) who helped him out and gave him a position in a training program... and then a lawyer in Chicago whose dad was famous paid attention to changes in the law and really expedited this process.

        Fast forward to today... my brother is graduating from medical school in May.
        So his education after high school was...
        Washington University in St. Louis double major biology and anthropology
        Yale University Masters in Public Health
        some more classes at the local calstate across the street from our house
        Touro University in Las Vegas

        His education alone is like half a million dollars.  He is a lucky guy to have his mommy and daddy pay for everything and keep him debt free. 99% of other people do not get this luxury. It is a LUXURY to be debt free like this! There is something wrong with this picture!

        mum and dad were running out of money so I got my engineering BS at UCLA. my tuition bill to my parents: 39k. housing+everything else: ~54k. About 100k if you include the mom make me food the dorm food is getting boring. The bill for my PhD to my parents: ZEE-ROH like Bill Clinton says it. So apparently the country invests in scientists. :)

        Why hello there reality, how are you doing?

        by Future Gazer on Thu Feb 21, 2013 at 09:16:12 PM PST

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    •  Let's not be stupid! (15+ / 0-)

         The hair on fire claim that each and every person who will have health insurance via ACA will all require immediate healthcare is rubbish.

           The physician shortage is a problem, but the assumption is that every patient sees a MD for every health care need is also a stretch.  Most physicians have RNs, who do the intake and PA's for doing physicals and OMG follow-up.

            Many hospitals have "hospitalists" who are supplanting the "on-call" physicians.   Many intensive care units are using Nursing Specialists for the managing of critical care patients.  

             What we need to understand is that patient care by direct physician care has changed over the past decade and many are sticking to the old idea that the only person competent to care for an individual (outside of surgery) is a MD.    
             I'm old enough to remember when the very idea of having a Nurse Anesthetist was sheer tyranny and yet now they are commonplace.

      •  The trend towards "hospitalists" (0+ / 0-)

        is awful, in my opinion.  Having had to deal with them in the past year during my mom's various health crises has not made me a fan. Instead of having one doctor who follows up -- and knows what your treatment protocols are -- you end up having to reinvent the wheel every 12 hours or so and things fall through the cracks.  The upshot is you get less personal care, a greater likelihood of errors, and lots more stress for patients and family members who are trying to get information and ensure the best care for their loved one.  I don't mind PAs, Nurse Practitioners, etc., but there are still times when an actual doctor is needed, particularly during a crisis situation.  In addition, there are times when having the continuity of just one doctor familiar with your case is highly beneficial.  

    •  And the AMA keeps it that way deliberately (10+ / 0-)

      by controlling the accreditation of medial schools.

      Is it any surprise that when we let doctors control the supply of new doctors they keep that quantity artificially depressed?

      “What’s the use of having developed a science well enough to make predictions if, in the end, all we’re willing to do is stand around and wait for them to come true?” - Sherwood Rowland

      by jrooth on Thu Feb 21, 2013 at 11:43:18 AM PST

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    •  Occupational birth control. (8+ / 0-)

      The slots in medical schools are absurdly limited in this country in comparison to others.  The excess profits of university/med school hospitals go to fund research, PR, and building campaigns, as well as inflate salaries for everyone from the President on down to the janitors.  But increasing the number of students is strictly forbidden.  Supposedly it would interfere with "quality".  In fact, it would remove the prop under provider charges, which in turn are necessary to pay off exorbitant loans for the exorbitant charges of the medical education system.

    •  Ask. Why the Dr. shortage when (1+ / 0-)
      Recommended by:

      so many college grads have a biology degree? Medical school should be free.

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