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View Diary: What you should know about health insurance industry lobbyists and their lies (276 comments)

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  •  I respect your experience, (2+ / 0-)
    Recommended by:
    Alexandra Lynch, Egalitare

    but I'm afraid I can't buy the concept that medical schools can't expand.  Of course they're limited in size and capacity now; that's how the system is set up.  Also, why the hell should anyone have to pay forty thou per year to get a medical education?  There's no reason on earth that ALL the insane dollar amounts associated with medicine can't come down.

    It's of great social value to have doctors, and plenty of them, and the cost of producing more of them should be subsidized by the people (i.e., the government).  The practice of medicine shouldn't be an exclusive, overpriced club.  And I don't buy the premise that the United States produces such a tiny fraction of people who are qualified, emotionally, socially, and intellectually, to become doctors.  Those I knew who were rejected were fine people.

    As to why more people don't want to be g.p.'s - remove the monstrous med school debt that almost requires a new doc to become a specialist so he can start raking in the big money right away, and maybe more people would be g.p.'s.

    As to your last question - can we wait that long? Hell, that's a reason to start reforming this idiotic system right away by opening the medical schools to greater enrollments.

    •  I didn't say they can't expand (0+ / 0-)

      I did not say they can't expand - I just said it would take resources that may not be readily available.  THe figure of $40K per year is what my alma mater, Albany Medical College, currently costs.  That is just the tuition, so one's total costs would be more.  I don't know why it is so expensive - we are all told that the tuition only represents a fraction of the cost of educating a physician, but you never exactly get an accounting of where your tuition dollars go.  I am going to have to start doing some resident teaching starting next summer, and that is not coming with any extra pay for me.

      The cost of my education was $160K, and it was paid by the Army over the years 1994 to 1998.  I did five years of active duty after my residency was over in exchange for that funding.  I think there should be more service contract options for med students - military and others.  I think any student should be able to get a gov't funded medical education, but they should have to serve in an underserved area for a period of time after they are trained.  

      A GP generally refers to someone who did a one year internship after med school, minimal training.  An FP - family practitioner - has done a 3 year residency in primary care, passed an exam, is board certified, and has to recertify every 7 to 10 years.  The two are not the same thing, so it is a bit insulting to call your family doc a GP - so don't.

      •  OK, did not know this (0+ / 0-)

        Up until recently, we had an absolutely stellar primary care physician. He's probably an FP rather than a GP, based on what you say. I miss him terribly. He took care of our diabetes care as well as our general primary care needs, and it was he who found my kidney disease back when it was just starting to become apparent, because he believes in doing regular labs on his patients and follows up with more if he has to. He'll take time to call me on the phone on a Saturday or Sunday to let me know the results of tests or plans to change my medication based on my current needs. He reads the current research, especially on diabetes and any complications resulting from diabetes, and is willing to discuss it with me and look into something that I come up with that he may have missed.

        He's still in practice. The only thing standing between me and Charles and regular appointments with Dr. I. is money. Dr. I. changed practices last month, and the new practice, across the hall from the old one, doesn't take our insurance as a preferred provider as of 01/01/09. If we were to see Dr. I. now, our insurance would cover 50% of the appointment. I have Medicare, and the new practice does take Medicare, but the other insurance is still primary and will be until June 2010. So I would get 50% coverage from Charles's employer group insurance and 20% coverage from Medicare.

        (There is a 30-month coordination period between your other insurance and Medicare if you have Medicare because you're on dialysis but are under 65, where your other insurance pays 80% and Medicare pays 20%. The for-profit dialysis clinics have been trying to convince Congress to expand that to 42 months. They say it benefits the patients. No, it benefits THEM, because they can charge the other group or private insurance whatever that insurance company will pay, and I have seen figures from other dialysis patients that have gone as high as $35,000/month.)

        Of course, starting in June 2010, I can go see Dr. I. again no matter what other insurance I have, because I'll still have Medicare and it will become primary. I'll have lost a year and a half of being followed by him, and he'll have to get notes from the other doctor he recommended we seek out; it won't be anywhere near as good as if he had been following me the whole time. We need to get an endocrinologist, too, to replace his work with us on diabetes care; it's going to take the work of TWO doctors to replace what Dr. I. has done for us for years.

        Want to be a living kidney donor? I need one from someone with a bloodtype of B or O. Drop a note at riverheart.livejournal.com.

        by Kitsap River on Mon Jan 26, 2009 at 09:29:41 AM PST

        [ Parent ]

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