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This was not even an angle I was thinking about until I spoke with my father (a radiologist) earlier tonight.

Both of us are liberal and in favor of healthcare reform, but whenever I think of healthcare reform (and discuss it with my father) I only consider it from the perspective of people getting covered, lowering medical costs, decreasing premiums, people being in favor of higher taxes to get health coverage, etc. etc. etc.  You know, the standard angles we all discuss and like to read on here.

But I never really considered a very simple but noteworthy angle of the physicians, which my dad brought to light just tonight.

Simply put, healthcare reform will certainly decrease the salaries of physicians (which is why many physicians are very much against a public option, let alone a single payer system), but, even in the current environment with our private insurance system, physician salaries are already decreasing!!!

My dad had brought up the point that healthcare reform will decrease salaries, but he went on to mention that his compensation has gone down every year for the past few years.  And he does not work for some run-of-the-mill hospital...he is a partner for a private radiology group.  The reason that compensation is going down is because there is less money flowing into the system.  As every informed person knows, insurance companies look for any quick out to avoid paying for tests and treatments, or they decrease the compensation to physicians, but more importantly, more sick people are experiencing rescission (being dropped from their plans) and are then left to pay for these expensive tests and treatments by themselves.  And in today's economy most of these people can't afford to pay these exorbitant costs, ending up in bankruptcy.

I am well aware of this issue, but I never thought about it until my dad brought it up.  I currently volunteer at a hospital getting experience to become a medical physicist (they work with radiation oncologists in planning radiation therapy) and the radiation oncology field is no exception to this problem.  Radiation Therapy is very expensive.  My main focus is CyberKnife treatment, and most clinics around the country are moving towards this high precision treatment method (one CyberKnife treatment can be anywhere from $50,000 to $100,000.  Other forms of conventional radiation therapy are cheaper but are still five figures).  Setting up a CyberKnife clinic is a big investment, and when a hospital can't afford it they court investors to help pay for it (which is the deal where I work).  Regardless of whether insurance compensates or the person attempts to pay out of pocket, the investor(s) gets money per treatment.  So there is always money flowing out, but money flowing in isn't always a guarantee.  Something has got to give, and in most cases it usually does not involve layoffs (finding qualified radiation oncologists, dosimetrists, physicsts, etc. is not easy).  So, what would appear to give is salary.  While I can't report any such salary drops where I volunteer, raises are few and far between.

The simple point is this (which is something that my dad has been trying to convey to his colleagues who are very much against healthcare reform): if our government does not do something to reform our healthcare system physicians will be facing serious issues regarding compensation in the near future.  The choice is between getting some compensation with government intervention (compensation that is less than what is currently in the private system) or getting no compensation by keeping the status quo (the compensation is still there, but it continues to decrease).  The status quo is broken, and compensation, and therefore salaries, will continue to decrease regardless.  Just look at it logically:  take a sick person who doesn't have insurance versus one who has government run insurance with the public option.  If these two people get care at a hospital you are talking about SOME COMPENSATION versus NO COMPENSATION.

Given SOME COMPENSATION versus NO COMPENSATION I think doctors and medical professionals would chose the former.  But of course, this simple angle is rarely given much light in the news or the main stream media.

Originally posted to Tokar on Thu Jul 23, 2009 at 08:13 PM PDT.

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