timesjoke
Active Members
Last evening I told you guys I had to break out early because I had company comming over and we needed a few things. Well the dinner party served as a kind of round table between me and severl friends and what we had on our minds concerning the recent events in healthcare and we were fortunate enough to have a Doctor and a nursing director there along with one of my County commissioners and a school teacher, everyone else was either a spouse or a person involved in construction.
Each of us took turns talking about our hopes and fears for how things are going from this point and I was surprised at how even the school teacher agreed that there is no way this bill will be paid for using the existing numbers, there will be a required increase in funding from some other source. A couple people did say that the bill was worth it even with new and higher taxes because "something" had to be done. Some time was spent on various other things that could have been done but we got that was not really the point so we got the discussion back on track on what we do now with this new law.
The doctor made a point he made to me long ago but added more at the end and I would like to share that with you guys. Like my first conversation with him long ago, he related how each practice must keep a balance of patients, some with higher paying insurance, and some with low paying government payments. The balance allows a doctor to keep a possition in the middle once the low payments and the higher payments meet. His new point was that under this new law, it seems like this will be a "government option" because they have taken control of all insurance companies. The Government through the HHS will dictate how much insurance companies can charge, and how much they will reimburse for services. At first the two teirs will allow that balance of payments but as costs rise because insurance companies will be forced to pay out more in claims, and they will not be allowed to raise rates, the last thing they will be able to do is match the payouts the Government pays, essentially making all insurance companies exactly like Medicare.
What does this mean? Well it means the 'middle ground' most doctors need to stay in business will be gone, they will all have to either go out of business or transform into a kind of 'health department' style of business where it is all low end clinic style of treatments, long waiting lines and minimum wage workers. Now some people may think there is nothing wrong with that but he warned us that the real harm will come down the road as young people who are able to be doctors see how little money there is to be made and choose other careers. Why would someone choose to work 12 or more hours a day and have to maintain constant education if there is no way to make a good living? Then he mentioned how quality of care would be lost because all incentive to excell would have been eliminated. A great doctor and a crappy doctor will be paid the same money with few exceptions, those who will make the most money will be the doctors who can create the fastest 'cattle call' medical service, less time per patient means more patients each day, and more payments so the incentive will be for the doctor to make up his mind quickly on the diagnosis and move on to the next person.
The rest of the night was us talking about other issues like the mandate for business to provide insurance or pay penalties, or individuals being forced to get insurance or have their income tax returns taken away to pay their fines. And what of the mistakes?
Put simply we all agreed that new taxes are on the way, and the medical services we know now are going to change. Not right away because most of this does not happen for a few years but planning now is certainly a wise decision.
Each of us took turns talking about our hopes and fears for how things are going from this point and I was surprised at how even the school teacher agreed that there is no way this bill will be paid for using the existing numbers, there will be a required increase in funding from some other source. A couple people did say that the bill was worth it even with new and higher taxes because "something" had to be done. Some time was spent on various other things that could have been done but we got that was not really the point so we got the discussion back on track on what we do now with this new law.
The doctor made a point he made to me long ago but added more at the end and I would like to share that with you guys. Like my first conversation with him long ago, he related how each practice must keep a balance of patients, some with higher paying insurance, and some with low paying government payments. The balance allows a doctor to keep a possition in the middle once the low payments and the higher payments meet. His new point was that under this new law, it seems like this will be a "government option" because they have taken control of all insurance companies. The Government through the HHS will dictate how much insurance companies can charge, and how much they will reimburse for services. At first the two teirs will allow that balance of payments but as costs rise because insurance companies will be forced to pay out more in claims, and they will not be allowed to raise rates, the last thing they will be able to do is match the payouts the Government pays, essentially making all insurance companies exactly like Medicare.
What does this mean? Well it means the 'middle ground' most doctors need to stay in business will be gone, they will all have to either go out of business or transform into a kind of 'health department' style of business where it is all low end clinic style of treatments, long waiting lines and minimum wage workers. Now some people may think there is nothing wrong with that but he warned us that the real harm will come down the road as young people who are able to be doctors see how little money there is to be made and choose other careers. Why would someone choose to work 12 or more hours a day and have to maintain constant education if there is no way to make a good living? Then he mentioned how quality of care would be lost because all incentive to excell would have been eliminated. A great doctor and a crappy doctor will be paid the same money with few exceptions, those who will make the most money will be the doctors who can create the fastest 'cattle call' medical service, less time per patient means more patients each day, and more payments so the incentive will be for the doctor to make up his mind quickly on the diagnosis and move on to the next person.
The rest of the night was us talking about other issues like the mandate for business to provide insurance or pay penalties, or individuals being forced to get insurance or have their income tax returns taken away to pay their fines. And what of the mistakes?
Put simply we all agreed that new taxes are on the way, and the medical services we know now are going to change. Not right away because most of this does not happen for a few years but planning now is certainly a wise decision.
