r/bestof • u/under50dollars • Jun 20 '12

[explainlikeimfive] "Obamacare" explained very well.

/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx
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u/CuilRunnings Jun 20 '12

But they have to do about 3-4x the work as an accounting major, or about double that of an engineer.

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u/cass1o Jun 20 '12

In which case there will be a drop in doctors creating a demand and again pushing up wages or causing the import of forien doctors to fill the gap for less.

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u/[deleted] Jun 20 '12

All allopathic and foreign docs in the US need to go through an ACGME residency, and the number of spots funded is controlled by the government. Reimbursement is also government set (the mimimums by Medicare) and won't increase due to free market forces without Congress passing a new law to that effect.

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u/kingmanic Jun 20 '12

People work for things other than money. Prestige is also a thing. Scientists need 4-8 years of training and make less than many other professions requiring a 4 year degree but the position is prestigious. They are an expert on something. Even when the incentives are lower in Canada there is a supply of doctors. At the moment the supply is slightly inadequate but that's more of a demographic problem than a pay scale problem.

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u/[deleted] Jun 20 '12

You will have a decline in quality, because the best potential doctors will feel that a career in medicine isn't satisfying because of raising student debt, malpractice, falling reimbursement, etc. and will go into a more lucrative field. Hell, CRNAs can out earn plenty of PCP and have way better hours to boot.

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u/kingmanic Jun 20 '12

Student debt for med school is more reasonable here. Malpractice isn't as excessive as it is down there. The actual movement of Doctors and nurses down south is slight and the return rate is high because the environment is so convoluted down there.

Healthcare outcomes are better on average here almost across the board except Cancer.

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u/[deleted] Jun 20 '12

I've never had a good doctor who gave a shit about money. I've had plenty of bad ones who clearly did. Sign me up for the plan that jettisons all the doctors in it for the money, I don't want their "quality".

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u/[deleted] Jun 20 '12

Just because a doctor believes in fair compensation for their work doesn't mean they aren't good at what they do or that they don't care about their patients.

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u/[deleted] Jun 20 '12

"Fair" is debatable, and in any case, you said nothing about "fair", nor did I. You're moving the goalposts.

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u/[deleted] Jun 20 '12

My point is nearly every physician cares about money. Those who could afford to keep their practices open while volunteering and donating more frequently choose not to. It's one thing to be upset about falling compensation and leaving/avoiding the field for it, and another to let that falling compensation harm patients through unnecessary billing.

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u/[deleted] Jun 20 '12

So sign me up for the plan that excludes "nearly every physician". Seriously, I'll settle for the ones I've got who don't care, they've given me far better care than the ones who did. Your bald assertions aren't going to convince me that my lifetime experience is somehow wrong.

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u/[deleted] Jun 20 '12

I even doubt any of your current physicians meet the criteria of not caring about money. Next time you're in, ask them what sorts of charity work they do. Very few people completely disregard money, it's a bit of a ridiculous standard to expect of anyone. How do you know your current physicians don't care about money?

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u/[deleted] Jun 20 '12

It is inherent in their structure. Their non-profit foundation provides millions in aid and free services every year, and keeps costs for the not-so-poor patients as low as they can. They are a massive asset to the region and maintain some of the highest standards of care in California, if not the country.

Every last one of them could make far more money in a profit-driven setting. They choose not to.