Re: [asa] health care

On Sep 27, 2009, at 4:53 AM, John Walley wrote:

>
> Well then you have the little detail of finding people who are
> capable and dedicated and motivated enough to go through 10
> demanding years of training to make $30K/yr to serve people who
> don't neccessarily appreciate their service or ackowledge their
> value. And they are always tempted to go back to their own country
> where they need doctors as well and maybe appreciate them more.
>
> This is the Atlas Shrugged scenario.
>
> John

Competitive compensation for physicians is something we should have a
good handle on. We should provide payment to doctors in order to
convince them to be primary care physicians here and not go elsewhere.
And we should be concerned not only the amount but also in the form
that they prefer. A recent poll done by the New England Journal of
Medicine -- http://healthcarereform.nejm.org/?p=1790 -- asked doctors
which form of reform they preferred, single payer, public option, or
private option only.

> Overall, a majority of physicians (62.9%) supported public and
> private options (see Panel A of graph). Only 27.3% supported
> offering private options only.

How do primary care physicians differ from other kinds of physicians?

> Primary care providers were the most likely to support a public
> option (65.2%); among the other specialty groups, the “other”
> physicians — those in fields that generally have less regular direct
> contact with patients, such as radiology, anesthesiology, and
> nuclear medicine — were the least likely to support a public option,
> though 57.4% did so.

So, it appears a good way to encourage primary care physicians is
through promotion of the public option.

Jack, as for malpractice insurance, doctors have similar issues of
having insurance companies fleece them like they do their patients.
http://www.insurance-reform.org/StableLosses.pdf

> Stable Losses/Unstable Rates represents the first comprehensive
> report on medical malpractice insurance analyzing what insurers have
> taken in and what they’ve paid out over the last 30 years, including
> jury awards, settlements and other costs. Its findings are
> startling. While insurer payouts directly track the rate of medical
> inflation, medical insurance premiums do not. Rather, they rise and
> fall in relationship to the state of the economy. Not only has there
> been no real increase lawsuits, jury awards or any tort system costs
> at any time during the last three decades, but the astronomical
> premium increases that some doctors have been charged during
> periodic insurance “crises” over this time period are in exact sync
> with the economic cycle of the insurance industry, driven by
> interest rates and investments. In other words, insurance companies
> raise rates when they are seeking ways to make up for declining
> interest rates and market-based investment losses.

Maybe physicians need a public option, too, for their malpractice
insurance.

Rich Blinne
Member ASA

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Received on Sun Sep 27 19:26:28 2009