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re: Once Again Economics Proves Why the ACA Can't Work
Posted on 8/3/17 at 11:46 am to Bard
Posted on 8/3/17 at 11:46 am to Bard
quote:
NEW YORK (CBSNewYork) – America will soon face a shortage of as many as 90,000 doctors.
"will soon face a shortage"
Probably assumes that the new additions to healthcare will use PCPs, which hsan't been the case thus far. We could, however, need the same amount of ER doctors as they were getting care for free in the ER previously......
0
Posted on 8/3/17 at 11:47 am to Bjorn Cyborg
quote:
The ACA is creating demand by offering free medical care
That isn't what the ACA did. This is a ridiculous position and argument.
Posted on 8/3/17 at 11:51 am to 5thTiger
quote:
That isn't what the ACA did. This is a ridiculous position and argument.
wasn't one of the stated policy goals of the ACA that it would allow poor people to seek regular, preventative care?
Posted on 8/3/17 at 11:55 am to 5thTiger
quote:
That isn't what the ACA did. This is a ridiculous position and argument.
But the stance that the ACA created additional demand is reasonable. In fact, it was the main reason the ACA was passed. To provide insurance for 30 million additional people.
You can argue whether the additional people who have coverage got "free" healthcare, or not, but there are definitely millions more people with health coverage, and many, many people are getting subsidized.
Posted on 8/3/17 at 11:55 am to 5thTiger
quote:
That isn't what the ACA did.
"free" medical care is wrong. But it did provide insurance for people who previously had none, which increased the demand for services. It's not a difficult concept. But it certainly didn't create this shortage. It already existed.
Posted on 8/3/17 at 12:03 pm to WheelRoute
quote:It is directly at the feet of the government.
Lay the shortage of doctors at the feet of the AMA, not the government.
quote:
Ever wonder why it's often so hard to find a doctor, especially if you don't live in a big city?
Ever wonder why the government has such a hard time understanding or following the law of supply and demand?
These two questions go together because it's the government that's created and continued a harrowing chokehold on the supply of doctors in America. And if it doesn't ease the grip soon, not even those of us who live in large urban areas are going to escape the consequences.
quote:LINK
At this stage, the government again plays a big role in the supply-chain jam. One of the key problems is that the number of residencies hospitals establish for new med-school grads is almost entirely dependent on Medicare funding. The baseline for that funding hasn't changed enough since 1997 to meet demand. Teaching hospitals have been complaining about this for at least five years. But by getting into bed with the government decades ago and allowing Medicare to dictate residency spots, this was a predictable Faustian bargain.
Read MoreBizarre crime on the rise in Florida because of ... flakka?
So, you survive all of that and — yay! — you become a doctor. Think it ends there? Nope! The government keeps throwing up hurdles.
Posted on 8/3/17 at 12:04 pm to HailHailtoMichigan!
quote:
The AMA would never be able to shut down a medical school without gov involvement
This isn't an issue at present and I don't have an idea whether it's true or not. The issue is whether the AMA will provide accreditation to new schools. Progress has been made but there are many indications the new schools will still not meet the coming demand of boomer retirees.
Posted on 8/3/17 at 12:07 pm to MSMHater
The ACA is just like the government telling us that they are passing new automobile regulations that mandate that our automobiles use half as much gas and generate twice as much horsepower while costing half as much within 5 years.
In 5 years, we will end up with cars that use half as much gas, have half as much horsepower, and cost twice as much. In addition, you can no longer lean on a car, because you will put a dent in it, because they had to lighten it up so much in order to meet the standards, and people are buying vintage Smart Cars because they appreciate the additional leg room.
The government, of course, would call this a rousing success, even as most people are outraged by the overpriced piece of garbage that we have to drive.
In 5 years, we will end up with cars that use half as much gas, have half as much horsepower, and cost twice as much. In addition, you can no longer lean on a car, because you will put a dent in it, because they had to lighten it up so much in order to meet the standards, and people are buying vintage Smart Cars because they appreciate the additional leg room.
The government, of course, would call this a rousing success, even as most people are outraged by the overpriced piece of garbage that we have to drive.
Posted on 8/3/17 at 12:08 pm to 5thTiger
Perhaps my wording was incorrect, but Obamacare absolutely increased demand on doctors.
You can't add millions of people to the insurance rolls, with the goal of increasing their health and well-being, without also increase demand on doctors.
So, either demand on doctors increased, or Obamacare is a lie and helped no one.
You can't add millions of people to the insurance rolls, with the goal of increasing their health and well-being, without also increase demand on doctors.
So, either demand on doctors increased, or Obamacare is a lie and helped no one.
This post was edited on 8/3/17 at 12:35 pm
Posted on 8/3/17 at 12:08 pm to Bard
and yet the republican controlled senate hasn't been able to pass a replacement
yikes
yikes
Posted on 8/3/17 at 12:09 pm to 5thTiger
quote:Unfortunately it is. But not just that . . .
That isn't what the ACA did.
quote:
In a 2009 interview, President Obama acknowledged the PCP shortage and the difficulty in attracting physicians to choose a career in primary care, stating: “…keep in mind that the status quo is we don’t have enough primary care physicians. We’ve got to create more primary care physicians. And what we want to do is to provide a powerful set of incentives for more and more young people who are interested in healthcare … to go into primary care.”[3] But the situation only worsened with the birth of the Medicare Annual Wellness Visit (AWV), courtesy of the Affordable Care Act.
As I outlined in Medical Economics last year, the AWV is a burdensome, inflexible Electronic Health Record (EHR) box-checking encounter scripted by CMS, with a weak evidence base and a one-size -fits all approach.[4]Thus, the net result of HITECH’s enactment in 2009 followed by the passage of Obamacare the following year, was a further erosion of PCP autonomy and a further reduction in primary care’s appeal.
For the PCPs, CMS’s embrace of P4P didn’t just limit autonomy, it replaced autonomy with compromise and conflict of interest. Some examples of the conflict: Does the physician engage female patients in a discussion of the pros and cons of mammography screening and risk falling short of the threshold percentage required for CMS “reward” revenue? Or does one simply go along with CMS guidelines, limiting mention of evidence raising doubts about the benefits of this screening measure?
LINK
Posted on 8/3/17 at 12:10 pm to 5thTiger
quote:
The ACA has nothing to do with a doctor shortage. Not understanding your attempt to link the two.
Read the entire post. If you're unsure of the laws of Supply and Demand (in general or as to how it pertains the this specific market), let me know and we can discuss it in more depth (I didn't want to get too far into it because of short attention spans).
To your 2nd sentence: I'm not attempting to do anything, the two are already linked because of the aforementioned Supply/Demand. Whether you or I want them to be linked or not is irrelevant because they simply are.
Posted on 8/3/17 at 12:12 pm to WheelRoute
quote:
WheelRoute
quote:You are barking up the wrong tree.
AMA/AAMC have a role to play.
Posted on 8/3/17 at 12:13 pm to Machine
quote:Yep.
and yet the republican controlled senate hasn't been able to pass a replacement
It's a big problem.
Posted on 8/3/17 at 12:15 pm to Bard
Progressive ideology is infinitely more powerful and persuasive than math. There is no human truth than can not be overcome by the ideology of the Progressive True Believer. Faith always trumps science.
Posted on 8/3/17 at 12:15 pm to Bjorn Cyborg
quote:That wouldn't make a dent. It isn't an issue of student availability.
They could slightly lower the admissions standards and have thousands more med students per year and solve some of these issues.
There is a limitation on residency spots due to the fact that they are funded by Medicaid. That money isn't increasing, thus limiting residencies.
There is a finite number of spots.
Posted on 8/3/17 at 12:16 pm to 5thTiger
quote:
That isn't what the ACA did. This is a ridiculous position and argument.
Are you arguing that it's only actualizing unrealized Demand that was already present as opposed to creating new Demand?
If so we can discuss it but that particular point boils down to perspective (ie: do you see dormant/unrealized Demand as true Demand or do you believe it does not equate into market economics until it becomes active/realized) because the end result is the same: higher Demand.
Posted on 8/3/17 at 12:21 pm to Bard
I will ask again, how do you get your insurance OP?
Posted on 8/3/17 at 12:23 pm to MSMHater
A surgeon requires less effort than a family doc? What?
Posted on 8/3/17 at 12:24 pm to WheelRoute
The bottleneck isn't medical school education. It's graduate medical education(i.e. residencies).
If govt. wanted to, they could expand funding to open more spots for primary care fields to increase supply of physicians.
however, the flip side of this, which has been mentioned previously, there's little incentive for US Medical Grads to enter into family medicine/primary care fields. Cost/time of education(4+4+3 years)/low pay relative to other specialties with increasing burden of paperwork/algorithms/check boxes/increase patient volume to deliver quality care as defined by the govt. are many reasons that push US Medical grads to pursue other fields.
So even if you increase the number of family medicine/primary care field residency spots, they are unlikely to be filled by US grads. You are more likely to have them filled by international or foreign medical graduates seeking entry into the US medical system. One can argue that this may be a detriment to overall quality of health care.
If govt. wanted to, they could expand funding to open more spots for primary care fields to increase supply of physicians.
however, the flip side of this, which has been mentioned previously, there's little incentive for US Medical Grads to enter into family medicine/primary care fields. Cost/time of education(4+4+3 years)/low pay relative to other specialties with increasing burden of paperwork/algorithms/check boxes/increase patient volume to deliver quality care as defined by the govt. are many reasons that push US Medical grads to pursue other fields.
So even if you increase the number of family medicine/primary care field residency spots, they are unlikely to be filled by US grads. You are more likely to have them filled by international or foreign medical graduates seeking entry into the US medical system. One can argue that this may be a detriment to overall quality of health care.
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