(10-19-2013 11:50 PM)Smaug Wrote:  I guess we could institute a military-style draft for medical schools.

Shove people through it whether they want to or not.

This is what most other countries do.

It's not Med School that is the problem, but Residency programs. You can't become a practicing physician without it.

(10-20-2013 01:15 AM)dawgitall Wrote:  There is definitely a shortage of PCPs. I know it is a drop in the bucket but most days I do drive by a brand new medical school. Campbell University medical school opened its doors and is dedicated to producing PCP. But I think the primary way we will see that gap closed will be with the increased utilization of Nurse Practitioners and Physicians Assistants.

Ibid to the residency slots funded by the Federal Government.... and that all doctors graduate med school the same, so "producing PCPs" is a political, and not meaningful comment... but yes to the rest of this...

(10-19-2013 11:14 PM)Hambone10 Wrote:  In states where the premiums aren't going up as much, the reimbursements for doctors are generally going down even more...

Which means while you aren't paying more for insurance, you have less access to doctors. There are "costs" other than dollars.

I'd ask the simple question...

Overall medicare reimbursements for PCP visits are down by over 25% under Obamacare. Eligibility for PCP visits is up by more than 30mm people... and no additional slots in residency programs are being funded to serve all of these people... and Obama himself said we were already short when he sold Obamacare to us.

How do you deliver more healthcare without increasing the reimbursement amount or the number of providers? Interestingly, Obama's entire premise relies on delivering more primary care to reduce the need for expensive procedures later... which he realistically has no prayer of accomplishing.

Leftists don't want to even address this reality... instead they want to trot out a few situations where people who apparently didn't have particularly good plans to begin with aren't much worse off now.

At this point it's going to take a year or two before the inherent inconsistencies and incorrect assumptions underlying the ACA come to roost. At that point, according to the Lib plans, Hillary will be on her way, it will be "too late" to do much about it (either ACA or Hilly), and the single-payer government one size fits all abonination will be back fully in play. The ACA was never about helping Americans get nbetter and more affordable Helthcare, it was and is about redistribution, plain and simple. The Lib attitude is if you're a winner or a loser in this, so what? They redistributed the wealth and got "their" people hooked up is all that matters. To heck with what happens, bad or good, to everyone else.

(10-21-2013 01:44 PM)Hambone10 Wrote:  

(10-19-2013 11:50 PM)Smaug Wrote:  I guess we could institute a military-style draft for medical schools.

Shove people through it whether they want to or not.

This is what most other countries do.

It's not Med School that is the problem, but Residency programs. You can't become a practicing physician without it.

(10-20-2013 01:15 AM)dawgitall Wrote:  There is definitely a shortage of PCPs. I know it is a drop in the bucket but most days I do drive by a brand new medical school. Campbell University medical school opened its doors and is dedicated to producing PCP. But I think the primary way we will see that gap closed will be with the increased utilization of Nurse Practitioners and Physicians Assistants.

Ibid to the residency slots funded by the Federal Government.... and that all doctors graduate med school the same, so "producing PCPs" is a political, and not meaningful comment... but yes to the rest of this...

Campbell is an D. O.. program. It is my understanding that they are usually PCP's and residencies will be at a number of the nearby hospitals as Campbell does not have their own facility. I don't know anything about the federal funding for residencies but it sounds like something that should be increased.

"Campbell’s efforts to launch a medical school will directly address the growing shortage of physicians in North Carolina, according to Dr. John Kauffman, the school’s founding dean. “Our state currently ranks 35th out of 50 in primary care physicians,” Kauffman said. “There are 20 counties without a single general surgeon and at least that many without an obstetrician. The future, however, is bright.”

Kauffman said Campbell’s osteopathic medical school will eventually graduate about 150 physicians each year, many of whom will practice in rural, under-served regions of the state. Students will spend their first two years training at the new facility and Years 3 and 4 training at community hospitals, where he expects many will live and put down roots.

The primary focus of the School of Osteopathic Medicine will be training for primary care and family medicine, general surgery, pediatrics, psychiatry and other services, with an emphasis on rural areas or regions with little or no health care options."

http://www.campbell.edu/features/school-...ovel-ready


"The school will train primary-care doctors to serve in rural communities and keep them in the state through partnerships with local and regional hospitals."

http://fayobserver.com/articles/2013/09/19/1284036

I work for the government and I am youngish and healthy. If I wanted to keep similar coverage to what I have Right now I would have to pay a 200% increase in premiums. It all depends on what state you are in. Obamacare is ravaging my state.

(10-21-2013 02:40 PM)dawgitall Wrote:  Campbell is an D. O.. program. It is my understanding that they are usually PCP's and residencies will be at a number of the nearby hospitals as Campbell does not have their own facility. I don't know anything about the federal funding for residencies but it sounds like something that should be increased.

There is a bit of an issue about DOs. They are arguably more and less qualified than MDs... It is generally easier to get into a DO program, but they have almost the same options/opportunities

WHat you say is certainly their goal (the school), but they (the graduates) can go into research or specialize and be surgeons etc just like MDs... I have a residency program in my rural hospital (I administer 3 hospitals) designed to accomplish the same goal as the one you describe and not one of my residents in the past 2 years has gone into rural healthcare and less than 40% into PCP.

They can't be physicians without residency... and yes... that should have been step number one. Unfortunately, that obviously costs money upfront that you don't see benefit from for years, and I am convinced that Obamacare wasn't sellable if they were upfront, so they intended for this to happen and for "another congress" to have to deal with the increased costs of filling the void.

We could learn a lot by actually looking at how the European systems compare. The following page contains links to four detailed anayses published since 2007:

http://www.healthpowerhouse.com/index.php?Itemid=55

In the most recent report the top 14 countries consist 7 with Bismarck multi-payer systems (Netherlands #1, Luxembourg #4, Belgium #5, Switzerland #7, France #8, Austria, and Germany), five Nordic countries with tiny populations (Denmark, Iceland, Sweden, Finland, Norway), one single-provider system (UK, 12th), and one transitional system (Ireland, 13th). The conclusion is that single-provider systems don't work with large populations. The single-payer approach isn't addressed, because there are no true single-payer systems in Europe, but single-provider is a first cousin to single-payer, and when most on the left say single-payer I think they actually mean single-provider.

Bsimarck is the way to go. As long as republicans don't adopt it (and they've had plenty of time, since it's basically what Heritage recommended in 1993) they will remain the stupid part. As long as democrats push something else, they will remain the evil party.

(10-21-2013 04:04 PM)Owl 69/70/75 Wrote:  We could learn a lot by actually looking at how the European systems compare. The following page contains links to four detailed anayses published since 2007:

http://www.healthpowerhouse.com/index.php?Itemid=55

In the most recent report the top 14 countries consist 7 with Bismarck multi-payer systems (Netherlands #1, Luxembourg #4, Belgium #5, Switzerland #7, France #8, Austria, and Germany), five Nordic countries with tiny populations (Denmark, Iceland, Sweden, Finland, Norway), one single-provider system (UK, 12th), and one transitional system (Ireland, 13th). The conclusion is that single-provider systems don't work with large populations. The single-payer approach isn't addressed, because there are no true single-payer systems in Europe, but single-provider is a first cousin to single-payer, and when most on the left say single-payer I think they actually mean single-provider.

Bsimarck is the way to go. As long as republicans don't adopt it (and they've had plenty of time, since it's basically what Heritage recommended in 1993) they will remain the stupid part. As long as democrats push something else, they will remain the evil party.

Owl69/70 what is your opinion of the RSC HR3121 American Health Care Reform Act or something modeled on it? (Though seldom mentioned by the media, this is an alternative plan and more cost-effective way to provide the choice in healthcare that Americans need, without the drawbacks of ACA.)
http://rsc.scalise.house.gov/solutions/r...terway.htm

(10-19-2013 05:49 PM)dawgitall Wrote:  Right now I pay $192 for a good 70/30 plan and it will go up to $202 in 2014.

Wow! It seems that you are one of the few that isn't affected much by premiums increase!

How about indemnity health insurance? Someone is offering me this kind of coverage. Will it be more costly?

(10-19-2013 05:49 PM)dawgitall Wrote:  I've always carried my daughter on my health insurance. Right now I pay $192 for a good 70/30 plan and it will go up to $202 in 2014. So I've been checking out prices. I can drop her from my policy and stay with what I have for myself. Then I wouldn't pay anything or I could convert to a very good 80/20 plan and pay $13.56 a month. If I drop her from my policy I can put her on the ECU BCBS plan for $688 a semester ($115 a month). It appears to be about equal to what we have now with the bonus that if she goes to student health services there is no charge. I could also just buy a BCBS plan from my insurance agent. There are 14 plans ranging in price from $117 to $234. It looks like the plan that most closely matches what she currently has is $174. So I've got some research to do and phone calls to make before the end of the month.

I thought prices for young people were suppose to have jumped up 100-300% because of the ACA? In this case they really haven't gone up to any significant degree.

Consider yourself lucky. Although with a new "ungrandfathered" policy my daughter (24) will see an aprox. $100 decrease in a similar plan...the premium is still going to be $400 per month.