(02-10-2020 09:35 PM)ruowls Wrote: Doctors don't have the luxury of an open market system. Being a good provider doesn't reward one to the extent that it does in other industries. It is pretty much a socialistic environment with a little wiggle room already.
You are saying that, as an MD, you are 'capped' in your 'take-home'? (to be exact, that is doctor salary or fees collected, and excluding the 'ownership profits' from ownership interests in a practice, testing facility, imaging, or rehab. In short, I am excluding the practice ownership interest because many are structured in a structure not unlike law firms, in that the partners employ other professionals as employees and collect the 'net revenue from the employee - operating costs, etc).
My point is that if we follow the path that big proposes, then why not toss in the entire enchilada? His proposal is a strict cost setting, government defined regimen for such an enchilada, and if that is the case, why not profit-regulate every aspect of it, such as, things *not* covered by insurance like boob mills?
Big has the stomach for strong government intervention, actually strict economic regulation, of the area with his proposal, I am exploring how far does he have the stomach to cover the field?
As for the surgery center, I am a huge proponent of it. A perfect example of what a free market approach can do to a sector is wonderfully exemplified by boob mills. Those procedures are for the vast majority for the most part are not covered by insurance. They are typically paid for with elective dollars from the clients. Costs for boob jobs has, in the last 20 years, been reduced in constant dollars by 70%+ or more. And, they precisely outline the efficiencies of the 'day surgery center' concept as well as the issues posed by strict insurance regimens and mandates.
Another ongoing example are lasik procedures, which have plummeted in real dollars by again 70%+, and still curving downward. And again, a perfect example of scaling a surgery center for the very precise purpose. The lasik cost example is actually an outlier, since it is many times (most) covered by some insurance.
As a final thought, if your 'take-home' is indeed upward limited (again, not owership interest), my heart goes out to you.
If someone told me I can *only* make x per year, or regulated my fees by law to no more than y, I would be horribly pissed. I am actually aghast that some people seem to be proponents of that -- and my questions and comments to that extent are geared to finding an outward boundary to which they would say 'no way', and then from them try to backwards engineer why they feel some services are best served by strict government control of their specific economies.