Voted for Gary Johnson. And no, never supported ACA. I understand its purpose but disagree strongly with its execution
Seems we should have gone with Trump's health care plan passed when the Pubs had the House, Senate and the Trump WH. Sorry, my bad, I bet he'll probably announce it soon though. OMG
They won't have to worry about losing their homes because they will be dead due to the delay in care.....
Or if they live in a border state, they just cross the border to get their emergent heart Cath and Stenting done.
This post is so full of misunderstanding its comical. You may not realize that private insurer generally pays the PA/NP the same rate as the MD so they aren't saving money (Medicare pays 15% less). You also know that PA's work under a Dr and the payment goes to the practice and not the provider, right?
I know that stat is thrown around as proof of something there is much that goes into that data not related to healthcare, but you know that. BTW which country is fatter?
While the quality is healthcare is certainly not the only factor in determining life expectancy one question that can be asked is who is more likely to defer healthcare, a Canadian or an uninsured or under-insured American?
The practice makes that decision. Insurance companies don't tell practices to hire mid-levels. Medicare pays 15% less if a PA sees the patient. Most private insurance pays the same rate. It's cheaper for the practice (by a lot) to hire a Mid-level instead of another MD.
Not sure man 40% of my ER patients were uninsured, under-insured or on Medicaid and that was at a "private hospital" they may not have been getting the most cost-effective care, but they walked in and were seen in short order.
I actually researched the issue. While the rate of elective cardiac catharizations and stenting in the US is double that of Canada (maybe because the procedures are lucrative for interventional cardiologists in a fee for service system) there is very little difference between the rates for emergency procedures. By the way I had an emergency procedure back in 2007. My LAD was completely blocked, within 45 minutes of being driven to the ER by my son (in retrospective I should have called 9-1-1) I was in the cath lab for the procedure. Fortunately, the hospital had an interventional cardiologist on call 24/7 who was actually present in the hospital at the time and it turned out that he was one of the top in the metro DC area. The hospital was INOVA Fairfax by the way. Less than a year after the procedure I was riding my bike in the mountains of Southwest Virginia.
Glad you had a good outcome. I'm sure our rates of Caths are much higher in large part due to medical/med liability.
I think it's more complicated than just Dr. Unions keeping supply down. Medical school seats are limited in large part due to the next bottleneck, residency slots (no med school wants to graduate MDs that can't get placed in a residency). And residents require a lot of time and attention from physicians supervising them, i.e. even more paperwork for a profession already flooded with it. Add to that the mostly retired practice of working residents to the bone (routine 80-hr work weeks) for a cheap(er) extension of an organization's doctors, and a residency program is more work with less benefit than 20-30 years ago. Increasing government funding for residency programs would have a decided impact on increasing medical school slots. There may be a lot of lobbying by doctors' unions against that increase, I'm not sure, but their words are probably finding a ready and willing audience across the country from budget hawks that won't pay attention long enough to appreciate the upstream and downstream needs and challenges of an MD pipeline.
The high end of American healthcare is outstanding. The base level care provided is high. However, it’s extraordinarily overburdened and expensive. For those blaming private healthcare in America, I’d call the American healthcare system far from private. You have homeless people in ERs throughout the country, you have Medicare, and you have Medicaid. It’s a highly mixed system with many explanations for high costs including the government programs, the overburdened ER, administrative costs, American Tort/Malpractice law, the relationship between the pharmaceutical companies and the government, and perhaps most importantly: the trifecta of death that is healthcare providers, patients, and insurance companies. As long as the above three are battling each other without knowing how much they’re getting or who is paying until after the fact, there will continue to be issues. Add fraud to the equation from all of the above and it only makes the system that much more expensive. There’s ways of mitigating this, but it’s never without cost, and it’s never a clean fix. Either extreme has its costs. Complete nationalization leads to similar problems to Canada. Not being able to see a doctor because you’d just have to wait too long. Complete privatization leads to not being able to see a doctor because it’s too expensive. We need some combination of the two so you don’t have these absurd waits to the point that you effectively aren’t receiving care, but also provide access to a great enough quantity of people to prevent major public health issues… but the current combination is beyond frustrating to deal with. Nobody should want healthcare only being accessible to the top 30% (or less) of income earners in America. Nobody should want the norm to be foreseeable medical expenses leading to financial ruin, nobody should want the system to necessitate socialist style vast redistribution of wealth and resources, and nobody should want the system being so accessible it’s basically overburdened to the point it isn’t accessible. Really tough for us to get everything we want though.
I don’t believe it. That’s like saying the pharmacy decides whether you get a generic versus name brand prescription. Insurance, in most cases, will force you to the generic. If doctors were able to bill insurance companies the same rate for a PA and pocket the difference, then you’d only ever see PA’s nearly 100% of the time. Insurance companies would push the practices out of network.
