RileyJohn

If the government does end up taking over health care, be it ten years from now, what effect would that have on the life of a doctor? Salary, hours, medical school, ect.

It's not really college relevant, but I'm curious as to what you think.

asmallchild

I really don't see it happening. I'm sure there will be movements toward this model but too many entities stand to lose money to make this occur smoothly (at least in my lifetime)

Think about it: will the insurance companies, pharmaceutical companies, HMOs, etc... etc... etc... disappear into the darkness without a fight?

I'm sure a change is coming but I feel it will be more among the lines of a compromise than a complete switch to 100% government run health care.

Bigredmed

The United States will never ever reach a single payer system of health care delivery. Ever.

RileyJohn

Well, asmallchild, wouldn't the pharmaceutical companies (the people who run this country) benefit from government funded health care? This would mean that the 40 million people who are too poor to afford their medication would finally get it. Meaning, the pharmaceutical companies would suddenly gain 40 million customers. I would think they would love the idea of government funded health care.

Princess'Dad

John
A system such as Canada or Britain would not work in the US. One of the main reasons is that if you are over a certain age (eg 55), in their system you cannot be dialized. Over a certain age and no ICU, etc. That is one of the reasons their system is cheaper.

As a doc, I think you will be working for a large group. The days of the single practice doc are going fast. Partly because your generation demands time off for family, etc.

toadstool

Generally, the government takes on an industry segment by paying the people who were doing it privately to administer the same business, but as government contractors. Payment would come from the government to doctors etc. The insurance companies would switch from being independent businesses to being government administrators. Any incentive to push for efficiencies, driven by enhancing the insurance companies bottom line would be gone. Instead payment would flow from the taxpayer to the government to the administrator/(ex-insurance people to the providers. A blank check - think military spending and $400 toilet seats.

asmallchild

This is very true. It represents a fundamental shift from what we see and do in America.

I've seen 90+ year old grandmas with paralyzing strokes being sent to the ICU so that "everything that could be done should be done" to keep them alive. These things would not exist under universal healthcare and I'm not sure we could handle this transition.

asmallchild

That is possible. At the same time, if there's only one buyer, they can set the price that they're willing to pay. And in order to get the drug to an additional 40 million customers for a reasonable price (after all, isn't that the point of having a universal health care system?), I suspect the government would balk at high prices.

asmallchild

How would you be able to negotiate your salary under a single payer system? It would make sense that the single payer dictates reimbursement rates.

As for getting into medicine for the right reasons, that's a very "pre-med" thing to say. You want me to see more patients while continuing to watch my pay decrease? This is on top of the increasing liability, decreasing respect, outrageous student loans, increased education, and decreased earning potential (in terms of time) seen in medicine. Insane.

rocketman08

Are we likely to see a totally socialized system in the US? No. Will we see an at least partially socialized system? Yes (in fact we have this already e.g. Medicare).

Nobody is seriously proposing a government single payer system in the US... there are serious problems with such a system and the US doesn't want to make these same mistakes. However at the same time it's clear that a fully privatized system does not work either as it's simply impossible to run a profitable company based on the concept of giving everyone equal access to healthcare regardless of income or pre-existing conditions.

The current proposals on the table will essentially expand the current government programs to ensure that everyone will have access to health coverage. They will also directly compete with private plans to help drive down prices.

The basics would stay the same, but a government funded system would be just as, if not even more, bureaucratic than what we have now... that won't go away. Just ask current docs about dealing with Medicare and they'll give you an earfull...

It's no secret that for all but fully private cash only practices (e.g. Botox beauty docs) there will be heavy negative pressures on salary. 'Controlling healthcare costs' means a lot of things (e.g. eliminating unnecessary tests and procedures), but one of those is limiting salaries as this is one of the biggest expenses.

Expect to see a lot more standardization. Salaries will still be very good (relative to other jobs) but this is not a profession to go into to 'get rich.' (Current docs will tell you those days are essentially gone even now...)

Probably not much change here...

It's not been mentioned too much, but it's possible that in exchange for lower salaries medical school would be fully or partially subsidized. Ultimately it will be a supply and demand thing... if people are still lining up around the block to attend medical school even with the rollout of whatever system is going to be rolled out then it wouldn't make much financial sense to subsidize it too much... but if the future changes turn away a lot of folks (who, if they just wanted money, probably should have never gone there to being with) then subsidies could be put in place to attract the right people into medical schools.

CC'er

Salaries will definitely go down. Compare Physician salaries in European countries( mainly GB, France, Germany, Belgium),Australia, japan, and Canada to those in US. The US physician salaries are BY FAR the highest. The German doctors get paid a FIFTH of what their american counterparts do. I suspect the japanese get paid even less. No one can seriously claim that Physicians in those countrys are severely lacking compared to American physician.

Keep in mind those country have universal healthcare.

Now consider Japan( yes it is a first world country): A woman going into labor went to ten hospitals for delivery, only to find that the doctors are on strike due to poor pays by their version of Medicare. The result? the baby dies within the woman.

I suspect due to recent economic conditions that there is a high chance that the reform will pass. Note: Drug companies receive MUCH of their financing from the NHI ( government). My parents research for drug companies and their grants are funded almost 100% by NHI.

If so, doctors may soon have to accept medicare. As of current, many to most private practices simply discontinued Medicare due to poor pay.

Bigredmed

Can you cite a source for this story? There's got to be more to the story...that doesn't even represent basic understanding of labor progression...

While it's certainly true that there are complications of labor that can, without proper interventions result in fetal demise, simply taking a long time to find a physician (or nurse, or midwife) is not sufficient to have that result. Further, if true there are grave ethical considerations that I believe would take much higher precedence in what went wrong than merely a physician strike or the impact of socialized medicine.

FURTHER, a similar situation is NOT going to happen in the US anyways. For one, as I found out in my time abroad this past year, most foreign countries have decent rates of physician unionization...something which is fairly nonexistant in the US. The AMA is the largest physician group and only about 25% of doctors are members...and it's not a union by any stretch. Second, there are federal laws in place already in this country which require ER's to treat/stabilize patients regardless of ability to pay...and childbirth isn't stabilized until that baby is out. Third, this is one case where the propensity towards legal action in this country would be a positive. Merely practicing "CYA" medicine would result in that baby being born...

Shalashaska64

Uh, absolutely false and you misspelled NIH. Academic researchers get a lot of NIH funding but pharma research is funded primarily through a combination of corporate business deals, selling stock, and/or drug sales (after suitable products have been FDA-approved)