<p>To turn this ship around is going to be a long process. Anyone who thinks ACA is going to solve our problems overnight is delusional. </p>
<p>This is 100-percent correct. And very much complicated by politics. Since, whatever the merits of the plan it will be altered a bunch, anyway. And that effort has gotten a big boost by this inexcusably rocky introduction and the dishonesty apparent in the sales pitch.</p>
<p>It’s okay to lie to us little people. We don’t know what is good for us.</p>
<p>"Page 6 is interesting.
Medicare and medicaid are the two largest sources of funding for graduate medical expenses. "</p>
<p>It is hospital funding from Medicaid funding. Some are tying the funding to training specific type of residents.</p>
<p>It is still not considered to be going to the college. It is going to the hospitals.</p>
<p>Did you see page 6?</p>
<p>Healthcare in the US is all about the insurance company, bigpharma and medical device lobby. They pay for and subsequently write the laws. We will be spinning our wheels until there is significant campaign finance reform and we are running backwards in that regard.</p>
<p>Yes I did. I see the claims about going to education but nowhere does it say the money goes to schools. </p>
<p>Texas tax payers fund the schools and associated hospitals and we have provided them with some of the largest endowments. We don’t need to steal from Medicaid.</p>
<p>Apparently medicare funds 94,000 residencies each year.</p>
<p><a href=“http://www.fiercehealthcare.com/story/residency-funding-freeze-exacerbates-doctor-shortage/2013-03-18[/url]”>http://www.fiercehealthcare.com/story/residency-funding-freeze-exacerbates-doctor-shortage/2013-03-18</a></p>
<p>I like this one;</p>
<p>[Patients</a>, firms shop for better health care deals - Yahoo Finance](<a href=“http://finance.yahoo.com/news/patients-firms-shop-better-health-173730334.html]Patients”>Patients, firms shop for better health care deals)</p>
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<p>Seen this way, health insurance is more of a problem than a solution.</p>
<p>I thought I said texas was an exception. I am not going to argue about which part of the education is paid for when it is obvious some parts of the education is covered by medicaid in most states and medicare.</p>
<p>I wouldnt use the word stealing either. </p>
<p>So much is subsidized by taxpayers and govt in this country and I see no reason to pretend otherwise. </p>
<p>How much does Johns Hopkins receive a year from the govt? I am not just talking medical schools. How much? There are so many private institutions like Harvard and Stanford that receive a ton of money from the govt which is funded by taxpayers.</p>
<p>Doesnt Stanford receive over 100 million a year from government sources? I am not saying Stanford shouldn’t receive the money but it does receive the money.</p>
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<p>Here is so what: next years risk pool has very few cash cows and mostly people who signed up because they wanted health care. So the pool is skewed more expensive. </p>
<p>Which means next year at this time the rates go up, or plans get dropped. The cash cows, who didnt like the financial calculation this year, like it even less at the higher rates and stay out.</p>
<p>When the rates go up more people are likely to drop the plans- except for the really sick. </p>
<p>The whole thing is a death spiral unless the government pumps more money into subsidies. Which expands the whole cost of the thing and is problematic when we are at the debt limit.</p>
<p>“This is 100-percent correct. And very much complicated by politics.”</p>
<p>I agree. We all know, intellectually, why and how we ended up with a law like ACA. It was either something like this or doing nothing at all.</p>
<p>Re: Who funds medical education</p>
<p>[Tuition</a> FAQ](<a href=“http://www.amsa.org/AMSA/Homepage/About/Committees/StudentLife/TuitionFAQ.aspx]Tuition”>http://www.amsa.org/AMSA/Homepage/About/Committees/StudentLife/TuitionFAQ.aspx)</p>
<p>The information is 10 years old (it was the most recent I could find with an easy explanation, the funding sources and where it goes operate in a byzantine system)</p>
<p>But you can see that only about 7.5% comes from either the state or federal government. That’s medical school, not residency.</p>
<p>You can also see the huge rise in tuition costs over those years and now the $30,000 price tag for private medical school or out of state tuition cited in the article has doubled. Today it’s more like $50 or $60,000 in tuition. </p>
<p>When young doctors have hundreds of thousands of dollars of medical school debt to pay off, they have to be concerned with reimbursement rates and how they are going to make a living.</p>
<p>“Seen this way, health insurance is more of a problem than a solution.”</p>
<p>Not everything can be treated at surgery centers like this. </p>
<p>Cancer, no. Infectious diseases, no. prematures births, no, etc., etc., etc. </p>
<p>This is not a general hospital. It’s great if you know you need to have hip replacement, or a hernia operation or other “elective” surgeries.</p>
<p>Althouse has an amusing post that the perfect person to bring in to fix a complex, over deadline program with multiple vendors and lots of complicated details would be Mitt Romney.</p>
<p>"How much does Johns Hopkins receive a year from the govt? I am not just talking medical schools. How much? There are so many private institutions like Harvard and Stanford that receive a ton of money from the govt which is funded by taxpayers.</p>
<p>Doesnt Stanford receive over 100 million a year from government sources? I am not saying Stanford shouldn’t receive the money but it does receive the money. "</p>
<p>As mentioned before, NIH funds a lot of research at most schools. They also pay for medical education for students doing MD/PhD. USNR research rankings of medical schools pretty much takes the total grants each year given by NIH to medical schools to derive the ranks. So technically a very low ranked school gets the least amount of funding from NIH.</p>
<p>However, schools like Harvard and Texas are still charging students 50k+ in tuition. Research money mostly goes to fund the researchers who may not do much for the school education if they are PhDs. MDs on the other hand might defray some of their salaries.</p>
<p>“Here is so what: next years risky pool has very few cash cows and mostly people who signed up because they wanted health care. So the pool is skewed more expensive.”</p>
<p>The date is April 2014 for sign up without paying penalty, not 2015. So if what happens with ACA is what happened in Mass, then next year’s pool won’t be skewed with only people with health care needs. </p>
<p>I also think people who now have individual plans which are being discontinued because they aren’t ACA compliant are not going to go without insurance - since they already have decided the risk of not having insurance is not worth it. The vast majority of these people are likely not “unhealthy.” They have insurance to protect themselves from the possibility of medical bankruptcy. I am sure they are going to b**ch and moan about their cost going up, but I don’t believe they are going to opt to go uninsured.</p>
<p>I agree with the last paragraph that you wrote TatinG. Medical school costs a fortune and doctors lose years of earning power while getting an education. It is a double hit. </p>
<p>Med students get subsidies. Residency is partially paid for by govt. Hospitals get govt money. Grants are given out. </p>
<p>It is ok. Med students need help. The costs are ridiculous.</p>
<p>What I dont like is trashing other people when they need help. There are millions of working people that can not afford health insurance.</p>
<p>I think we should help med students and people who cant afford health care.</p>
<p>I didn’t know that hip replacement and hernia surgeries were considered elective. Maybe not life threatening, but surely pain relieving and not frivolous. Maybe if you had some liposuction while they’re doing it, I’d consider that elective. I wonder if my husbands open knee surgery would be considered elective. It wasn’t life threatening, but necessary if he ever wanted to walk again. I guess walking could be considered a choice. Thank God we had access to an awesome surgery center.</p>
<p>I am still not sure how paying residents working for 80 hours a week is considered helping them (50000/4000 = 12.5$/hr). They could just be declared doctors after med school and move on if we don’t have this ridiculous 3 year residency requirement at almost minimum wage when they have already gone through 8 years of education. </p>
<p>I am telling my kids its not worth it and they could be earning 6 figures after 4 years of education rather than wait for 11 years to have any real income.</p>
<p>“I didn’t know that hip replacement and hernia surgeries were considered elective. Maybe not life threatening, but surely pain relieving and not frivolous.”</p>
<p>I was not suggesting they are frivolous or not necessary, but for anyone to suggest that surgery centers like the one in OK are a substitute for not having insurance is going to be in for a rude awakening when they find out that most things one needs medical or hospital care for isn’t done at centers such as these.</p>
<p>Well… Residency is part education… Part very very very
cheap labor. </p>
<p>Texaspg, I know what you wrote about your kids is partly in jest. I do read some posts in the pre med section. ;)</p>