<p>Yes, I know we’ve all had this discussion before, and it’s probably not a good one for this thread. But it’s not paranoia to look out there and see what’s happening to people, we’ve been moving that way for a long time. All we can do for our kids is encourage them to find a way to be on the top of the economic ladder, not the bottom…as there seems to be only two rungs. I suspect that most of our kids here will end up just fine.</p>
<p>Here’s hoping. One of mine is in good shape. The other 2 are artists. What was that stuff about quitting work to be a poet? That could come in handy. Sigh.</p>
<p>Hey, at least they can be broke and have health insurance, ay?</p>
<p>Hopefully they are very talented artists.</p>
<p>My youngest just made the switch from management to computer science, though he really wanted to major in drama. He realized how difficult it was to make it with a degree in theatre. Then again, the CEO of a startup tech company might be well served knowing how to perform.</p>
<p>dstark, I had a HSA policy which had no copays or coinsurance. I would bet the article is reflecting what the doctor’s total allowable reimbursement is. For instance, the doctor can charge $134 but the insurance company only allows $87 of that charge. How the $87 is paid depends on the insurance policy’s copays or coinsurance rates. Covered Ca. is only allowing $59 on average. There is a reason why doctors are not signing up; the reimbursement rates suck. </p>
<p>I have talked to a number of doctors, and they have told me the way things are going they would not recommend medicine as a career. </p>
<p>The other interesting nugget from the article is the quote from the doctor who was in the network but did not authorize it. I wonder how many doctors are in this category. Buying a plan on the Ca individual market is a shot in the dark, as one have no idea who is in the network.</p>
<p>PS. Since many on the exchange are responsible for their deductibles, that’s another risk the doctor has to take under this new regime. Lower reimbursement rates and hoping the patient doesn’t stiff them.</p>
<p>GP,
“dstark, I had a HSA policy which had no copays or coinsurance. I would bet the article is reflecting what the doctor’s total allowable reimbursement is. For instance, the doctor can charge $134 but the insurance company only allows $87 of that charge. How the $87 is paid depends on the insurance policy’s copays or coinsurance rates. Covered Ca. is only allowing $59 on average. There is a reason why doctors are not signing up; the reimbursement rates suck.”</p>
<p>GP, I dont know. My copays are $60. I would like to see real numbers. When I get charged, my copays are an additional cost</p>
<p>“Hey, at least they can be broke and have health insurance, ay?”</p>
<p>That is right. :)</p>
<p>Ds, the link was in response to some info on this thread. Thought it might clarify. No kids in med school. Doubt either will end up rolling in dough. But one of my current resps involves working with med students. More students enter every year. Lots of interest. Not all looking at lucrative specialties. At least, in the first few years. </p>
<p>Lookingforward, I was just curious. </p>
<p>Very good link you posted.</p>
<p>busdriver – my worst date ever was with a private pilot who attempted to land at dusk at the military field rather than the commercial field, and then flying with the guy back to Van Nuys airport later that evening. I still shudder. </p>
<p>My PC doc’s practice has modified to add NP’s and PA’s, and to create a lot of same day appointments. The goal is that if you call in with a problem, they can get you in that day or the next morning at the latest. This is smart medicine. She also follows protocols for various health conditions. Less expensive drugs get tried before more expensive drugs. We talk about what we would do with various test results (like MRI’s) before proceeding in that direction. I’ve avoided a few on the grounds that they wouldn’t be actionable in my specific circumstances.</p>
<p>Dumb medicine is what I saw years ago, where docs – including pediatricians, who should really know better – pre-schedule the same number of appointments on Monday as on Thursday, even though all of the patients with problems that came up Friday, Saturday, and Sunday were told to call the office and come in on Monday. And docs are still prescribing way too many antibiotics for conditions antibiotics don’t treat, inflating everyone’s costs, and increasing drug resistance to boot. We still have lots of unnecessary hospital acquired infections, and far too many patients readmitted soon after discharge. And mental health is still a mess. Patients request specific name-brand drugs, and docs sign off on them rather than questioning the need.</p>
<p>It isn’t as if we have this amazingly perfect health system and just need to find a way for insurance to work with it. We have a gravely defective health care system, and while it is a shame that insurance changes seem to be more of a driver than adoption of best practices, the system we had needs to change, and change fairly significantly.</p>
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<p>This is smart, financially prudent medicine. After all, I can understand why I’d want the $10,000 drug that is sure to work before the $10 drug that works 90% of the time. But… sorry, I love ya, arabrab, but you shouldn’t get the $10,000 drug first, if you and I are on the same policy; I want you to try the $10 drug before spending my premium money for the gold-plated stuff. And since you no doubt feel the same way about me, we should both be trying the $10 drug first.</p>
<p>Thought she meant the same. Add me the agree list. I actually learned a lot from my docs. Sometimes, aggressive isn’t needed. Or fancy, or those guys with the big ads or that one research report you saw digested. Other times it may be. Lots of ground in between.</p>
<p>typo</p>
<p>“My son just notified us today that he isnt going to go into medicine.”</p>
<p>Was he planning to at one time? </p>
<p>Yes. He was for many years. We were just notified today of his change of mind.</p>
<p>The time commitment. The lack of income for many years. The lifestyle he wanted now were all reasons he decided to go into something else. You know… The usual negatives. :)</p>
<p>I was kind of into it. The whole having a kid becoming a doctor thing. Oh well. It is his life. Whatever he wants as long as he can support himself and it is legal is ok with me. Well…if he becomes a porn star I wont be happy. 
</p>
<p>Now I dont have to worry about doctor pay. :)</p>
<p>I didnt go to med school. I dont think I could memorize all those words. </p>
<p>Texaspg, your eldest is still on track to go to med school?</p>
<p>She is but I am encouraging her to keep an open mind ever since I read this story. I do want to retire instead of funding the kids through med school with no return on my investment!</p>
<p><a href=“Solving Problems for Real World, Using Design - The New York Times”>Solving Problems for Real World, Using Design - The New York Times;
<p>“In April, LinkedIn acquired the company from Mr. Kothari and Mr. Gupta for $90 million.”</p>
<p>Texaspg, looks fantastic. I love it. Thanks for the link. Awesome. </p>
<p>“She is but I am encouraging her to keep an open mind ever since I read this story. I do want to retire instead of funding the kids through med school with no return on my investment!”</p>
<p>I understand. I hope I dont come across as too obnoxious but I told my wife, “We just became $400,000 richer.”</p>
<p>I looked at the medical school issue as a win-win. My kid becomes a doctor which I will pay for or I have $400,000. </p>
<p>CF – Oh yeah, I am TOTALLY in favor of the $10 drug – actually, the one I use is under $7 for a 3 month supply at Costco’s pharmacy. I don’t feel in the least aggrieved that I’m not using a $70 or $150/month drug – and I’ve got confidence that if the cheapo drug hadn’t worked, that we’d have moved to an alternative. </p>
<p>I’ve also learned through a lot of years with software (like you have, I’d guess) that being an early adopter is often a risky proposition. My doctor’s strategy of starting with lower cost drugs also means that we’re starting with drugs that have more of a track record, and somewhat less likely to be yanked from the market because of poorly understood side effects. </p>
<p>Jewish mothers are going to have to rethink their fervor for having their children marry doctors. :)</p>
<p>I noticed the news today that Tom Brokaw is being treated at the Mayo Clinic for Multiple Myeloma. I wonder why he didn’t go to his local community hospital since many here think they’re so great. Too bad people in the individual market will not have the same opportunity to go to the best specialized centers for illnesses such as this one.</p>
<p>What about Jewish fathers? :)</p>
<p>GP, Did you ever listen to Nichols and May At Work? </p>
<p><a href=“Nichols and May at Work... on Vimeo”>http://vimeo.com/13423347</a></p>
<p>“I looked at the medical school issue as a win-win. My kid becomes a doctor which I will pay for or I have $400,000.”</p>
<p>Exactly my problem dstark except I need to spend it twice if they continue in that track. :(( </p>
<p>Texaspg, Twice would be brutal. Actually once is brutal.</p>
<p>You need to coax your kids into loving those Texas medical schools. :)</p>