<p>:)… Texaspg… That is true. :-* </p>
<p>It’s a net positive to have more doctors in underserved areas. Well, maybe not net positive, we can argue that, but surely its positive to have more doctors in places that need more doctors.</p>
<p>BD - Residencies are funded with medicare money although I am not sure what actually happens to hospitals if they cut it off completely. Residents make the hospitals work to be cheap by working almost for minimum wage considering they get paid 45k for 80 hr work weeks. A nurse working 80 hours a week would be paid 150k or more in comparison.</p>
<p>The number of students being allowed to become doctors is capped somewhere at 19k because the medicare funding for residents has been fixed since 1997 or something like that. This was a logical next step, i.e., to produce more doctors to shoulder additional 20-30 million people expected to become part of the system.</p>
<p>Most medical students take out loans to pay for it. Mom and Dad don’t usually pay the $60k per year cost. So, at least at first blush, a program which forgives the loans may seem attractive. However, these programs are limited to primary care only so if the doctor is interested in a speciality, it’s a no go.</p>
<p>If the money is to allow more residencies, then that sounds like there is value in it. Forcing residents to work so many hours is unsafe for the doctors and the patients. But if it’s for funding medical school, unless they can get a huge commitment to work in these underserved areas that is enforceable, it does not seem like something we have the money for.</p>
<p>The reality is, students are still scratching and clawing to get into med school. There are no shortage of applicants willing to pay the full boat. There is no reason to spend huge sums of money to entice kids into med school who are already begging to get in. Maybe if current doctors get fed up and decide to retire in hoards, it might be worth it.</p>
<p>Yes, students are still scratching and clawing to get in. The GPA and MCAT score for accepted applicants keeps rising. But with the huge debt load, primary care is not financially attractive. </p>
<p>If Medicare already pays for all residencies, then we are already subsidizing people wanting to become doctors. But if Medicare only pays for N residencies per year, then we are also restricting the number of new doctors produced per year to N. If we want more, and that’s the way residencies are funded in the United States, then we will have to pay for more.</p>
<p>This 2.5% increase in premiums for an under-representation of the 18 to 34 group was from a Kaiser study. However, the study did not take into account the demographics of this group. For example, if most of the young people who signed up were sicker and those who didn’t were healthier, then premiums are likely to go much higher. If half of this group is what is called high cost consumers (the sicker population of the 18 to 34 group) you could see a 26% increase in premiums. BTW, this assumes 40% of all enrollments are 18 to 34-year-olds, which is no where near the number we are seeing now. It is very logical to assume that a high percentage of the 18-34 group signing up are probably less healthy than those who are not signing up</p>
<p>. <a href=“http://www.valuepenguin.com/2014/01/what-demographics-may-indicate”>http://www.valuepenguin.com/2014/01/what-demographics-may-indicate</a></p>
<p>True, GP, but irrelevant. If sicker people than the insurers expected signed up, that’s bad. But we knew that. What we don’t know is how sick insurers expected their enrollees to be. They certainly didn’t expect their enrollees to be as healthy as the general population and they have said as much. </p>
<p>CF, “irrelevant” is hardly the word I would choose.</p>
<p>I think one could conclude that if this group is much less than 40% of the sign ups, then there is probably a greater likelihood that we have an unhealthier representation of this group, since it is likely that it is the healthier subset which didn’t sign up. </p>
<p>Perhaps I should have used the word “obvious,” then. That’s why I said in a previous message that the big reasons for premiums to go up would be too few healthy people signing up, and general increase in health costs unrelated to the risk pool. Because it’s obvious that if sicker people than expected sign up, then premiums will have to go up next year.</p>
<p>CF, I edited my previous post to explain why I think a less than 40% representation of the 18 to 34 group is an important factor in determining premiums next year for exchange plans.</p>
<p>Where did the baseline come from? </p>
<p>Who did this study? The author? </p>
<p>16 percent of young people are 80 percent of the cost? How many young people are we talking about? Are all these people all uninsured?</p>
<p>There are a lot of percentages used. Percentages of how many? </p>
<p>dstark, take a look at the article I linked to in my post.</p>
<p>GP…I looked at it… </p>
<p>You are explaining why the numbers are bad. I want to go to the gym. </p>
<p>Answer my questions.</p>
<p>I am glad you’re going to the gym, someone has to keep the premiums down.</p>
<p>I found the study from a CNBC article. Don’t know who the author is. I thought the assumptions and conclusions were well-documented I will do some research later and get back to you with more info.</p>
<p>Ok…</p>
<p>I know this is going to be a lot of questions.</p>
<p>There are 17.8 million young people uninsured. </p>
<p>16 percent make up 80 percent of the costs.</p>
<p>17.8 million times 16 percent Equals 2.81 million.</p>
<p>That is also 40 percent of 7 million.</p>
<p>So…how much does the most expensive 2.8 million young people cost? </p>
<p>How much does the most expensive 2.3 million cost?</p>
<p>How many are signing up for medicaid?</p>
<p>How many did the insurance companies count in their numbers?</p>
<p>How much does the most expensive 4 million young people cost?</p>
<p>How much does the most expensive 1 million young people cost?</p>
<p>I feel like I am back in school and have been assigned a term paper. </p>
<p>dstark, the author was making certain assumptions about this 18-34 group and drawing conclusions which seemed logical. You would admit the 2.5% figure came from a Kaiser study and the author of that study did not look at demographics of the group or make any assumptions about their health relative to the 18-34-year-olds who did not sign up.</p>
<p>
I think it’s wonderful if you have the financial ability to fund a child through medical school – but that is very rare. I certainly cannot fund my children through grad school – and the offspring of CC parents are better off than most if they’ve had their parents subsidize the the bulk of their undergraduate education.</p>
<p>The vast majority of med students will pay their own way, and by “pay” that means either taking on a 6-figure debt for most, though some will choose to enlist and serve in the military for the sake of the educational benefits. </p>
<p>If the goal is to get more primary care physicians in high need communities, then it makes sense for the government to subsidize those students. The parents who are paying their kids’ med school bills and living expenses probably have something different in mind for their residencies. </p>
<p>…and the author says: “While a bad mix would mean… less in premiums than they are paying out in benefits, it doesn’t necessarily mean they would have to raise premiums in 2015. Fortunately…programs that will help alleviate the losses from a bad mix of enrollees.”</p>
<p>…" "What could be problematic is if the mix does not improve in the long run. "
(And that circles back to Dstark’s belief things will settle out over a few years.)</p>
<p>He wrote it.</p>