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Title: To all universal health care advocates..
Description: I am sorry in advance.


savwboy - April 8, 2008 04:14 AM (GMT)
I have always preached what I call "collateral damage" or the moral hazards when the government steps in to address a problem. There usually is unintended consequences....like this

Once they discover that she is Dr. Kate, the supplicants line up to approach at dinner parties and ballet recitals. Surely, they suggest to Dr. Katherine J. Atkinson, a family physician here, she might find a way to move them up her lengthy waiting list for new patients.

Those fortunate enough to make it soon learn they face another long wait: Dr. Atkinson’s next opening for a physical is not until early May — of 2009.

Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance.

Since last year, when the landmark law took effect, about 340,000 of Massachusetts’ estimated 600,000 uninsured have gained coverage. Many are now searching for doctors and scheduling appointments for long-deferred care.

Here in western Massachusetts, Dr. Atkinson’s bustling 3,000-patient practice, which was closed to new patients for several years, has taken on 50 newcomers since she hired a part-time nurse practitioner in November. About a third were newly insured, Dr. Atkinson said. Just north of here in Athol, the doctors at North Quabbin Family Physicians are now seeing four to six new patients a day, up from one or two a year ago.

Dr. Patricia A. Sereno, state president of the American Academy of Family Physicians, said an influx of the newly insured to her practice in Malden, just north of Boston, had stretched her daily caseload to as many as 22 to 25 patients, from 18 to 20 a year ago. To fit them in, Dr. Sereno limits the number of 45-minute physicals she schedules each day, thereby doubling the wait for an exam to three months.

“It’s a recipe for disaster,” Dr. Sereno said. “It’s great that people have access to health care, but now we’ve got to find a way to give them access to preventive services. The point of this legislation was not to get people episodic care.”

Whether there is a national shortage of primary care providers is a matter of considerable debate. Some researchers contend the United States has too many doctors, driving overutilization of the system.

But there is little dispute that the general practice of medicine is under strain at a time when there is bipartisan consensus that better prevention and chronic disease management would not only improve health but also help control costs. With its population aging, the country will need 40 percent more primary care doctors by 2020, according to the American College of Physicians, which represents 125,000 internists, and the 94,000-member American Academy of Family Physicians. Community health centers, bolstered by increases in federal financing during the Bush years, are having particular difficulty finding doctors.

http://www.nytimes.com/2008/04/05/us/05doc...lth&oref=slogin



A year wait for a physical in mass! Socialized medicine is struggling there already..

savwboy - April 8, 2008 04:17 AM (GMT)
Damned gummit!!!
I did again! Could someone move this to politics please? 678hnn77

Ramen - April 8, 2008 05:04 AM (GMT)
Solution is to get more doctors, not have more people without health insurance.

savwboy - April 8, 2008 06:11 AM (GMT)
QUOTE (Ramen @ Apr 7 2008, 11:04 PM)
Solution is to get more doctors, not have more people without health insurance.

You should be able to find plenty of them at the employment agencies.. :blink:

Steve_Bartkowski - April 8, 2008 12:34 PM (GMT)
QUOTE (Ramen @ Apr 7 2008, 11:04 PM)
Solution is to get more doctors, not have more people without health insurance.

Sure, we'll just plant a few doctor trees in Massachusetts...

Ramen - April 8, 2008 01:13 PM (GMT)
QUOTE (savwboy @ Apr 8 2008, 12:11 AM)
QUOTE (Ramen @ Apr 7 2008, 11:04 PM)
Solution is to get more doctors, not have more people without health insurance.

You should be able to find plenty of them at the employment agencies.. :blink:

Allow doctors to write off student loans if they work in high-demand areas and give other tax breaks and incentives. Or wait a couple of years and let the demand naturally drive up the supply of medical professionals. The free market will take care of the demand.

Steve_Bartkowski - April 8, 2008 01:16 PM (GMT)
Not only are wait times increasing, but cost (that will fall on the taxpayers) is increasing quickly as well...

---------------------------------------------------------------------------------------
State Watch | Massachusetts Officials Considering Ways To Address Rising Costs of Health Program
[Mar 31, 2008]
Gov. Deval Patrick (D) would not rule out a possible increase in the $295-per-employee fee that some businesses contribute annually for Massachusetts' Commonwealth Care health insurance program, saying on Wednesday that "[e]verything is on the table" for discussions about controlling costs of the program, the Boston Herald reports. The annual assessment is paid by employers that have 11 or more employees and do not offer employer-sponsored health insurance.

About 176,000 people were enrolled in the state-subsidized Commonwealth Care program as of March, which is "far more than anticipated at this point," according to the Herald. Patrick said that shortfalls in funding for the program have resulted from its success because more people have signed up than lawmakers projected. For the next fiscal year, the state has estimated that costs will increase to $869 million, but the estimate must be revised because of continued enrollment growth, according to the Herald. Some have estimated that an additional $150 million is needed to cover the program's deficit (Fitzgerald, Boston Herald, 3/27).

http://www.kaisernetwork.org/daily_reports...cfm?DR_ID=51250
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Ronald Reagan, what do you have to say about this?

Ronald Reagan Speaks Out Against Socialized Medicine

Ramen - April 8, 2008 01:29 PM (GMT)
$150 million out of a $28 billion budget is nothing. And $900 million is only about 3% of the total Mass fiscal budget.

Stop acting like it's bankrupting the state.

Steve_Bartkowski - April 8, 2008 01:36 PM (GMT)
QUOTE (Ramen @ Apr 8 2008, 07:29 AM)
$150 million out of a $28 billion budget is nothing. And $900 million is only about 3% of the total Mass fiscal budget.

Stop acting like it's bankrupting the state.

Ya $900 million is only 3% of the state budget but watch... The wait times are currently huge. Demand for care far exceeds supply (of doctors). Doctors will increase charges because they can (demand > supply) and the taxpayers foot the bill. I expect the costs will continue to escalate year after year.

Ramen - April 8, 2008 01:38 PM (GMT)
Or the high demand entices more doctors to the state and prices stabilize. A lot of docs out there with small, local offices that see a good opportunity.

Ramen - April 8, 2008 01:40 PM (GMT)
And doctors don't get to charge whatever they like. Insurance companies always dicker with the doctor over charges/services.

Steve_Bartkowski - April 8, 2008 01:41 PM (GMT)
QUOTE (Ramen @ Apr 8 2008, 07:38 AM)
Or the high demand entices more doctors to the state and prices stabilize. A lot of docs out there with small, local offices that see a good opportunity.

Well, you also have to factor in malpractice insurance costs. How does Mass compare to other states? A lot of states have put caps on malpractice suits which have lowered malpractice insurance costs. What about Mass?

Steve_Bartkowski - April 8, 2008 01:42 PM (GMT)
QUOTE (Ramen @ Apr 8 2008, 07:40 AM)
And doctors don't get to charge whatever they like. Insurance companies always dicker with the doctor over charges/services.

It is negotiated. When demand is higher than supply the doctors have the upper hand in the negotiations.

Ramen - April 8, 2008 01:48 PM (GMT)
Actually, it is stipulated by the insurance companies that they won't pay more than a certain amount for certain services. The doctors can try to force the patients to pay the rest, but most times they just don't charge as much. Unless we're talking about PPP/HMO or some kind of network of doctors.

Regardless, the state is paying for the health insurance, not the doctor's bills directly. Rates may go up some over the next five years, but you're making it sound like Mass. is headed for bankruptcy, which is just silly.

JDaveG - April 8, 2008 01:53 PM (GMT)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:41 AM)
QUOTE (Ramen @ Apr 8 2008, 07:38 AM)
Or the high demand entices more doctors to the state and prices stabilize.  A lot of docs out there with small, local offices that see a good opportunity.

Well, you also have to factor in malpractice insurance costs. How does Mass compare to other states? A lot of states have put caps on malpractice suits which have lowered malpractice insurance costs. What about Mass?

Do you have a link to a study where caps have lowered anything?

The only one I've seen is California, which is often used to show that the cap lowered premiums, when in fact premiums remained constant after the cap until insurance reform was also passed.

Steve_Bartkowski - April 8, 2008 01:59 PM (GMT)
QUOTE (JDaveG @ Apr 8 2008, 07:53 AM)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:41 AM)
QUOTE (Ramen @ Apr 8 2008, 07:38 AM)
Or the high demand entices more doctors to the state and prices stabilize.  A lot of docs out there with small, local offices that see a good opportunity.

Well, you also have to factor in malpractice insurance costs. How does Mass compare to other states? A lot of states have put caps on malpractice suits which have lowered malpractice insurance costs. What about Mass?

Do you have a link to a study where caps have lowered anything?

The only one I've seen is California, which is often used to show that the cap lowered premiums, when in fact premiums remained constant after the cap until insurance reform was also passed.

JDaveG - April 8, 2008 02:21 PM (GMT)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:59 AM)
QUOTE (JDaveG @ Apr 8 2008, 07:53 AM)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:41 AM)
QUOTE (Ramen @ Apr 8 2008, 07:38 AM)
Or the high demand entices more doctors to the state and prices stabilize.  A lot of docs out there with small, local offices that see a good opportunity.

Well, you also have to factor in malpractice insurance costs. How does Mass compare to other states? A lot of states have put caps on malpractice suits which have lowered malpractice insurance costs. What about Mass?

Do you have a link to a study where caps have lowered anything?

The only one I've seen is California, which is often used to show that the cap lowered premiums, when in fact premiums remained constant after the cap until insurance reform was also passed.

I tried to open it several times, to no avail. I'll try again later.

Steve_Bartkowski - April 8, 2008 02:23 PM (GMT)
QUOTE (JDaveG @ Apr 8 2008, 08:21 AM)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:59 AM)
QUOTE (JDaveG @ Apr 8 2008, 07:53 AM)
QUOTE (Steve_Bartkowski @ Apr 8 2008, 07:41 AM)
QUOTE (Ramen @ Apr 8 2008, 07:38 AM)
Or the high demand entices more doctors to the state and prices stabilize.  A lot of docs out there with small, local offices that see a good opportunity.

Well, you also have to factor in malpractice insurance costs. How does Mass compare to other states? A lot of states have put caps on malpractice suits which have lowered malpractice insurance costs. What about Mass?

Do you have a link to a study where caps have lowered anything?

The only one I've seen is California, which is often used to show that the cap lowered premiums, when in fact premiums remained constant after the cap until insurance reform was also passed.

I tried to open it several times, to no avail. I'll try again later.

Works fine for me. I'm using firefox. The link is:

http://www.rwjf.org/reports/grr/050298.htm




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