House Healthcare Reform Bill Passes

[bokelley]

For several years, dh has talked about concierge medicine. He's even more interested in it, now.

What is concierge medicine?

[rainbabies]

Cash only business.

I have to say that a large part of going into medicine was for altruistic reasons. I have and always will enjoy donating my time free of charge but at a point early on in the process of medical education this becomes a business decision.

It's been my feeling that since I made the decision to enter medical school some one has been trying to take financial advantage of me. There's always some one with there their hand in your pocket. It starts with exorbitant costs for applications, MCATs, review courses etc. By the time I finished my second year of medical school I was so burdened by debt that I couldn't turn back if I wanted to. Then there were board exams on top of the ridiculous cost of tuition. Applying to residency was not cheap either. Now upon the completion of my residency I continue to shell out money that I don't have for more board exams, licensure, and a multitude of miscelaneous expenses that are mandated and outwardly seem pointless. At no point in time has anyone been there reaching out to me to assist in defraying expenses. Now at the end of my training and over a quarter of a million dollars later I'm expected to be altruistic first and graciously accept a significant cut in potential income.

Maybe I'm being greedy but I feel that what I have to offer as a physician is a valuable commodity and that I deserve to be compensated for not only my time based on the degree of education but also the risks that I take medicolegally on behalf of my patients. As an OB the likelihood of seeing the inside of a courtroom is about 100%. Most of my classmates are there before we leave residency.

I have brought up on many occasions what a future in concierge medicine might hold. In my heart I feel pity for the have nots that will still have poor access but on the other hand I feel that this health care reform will trap me in a system that leaves me little alternative but to turn my back.

I'm sure that the anesthesiologist who gets paid $5 for an epidural on a medicaid patient would rather get paid in chickens. After all a chicken is worth more than $5.

I digress......

[PrincessFiona]

Tucker

Welcome!

It's such a dilemma. My husband comes from a country with a system of democratic socialism if you will. He has always believed (and continues to believe) that a society must provide healthcare for all...but he is opposed to its implementation here in America. His reasons include the fact that we pay higher taxes but don't have any of the benefits (unlike in Europe where we would be paying the same taxes as we are now but would benefit as much as everyone else from that money), the low payment to physicians for medicaid and medicare with constant cuts but very demanding patients, and the extremely litigious nature of our country.

He sees many patients with no insurance, comps these visits (even the ones at 2am in the ICU) and practices medicine the way he feels it should be practiced. That being said, he also feels that after the years of education including residency and fellowship training, that he should be compensated for his knowledge....we have no problem paying our veterinarian, car mechanic or builder top dollar for what they do when they do it well. Medicine isn't really a commodity where if you can't afford to buy it you just don't have a luxury item...it can be life or death. There IS a moral imperative here to provide health insurance or coverage in some form to all working Americans. I just don't know that we can accomplish that here. Taking away physician pay is a bad idea in so many ways that I can't even begin discussing it.

There are two-tiered systems in every country with socialized medicine, btw.

Kris

[GrayMatterWife]

Abigail, it's always been my understanding that, at least in the UK, the two-tiered system already exists. If we have to pay out the wazoo for medical training, we're making the money to go with it.

Yeah, that's how it's been explained to me. I just don't think informally institutionalizing the tiering is the ideal. I realize that no matter what system you're in, money will ALWAYS talk and be able to buy you care. But, I just think it is a very false notion that government health care will in any way discourage this. I think it will encourage it and make the tiering worse.

[Thirteen]

As a house divided politically, we have differing opinions on health care.
But the passing this weekend on our vacation just left us both with a big "what's going to happen now?" feeling.

[Rapunzel]

I have purposely been avoiding all mention of this healthcare issue lately. My head is in the sand! Ignorance IS bliss!