Two physicians ready to scale down.


 

  It is now clear how Obama is planning to “fix healthcare” and where to get the money from. Latest I heard is that couples making more than 208K will have less possible deductions on taxation, including mortgage interest and possibly student loans as well. It is likewise very clear that he will continue to talk about healthcare without involving the people delivering it.

       Me and my wife are two primary care physicians. We esaily work 80 hours each week, but no more. It is obvious where we will be heading with taxation and how we will be pubished for our work. So far, our plans are to significantly reduce our work-hours. From next summer, we will work a combined of 32 hours plus call-time. This is likely to keep our combined income low enough to avoid Obama’s taxation draconism.  We will work just a couple of days a week, have much more time to ourselves and likewise be able to do much more with our house on our own without having to hire people.

  I believe we are not the only ones. We will see many of our collegues do the same the next years. Others will stop accepting medicare and medicaid, enter concierge medicine or simply quit entirely.

  I understand that two doctors are just an insignificant tiny figment in Obama’s world, but as an example of how he intends to wipe out will to be productive and reap rewards, we are a good example of what will be coming. Should the government mandate minimum work hours for doctors or others in order to keep the license, we will quite entirely. I am sure this is something bound to happen in any field where hard work, productivity and innovation will be punished with draconic taxation combined with demonization without any appreciation.

 Certainly the healthcare system is very flawed, but the solution is HSA’s with catastrophic coverage and not socialized medicine. I am not willing to work 80 hours a week in this field for 50K, having to look over my should at every moment in fear of Obama’s campaign contributors (the trial malwyers) while being increasingly burdened with medicare bureacracy.

 

 No thanks.



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14 Comments Leave a comment

Interesting perspective

izoneguy (Diary) Wednesday, June 17th at 7:56PM EST (link)

Have you talked to other doctors in regards to what they might do?
One of my doctors said she felt “powerless” and had no idea what to do. Again the liberals are projecting their ideas into a marketplace where they have no idea what the realities are. They talk of greedy doctors?? What about the greedy lawyers? MOST of the problems with escalating healthcare costs COULD BE SOLVED if lawsuits were not such a prominent cost driver of healthcare. Of course telling this to a bunch of lawyer/politicians is like telling them their children are stupid & ugly.

The point cannot be made often enough: Modern liberalism, as embodied in the Obama presidency, is the defender of the status quo. And the status quo is a road to economic ruin. Political forces cannot redistribute the wealth that the economic system does not produce.

 

HSA & Catastophic Health Insurance Coverage!

DONTREADONME (Diary) Wednesday, June 17th at 9:13PM EST (link)

This is the first time I have read anywhere a Dr. suggesting this. I agree 100%, when I was unemployed for three months all I wanted was catastrophic health care coverage until I was able to find a better job. I had a hard time finding this plan. This is a great idea if you have the savings to make the deductable. Here is what I wanted for health insurance, I would take a $5000.00 deductable and a $75 a month premium to be covered against cancer, heart attack, car accident or any other ailment that required ICU and longterm hospital stay. If need be I would cover the costs of my appointments and basic health care management, and hope that my catastrophic insurance would not be required.

This is a much better option than any public health care plan.

5 x 5 x 5 Compare health insurance to house insurance

David123 (Diary) Wednesday, June 17th at 9:18PM EST (link)

You need house insurance in case your house burns down. If one of your lightbulbs goes out, you just buy a new lightbulb yourself, you don’t get the insurance company to buy you a lightbulb.

David123

great analogy...

DONTREADONME (Diary) Wednesday, June 17th at 9:25PM EST (link)

exactly what I was thinking when I was unemployed. Too many think health insurance is a subsidy, its not but as an added incentive to get you as an employee health insurance plans have begun to cover everything. Having health insurance from your employer is not a right it is a benefit. Other than that at my age I would rather have the extra pay and have catastophic health insurance with an HSA.

Rush Limbaugh used a similar analogy

David123 (Diary) Wednesday, June 17th at 9:55PM EST (link)

http://www.rushlimbaugh.com/home/daily/site_061709/content/01125109.guest.html

He said that you don’t get car insurance for an oil change. Exactly!

David123

 

Health Insurance Is NOT a Right

zoltanne (Diary) Thursday, June 18th at 8:32PM EST (link)

As you stated. It’s just a benefit provided by either your employer, you as a business-owner, or your own personal insurance coverage.

And because it is a benefit, the Feds have stated they want to tax this benefit.

Okay. Fine….then the Feds have just declared health insurance coverage to be a benefit and have quantified it. Therefore, they cannot have it both ways and also declare that health insurance is a right.

 
 
 

We did that.

itrytobenice (Diary) Wednesday, June 17th at 10:46PM EST (link)

For a time when hubby was self employed, we had catastrophic coverage with a $7,500 *per occurrence* limit. It cost us about $400 mo. for our family of 4. But they were willing to cover any treatment that was medically acceptable.

Hubby and I did it because there was no way I would trust my kids’ care to the Medicaid system where they treat leukemia patients with the cheapest of all possible plans when others are more effective.

I figured we were all healthy and in 25 years, we have only met our deductible 3 times and two of those times were producing babies. :)

$7,500 wouldn’t bankrupt us and I felt safe if anything terrible had happened; nothing happened for the three years I had the plan that exceeded $100 and I won.

Fortunately, under Dear Leader, that kind of plan is impossible because the feds surely know better than me. [insert series of swear words and comments that would get me contact with the Secret Service here]

Proper grammar saves lives.

Let’s eat Grandma.
Let’s eat, Grandma.


Activists Taking Action: Unified Patriots

 
 

Indentured servitude used to be illegal.

itrytobenice (Diary) Thursday, June 18th at 12:13AM EST (link)

Who can conceive of a situation in America where an individual can go to school for 4, 6, or 8 years and then start a business and then have Uncle Sammy come along and take it over?

Where do they get off thinking they can tell anyone how much they are allowed to charge their clients? This is insanity.

Proper grammar saves lives.

Let’s eat Grandma.
Let’s eat, Grandma.


Activists Taking Action: Unified Patriots

 

You're not alone-

johnCV (Diary) Thursday, June 18th at 11:47AM EST (link)

A friend who is a successful saleman and his attorney wife are already starting to wnd down thier ‘productivity’ to stay under obama’s punishment level. They are looking t ways to preserve weath instead of creating it.

Perhaps the Teleprompted One can explain how this will improve America.

Hopenchange – It’s not just for losers anymore.

 

You are not the only ones

JHancock (Diary) Thursday, June 18th at 2:12PM EST (link)

I’m a medical student who, seeing the way health care is headed decided to take an extra year to also get an MBA. If we go to socalized healthcare I will likely work as a Doctor only for philanthropy sake and not for a living. Instead, I’ll be using my MBA to make more money with less hours on the business/administrative side of things. In short, medicine will become a public service hobby (possibly done on mission trips to foreign countries) and not my main job–for every med student like me, who is smart enough to realize you can’t pay back 200k in loans and 10 years of lost salary while going to school with less than 200k a year-America loses a health care provider, Decreasing supply as social health care increases demand!

Sooo…figure it out America! Less pay=less full time doctors=longer waits and more rationing!

The only way I can see this not being a problem is if training is cut from 10-15 years down to 4-6 including college, with school prices greatly reduced–of course America would never put up with LESS physician training, the trend is currently for residencies to increase in length!

Good Luck :)

drkven (Diary) Thursday, June 18th at 6:01PM EST (link)

I will never stop appreciating the BEAUTY of Medicine. the knowledge, the theories, the constant chase for rigorous care and healing. I probably spend 80% of my sparetime thinking about healing, medicine and wellness. I used to be a strong-arm socialist in my “former life” in a Socialist nation in Europe. My grandfather fought police as an ilegal union member before the Nazis invadedour country. I’m raised very much according to the socialist utopia and if Obama could make it all how we have it, he would. Tobe a socialit nation, we are doing “fairly well” because America is guaranteeing our securty, so we can provide more welfare and comfort for nothing. I used to be one of the brainwashed, thankless dummos that couldn’t fathom how great America is and how America works.

The healthcare system in America is, in my opinion, the best in the world to be no matter how much money you have, no matter how sick you are or no matter what opinions you have. Most people of even respectable intellect and reason in Europe thinks our (Americas) patients die outside every ER and people getting cancer cannot afford the treatment. Not true. Sure, our medical system is very broken with regards to payment, but it is more of a financial way of damage compared to death. It would be easy for hospitals/insurance companies to implement “compasionate” debt and it would preserve our system. I personally doubt Obama will succeed with too much, but I could be wrong. Likewise, I don’t think these people have studined socialized medicine from other countries way of life, culture and minds.

Choose Medicine because:

Cancer, cardiovascular, psychiatric, trauma, Ortho, Herbal medicine, Psychiatry to mention but a few. There are no other places that can out compete the breath and availability of constant high-quality services. And if you want “alternative” medicine nothing beats America there either. Seek out Reikki, Ayurveda or Chiropractics and America will constantly have the top. Even accreditation in Hypnosis is possible in America.

*Constant innovation; Imagine always being in an environment where even life or death decicions IMPROVE every month as we learn from mistakes. If you chop of the wrong leg in America it is on all news, while otherwise it just happens. You learn to use new equipment every year and sometimes what you learned in school as 25 is something very different from how you do it as 40. Imagine all kinds of questions you have to explain every day and understand all the difficult to understand answers you get from specialists, pathologists, L&D nurses, Paramedics and so on…Very exciting and challenging…

*Real rewards for what you do both in a material and acknowledgement factor it takes alot to find most other places. Research?? No place where individual incentives to contribute to the common outcome are better. You can always run your own trials even if you just start analyzing what you did and what your patients choose. For example, me, I started realizing just a few months ago how important Vitamin D is (another debate in another website), and now I order way more tests of it. I have found so many deficient VitD patients we simply have not found important to test, until now. Some Nursing home patients I know with severe depression, bone pain (“Fibromyalgia”) and osteoporosis have really picked up with their VitD levels in check. Will see more results in 2-4 years as I will keep their VitD levels in check until then.. This have innovated itself almost. It came almost entirely from the naturopath thinking and a friend of mine talked about it when he was in naturopathic school (before he went to medical school after practicing naturopathy)
.From there, it arrived Allopathic Medicine even if the practitioners would not make a dime more by bothering to check it, but see it as an inherent value due to improving a patient’s health. In Europe I would not be allowed by the government to order so many Vitamin D test. They would simply tell me to tell them to supplement according to “guidelines” because testing is too expensive. I worked on a Telemtry unit in my homeland for a summer as US-trained Medical Student and worked as a telemetry- tech with no training, becase they never had one. Here in the US, telemtry techs might read an EKG better than me, because of the system. Again, because of the efficient system rewarding innovation and focus.

*The flexibility of your thinking. Because medicine in America, especially gives you so much freedom (despite the insurance companies and especially Medicare) compared with any socialist nation in Europe.

A reply, but I feel very passionate about this. I’m glad you have entered medicine and when you are done, it wil still dominate your life more than anything, even if you only do philantropy. I am actually also studying for an MBA right now, with international emphasis. At the same time, I am trying to learn Ayurvedic Medicine in weekends. Both me and my wife have been seriously considering moving to India and practicing medicine for a few years. We could find a niche there, that would easily equal our pay here, but we love to live in the USA because it simply is the best, even with Obama.

Good luck and if I can be to any help or assistance, I will ;)

 
 

How I see an effective health insurance policy that would work.

drkven (Diary) Thursday, June 18th at 6:27PM EST (link)

I am sure everybody has some ideas about how our health insurance should (and will) be in a few years. I assume (for some reason), that we will have flat-tax in the long run. I’m optimistic here.

First of all, the health insurance, Like David123 said, should cover catastrophies and serious sufferings and then you could implement a sliding scale of costs to the rest.

Let’s say, you decide your policy to have 10000 deductible. A medical disaster would cost you 10000, might therefore leave you 10K in debt, but that’s it. Bad, but not a disaster. Routine visits would be covered by yourself unless you spend 10000, not very likely most of the time. Therefore, since you put so much into taking part of “the risk” insurance companies are more willing to offer you a better policy as well. Health Saving Accounts would be free and unrestricted with regards to healthcare, maybe even renaming it as a tax-free catch-all bank account instead. The challenges are twofold: Make sure it would function for people with chronicd isease and reward preventive self-care. Smoking, alcohol, Obesity are, often called “preventive” by many, including Obama. Well, then let people get more rewards for preventive care also. Second thing would be to keep a freely-floating health insurance industry that would profit out of this while keeping it reasonable and effective. If America can put the man on the moon, we can also design the financial frames of our healthcare in the best way too.

Secondly, like itrytobenice was saying, we can have situational and circumstancial happenstances in your life that will change the ways you cover yourselves. If you are willing to chance upon good health, it is your choice, just know how you can prevent illness also, or be ready for it. STILL, at worst situation it would be mostly covered. We would need the same safety net as today, but it would be much cheaper and more fair. Maybe there could be a financial bottom that was guaranted like FDIC, I don;t know, but that could be a possibility if you really don’t believe the private can do it.

Finally, Rush Limbaugh explained it to me on his radio station a few days back and I was fascinated with how well he understood this. Electronic Medical Records is just a minute part of the whole problem, just like non-residents are just a small fraction of the challenge. Conceptually this would work and would alse be an amazingly easy way for the healthcare system to asess itself by how it would respond. Good preventive care could make tremedous differences if let to do it by it’s own without government telling what to do. If conservatives just talk about their option being nothing but improvement of the same they cannot win this debate. They need to talk about HSA, how they work and what would need to change. I’m not even sure the trial-lawyers are that big of a cause. Certainly (again) a bigger part of the problem, but not THE problem.

This can be done and is so easy to imagine possible in dynamic (still) America that I think it will happen, soon..

 

Patients/Consumers are out of the loop.

Common_Cents (Diary) Thursday, June 18th at 8:19PM EST (link)

They are not engaged as consumers and watchdogs. They are playing with OPM-other peoples money.

An elderly guy would hit you on the head w/ his cane if you overcharged him a nickel for a hammer at your hardware store. That same guy brags to his friends at breakfast about his recent $20,000 hip replacement without batting an eyelash.

Not that he didn’t need a hip replacement or that was according to the plan he paid for but the point is he is left out of the equation on any cost containment on anything, especially the preventative/routine care (oil changes).

I am hearing about cash practice coop programs where a group of people timeshare a doc for flat or monthly fees, bypassing the inefficient billing system we have now.

Obama=Golfer in Chief, Leading from, behind, the Back Nine.
Leaders don’t create movements. Movements create leaders. Get involved. Your future depends on it.
Govt “invests” YOUR tax money for POLITICAL return rather than economic return.

 

Concierge Medicine

drkven (Diary) Thursday, June 18th at 10:33PM EST (link)

That’s what you are talking about. The old Marcus Welby model of a physician. They work very well with HSA, especially, since their fees typically can come out of HSA’s until now..
And less constrained to practice cookbook medicine as you really only work for the patient. The better you know the patient from before if something happens, the faster you will get well as he/she tends to know more at an earlier time. We are trly talking about preventive care here, along with the day-to-day medicine, but currently harldy possible anywhere.