Comments on: The future of medicine http://www.medrants.com/archives/2295 Contemplating medicine and the health care system Sat, 20 Mar 2010 04:42:37 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: shibumi http://www.medrants.com/archives/2295/comment-page-1#comment-14048 shibumi Tue, 08 Mar 2005 17:22:19 +0000 http://medrants.com/archives/2005/03/07/the-future-of-medicine/#comment-14048 db: I agree with you that our health care system is riddled with illogic and, at times, sheer absurdity. You must realize, however that our health care system IS a political process. How else can you explain such arrangements as the Medicare Reform Act of last year with the new prescription drug benefit. The federal government, BY LAW, cannot set or negotiate the price of covered medications for subscribers (do you think the PAC money from the pharmaceutical industry had anything to do with that?) At the same time, reimbursement rates for Medicare payments to physicians (your office visits) are scehduled, BY LAW, to be cut 5% a year from 2006 to 2012. Who sets these rates anyway? A bunch of people sitting around a room in Washington D.C. How can you expect logic from this kind of arrangement? As respect to physician shortages or gluts, arf's comments above offer some insight. I don't think you can really talk about surplus or shortages of physicians as a whole but rather you have to look at specific specialties. These will always vary with MARKET conditions. Med students will not enter areas of medicine iin which they cannot find employment or resonable compensation. I am not of big proponent of free market theory for medicine but if you look at the one area of medicine that is completely in the free market (cosmetic procedures, some bariatric surgery) this system works very well. Which leads to an amazing clash of cultures. The same people who will willingly pay thousands of dollars, up front, for plastic surgical procedures feel very put out when they have to pay a ten or twenty dollar co-pay to see you in the office for real medical care. Talk about absurd! I don't think we'll see common sense in medicine in our professional lives. db: I agree with you that our health care system is riddled with illogic and, at times, sheer absurdity. You must realize, however that our health care system IS a political process.
How else can you explain such arrangements as the Medicare Reform Act of last year with the new prescription drug benefit. The federal government, BY LAW, cannot set or negotiate the price of covered medications for subscribers (do you think the PAC money from the pharmaceutical industry had anything to do with that?)
At the same time, reimbursement rates for Medicare payments to physicians (your office visits) are scehduled, BY LAW, to be cut 5% a year from 2006 to 2012. Who sets these rates anyway? A bunch of people sitting around a room in Washington D.C. How can you expect logic from this kind of arrangement?
As respect to physician shortages or gluts, arf’s comments above offer some insight. I don’t think you can really talk about surplus or shortages of physicians as a whole but rather you have to look at specific specialties. These will always vary with MARKET conditions. Med students will not enter areas of medicine iin which they cannot find employment or resonable compensation.
I am not of big proponent of free market theory for medicine but if you look at the one area of medicine that is completely in the free market (cosmetic procedures, some bariatric surgery) this system works very well. Which leads to an amazing clash of cultures. The same people who will willingly pay thousands of dollars, up front, for plastic surgical procedures feel very put out when they have to pay a ten or twenty dollar co-pay to see you in the office for real medical care. Talk about absurd!
I don’t think we’ll see common sense in medicine in our professional lives.

]]> By: arf http://www.medrants.com/archives/2295/comment-page-1#comment-14006 arf Mon, 07 Mar 2005 18:30:53 +0000 http://medrants.com/archives/2005/03/07/the-future-of-medicine/#comment-14006 db, I do seem to remember predictions of a significant physician shortage back in the 1970's and early 1980's. This was followed by predictions of a physician GLUT in the 1990's. And that glut was not predicted, it was demonstrable at the time. Academics were seeing their trainees having a hard time finding suitable employment, and those that found employment found the terms of employment were onerous to say the least. No offers of partnership, drastic restrictive covenants excluding the new doc from entire metro areas, etc. The reason we got shortages of some specialties (anesthesia, radiology for example), came from medical students seeing the FACT that their immediate seniors were having such a hard time in the 1990's that they stayed away from those fields in droves.....leading to a shortage. The glut was written about, backed with data, in the major journals just a few years ago. Now we see predictions of shortage......AGAIN. So maybe the predictions of shortage are correct this time. Maybe not. We've seen the prediction cycle go back and forth, and we've certainly seen what happens to doctors when there is a glut, even if just for a couple years. db, I do seem to remember predictions of a significant physician shortage back in the 1970’s and early 1980’s. This was followed by predictions of a physician GLUT in the 1990’s. And that glut was not predicted, it was demonstrable at the time. Academics were seeing their trainees having a hard time finding suitable employment, and those that found employment found the terms of employment were onerous to say the least. No offers of partnership, drastic restrictive covenants excluding the new doc from entire metro areas, etc.

The reason we got shortages of some specialties (anesthesia, radiology for example), came from medical students seeing the FACT that their immediate seniors were having such a hard time in the 1990’s that they stayed away from those fields in droves…..leading to a shortage.

The glut was written about, backed with data, in the major journals just a few years ago.

Now we see predictions of shortage……AGAIN.

So maybe the predictions of shortage are correct this time. Maybe not. We’ve seen the prediction cycle go back and forth, and we’ve certainly seen what happens to doctors when there is a glut, even if just for a couple years.

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