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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Don Hurst who wrote (9809)	9/24/2009 8:31:28 PM
From: skinowski	Read Replies (2) \| Respond to of 42652

Keep writing posts such as that one You know, Don, I try to call 'em as I see 'em. The HMO movement (including Medicare Advantage) was interesting, with lots of experimenting going on. They certainly overdid it with all the bullsh*t preapprovals and precertifications. I think what really shaped the healthcare landscape over the years (since 1985) was the "relative value" system, which in effect turned out to be no less than a government imposed price control regime. The problem with government handing down fixed prices is that they never hit it right. Aways some providers turned out to be relatively overpaid, and others - the other way around. Basically, a solo primary care practice is quickly becoming a thing of the past. I would venture a guess that WRT availability of Family docs and Internists within a few years there will be more of a shock than we now expect. You see, historically older doctors would slow down a bit, start seeing fewer patients, but would continue working - often well into their 70's. Now, these folks will be out of business and retired as soon as they can reasonably afford it. Why? The answer is very simple. Staying in practice is exceedingly complicated - and it doesn't pay. As employees, they have to work too hard. Employers are under the same pressures as private docs, and unless everyone is working their butts off, they cannot make it. Ultimately, this is a reflection of fees being too low... there is nothing that can be done about this. I don't believe that handing over healthcare to the federal government will do much good. We need tort reform, which would be a good first step in fighting the extremely expensive and wasteful mindset of "defensive medicine". To decrease costs further, we need less regulation, not more. We must be spending on complying with regulations more than the GDP of a medium sized nation.