I didn't see the seniors caring about the rest of us at the town-hall meetings. They want their Medicare, but didn't want the rest of us to be able to buy into it. If the public option passed, it would seem $$$$$ would be flying into Medicare. It could have saved the middle class family and small business from the jaws of big insurance while simultaneously breathing new life into Medicare. Oh well. You get what you vote for. Death panels? You betcha!

Just remember you said that when you turn 65 and start looking for a doctor.

Sorry, I've got a long way to go until I reach 65, and you get what you give. Most of the people who were throwing fits and demanding that the rest of us be chained to big insurance were, they themselves, recipients of the very evil socialized medicine they claimed to be so against.

I can't feel sorry for 'em now. If they hadn't fought allowing the rest of us to BUY in and free ourselves of the bloodsucking insurance companies, Medicare would probably be in a lot better shape financially. You'd have young, healthy people, flocking to be able to get the socialized medicine they demonize while simultaneously taking advantage of.

I also find it interesting that many of the people receiving Medicare and Medicaid where against the public option. If that had stayed in the health care reform packing, it would be getting money from younger and healthier individuals who are sick and tired of dealing with insurance companies. Most of the people using Medicare have paid in to it by working most of their lives, but Medicaid is abused by a lot of people on it. It's astonishing that procedures that cost those of us with insurance a great deal of money like to name one childbirth cost next to nothing for people on Medicaid. If anything, make cuts to Medicaid instead of Medicare.

Another issue that will come up is the lower number of people that chose to go into general practice and geriatrics, two medical subfields that treat a lot of senior citizens. One reason is the lower salaries in those fields make it harder for the doctors to pay off their student loans. I know people who either have gone to med school or are thinking about it and they said that those are two fields they plan on avoiding. One said that they don't think they could handle the hypochondriac tendencies of older people and their children who think they know more than the doctors. Another said that they got tired of older people not appreciating how good they have it in the US compared to people in other parts of the world. Their family is from India and he said if they saw how it was there, especially in rural areas, then they'd be more appreciative for the access to state of the art medical care that they have here in both rural and urban areas.

I also think that older people don't make it any easier for the doctors. My grandmother is in her 90s and from how some of my relatives talk, she is a nightmare patient. Her male doctor retired about ten years ago and a female doctor came into the practice. She was assigned his patients, including my grandmother. She refused to go to the woman just because she felt that she was somehow incompetent due to her gender. She was probably a better doctor than her old one was, especially towards the end, but my grandmother could not see past her preconceived notions of gender roles. She also has routinely ignored doctors' advice to quit driving and their suggestions that she hire someone to come to help her around the house. Their suggestions have a strong basis in the reality that she isn't really able to do everything that some of her kids make her think she can do, especially the driving and the fact it's a miracle her house hasn't been damaged by her inattentiveness to kitchen appliances. If a significant percentage of older patients are like my grandmother, I don't blame the doctors if they want to treat patients who pay in full and follow their advice.

I don't have a long way before I turn 65, but I feel the same way as the kids.

F@ck the old people and baby boomers.

They've had many decades of prosperity and they've flushed them down the toilet. They've had nutritional information and they stuff themselves and their kids with crap.

The last two years has changed me. I hope the GOP does exactly what they campaigned on and close down Social Security, Medicare, Medicaid, all VA benefits and every other form of "liberal socialism".

Give the old and boomers exactly what they voted for....and let's see how much they like it...

LU: If they shut down Social Security SSI benefits, food stamps, and other social programs, then it will very likely lead to extreme riots all across the country. Look at the Rodney King incident in Los Angeles, and the part where the cement truck driver had bricks thrown at him. He was nearly beat to death. Think it can't happen again? Don't bet on it. Medicare, on the other hand, is something that the poor would be less inclined to use. Cuts in that program would not be as noticeable as a reduction in housing and cash benefits. There is also Medicaid to fall back on if Medicare can't or won't reimburse. Think about it.

I hope the GOP does exactly what they campaigned on and close down Social Security,

Social Security is a solvent, efficiently run program that has been the major contributor to the elimination of poverty in old age. Accounts of its imminent demise are exaggerated to the point of lies. Social Security operates on a pay-as-you-go basis, and by law cannot contribute to the deficit or be used to fund other programs. Income is based on payments into the system. By any objective definition, it has been a success. If that's socialism, smite me with it.

We need to re-engineer our medical system to look like Canada's. The days of open checkbooks for the U.S are over and we will never see a post-war boon again. Let't get real and move on. Everbody, and I mean everybody will get less wasteful medical care going forward. Doctors, hospitals, drug companies and insurance companies will make less. There is no other way.

For those of you who said screw the seniors take away medicare, Did you even read the article in detail and see that TRICARE, that is for service people and their families is tied directly to medicare? Or are you WE support the troops people all mouth on that issue?

All payments are tied to Medicare, private insurers will not pay more for a procedure than Medicare will, ask any doctor.

The first items to cut should be congress's own chushy retirement and health care plans.

Kelly, I hope you remember your comments when you're as old and difficult as your grandmother. Your unkind comments about the elderly and their families that indicate you have a good start.

LU's comments were clearly meant to demonstrate the negative consequences of having SS, etc killed. Everyone calling out that post as "wrong" is actually agreeing with the endgame.

The first thing that needs to go are the 170 military bases and active military conflicts in Afghanistan, Iraq (say what you want but it's ongoing), Yemen and elsewhere. The several thousand nukes that we maintain that we've deemed to be illegal for most other countries to have. The money you could save from "Defense" alone would far more than cover the entire country with single-payer coverage.

I remember when these cost saving policies were put into place in the 90's. I'm a PT, and that was when we first had to deal with DRG's. As I recall, each diagnosis had a specific number of treatments the patient could receive barring other complications. Many patients were only able to receive six PT treatments though they certainly could have benefitted from more. I hated having to end treatment often before I felt the patient was ready-even though we were forced to make treatment as efficient as possible, which is not a bad thing in and of itself. Also at that time, despite a continuing need for PT's, some were actually being laid off in my area b/c there wasn't enough money to pay them. It must have been after one of those relief bills were passed (postponing the cuts) that PT's were able to be hired again.

Many people have held up Medicare as an example of a government-run system that has worked well, and therefore as an example of what a single payer system could be like in this country. Having experienced Medicare as a healthcare worker and having seen my patients denied needed care due to cost-also having seen needed professionals laid off due to lack of money in the system to pay them, I would beg to differ. This is not simply due to fear for my job. I'm not even working right now due to health issues. This article is talking about policies put in place in the 90's. If something is not done, how will patients get the care they need? So how can this be a good model for a single payer system? Do we all want to be under this kind of system? Most of the Medicare patients I saw had other insurance as well b/c Medicare did not cover all their needs anyway.

I just had a conversation with the othropedic Dr that fused my back and he told me about the pay cut and a law that will make him a felon if he works for cash after compleating the limited number of procedures

Tricare is socialized medicine. Period. You can't say you're against it, then turn around and use it. If it's so bad, then yes, get rid of it for the troops, the cops, the teachers, the garbage men, and the politicians. Surely, they don't want to be socialists, do they?

p.s. I come from a military family, but enough is enough. If the government thinks the private sector is so much better and doesn't care that the rest of us are getting gouged, they need to be chained to big insurance right along with us. In their opinion, it's the better way. Let them walk the walk.

Congress should rethink these cuts to Medicare and rescind them. After all, they already know the resulting chaos and furor that will occur if they allow these cuts to take effect, which is why they’ve deferred them year after year.

Why do they not want to defer these cuts for still another year? Well, the perceived revenue they think they’ll be saving by imposing these cuts is needed to fund Obama care. No one is saying the previous healthcare system was perfect and it certainly was in need of some adjustments but Obama has created a healthcare house of cards which will surely come tumbling down.

for those posters who seemingly don't care if seniors have any health care, just remember, you may live longer than you think.

The seniors have shown they don't care about us. Not one bit.

My physician has posted a sign in his office that "ALL MEDICARE PATIENTS WILL BE ON A CASH-ONLY BASIS EFFECTIVE DECEMBER 1st!" This effectively eliminates all Medicare patients from his practice because 1) that means that Medicare patients will pay his full asking price (even private insurance does not pay his walk-in price) and Medicare will not reimburse the difference, and 2) he full well knows that many of his Medicare patients cannot keep up with the paperwork that is necessary to file claims. (For example, his office will not supply procedure or diagnosis codes necessary to fill out the paperwork.)

I am a "Medicare Part A-Only" patient and will be fined another 1% every month the rest of my life for not participating in Part D the instant I became eligible. I am not sure what he will do with me, but I assume that he will be very suspicious of me for fear that I will suddenly switch and somehow deprive him of his new BMW.

You know, I have never seen a physician in an unemployment line. I do not know of any physicians who have lost their houses during the recession. They tell how they were "starving" on $40,000 a year as an intern and on $75,000 a year as a resident, but I am suspicious that we are talking about having to eat an inferior grade of caviar.

The average "breast surgeon" (there is not actually such a specialty) averages over $450,000 a year. They all claim to make much less, but they don't count the money they put into their PC's investments and 401k's and their income from self-referrals. The average Family Practitioner makes over $250,000 a year and does it without a even college degree --- only a vocational degree and OJT.

These people make huge incomes off the misery of others and whine every time anyone challenges their god-like status. Maybe it is time for us to start looking much harder at physicians reimbursements and perhaps tying them to this country's rank in malpractice incidents or in this country's ranking among other countries in health care delivery or per capital cost of health care.

Yabbut, most of the advice given to her by doctors is for her own good. She has no business being out driving at her age with her slow response time. She thinks that she's able to remain independent and take care of herself, when that's not the case. My father has seen her leave her stove unattended for extended periods of time. He's also scared that she'll kill someone while driving. He's looking out for her best interests, being a good son, not that she sees it that way. I think his worst fear is that one day someone will come by and not have any response from her. I cannot possibly imagine how he would feel if she hurt somebody or died in circumstances that could have been preventable if either someone came to look in on her or if she had been in an assisted living facility.

Maybe when you have a relative in a similar situation you will understand. It's not a situation that I want for myself when I get to her age. I can only hope that I have the common sense to know when I have to stop driving and the realization that I cannot live on my own independently. Some people have those traits and other don't.

I have a fairly simple idea on how to solve this mess. Find out if the person receiving Medicare supports the public option or not. If they support the public option, then they get the full care and their doctor doesn't get a cut. If, however, they reject the public option, then their doctor only gets the correct cut price, based on 1990s value as Congress originally intended.

As I said a long time ago, it is not true that only 20% of the US are of the liberal persuasion. 100% of Americans are liberal when it comes to their own unemployment, their own social security or disability or their own medicare. People only suddenly become fiscally conservative when someone else is in need.

My husband, age 65, recently began getting his Social Security check. I took his statement, added up what he had paid into Social Security plus his employer contributions. That amount of money totals 11 years of payments before he starts using "the younger generations" contributions. The majority of people on Social Security are getting monthly refunds of THEIR money.

The Mandated Universal Health Care Reform legislation is junk....PERIOD.

Forget about what Mr. Obama and his cronies have said about "his" landmark legislation. Makes one wonder why Mr. Obama continually discusses "his" pet bill even after it passed LAST YEAR. I suppose the more we hear how good it is, then we will think it is all good.

Yet, his Administration is giving "waivers to the legislation" to companies. Now why did they do this ??

Yep, cut $ 500,000,000,000 from the Medicare program but make sure you cover your political base (company waivers) for votes.

Oh, I wonder how the Death Panels figure into this mess. Wait, this Administration has stated there will be no Death Panels. Someone going to say this is a conspiracy theory ???

re: seniors can't find a doc...well neither can the 40 million plus uninsured that are viable, healthy and work where insurance is not offered. Not to say seniors aren't viable, but they have reaped far more benefits than they ever paid into...did anyone really think this would not eventually bankrupt our country one day??!! Not to mention Social Security...me and my children and future generations will work until they die unlike the many seniors that have been retired 20 years plus. That generation has it made and never will there be any like it...early retirement, free healthcare, etc. And as far as "death panels" why should half a million be spent on a person's last days when God did not intend for a body to live to be 300 yrs old. We must be realistic. My father died and could have raped the medicare system demanding life support etc., but he was realistic that it was "his time."

You know what really chaps my ass ;-)

Make a office visit appointment at 2pm get there 10 minutes early and wait 10 minutes NOPE.. how about 2 hours! I make $45 an hour, thought about billing the doctor for that two hour wait.

Ido -The Medicare payment cuts to doctors have NOTHING to do with the healthcare reform bill. Really, did you even read the article?

The cuts were passed in legislation in 1997 (by a Republican Congress), and called a "sustainable growth rate" payment schedule. They've been put off repeatedly due to the fact that it was short-sighted legislation (does "cut spending but not worry about the consequences" ring a bell?)

For a good explanation of how the GOP got us into this mess, read:

Newsweek: Why Medicare's 'Sustainable Growth Rate' Isn't

You know, the GOP depends on the memories of people like you to stay in power.

Many people have held up Medicare as an example of a government-run system that has worked well, and therefore as an example of what a single payer system could be like in this country

Medicare is not a single-payer system. It is a public-private partnership based on payroll taxes contributed by employers and workers, then distributed by the government to mostly private entities. Moreover, it focuses on care for the aged as opposed to the general population. (This difference is profound in terms of how health care dollars are allocated.)

The prime example of a single-payer entity in the United States is the VA, and even that doesn't reflect the policy choices of most single-payer countries, which emphasize prevention via public health and primary care.

Cathy,

If you are going to do that sort of calculation, you have to 1) factor in BOTH the employee and employer contributions and 2) adjust the figures for inflation. I am 67 and am still shocked at how small an amount I earned (and was proud of) 50 years ago. But if you do even a cursory annual inflation adjustment, I wasn't doing that bad when you factor in 50 years of inflation.

My guess is that you will end up, if you do the math right, the same as the originators of Social Security predicted: The amount paid in will fall 1-2 % short of the life expectancy. The reason for this discrepancy is an increasing end-of-life life expectancy that has taken health economists a little by surprise. The overall anticipated shortfall was supposed to be around 10% when you factored in disability, ADC and other Social Security programs (excluding Medicare.) This shortfall was intended by the originators to be made up by the federal government out of general revenues. They did not anticipate that the same federal government would BOTH raid the trust fund and spend it as general revenues and then be so broke that they could neither reconstitute the trust fund NOR make up the shortfall as intended, let alone do both.

Citizen K,

Good post!

And I would point out that the overheads reflect this as well:

The VA has about a 2.4% overhead because many of the physicians and other providers are employees.

Medicare has about a 3% overhead.

Private insurance and treatment is difficult to assess with any real precision but all health economists agree that it is significantly more than 30% overhead.

if all of us get together and vote out medication, education, incarceration and defence we will do just fine.

Cathy-2024405 1.22

Plus interest! Your husband contributed 11 years worth of payments but counting interest on all that money he should be able to receive social security payments for well over 20 years before using any of the so-called “younger generation’s” contributions.

Why interest? Consider if instead of social security you simply put the money into CD’s or some other safe investment. After all those years you would have a sizable amount of money in excess of the original contribution.

If the mindset is that you only get back what you put in without any interest, you may as well just put the money under your mattress.

Chris,

WHERE do you get the idea that family practitioners have no college degree, only vocational degrees and on-the-job training?

I appreciate my doctor, and the hard work and education that it takes to become an M.D. I am just not sure that obtaining any particular degree should mean that every one that obtains it becomes a millionaire, or that Congress should be looking for ways to "protect" that right. And I know someone is going to say that they don't. My response to that is that there are 9 MDs teaching at the University of Utah School of Medicine, a State operated school. They all make more than a Million Dollars a year.

The days of rural doctors accepting a few chickens or a side of beef for payment disappeared with the house call. And I understand that is progress. The real sad state of doctor medical billing is that those who have insurance, any insurance, have their payments cut significantly by the insurance companies. Those who have insurance see these cuts listed as "adjusments" on their bills. Sadly, those who need these "adjustments" made the most, those without insurance, pay more gross for their medical bills than someone who has insurance.

The only cure for injustice in medical costs is to take away the medical coverage for all government workers, including all of those elected to any office, and require a national health insurance plan. If Congress won't give us their insurance plan, we should insist that they be on our insurance plan.

Thanks, Chris.

Speaking of efficiencies, single-payer programs are the most efficient in the world. Rather than court national bankruptcy, they save money hand over fist. In 2009 -- a tough economic year by any definition -- Norway ran a budget surplus (in fairness, Norway has a nationalized petroleum industry), Sweden's deficit was less than 2% of its revenues, and Denmark's and Finland's were less than 5%. The US deficit in 2009 was 28%.

he population is uneducated about the cost of benefits people receive from Medicare. It is not free as many younger people believe. Although there is no charge for Part A coverage, which is for hospitalization, that is of little use without Part B, which covers doctor charges, and we know you can't get hospitalization without a doctor. There is a standard charge for Part B which is fairly reasonable, but it only pays 80% of what is covered and not everything is. That 20% as we all know can financially bankrupt any middle class or lower income person. So many pay for a private supplemental insurance to cover that 20% and that not only doesn't come cheap, it keeps increasing same as any other private insurance. Then there's Part D, prescription drug coverage, which even if you're fortunate not to need it, if you don't sign up for it at 65 when you're eligible, you pay a substantial penalty later if you do need it and sign up and that penalty is permanent. So, let me assure you, everyone, Medicare is not free any more than any other insurance is. It's true it's a windfall for people who are financially well off, but it's still a huge expense for older people who are not.

Medicare has about a 3% overhead.

Private insurance and treatment is difficult to assess with any real precision but all health economists agree that it is significantly more than 30% overhead

That really isn't true at all. First, only a few extreme people use 30% for private. Most say that they fall between 12-22% with an average of around 17%. Also consider that state tax on premiums also get reported as overhead which account between 2-4%.

As for medicare, the 3% that they report only includes the costs associated with reimbursement, mainly the wages/salaries of people who collect incoming money and those responsible for payment. That means that higher level salaries within CMS, utilities, rent/property purchasing, most legal expenses are not counted as overhead. If you factor those in, the overhead now becomes 6-8%. And on top of that, you also need to factor in the costs of legislature creating policy, both their time and whatever consulting they pay for, which then brings the overhead closer to 10%.

From that standpoint, CMS isn't so much better than private. However probably the biggest thing to consider is demographics, CMS is mostly for older and disabled patients which means that on average you have a substantially larger payout per diagnosis per year than you do for private because they tend to have chronic conditions. So you have a higher volume of reimbursement for the same overhead which helps to deflate the overall overhead numbers CMS comes up with.

So what everybody should be doing is comparing the overhead costs per patient and not per volume paid. When you do that, most experts calculate that medicare has roughly 30% higher admin costs per patient than private insurers do.

This post is not to advocate one side or the other, simply to educate on this aspect. Numbers tend to lie/mislead when they aren't put into context. You really need to look into how they get the numbers. The 3% and 17% really are apples and oranges.

Mitchell

Citizenk
Actually Medicare IS a single-payer system and the VA is "socialized medicine" (according to the original definition), also a type of a single-payer plan in which the government owns healthcare resources and employs the personnel. However, the term "socialized medicine" has been usurped by the neocons and the tea party and is so convoluted now that its hard to be sure , short of asking someone to define it, what they mean when they use it !
The main difference between the two is function. In single payer plans one provider pays for healthcare services without necessarily providing the healthcare it pays for. In the example of Medicare, it pays for services provided by private practices, In socialized medicine (again using the original definiton) there are no private doctors. The VA doctors, for example, work for the Government .

PNHP (physicians for a national helath program) defines single payer this way...
Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or "payer." In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs.
www.pnhp.org/facts/what-is-single-payer ·

wikipedia offers another great definition of single payer including this...
The term single-payer thus only describes the funding mechanism—referring to health care being paid for by a single public body from a single fund—and does not specify the type of delivery, or for whom doctors work. Although the fund holder is usually the government, some forms of single-payer employ a public-private system.
en.wikipedia.org/wiki/Single-payer

As you've indicated, one reason single payer for all citizens would be less expensive per capita than medicare is now is because the population provided for would be at an overall lesser risk level than the limited group that currently receives medicare coverage.
(Imagine the rates for car insurance if the only people that had to carry it were substance abusers, teenagers and elderly drivers.)

Why are you blaming the snake oil saleman?

Look at all of the fools standing in line instead of caring for themselves through diet and exercise.

Your statement shows TOTAL ignorance !! Do you know how many years it takes to become a physician? Do you have any clue how much debt a doctor has coming out of medical school? Do you know that it takes most doctors 20-30 yrs. just to get their students loans paid-off from medical school costs? It's like having 2 mortgage payments each month...one on your home and then one to pay toward your student loans. If the reduction in Medicare payments does happen....nobody on Medicare will be able to find a doctor to take them as a patient. And, DON'T blame the doctors !! They have to make a living, pay their bills, pay their employees, pay their student loans, etc.

No one on Medicare will be able to find a doctor???? That's the big scare??

They have the option of PAYING FOR IT THEMSELVES.

There's not going to be a doctor's shortage, the number of doctors will remain the same.

But some will dump the government programs, which will make it nicer for the rest of us. And other doctors will continue taking the government programs and find a way to make a profit, probably by herding them in like animals.

Look at all of the fools standing in line instead of caring for themselves through diet and exercise.

At ages 40 and 50, a human's metabolism slows greatly, making weight loss difficult to impossible unless you have the time to exercise regularly and have favorable genes. Nearly three-quarters of medical care goes to people over 65. Vigorous exercise at the level needed to maintain weight is not an option for most of them.

They have the option of PAYING FOR IT THEMSELVES.

Not in any meaningful sense. The expenses of medical care in old age are well beyond almost everyone, and will become even more so as medical expenses rise and real income levels remain flat, which has been the case for about 30.

When you turn 65, take a look at your savings account and IRA. Assume that one instance of major cardiac surgery or cancer will wipe them out or come close to it. (Because, unless you are wealthy, either likely will.) Add in the likely expenses of additional health care induced by the aging process. At this point, you will have an option: Do you want to purchase medical care for a significant disease condition or eat?

the politicians taking $500 billion from medicaire to fund their "obama care" is the cause of this. and the major cost to doctors is malpractice insurance , which is driven by all the ambulance chasers on TV with the commercials. dem congress refused to address tort reform. so the problem here is the misguided liberal congress and administration. when the doctors decide to refuse to take any insurance because of low payment and require up front payment, how many will be happy with reform and big government. no government can make doctors treat patients.

I am 60 and agree with 1Devon and the other kid, all those old blue hairs screaming about "socialized medicine" while taking advantage of socialized medicine were just old hypocrites.

We all pay into Medicare but once the care you receive exceeds the payments paid, you are on "socialized medicine" because younger workers paying premiums are paying your bills. Allowing us to pay premiums in the "single payer" Medicare/Medicaid instead of outrageous premiums to private insures would have been the best and simplest fix. but NO.

You voted to screw all of under 65 with no private insurance, so don't come whining for help now, it is falling upon deaf years.

And while we are on the subject, your COLA is NOT paid when there is not an increase in inflation, so quit screaming about something you are not "entitled" to!

Otherwise, I suggest that GOP actually means Greedy Old People!

LU - physician shortage is based on number of patients increasing aka demand increasing because doctors are now saving more lives and our population is increasing. So yes the number of doctors will be the same but there will still be a shortage of physicians. Get it? Come down to a family medicine clinic in any city and you;ll get it better

Unfortunately, your right about the attitude of entitlement from physicians who are more interested in accumulating wealth than in advancing their field of practice. What difference does it make to this physician if she loses money from a cut in Medicare payments or from the self imposed refusal to treat Medicare patients? She's going to take a hit either way. Doesn't she, like everyone else in America, have to contribute to the economic recovery by making sacrifices like we've all had to make? She is functioning in a system devised specifically by the AMA to limit the supply of doctors therefore keep demand for doctors and their fees high. Well, the consequence of an artificially limited supply of doctors, a monopolistic practice, for the sake of increased compensation is that you threaten the system from which you are extracting excessive income. The greed based medical practive then has painful consequences for Americans in need of medicical care. Instead of whining about her loss of income, this physician should be actively working for a reform of a medical provider system that's dysfunctional and ridiculously expensive. We need more physicians, less cost, and higher quality medical outcomes.

....or, if you are upset that the best and brightest of this country compete hard for top spots in medicine are not your type - head over to the Caribbean, they will "fix-ya up good". I hear only $5 for a cranial lobectomy - ill front you the cash.

Right now "the brightest and the best" are often not choosing not to go into medicine b/c it's so hard to get through med school and residencies, etc. then you have to pay off all your debt and your malpractice (and you can lose a case even if you have done absolutely NOTHING wrong); and for many it's simply not worth it. They have to stay up all night to be on call, go in early for rounds before a full day at the office, and see 30 or so patients a day-many of whom scream at them for being kept waiting, not knowing the dr may have had an emergency early that morning at the hospital with a patient that made him late for the entire day and that he is desperately trying to catch up but that he wants to give his patients their time. Many doctors I know are urging their kids not to go into medicine. Also, doctors are getting out. Some are deciding that medicine has changed so much that they don't recognize it anymore, and they don't like it like they used to. So yeah, I think there will be a shortage of doctors in the future. How do I know this? My brother's a doctor. I also know other doctors-I'm in the field. I can see with my eyes.

I am a physician assistant, so I see it as well. The answer is single-payer, and government-funded medical training. I agree that physicians should be compensated for their sacrifices and time, but some are just plain greedy.

If they feel they are not making enough money, they should go into banking and the corporate world. At least it is more intellectually honest.

We can either go to single payer, or start bringing in more foreign medical graduates. Many of the Indian physicians I work with are top notch, and didn't go into medicine in an eternal quest for wealth, i.e., McMansions and Mercedes.

While I agree that some physicians are greedy, there are a lot easier ways to make money. And being a doctor just isn't all that profitable anymore except perhaps in certain specialties. It takes a lot less schooling to become a lawyer and you can even charge for phone conversations, which you can't often do as a doctor. Being a lawyer pays well in a big firm and you don't have that huge debt to pay off (not as huge, anyway) or the malpractice or-in a big firm-your own insurance, staff, etc. They do work hard and long hours, but they can bill for them. How do I know this? I had three lawyers in the family. One of them even used to tell lawyer jokes.

the politicians taking $500 billion from medicaire to fund their "obama care" is the cause of this.

Actually, if you had bothered to read the article before commenting on it, you would have found out that this problem started in the 1990s and has nothing to do with Obamacare.

Step into this doc's shoes and go to medical school and bust ass like she did to see if you don't deserve more than others. I work in the medical profession and know how hard they work. Until you walk a mile in their shoes, quit bashing their life style!!! They deserve it. What has happened is the oldies that use and abuse the system like my mother-in-law that goes to a doc every time she farts or doesn't fart---literally! They have referred her to a psychiatrist after every orifice was scoped and nothing was wrong and she won't go the only doc that can help her hypochondriac self. As a dr. on our ethics committee stated, medical futility is such that if it is explained that it will come out of your pocket, we all know what the decision will be!

My doctor told me once that he did not take home a paycheck at all that month because he saw too many Medicare patients and all the reimbursements only covered his office overhead.

This is a man who still makes house calls, works nights and weekends and takes the time to truly evaluate every patient when they come to see him. I don't believe that most primary care physicians are living high on the hog seeing publicly-funded patients.

It seems to me that the "real" moneymakers in this country (investment bankers, insurance executives, etc.) do a good job of keeping those of us at the bottom fighting among ourselves to take a few scraps from each other while they waltz off with the lion's share.

Don't believe me? Here's a great article:

Focusing on health costs: A close-up look at health CEO salaries

[T]the average nurse in Florida earns just under $63,000 a year.

The average family practice doctor? According to PhysiciansSearch.com, for those in practice at least three years, it’s around $150,00 a year.

The average OB/GYN? $250,000.

The average cardiologist? $317,000. So what about the executives? HCA: Richard Bracken, the CEO of the largest hospital chain in the nation, earned $8.89 million in 2009.

(These figures included salary, bonus, restricted stock grants, pension and deferred compensation plans reported in the company’s proxy statement, Modern Healthcare said.) About 62 percent of HCA’s admissions’ are paid from tax dollars, ie Medicare, Medicaid, and managed Medicare and Medicaid programs, the company reported to stockholders. Privately insured or uninsured patients made up the rest.

Tenet Healthcare: CEO Trevor Fetter earned $6.8 million, including the same extras. About 47 percent of Tenet’s admissions are paid with tax dollars.

UnitedHealth Group: CEO Stephen Hemsley made $7.46 million in annual compensation, plus he exercised stock options worth $98.578 million, for total compensation of more than $106 million.

Cigna CEO H. Edward Hanway earned annual compensation of $17 million, and exercised stock options worth just under $1 million.

Humana CEO Michael McCallister earned $3.1 million, with exercised stock options worth more than $11 million.

Aetna CEO Ronald Williams earned $8.17 million, and exercised stock options worth more than $5.4 million.

WellPoint CEO Angela Braly earned $9.1 million and exercised stock options worth more than $1 million.

Is any one of them worth more than my doctor? I don't think so.

Until we get serious about where the money's REALLY going, things will only get worse.

The old "education" is so onerous argument that physicians fall back on is truly bogus.

1) An MD, like a JD (the degree most lawyers have) is not a college degree like a BA or a BS. It is a vocational degree and is granted by a "school", not a college or university. It is NOT the equivalent of a PhD which takes MUCH LONGER to earn.

2) Interns and residents are well-paid. I'm sorry that it is not the $250,000 that they are told they would be earning as soon as they went in to practice, but when I went into the service they paid $98 a month. How is that relevant to what I make today?

3) This country leads the world in malpractice incidents. Medical malpractice (not just physicians, but including the whole for-profit establishment) is the fifth leading cause of death in this country. It is not even in the top ten in any other country. And all physicians can talk about is "tort reform" and how unfair their malpractice insurance is. In fact, most states have already implemented tort reform and it has helped malpractice rates go even higher in those states. And lawyers pay almost exactly the same malpractice rates as physicians. (Most physicians do not even pay for malpractice insurance --- it is carried by their employer.)

4) Like the physician in the article said --- "it is a business." Except that it is a business where you are guaranteed to be successful. Have you ever seen a "Going Out Of Business" sign at a physician's office? But as a business, it is the physician's job to give you the least possible service at the highest possible price, just as with any other business. This may be a good business model for Starbucks, but in health care it guarantees that we have the 37th ranked health care system in the world.

So physicians can cry and whine all they want. I will listen when this country is #1 in health care. I will listen when medical malpractice is NOT in the top ten leading causes of death. I will listen when physicians are paid consistently with others with the same degree of education and training. I will listen when they stop lobbying against their patients. I will listen when office visits start lasting longer than 3.5 minutes average. I will listen when unemployment among physicians starts nearing 10%. I will listen when physicians mansions start getting foreclosed on. I will listen when physicians are required to disclose all their income from sources that are potentially conflicts of interest. Maybe then I will listen. But until then, physicians can take their arrogant "society-owes-me" attitude and tell it to each other.

Chris,

Most MDs got a BS before they ever entered med school. You do know there are classes you have to take before you are admitted to med school, right? It is MUCH harder to get an MD than a BS or a BA. No, it is not equivalent to a PhD, but it can take just as long to earn. BS, then master's, then PhD usually take 8 years; BS then MD also take 8 years. And then MDs do residencies.

Chris, where in the world did you get your info? Students can't even go to med school until after college (some very special programs compress it slightly by one year, I think) and even then it's very hard to get in. Med school itself lasts 4 years and is very difficult academically. It also is part of a university. The med school students I knew didn't have time even to date. Then, as stated above, they have internships followed by residencies. Maybe you are talking about some other kind of doctor b/c you are not talking about MD's.

lol i think chris made a new record of being wrong about everything... but with unusual confidence

Well, doctors DO have to get a BS or BA before going to medical school (and of course Harvard Medical School IS a university, too, even though it's called "School".)

Unless you're Rand Paul, of course, and can get in on a legacy.

Chris, malpractice is not the 5th leading cause of death. Don't use lawyer sites for that information. They only reach 10th if they count every single case of hospital acquired infection are counted as malpractice. The reason no other countries lists it anywhere close to the top 50 is because they specifically don't count all infections as malpractice.

Also, the US is top 5 for the quality of healthcare, the stuff you read about the US being 40th in overall health or infant mortality is because the US enjoys the worst lifestyle for health and fitness by far of any other industrialized country. No amount of quality healthcare can make up for it at this point.

I think Dani is on to something.....

Mitchell

Agreed, Mitchell.

Also, infant mortality will be higher in the US due to the number of preemies born alive here who would have been stillborn in most other countries. These babies have serious health problems and are more likely to die in their first year of life, skewing the statistics to make infant mortality rates look worse in the US. Also, in some countries, a baby who dies in the first 24 hours of life is never reported as having been born at all. These factors inflate our infant mortality rate, and deflate others'.

To those who think the doc's are filthy rich... please get over yourself. Most doctors, pa's and nurse practitioners are are working themselves to the bone, mentally and physically, for pay cuts EVERY year while they try to take care of this increasingly litigious society. I am a doctors wife and a nurse practitioner.... we do not own a Mercedes nor a home in the Riviera. We deserve to make a living just like every one else. We go to work every day knowing that IF we make a mistake it may cost a life, our reputation, and our livelihood. We all went to college anywhere from 6 to 15 years POST high school and trust me when I say we don't get paid anything like big corporate executives BUT we do deserve to get paid!!!!

Unfortunately, it is a business and has to be ran as such. Otherwise, you would not have an office to make appointments with.

STOP ATTACKING THE HEALTH CARE PROVIDERS! MOST OF THEM ARE LEGIT BUT ARE NOT GOING TO CONTINUE TO TAKE THE ABUSE FROM THE GOVERNMENT OR FROM THE VERY PEOPLE THEY ARE TRYING TO HELP.

Mitchell
You are comparing apples to oranges. Another reason a country can have some of the highest quallty of healthcare and simultaneously some of the worst results is the problem of limited access. The best healthcare in the world doesnt help someone who cant afford to pay for it, or whos insurance company denies access to it.
What we have is a fifth place rating in healthcare quality for the wealthy , well connected or insured (and even then only at the whim of the insurance companies.)

It must give you a good feeling to be so stupid and critical. My doctor charges $175 for a visit - he gets $33.87 from Medicare. He has a staff of 3 people, never rushes you out of the office, returns phone calls the same day, and visits you in the hospital - even if you are there for something other than his specialty.

He starts his day at 6 a.m. visiting patients in the hospital, sees approximately 25 - 30 patients in his office, and ends it after going back to the hospital around 6 - 7 p.m.

I begrudge every penny of the $33.87 he gets.

Like I said in another post... I have lived on $12,000 a year before, and it wasn't very hard to do. I don't even know what I would do with $75k a year! That would last me like 5 years and I could even live pretty comfortably. They are greedy. Doctors here are paid more than in any other country I know of, and they are all about the same quality. So what if they reduced their incomes? Maybe it's time that a person becomes a doctor to help people, not because it's one of the highest paid jobs.

Wow. Try living on 12k a year when you have to pay 12k a year just for your student loans. Oh, did I mention that I also pay for my own insurance for my family. Thats another 13k a year. What about the gas my 2007 altima (read:not lexus or mercedes) uses to get me to to the ER's to see patients that are here undocumented or have no insurance and no means to pay...that gas is about 6k a year. My mortgage on my townhouse (read: not a mansion) that is 24k a year. Oh and that silly little thing about being compensated for spending my ENTIRE young adult life studying to help people and be proficient at it. I guess that counts for nothing. When the rest of those that make 12k a year were out partying in high school or college, I was studying. I guess it would be unfair, even greedy for me to be asked to be compensated for that sacrifice. I guess I am greedy because I want to be compensated for the stress involved with treating human beings and, often, having their life in my hands. Many people don't blink an eye spending $40 for case of beer and a pack of smokes but how dare I ask for a $40 copay. Your comment is beyond assinine and ignorant. And if the doctors here are "about the same quality" as any other country you know of, ask yourself if you would want open heart surgery or cancer treatment in mexico, iran, russia or the United States.

Firstable, I am married, I work 40 hours a week, go to college 3/4 AND have a baby... My HS GPA was 3.92 and took A/P tests and got the best grades of those classes. So that I made $12,000 last year and lived ok does not mean I was out partying, in fact I do way more than most people my age. When I said "about the same quality" I meant with 1st world countries. You just put 3rd world countries. Evidently the care is not going to be the same then, but comparing the USA doctors with European doctors, yeah, they are about the same. I understand you have expenses and blah blah, but that does not mean that paying you 200k a year is acceptable. Of course a doctor should earn more than a mechanic, but again, I feel that doctors here are WAY overpaid. You really can tell me you won't be able to live VERY VERY comfortably with 100 k a year? I don't know how you spend your money, but the way I spend my VERY low income in comparison to yours, it still allows me to have housing, bills paid, toys bought and food brought home.

So, SpanishChick, I assume when you've finished with college you'll still find $12,000 a year an acceptable amount as your income. After all, you yourself said you can live OK on that amount. You don't really expect to be rewarded for your hard work and sacrifice, do you?

Where do you live with an income of 12000? In new york you cant even pay rent in a studio for that much. And just because you lived on it doesnt mean that someone going to school for 8 years, barely sleeping and training their life off to help people have to earn that much. Im sure people who earn nothing in africa still live a comfortable life. You should be ashamed of taking 12000 for the same

SpanishChick - Not sure what part of the world you live in, but I live in NYC and 100K a year makes you middle class - not a life of luxury. At $12K a year I'm certain you pay minimal if not any taxes. Please know income tax alone lowers your $100K salary to $70K. In NYC, you'd be lucky to find a 2 bedroom apartment in a low crime neighborhood for under $2K a month - so $24K a year for housing alone. You should get the picture at now how basic expenses add up.

As for these doctors, costs for office space, staff salaries, equipment, $100K premiums a year just for malpractice insurance and 20 years of student loans from med school add up. Hard work should be rewarded. I mean we live in a country where ballplayers make $20 million a year, yet cut salaries of people who save other people's lives.

Do you even live in the U.S.? If you do - at $12K a year you qualify for MANY government programs since you'd fall under the "extreme poverty" income level. Do you collect food stamps, medicaid, healthplus, housing assistance, tuition financial aid? I can also see living on $12K a year if I had the govenment paying those bills for me.

SpanishChick, I doubt you pay 100,000 a year for malpractice insurance alone, have minimum of 150,000 to 200,000 in school loans to pay off, work well over 40 hours a week, pay for all your own medical/life/other insurance, and pay for a full office staff and equipment as well as overhead costs including rent. While you may not party, you likely get out more than a medical student, intern, or resident does during their schooling-I doubt you had to be at work for more than 24 hours at a stretch, for example. I doubt your work day begins at 5am and ends at whatever or that you have to stay up all night for work. (Doctors have kids, too, and are even mothers.) Is it so much to pay these men and women some money?

TRin PA, I work with many doctors who are far more humble and don't whine about their sacrifices. And FYI, medical tourism is growing by the year. Patients are going to India for heart surgery, because they can't afford the ridiculous cost here.

I am sick to death of hearing how "superior" our system is here. If you can afford the best, it is great.

But then again, I work in oncology, and see every day that when the good Lord has your number, you're going no matter who your doctor is. Just ask wealthy people like Jackie Onassis.

I only "whine" when people call me greedy and motivated soley by money. The problem is, I shouldn't have to defend my pay. Do you? Do 325$/hr laywers, do mechanics? Why is it that we do? I am not in medicine to become monetarily rich. If I wanted that I would have been a lawyer or run for public office.

You don't know me. Making the assumption that I am some whining, egotistical physician is ignorant. I am having a discussion on a public forum, but yet you personally attack me. That is uncalled for.

Second, I never mentioned that the care in the United States is superior to other countries, but I should have because I think it is.

Lastly, doctors are not the ones driving up health costs. If you work in oncology, you should not have to hear this from me.

TRinPA speaks the truth. Well said

I'd assume SpanshChick is not paying student loans. Matter of fact, if you're still in college you're almost certainly still LIVING off student aid. And unless you're just not counting hubbie's income, you'd also probably need a free place to live - still at Mom and Dad's, maybe?

Oh, and your story doesn't add up, anyway. Even at minimum wage, if you're really working 40 hours a week you'd be grossing $15,080 a year. (And if you really were living off $12k a year, you'd know that little fact.) My guess is you're a male Tea Party troll of around 54 who makes way more than that.

Ok, let me clear some points. I said last year we made 12k, not that I was still making that... now I make about 20K because finally I was able to find a better job that allows me to work 40 hours a week. I live in Kansas, if that makes a difference. I pay 450 for rent (3 bedroom apartment) and about $300 utilities, but that's because I don't have cable TV... I pay for netflix (instead of $60/month, only $9/month). And I don't buy organic chicken, I buy normal chicken. My point is that a lot of people think you couldn't make it in a very low income, but you can, you just have to be selective about what you buy. Imagine if we made it with 12K, how rich I would be with 75k. I wouldn't even have to work in years.

By the way, I also think that colleges here are overpriced, and that's not just my opinion, but lots of American people I know too. I think maybe we just need to change a LOT of things. If colleges weren't so expensive, maybe doctors wouldn't complain about making 100k a year (LOL) and maybe if the insurance companies didn't charge ridiculous amounts, maybe the doctors would be able to make their rates cheaper too (for me to pay $300 a visit is absurd), which would mean that people would actually be able to go to the doctor when they are sick and pay for it themselves.

I will pay my student loans once I'm done with college, that's how it works. And umm... actually I have no family here but my husband and daughter. My mother and father are in different countries, so yeah, I don't have family support.

One las point - I DID say that doctors should earn more than mechanics, I just said that how much they are making is WAY over what I consider a doctor should be making. I guess since I have lived in a very tight income before, I don't understand how someone can't make it in 100k a year. That's a joke to me. I'm not sure if it's because of your giant house, with the vaction home, and the vacations you take to difefrent places, and the boats you might have and all that good stuff... If we were all to live a simple life with just a few pleasures now and then, we could ALL make it with 100k a year and have left over.

Spanish Chick,

There aren't a whole lot of places where $450 per month will get you a 3-bedroom apartment (except for HUD).

We have something here for very low income people, so they can find a house and have it for very cheap (I'm talking $100 a month rent). My house is not that, it's regular price.

Spanish chick, You are not going to see any doctor in this country eligible for reduced rates on housing. You need to become Americanized if you are going to live in this country. Good luck.

And Spanish chick, Why would doctors and their families want to live in low income housing. Isn't one of the major points in becoming a doctor to be able to take care of the family in an accustomed manner???

I don't understand how someone can't make it in 100k a year

That's a joke to me. I'm not sure if it's because of your giant house, with the vaction home, and the vacations you take to difefrent places, and the boats you might have and all that good stuff...

SpanishChick, you obviously aren't listening. There are doctors I know who pay at least this much for malpractice alone. There would be nothing left to live on. They couldn't even eat.

I know an OB/GYN who moved here (VA) from KY. When I asked him why, he said his malpractice insurance was $120,000 per year. This is without ever having had a malpractice suit against him. So at $100,000 per year income, he couldn't even pay that one bill, let alone eat.

Yes, now doctors find that rural people do not often sue. They come here with a government incentive and they are not sued. Makes sense to me.

Actually, betty j., the part of Kentucky he moved from was fairly rural. That's what started our conversation; it was close to where I grew up in WV. The thing is, he had never been sued; his insurance rates were that high with a clean record.

I think you're missing Chris' point. But why don't we just concede that anyone with an advanced degree of any kind works hard for it.

Doctors are underpaid compared to CEOs and Wall St bankers. So are teachers, police officers, soldiers, and just about every one else in a political economy that defines its success in terms of how well-off its wealthiest citizens are as opposed to the overall standard of living.

Re malpractice, about half of the money spent on lawyers and settlements winds up in the pockets of the plaintiffs. Nonetheless, it is their sole outlet in a health care system that demands an increasing financial contribution from them while yielding little in the way of usable outcomes with which to make decisions about their medical care.

For example, suppose I need back surgery. My PCP refers me to the hospital in his provider network. The surgeon commits an non-negligent error during the operation and I have to deal with pain management issues for the rest of my life. My insurance will cover some but not all of the post-op expenses; since this happened before the ACA, every reimbursement they make counts against my lifetime limit. The breaks of the game, right?

Except that no one told me -- and I couldn't find out because the measurements aren't public -- that my hospital rarely performs a procedure that the community hospital in my area performs all the time and with great success. The lawyer I saw subpoenaed that information and thinks I have a malpractice case. By now, the only person I trust is him. I sue because my back is killing me and because I've lost faith in the health care system to look out for my interests.

Now, a consumer-friendly system avoids this situation. In a truly consumer-friendly environment, I can seek the best possible option and my insurance company will pay for it whether its in my plan or not. The information I need to make the best choice is not only available, it's readily available: I don't have to tease it out of the system.

Create an environment like that, and the amount of malpractice suits will drop.

Yet even with a 23% pay I bet that doctor still makes more than 10 times what I do.

But I'm supposed to feel sorry for her? Yea not gonna happen.

No, we're not missing Chris's point. He has stated several times that doctors are using their high degree of education to justify their incomes and tried to say they are less educated than they are. In another post, he said family practitioners do not have college degrees, when they actually do. His point is to justify paying them less, and he is trying to justify that with false information.

Actually, in the case of most surgeries, the surgeon will tell you whether they perform that particular type of surgery often. You just have to ask. My sister was referred for back surgery to a surgeon who did spinal surgery often. Her insurance wanted her to go to a general surgeon who did no spinal surgery. She fought them and they paid for her to go to the original surgeon. BTW, most PCP's know which specialists are the best at particular treatments, and refer accordingly. They may not even know what hospital or specialist is in-network for a patient.

Just ask. Be proactive with your health care. To get the best, you may have to go out-of-network, and pay accordingly.

Has anybody noticed that health insurance premiums keep going up and provider reimbursements are going down? Any idea where the difference is going?

Second that,

Very good question.

Has anybody noticed that health insurance premiums keep going up and provider reimbursements are going down? Any idea where the difference is going?

Volume of services provided. Mostly for more tests, be it defensive medicine or patients demanding them, and also just more doctors visits on average. More and more people go to the doctor for every little sniffle they get, especially those with children.

So on average, the costs per patient per year have gone up.

Mitchell

While it is true that patient costs to include premiums are increasing, the amount paid to providers to include doctors remains fixed by the govt. with very possible decreases in Medicare reimbursement. The money is not going to the doctors and other healthcare providers. Quite the opposite it true.

In certain instances where HMO insurance is accepted, the practice is probably subsidizing patient care in all likelihood. Overhead costs are increasing as well.

There is a physician shortage already in Primary Care particularly in rural America.

Then rural America should start voting to support their interests and stop voting to support Glenn Beck's. You want small government? Good luck finding a doctor, teacher or someone to clean up that toxic mess at the agribusiness poultry farm down the road.

Medicare and Social Security are still the third rail as far as the politicians are concerned and the ones that don't know that will learn very quickly.

I live in a small community in what you would call rural America and I have never supported Glen Beck, Fox News, Tea Partiers, Republicans, or any other entity that does not value the worth of a working American. I also respect the elderly, assume they will have and should have Medicare, and pay whatever I need to through a budget to pay for my health care. My county usually always votes Democratic because we believe in Human Rights and different values. However, this election there was not much to offer so it seems my whole state went Republican. Rural America gave Obama a chance, and we are still willing to give him a chance if he can pull through and give us what he promised. I also have some of the best doctors in the country. They will do whatever they can to help their patients within reason. They do not advocate unneccessary medical procedures to appease the paranoid.

Great idea James. I'm sure you get up in the morning and go to work for free, right?Heck, I bet you're rushing out right now to enroll in medical school. I'm sure you made all the sacrifices and busted your butt so you have the grades to make the cut, right? And the $200,000 plus you'll have to borrow to get thru medical school, you can start paying that off with a second job when you're putting in 80 to 100 hours a week during your internship and residency.

do you really want the fools in washington to be administering your health care. those bureaucrats cant even find their own butts. i have been waiting for a whole year for the VA to recognize that my wife of 20 yrs is actually my wife. now thats quality work.

James, unless you've got your nose in the books of a private practice and look at the flowsheet, please shut up. This woman is doing the same thing businesses all over the country are doing, balancing the books and trying to figure out how to pay the bills. Of course, her business bills are probably a bit more expensive than the bills you pay. Overhead in medicine is a pretty penny these days. Her malpractice is probably upwards of 40K a year. Every time she puts a patient under for a procedure, she takes the risk of a bad outcome, a misdiagnosis. What are you doing in your life that's so goddamn important?

Sorry, James you do sound a bit like the republican woman that wanted to trade chickens for medical care. The Oath does not say, nor should we expect doctors to work for free(with catastrophic disasters as an exception) but not in their day to day lives. Yes, private practice is a business and as such needs to budget, the main point the good doctor is making is that Congress needs to fix the "doc fix" NOW and stop kicking it down the road, so she can budget her business, a very basic need in private practice or any business.

James, Get real and find a doctor who you like and will take care of your needs and your quirks! They are out there, you know.

You are a moron, that 23% cut is a 50% cut in her salary, so she would go from 260K to 130K, and your primary care doctor would go from about 150 to 75K. How would a 50% pay cut feel to you?

I've lived in $12,000 a year. They will be PERFECTLY fine with 75k a year. Are you kidding me? With that I could live for like 5 years pretty comfortably. James is right. Doctors here in America are as greedy as they come, it's not about curing people, it's all about the money, money and more money.

How would a 50% pay cut feel to you?

Not good but I run a small business and sometimes thems is the shakes. In good times I make out very well and in bad times I don't. Suck it up.

Your business probably doesn't involve a decade or more of grueling loans and academics. And your skill level is probably laughable in comparison to a surgeons... do not compare plumbers' salaries and surgeon salaries. Nobody dies if their sinks clog. Some doctors are more compassionate than others. Some doctors are more skilled than others. In the end they provide a product not a civil right. And they should be able to prosper in proportion to their ability and contributions to the community. So you don't like their demands or prices.... but you're sick.... I guess you can just suck it up.

In good times they did very, very well. Those times are over. They can cry all they want but that's the truth. So they have to decide: stay in it for the benefit to humanity or leave because they can't afford to live on a wage closer to their average patient.

What's funny Drew, is that I know doctors that go to other countries to volunteer, but then here in America they charge everyone the same. Now that's a litte funny don't you think? Also, do you really think having health coverage is not a need and only people that can afford it should receive it? I hope you are never in the position of being poor and having a horribly sick baby. I bet you are going to love feeling powerless, not being able to do anything for your baby, just letting her get sicker and sicker because you can't pay a doctor $300 for a visit and some medication. I bet you also think we should just let immigrants die if they are illegal, like they did with one in a hospital when they denied her medical attention for her status.

Spanish~ You really don't have a clue. When Dr.s volunteer to go to other countries they do it on their own dime, the bring a medical staff and their own equipment. They give also gives up their vacation time to go and help other people. Anetheisiologists, nurses all go to help. They go to countries like the Philippines that an operation and hospital stay would cost a whole months wages....... $7. There is no pain medication, there are no sterilized operating rooms. There are lizards on the walls and they leave them because they eat insects. The Drs. in the Phillipines aren't even qualified to be an RN in the US. The hospital staff goes through the trash to keep the gloves that the Dr.s and nurses throw away, they wash them and hang them in the sun to be used again.

I suppose your next remark would be, "Why don't they do it for free here?". They do, they do it for a community that donates to their cause. 50 operations in 1 day to people that have no insurance. So get off the high horse and really think before you denounce these very talented individuals that we have that are called Dr.s.

How would a 50% pay cut feel to you?

For thirty years, real income levels have been flat for almost all jobs. Doctors are one of the few exceptions. Even at 50% pay cut, she'd still be ahead of anyone else her age.

Hard to feel sorry for her anyway. That's Republican whining coming from her mouth, and they're the ones who are hard-core about the cuts.

She has also trained more than anyone else, has more loans than anyone else and pays more tax than most. Family Physicians arent making enough and nurses are doing better than them. It says a lot about our wonderful healthcare system. Republicans or Democrats, you should want your physician to be the best out there and after a hellova long training, theyre entitled to it

Spanish, your remarks are astonishing. No one wishes anyone to get sick or be deathly ill. And judging from your passion, you have had a bad experience in the past. But what is true is that doctors spend up to 12 years AFTER college (you arent even there yet), climbing a ladder to treat patients in a correct fashion. Coming out of med school - that is close to $250k debt for med - $150 debt college, and living on up $30k a year for up to 6 years post med school (in cities like NY where everything is so damn expensive). While all this is happening your debt is accruing, many dont have a chance to settle down to have kids and start a life, and you are 40 by the time you make your first real pay check - which yes may be in the 100K range. But now you need to feed your family, pay your debts, and somehow afford rent. Maybe by the time you are 60, you are in the black, making money and finally buying cars and whatever. How much is worth it to you to put your family on hold? If the answer is 12k a year you are sadly mistaken little girl.

The reason it is so expensive is that you and the millions like you, have demanded the BEST care in healthcare. If you want less then go to one of your spanish countries. Doctors over there train for 6 years which include college!! They are practicing at age 21! They don't make as much because the quality is less and the time is less.

If you cannot afford it, then there are options. Some of the best doctors in the country hold clinic hours for patients who are uninsured and underprivileged. The best part about this system that is if you trip and fall walking into the clinic, you can still sue them for paying NOTHING on the dollar. You want to b**** about something, complain about those that give services for nothing and still are liable to lawsuits. Not to mention doctors cannot write off bad credit either. You declare bankruptcy (like 10% of the country did over the last few years) then guess who is left holding the bill - the same people you are complaining about. Get your facts, maybe finish college (also keep your $12k a year, 'cuz like you said you do fine on it and so should doctors), and then we'll talk.

Jack,

What are you talking about? Throw the book at her for what? Any physician can refuse to take any kind of medical insurance they want to. I don't accept any kind of insurance, am on no panels and refuse Medicaid or Medicare. I refuse to have the value of what I do determined by some dimwit insurance company. This approach allows me to see some patients pro bono and others at a reduced rate. The reimbursement rate for Medicaid for example is laughable and currently in my area I know no one that accepts it. Those low income folks have to go to what is in fact socialized medical clinic known as county health-care.

William - unfortunately, thanks to cuts made to public health under the Reagan administration, there are very few county health clinics left.

Eric - AGAIN - I never said doctors should make 12k... I said I was able to make it last year with 12k and having a family. 12k to 75 or even 100k is a BIG difference. I'm ok with them making 75K or even 100K, but 200K? now that's just too much.

Something I should have mentioned by the way is that my mom is a doctor in Spain. She earnt more than some people, but we were NEVER EVER rich, or lived in a giant super awesome house, or had a pool and great cars. Maybe, like I said in another post, this is bigger than just this article. Maybe the USA also needs to change how much colleges make us pay, so we don't end up with a 100k debt once we are done. In Spain and other parts of Europe we have PUBLIC colleges, and please don't tell me that we have less quality teachers and doctors and blah blah. My mom is atcually a very good doctor, and the other day I was just reading an article about how the USA children are way behind in math in comparison to other 1st world countries. More expensive doesn't mean better quality.

Spanish chick, You have no idea what you are talking about. You may live on 12 grand a year, but the rest of us would starve on that income. I know you think you have a point, but doctors give and give and finally when they make a living I don't blame them a bit for being upset with the odds of a successful practice. Most doctors have a $200500.00 debt after medical school. Top that with marriage and a family and you have doctor's living off of $50,000 per year. I as a single person had a hard time living off of 50 grand per year because my take home wages were only 28,000 per year. That is what we are talking about. Taxes and no charity.

The best part about this system that is if you trip and fall walking into the clinic, you can still sue them for paying NOTHING on the dollar.

This is exaggerated. By law, an emergency room must accept anyone who is in imminent danger of dying, regardless of ability to pay. It can turn away anyone else.

If you're referring to free clinics, you must not have spent much time in any if you think they are filled with people who have tripped and fallen. They get conditions that are unheard of in suburban hospitals: A friend who worked in one actually diagnosed a case of leprosy.

Spanishchick - you should really stop justifying yourself. Not all docs make insane amount of money and not all are greedy. there are some that choose to stay in primary care despite everything and have to deal with an insane volume of patients who smile at their face and then sue them for useless things. Do not generalize everyone.

As far as your entire 12k story goes, to each his own. Ive lived on bare minimum in ny while i was training and ive worked 8+ years to get into medicine when ive barely slept. I did it because I wanted to help people and am choosing a field in medicine which isnt going to pay me top dollars anyway. People like you make me sick. Just because you lived on 12k in a place where you had a 3 bedroom apt doesnt entitle you to judge others. I dont think ive ever lived in a 3 bedroom apt lol. Heck most residents i know on the east coast arent living in 2 bedroom apts, much less 3. So get over it. I applaud you for your struggle but your entire argument is downright pathetic.

Spanishchick never mentions how much she got in Pell Grants. Who goes to college 3/4 of the time? What a waste........

The staff at most hospitals and medical practices - like the geeks who worked during the tech bubble of 2001 - are being paid with debt. The business model isn't sustainable so neither are the paid staff.

The correction is coming friends and it is going to be a bitter pill to swallow. We'll be a better country when it's finished, though.

The bitter pill is not going to force anything on physicians. They will simply not take medicare patients. It will be the patient that suffers.

So... you get the bitter pill

You know, Joe, anarchy is not a system of government. Despite what teabaggers like yourself seem to believe. You don't like government? Try Somalia.

That doctor has a bunch of people who work for her to allow her to see her patients. A cut of that magnitude will absolutely be met with staff and service reductions. How else do "businesses" cope in lean times? Medicine is a business, but it is a business where the costs usually can't be passed on easily to the consumer as is done elsewhere.

And this is what bothers me about the whole system. I'm OK with people making obscene amounts of cash if they are running a business and the business does well, but why is it that when business is not doing so well the first recourse is to lay off workers rather than cut that fat personal salary?

If medicine is a business, then your paycheck is your reward for doing well, if you make more in the good times why don't you make less in the bad times?

I PAID for Social Security and Medicare (worked a full-time job with each check showing what was paid). I am now a retired senior, and AM STILL PAYING FOR MEDICAL INSURANCE.

There are good and bad physicians. I also believe physicians have a right to live a life like the rest of us. Also, a physician who has an office has expenses, including office overhead and INSURANCE EXPENSES.

No matter how much you paid into SS and Medicare you ran up a debt 1000 times greater. Thanks very much for your Cold War, Vietnam, Iran, Afghanistan (twice), Johnson's Great Society, the War on Drugs, endless tax cuts for the wealthy, deferring infrastructure repairs decade after decade, and so on and so on.

If you had done a better job governing this country during the past 50 years I might give a flying frack what you think you deserve. Since you royally screwed the pooch I think you should be happy we don't put you all on ice flows and kick you off into the mist.

People who pay into SS and Medicare should be able to get that money back when they retire, Joe. What's not fair is for people to get SS and Medicare benefits that they didn't pay for up front when they were employed. That makes no sense.

Medicaid is a different story. People who need help in life and can't pay for decent health care deserve basic care. I think Medicaid is a measure of our humanity.

If I pay a certain amount into SS and Medicare, when I retire I expect that money back + at least interest equivalent to what I would get from a savings account. I don't expect a penny more. SS and Medicare have not been fully managed this way. So if the government can't properly manage these funds, give all the money back and let people manage those funds themselves.

The problem with that idea is that Congress borrowed money from the SS fund to pay for wars in Iraq and Afghanistan. Just because your politicians lied and told you that the wars wouldn't cost anything doesn't mean that it was true. They paid for it using your social security money.

Yeah because pharm and doc work the same. Pharmacists count pills where they have a tech and a machine to help them. A doctor saves your life when youve already booked your ticket out of this world. I dont get why pharmacists get paid so much anyway when everything is electronic

I worked for a doctor. He saw his medicare patients every six months unless there was an emergency. He would fire his patients if they didn't take proper care of themselves. Very few patients were prescribed dope for any length of time.

My mother went to another doctor at the same time. She had an appointment every three weeks because that's how often a doctor can charge her cards. He would write a script for every little complaint.

Two different doctors. Two different approaches to their job.

You are correct. The Hippocratic oath's first lines goes like this: "I promise to work long hours and receive no compensation for my efforts. I will be a slave to society and government and never, ever complain that I can't pay my rent, malpractice, staff, electric bill, etc ,. I will smile when nurses make more money than I do." Let's see you and others on this blog bashing doctors give up 11 or more years of your life, rack up 200 K in loans, and then work for free. My guess is that you're not Mother Theresa, but rather someone who suffers from class envy and a sense of entitlement.

I vote for class envy and a sense of entitlement.

He may be a component but it is not true that he is not benevolent as well, my doctor has seen me at a reduced rate or free when I was unemployed and had no insurance. I do not expect him to do that every time but your statement paints all doctors as money grubbers and that is simply NOT the case.

Plus, I am certain I am not the only patient he helps when we need a hand.

Samuel, if that is the case then why do health insurance premiums keep going up with reimbursements to providers including doctors keep going down? Any idea who the money is going to?

All insurance contracts (Blue cross, Cigna, United, Cofinity, etc) pay us based on the current Medicare rate. For example, 110% of medicare rate for an office visit, procedure, etc. We cannot change our rates because the insurance companies do not care and do not change their payments. They only move based on Medicare rates, which haven't changed since 2001. So you see the problem: If Medicare drops 23%, all payments to us will drop by the same. The only way around this is to go to cash only patients and drop ALL insurance, which is what I guess you are suggesting. A medical practice cannot do the regular business moves you talk about, simply because it is not in our power to do so. Medicare and HMO's call the shots and take your premiums, but they sure as hell are not giving those yearly increases to physicians. It's going to their CEO's, shareholders, and their overhead.

FamilyDoc : I concur. I work at major hospital and we are attempting to cut 50 million in the next 18 months to adjust to the Medicare cuts. There are only three groups making big money in healthcare, insurance companies, medical / pharmaceutical companies and lawyers. Unless there are some immediate changes from the government, I don't know how the docs, clinics and small hospitals are going to survive. My brother-in-law is a Rheumatologist and has told me that he will have to cut his salary in half just to be able to pay his staff next year.

What the story didn't mention is that the 23% Medicare cut is on what the reimbursement is and for some that is around 30% of the charged amount. 30 cents on the dollar.

>There is a way for doctors to continue seeing Medicare patients even with these cuts, they can charge the non-Medicare patients more to cover the losses.<

What you can charge is generally dictated by the insurance companies. I can't even give another physician professional courtesy any longer as it's deemed fraud.

Medical practice just ain't worth it & getting worse by the day.

>There is a way for doctors to continue seeing Medicare patients even with these cuts, they can charge the non-Medicare patients more to cover the losses.<

This statement is so ignorant it defies explanation. Clearly, Joe (or Jane) Public has no clue how reimbursement works for medical care in this country.

I'm sorry you didn't catch my sarcasm. I do know how reimbursemnt works, I deal with it all of time at the hospital that I work at. The point is that doctors and hospitals have to accept what the government gives them with very little room to account for losses. To even stay viable you need an accounting genius and fortunately for us, we have one of the top CFO's in the country. Those who don't, then I hope change happens quick enough to save them.

Thank you! We don't have the answers but constantly shoulder the blame.

So.... it's the Teabaggers fault? They did all that? I didn't realize with their 32% election success that they could be so powerful.

I was not referring to the recent election, rather to all the protests when the politicians went home to hold their town meetings, which were more like town melees, in some places.Go back and take a look at the videos; pay special attention to the signs being held up and the shouting down of anyone with a differing point of view. Then tell me that the old Teabaggers--99% of whom I'll bet have Medicare--weren't protesting the very government-run health insurance that they love so much!!!

I agree.

The patients can always pay the difference out of their own pockets if they want to continue to see a doctors.

LU, we can't charge the difference. that's illegal.

You are globally misinformed. Let me try to help you. Practicing doctors didn't support Obummers healthcare reform. The vast majority were against it. The AMA is comprised of maybe 160K medical students, interns, residents, and academic physicians. The vast majority of practicing, private practice docs (800K-900K), do not belong and do not support AMA views. I resigned the AMA in med school when they decided to turn my biographical data over to the defense department without asking. Being born the tail end of 1959 I was never required to register with selective service, so they took care of that for me. They keep on bugging me to join. I never will.

There is not one thing in that statement that is remotely intelligent. Did you read the post above that explained how Medicare got to this point? It had NOTHING to do with Obama! Most doctors are NOT "filthy rich". Aside from the ridiculous reimbursement from insurance companies, there are the hundreds of patients that do not pay their bills. For a medical practice of any size, thousands of dollars are written off to bad debt each month! For some reason, a lot of people think that a bill from a physician is not a real bill, that it's negotiable. You can't take your car to the shop and then say....I want my car but I don't think I should have to pay, or I'll send a payment next week. The mechanic can hold on to the car, doctors have no leverage. Doctors have every right to make more money than the average person....they chose to go to school for 10 years and paid tens of thousands of dollars. You obviously have NO education or you wouldn't make such blatantly stupid comments for everyone to see.

My family practitioner has been out of medical school for 16 years. My youngest child was his first pediatric patient. I've known him personally for 20 years. He has a nice house, but it's not a mansion. He drives a GMC truck, not a Mercedes. His 3 children have all gone to public school, not private ones. He has called me at 7PM from his office with results from a lab test. He runs a single physician (him) clinic, with 4 employees. He doesn't go to the Cayman Islands for a vacation. I wouldn't embarrass him by asking him just what per cent of the gross from the clinic actually goes into his pocket, but I have no doubt it's low. He is by no means 'filthy rich'.

It only takes 3 years to become an ambulance chaser. It takes 6+ years (after graduation with a BA/BS), depending upon speciality, to become a physician.

Why on earth would anyone want to become a physician?

from a doctor

"all doctors are filthy rich" is probably the most ignorant comment I have ever seen.

It's rather amazing how many people have told us that these Medicare problems that were started in 1990 are all Obamacare's fault. This tells us two things:

1. This comment board is full of trolls - people who aren't interested in an honest discussion but are here to annoy people and to lower the quality of conversation. They are probably paid to do this, since I doubt any honest participant would behave in such a fashion.

2. These trolls don't read very well, because the article itself says that the problem started in 1990, way before Obamacare was even an idea.

Thank goodness you're retired in America demoblat. We don't need a bitter doctor that hates his job and does not respect his patients. Please stay in Haiti since you love it there so much.

Doctors need 12 or so years of college before they practice and earn more than minimum wage for what they do. Calls for pay cuts are a very strong signal that kids today should NOT become doctors.

or like most business on wall-streat outsource their products and services.

Oh yeah thats right, all products and services dispensed are regulated by the FDA. Hmm maybe we should get rid of them too.....

al - horribly ignorant comments.

If anything, doctors are underpayed.

2nd: As for these Indian doctors lining up to treat people for 10K/year. Please come to the hospital and spend a day there. Indian doctors are lining up to try to get residency programs in America so they can practice here. There are thousands of foreign medical doctors currently liscenced cardiologist, surgeons, ect in their countries who are begging residency programs here to let them start all over just so they can practice here.

Please get facts straight before posting.

It doesn't matter significantly how much doctors are paid, since the doctor part of healthcare is only 15%. You know what one huge component is? Insurance companies. 1 out of every three dollars in healthcare goes to insurance companies. Your insurance company makes twice as much money out of your doctor visit and subsequent followups than your doctor does.

But nooooo! We have to have that insurance company, otherwise it would be toooooo much government interference. And the doctor should sit down and shut up because he or she is filthy rich.

Correct, Byron. For examples, see my post above at #2.15.

Doctors are a whole lot less "underpaid" than anyone else today is.

What's the average income of a GP? $150k? $200k? All while the rest of us (truckers to plumbers to engineers) are struggling along at $25k to $90k with flat incomes for the last decade?

Spare me the lecture about all the years doctors spend in training and how much more important their work is relative to others'. No docs are working for free while training and the average doctor is no more important to society than the average engineer is.

Better yet, I've had two relatives "killed" by their doctors' sloppy work and I don't know any engineers who have ever killed anyone. And yes, one of those sloppy doctors was an Indian working in the USA.

It's no wonder Indian doctors are lining up to work in the USA. If I could move my income from $10k/year to $200k/year by only moving, who wouldn't?

Al,

So colleges and med schools pay students during their 8 years of pre-residency education, and not the other way around? Now that's a revalation! If I'd known I could have been paid for attending class, I'd never have taken out those pesky loans!

Rather than a loan, you should have gotten a job. That's how I worked myself through 6 years of "pre-residency education" in engineering.

Cry me a river, doc.

"Doc" as in DDS, not MD, but I understand how the medical students feel.

I had a job, when I had the time. How many semesters did you have 37 required hours of coursework? Could you have spent 40 hours weekly in class and lecture, spent your evenings and weekends doing labs (or, in the case of med students, in the hospital) and studying, and still maintained good grades? We also had to do community service to graduate; did you?

Doctors are enjoying a greater return on a greater investment, which is just as it should be.

Meant "medical doctors", not "medical students". Post gave me flashbacks of being a student!

10-12 years ago, you could get your teeth cleaned around here for $60.

I had my teeth cleaned a few weeks ago for $120.

While my dentist hasn't killed anyone (that I know of), he did do a crown for me once that "mysteriously" got immediately infected and required a root canal. I never even got so much as an apology from him for that.

Meanwhile, I feed and cloth all of you.

Cry me a river.

Not only did I not get an apology for the infected crown, but the root canal through the new crown cost me an extra $1000.

Cry me a river, doc.

Al,

Teeth that are broken down enough to need a crown, and then are put through the trauma of a crown prep, sometimes do become infected through no fault of the dentist. Human tissue becomes inflamed and sometimes dies when it is surgically altered. Your need for a crown and subsequent root canal is in all likelihood due to your own neglect of your dental health. Own your problems.

Cry me a river.

Your diagnosis is incorrect. You must be a poor dentist.

Actually, I went to sleep grinding my teeth one night after a coworker of 29.5 years seniority got canned in a "workforce reduction" that I survived. I was either worried over their fate or I had survivor's guilt.

I woke up the next morning with a broken tooth.

I'm an old man with my original teeth (only two crowns) and my dental health is perfectly fine.

You're a good example of what's wrong with the healing arts.

I didn't make a diagnosis. I stated a likelihood. Can you tell the difference? It is unusual for a sound, unrestored (unfilled) tooth to break, especially after just one night of bruxism. Any other dentist will tell you the same thing.

The reason for the infected tooth (not crown, by the way. The crown is nonliving and can't become infected) is still likely the same. All work done to teeth for fillings, crowns, etc. is trauma. Any time you cause trauma, inflammation and necrosis with subsequent infection can occur. Even with perfect technique, it occurs. I can find references in respected dental texts if you'd like, but I doubt you'd allow their validity.

The "broken" tooth had a 40-year old filling in it. The tooth "cracked" overnight and was painful the next day. On a following trip to the dentist, he stuck his pick in the crack to pry on it a little to confirm that was indeed the painful tooth and it split apart, which is pretty much what the doc said would happen.

That particular dentist was a good one, by the way. He was an older man and he knew his business. His younger partner did the followup crown that got infected and I was referred to an endodontist for the $1000 root canal. I could tell from both dentists reaction that the need for the root canal was "unexpected".

The first dentist I ever went to (in 1960-ish) was an older fellow with a second floor office on a small town square. The floor was wood. He had no office staff, he worked alone. His "office" was only a large room. No A/C, only fans and open windows.

My current dentist is a recent dental school grad. He just bought out the practice of a retired dentist. He's a yuppie. He has six staff people. He isn't a dentist as much as he's a "businessman". He has no personality and no regard for his patients. We're only "customers". When he tells you to open your mouth so he can look in, it's little different than a mechanic opening the hood on a Chevy.

All in all, for all the progress we don't seem to have gotten very far.

Teeth with fillings are more prone to cracking - that's physics. The tooth decay that caused the original filling to be necessary was YOUR fault.

Again, the crown did NOT get infected. Your tooth did. It was traumatized by the filling, crack, and the work necessary to get it ready for the crown. It is not expected that the tooth will become infected afterward, but it is not rare, either, so I can't see either the general dentist or endodontist being all that surprised. If you ask that endodontist, he probably does several root canals per day on teeth with the same history as yours.

If you feel like a number at your current dentist's office, change dentists. Noone makes you go there, and you should not feel that way. There are plenty of good dentists out there with your best interests at heart.

We are not all money-grubbers. I frequently recommend treatments that make less profit for me, because I believe they are the best course of action for my patients. For example, I usually recommend implants to replace single teeth rather than a bridge, even though the bridge makes me more money. I send the patient to a specialist for much of the work for an implant, so the specialist makes more money, and I make less. And no, I do not get a kickback. I just believe this is better for the patient.

Sounds like your jealous............

what about the other doctor that took a beating in the market, does that make you happy?

My bad.......... should be .......Sounds like you are jealous........

the priorities are that doctors want do well for their patients (it's why they went into it). The reality of the situation is that very few docs are "making a killing". I'm envious that he is still making money in the field, cuz most of the doc's are not - and even less with this cut coming up.

Would it make you feel better if he was doing poorly too? Lets just have all the doctors retain student loans for the rest of their lives...

Jealous? Not hardly. I suspect I've made more of a killing in the stock market than my doctor has only I don't sit around telling everyone about it.

No, just telling everyone on Newsvine............... I smell BS!

Pepster, it's ok if Al makes a killing and brags about it. It's only bad if medical professionals do the same. He thinks the Hippocratic oath includes a vow of poverty.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Where's the part of that where Hippocrates demanded a guaranteed income of $200-500k/year or else you could "stick a fork in him because he was done"?

There's a recent addition to that oath.

I will demand all your money so I can buy a new Benz, or you will die a slow death from your illness.

Now, it's complete.

Al, you're making a fool of yourself. Anyone with an ounce of intelligence knows the oath lays out behavior expected from doctors, not benefits guaranteed to doctors. Nowhere does it say doctors must provide care with compensation, or only the compensation the almighty Al believes is fair.

The point of the original article was the doctor's intention to withhold care in the face of declining insurance payments. That IS about behavior.

I don't know what's "fair" compensation. I know a doctor making $200-500k/year and complaining it's not enough seems a bit out of touch with the times.

Yes, witholding care is behavior, but there is nothing in the oath that says a doctor has to provide care for no payment or for less than it costs him/her to provide that care. It's simple arithmetic - if you spend more on a patient's care than you make, you'll go bankrupt. Do that on a lot of patients, and you'll go bankrupt faster. The article stated she was already dipping into savings to pay staff. You can't do that for long and maintain a viable business.

Al, I'm not sure why you have such an axe to grind against doctors. You seem determined not to listen to anything the doctors on here are posting, but you keep posting the same things over and over that you insist are true despite evidence to the contrary. You even seemed to be giving the DDS a test case to see if she could diagnose you over the internet and said, "Aha!" when she didn't say what you wanted. Maybe I misinterpreted things, I don't know. So many of you, no matter how many times you hear how much a doc has to pay for malprace, loans, office,and so forth still grouse about how much they make. It's not really about that, is it? It's about your anger. Whatever it's about, I doubt it will enhance your life in any way. As the saying says, It's "like drinking poison and expecting the other person to die." So all of you, decide if it's making your life better. If it's enhancing and beautifying your life. Or is it time for it to go?

when the repubs repeal oboma care the doctors and health care workers will be left with out any gov support isnt that great