After traveling and doing some interviews, I’m have been catching up with replies to your comments. So if didn’t reply to something you said in the last week or two take a second look: you maywell find a response. (I still haven’t replied to the comments on the “Compensating Physicians For the Trust We Place In Them” thread. I plan to weigh in later today Saturday)
Health Beat by Maggie Mahar
Why does the govt plan have four
different levels of service/care and
how much more for the premium plan.
2.5% of income x4 for
a family with 2 children with the
basic plan or is it just x2?
Are children extra? Why?
Government plan should set the
level for the all basic health insurance plans.
Too many bogus health care
companies are allowed to exist! Why?
I heard you on Fresh Air and I was wondering how this new system will not punish those of us who have suffered and paid the significant costs of the previous system. I am a 49 yo family physician who has practiced for 19 years in what is, in reality, a “physician shortage area” of New York state, but did not qualify for the NYS shortage forgiveness due to the existence of a local clinic from a large hospital(in another county) located in our county — even though the docs at that clinic are only there part-time and do not provide after hour care or inpatient coverage for their patients.
So, as I came from a lower middle class family, I came out of med school with over $100,000 of state and federal loans which once deferred through my residency jumped to $400,000+ total.(This was due to the compounded interest that happened when I deferred the loans as I earned $26,000/year as a family practice resident for 3 years) Despite the fact that I have been now practicing in this rural community for 19 years, watching many doctors come and go and hospitals close in my town, I am still paying $4000 per month on my student loans. I barely make ends meet by having a PA and an NP full time working with me.
And I keep hearing that less than 2% of med school grads are going into primary care, so the govement is planning to give them loan forgiveness and incentives to decide to go into primary care. What about giving loan forgiveness or financial incentives to the docs who are ALREADY HERE, doing quality primary care in underserved areas, to keep us here—instead of driving us into administrative jobs that pay more? I still find it incredible that I am still paying off my student loans at almost 20 yrs post med school graduation, and STILL have trouble making enough to keep my house and my family(including 7yo twins) financially viable. I have no money to put toward retirement and no money to SAVE toward college, and I assure you, I do not live extravagently—in fact my current car will qualify for the new “cash for junkers” program.
Why can’t the goverment do more to encourage doctors like me to STAY in the profession, working WHERE they need them—since Keeping qualified people is ALWAYS cheaper than hiring/producing new doctors, and is infinitely better than encouraging people who really do not want to do primary care, or who will only do it ‘for the length of the forgiveness program’ and then move out of the area of need or perhaps even leave primary care?(I have seen this happen over and over in the previous physican shortage program in New York State).
If I did not have to pay the Federal goverment $250,000 back to pay for the original $80,000 principle I had to borrow in med school, plus the $160,000 to New York State for the $26,000 principle I borrowed from them, I might have an easier time earning enough money to make primary care in this under-privileged area do-able for me and my family for years to come. If I had qualified for the 19 years I have practiced here @ $20,000 per year—I would have been forgiven for $380,000 by now!
Any suggestions on this issue or who I should speak to, since I know, I am not the only FP who feels this way. Has the administration thought of those of us who have “paid our dues” and continue to be burdened while we struggle to provide the care that is needed?
I think this is a ‘real issue’ that has not been addressed for the greater good of the entire healthcare program, which from a ‘cost accounting’ aspect, could actually be LESS expensive than much of the things they are proposing.
Why do the players and pundits debating health care reform persist in employing the word and paradigm “insurance”? Insurance is defined by the Merriam Webster online dictionary as “coverage by contract whereby one party undertakes to indemnify or guarantee another against loss by a specified contingency or peril.” In other words, it’s protection against something that may happen, not something that will happen. And it operates by spreading the risk amongst a large pool of people most of whom will never experience the contingency; that’s how it spreads risk.
But health care isn’t really about spreading risk, because everyone in the pool is going to need it. The need for health care is not something that “may happen”. Sickness and old age are guaranteed to all; there’s nothing contingent about them. And even the well need health care.
Once the word “insurance” is jettisoned, doesn’t it become clear that private insurers, with their armies of actuaries, add nothing to the efficient provision of and payment for health care? What is the economic justification for keeping them in the picture?
cheryl An–
I understand what you are saying about primary care docs already practicing being strained financially.
But how could $100,000 of debt become $400,000 in just 3 years? That makes no sense. Interest does not compound at that rate.
And $400,000 is an unusually high level of debt for someone to accumulate by teh end of residency. $200,000 to $250,000 is avereage, even in NYC. And the cost of living in your area is much lower than it is here???
I’m puzzled.