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Doctors to Be Made Slaves of the State

DDD said:
Why are people in public hospitals left with no doctors in the first place? Obama's ACA should include the people that go to such hospitals also. Is that not the case?
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Public hospitals are funded by local government, sometimes the state, and whatever they can get from Medicaid/Medicare. They hire doctors to be on their staff.
 
Manc Skipper said:
You understand it wrongly again. A pattern has emerged.
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Snark with no substance or explanation. Not very helpful.

Here's the history:

...[In Great Britain] during the war, a new centralised state-run 'Emergency Medical Service' (EMS) employed doctors and nurses to care for those injured by enemy action and arrange for their treatment in whichever hospital was available. The existence of the EMS made voluntary hospitals dependent on the Government and there was a recognition that many would be in financial trouble once peace arrived.[2] The need to do something to guarantee the voluntary hospitals meant that hospital care drove the impetus for reform.

In February 1941 the Deputy Permanent Secretary at the Ministry of Health recorded privately areas of agreement on post-war health policy which included "a complete health service to be available to every member of the community" and on 9 October 1941, the Minister of Health Ernest Brown announced that the Government proposed to ensure that there was a comprehensive hospital service available to everyone in need of it, and that local authorities would be responsible for providing it.[3] The Medical Planning Commission set up by the professional bodies went one stage further in May 1942 recommending (in an interim report) a National Health Service with General Practitioners working through health centres and hospitals run by regional administrations.[4] The Beveridge Report of December 1942 included this same idea.
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So, war time medical service led directly to the NHS. Doctors were hired for the EMS, not drafted, but I'm sure a lot of doctors were drafted for regular service. The exigencies of war were a big part of what prompted the shift to socialized medicine. People were very much accustomed to central planning by the end of the war and didn't think twice when it continued into peacetime.
 
Manc Skipper said:
You understand it wrongly again. A pattern has emerged.
Click to expand...

Snark without substance or explanation. Not helpful.

Here's the history:

During the war, a new centralised state-run 'Emergency Medical Service' (EMS) employed doctors and nurses to care for those injured by enemy action and arrange for their treatment in whichever hospital was available. The existence of the EMS made voluntary hospitals dependent on the Government and there was a recognition that many would be in financial trouble once peace arrived.[2] The need to do something to guarantee the voluntary hospitals meant that hospital care drove the impetus for reform.

In February 1941 the Deputy Permanent Secretary at the Ministry of Health recorded privately areas of agreement on post-war health policy which included "a complete health service to be available to every member of the community" and on 9 October 1941, the Minister of Health Ernest Brown announced that the Government proposed to ensure that there was a comprehensive hospital service available to everyone in need of it, and that local authorities would be responsible for providing it.[3] The Medical Planning Commission set up by the professional bodies went one stage further in May 1942 recommending (in an interim report) a National Health Service with General Practitioners working through health centres and hospitals run by regional administrations.[4] The Beveridge Report of December 1942 included this same idea.
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So war time medical service led to the development of the NHS. The exigencies of the war were a big part of what overcame any resistance to centralized control of medical care. Doctors were hired for the EMS, not drafted, although I'm sure a lot of doctors were drafted for regular service. No doubt a lot of young doctors had gotten used to drawing pay from the government by the end of the war.
 
LowDown said:
Time was when physicians were expected to spend some of their time taking care of poor people. In order to be a member in good standing of the medical association in Philadelphia, then the great center of medical learning in the country, a physician had to spend half of his time taking care of the poor. This was done in charity hospitals, and doctors would often take the opportunity to teach students as part of that duty.

Time went by and this approach became obsolete. Medicare came in, then Medicaid. Legal decisions whittled away at the medical association's authority to govern physicians. Charity hospitals started hiring physicians to be on their staffs. Many physicians took lower pay for part time work in those hospitals.

Over the years reimbursement for service to Medicaid patients has gotten so low that physicians are losing money for every patient they see. Some doctors limit the number of Medicaid patients they see, others opt out of the program all together. As reimbursement gets worse and worse more physicians are opting out.

So the inevitable has happened, and a Democratic politician has proposed laws mandating that physicians treat Medicaid patients. This, in effect, is mandating that physicians treat them for free since the reimbursement doesn't even cover their expenses. My understanding is that the ACA will increase Medicaid reimbursement to some extent, but even so it will represent a big reduction in practice revenue.

So far this is just one Democrat in one state, but it's something that's bound to grow legs as the ACA kicks in and Medicaid patients (and Medicare patients, for that matter) can't find doctors. If that happens then I can almost guarantee that a large number of physicians and other health care professionals will leave the profession because they will have no other choice.
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I think you're overly concerned here.

If we look at the big picture yes, medical practitioners (particularly general practitioners) are going to take a hit and many will leave the profession. But in that is opportunity. See, we currently have lots and lots of unemployed who served in the manufacturing industry so we could just make them doctors. Turning a wrench and using a scalpel aren't all that different. If you can replace a P trap then you should be able to replace a knee and wiring a three way switch is hardly any different than patching nerves back together.

See, we're still good.
 
LowDown said:
Time was when physicians were expected to spend some of their time taking care of poor people. In order to be a member in good standing of the medical association in Philadelphia, then the great center of medical learning in the country, a physician had to spend half of his time taking care of the poor. This was done in charity hospitals, and doctors would often take the opportunity to teach students as part of that duty.

Time went by and this approach became obsolete. Medicare came in, then Medicaid. Legal decisions whittled away at the medical association's authority to govern physicians. Charity hospitals started hiring physicians to be on their staffs. Many physicians took lower pay for part time work in those hospitals.

Over the years reimbursement for service to Medicaid patients has gotten so low that physicians are losing money for every patient they see. Some doctors limit the number of Medicaid patients they see, others opt out of the program all together. As reimbursement gets worse and worse more physicians are opting out.

So the inevitable has happened, and a Democratic politician has proposed laws mandating that physicians treat Medicaid patients. This, in effect, is mandating that physicians treat them for free since the reimbursement doesn't even cover their expenses. My understanding is that the ACA will increase Medicaid reimbursement to some extent, but even so it will represent a big reduction in practice revenue.

So far this is just one Democrat in one state, but it's something that's bound to grow legs as the ACA kicks in and Medicaid patients (and Medicare patients, for that matter) can't find doctors. If that happens then I can almost guarantee that a large number of physicians and other health care professionals will leave the profession because they will have no other choice.
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Well, since Democrats like to think we all have a "right" to health care...and since they've passed a law mandating that people buy health insurance...it only follows that they think they should pass a law that mandates that doctors see patients. To the Democrats, a "right" trumps everything.
 
Mycroft said:
Well, since Democrats like to think we all have a "right" to health care...and since they've passed a law mandating that people buy health insurance...it only follows that they think they should pass a law that mandates that doctors see patients. To the Democrats, a "right" trumps everything.
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Unlike SNAP, Medicaid and Medicare do not offer the normal market price as reimbursement. Medicaid and Medicare simply expect that the gov't mandated discount rate will be accepted.
 
Mycroft said:
Well, since Democrats like to think we all have a "right" to health care...and since they've passed a law mandating that people buy health insurance...it only follows that they think they should pass a law that mandates that doctors see patients. To the Democrats, a "right" trumps everything.
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i have a right to own a gun a right that is written in the constitution so when are they going to send me my free gun
 
trfjr said:
i have a right to own a gun a right that is written in the constitution so when are they going to send me my free gun
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Don't matter if it's written in the Constitution. It only matters if the Democrats think it is a right. Unfortunately, they don't think you have a right to own a gun...so they will never pass a law mandating that you buy one.
 
LowDown said:
Time...choice.
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Will doctors' figure this out and take it to court on Constitutional grounds?
If so, when should we start seeing the first of these suits?
And if these lawsuits don't appear by that time, can we conclude that the sentiment expressed in the OP may not be the most accurate?
 
Simon W. Moon said:
Will doctors' figure this out and take it to court on Constitutional grounds?
If so, when should we start seeing the first of these suits?
And if these lawsuits don't appear by that time, can we conclude that the sentiment expressed in the OP may not be the most accurate?
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1. This is a proposal from a Virginia State Legislator.
2. The State of Virginia has not passed such a mandate as yet.

If...and when...VA does pass this, only then may we see lawsuits.

On the other hand, I suppose it might be possible that a US Legislator would propose such a law in Washington. It might be a tough sell, but a lot of people thought the Obamacare mandate would be a tough sell, too. I guess we'll have to just wait and see.
 
LowDown said:
Public hospitals are funded by local government, sometimes the state, and whatever they can get from Medicaid/Medicare. They hire doctors to be on their staff.
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I guess in a mass governmental body such as the USA the health care system should be this complicated to account for such mass populations. First are governmental hospitals that have no doctors but they need to hire them. Then there is Medicare/aid and Obamacare. So many places to choose from that I wonder why there are not other health care systems also.
 
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