Deep thought/QOTE
If Unions are the Devil and we railed against the UAW making (not true) $70 an hour, how come we aren’t railing against that other union that is protecting their workers by keeping demand high and supply low. Their workers are definitely making a few hundred thousand and up to a few million a year? AKA the AMA?
Two thoughts
1) Damn ineffective union in one sense: AMA represents only about 19% of active physicians
2) You’re exactly correct that a large part of the AMA lobbying is to protect exclusivity: that’s why Physicians’ Assistants, Nurse Practitioners, and Midwives have been systematically frozen out of independent practices at lower rates than doctors charge for mundane services.
No need for the UAW now. The gov’t will run the auto industry. Watch how Ford will go under as we subsidize Chrysler/GM.
Doctors pay will definitely go down with BO-Care…and also the number of doctors. But the gov’t will handle this by not allowing care to people based on their standards…ask anyone who’s been treated at the VA hospitals.
See how ineffective the teacher’s unions are now as the govt controls them…the Delaware union is naive enough to thing that a 2.5% cut was a great negotiation.
So, do you have a comment on the AMA or not Tom? Or once again you display your ignorance by coming here to argue for the sake of arguing?
Donhoni….I take it you read Mat Marshall’s letter to the editor in Sunday’s Snooze. What nerve! That joker has never even had a real j-o-b and if his ‘effort’ on KHN’s campaign was any indication of his abilities he’ll never keep a job.
(Dominique: Sorry but Mr. Mat overstepped his knowledge and experience and presented himself as an informed working person. I must say the letter was very well written. src)
I don’t think the AMA is a union, more of a professional organization which is much less organized.
Lower rates paid to Nurse Practitioners, et al is really a function of the insurance companies, which set rate tables. Docs (both AMA and unaffiliated) AND hospitals fight with insurance companies to keep their rates high and the other guys lower. However, they do it individually and independently. To do otherwise is to violate federal anti-trust laws.
The low supply of primary care docs is a function of the high cost of medical school and the (relatiely) low payment schedule for primary care docts vs. specialists.
I dunno, dv. My father, when practicing, was a member of the AMA, but he sure the frick didn’t make what you accuse him of. Point is, don’t assume all “medical doctors” all make multiple hundreds of k’s, because they don’t. Many specialists do, but the lot of your general practitioners don’t. I will give that they top the $100k threshold, but in most cases, that will represent the household income. Given the schedules of General Practitioners, the spouse usually won’t be working a regular FT job, if at all.
FTR, my father didn’t rake in the $$$, AMA or not. One big insight into why this was probably so, is when Aetna worked their magic and forced him to stand in front of the medical board of his then-practicing state, because one of his patients (who was on an Aetna HMO – the former US Healthcare) couldn’t afford a needed prescription that was also a narcotic. My father arranged with the patient to provide the prescription and all was well…until a do-gooder made some calls and somehow freaking Aetna became involved. He held onto his practicing lisence, but had to refer all narcotic-level scripts off for a year. That’s when he started planning his ramp-down to retirement.
Bigger point, don’t get into a tizzy about all members of the AMA, because it isn’t a one-size-fits-all. To your point, yes, a big shitload of people need to get over the talking-point stereotype that all unions are inherently evil. I question their politics-over-membership, but I also question profit-over-humanity, so there you go.
The utter stupidity here is getting scary.
First, I pay almost $3,000 a year in union dues and I support collective bargaining. However, unions can and have been part of the problem. Unfortunately, unions are a by product of management.
Second, the AMA. My oldest son is an MD and being a member of the AMA is voluntary and about 37% of Doctors are AMA members. At my employer, I have to be a union member or I will be fired.
Third, the earnings of MD’s. If you resent that fact then show your liberal independence and do not use their services. Show your principles-if you have any.
Fourth- again the earnings of MD’s. For my Son, Four years of College, four years of Medical School, five years of residency, two years of fellowship and then private practice where the government is gradually ruining Medicine.
You guys need to over jealousy and anger with what others do and try doing something of merit on your own.
Mike Protack
It would be far less stupid and frightening if you stopped commenting.
RS, sorry about your dad’s experience but it isn’t uncommon: most insurers require docs to ONLY provide what the insurer allows, even if the doc is willing to do more pro bono or using another avenue. If the patient can pay retail rates for the extra care, fine; but no deals from the participating doc are allowed.
As I said, it is the insurers (including Medicare) who are determining how much money goes onto playing field for the vast majority of doctors, hospitals and other practitioners. The AMA has nothing to do with salaries.
BTW, the person most responsible for the setting of MD and hospital payments (not earnings, Del Repub, which is a different issue completely) was Mr. Republican Himself, Ronald Reagan. Reagan pushed through at a breath-taking pace the use of the DRG’s for Medicare payments — at the time a new, very controversial, and largely untested method of standardizing payments based on the predicted use of resources by diagnosis (in other words, all persons with cancer X will use Y amount of resources on average, and all we will pay for is Y amount. If your patient uses fewer resources, you win; if your patient uses more resources, you lose. That’s a simple, but accurate, explanation). Once Medicare began using DRGs, many major insurers jumped on board and used “percent plus or minus Medicare” as their payment schedule. Now it is a standard.
Reagan effectively “socialized” the payment schedule and created a national set of standards of care based on those payments. Thus, RS, AEtna was willing to pay not for your dad’s well-reasoned standard of care for that particular patient, but only on its standard of care for the “average” patient.
Thus, RS, AEtna was willing to pay not for your dad’s well-reasoned standard of care for that particular patient, but only on its standard of care for the “average” patient.
It absolutely hastened his plans for retirement. He ramped down slowly, but he went from no plans of it to that, all because of what went down. Most Physicians do care, especially the family-practice GP’s, but they aren’t given enough bureacratic space to do so.