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intercst
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Concierge Service is very bad medicine. Doctors in each speciality should discuss things directly. A concierge is like playing telephone. And the specialists stop talking to each other. Horrible medicine.
I agree, but it’s what you get if you underfund primary care doctors and don’t pay them for the time spent arguing with for-profit insurers.
intercst
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Concierge service in the US cost extra.
It’s a phenomenon that’s happening in a good many other countries too. There wasn’t a tremendous amount of discussion on concierge care in the article (I’d be interested to see if that works at all in a meaningful way in Canada)
Hard to find a solution when there are so many different reasons. Primarily, I guess, one would have to find a way to dissuade individuals from seeking out jobs that provide for greater reimbursement….and then working towards early retirement. Primary care isn’t exclusive in this regard…..and physicians, apparently, aren’t much different from other sectors of the workforce.
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Educate more doctors. Doesn’t seem that hard.
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Even if you do, who is going to want to go to some town that only has a few thousand people? Can’t make any money there. Big city pays better. And will better support specialists (who generally make more).
But it really is a complex problem. OB-GYN malpractice insurance is sky-high, so many areas don’t have any OBs because their practice can’t support such high premiums (i.e. rural areas, not enough people). Just one small example.
Single payer is probably the best solution (though not perfect), and finding some way to rotate doctors through more rural areas (perhaps in exchange for medical school tuition).
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Create a governmentally managed system to recruit, teach & train with full scholarships, and then employ as needed where most needed for some set period as repayment for the training.
Pretty easy but impossible in the USA because socializmisevil says AMA and others.
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Not pretty easy, because med school “only” costs about $60-70K per year and a first-year attending physician earns about $400K. Getting your med school expenses taken care of just isn’t all that big an incentive, relative to the potential impact on your earnings if you were to agree to go where the government decided for some period of years. Especially considering that you’ve already kind of given the system several years of your life in a residency, which is itself often a massive amount of economically valuable work at relatively low pay.
So even if you don’t believe socializmisevil, this isn’t likely to have the kind of uptake you’d want in a real solution.
IIRC, Canada does have single payer (at the providence level).
D2
You would do simply create a program (The Medical Corps?) that provides free education for those who contract to serve at low pay, where told, for some term of time. After that term they could establish their own practice.
My 3 successive doctors in Spain had all done a program like that in Spain. The youngest was still serving, the other two were full scale professional doctors.
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Last I heard the AMA is for universal Healthcare.
Well we got half way there and ran out of steam. Ofw
The American Medical Association (AMA) advocates for universal access to healthcare coverage but strongly opposes a government-run, single-payer, or “Medicare for All” system. Instead, the AMA promotes a market-based approach, focusing on improving the Affordable Care Act (ACA), expanding Medicaid, and utilizing employer-sponsored insurance.
I doubt the AMA favors transparency, competitive pricing for medical services, and strong antitrust enforcement for large scale group practices that stifle competition.
intercst
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You did not read my post.
You did not comprehend my nor intercst posts. The AMA has long wanted and long has had the power, money, and glory to control healthcare policy… OF COURSE they want universal healthcare paid for, somehow, by the guvmint, regardless of, well, just about everything. This is not the result of a carefully thought out process of policy analysis, it is the result of utterly normal evolution over time of money and status.
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Simple to describe, and simple to create - and unfortunately, you won’t get many takers. Again, that free education is “only” about $200K worth of value. That will be far less than the loss of earnings from spending the first few years after residency working somewhere you don’t want to be at “low pay.” Especially after you’ve already spent 3-7 years working as a resident at “low pay” for horrific hours and have had to delay your eventual actual earnings potential by all those years.
Sure, there might be some small number of students who lack access to financing options who might take you up on it - but not many will be willing to spend years in Possum Bottom or Cicely or wherever just to get their med school paid. The way to get doctors to relocate to those rural areas is to pay them enough of a premium to induce them to move those areas. That doesn’t happen, because unlike a med school subsidy it then becomes painfully apparent how much money the government is paying to provide medical care to a relatively small population.
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Disagree. There’s a large number of people who go into the Army just so they can get their college education paid for later. Imagine offering them the opportunity to NOT go into the Army, and getting it paid for anyway.
Google tells me that hundreds of thousands of people using tuition assistance while service, and that up to 400,000 used it “post service” during the years 2020-2021. Now surely not all of those would want to specialize in medicine, but I’ll wage some decent portion would, especially if it was paid for and offered the promise of a lucrative career for the rest of their lives.
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Yeah - because the average salary for a college grad is about $60K. So taking a few years at “low pay” has a vastly lower opportunity cost for that 18-year-old GI Bill candidate than the opportunity cost a post-residency attending physician faces. Google tells me the average starting salary for a first-year attending is about $400K. Even the lower paid ones like family medicine are coming in close to $300K.
It’s just not enough of an economic benefit to the newly-minted doctor. Plus, they’re going to be later in life, either with a family or eager to start one - decamping to a place you have no intention of living in for several years at that stage of life also carries a much higher nonmonetary cost to you than the high school kid spending a three-year service term in the Army before college.
You’re focusing on the differential between college cost and first year salary.
I’m focusing on the segment that can’t even afford the first year college cost. There are a lot of them.
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For college, sure. For folks who have already completed college and have been accepted into a medical school? Probably less of a factor. Their post-residency earnings are going to be so high (again, between $300K-$500K) that the incremental financing of medical school - while substantial - is far less likely to be a material obstacle.
For a general college graduate, spending three years earning half pay ($30K soldier’s salary vs. $60K for a college grad, not including some value for housing and food) for four years’ tuition is an excellent tradeoff - especially since most recent college grads simply cannot afford to carry a $200K loan into a starting salary of (again) $60K. But for someone to trade off three years earning half pay (as an example) at $400K per year? In exchange for that $200K in tuition avoidance? It just doesn’t make economic sense for very many folks. Sure, maybe some - but not nearly enough to make this a real viable solution.