Well, actually, paying for it IS a problem. Low income elderly on fixed incomes usually qualify for Medicare only, and Medicare doesn't cover stuff like costly prescriptions or medical procedures. They have to pay out of pocket for these things, and many elderly on fixed incomes find themselves getting substandard medical care as a result.

Those who qualify for Medicaid in addition to Medicare are somewhat better off. At least their prescriptions and much of their other medical costs are covered. Trouble is that more and more doctors are refusing Medicare/Medicaid patients, because Uncle Sugar ain't paying the Doc's the high fees they've come to demand. So, maybe its MD's who are unhappy with their incomes. ;)

maybe it's MD's who have weighed the risk/reward and have said - nope, not gonna do that. As is their right.

My dentist only charges half his established prices for anyone who doesn't use their dental insurance, because the paperwork and bureaucracy is such a damn pain. He says his cashflow is lower, but his profit is higher.

Do you personally know any doctors? Between malpractice insurance, and paying for medical school, plus the huge headache of paperwork just to get whatever the government/insurance companies have said they're going to pay today... they're not living nearly as nicely as you'd like to imagine. My OB-GYN has recently had to start offering laser hair removal and other cosmetic shit in his office, because the regular practice isn't paying for itself.

"Hey Doc, as long as you're down there...!"

Thank you.
That was the announcement right there.
Yes, thanks.

That's a pretty good idea. At least the reward after the uncomfortable exam would be a shiny clean nether region.

I am sure someone already posted this, but I am not reading five pages just to find out.

I want more, but I am also content for today. I make enough to pay the bills, fund retirement, and have some toys, but I want more so I can pay off the bills faster, retire sooner, and have more toys. I also want to have enough to pay for my kids college (actually, I want them to get scholarships) so they don't have to work during school. I could say more here, but, alas, I am too lazy during my lunch hangover to continue typing.

As a matter of fact, my ex step father is a retired doctor. He took early retirement rather than continue to deal with the whole malpractice nightmare. However, he got his medical training paid for by the Air Force in exchange for him agreeing to work for them as a flight surgeon for x number of years. Don't know if the military still has such programs, but I certainly realize that the normal cost of a medical education is very high. My step father had to go to all these on-going education things to keep his licence current, too.

I'm in agreement that Doc's should have the right to choose whom they are going to treat and what insurance they will accept. IMO, the entire malpractice thing plus the insurance companies and their ever increasing demands for more paperwork, more fussy rules and regulations are responsible as anything else for the escalating cost of medical care.

So maybe its the stockholders of insurance companies who are unhappy with their income.

it isn't an issue of one group wanting more money. too many conflicting interests and too much bureaucratic BS.

A lot of folks in my area head south of the border for medical care. They are treated by american trained (and often american) medical staff, using the latest techniques and best practices. They pay a fraction of the cost and don't have to mess around with referrals, insurance companies, copays, etc.

If they want X treatment, then they need to pay Y (which happens to be a fraction of the cost within the US) If you can't pay, you don't get treated.

Well, I guess it depends upon what sort of society you prefer to live in. I've visited extremely poor areas of South America and once came across a dead man lying on the sidewalk in front of me. Less dramatic, but still distressing were the number of people suffering from diseases which could have been cured if only they'd had the money to get medical care.

One reason medical care in Mexico and other third world countries is less expensive is that the standard of living is so much lower. I don't think the doctors have to worry about malpractice to the extent they do in a first world country, either.

BTW, if you want an idea of the horrible standards of living that US OB-GYN's have to endure, you might Google some of the recruiting websites for that speciality. The one I looked at was full of offers to help prospective new doctors pay off student loans, cover malpractice insurance and more. When salaries were mentioned, they were in the 150K to 200K range - not bad for a new entrant to a profession.

i know what it's like to go hungry, so now i can never be full.

That is kind of the point, these are American doctors who live in America, paying American living expenses. They drive across the border daily to go to work. They charge significantly less than they would have to if they were just north of the border because they don't have to pay exorbitant malpractice coverage and they work on a direct payment method.

As far as what they are paid, let me ask you: would you rather go to a doctor who is paid well, or one who is just squeaking by?

$150-200K/year isn't that much money when you consider the supply demand issue. You also might want to factor in the cost of servicing their student loans, too. The new guy at the dentist's office is currently sitting on $225,000 in student loans. Someone who takes on that debt isn't going to step out into a $50-60K job.

$150K seems like big money(and it's not peanuts), but consider this, car sales and mortgage sales make that. It's not that big a number any more.

All of that makes really good sense. But, at least in my town, you don't see very many doctors who don't live in the biggest mansions, drive the nicest cars, belong to the Country Club, attend the nicest charity balls, etc. I guess I've always assumed once they got past all they had to shell out to get where they are, things were pretty good. I don't think about factoring in all that overhead.

Anyway, most of them have my utmost respect!

Some can afford that. However, I know two doctors who live WAY beyond their means. I think it is living up to the assumption that all docs are rich.

most of the docs i know are living on the edge. they are living in a manner consistent with what everyone else thinks is normal for a doctor. there is usually a lot of debt backing up that pretty stuff. the cash flow can be immense, but so can be the cost of doing business.

there are exceptions obviously.

Something I have difficulty getting my head around is the idea of medicine as business. I know that it is. I just have difficulty with the idea of Doctors also being business people.

[eta] that doesn't apply to cosmetic procedures, I'm just talking necessary medicine here.

[flint] something else you might want to get your head around: my wang! [/flint]

i should have just posted that as Flunt. damn

lol I just laughed and scared the dog who was asleep at my feet :P


I know...I know....damn that human nature. And waiting...damn waiting...I heard this one guy had to wait 150 years and then they amputated the wrong leg....and he was left on a gurney in the corridor to recover. I heard that.

oh hell, they do that here. not too long ago a guy went to the VA hospital where they were supposed to remove a testicle (cancer, i think). He woke up to find out they'd removed the wrong one.

yep, now he's completely nutless.

that is why medical care is not something to try to save money on. pay for the good stuff.

Most docs are not good business people.

Our medical system over here is not too bad. I think it's way better than that in the US, but it's not perfect.

A lot more people are heading towards private health these days, mostly thanks to the conservative government we've had for the last 12yrs. I'll be interested to see what changes are made to both the private and public health sectors over the next couple of years if they give Johnny the big A.

I wonder why they're having to recruit them, then?

An ob-gyn in Long Island will pay $143,148 a year for malpractice insurance. (This is compared to $85,772/year for a general surgeon in the same area.)

In Illinois, an OB could pay as much as $170,000 a year (compared to about $75,000 for a general surgeon.) It's not as high in every state, but I'm pretty sure traveling to a neighboring state is not an option for most residents.

Hi SamIam! Good to see one of your random visits!!

To the Haters.
Would it really bother you that much to let me have some proper healthcare for my husband before he kicks the bucket and leaves me on this ridiculous piece of insanity called earth, broke and crazy?

Should I really have saved 6 digits just in case my young husband had terminal cancer? Really?

This is a pretty sore spot for me right now. I'm in danger of cussing at people again. Universal Healthcare would enhance my life right now is all I'm going to say. And don't call me lazy or a welfare slut. My husband and myself are very hard-working people. (Unless I'm dicking around with you guys on the cellar)

Just nevermind. Really. Fuck it. It's like banging my head against a wall.

When I go to the doctors for a checkup, (every 15 or 20 years, whether I need it or not) and she runs the routine battery of blood tests, I feel better when she tells me everything is OK.

At least until I get the receipt from the insurance company that says for almost $700 in tests, they paid $36.... and the lab accepted it. I wonder how good a job they did on checking for problems?

Yo Cic, just let rip, don't hold back. please. you may not feel better, but you might, and you won't feel worse.

The reality is, though, that there is no perfect healthcare system, no perfect insurance system. You'd be just as fucked in the UK. Life just sucks, sometimes. With Universal healthcare comes universal awareness that wasting the doctor's time is a bad thing. So diagnoses often come too late...

Cancer is just a bummer, no matter what insurance and cover you have. Sorry it happens to be your bummer right now. I have you down as rthe type of person who doesn't give up, though, so good luck, you will get there.

Hmmmm... I make enough. I should work less. That is what my family says. But seriously, I want to work really hard to make a better life for my kids and be sure my wife is set up if I kick it early, and or save for when we/she gets older. I know that few of you will believe this but after I retired from the military I more than trippled my salary and work twice + the hours. My average work week is 50 to 110 hours a week, every week. I will have a period of 3 or 4 days off in a row everyother month and one 2 week period a year where I am off from my regular job, but often I just work somewhere else. I currently have one job as an employee, 4 as an independent contractor, and one where I don't have to do shit as I draw retirement pay from the military. I feel driven to make more, work harder, for as long as I can until I am dead. Life goes on.

Old man goes to dr. Gets a shot and a scrip. Dr tells him if not better tomorrow comeback.
Old man, why, going to give me my money back? :bolt:

Yeah, the "real" price should be somewhere between the two. My Doc charges $120 for an exam, which is what a "self-paying" patient pays. Medicare pays 80% of their $110 allowable, but most of the private insurance companies pay $32 to $50. I think that if you accept Medicare, it's illegal to charge someone a discounted price, if they're a "self-pay".

Technically you are correct. A few places I work do it. Why? to help the patient, not because they are getting rich off of this group of patients.

I know....I know. But since my little plans for insurance have been foiled, I now have more options. Like, my husband has to quit working at some point (when he's sick)so I can prove us indigent enough to be accepted for medicare or medicade. Until that time occurs we are paying out of our pockets. And when it gets really bad I can apply with the state of NM as a home healthcare worker and can take care of my husband at home. Of course we are not going to be able to afford the place we are in, and downsize to a studio. Or I'm going to ******* and run ......and let my husband die on a beach in Mexico with some fucking dignity....haven't decided yet. It could go either way.

Maybe I can pay a Canadian on this board to marry him for a short period? Any takers?

Well- pm me if you are interested. :D

I bet it was on the internet. That's where I do all my research. And TV.

Hey, Cicero! Nice to "see" you again! Sorry as can be about your bad news. Damn, Damn, Damn, and Damn again. If you want, PM me with your phone number (I lost it), and maybe I can give you some advise re the SYSTEM :mad2:

To Clodfobble: Their are recruiting sites for EVERY profession. I bet they are even some for your line of work, whatever it is. Recruiting sites are not in themselves evidence of scarcity, although they can be an indicator of sorts. There's a big shortage of doctors of all kinds in the more rural areas, and I noticed many of the ads for OB-GYN's were for places like Bumfuck, Idaho (no offence to anyone here from Bumfuck).

To Lookout: I discovered an entire site on how doctors can disguise their assets - putting money in their children's names was only the most obvious of more devious plans that I didn't have the patience to read, not being a broker or a banker. And, anyhow, I don't have much sympathy for someone who whines about making a mere 150K/year. Sure, people in other professions can earn as much or more, so why didn't the folks who became Doc's just skip the entire Med School/Advanced Training treadmill, and go sell used cars, for example?

I would assume that at least some people are drawn to medicine for other reasons than money - reasons that cause them to suck it in and eke out an existance at a lowly 150K. And you never answered my question about what sort of society you prefer to live in. Is it one where Cicero's young husband dies of a deadly disease due to lack of medical care? If so, quite frankly, shame on you!

well, there you go, why don't you just ask when I quit beating my wife?

Do I wish ill upon Cicero or her family? absolutely not, it is horribly sad. Do I want to live with universal, tax payer funded medical care? hell, no. I prefer to live in a place where the market (consumer) decides the value of all goods and services. Supply and demand and all that.

Now if you want to talk about legitimate ways of sheltering money, i can do that all day - but this probably isn't the right thread.

I guess you just completely skimmed over the part where a huge portion of that salary, often over $100,000 a year, goes directly to paying for malpractice insurance? Hint: subtraction is the key here.

I think making refers to what he puts into his pocket AFTER expenses like insurance. But that's just a guess...

I am sure it works differently for different docs, but many times malpractice ins is paid by the practice.

It still comes out of your bottom line to the practice as potential income. It is an expense that must be paid every year.

Very true, but it is not necessarily a direct 1-to-1 correlation to a doc's salary unless it is a single doc in the practice.

Don't misunderstand me here. I think they deserve the money made. Some even deserve more than what they get once told by the insurance carriers what they get to make.

One practice I work for has 4 docs. They get all get a salary. Then they get a bonus based on the amount of work they do individually. It is a big busy practice and they all make a pretty good chunk of change. They all pay nearly 100k in malpractice each. The practice pays for it. The practice only gets income because of the docs. The docs are the only source of income, no docs, no income, no practice. If they did not have income to the business the business could not pay their malpractice, from their income. The higher the malpractice payment the less they have for other costs, including their own salary, and the salary of about 30 people who work for them.

That is what I am saying. I am not sure if you are agreeing with me or not.

Let's say the malpractice ins gets cut in half so they now have, just to simply things, an extra $200,000 in profit for the group. That doesn't mean that they will each get an extra $50,000. They probably would like to spend that money on extra support staff or new equipment or more current magazines in the waiting room. In my business, an extra $3,000,000 to our bottom line does not immediately get divided up among the managers and partners. It does increase our bonuses, but not by a total of $3,000,000.

I am not saying that it would absolutely not change how much money the doc takes home. It might. It might not. I was simply refuting Clod's claim that a large portion of a doc's 100K salary goes to pay for malpractice insurance.

We are in agreement. But when people pay out such large sums the only way they see it is that it is robbery, which it is in many cases.

...I was with you right up until the point where you said all your other points somehow refuted mine. :confused: Yes, malpractice can sometimes instead be a large portion of the practice's income, which directly affects how much money is left for doctors' salaries... I don't really see why that is anything other than a semantic difference. I agree with everything you have said.

48% of all counties in the US have no OB-GYNs at all, because either the hospitals or the doctors or both cannot afford to practice in those areas.

For the record, I did not make enough money this week. I'm not going to be thrown out of my apartment or anything, but business has been so bad recently at the shops. Of course, my boss recently bought a new minivan for his family, so he must be doing well.