The 21% cut in payments to doctors and providers come to a $245B savings

[RB TexLa]

One way the administration could move people from the side of the doctors who feel they deserve to have this tax money to us would be to propose a $245B tax cut for those making under $100K.

[Oregone]

1. Tax cuts: the magic eternal solution to all our ills

[RB TexLa]

5. It's to make people understand that they need to be on their own side instead of the side of the

doctors who feel they are entitled to a certain amount of funds from the federal government. But don't worry the doctors will do everything they can to steal the difference from medicare.

[OHdem10]

2. The problem here is they underpay the Doctors and therefore,

you have Doctors refusing to take Medicare Patients.

If Doctors refuse to see you, the Insurance is not worth
the paper it is written on. Cutting them more just means
more Doctors will not accept patients.

[RB TexLa]

3. Accelerate collection on their federally backed student loans, open visas for doctors

to compete with them. Do those two things and instead of refusing to take medicare patients they will be on television advertising for medicare patients.

[stray cat]

7. Use tax dollars to pay off student loans and have med students totally on a merit based acceptance

but give them a free ride. 300,000 in student loans takes awhile to pay off at government reimbursement rates.

[madrchsod]

13. of the ten heart doctors i have seen one was from the usa.....

they do`t work any cheaper than a usa born doctor...

by the way most of our competitors do`t subject their students and parents to tens of thousands in loans. my wife and i owe 8,000 for my son`s college.do`t worry you won`t get short changed...if we do`t pay they`ll take it out of our social security or our estate when we die..

you should either educate yourself on the world around you or find another spot that is more in line with your ideas...

[Hannah Bell]

26. they get most of their education funded by their home countries then the us government

poaches them.

there's a name for that

[juajen]

68. No, in case of death all student loans are wiped out, just like an insurance

company payoff upon death, they (the insurance company) pay off your student loans. I know, for my late husband's student loans are finally no longer a problem. All paid off. When you take out a student loan, the borrower pays a premium for the insurance to take care of the loan in case of death.

[lib2DaBone]

4. cut social safety nets and cut government spending in a depression...

.. it will stop any recovery, make the deficit WORSE and throw the country into an immediate deflationary crash. Recovery from this type of scenario is the most SEVERE, and it will take generations to fix. (if at all)

i.e. It's the solution you LEAST want to do in a depression.

A much better solution would be to institute a small transaction tax on Wall street and the Goldman-Sachs Bankers, which would bring in more than the amount needed to pay for health care for every person in the U.S.

[stray cat]

6. Maybe cutting your pay would be more similar to the savings proposed?

Its so easy to call on everyone else to make sacrifices as long as you don't have to make any.

[fasttense]

8. More doctors from foreign countries would love to come here.

Why don't we open up more H1B visas for doctors?

Didn't that work for IT and computer labor? It lowered their wages. Bill Gates says we need more H1B visas. So, I think he would go along with it. If we lower the doctor's wages, we will lower health care costs.

:sarcasm:

[camio]

9. What an astonishingly stupid idea. NT.

[AnneD]

10. They are trying to do that to teachers too.

Either they want us to do more unpaid overtime or fire 'surplus' staff and make teachers pick up slack. They also make it easy to fire those that raise objections. The newest craze is firing the teachers if their students score low on standardized tests.

How are these folks going to pay for all those student loans. A Doc gets out of school with 130k or higher in debt. You can't expect these folks to eat that cost. I expect these folks to be degreed and I expect to pay them.

[ProgressiveProfessor]

11. In some cases Medicare reimbursement will now less that the cost to provide

so docs will either have to drop Medicare patients, reduce the time/service they get, or not accept any more of them. Not real smart with an aging population. SOme small hospitals are in a similar position.

Not all the practicing MDs are filthy rich with Park Avenue offices. Family practitioners are in some places hard pressed to provide quality care, decent salaries to their staff, pay their student loans and feed the family.

[nightrain]

12. RB, sadly it appears that you have little understanding of the

greater impact that a decrease in payments will have.

Are you aware that many other non-Medicare payments to many other kinds of practitioners are based on the 20% lower Medicare reimbursement rates?

I don't suppose that makes a difference to you.

Some of us practitioners are NOT 6 figure income earners, but squeak by like most people these days.

HUGE UNREC.

[RB TexLa]

14. That is the goal, to use the federal government's buying power to lower health care costs.

[nightrain]

16. and how does reducing my meagre income help?

[RB TexLa]

17. Lowering government costs and overall health care costs pale in comparison to what it does to you?

wow, really, wow. Let me guess, your three favorite words are "Me, Me, and Me."

[nightrain]

52. I asked a serious question, and you dish out junk.

Try being real.

[Hannah Bell]

60. Reducing workers' incomes to the tune of $250 billion in a depression = more depression.

It's not about the poster.

I repeat, where are the cuts to insurance corps, pharmaceutical corps, medical equipment corps?

No, the cuts are to "practitioners", i.e. workers -- not to corps.

They're being protected. Independent practitioners are being targeted. So the corps can come in & pick up the pieces, = further consolidation.


Let me know when our elites sacrifice some of their income & perks.

Until then, your "why are you so selfish" talking point falls on deaf ears. This administration is targeting the working class to benefit elites.

[Hannah Bell]

54. where are the cuts to the pharmaceutical corps, the insurance corps,

the medical equipment corps?

"lower health care costs" --

wrong. to put the last independent practitioners out of business so corporate medicine can consolidate.

[RB TexLa]

56. Cut or gut what we pay to all providers

[Hannah Bell]

61. pharmacorps aren't "providers".

[laughingliberal]

55. Going after doctors' pay is the wrong approach

Hospitals, yeah. Doctors? no. A lot of primary care physicians are way underpaid. They have offices and staffs to maintain. My own physician has considered closing her practice as it is barely supporting itself right now. The pay to physicians should probably be increased and the pay to the for profit hospitals needs to be lowered. Of course, the only way to do either of these is to go to a single payer system.

[bobbolink]

24. Oh, I think the "understanding " is there... its a move to kill off those of us considered

"extraneous" and "worthless".

Interestingly, this is proposed by those who call themselves "prolife".

Yet, they want us to kill ourselves, rather than being honest and providing us with the means to have a painless exit.

Hypocrits.

Damned hypocrits.

[MiniMe]

15. How much would a 10% cut for Senators and Congresspersons add up to?

Just curious.

[OhioChick]

22. Good question. n/t

[RB TexLa]

23. It would be goog politics for them to take a reduced pay during a depression

Just like the president could have not had a state dinner as a mostly symbolic act of saving money.

[Dr.Phool]

34. Not enough. Make it 25%.

And eliminate their medical insurance. They can always go to the emergency room for care if they need it.

[mmonk]

18. Tax cut ideology won't work on this one. There are lots of examples

where the center piece of the tax cut religion or cult doesn't work. A tax cut in this case would not lower costs just as it did not lower costs when the republicans tried to sell it on Medicare Part D fiasco. A tax cut would make it so Doctors would no longer accept Medicare. They want to get paid for services rendered just like you would. Cutting Medicare is getting rid of Medicare.

[RB TexLa]

19. A cut would be just to get people off the side of the doctors on the reduction

it's not for any benefit of the tax cut.

[mmonk]

20. The problems with our healthcare payment system has to do with

a middle man for profit monopoly system. The Doctor is normally at the end of the chain. The overhead to pay that doctor through Medicare is small.

[RB TexLa]

21. It's a low overhead but there is a cost to that. The low over head allows doctors to steal more

medicare than they can steal from private insurance.

[mmonk]

25. I understand what you are trying to say.

However, what is an elderly person on fixed income to do?

The American Medical Association said that starting Monday, the 21% cut will force doctors to "consider the difficult decision to limit the number of Medicare and TRICARE patients they see in order to keep their practice doors open."

"Our message to the U.S. Senate is stop playing games with Medicare patients and the physicians who care for them," said AMA President J. James Rohack, MD, in a statement. "It is shocking that the Senate would abandon our most vulnerable patients, making them the collateral damage of their procedural games."

http://www.medpagetoday.com/PracticeManagement/Reimbursement/18711">LINK

[bobbolink]

27. Thank you for that link. Good quote. Yet many here obviously wouldn't give a rip

what happened to many of us.

In fact, doubtless many would cheer the deaths of what they see as "useless garbage".

[RB TexLa]

29. It's the doctors that are telling them they are not worth treating for 20% less.

[bobbolink]

32. I only have this to say to you, since you refuse to hear anything....cut us out, and then

YOU are responsible for seeing to it that we can die a painless and dignified death.

What you want is for us to die out of sight.

THAT is hypocritical.

edited to say... it's also irresponsible.

[RB TexLa]

36. I don't know who "us" is but I don't want people to die out of sight.

[bobbolink]

42. "WE" are the ones you are so casually dismissing as inconsequential.

No, I suppose you would like our deaths to be a public spectacle, like a hanging.... as a warning to others, right?

[RB TexLa]

43. I am not dismissing anyone the doctors are. They are the ones telling people

they are not worth treating.

[Name removed]

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[Name removed]

45. Deleted message

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[Name removed]

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[Name removed]

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[Hannah Bell]

62. bullshit. it's this admin that's putting them in the position of treating to

their own detriment or not treating to the patient's detriment.

the results =

1. less government spending = less economic stimulus
2. more independent practioners out of business
3. elderly with more trouble accessing medicare = more untreated health problems = higher rates mortality/morbidity
4. more corporate consolidation of healthcare
5. higher stock prices for healthcorps

[RB TexLa]

28. And you believe the doctors when they say they can't stay open with a 20% cut

I don't and the senate doesn't. The message from the doctors seems to be everyone but them should have to sacrifice.

[mmonk]

30. Why do you want to cut medicare?

Why not put the top tax rates back before Bush? Why not cut out subsidies and eliminating the donut hole where there is no negotiation for drug costs? There are better ways to go than pushing more of the elderly into poverty.

[RB TexLa]

31. They can be treated at the proposed rates. The doctors are lying. We can sunset the Bush tax cuts

and at the same time use the buying power of the federal government to lower health care costs. Once the doctors and providers are forced to accept the cuts, private insurance can follow with cuts. And of course we have to cut what we pay for drugs through negotiation and all other means available.

[mmonk]

33. Private insurance will follow? On what planet?

In 2009, the top six insurers combined profits rose 56% while insuring 2.7 million less people while raising their rates across the board.

[RB TexLa]

37. You do not think private insurers want to pay less to doctors?

[Dr.Phool]

40. They don't want to pay for ANY fucking thing.

That's the problem.

[mmonk]

50. The object of a for profit health insurance company is already to pay out less

and take in more. It's called business. It's why the incentives in the U.S. system are all wrong. The purpose of a for profit health care insurer is not to meet the mediical needs of citizens or to pay a lot to doctors, it is to turn a profit for their stockholders that it is its only fiduciary mission.

[Dr.Phool]

38. You do realize that Bush cut Medicare reimbursement rates by 30% already.

[RB TexLa]

41. I know, I see all those doctors begging on the street corners. How did they survive?

They couldn't have been lying then as they are now about not being able to take the cuts, could they?

[laughingliberal]

57. Doctors' pay is the least of the problems in the system

Some specialists are making out well but I know primary care physicians who are making, after the expense of a private practice, about what I did as a nurse.

[Hannah Bell]

65. more bullshit.

Private medical practice has been declining at an annual rate of about 2 percent a year for the past 25 years, according to a review article in The New England Journal of Medicine...

More recent data from the CSHSC show that 51.8 percent of primary-care physicians owned their practices in 2005, compared with 54.3 percent in 1997. The portion of practice owners among medical specialists dropped to 47.3 percent from 58.1 percent. And among surgical specialists, the percentage fell to 68.4 percent from 75.5 percent.

According to the study’s authors, “The low percentage of primary care practitioners in independent practice may reflect the serious problems of overwork and underpayment that primary care fields have faced for many years…” Hence many primary-care doctors sought employment before specialists did, they say.

...Family doctors in groups of 10 or fewer doctors made a median $156,501, versus $165,744 in groups of 11-25, $175,847 in groups of 26-50, and $181,116 in groups of 51-75."

http://74.125.155.132/search?q=cache:fYTpQ70Ul64J:industry.bnet.com/healthcare/1000400/why-more-physicians-prefer-to-be-employed/+doctors+private+practitioners+percent+drop&cd=2&hl=en&ct=clnk&gl=us


"Median" = half make less. You really think $156 - $181K is outrageous compensation for a doctor? Really?


What do *you* do for a living?

Because of the last two people who tried to tell me teachers, public employees, etc made too much, one was sending her kids to a $25K/year private kindergarten, & another got his living by selling large commissioned art installations to the wealthy.

Hypocrites & scabs.

[Hannah Bell]

63. no, the admin is lying. there will be no follow-up by private insurance. their profits will *rise*

& there's been *no* action whatsoever on pharmaceuticals. in fact, action on this front was specifically disallowed by the administration.

it's *absolute* bullshit you're spewing.

[liberalhistorian]

73. Wow. You really do know less than shit about nothing,

don't you? I've seen some really facepalm-worthy crap on here, but this is beyond even a facepalm. And that's saying a lot.

[OmmmSweetOmmm]

35. Just think of all we can be saving if we got our asses out of Afghanistan and Iraq! nt

[RB TexLa]

39. I think that should have been done a long time ago. I was even for leaving equipment there to get

out quicker.

[juajen]

69. How very right you are; yet, this is never really talked about, or is

intentionally avoided by our President and most of Congress. I so hope that he is good and is doing what he can and still remain viable, for I really like him. I need to have faith in him or else lose all hope. How many of us are in the same boat?

[OmmmSweetOmmm]

71. He lost me at Rahm. Latest travesty

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=7810271&mesg_id=7810271

[Ikonoklast]

48. Oh, it's you.

Yeah, tax cuts are the answer to every problem.

Republican position and talking point.

Unrec your libertarian drooling.

[RB TexLa]

49. The tax cuts aren't an answer it's a tool to get the American people to turn on the doctors

in this fight. Not an answer just a political tool.

[Hannah Bell]

66. Because doctors are the villains in the health care drama, like teachers are in the education drama.

Bullshit. bullshit.

The war of all against all.

This admin is trying to get people to fight each other for crumbs, you mean. While its funders & owners laugh all the way to the bank.

[Yo_Mama]

51. It's not the doctors who aren't getting the money!!

It's the seniors covered under Medicare who aren't getting to see doctors. How does that justify a tax break for the rest of us? Which will, btw, not show up for those who need it the most, like the unemployed, etc.

You can make a lot of money as a doctor charging cash - not accepting insurance at all. And then if you want to, you can see some patients pro bono.

And if a doctor stops accepting Medicare at ALL (in many areas there are very few to none accepting new patients, but they are still carrying their current patients), then he doesn't have to take the Medicare payment. The patient pays him directly for whatever. So the senior is going to be forced to pay the doctor or not get care.

Here is an article from April 09 in the NY Times. I fail to see how preventing poorer older people from seeing a doctor is going to do anything good for the country:
http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

Please read the article. Mayo Clinic is now charging Medicare patients extra. The real story here is that reimbursements are being cut so much that seniors' medical insurance is effectively being partially revoked. This should not be anything that any DUer supports.

[Hannah Bell]

53. where are the cuts to the insurance corps?

[laughingliberal]

58. And the hospitals? nt

[taught_me_patience]

59. I don't know where you're getting the notion that doctors

are getting rich off of treating medicare patients. Seriously, you are completely uninformed about this issue. The 21% cut in payments negatively affects many middle class families while worsening care for those who need it.

[DeltaLitProf]

64. The reimbursements should be INCREASED and the difference

. . . should come from the bloated defense budget.

But of course this'll never happen.

[demmiblue]

67. No pay cuts for docs, increased pay for nurses.

Screw the insurance companies.

That is all.

[anonymous171]

70. Tax the rich. nt

[nightrain]

72. RB, so much venom toward practitioners. Did some practitioner hurt you or something?

[havocmom]

74. Or, we could do single payer to all, cut the vampire insurance companies out

and help people get through med school without incurring horrendous debt. With so much less paperwork, doctors would not have to hire small armies of clerical workers or join huge corporate clinics that make them keep to 10 minutes or so with each patient.

The laid off clerical workers can be trained to work in subsidized alternative energy fields.

Obsolete insurance exec can just pound sand.