Chris Link, MD., The American Thinker:
Anesthesiologists bill for most surgical cases with a combination of base units depending on the particular surgery (e.g. cardiac bypass has a higher base value than a hernia repair), plus one time unit for every 15 minutes. The average anesthesiologist bills 10,198 units in a year. Medicare pays, on average, $20.925 per unit. Now $213,393 a year sounds like a pretty decent living for most of us and it certainly would be until you start backing out expenses.
A billing service is in the neighborhood of 6% ($12,804) and average malpractice is about $23,000. I’m paying around $15,000 a year for health insurance for a family of four. Various expenses for continuing education, computers, cell phone, office supplies, etc. adds up to around $5,000. AMA, state and local medical society and American Society of Anesthesiologists dues add up to $1,700, if one chooses to join. I’d like to retire someday, so I put away 10% for retirement. Self-employment taxes take $17,154. And I have no employees or office. Most medical practices have a much higher overhead both in real terms and as a percent of revenue.
So what’s left?
$117,753, but without the “doctor fix” it would be $85,770. All that in exchange for 50-60 hours a week (including being on-call), coming out of school with an average student loan debt of $156,000 with a payment of over $1,000 per month, and putting your life on hold until at least age thirty. Suddenly it doesn’t look like such an attractive option.
And then there’s the guy you knew in college who coasted through studying sociology and went to work for the US Department of Health and Human Services right after graduation. He’s had eight years to climb through the bureaucratic ranks and is now one of the 19% of the federal workforce that makes over $100,000 and that’s before bonuses and overtime. And you always thought he was kind of an idiot.
The average pay of a federal worker in now $71,206, compared with $40,331 in the private sector. Excellent fringe benefits widen the gap even more.
Most of my colleagues are similar to me in coming from middle class backgrounds. I worked to go to school and probably paid for half of my education at a state university. I borrowed money for medical school. Another significant number of doctors are second or third generation physicians, but very few come from well-to-do non-medical backgrounds. And what will happen when medicine is no longer an attractive option for bright motivated youth to move up the socioeconomic ladder?
See that assistant supervisor at your local DMV? The guy sitting in the office drinking coffee, shuffling reports and playing solitaire on the computer?
Meet your heart surgeon.
Not only are we witnessing the makings of a permanent Democrat client state; we are witnessing the cultural evolution of a free society into the world of Brazil.
Time was that Kafkaesque was used to describe a cautionary tale, not a civic game plan.
Enjoy your cubicles, insects.
It used to be that people took government sector jobs for the civil service job security and generous benefits, in exchange for lower salaries. Now the mousy government clerks have become the SEIU purple-shirted thugs.
What the fuck went on there?
Peaches and Herb sing: Stultification and it feels so good.
See, what I don’t understand is why the ruling class doesn’t see the overall decline in medical quality hurting them as well. I mean sure, they will always have the best and the brightest for themselves, but
ifwhen the system stagnates, and there is never enough financing to drive innovation and new technology, everybody is in the same boat. With the tide in ebb.Where is the politician from Nova Scotia going to go for his cutting edge surgery in the future?
Hey, Jeff, Roger has a piece at PJ that’s right up your alley.
I was with my BIL, who works for an evil pharma conglomerate and deals exclusively with doctors, on Easter. He relates that the docs he’s talked to are, without exception, scared to death for the future of their profession.
the crushing obamadebt is his mostest clever instrument of tyranny… let’s yoke the motherfuckers, says our little president man.
Yoke ’em and then rape ’em.
Hate him.
Serves ’em right for taking all those big bucks for unnecessary tonsillectomies. Or something.
And tossing pacemakers around willy nilly. Take the pill, Grandma!
Christ, what a douche.
Doctors’ high pay (which is much higher than “we” think it is, in relative terms, because Americans are far income-poorer than almost everyone thinks we are) is a bubble resulting from market barriers erected within living memory. At the behest of…
“But this is one too many!”
Fuck you, parasite.
My husband’s family practice doc gave him an EARFUL. Everyone should be very afraid.
Getting an earful from your urologist never felt so good.
*** TRIGGER ALERT ***
Do not be afraid to click the link; my sick wordplay notwithstanding.
Once the GOP controls Congress and the WH, the first order of business should be this: The abolition and prohibition of public sector employee unions.
Let the Democrats scream. They know that would not only be death for the fiscal death spiral they’re trying to plunge the country into, but it would mean death for their political power as a national party.
Justification for this ban on public employee unions? BENDING THE COST CURVE OF GOVERNMENT DOWN.
Sound good?
If doctors are really worried about their profession, they need to follow Cassell’s lead.
OT, but get a load of this overt attempt at indoctrinating Texas school kids in accordance with the progressive mindset.
http://powip.com/2010/04/if-stuff-like-this-is-happening-in-texas-schools/
That’s how they plan to brainwash your future DMV clerk-cum-heart surgeon; to make sure they think the right way, before recieving their government-given student loan, and going on to get such propaganda reinforced at the ivory tower…
I could be a single issue voter on that plank Good Lt.
Another justification? Conflict of interest. Public unions negotiate against the private citizen.
I met some attorneys for DC the other day. Their jobs were to fight fraud in the welfare state that is The Nations Capitol. They described fifth generation welfare collectors making 100+ thousand a year gaming the system by trading foster kids like baseball cards.
You, Mr. Taxpayer, are the chump.
From the link:
A friend tells me that as a practitioner-specialist/CEO, he recoups half of what he bills to insurance. And one-third of what he bills to Medicare. What’s up?
What’s up is what I alluded to in a previous piece, which is that prior legislation plus Medicare have driven the entire industry’s cost, billing, and recovery structures for years. This is medicine’s positive feedback loop, a system made unstable by the jackasses in Washington.
That part about mandatory ER care? Like that times a whole lot. Medicine is all jacked up because medicine is already socialized, if only by effect and not MSNBC’s definition.
Breaking stuff in order to own it, that is Washington DC. The endgame has private practices and medical companies selling themselves to hospitals just to survive, and hospitals being bought by government in time. Like, in most of our lifetimes.
Every month I depend on patient assistance from the private sector to stay alive. I have found that sector most generous. I’m with Carin: Everyone should be very afraid.
Whoops, sorry, I meant VDH on postmodernism.
My personal bitch: I am an engineer. My company already took away yearly bonuses for us. Needless to say, I now make less than my wife who is an art teacher. Sure she has been there for a while and I am proud of her, but she really doesn’t do much other than babysit other peoples kids. She works 7 hour days. She gets nearly 3 and 1/2 months off a year. Me, I am responsible for keeping millions of dollars worth of commercial transactions and so on up and running.I sometimes work 10 hour days (salaried, so no overtime). I get 5 weeks of vacation a year.
This year for me: No pay raise – company hasn’t come out and said it, but the word is they can’t afford to give any because of costs built into the new healthcare deal – although I am sure, as is always the case, the executives will still somehow manage to make themselves some sort of great bonus. I still see people around me (I work with alot of nerdy fucks – star trek lovers) who just think Obama is the bees knees. It’s totally insane.
For my wife: about a 10 grand pay raise for finishing some bogus on line college garbage for 15 extra hours past her masters degree.
SEIU (AKA “Engulf and Devour”) happened. In California, the legislature is a wholly-owned subsidiary.
I presume you mean this VDH Craig?
This is my favorite part:
I hope millions take my advice and aggressively knock the accuser on his ass (rhetorically of course) every time it’s tried.
See, what I don’t understand is why the ruling class doesn’t see the overall decline in medical quality hurting them as well.
(a) If we’re all equally miserable, then mission accomplished, because it’s all about fairness.
(b) The piper never comes to collect his fee. Consequences are for greedy capitalists.
(c) RAAAAACIST!
(d) Unless you’re in a union, in which case you’re more equal than the others.
#15 Bob.
Looked over just a bit of that and it did nothing good to my blood pressure.
I am really starting to hate those people. I can handle people having different ideas; I cannot handle malicious lies.
For some reason unknown to me my GP likes to discuss things far off topic. He keeps me there longer than scheduled just to engage while clients are waiting. He hated Bush and issued the most discouraging and trite opinions. At one point he asked, “So what do you think of your man Bush now?” As if Bush was my man. I shrugged. I was in tremendous discomfort with a paralyzed face at that moment and in no position to counter antagonism which I thought was unfair. He went on demeaning Cheney and Rove with the usual calumny. I croaked, “Whenever I see Cheney on TV I think, ‘Uncle Cheney!'” He looked at me as if I were an alien creature. Ha ha ha. So anyway, I caught glimpse of his office which is a perfect disaster. Evidence of a disordered mind. I thought he was moving or reorganizing but the nurse said, “No. It’s always like that and he gets quite mad when we straighten it.” I swear, it looked like an explosion of paper that somehow landed in careless stacks. Which led to the thought, “What dreadful piles those papers are. All deathly serious shit, the type of mail that makes a tender-hearted bloke cringe, such as myself.” The sort of mail I put off opening. Imagine if I sent him some mail that was serious in appearance, priority mail, certified, return receipt, delivery confirmation, the full urgent postal panoply, that contains something so ridiculous and unanchored in reality that it makes him piss himself laughing. So I made this pop-up card and mailed it. Weeks later when I called the office about a line item on their invoice the RN ended by saying “Oh! We have your card here. We keep it at the front counter so now everybody coming in plays with it.”
Lying liars on our public money nickel Dicentra.
Ruining our younger generation by wasting their time on that drivel instead of actually educating them.
And people wonder why our kids can’t read, write, or do higher math; or at least a combination of a subset of those abilities.
It makes my head hurt too just thinking about it; especially in view of the hew and cry on the left about how, “Texas is standardizing wingnut values into their textbooks and that will effect the rest if the states in the nation!1!!11”.
sdferr,
Didn’t you send me a link that argued the opposite of the statement in that piece Bob linked. That conservatives do articulate a political philosophy and that it is progressives that do not?
I have to run and can’t search for it.
Swap the period and the question mark.
The first line in that document is such an umitigated lie it isn’t funny, Bob. Liberals (there use, not mine) are optimistic? Bullshit. Pessimism underlies the whole modern liberal ideology. That’s why they need coercion (i.e. the state) to make it “perfect”.
The problem is that the Progressive political philosophy is learned in the crib, and can be succinctly distilled to two words – “gimme stuff.”
I agree OI,
What may be even funnier is the beginning of the third part where it essentially says that liberals trust people to use good judgement, but that conservatives believe that people need to be controlled for their own sakes…
What a crock, coming from someone who I assume is a paragon of PC virtue and probably agrees that the state should save obese kids from themselves.
It’s hard to read that paper without simulaneously having your head explode, marveling at the inherent projection, and rolling on the floor in laughter; except it’s no laughing matter that they are teaching this drivel to our children on all of our nickels!
Well… we have Hobbes on this score:
And Madison, echoing:
Poor Sam. Such a sentence must be positively mind-bending for him.
liberals trust people in government to use good judgement
ftfy
Those terms Hanson is using. They are so…strange. So alien.
I don’t know how Hanson can use such words without confusing nearly anyone within reading distance.
VAPORS!
I know Jeff, It seems like I’ve heard some of those terms before…
But I’m just not sure where…
Mr W.?
“They described fifth generation welfare collectors making 100+ thousand a year gaming the system by trading foster kids like baseball cards.”
HOW? ‘ve had 2 foster children in my life (one when I was youngliving with mom, one a cupla years ago) And we sure as HELL didn’t make any money.
I think I smell economies of scale building in there somewhere Danger, else it is hard to figure.
Nope, I meant this VDH
Hanson rocks.
messenger friend D agrees bour3’s card is awesome
Here I was, just contempling recent dispatches from the, “YOU LIE!“, department and who pops in but RD/Meya/whoever he/she/itself…
http://www.youtube.com/watch?v=YwTGGHaCHAE
Must’ve been the negative waves, Man.
Fuck you, RD. Swordfish style.
RD,
You are not authorized to post off topic here in an attempt to derail the thread. Please discuss the topic at hand, the impact of Obamacare on Doctors wages and the resulting chill effect on those considering medicine as a career; or possibly how the usual mediaocre types will drift into it as often happens in the civilian government workforce-especially in view of thenationalization of the student loan industry.
That is all
Meanwhile, RD using the phone too.
I’m sure there’s a point there somewhere.
A stalker links to a story about a stalker. RD has a curious way of trying to score points.
Come on, Pablo. You can’t paint the entire movement with such a narrow brush.
“Contemporary liberalism is largely illiberal” doesn’t even smack of incoherence.
The jackass who left the message? I bet he shoots his 9 holding it sideways. After he missed the first two shots, he’d have the shit beat out of him. Punk.
That’s a kill shot!
I am icky. Some people like that, though.
Here’s the thing geoffb had in mind above, I think. James Ceaser (from Entropy sometime back):
With temporary meaning.
Well then.
Ceaser’s concluding paragraph (after much intervening analysis):
Is there a link to that, sdferr?
Lemme go rummage around and see JHo. brb
udaman.
Here you go. takes to Entropy’s link, expect not a website, but a wordpad doc.
Thanks, sdferr.
de nada
Medicare is one of the reasons there is so much cost-shifting in Medicine. Most hospitals either barely break even, or lose money on Medicare patients, and have to rely on the Aetna/BC/BS/UHC private payors to pick up the slack.
If your payor mix sucks badly enough (tons of Medicare/caid, and not much private-pay), your hospital can easily go out of business.
So not only do the illegals, Medicaid, and the uninsured take a free ride on the back of the insured… so do the Medicare patients in many places.
Price controls don’t work… and we’re about to learn that.
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