U.S. doctors switching to salaried jobs
By Elisabeth Rosenthal, New York Times
American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following.
Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years.
Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins.
Health economists are nearly unanimous that the United States should move away from fee-for-service payments to doctors, the traditional system where private physicians are paid for each procedure and test, because it drives up the nation’s $2.7 trillion health care bill by rewarding overuse. But experts caution that the change from private practice to salaried jobs may not yield better or cheaper care for patients.
This referenced article hints at more complexity than where the summary ends, including this comment from a doctor in NY:
“Some people are operators and give the rest of us a bad name,” he said, adding that he had changed his opinion about America’s fee-for-service health care system. “I’m fed up — I want a single-payer system.”
We would have joined the rest of the industrialized world with some sort of single-payer healthcare system by now if it wasn’t for the incessant, willfully ignorant braying of the hate gubmint teabaggers.
Here is just one of thousands of reports on how terrible our for-profit insurance co. scam system is: http://www.bloomberg.com/visual-data/best-and-worst/most-efficient-health-care-countries The sooner we face up to the facts of this fiasco, and ignore the foxbot rubes screaming “socialism” at every attempt to fix it, the better. We Do Not have the best healthcare results in the world because unlimited money in politics allows the private sector Insurance and Big Pharma companies to purchase enough seats in Congress to prevent change. We must join the movement to overturn SCOTUS decisions that make corporations=people and money=speech. http://www.movetoamend.org
Let’s not.
When has central planning and massive government control ever been more efficient than small, localized decision making? Never.
What causes folks to want to control everybody else’s ability to choose for themselves how they want to live? Run their business? Access medical care? Education?
Leave us alone. Let us be free.
Dog,
I don’t want to know what your history is for you to spew so much venom about control and some kind of so-called freedom. But it must be bad. I am sorry for you.
You think small localized decision making and planning is good, like the City of South Lake Tahoe??? Get a grip.
Single payer medical care is something already tried and proven. It is Medicare in its current form.
The system is there already for all of us 65 or older. It works, the care is good (I choose the doctors, I go to, it would not require any reinvention to add the rest of Americans to it. Medicare also runs several percent lower in admin/management costs than private industry.
Governments owe their citizens a few things and adequate, affordable health care is one of those.
But the money paid to lobbyists and congressmen to keep the profits rolling in for insurance companies is so unreal and pervasive that to go to a single payer system would require the upsetting of significant parts of the money machine, and congress will not act. So far anyhow.
Our current, mostly for profit system is failing the majority of Americans. Far too much money poured into the overly complicated insurance system gets spent on administration, salaries etc and never makes it to the care providers. There are insurance company CEOs making $20 million/year. That comes out of our paid premiums, and causes the private insurance costs to be so high many people cannot both eat and afford health coverage.
Just an example of the insanity:
My wife’s health coverage before medicare was $900/month for coverage that had an $8000 deductible.
The insurance co. underwriters assessed her health risk, and she was getting surcharged for having a body mass index that was according to them, less than ideal. You think she is overweight of obese? Wrong, she is 5 foot 6 and weighs about 120 pounds. This is bad?
This must change, and it does not involve a loss of freedom for anybody
You just made my argument for me.
It’s the Federal Government’s ‘scientists’ who came up with the bmi that the insurance companies use to penalize people. An individual doctor who isn’t bound by the central planners’ numbers would tell you that there are healthy fat people and unhealthy thin ones. We don’t all fit into the central planner’s box. The symbiotic relationship between the Federal Government, the lobbyists, and the corporations must stop. Without government support, corporations CANNOT become the monolithic powers that they are. Smaller, leaner, more innovative competition will always cut away at the power of larger, less nimble organizations. Government protects those corporations to the detriment of innovation.
Again, I ask: Why do you want them to control you? Why can’t you let people be free?
We are headed towards a Medicare type system, single-payer, eventually. A way will be found to keep the insurance companies ‘in the loop’.
I guess if freedom means getting ill or hurt but having no way to get medical help because you cant get medical insurance due to a preexisting issue or just not being able to afford the basics, than have your freedom, dog, knock yourself out, but dont deny me my right to be given help or to ask for help and know that my government is there to help. See whats freedom to you might not be the same to someone else. So who trumps who?
“When has central planning and massive government control ever been more efficient than small, localized decision making?”
We spend 17% GDP on health care.
Countries with a single payer options spend around half of that.
” dont deny me my right to be given help or to ask for help and know that my government is there to help. See whats freedom to you might not be the same to someone else. So who trumps who?”
That’s not “freedom”. That’s redistribution, or, in plainer terms, “theft”. Having government steal from one person to provide something for some other person is theft once removed. It’s still immoral.
gofigure, single pay systems are not free the people pay for it one way or another. I hear all the time that we should go to a system like England that way it is free(believe it or not people here think that it really doesnt cost the individual anything not relizing it cost in form of higher taxes)
reloman, no one who advocates for a single payer system thinks that.
Dog. What exactly happens now when a poor person walks into Barton emergency from say being diabetic? Is the woman or man denied care at emergency for lack of money? NO. Who ends up paying for the costs of emergency care patients? The County – State Governments. This is not “theft” from one person to another. This is called a “civilized society” in which we care for each other. Unless you want to emulate the 3rd World model and refuse care at the door of emergency for lack of payment, preventative health care is going to cost less in the long run. But, this was all hashed out in a 2012 Presidential Race. It is time to move on from this circular argument.
It’s only circular because you call ‘theft’ by a euphemism. “Civilized Society”.
There have ALWAYS BEEN, and there will always be, private charities who will care for the indigent. And the more prosperous a society is, the more they usually give. Keep us all poor by overtaxing (stealing from) us, and we give less. And the money the government steals is used much less efficiently than money used by private charities.
You say this was all hashed out in the last election? No, it wasn’t. However, the 2nd Amendment hashed out the right to bear arms over 200 years ago, and you’re still fightin’ it. So don’t go gettin’ all righteous on us.
Dog give us one example of a country that cares for its indigent through 100% private charities.
You live in a fantasy world.
Dog! This is the 21st Century, not the stone age. Theft is what ENRON did to California and what JP Morgan, Chase and Barkleys continue to do now that they are in the energy markets. Theft is whole Libor scandal and banks gaming the world interest rate market. Theft is Goldman Sachs gaming the worlds metal markets.
Were charitable organizations able to keep up during the Great Depression or Great Recession? No.
The 2nd Amendment does not mention: machine guns, RPG’s, high capacity clips, drones, laser guided missiles and weapons of mass destruction either. Do you think every citizen, including mentally ill citizens, should have any weapon produced on the Planet?
cosa, sorry but the vast majority of people in our society are uninformed and a very good majority believe that the single pay system is free to them, that they dont have to pay for any of it as the goverment provides for it out of(i would guess) some secret slush fund they have for a rainy day. Many people would be against it if they had to pay for it out of a form of taxes from their pay checks.
Their are a very large number of industries to blame for the cost of our healthcare being 18% of our GDP, from insurance companies, to drug companies, to legal system, to health care providers, to goverment oversite, to bad health habits of the population, to going to the doctor for ever sniffle, and probably others that I dont know of.
The people advocating for a single payer system, who would use a number in reference to GDP, do not believe it is “free”.
Sure there are dumb people, but they aren’t advocating. That is why I used “people who advocate”, so that I wasn’t talking generally.