Here is something to brighten your day:
Like many low-income neighborhoods, the north side of Milwaukee has seen a gradual depletion of its primary care doctors over the last two decades. One by one, they have retired or surrendered to financial reality, rarely to be replaced.
At the few remaining practices, the wait for an appointment can make it almost purposeless to seek one. When Martha Brown’s 3-year-old daughter, Loverree, woke up with a runny nose last Thursday, her doctor’s office told her it would be a week. “I couldn’t wait,” Ms. Brown said. “I had to see what was wrong with my baby. I think she’s got an infection.”
Rather than heading to an emergency room, Ms. Brown took her three children to the Milwaukee Immediate Care Center, a small nonprofit clinic that has treated the north side’s largely African-American community since 1986. The clinic, which keeps hours at night and on weekends, is the only full-time operation in the neighborhood that provides urgent care, luring patients with a sign that reads, “When You Need a Doctor Today.”
Ms. Brown’s decision made good sense, not only for her but for the state and federal taxpayers who support her health coverage through Wisconsin’s Medicaid managed care program. But whether the option will remain available is an open question.
The clinic has teetered on the brink of insolvency for years, battered by foreclosure filings, delinquent tax claims, building code violations and the loss of contracts with two major H.M.O.’s. It has had to cut its hours in half, significantly reduce its medical staff and mothball its X-ray equipment.
Maybe what we really need is a complete and total breakdown of our entire health care delivery system before anyone in DC will do anything, although many would argue we are already there.
someguy
This is exactly why we need single payer. If we have that, doctors in training – enjoying subsidized loans – can be pushed away from lucrative self-serving specialties like cardiac and neuro surgery and into specialties that benefit more than wealthy patients with caddilac insurance policies. This is simply insane that poor people can’t get medical care – and increasingly nor can the middle class.
Ajay
Maybe what we really need is a complete and total breakdown of our entire health care delivery system before anyone in DC will do anything, although many would argue we are already there.
I dont think it will make any difference. Wingnuts dont really care.
I felt exactly the same in 2004 and surely in 2008 it was clear that the moron we had as president was responsible for a trillions of $ in deficit, trillion+ dollars spent on a war which was supposed to be $10 billion war. People lost jobs, homes etc. Banking and Car industry in US was annhilated. IOW, a total disaster from any point of view.
But low and behold, idiots still want those days back. Southern White Hope is the only way for them to take their country back regardless of how the elected leaders perform.
Kryptik
Don’t you see though, John?
If they couldn’t remain financially stable, that means they weren’t very good doctors/hospitals, thusly they deserved to go under. It means what we have left is higher quality!
It’s just like how those who can’t buy insurance don’t deserve to have health care. If they couldn’t remain financially stable enough to afford a plan, that means they weren’t responsible enough to be worth it!
Free market rules!
GReynoldsCT00
I think every one of those assholes in DC should have to access their health needs via Emergency Room; they’ll never get it, otherwise. This has been another episode of FYIGM…
jibeaux
Call me cynical, but the breakdown of the health care system has a looooong way to go between poor neighborhoods in Milwaukee and Senators’ and Congresscritters’ personal physicians, and I don’t see that we’re going to get any real recognition of the break down in health care delivery, at least among some of our illustrious representatives, until it gets to that latter point. For too many people, a system that works well enough for them personally is not in need of fixing.
fish
But you have to wait for a nose job in Canada!
arguingwithsignposts
Yes, this exactly. Just like RAM setting up shop to provide health care in LA – it won’t register. The people who make the decisions have quality access. A lot of middle class people have relatively speedy access. So the problem doesn’t get addressed.
DougJ
Maybe what we really need is a complete and total breakdown of our entire health care delivery system before anyone in DC will do anything, although many would argue we are already there.
It will never break down enough that people with money won’t be able to afford it. And that’s all that matters.
Nobody in DC gives a fuck about people on the north side of Milwaukee.
asiangrrlMN
Ok. It’s time to really get serious about repealing healthcare for Congresspeople. They really won’t get it until they have to experience the nightmare first hand.
joes527
Wouldn’t make any difference.
We live in a country with a significant mass of people who will argue (vehemently) against their own interests in order to preserve profits for the profitable.
It makes no sense, but that’s the country we live in.
gbear
Sadly, what DougJ said.
geg6
Any country that has elected officials laughing at and telling an uninsured working mom and her 2-year-old to grow up and just pay for health insurance and quitcher whining is a country that simply doesn’t give a damn about how many people live or die as long as they are not in any way inconvenienced. We are monsters.
GranFalloon
joes527, what a succinct way of putting it. So on the money (pun intended). It has always staggered me, how the GOP has so wonderfully succeeded in convincing this critical mass of voters to support those things that harm them or, at the very least, to vehemently get behind causes that don’t really matter to them. You almost have to have a grudging respect. Hence:
You get unemployed factory workers in favor of tax cuts for corporations and in favor of increasing the exempt amount on the inheritance tax.
The parents of soldiers are most in favor of war at all costs.
You get Medicaid patients screaming to keep the government out of healthcare.
You get common laborers citing Atlas Shrugged.
You get those who would benefit most from Obama’s tax plan and health care bill vehemently opposing it.
You have out-of-work high-school educated blue-collar workers yearning for the days of Reaganomics.
This also leads to the same people who once said “If you’re not a terrorist, then you shouldn’t complain about a TSA body cavity search” now taking to the hills when it comes to filling out a tax return.
Comrade Dread
You know, I wouldn’t mind bailing out places like this. They deserve to be bailed out a lot more than the banks did.
And why aren’t we trying to get more places like this opened?
Oh, I know why the Republicans would oppose using Federal money to do it, but the Democrats don’t seem that interested in creating more clinics to service poorer neighborhoods either, which would help address the need for medical care for the poor and uninsured.
Ivan Ivanovich Renko
@GranFalloon: “We’ll do without ourselves rather than have those shiftless Negroes get anything.”
ksmiami
That giant sucking sound is the sound of our medical costs swallowing 20% of our GDP because we have an out of control treatment oriented system and our doctors, pharmaceutical and insurance companies MAKE TOO MUCH GODDAMN MONEY for what they do.
GranFalloon
ksmiami,
“our doctors, pharmaceutical and insurance companies MAKE TOO MUCH GODDAMN MONEY for what they do.”
Oh, but don’t you agree that “teh plaintiffs’ bar” has directly caused the high cost of health care by filing frivolous malpractice suits?
I don’t. Because (1) the amount of malpractice verdicts and settlements is a meaningless fraction of premiums; and, more importantly (2) it seems – possibly coincidentally – that increases in malpractice premium rates just so happen to be inversely proportional to the Dow.
Weird, huh? Wonder why.
sparky
the interesting thing to me is that the oligarchy doesn’t seem to realize the danger of playing with fire. maybe it’s because there hasn’t been a real insurrection in so long that they just can’t imagine that pouring fuel on people’s anxieties in a time of economic uncertainty might end badly. the Empire has a long fuse, but i confess i would prefer to not find out where it goes.
Stefan
At the few remaining practices, the wait for an appointment can make it almost purposeless to seek one. When Martha Brown’s 3-year-old daughter, Loverree, woke up with a runny nose last Thursday, her doctor’s office told her it would be a week.
I’m sorry, this can’t be in America. We don’t have rationing here. The reporter must have gotten confused driving around Milwaukee and somehow made it into Canada instead…..
jcricket
surely the free hand of the marketplace will innovate this problem away… oh wait, that’s why we have no primary care doctors in rural or inner city areas? We obviously know it’s the darkies fault for living in the horrid, horrid cities (rather than suburbs like real Americans).
Perhaps the self-sufficient red-staters in rural areas can band together and have community doctoring where they take turns diagnosing and treating each other using some manuals, teh google and webmd.
jcricket
@GranFalloon: Honestly, while some of it is economics, a lot of it is also the Republican embrace of Christianism, xenophobia, racism and homophobia as a strategy. I’m not saying all those poor whites are the latter four – but a lot of them are (esp. the crazies we’re seeing now out in full force).
But on the economic front Republicans have spent 30 years convincing people of the “two Santa Clauses” (low taxes, high services). Yeah, it’s intellectually dishonest, but it’s been working pretty well. Especially since Democrats have failed to show that Republicans are lying, cheating, fiscally irresponsible fools and failed to articulate the positive case for progressive taxation and government intervention.
Can’t blame the GOP for being who they are. But I blame us for responding so poorly and always being on the defensive.
Stefan
surely the free hand of the marketplace will innovate this problem away…
What free-market advocates never seem to understand about how markets work is that markets don’t arrive at a solution for everyone, they just set a price for a product. And the markets have decided that the price of healthcare is too high for these people so they just aren’t going to get it.
The Raven
It’s got to come home to the
LordsSenate before we see action.latts
@GranFalloon:
You get unemployed factory workers in favor of tax cuts for corporations and in favor of increasing the exempt amount on the inheritance tax.
They’ve been led to believe that only the continued benevolence– which is unsurprisingly directly tied to low taxation– of the wealthy allows them to keep their jobs at all. Unfortunately, globalization doesn’t help counter this impression.
The parents of soldiers are most in favor of war at all costs.
Soldiers are deliberately whipped into a righteous fervor at wartime, and even in peace are conditioned to see the world as a series of battles that must be won at all costs. Parents usually adopt their kids’ views, and if they lose their children to war, most absolutely cannot accept any conflict resolution that doesn’t resemble a grand victory (the ‘make sure s/he didn’t die in vain’ syndrome)… inconclusive, bloodless negotiations are deeply unsatisfying for them.
You get Medicaid patients screaming to keep the government out of healthcare.
I think you mean Medicare, but I take your point. First, they’re fine with taking government largess but rebel at the notion of government fiscal discipline (that’s the hypocrisy). Second, the right has redefined the universal programs– Social Security, Medicare, and to some extent military & veterans’ benefits– as personal savings programs rather than public insurance. They’re only getting what they paid in, in their minds, even though that’s objectively untrue.
You get common laborers citing Atlas Shrugged.
Self-image. They aren’t society’s winners, but they conceivably could be in a more perfectly capitalist world, or at least they have the pride of productivity within their constraints.
You get those who would benefit most from Obama’s tax plan and health care bill vehemently opposing it.
But others, people they don’t like, could benefit even more, and that’s intolerable. Plus their potential benefit from it is a reminder that they need help, which is humiliating.
You have out-of-work high-school educated blue-collar workers yearning for the days of Reaganomics.
They felt more positive back then because the rhetoric was populist/nationalist, while the destruction of their economic foundations was quiet & mostly invisible.
Common theme?- it’s all about feelings and not reason. The right flatters their base and demonizes others, which is particularly appealing to those who are culturally insecure in a changing world. It looks back to a social structure in which they enjoyed more status, if not more actual security, and validates their anxieties. It’s really masterful distraction & manipulation, if you think about it– I’m not sure it’s ever succeeded so well and for so long in such a large population, to be honest.
Church Lady
Did everyone miss the part that said “surrendered to financial reality”? The family in question is on Medicaid. Both Medicaid and Medicare reimbursements are notoriously low. My own primary care physician stopped accepting new Medicare and Medicaid patients a couple of years ago. She says the reimbursement rates paid by Medicare and Medicaid are below the actual cost of care and that she just couldn’t afford to take any more of those patients on.
How do you solve this problem with single payer or a public option, where reimbursement rates would be similar to those already existing for Medicare and Medicaid?
DougJ
CL – stop spoofing. For real. I know you’re not on the up and up. I readily admit that you had me going for a while.
Leelee for Obama
@Church Lady: I watched Dr. Dean last night on BookTV. The Blue Dogs made it part of the bill that the PO cannot reimburse at Medicare/Medicaid rates, but higher. That sounds right. Also, PO must be self-sustaining after a start-up period. It will operate as a non-profit, however, there will be no highly-paid CEOs etc., so it will be better able to keep costs down by reinvesting profit amounts back into system. Primary Care will be encouraged through Ted Kennedy’s Community Health Centers, as medical homes, and by offering to erase the debt ($100,000-150,000 or more estimated) for Docs who choose Primary Care. That sounds right, also. This will take years, I may not get to see it working perfectly, but it is what’s needed, and it’s a reasonable compromise to Single Payer, which would be better. All businesses should be on board for this ( as a competition thing ), as well as Docs-they don’t think their compensation is adequate, and they can’t say no forever to Medicare-Medicaid patients-w/o those, there is no break even point, let alone profit-This mess has been left too long, but it must get done and now is the time.
Pender
I know this is beside the point, but she needed urgent care because her baby had a “runny nose” and it couldn’t wait a week?
Does she call an ambulance when her baby poops?
Anne Laurie
The Invisible-Hand-of-the-Free-Market worshippers will point out that runny noses are why “doc-in-the-box” insta-clinics were invented. Of course there probably isn’t a chain drugstore or Walmart within reach of Mrs. Brown and her daughter, and the fee-based medcenters don’t accept Medicaid, but if we start propping up not-for-profit clinics it would be sinfully unfair to the shareholders! Just ask
our DHS minderany sensible yustabeliebral conservative, like the Church Lady!If history is any guide, what it will take to change the minds of this country’s “medically privileged”, such as our squabbling Congress and those members of the middle class who haven’t lost their insurance coverage yet, is a nice fast-moving epidemic that spreads from the great unwashed to their financial betters. Once kids in the good school districts start dying from H1N1, or goddess forbid something like an enhanced strain of MRSA, there will be indignant calls on every news show for a national mobilization to “streamline” medical provisions to every American. (Well, except on Fox, where the anchorpods will call for a national day of Xtian prayer and a open hunting season on poor non-white people.)
olo
When my neighbor’s doberman killed my goose & some chickens, I shot the dog dead.
Ginger Yellow
I’m not in any way conservative and I support universal healthcare, but I’ve got to agree with 28. A three year old with a runny nose is not exactly a health emergency. It’s pretty much the default condition.
Church Lady
@DougJ: I really don’t understand why you are so convinced that I’m a spoof. It must scare the hell out of you that there are a whole lot of people that think like me out there. Sort of puts a pin in your far left utopian balloon, huh?
kay
@Leelee for Obama:
I have another idea. Perhaps medical providers should find another way to increase their personal take-home rate, within the Medicare structure. When delivery costs less, they can take home more.
They could look at the other side of this equation, and lower their delivery cost, which is what every other for-profit model does, when they realize they can no longer increase rates.
The answer to this isn’t “pay doctors more”. The money is there. Maybe doctors should find out where it’s going, if it isn’t going to them. Maybe they could find a way to cut delivery costs, instead of demanding higher rates. We’re paying a ton. Where is it going?
DougJ
Sort of puts a pin in your far left utopian balloon, huh?
That’s exactly how a spoof would talk.
I think you’re a spoof because you often say smart things but often say things that are unbelievably dumb. That combination usually spells spoofery.
Leelee for Obama
@Ginger Yellow: My DD is told to bring my three GrandDaughters into the Pediatric office for many things I think are silly. When my Daughter was a baby, I would go with vaporizers, humidifiers, honey and lemon, all kinds of things, before I would even call a Doctor, let alone go in to see one. But, see, the oldest of her three is ashmatic, and the little ones are in school or with other little ones, and their “runny noses” could put the oldest in the Hospital, as happened last year, with bacterial pneumonia. You cannot judge this situation w/o all the details. A clinic like the one mentioned would save a bundle for Medicaid with my little family-but they don’t take Medicaid at the Urgent Care near them, and the one that does is just as far as the Pediatrician, and charges the same. Anyone, see a problem here?
gwangung
That, and the lack of response to substantive, non-emotional points.
kay
@Leelee for Obama:
Physicians are insisting that they should be paid on a fee for service basis. Then they’re saying they can’t cover cost and make money on a fee for service basis. But that isn’t how fee for service works. The idea there is to deliver the service at the going rate more efficiently, and that’s how you make money.
They have to choose. They can be paid a salary, or they can be paid on a fee for service basis. You can’t take the upside of a fee for service model while completely abandoning any responsibility for figuring out how to make money on it. The solution isn’t to keep raising the fee, and that’s what they’ve been doing, year after year.
I cannot believe it takes a government program to convince the medical industry that they should streamline record’s keeping. WTF? They missed the whole latter half of the 20th century? They just decided not to invest in that? That’s nice. What if everyone did that?
If you want to practice without worrying about how to profit off a fee for service system, we have a model for that. It’s called “a salary”.
Leelee for Obama
@kay: Medicare pays 20% less than cost, not charges. Medicaid pays 65% of cost, not charges. Insurance Cos negotiate to pay the same rates, with tons of paperwork and oftentimes, refusal to pay. This is in Primary Care; I’m in no way weeping for spe-cial-ists. At the hospital level, the sames rates apply on the Single Payers, and the insurance cos pay about 125-135%.
I think SP is better, with higher reimbursement rates, but the Swiss Model, where the insurance cos are regulated like Public Utilities, would be fine with me. The Companies would be screaming for the Public Option if this idea was seriously floated.
Church Lady
@DougJ: Most people here think that BOB is a spoof. By your reasoning, BOB must occasionally come out with some profound, or at least coherent, thought. I haven’t seen it yet.
I think your still mad at me.
Church Lady
@kay – The fees that doctors charge have to cover a whole lot more than just their own income. The money goes a lot of places, other than actual care. There is the clerical staff that files insurance claims, including claims to Medicare and Medicaid. There is the nursing staff, and nurses make a pretty decent living these days in most parts of the country. There is the cost of of rental/ownership of the actual office space. There is the cost of malpractice insurance, which for certain specialties is through the roof. There is the cost of expensive equipment such as X-ray machines, EEG and EKG monitors, ultrasound machines, etc.
Where do you suggest they make cost reductions?
Leelee for Obama
@kay: Kay-as someone who has worked as a seamstress/tailor on a fee-for-service basis that was split 60/40 with the owners of the cleaning stores where I worked, when the cost of the running the business (overhead, paperwork, supplies, etc.) went up, they raised the fee for the service. I’m not saying all the raises by physicians are legitimate, but the way it is done is a perfect example of how fee-for-service works.
The truly obscene problem is that health care became w for-profit industry, with stockholders looking for easy money.
Leelee for Obama
@Leelee for Obama: The rest of the equation for the raise in fee was a knowledge that they might lose 25% of their customers, and they’d break even, with less expenditure.
kay
@Leelee for Obama:
I work on a fee for service basis. I can’t raise prices every time overhead goes up. I have to work more efficiently, because I live in a low-income rural area, and there is a “going rate” and that rate is tied to what people here earn, not to what I think I deserve, or what people in New York and Chicago are paid. The cost of living is lower. It makes sense.
I also purchase malpractice insurance. The best way to keep your malpractice rates low is to NOT, um, malpractice. That’s an issue that doctors could address, but don’t. They could police their own.
My local medical group (which is essentially a monopoly, they own the medical groups in three surrounding counties) is POORLY RUN. I’m not bashing doctors, but this idea that they can operate as fee for service professionals and just keep demanding higher rates without regard to the fact that they practice in New York City or rural North Dakota is not the way the world works. I think there are physicians who would opt for a salary, I don’t “think”, I mean, there ARE physicians who work for a salary, and what you get in exchange for a (lower) salary is you don’t have to worry about running a practice. You get a guarantee, but you don’t get a share in a practice. You can’t have it both ways.
kay
@Leelee for Obama:
” By promptly disclosing medical errors and offering earnest apologies and fair compensation, they hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.
Malpractice lawyers say that what often transforms a reasonable patient into an indignant plaintiff is less an error than its concealment, and the victim’s concern that it will happen again.
Despite some projections that disclosure would prompt a flood of lawsuits, hospitals are reporting decreases in their caseloads and savings in legal costs. Malpractice premiums have declined in some instances, though market forces may be partly responsible.
At the University of Michigan Health System, one of the first to experiment with full disclosure, existing claims and lawsuits dropped to 83 in August 2007 from 262 in August 2001, said Richard C. Boothman, the medical center’s chief risk officer.”
This is a no-brainer for any other fee for service profession. Apologize, offer fair compensation, and you won’t get sued. The contractor who put installed my windows wrong knew this, and he has a sixth grade education.
I feel as if physicians are insulated from the marketplace, but want the upside of the marketplace. I don’t think that’s rational. It’s not that I “object” to it, I just don’t think it works. I think we know it doesn’t work.
Leelee for Obama
@kay: What I found interesting in Dean’s talk last night is that Primary Care Docs in the UK make more on salary than PC docs make here. Again-not defending fee-for-service, just telling you my experience. I have always thought that soc-ial-ized medicine made the most sense, with Single Payer like Canada a good second choice. In this great land of ours, I am not sure either will ever become the accepted way, barring a complete change in perception due to some kind of natural or not so natural disaster. I found it interesting that the UK’s system found it’s roots in the war years, when they were getting the shit bombed out of them, and gov’t HAD to do it. After the war ended, neither patients nor docs wanted it to change too much. France’s system has roots in the war as well. but built on slightly different pillars. We are spoiled by our natural barriers to this kind of thing, because neither Canada nor Mexico has ever decided to try invading. It might have begun to change after 9/11, had Al Gore been President, but maybe not. Katrina might have waked up the proper outrage, had Al Gore been President, but maybe not. One also needs to remember that it is entirely possible neither of those two disasters might have happened , if Al Gore had been President.
As to the local medical groups being poorly run, it’s obvious that the free-market has not solved the problem, because otherwise, some entrepreneur would’ve come in and put them out of business. Could it be that they are protected in some way? (cough, cough)
I’m not trying to defend any of the cluster-fuck, just looking for ideas.
kay
@Church Lady:
Where I live, the medical group owns the “works”. They own all that expensive imaging equipment, and they bill, separately, for each use.
I don’t know how you lose money on that. I would (and do) suspect the opposite problem. That the equipment owner is maybe too anxious to use that equipment and bill for it, because once the initial cost of the equipment is covered, and the salary of the skilled operator is covered, it’s profitable for the owners of the practice, who also are the person charged with determining if the patient needs that expensive imaging equipment.
ThatLeftTurnInABQ
@Church Lady:
Having read BOB’s comments for a couple of years at ObWings before he got banhammered by hilzoy and moved over here, I’m convinced beyond a shadow of a doubt that BOB is no spoof – he is the real deal.
Church Lady on the other hand normally uses a fairly civil tone on this blog and only occasionally reaches for the rhetorical sledgehammer. I’d be very surprised if this is spoofing. I almost always get something out of reading Church Lady’s comments even when I don’t agree with them most of the time. At least they make me think about why I don’t agree with them. If this is spoofing it is of a curiously low key and constructive variety.
But then that’s just IMHO – free opinions, worth what you paid for them.
scarshapedstar
I dunno what to say about this. I’ve had my sights set on oncology for quite some time because I’m fascinated by molecular biology and I think that genetics, rather than radiation and chemo, will be the foundation of cancer treatment by the time I get into and out of medical school.
But I’m also quite aware that we need general practictioners more than anything else these days, because everybody wants to be a specialist or a surgeon who makes the big bucks. Not saying I don’t, but I think there’s a generational effect here, namely that modern biology labs are more about cloning and PCR (which didn’t exist when my mother was getting her bachelor’s) and less about dissecting things, and I think this extends to a desire to work with more high-tech tools than a tongue depressor and a stethoscope.
Maybe I’m projecting here. Maybe it really is all about the money. But the only solutions seem to be leveling the pay scales and letting more people into med school, both of which are opposed by high-paid specialist doctors — most of which are still members of an older generation.
I look forward to being one of the first doctors to work in a rational healthcare system. I just hope it happens in my lifetime.
Lettuce
I am from Milwaukee (and apparently not far from where this person is), and while I cannot say enough that the service she chose should be better protected, it’s also not true that she was without options.
The clinic at St. Mary’s would have been close, as would the clinic at Wisconsin’s Children’s Hospital, (not as close, but still close.) In fact, Children’s Hospital is where I would have gone.
That’s not to say we shouldn’t have a large and robust public option.
kay
@Leelee for Obama:
What I want is to have a rational discussion of health care costs that includes physicians. I think it’s pretty silly to say we must cut health care costs, but physician’s way of doing business is some sacred cow that cannot be discussed. That’s the general meme. They’ve joined police officers and CIA officers in the group of professionals that cannot be questioned.
Why do costs go up at twice the rate of inflation? Is there anything physicians might do about that, or are we just going to accept everything they say as unimpeachable?
kay
@scarshapedstar:
I’m for letting more people into med school. Not lowering standards. Just opening more slots. If they’re not allowing qualified people in, they don’t have enough schools.
Andrew W.
Spoof.
kay
@scarshapedstar:
“But the only solutions seem to be leveling the pay scales and letting more people into med school, both of which are opposed by high-paid specialist doctors—most of which are still members of an older generation.”
Do they actually block opening more slots? I mean, is that just general understanding on your part, or is that what you know?
Church Lady
As I reread the posted exerpt, something else caught my eye that slipped by the first time. The woman complained that she was going to have to wait a week for an appointment and wasn’t willing to – she had to find out what was wrong with her baby RIGHT AWAY.
I have so-called “gold” or “Cadillac” insurance and I can’t get into my doctor the day I call if I’m sick. Heck, I’m lucky if I can get in the following day. It’s usually a couple of days wait and, most of the time, whatever was making me feel like I was ill has passed. And that’s for a “sick” visit. An appointment for an annual physical has to be booked at least three months out. Other things can take even longer. In June, my primary care physician booked me an appointment at the Women’s Clinic at a local hospital for a diagnostic mammogram and a bone density test. First available appointment? September 22. For those counting, that’s three months between making the appointment and getting the tests performed. Thank God it’s routine – If I had found a lump, I would have been completely freaking out a long time ago.
I didn’t drag my kids to the pediatrician everytime they had a runny nose when they were little. If I had, the co-pays would have broken me financially. Little kids seemingly ALWAYS have runny noses. That’s the reason mother’s always have snot stains on their clothes. :)
Leelee for Obama
@kay: I have no sacred cows at all anymore, but doctor’s fees were never one anyway. We need to get to a place where people get health care for reasonable rates-and insurance cos can’t make millions of dollars for doing little and doctors make a living, not a killing and I’m not snarking there.
Ruckus
@latts:
I was going to comment on GranFalloon’s post but you beat me to it. And I like the way you expanded on it as well, better said than I was thinking.
I was wondering though if the RW is taking it’s cues from Barnum and Bailey. It looks like a circus act, could sound like a circus, you know lots of commotion with little or no substance (and if circuses sounded batshit crazy), and at the end of the day you have to clean up elephant shit.
kay
@Leelee for Obama:
I feel as if these “truths” are just accepted. We do it with education costs. If physicians borrow 100k for med school, and start at 100k a year, how is that different than a teacher who borrows 32k and starts at 32k?
Why is one an unimaginable burden and the other just part and parcel of being a new entrant into a profession?
If they’re specialists, and borrow 300k for med school, well, specialists earn more over a lifetime. They will be poor when they’re young, and the more years they practice, the smaller the burden the debt is compared to compensation. Join the rest of the world, right?
Physicians (essentially) are guaranteed a position after licensing. What’s the unemployment rate among the physician ranks? Is that true of any other profession? That’s valuable, all by itself. They may not love the pay rate, but they’re all working.
Sue
The clinic is on Capitol Drive, in a poor part of a city that’s still pretty segregated. It’s run by a man who is obviously committed to helping the neighborhood, but has probably too often sacrificed safety and upkeep of the building in order to keep the clinic going. A few years back the clinic was closed for awhile when an inspection noted (among a lot of other things) rat poison immediately adjacent to a kid’s waiting area, so in spite of the fact that this is a worthy enterprise, it’s still a poorly-run one. In an ideal world, he would have a bailout and funds to make this work. Right now what he needs is the volunteer services of a smart fundraiser and p.r. person. It’s well-known-enough and in a visual-enough location that big money might be staying away for reasons other than racism.
Calouste
@Church Lady:
Nice switch from talking about the problems of your primary care physician to problems of specialists with half a hospital full of hardware.
Maybe if you were less dishonest in your arguments, people wouldn’t call you a spoof.
Church Lady
@Calouse: Either I was unclear, or you are dense. My point being that it isn’t easy to get a quick appointment with ANY doctor these days, no matter what your financial/insurance situation is. What is the answer to this problem? I don’t know, but I certainly don’t think it can be blamed on lack of insurance.
DougJ
I think your still mad at me.
Not at all. But I think you’re just trying to get a rise out of people (and doing a good job if it, I must say).
Leelee for Obama
@kay: Sorry I didn’t see your post. I know what you mean, but the idea is not to pay off all docs loans, just those that go into Primary Care. And about teachers, I think paying off loans for grads that will teach for 5 years in an under-served or rural are is a good idea also. Hell, unless the GOOD teachers anywhere get paid better sometime soon, paying off part of their education is the least we should do. There are some professions that are more important to support than others. And having a job guarantee doesn’t necessarily pay off huge loans. If more docs go into Primary Care, we’ll have a better chance to head off problems with a universal health care plan. I also think the Nurse Practitioners should be helped as well and nurses make better money these days, sure, but they have loans also. We can survive w/o a few less financial geniuses and politicians and many other professions. W/o docs and nurses and teachers, we are fucked even if the services are free.
scarshapedstar
Kay,
As a second-time medical school applicant with a 90th-percentile MCAT, the way it works basically is that there’s more qualified applicants than there are seats, and so it comes down to a lot of jumping through hoops. You talk to the admissions department, they give you some Aegean stable to clean out (“Get a master’s with a 4.0 and then we’ll talk”) and when you do that they give you another task. After a few years, you get in.
I don’t think it’s simple to “open more slots” because the labs are only so big and the professors only so many. I’ll have to look into this but I have the distinct impression that the number of Americans who need healthcare, and the number of Americans who want to become doctors, are growing much faster than the number of medical schools. Building them is a significant and expensive undertaking that not everyone supports. If there’s any New Orleanians watching the uproar about demolishing the flood-damaged and dilapidated Charity Hospital in favor of a new LSU/Tulane teaching hospital, you know what I’m talking about.
It’s a question of infrastructure, which currently priority #99,999.
mai naem
Also, Maria Antoinette Bartiromo wants to know why this woman’s baybee isn’t on Medicare?