Still all about the money.

great post peterr

you have to qualify for a license to practice medicine

that means you are entering the game and you agree to the rules of your license

therefore, we need to make the rules clear, with your license to practice medicine you absolutley have to work within the system of health care

you play or you don’t play but you don’t get to choose when you play and who you play for

each doctor needs to put in mandatory public health care time as far as I am concerned

Don’t doctors need to treat some minimum number of patients to keep their skills shart? Maybe it’s just surgeons who need to do that, but I don’t know I want to see a doctor whose recent experience was so limited.

Michelle Bachmann said that universal healthcare would flood doctors with patients and crowd out people like her.
It seems the free market has already done that. But Michelle lying liar that she is won’t say a word about it because she is controlled they got to her!

I was thinking the exact same thing

I don’t think concierge is such a big deal.

Look at all the doctors who are working part-time. It’s the same issue there.

I do agree that there should be at least a year of mandatory public health service. (Actually there should be at least a year of mandatory public service for everybody.)

“(Concierge medicine) will provide exceptionally good care for patients who qualify,” EUpperly said

Fixed his name for him.

The U.S. has just the kind of medicine a capitalist system would create: rich only need apply.

Licenses are an economic devise for limiting supply.

I prefer to be treated by someone with lots and lots of experience. My first to labors were assisted by youngish doctors and ended up having complications both times. The third time, I went with a midwife who had delivered a bazillion babies in Africa. Piece of cake. She was incredible. I’ve had a real skepticism and fear of doctors ever since.

My line of thinking also. Nurse Practitioners are generally dedicated top professionals and are utilized by Kaiser and the VA, maybe others, though I don’t know of any. Nurses have a totally different patient centric mind set that could radically change the quality of health care.

Our family practitioner here in Chicago is instituting a ‘membership’ program. He called it ‘concierge’ service originally, but has now changed the name. Essentially there he has a $30/mo individual $50/mo family surcharge. He explains that between malpractice insurance rate increases and insurance payment rates that he had 3 choices:
1. move out of Chicago where malpractice insurance for family practice is less.
2. Cut appointments to 10 minutes and start overbooking to max insurance income (this is how most of the medical centers operate)
3. Add a surcharge
We like our doctor a lot, and respect his decision to practice medicine in a manner which he finds comfortable.
He was my doctor at the medical center and I followed him when he struck out on his own (at a cut in income, I might add).
For the past 8 years, he has provided my family with exemplary care including 24 hour on call availability (which is much better than the Emergency Room when your first kid has their first fever and you are unsure).
My first instinct at this announcement was “enough is enough” – then I remembered that phone call and the years of valuable consults.
I will pay. And I respect his decision to practice medicine rather than business.
My doctor teaches and devotes time to clinics. I have not asked for details – nor will I.
The system is seriously broken, but I do not think it constructive to throw arrows a those who find circumventions.
I also do not buy the argument that malpractice insurance is the root.
It is yet another symptom.
The problem is pretending that there are market based solutions to an effective natural monopoly.
Public health is an essential service like electricity and infrastructure.
Leaving essential services to unregulated free markets leads to natural monopolistic behavior such as we see from the huge health care providers which is no way offset by insurance conglomorates

As Uwe Reinhardt never tires of pointing out, it all comes down to whether you think people’s access to health care should depend on how much money they have. Hey! It’s the American way!

I assume that $30 a month charge is in addition to whatever your insurance pays. It sounds like a very good deal to me.

Now if we had single payer, you’d have money left over to pay this concierge fee, buy a gym membership, maybe a vacation…

By the same token, Knut (and not to go too far off topic, I trust?), people’s access to justice, within our “rule of law”, “no one is above the law”/s legal system, is also determined by the heft of their pocketbook …

DW

Welcome to the new Gilded Age
A country of haves and have nots.

It’s not coming
It’s already here

I understand this is also known as a Boutique practice. Whether that or medicine for the masses, it’s all eggs, bacon, beans, and a fried slice. Harley Street specialists are likely to put you 6 feet under sooner than the average physician. They have to keep practicing till they get it right, after all.

rapidly moving to the “have a lot” and “have nothing”

Agreed
Single payer could conceivably be more wasteful than our current system, but it would be hard.

Yep
Like I said, I don’t think my doc is greedy – but he does want to practice according to his terms – terms i agree with.

And, I might add, if you are freakin loaded and you want a private physician – and there is a physician who wants to practice that way – so be it.
Just so long as the freakin wealthy part doesn’t come from crime.

One additional factoid.
My doc said that out of a dozen or so family practices in Chicago when he struck out, there are 2 left – including him.
Most of the others moved to WI or IN

De-lurking from Okinawa.

The CBS weekend roundup news radio show earlier today had a spot about the exceptional health care the U.S. Congress receives. Occasionally this story about the exclusive health care benefits provided to Senators and Representatives surfaces and then disappears.

In this CBS story, Lindsey Graham was giving a tour of the exclusive on-site at Capital Hill medical facility, usually referred to as the Office of the Attending Physician, to the CBS reporter. I believe that the NYT has recently run a story about this ‘extra’ benefit that members of Congress receive, and I think it was on an NPR story recently as well. This medical facility is available 24/7 to members of Congress, and is staffed by U.S. military physicians. Each member of Congress is supposed to pay a flat yearly fee of $900.00 to cover this additional benefit, but I recall an earlier story stating that even if a member hasn’t signed up for this benefit, he or she will be treated at no additional charge.

Graham made the comment to the CBS reporter that if a public option is passed, he would have to drop this member’s only on-site coverage and go with the public option.

Yeah-right, Lindsey.

This exclusive medical support to Congress is justified by the rationale that their time is so valuable, they need to have a top-notch medical facility at their work place, in order to keep their time away from their legislative duties seeking health care to a minimum.

The CBS story also stated that the health care benefits that a member of Congress signs up for under the Federal Employee Health Benefits Plan, stays with that member even after they leave office.

Concierge doctors. Found: the ultimate niche market!

Hey Doc’s, nice moat you’ve got there.. Be a shame if anything happened to it… like medical landfill, paved into a parking lot.

hey, it is Medicare and other fed funds that PAY for medical schools and keep them operating. The tuition is a fraction of the cost of schooling.
Docs should be required to do something for the free-ride part, including some public service component.
going into concierge practice is not public service.

First: those who think the practice of medicine is all about money are accepting the Randian/GOPer theory of economics. If it was the case no physician would have ever treated a Medicare patient, much less Medicaid. (In fact I for some years chose to treat pro bono rather than deal with the paper of Medicare/caid for so little.) Actually physicians incomes have in the past 20+ years followed pretty much the airline pilot’s curve. ie down, way down. There is really only one acceptable level of medical care, “good enough” whatever the going rate may be or how rich the patient may be. Yes. No matter what rules a government puts in place the rich and those who want only to be rich will find ways to purchase and sell souls. I say leave them to heaven.. Would you all really like to have Miichael Jackson’s array of concierge doctors?. Has anyone thought about supporting an environment in which physicians work that will attract bright socially conscious young men and women? The repeal of laws excluding insurance companies from anti-trust and malpractice liability would be a good beginning. In fact if this had been done 30 years ago health care would not be in the abysmal state it is. Now meaningful competition to corporate control has eliminated any genuine competition and I and 75% of my colleagues believe the best and only remedy is a single taxpayer funded payer program. But if you continue an environment in which only rather dumb sharks can thrive; that is what you will get.

sure, that’s one purpose, anotheer is insuring quality of service

in this case you don’t everyone becomming a doctor now do you, nor driving a car, nor owning a gun

licensing has a clear positive purpose, of course it can be abused but that doesn’t mean you throw the baby out

However, licenses also are an indication that you are really qualified to do what you say you can do.

Licenses are a good thing. And not just in the medical field. If someone was going to open you up and muck around in your insides, wouldn’t you rather have a board certified surgeon doing it than your local shadetree mechanic?

Gosh, perris, I had little realized that licensing assured the “quality” of drivers and those permitted to carry firearms.

This would suggest, it seems, that the majority of auto and gun-related carnage or even mere “accidents” is caused by the un-”certified” among us.

While you might well have provided a genuine “handle” to get a grip on the second “set”, you would probably find little evidence to support such an implication regarding the first …

And nobody should be thrown “out”, even with the bathwater.

;~D

Exactly.

And I do want my supply of doctors (and others) limited to those who have demonstrated their competence to a licensing board.

And America takes another lurching step towards outright feudal plutocracy.

Try getting a drivers license in England sometime. That’s a real eye opener. In the US the “right” to drive is right up there with life liberty and the pursuit of happiness. Not so elsewhere.

You are confusing business licenses with medical practice licensing. Licensing to practice medicine requires graduation from an accredited 4 year medical school, in some states also serving a one year minimum internship in an accredited facility, and passing exams in a number of basic and clinical sciences called Board exams, Recommendations and documentation as to character are usually required. There are some variations depending on the state issuing the license. Beyond that various specialties have certification boards that involve proof of years of specialty training, oral and written examinations, and requirements specific to the specialty.

So I have heard, karnak12.

And, reflecting upon what I had heard, and speaking to several European friends about the matter, we concluded that in most places one drives to get somewhere, while in America we simply drive to distraction.

Also, in America, more than in most places, one’s auto is one’s ultimate “measure”.

Thus, the automobile in America carries a far greater burden of psychological implication, than cars in any other part of the known universe, being a protected form of “expression”. Not unlike the way that corporate monies are regarded as a part of a corporation’s right, as a fictitious “person”, to “free speech”.

It is all a part of our wonderful American “Exceptionalism”, and must be appreciated as such.

;~DW

So Lindsay Graham thinks we should feel sorry for him having to give up his “gold-plated Cadillac” medical care for public option?

What planet is he….oh, never mind.

Soooo . . . in roughly a hundred years or so, we’ve gone from snake oil salesmen to limiting oneself to administering exclusively to the aristocracy . . . nice scam!

And, taxpayer subsidized, too!

Is this a great country or what? (sarcasm: ON)

Would boycotting the health fundraising industry help? Org’s like breast cancer research, alheizheimers research, etc… When we donate to them is it the same as putting money in the pockets of the health industry that is fighting the public option?

You don’t frighten us with your silly knees-bent running around advancing behavior!

It’s not as if they spend so much time working either. I seem to remember a recent headline saying that they are now going to three day weeks.

Internationally, the rule of thumb is a bad system cannot deliver good care. The very richest get care only a bit better than the average. Bet the concierge doctors are lots more polite, though.