Health Care, Part IV: Doctors and access to care

How about this: Obama and subsequent Presidents can forgo all but $100K of their $400K salary each year, reduce their travel budget to $10K from $19K each year, and their entertainment fund can be taken from part of the salary that they are forgoing instead of needing it's own budget. That would buy a lot of health insurance for people with pre-existing conditions. If you want cheap healthcare, and you don't mind doctors getting up to -41% pay raise from CMS/HHS over the next decade, then the president and congress can do the same with their salaries. BTW, did you know that Congressmen's 401 Ks are matched by the federal gov't, but military members are not? I wonder why people are fine with doctor's salaries going down? Is it because they believe that it's not fair for someone else to make money? Should we be fine with everyones' salaries going down? That's the slippery slope we are on.

Who willingly goes into a career where they can expect negative pay increases? I get that some people have experienced unemployment or underemployment in the last two years. It stinks on ice. So people look at that field and say, "Wow, that field is shrinking. I better go into something else so that I can find a job to feed my family."

That will happen to doctors. There will not be enough people going in to medicine, willing to put themselves through what we have done-a total, after Neil finishes at Harvard, of 17 years of school/training after high school- if they know that their income will shrink every year for the foreseeable future. Your best and brightest will figure out that if they are making $40K, they will not work past 4:30. They are not going to want to work until 7 every night or work on weekends missing out on life. They will not even be able to live comfortably and still pay back their medical school loans and credit card bills that they racked up while their peers were out working at a well-paying job. Less people will go into medicine with a single payer system, so with less doctors, you will have access issues. Or you might, instead, have hospitalists that work for the hospital, not the patient, and then you lose continuity of care, or seeing the same provider that you always go to. It won't matter because your records are on the computer, but there is something to be said for having a dr know their patients, especially in peds and geriatrics. Also, if the patient is not the customer, and the govt or an insurance company is, then the patient loses in customer service, at least.

Or on a positive side, drs would feel no need to rush through seeing patients because they get paid regardless of how much time they spend with a patient. The patient is happy because they feel they have been listened to, thoroughly worked over for their illness, but you cannot see as many patients in one day at that rate.

Thanks for reading through my thoughts. If there are errors, please comment. If there are grammatical errors, please overlook them. Audrey has been helping my type for the last two days, and I am out of time for editing and revising.