Quote:
Originally Posted by golfing eagles
It's just my opinion, but here is my basis:
1) there is a growing shortage of doctors, especially in primary care. If the Obamacare dream of covering everyone comes to fruition, that's 40+ million more patients in need of primary care with less doctors
2) When I first started medical school in 1978, there were 129,000 American applicants for 17,000 seats. Last I saw numbers about 6 years ago, there were 23,000 applicants for the same 17K seats. Due to a variety of economic and social changes, the talent pool is being diluted, and therefore the "average" physician probably starts out with lower qualifications than in the past.
3) Our residency programs cannot fill with American graduates, therefore the programs are getting filled with FMGs, 5th pathway graduates, and previous practitioners from abroad. Some are good, some are not.
4) Medicare is going bankrupt, some insurers are dropping out of the medicare market, and the cost keeps going up. Add to that the cost of 40+ million new "insurees" that for the most part are subsidized, the cost of advanced technology, the aging of the baby boomers, and the unfunded liabilities of Obamacare. This means either raising taxes to pay for all this, or the dreaded "R" word---rationing health care like they do in Europe. I'm not sure Americans will stand for either.
5) Probably nothing is being done because no one knows what to do, or no one can agree on it, or the issue is too politically charged for any elected official to want to take the lead on it
6) I'm not sure some, if not all of this has been scripted to cause a collapse of our healthcare system ...:
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Lots of opinions and a couple of "facts" upon which those opinions were formed.
Easiest to fact check, how many applicants were there for medical schools in 1978? was is 129000 US applicants? Not even close. In 1978 there were under 30,000 applicants. The last year reported in 2014 had the highest number of applicants in history.
Medical School Applicants, Enrollment Reach All-time Highs - News Releases - Newsroom - AAMC
Medical School Applicants, Enrollees Reach New Highs - News Releases - Newsroom - AAMC
Long term trends are here up to 2002
Medical Schools And Their Applicants: An Analysis
So that fact is in error by a huge amount.
Primary care providers no longer means physicians. An increase of 10% in the number of insured lives means that all else being equal, you need 10% more primary providers. This requirement is likely to be met by advanced practice nurses and PA's in large part, freeing the more highly trained MD's and DO's to handle the non-routine patient care.
In 1965 23% of residency positions were filled by foreign medical graduates
Foreign Medical Graduates in the United States - Harold Margulies, Lucille Stephenson Bloch - Google Books
and it is 21% now
Medscape: Medscape Access
When you start with non-factual facts, you might end up with non-reasonable conclusions, or not
As to what we Americans will stand for, that is for the political forum but to suggest that there is some secret conspiracy of people attempting to collapse the health care industry is ....