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Originally Posted by Villages Kahuna
Assuming that our principal purpose here is to understand more about what is going on politically, your response, Steve, is very valuable. It is essentially what the doctors on the CNN show were saying, and they were both salaried physicians.
The doctor-panelists did say that there were some "legal impediments" to moving from a fee-for-service physician business model to a salaried model. I'm assuming that would have to do with "forcing" physicians who were "sole proprietors" or had only 1-2 partners in a practice to become salaried. That wouldn't be a small problem, but I suspect it could be resolved with a payment schedule that would essentially force physicians into a salaried form of business organization.
But it's good to hear confirmation of something we've all suspected from a doctor who knows first-hand what the potential savings might be.
One question: would the "salaried doctor" model be what is meant by "paying for quality, not quantity"? I've heard people discuss needed reforms and use a term like that and I have no idea what they mean.
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Salaried equates to
employees. Every physician I know is an employee of an LLC or PA or INC already. So, the question is going to be how will the LLC, PA or INC be compensated for services rendered? The staffing within the LLC, PA or INC is a business decision for the entity, and how the LLC, PA or INC distributes moneys within itself is going to be darned difficult to legislate into any fixed model. I don't know if it's even going to be possible without total nationalization and all licensed medical personnel becoming federal or state employees.
Most medical practices have a significant net worth. Nationalization zeroes that value. I can already imagine the court cases on that.
These are indeed "interesting times." and there will be unexpected (and expensive) consequences.