agree
 

We have been here for almost twenty years.
It has gotten worse in the last several years.
The Villages advertised a new hospital, but now there is no hospital.
Our doctors have all left and was just told that that four radiologists have left the area.
It isn't getting any better and I'm sure it will get worse.

"If you build it, they will come".

This shortage is not just in The Villages but in Florida as a whole. Checking the data, no part of Florida has what could be called adequate physician care. The entire state has a shortage of primary physicians and specialty care physicians: no part of the state is expected to have adequate specialist care by 2035 with most of the state having at best 80%. Primary care physician availability outlook is a bit better, but only the southern tip of the state:: Miami, Ft. Lauderdale, etc. are expected to have 100% of adequate primary care physician coverage but this does not extend to the rest of the state. ("Florida’s physician shortage: It’s not just primary care and rural areas", Jarrod Fowler, MHA FMA, Florida Medical Association Website, April 21, 2022).

Why? Who really knows? A couple of things that we DO know however is that people with money and the wherewithal to relocate are fleeing their high-tax, high-crime states like deranged lemmings in search of friendlier surroundings, and for most, those "friendlier surroundings" happens to be spelled FLORIDA. According to data I've read Florida has FOUR TIMES the influx of new people than does the next state in the row, Texas (might be wrong about Texas). These folks are also taking their money, their toys, and most importantly their spending power with them. It has led to some monumental problems at both ends: influx AND outflux. My home state of Minnesota for example as a stable population if you're just counting heads, but the people with the money are the ones scurrying south. They're being replaced mainly by third-worlders, recent immigrants who are steered toward Minnesota by Federal authorities as well as migrant farmhands, in addition to the more-than-sizeable resident population currently on welfare. This is not new: as far back as 2004 there was an article in one of the Twin Cities publications that put a financial value to it and even then it was multiple billions leaving the state every year. Today, with the multiple COVID messes and economic upheaval I'm sure it is far worse.

Second (conjecture on my part) it is probably a lot harder for a doctor to leave his/her practice than it is for a couple of retirees to pack up and skedaddle. Took us maybe three months after we made the decision but we had no notices to give, interviews to arrange, etc. etc. I'm pretty sure that with all that money leaving, the people who were formerly PAID with that money will be leaving as well, just a lot more slowly.

I don't know. That whole COVID thing blindsided a lot of people and the influx of folks to Florida overall, not just TV, has been unprecedented and could not have been planned for. I'm sure the medical situation will improve; maybe not fast enough for some, but it will. After all the money is here.

I don't agree with that at all. I would much prefer to see a medical doctor than a nurse or a physicians assistant.

The US Census Department's American Community Survey just came out, and Florida is, indeed, the top destination for domestic migration with over 740,000 people moving in. However, what is far less discussed is that almost 500,000 people moved out of Florida, and the state is one of the top outbound states as well as inbound. It's still a net domestic migration of about 250,000, but that is still a lot of people leaving. Interestingly, medical care is one of the primary reasons given for leaving, along with high cost of living and insurance premiums.

Obamacare didn't ruin medical care in America. It just drove the last nail in the coffin.

The road to ruin started in WW2 when the gooberment enacted wage and price controls when all the labor was off fighting a war. Business used the only tool in the toolshed to attract workers -- free hospitalization insurance. To this day, we remain the only country in the world where most people get their health insurance through their employer.

... Which meant that the moment someone retired, they lost their medical insurance, right at the moment when they needed it most. So the gooberment stuck a bandaid on it and created Medicare. Like all other medical insurance at the time, it only covered hospitalization.

Then, in the 80's the bright boys at Blue Cross came up with a brilliant scheme to sell everybody on the lunatic notion that we should buy insurance to cover ordinary doctor visits. It was like buying insurance for groceries, but like the rubes in any scam, we all bought into the idea of "free stuff" and joined an HMO.

...Which, in addition to driving the paperwork costs through the ceiling, caused doctors to notice the deep pockets of the insurance companies. Prices were adjusted accordingly, and now NOBODY could afford a doctor without a "healthcare" plan. For instance, the "well baby" appointments for my 1981 daughter prior to the invention of the HMO was $15. Once we were forced to join "Prucare", it still cost $15 -- but now the doctor billed Blue Cross another $100, which was equivalent to about $500 in the 80's.

"Heathcare" became so outrageously expensive that Bush expended Medicare to include doctors visits -- and started charging seniors the cost of a doctor's visit every month for the privilege.

Then, Obama noticed that the average "healthcare" policy in America was over $15,000, and about half the people in America couldn't afford it unless they worked for a fortune-500 company who could. So he nailed the last nail, and created Obamacare, to "insure" that every home in America was forced to pay at least $5000 a year (or a $500 fine) for a $10,000 deductible and a "network" of the worst doctors in America.

Now, everybody's gotten into the act. I just paid $3000 to a vet to remove a splinter from my dog's throat, because I don't carry pet "health" insurance. My Dentist just charged United $450 to clean my teeth and presented me with a $5000 "treatment plan" to replace a bridge that hasn't caused me a moment's problem in 40 years.

Boy, I can't wait for some moron to suggest that we need insurance for groceries in this high-inflation environment that our googerment created. How about you?

As I was reading through your post, I began thinking of how much it costs for Vet expenses each year for our dogs and sure enough, you mentioned it later in your post. Our dog had a bout with a auto-immune disorder called IMPA last year, and I am happy he recovered but 3 days in the pet hospital and testing, treatment and medicine cost about $9,000. Even if they stay healthy, the annual cost of checkups, vaccines, heartworm, flea and tick prevention....we honestly spend more on our dogs' healthcare than we do our own (knock on wood).

I worked in the health insurance business for 25 years. In my opinion, there are too many profit centers in the health care delivery universe. I am not anti-capitalist, and anyone who has invested in health insurance companies in this century has made a lot of money. But it is simply a fact that when so many publicly-traded companies such as drug companies, durable medical equipment, ambulance, even for profit hospitals and many more all have a fiduciary responsibility to their shareholders, patient care cannot be the number one priority. So many physician groups are being bought up by hospital systems and conglomerates. We are not headed in the right direction.

You are 100% right, in my opinion, about tying health insurance to your job. It shouldn't be and in 2023, there is no logical reason for that.

Reasonable, considering how insurance premiums for the most part are off the charts and doctors, especially specialists, are indeed scarce.

We were lucky: after a particularly bad experience with an overbearingly arrogant third-worlder who seemed to have graduated from the Josef Mengele school of doctor-patient relations, we found one who we are satisfied with, at least for the primary physician stuff. We see an NP, whose work is overseen by the doctor, and are quite satisfied thus far. Not so happy with the specialists but I've been seen by Mayo Clinic cardiologists for the past two decades and Jacksonville isn't that far away.

Sometimes though it seems we ignore answers that are right under our noses. Many other countries have doctor shortages but some don't, at least to the extent that we do. The government of Thailand for example will assist outstanding students who otherwise couldn't afford medical school, paying tuition and expenses. The payoff is that such students, once they attain their M.D., must work for the government in government-run hospitals and clinics for a certain period of time before setting off on their own. Such doctors are free to set up their own practices during the time-periods when they're not working for the government, and many do, moving into their established practices full-time once their obligation to the government is fulfilled. It has resulted in what is essentially a two-tier health care system there, with day-to-day care for those who otherwise could not afford it available at the government-run hospitals and clinics. That does NOT mean bad care however. Personal experience: my wife and I were partying with some of her friends one night. Hot over there in April and a lot of the guys, me included, shed our shirts. Next morning we were scheduled to go on a van trip upcountry to some park or other. I woke up that morning with a whole lot of red pinprick-looking things from the waist up and knees down. Didn't think much of it, but by 10:00 AM they were the size of dimes. At noon they were quarter-sized and itched like hell. The crew decided to stop at a small government hospital near the town we were going. It was a Saturday so there were quite a few people waiting, but they moved me to the front of the line. I was examined by a doctor who prescribed a salve and a drug. Turned out I had been bitten the night before by an insect too small to see, one that Thais are not affected by but we foreigners are. He said that the itching would be gone by evening and the splotches would be gone in 3-4 days. Right on both counts. We stopped and paid the bill on the way out. E.R., Doctor exam, and meds came to a total of 112 baht. About $4 American.

Why couldn't something like that work here, on a national or state level, or both?

Medicare Part B covers doctor's visits and this was part of the Medicare act passed in 1965. Not sure which President Bush you are referring to. You seem to be ranting IMHO.

Nice post
 

What an edifying post. I was a ware of parts of it, but that ties it all together nicely for me. Not picturing a lot of ways out of it though, especially given the record of those making the rules. :-(

Gooberment. I like that. Except that it maybe leans a little too heavily towards incompetence when corruption would seem, to me, to be the greater driver.

You're right. Bush's contribution was part "D" -- drugs.

Don't see how that changes much, though.

What I can't understand is why everyone is not ranting about this. Must be all that "free stuff"we got.

Unfortunately, I think your wish has already come true. There is an ad on TV for insurance that you are only eligible for if you have BOTH Medicare and Medicaid. It puts $164/mo back in your SS check and gives a monthly allowance for groceries, OTC meds, diapers, vitamins and the like. Guess who must be paying for all that "free stuff"?

I have never been in the medical profession. However, I am quite aware the baby boomers are 20% of the US population. The generation behind us is nearly as large. With these percentages, it is easy for me to understand the shortage in medical professionals. It is not going to get better. The percentage of elderly is too high to make that possible.

In the past few years, I have seen more and more proclaimed frogs forced to leave the Villages for medical reasons. Within ten years, the population of the Villages is going to double. My husband and I have taken note and have made plans to move back to our less populated hometown, when needed. Like those who have left, we do not see how moving back can be avoided. Unless, of course, we both die in our early seventies.

Our country is approaching nearly 1 in 5 retired. Some of us may live to see 1 in 4. It appears medical personnel are carefully scrutinizing the numbers before coming to the Villages. The new hospital is a no go. IMHO, The developer should have used the same thought process before attempting to double the size and population. We will never have enough medical professionals to meet the rapidly rising demand. Call me a pessimist but the numbers speak for themselves. Time will tell.

We have been very pleased with our Villages Health and United Medicare Advantage. Have had it for years. We also have an excellent dentist through network.

I think the medicare premium taken out of Social Security should be eliminated. Premium should be zero for all even for those with high income. Personally, I don't have much confidence in doctors that go to medical school outside of the US. My understanding is that the rate of pay for medical doctors in our area is low and that explains why doctors do not want to work here. I had a long conversation with someone in the medical field who works in Virginia because they are paid twice as much there.

Doctor pay rate
 

I wonder how much the rate of pay for, say, a Villages Health doctor would have to increase in order to entice more of them to come and stay. I also wonder who makes the pay rate decision and on what it is based. Guess I don't even know who "owns" Villages Health. If it is the developer, then I suspect they've thought it through and war gamed it to no end and probably have contingency plans for all scenarios. Reckon they read this TOTV stuff? :-)