What is the "self insured public service well" ?

Why do we have a shortage of American trained doctors ? Probably the same reason there is a shortage of engineers and mechanics. Young people are taking the path of least resistance, they don't want to study hard, they don't want to work with their hands. Doctors are in fact anatomy mechanics and the work requires too many hours and much hard intensive work. Laziness comes to mind, living at home with Mom and Dad till their 35 doesn't help. Mom and Dad refuse to kick their sorry butts out.:censored:

Medical insurance provided to public service retirees funded by taxpayer (public) dollars as opposed to the private sector which is funded by the retirees themselves or in the case of the dwindling number of corporations that provide medical insurance to retirees themselves, funded by (private) dollars.

Good point RickeyD. I will be interested to see what others like Chatbrat say in response to your point.

Ok. Thanks for the explanation.

There is a physician shortage for these reasons:

1. Growing and aging population in need of healthcare
2. Large segment of the population retiring / leaving the workforce
3. Medical schools have not significantly increased the number of graduating physicians per year in 30+ years

Lastly, for many attempting to further their education, cost becomes a factor. To become a nurse practitioner will cost $60,000 minimum (after you have already paid years of tuition to become a RN). Not everyone can come up with the money to pay for these programs even if they are accepted.

Kindly, I have to say, the majority of young people are not lazy. Many return home after college secondary to student loan payments. Payments can be $250 a month or far above $1500 per month. Student loan interest is 8% on average; so its best to pay them ASAP.

Additionally as you pointed out before, these folks have to pay for health insurance because few companies take on the entire cost. Example: my youngest daughter is a RN, at a local hospital she is paid between $18-20/hour and pays an additional $180 per paycheck (every 2 weeks) for health insurance thru her employer. Now add in co-pays and deductibles...

Rickey D, I think this is a great point and one I have not considered.

Many of the people who have Medicare or some other form of healthcare insurance provided as a retirement benefit (i.e. Veterans benefit) do not want socialized medicine...yet they are utilizing a form of socialized medicine already.

I don't have the answers, but this is an excellent point.

U.S. medical school applications since 2003 -

https://www.aamc.org/download/321470...actstable7.pdf

In 2014 20,300 students accepted in U.S. medical schools.
In 2003 there were 16,500 students entering U.S. medical schools.

AAMC refused for years to allow the building of new medical schools to compensate for the physician need.

Foreign doctors have filled physician jobs in places where there have been extreme shortages, like The Villages was several years ago. Please don't misinterpret this tho, many foreign doctors give excellent care.

I just got back from my first appointment. Here's what I learned.They are really, truly not accepting any new patients who are not eligible for Medicare. The only way I got in was that I made my initial appointment last May so I was grandfathered in.

As to Medicare plans, my understanding is that the only plan they accept is the United HealthCare Medicare Advantage plan.

So, there you have it.

For what its worth, I got the impression that The Villages Health folks weren't especially happy about it, so perhaps there are external factors that drove the imposition of the new requirement.
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bc

My guess is you are right, and that the external factor is United Healthcare!!

That is absolutely fascinating, and somewhat unfathomable. Let me be blunt for a minute, and just give a reality of life. If you only accept patients 65 and over, the men , on average, will be with you for 13 years and the women 16 years. Sorry, but that's the reality. You need to replace those patients with younger people to sustain a practice. You may conclude you can just replace those no longer with us with 65 year olds in a 15 year cycle, but that is likely to fail. Since many move here in their 50's, they would have to seek out area physicians. Those patients are not likely to leave that doctor after, say 10 years, to join TV Health when they turn 65, so this policy is one of long term spiraling failure. In addition, private insurance generally pays a little better than medicare, so this makes no financial sense in the short term either.
My first appointment is in 3 weeks, I literally signed up 3 days before that change was made (I'm 56). Phew! I'll also check this out a bit further, because after 30 years of running a practice, this still makes no sense to me.

The Villages Health Care System
 

You may be "grandfathered" in now or you may simply be a transition patient depending on how well the new business model works. I would feel uneasy in your position. You don't have a contract with them do you ? When a business trashes customers the way they have I wouldn't give them the time of day, let alone my money.
Because they use the trademark "The Villages" doesn't make them special, IMHO

I would find it even more inexplicable if they dump all patients under 65, it would be tantamount to professional suicide as a business venture. I don't feel uneasy--I have a 30 year relationship with my doctor there, but that is a special circumstance that does not apply to everyone else. I'm still scratching my head over this new policy, but I'll find out, although I may not be able to share confidential information with everyone. And being "The Villages" does not in and of itself make them special, but without going into details, I am familiar with the practice model and planning that went into TV Health, and it IS cutting edge and "special", which is what makes their new policy so confusing

Villages Health
 

Here is my understanding as a patient under the age of 65 (been a patient since inception). If you are under 65 and currently a patient and have insurance they accept, you are okay. If your insurance changes to a plan they do not accept (like Aetna), you can no longer be a patient. Although they accept cash, they will not let you pay cash if you have insurance. I spoke with five different people, including upper management CEO types, and if you have insurance they do not accept, you are out of luck. I questioned the logic because using them would only mean out of network for me, so I would pay cash and then submit the claim to the insurance company. They told me their policy is to not accept cash from a patient with insurance. Didn't matter what my argument was; didn't matter that I've been a patient since inception. If my plan changes to something they don't take, I have to find a new primary care doctor. I'm not happy about this because I love my doctor, but that's they way it is for those of us under 65 who do not have insurance they accept. Unless, of course, I drop my insurance completely and pay cash for my visits.