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MDs- Are they really benefiting in today's society?

Piobaire

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Originally Posted by haganah
That isn't a study but more like a sales brochure, but regardless, it says that 11 conditions that were not present in a patient will not be taken into account after admission of the patient. That isn't really addressing my point.

I'm not trying to pick what you say apart but if you have data, I'd love to see it beyond the broad strokes since I am interested.


If your point is physician payments, I never attempted to address it. Please re-read the thread, and at all times you will see my points have been consistent, and not dealt with physician payments. I am not sure what you mean by "data." I just gave you a link explaining the new policy CMS adopted re: DRG payment to providers in regards to a list of events. They were previously paid for. Now they are not. As I originally stated, Medicare payments have been effectively reduced, through this mechanism. This link, from an email I had, was useful in having the consultant explain to you the mechanism. You do not seem to want to accept this mechanism was put in place, and I am fine with that. It supports my theory enumerated above.

Edit: Better yet, let CMS explain it to you: http://www.cms.hhs.gov/HospitalAcqCond/01_Overview.asp
 

haganah

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Originally Posted by Piobaire
If your point is physician payments, I never attempted to address it. Please re-read the thread, and at all times you will see my points have been consistent, and not dealt with physician payments. I am not sure what you mean by "data." I just gave you a link explaining the new policy CMS adopted re: DRG payment to providers in regards to a list of events. They were previously paid for. Now they are not. As I originally stated, Medicare payments have been effectively reduced, through this mechanism. This link, from an email I had, was useful in having the consultant explain to you the mechanism. You do not seem to want to accept this mechanism was put in place, and I am fine with that. It supports my theory enumerated above. Edit: Better yet, let CMS explain it to you: http://www.cms.hhs.gov/HospitalAcqCond/01_Overview.asp
There was a threads about MDs and I made a comment in response to them getting paid. Regardless, even on the hospital side, you provided a link that said payments to organizations on patients that were not diagnosed with 11 conditions prior to entrance were not reimbursed at the previous rate. What did I miss here? How about the other conditions that were outside of those 11? How about those that were diagnosed prior to entrace as opposed to after the fact? It's funny how the doctors don't make any money, the hospitals are going broke, and the insurance companies are all going bankrupt.
 

Piobaire

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Originally Posted by haganah
There was a threads about MDs and I made a comment in response to them getting paid. Regardless, even on the hospital side, you provided a link that said payments to organizations on patients that were not diagnosed with 11 conditions prior to entrance were not reimbursed at the previous rate. What did I miss here? How about the other conditions that were outside of those 11? How about those that were diagnosed prior to entrace as opposed to after the fact?

It's funny how the doctors don't make any money, the hospitals are going broke, and the insurance companies are all going bankrupt.


You don't want to hear anything other than what you want to believe. I know you're just picking a fight, as that's what you do, but any reasonable reader can see I presented something very cogent and supplied links directly from CMS. We won't mention the fact, I started this conversation with you, by pointing out you confused Medicare and Medicaid, a very huge distinction. Of course, it's not like Medicare patients and their coverage levels, are the only variable in this game. I won't mention the other variables, such as care for medically indigent and illegal immigrants, as this will give rise to further calls for "data," which you will also refuse to accept.

Please, carry on your fight without me. Maybe you can start to ad hom me, as you're doing to Shikar? It will be very exciting!
 

haganah

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Originally Posted by Piobaire
You don't want to hear anything other than what you want to believe. I know you're just picking a fight, as that's what you do, but any reasonable reader can see I presented something very cogent and supplied links directly from CMS. We won't mention the fact, I started this conversation with you, by pointing out you confused Medicare and Medicaid, a very huge distinction. Of course, it's not like Medicare patients and their coverage levels, are the only variable in this game. I won't mention the other variables, such as care for medically indigent and illegal immigrants, as this will give rise to further calls for "data," which you will also refuse to accept. Please, carry on your fight without me. Maybe you can start to ad hom me, as you're doing to Shikar? It will be very exciting!
Every time you can't discuss something, you start to make accusations of how the world is against you - it's not the first time. Just like it wasn't the first time that shikar came into a thread, dismissed what others wrote, and didn't write any reason why (ie check threads on iran, islam, pakistan, beheadings) but I am glad you pointed out that I brought that up when he did it again. I asked you a question and you launch into this long diatribe. Let's just take this step by step again for you: 1) I posted in a thread about doctors and wrote something about them getting paid. 2) I wrote about how a cut for Medicare payments to physicians was actually reversed and increased. 3) You wrote back about hospitals to me. 4) Even on the hospital front, you write about how payments for patients that were admitted for 11 conditions that were not diagnosed prior to admittance was reduced. Hey, I hear they have a sale on 11 items in a store, and only if you buy those items using a Diners club card, thus the store must be going broke without looking at what else the store sells. I'm not sure why you're so upset, but you really should get over it.
 

Piobaire

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Originally Posted by haganah
Every time you can't discuss something, you start to make accusations of how the world is against you - it's not the first time. Just like it wasn't the first time that shikar came into a thread, dismissed what others wrote, and didn't write any reason why (ie check threads on iran, islam, pakistan, beheadings) but I am glad you pointed out that I brought that up when he did it again. I asked you a question and you launch into this long diatribe.

Let's just take this step by step again for you:
1) I posted in a thread about doctors and wrote something about them getting paid.
2) I wrote about how a cut for Medicare payments to physicians was actually reversed and increased.
3) You wrote back about hospitals to me.
4) Even on the hospital front, you write about how payments for patients that were admitted for 11 conditions that were not diagnosed prior to admittance was reduced. Hey, I hear they have a sale on 11 items in a store, and only if you buy those items using a Diners club card, thus the store must be going broke without looking at what else the store sells.

I'm not sure why you're so upset, but you really should get over it.


Me? Upset? Oh my dear man.

You left out what should really be point #2 and #3 however:

2) Haganah confused Medicare and Medicaid, a very "lulz" mistake to make
3) Piobaire tactfully corrected him.

Oh, and #4 is currently incorrect...but we'll let that slide.
laugh.gif


And yes, I have clearly demonstrated I have no grasp of this material, and can't discuss it.
rolleyes.gif


Carry on the fight without me. It should be very exciting for you!
 

Shikar

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Originally Posted by haganah
Just like it wasn't the first time that shikar came into a thread, dismissed what others wrote, and didn't write any reason why (ie check threads on iran, islam, pakistan, beheadings) but I am glad you pointed out that I brought that up when he did it again.

I HAVE A FAN CLUB!!! SIMPLY AWESOME!!!
worship.gif


Regards.
PS. And now I understand the rage.....
 

haganah

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Originally Posted by Piobaire
Me? Upset? Oh my dear man. You left out what should really be point #2 and #3 however: 2) Haganah confused Medicare and Medicaid, a very "lulz" mistake to make 3) Piobaire tactfully corrected him. Oh, and #4 is currently incorrect...but we'll let that slide.
laugh.gif
And yes, I have clearly demonstrated I have no grasp of this material, and can't discuss it.
rolleyes.gif
Carry on the fight without me. It should be very exciting for you!

Yes you got me. The whole argument falls apart because I wrote Medicaid instead of Medicare. You clearly have a grasp on this material!!!! Next point out a spelling error and your nonsensical argument will be complete!
 

Piobaire

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Originally Posted by haganah
Yes you got me. The whole argument falls apart because I wrote Medicaid instead of Medicare. You clearly have a grasp on this material!!!! Next point out a spelling error and your nonsensical argument will be complete!

crackup[1].gif


Say, didn't you and I go exactly down this path once before? Wow, history does repeat.
 

chorse123

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Originally Posted by btinl
Maybe even add on Emergency Medicine (shift work, good pay). Downside is that it can be very stressful.

A friend of mine is doing this. I think he said he'll start at $250k when he's done with residency. Granted, that's after 4 yrs undergrad, 4 years med school, and 3 years residency. And a mountain of debt.
 

needler

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Originally Posted by haganah
Sorry. Yes. "Nine days after a 10.6% cut to Medicare physician payments went into effect, the Senate acted in dramatic fashion to replace the cut with a modest pay increase for the next 18 months. The legislation (H.R. 6331), which passed both the House and Senate by veto-proof margins, extends the 0.5% Medicare pay increase in place for the first half of 2008 and gives physicians a 1.1% raise for 2009. " That is just one example.

You have heard of inflation, correct? Payments to physicians are meant to cover all their practice costs, including paying employees, rent, utilities, etc. A 1.1% raise IS a pay cut, because the cost of all those things (and all the things they buy with their salary) increased last year by an average of 3.8%. Thus they took a 2.7% pay cut from the year before. Add it up over ten years and you're talking a serious dent.

Congress certainly figured this one out a while ago, because their paychecks include yearly cost of living increases. And theirs certainly don't come out to a net negative.
 

haganah

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Originally Posted by needler
You have heard of inflation, correct? Payments to physicians are meant to cover all their practice costs, including paying employees, rent, utilities, etc. A 1.1% raise IS a pay cut, because the cost of all those things (and all the things they buy with their salary) increased last year by an average of 3.8%. Thus they took a 2.7% pay cut from the year before. Add it up over ten years and you're talking a serious dent. Congress certainly figured this one out a while ago, because their paychecks include yearly cost of living increases. And theirs certainly don't come out to a net negative.
I see. Just so I understand, let me use some plugs for calculations and you can guide me along in this. Let's say reimbursement by Medicaid is 100% today but there is a 10% rate of inflation, then next year, if the world was fair to doctors, they should receive a 110% reimbursement correct? FYI, from the Government Office of Accountability (aside from the increase in 2008):
"From 2000 through 2005, Medicare spending for services provided by physicians grew rapidly. While Medicare physician fees rose by 4.5 percent over the period, program spending on physician services per beneficiary grew by approximately 45 percent. The number of physicians billing Medicare and total allowed charges per billing physician also increased, as did the proportion of claims for which physicians accepted Medicare payment as payment in full.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)16 and the Deficit Reduction Act of 2005 (DRA)17 averted fee reductions projected for 2004 through 2006 by specifying minimum updates to physician fees for those years. The MMA-specified minimum annual increase of 1.5 percent replaced SGR system fee reductions of 4.5 percent in 2004 and 3.3 percent in 2005. DRA had the effect of replacing a fee reduction of 4.4 percent in 2006 with a 0.2 percent fee increase. These legislated minimum fee updates have resulted in additional aggregate spending. "
 

herpsky

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it's pretty funny how i totally style on my attendings but get pimped like crazy in the wards and cry myself to sleep every night

lulz
 

needler

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Originally Posted by haganah
I see. Just so I understand, let me use some plugs for calculations and you can guide me along in this. Let's say reimbursement by Medicaid is 100% today but there is a 10% rate of inflation, then next year, if the world was fair to doctors, they should receive a 110% reimbursement correct?

FYI, from the Government Office of Accountability (aside from the increase in 2008):

"From 2000 through 2005, Medicare spending for services provided by physicians grew rapidly.
While Medicare physician fees rose by 4.5 percent over the period, program spending on physician services per beneficiary grew by approximately 45 percent. The number of physicians billing Medicare and total allowed charges per billing physician also increased, as did the proportion of claims for which physicians accepted Medicare payment as payment in full.


Yes, payments increased by 4.5%. Over five years, not annually. With a conservative 3% inflation rate, that amounts to over 10% less than inflation and your own link proves your argument incorrect.

I don't know about "the world being fair" but it has happened in other countries that doctors start out making a certain wage and rather than politically tricky pay cuts the government just keeps them at the same salary for decades and allows inflation to erode the actual value. Government employees, on the other hand, receive raises designed to keep their purchasing power the same despite inflation.
 

haganah

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Originally Posted by needler
Yes, payments increased by 4.5%. Over five years, not annually. With a conservative 3% inflation rate, that amounts to over 10% less than inflation and your own link proves your argument incorrect. I don't know about "the world being fair" but it has happened in other countries that doctors start out making a certain wage and rather than politically tricky pay cuts the government just keeps them at the same salary for decades and allows inflation to erode the actual value. Government employees, on the other hand, receive raises designed to keep their purchasing power the same despite inflation.
If you can answer my question with the example I provided you, it will help us both understand this concept of inflation which you speak of.
 

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