<p>Uhhh…those people who were uninsured have always been there, have always been getting sick, and always been using medical resources. The health care bill is just going to push them to finding care sooner, seeing medical professions when they are less sick and more easily treated, easing strain on ER’s and being less likely to be admitted to the hospital. </p>
<p>If anything, if fewer people are using the ER and are less critically ill, and are more likely to be seeing SOMEONE to manage their longterm chronic medical conditions (Diabetes, hypertension, cholesterol, COPD, Asthma) then there should be a DECREASE in mortality.</p>
<p>Now in pediatrics - most kids are already insured. Trust me, through SCHIP and Medicaid coverage, both of which are generally expanding for kids (although Arizona was notable for trying to cut their SCHIP program). Depending on your state, insurance rates for children are over 95%. </p>
<p>Further, whoever said infants weren’t a profit sector is wrong. First off, NICU’s at most hospitals are generally one of the biggest money makers. Even hospitals that are running in the red everywhere else will have profitable NICU’s, in large part because this care always gets paid for. Second, if you’re a general pediatrician, there are visits at birth, 2 months, 4 months, 6 months, 9 months and a year of age that are universal and are paid for by nearly all insurance companies and medicaid. Medicaid will even pay for an additional visit at 1 month of age. That’s 7 visits…If you’re building a practice it’s far more effective to recruit newborns than any other age group, and for the most part (and I can speak from experience in my continuity clinic) these are straight forward visits that when you’re experienced can be compressed to fit in 15 minutes pretty easily. Trust me, compared to my ADHD visits for the 6 and 7 year olds, it’s much easier and quicker to do a 4 month old healthcare supervision exam…</p>
<p>Well, eliminating more residency and medical school positions would definitely not help us in the court of public opinion, especially at a time when there is already a shortage of physicians.</p>
<p>Tort reform is one option that’s supported by both physicians and the public. But, there’s a lot of politics behind where we don’t have tort reform already.</p>
<p>BRM, DS heard from his friend whose brother is in residency currently that the life during the residency is much tougher (e.g., sleep starvation, no time to exercise or eat well) than in medical school. He could still go to gym while in MS3/4 but could not while in residency. Do you feel the same?</p>
<p>BTW, I followed most of your (and several other MS students/frequent contributors like BDM, NCG, Shades, mmmcdowe, etc.) posts in the past. These posts are very educational. Thanks!</p>
<p>And also, private insurance rates are all based on Medicare rates.</p>
<p>Most private insurance pay like 130%-160% of medicare rates right? Correct me if im wrong. So if medicare rates fall, physicians accepting private insurance will see their revenue fall as well.</p>
<p>Well job security really isnt worth too much if the income is mediocre.</p>
<p>A DMV worker has a very stable job security; thats why they treat us like crap and get away with it. But still, banking mediocre money for life is ridiculously unattractive. People would much more covet a highly unstable but lucrative career as an investment banker than a DMV attendee.</p>
<p>When my H took the board exams for his specialty, he was told that the bottom 15% of test takers would not pass regardless of their score. I suppose if the the group as a whole did badly, that percentage would even be higher. It was the way the profession kept it’s numbers low enough to be manageable. </p>
<p>“Well job security really isnt worth too much if the income is mediocre.”</p>
<p>Job security is everything. Having a job is #1 priority, income is secondary. I had my salary slashed in half, then I had it almost double. All I wanted is to have place of employment. And you will too, you just do not know it now.</p>
<p>@MCAT2 - overall, yes much more time consuming, but more than anything, it’s just different. I work between 65 and 85 hours a week (just got done with a string of eight 12 hour ER shifts in a row = 96 hrs)…and I have to be where they tell me to be, when they tell me to be there. While I probably spent a similar amount of time in class/studying during the first two years for some short time periods, there were more breaks and I was in control of my time, and where I spent it. Do I want ot be in the library or the coffee shop? I get to choose. Waste a couple of hours on Facebook? Sure. Those things are no longer options. I have months during my residency where it’s just impossible to get to the gym, and certainly when it’s more difficult to eat well, when I’m pretty much limited to what’s available at the hospital.</p>
<p>Depending on the expectations during M3 clerkships, it can be extremely difficult to take care of oneself in terms of diet and exercise, but every school has some blocks that are far easier than others. But as my friends and I are fond of saying, nothings as good as it seems…except for the 4th year of med school.</p>