This all started way before Obamacare. The other pp was correct, drs don't actually make that much money after all is said and done. I used to manage medical practices, for every 1 doc you need at least 3 employees; a nurse and 2 front staff to handle all the paperwork and patients/ phones. That's 3 salaries. Plus malpractice is huge, add in rent (esp our area) and you are looking at very slim profits for someone who works avg 60 hours/ week, very little vacation time, and almost no sick days (they have patients scheduled after all!).
This is why you are seeing less and less single doc practices. Don't forget the pharmaceutical companies are charging the docs more for the vaccines/drugs than most insurance will pay for. So your ped is actually losing $ on some of the vaccines for your kids, but they know they have to offer the, or you will go elsewhere!
HMO's dicitacte the length of some office visits to 15 minutes, anything over that the doc is losing $.
The people making the $ are the ins companies, the malpractice lawyers, and the Pharma companies

Anonymous wrote:

Anonymous wrote:Honestly, I'd pay for an OB who would spend more than 5 minutes with me at appointments!! A PCP, not at this point in my life.

i agree, go with a midwife.

Nurses are AWESOME. I see a Nurse Practitioner as my PCP. She budgets half an hour for appointments, and phones me herself with any lab results, budgeting the time to immediately answer any questions I might have. It's concierge service without the fee.

She has a Master's degree (so ~5-7 years of education, including her BSN) and in DC is permitted to prescribe medication. It's true that she has fewer years' training than a doctor, but that also means a far smaller debt load, and I 100% trust her ability to refer me to a specialist if I present with a condition that she can't deal with on her own.

Anonymous wrote:Honestly, I'd pay for an OB who would spend more than 5 minutes with me at appointments!! A PCP, not at this point in my life.

i agree, go with a midwife.

Blame it on insurance companies and LOBBYISTS for insurance companies. Someone is getting their pockets lined, and it is not mid-class America. We have the poor taken care of through medicare and medicaid, and the rich taken care of through "concierge" (whatever) - what about the rest of us?!?!?! The majority, with seemingly no voice. 'Tis a damn shame. No wonder we are falling behind. We can't even take care of our own.

Insurance companies price everyone OUT of insurance, for the companies own beneift and convenience. Regular families can barely afford the premiums, and they say there are preexisting conditions when there are none. We live in Washington D.C. and NO ONE is doing anything about this? There is no one that works on the hill here? Hullo?

I don't believe doctors are to blame, because they have to make a living too. They don't go through almost ten years of schooling to not repay their loans (although they have the highest default rate, but that's another show, people).

It is clear that the insurance companies are getting rich off you and me and something needs to be done. Anyone? Suggestions? Where to start? I am sick and overwhelmed, so it seems too much for me, but I am willing to send emails. Really, let's have DCUM be productive for once. We should not be sacrificing our children's college fund for health care. Something is wrong here.

[If you have decent insurance, or someone (job) is paying it for you, be grateful. I have actually heard about someone complaining about what their dental (!) coverage failed to cover, when I was shocked that anyone has dental insurance! I am not talking about the spoiled and/or clueless, I am talking about everyday people here.]

Anonymous wrote:Blame it on the insurance companies. They are raking in hefty profits, even in this economy, squeezing blood profits from businesses, doctors, and patients.

RIGHT cause they are evil.

The profits on insurance are very small and mandated by law. The problem is that the government has enacted and is going to enact more paperwork and worthless processes that cause expenditures to rise. On top of that the government is mandating certain pricing for certain items. Add to this the ambulance chasers like John Edwards and you have the perfect recipe for a big waste of time and money. Again in the end the lawyers win and no one else, we are paying for all of this one way or the other.

Anonymous wrote:[

Hogwash. It has to do with the insurance companies. Our doc instituted a similar fee structure this year. They simply could not sustain the practice at the rates the insurance companies were paying them. The insurance companies, on the other hand, are pressed by increasing technology/medical costs and the fact that there are not enough healthy people in the insured pool. (Plus, they need to pay their executives bonuses and salaries that would make Imelda Marcos blush!)

I haven't made up my mind on Obamacare, and malpractice is no small issue, but these fees are coming from someplace considerably more complicated than the pp's politically motivated pablum makes clear.

100% agree with this. I had several doctors completely drop insurance during the prior administration, this is NOT an ObamaCare issue. The insurance companies are squeezing the PCP's way too much. On the one hand, I don't blame doctors for using the Privia service to try and make ends meet, run an efficient office and be able to pay their staff competitively, and also provide better service. However, for me, the whole notion of providing those with the most money the best care is so disturbing. Those extra conversations will save the lives of affluent people, and all of those who are 'merely insured' will suffer.