Re: Worries about Clinton/socialized medicine? Archived Message
Posted by Dave J on January 18, 2008, 8:43 pm, in reply to "Re: Worries about Clinton/socialized medicine?"
Socialized medicine for the three "in house" specialties of Radiology, Anesthesia and Laboratory could be a real problem. These three specialties usually have some sort of agreement with the hospital. IE: sole provider agreements or a fix fee for service agreement. The provider as part of the agreement has to take whatever work comes down the road. Unlike other providers such as surgeons, you do not have the option of turning someone away who can not pay, has no insurance or has poor paying insurance. As a result, if you get stiffed, there is nothing you can really do about it. Such as with Medicare. Already they have cut the Medicare payment for anesthesia. Instead of getting more pay this year do to inflation, we get less. Now imagine government controlled (Or mandated) care at prices they set. (Price fixing.) Imagine not just Medicare patients coming with poor payment that you have to care for, imagine all of the patients having some sort of government arranged health care. Just as you can not refuse to care for Medicare patients, you will not be able to refuse them. Socialized medicine could result in a 50% cut in the pay of all anesthesia providers as the government tries to save money. This could cause MDAs to get out of anesthesia as there are OTHER specialties they could go into and made decent money. Or instead of supervising 3 CRNAs/AAs, they will go with 4 or even try five. The demand for CRNAs and AAs could go up. Supporting that conjecture is the fact that for CRNAs the practice of anesthesia is THE big money specialty in nursing. There are very if any other nursing specialties that pay as well. CRNAs would be more willing to stay in anesthesia despite massive cuts BECAUSE no other nursing specialty would pay as well. And the same would hold true for AAs. Bottom line, socialized medicine would drive out MDAs or cause them to supervise far more people than they should, harming patient care. It will probably not impact CRNAs and AAs other than in the pocket book. And for that reason, I see the threat to CRNA practice as NOT AAs, but socialized medicine and how they will try to keep costs down by making providers accept less money.
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