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NYT Wants To End Doctors’ ‘Fees For Services’

From the New York Times:

Apprehensive, Many Doctors Shift to Jobs With Salaries

By ELISABETH ROSENTHAL | February 13, 2014

American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following.

Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years.

Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins.

In reality, ‘independent’ (that is, private doctors) are going to work for hospitals and medical centers because private practice involves: 1) too much paperwork, thanks to the government. And 2), low re-imbursements fees, thanks to the government. (Becauase private doctors don’t have the clout of hospitals when it comes to negotiating fees.)

And Obama-Care is only going to make both of those situations far more worse. Which, of course, that is no accident.

Health economists are nearly unanimous that the United States should move away from fee-for-service payments to doctors, the traditional system where private physicians are paid for each procedure and test, because it drives up the nation’s $2.7 trillion health care bill by rewarding overuse. But experts caution that the change from private practice to salaried jobs may not yield better or cheaper care for patients…

Which is why the government has to set these salaries. To make sure they are fair.

Hospitals have been offering physicians attractive employment deals, with incomes often greater than in private practice, since they need to form networks to take advantage of incentives under the new Affordable Care Act. Hospitals also know that doctors they employ can better direct patients to hospital-owned labs and services…

The base salaries of physicians who become employees are still related to the income they can generate, ranging from under $200,000 for primary care doctors to $575,000 in cardiology to $663,000 in neurosurgery, according to Becker’s Hospital Review, a trade publication.

Because of the relatively low salaries for primary care doctors, Dr. Suzanne Salamon said that for the last two years she has had trouble filling a prestigious Harvard geriatrics fellowship she runs…

What the NYT really wants is to do away with doctors’ fees for services all together. The NYT wants the government to be able to decide how much a doctor should earn a year, depending on his specialty — and their usefulness to the state.

Which will be just one more step down the road to government run single payer.

This article was posted by Steve Gilbert on Monday, February 17th, 2014. Comments are currently closed.

2 Responses to “NYT Wants To End Doctors’ ‘Fees For Services’”

  1. captstubby

    a brain surgeon named Dr. Hendricks,
    Atlas Shrugged,
    “I quit when medicine was placed under State control some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I could not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, but ‘to serve.’ That a man’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”
    and if the Saboteurs of the Workers will not do their Duty,
    we will use the Party Trained Community Organizers to preform these tasks.


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