The same reason someone would want to be a doctor any time?

I could have become a doctor and was offered a full ride and snap turned it down. You are overworked, undercompensated, and under appreciated.

residencies are artificially limited. supply does not seem to be the issue

While it is true to some extent that there is a doctor shortage, really there is a doctor misallocation. "Too many" doctors sub-specialize and more importantly, there are way too many doctors in certain geographical regions and not enough in less desirable places.

The geographical problem is probably even bigger than the specialization one, but right now not even increased salaries are helping that. For example, In my state a rural/smaller town OB/GYN might get can offer of 350k first year, while in the more desirable area salaries are like 190k and you still can't get many new OB's to take the higher paying position. We had a Family Practice doc giving a talk at our school mention that the only OB/GYN within an hour and half of his practice died in a carwreck and suddenly he had to start doing tons more deliveries because there just was nobody else to do it. After like a year they still couldn't get an OB/GYN to move anywhere close nearby, so he went back to a medschool to get extra training in more complicated OB, and now functions as the OB/GYN in the area. (And this guys group practice of 4 family docs already cover the ER and take care of anyone who gets admitted to the little tiny town hospital)

While in the more desirable areas the docs are fighting for enough patients to try to keep their practices profitable.

Hey, you keep that info to yourself! I'm counting on that to give me a sweet ride out in the country somewhere.

Krmont I think you missed this.

No, he just starts ignoring people who realize he has no clue what he's talking about.

They take data based on last years programs, apply the new numbers with new legislation based on assumptions and predictions, which are almost guaranteed to be wrong. No matter what industry you are in, things always cost more than the planned budget. There are always unforeseen problems, errors, and costs. I will happily bet anyone if they are willing on Obamacare meeting its proposed budget/surplus.

http://dfw.cbslocal.com/2012/02/28/r...re-fraud-ever/

This is just one case...

Obviously they still are not paying enough. And this will continue to be the future. 20-somethings don't want to work in rural areas. Same issue in my profession, pharmacy. Many rural areas in Ohio need pharmacists, especially retail pharmacists, and the three C's are saturated, and yet no one wants to move to SE Ohio, etc.

But the hard question is who should be paying more. Health insurance companies sure don't want to do it, nobody wants the government to do it and the predominately poor people who live in rural areas sure can't do it.

The ones that are consuming the health care. Looks like the poor people will have to drive to the city if they want OB/GYN care I guess. Of course this could all be solved if we had market forces in the health care system. And not whatever the hell the US market is.

PS: Also to answer your question, if we did have single payer, it would be the gov't that has to pay more. Just like in Canada. Rural docs, nurses, pharmacists get paid a lot more to go "up north." Supply/demand and all that. Just like the oil rig workers get paid nicely to work in the hell of North Dakota and/or Alberta.

Surf-- I don't know if you are in the medical field, but the issue of rural healthcare and higher salaries is quite common and well known to those in those careers. I think it just says a lot about generational shifting. You are having the older medical professionals retire/die in the rural communites and the 20/30 somethings that refuse to move there even with the higher salaries.

I live in metro-Cleveland and I know I would make the same/less in NYC even with the higher cost of living because it's a more desirable city. I know I would make much more working retail hell at a Walmart/Walgreens in middle of nowhere Nevada, but I like my hospital gig in Cleveland. You can't get the 20-somethings to move to the rural areas, or at least in large numbers yet, and you won't be able to make them.

Im a medstudent in a state that is poor and has tons of rural areas, so I hear a ton about it, but obviously don't have any firsthand knowledge yet. I grew up in one of the more affluent regions and I personally can't really see myself moving out into the super poor/rural areas almost regardless of any salary differential.

I think the most obvious solution is to HEAVILY weight admissions to state run health professional schools towards people who grew up in the most undeserved counties in the state. People are much more likely to work rural if they grew up rural. Realistically a doctor in the bottom 5% of doctors intelligence wise who works in a rural area is going to help the state more than a top 10% working in a saturated (sub)urban market.

or you could fix the usmle requirements for foreign med grads and force them to take some of those slots for x amount of years

I think they already do that, I met a Canadian doc who was practicing in my state because it was the only place she could get a license/visa/etc.

$350,00 is undercompensated? What did you become instead, an NBA player?

Poker player?

no unless something has drastically changed in the last 4 years. you still have to make a much higher score than a us grad then when you do they still limit what and where you can go.

An excerpt from "Year 501: The Conquest Continues" (copyright 1993) by Noam Chomsky, on the health care issue. Not much has changed in 20 years:

Source.

I love the "logic can't be refuted by fact" statement, this is why we can never actually have useful debate between a strict libertarian stance and any other stance. The axiom of the libertarian stance is that the outcome of the market is the definition of efficiency, so its impossible to consider any other stance because it inherently is going to violate that axiom. And its much easier from an argument standpoint to just stick with a strong axiom like that than it is to actually sift through real world data and experiences which are inherently messy and complicated.

Before Obamacare, when lifetime caps were a thing, preemies would sometimes blow through their entire lifetime cap before leaving the hospital for the first time. Chew on that yo.

Obama, and Obamacare is not socialist. Socialists lol that it would even be called that. They are appalled that socialism would even be linked to Obama.

Obama, and this healthcare plan paints him as Corporatist more than anything. Look who benefits the most from his plan.

This is absolutely possible. My daughter was 2 lbs 5 oz when born and spent the first month of her life in a NICU. The bill was right at $250k and she did not need any surgeries.

It's a sad state of affairs when these selfish babies that choose to come into the world early can just sit back and be a drain on the system for the rest of their lives, get a job preemies!