Medicine in the Weimar States of America?

Furnace MoneyThe Happy Hospitalist posts about something I have been thinking about for a while.  The rising cost of health care, declining physician reimbursement, and increasing practice expenses were a bad enough collaboration when the economy was doing fairly well.  But in the last few years — and the last few months in particular — things have gotten quite a bit worse.  Quoth the Hospitalist:

I can’t think but wonder when the day of reckoning for our government financed health care will come. Our government is now on the hook for almost 5 trillion dollars of bailouts for worthless assets. Five trillion dollars. We are printing money to support a house of cards that must deflate. What we have is a fantasy economy based on paper.

In exactly 13 months physician payment through the Medicare National Bank is scheduled for an across the board cut of 15-20%. Because a cut in payment does not translate into a cut in overhead, an office with a 50% overhead expense can expect an immediate 30-40% cut in take home pay. Add to that a 5% rise in office expenses and you are looking at a 35-45% cut in take home pay, immediately. That means a comprehensive care doctor making $150,000 in take home a year will suddenly make $82,000-97,000 a year. And eventually, less than Burger King pays.

Try and find anyone in this country willing to put in seven years of their life and put their family on hold. Willing to come out $150,000 in debt. Willing to accept a constant threat of lawsuit. Try and find anyone willing to do that for less than the pay of a pharmacist or an extender.

I’m no economist and the crowds at the shopping centers seem to belie the idea that the economy is tanking.  I hope the Happy Hospitalist is wrong.  If we have to add major currency inflation to the health care financing equation, then we’re in deep trouble.

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