1. actually might get paid for all the patients without insurance that i see
2. This is a comples problem with many pitfalls and problems. UHC will bog down the waiting time for procedures and the elderly could get shut out of many non-life threatening medical treatment. Look at the Uk as a medical model. Elective hernia repairs have a 6 month to 1 yr waiting list. Luckily, I am at a point in my career that I will be retired before too much is changed. So I don't think it will play a terrific impact on my practice but it will play a significant role in my health care.
3. WOULD LIKELY LEAVE HEALTH CARE IF UNIVERSAL HEALTH CARE EVERY CAME TO BE.
4. My career would become more flexible because my own personal health insurance would travel with me rather than be provided by my employer
5. No bearing. A physician should treat the sick.
6. Lack of choice to participate or not
Government regulation with tough civil and criminal penalties
7. No effect: I will retire this year regardless.
8. I would seriously comsider retiribng from medicine
9. Since I am close to retirement, given the economy of the country and the paucity of physicians in my specialty I would probably have to work 80 hours/wk instead of the 70 I work now and would never be able to retire.
10. Already semi-retired so my answer here is irrelevent
11. Ability for hospital to pay for specialty employed physicians
12. I'll have even more patients and more visits to do. When something is perceived to be "free" it gets consumed whether necessary or not.
13. [No Answer Entered]
14. i would be retiring early
15. Would make more sense to have standard, simple payment tables, or standard payment tables to Doctors that would allow us to know exactly what we are getting rather than the present system which has so many variables that not two Doctors are paid the same amount for the same procedure.
16. It would be a total mess unless the ability of frivolous law suits were capped or done away with completely.
17. probably would not change my current fee for service practice
18. depending on what healthcare system is adopted, i think the changes can be positive or negative. i believe too much government regulation can increase costs and make system less effective. there has to be an appropriate mixture of private and government policies.
19. I hope to leave medicine at the end of this year, regardless of what plan is established.
20. It might hasten my retirement from practice.
21. The outlines of the plan I specified above achieve the main purpose of a one shoe size fits all UHC without any of the drawbacks and, in fact, goes further to address the US 'health status' (novel thought)
If the US makes the irrevocable error of a single payor system, I will find another type of employment outside of medicine.
22. UHC should be accompanied by Universal Doctor Care with the government providing malpractice coverage for all doctors. Another alternative would be to make it mandatory for insurance companies to provide coverage for all patients. Doctors are really tired of working more and more for less and less. We are all looking for an EARLY exit strategy.
23. probably will retire
24. I would no longer practice.
25. I quit practicing because of no reimbursement by insurance companies. The trick is to regulate the insurance industry, then medical care would be a lot cheaper.
26. test
27. Income for nurses and other healthcare occupations would decrease due to government regulations on hospitals. Thus, compounding the shortage for nurses across the nation.
28. I don't think it would significantly change my career.
29. I think that we should extend patents for Rx drugs so that they don't have to try to make alll that money back in a few years. If the companies knew that thye had more time, the drugs would be cheaper.
30. I am in transition already to a non-clinical position
31. There is extensive and expensive waste and fraud in all of our current federal programs. UHC will dramatically worsen the problem. Need to allow the marketplace to work by incentivising patients and physicians to get the most value for the least amount of dollars. Patient ignorance and non-compliance, physician red tape, lack of tort reform, lack of true marketplace competition, needles massive # of rules and regs are just a few of the barriers to more inexpensive and efficient medical care. jgf
32. Would NOT consider further training in medicine.
33. the resultant increase in work load, brought about by giving access to health care to all citizens, would require many more professionals in the future to deliver the care, including longer careers
34. I will not change careers since I work as a medical director for an MCO. I will however likely never return to clinical practice as the life style of an internist is too demanding. I do not believe free market forces should be removed from health care. We are already seeing a huge decrease in medical student applications and almost a quarter of the U.S physicians are FMGs. If we get a universal system we will increase our dependence on FMGs right at the time we need more trained providers with the aging baby boomers.
One glimpse at other universal systems is all you need to see that it will not work in this country. We have the best medical care in the world because of the market forces that drive the system. Our healthcare system is far from perfect and some have limited or no acces but the proposed changes will dramatically alter the quality of care for ALL our citizens. Attempts to correct the problem for some will have a negative impact on everyone.
35. I have recently retired. One of the major reasons for my retirement was the dissatisfaction of the "tactics" employed by private 3rd party payors.
36. The culture of American Corporate mindset has to alter. Doctors make money associated with patient care, not associated with numbers of patients. Doctors should be responsible for Evidence based medicine. Patients should be held accountable for good and bad health behaviours. Rewards may be in terms of reduced care costs and possible free medicines for certain conditions.
One source for payments to all sites of care would integrate and not fragment the care. All patients could be treated equally. Some patients may opt out for a different type of care... e.g BOUTIQUE etc..
37. none currently, work as a contractor for the government
38. Under UHC, doctors would be essentially government "employees," with the right to unionize, strike for higher pay, etc. I wouldn't mind having 4 weeks of paid vacation per year, malpractice insurance covered by the government, sick time, etc. Unfortunately, new innovations, access to expensive procedures, and other services would be stifled (e.g.: How many MRI machines do you think the government would provide in my town? Under a private system there are about TEN! The possibility of making money is what creates more services; competition creates better prices).
39. Must decrease & streamline regulations to allow for increased productivity or more providers will leave the system.
Mus increas use of midlevel providers for more efficient care.
40. I am retired, teaching part time at a school of nursing. There wouldn't be any difference in my career plans
41. I would stop being so discusted by the greed evident at every aspect of healthcare delivery that I am involved with.
42. I would quit
43. I would retire
44. I am currently "retired" and might consider returning to practice.
45. [No Answer Entered]
46. Making health care an expectation of everyone would make me leave health care all together. We are too much of an entitlement society!
47. [No Answer Entered]
48. I actually think that use of Nurse Practitioners should increase and use of physicians would become more for specialized care. As a result routine medical visits would decrease plus nursing has always had a strong providing of prevention.
49. none.I will soon be laid off from my salaried position and will probably retire.
50. WHO TAKES RESPONSIBILITY FOR THE MEDICAL DECISIONS? IF I HAVE TO TAKE RESPONSIBILITY IN MALPRACTICE FOR THE DECISIONS MADE BY THE SYSTEM, IT MAKES IT DIFFICULT TO PRACTICE
51. Would leave and go to biotech industry.
52. None
53. The reaction of my group to the changes in the environment. If they increase the workload to maximize profits, I will burn out.
54. Health care is a joke and in shambels. Everyone out for themelves to make money!!!!!!!!!!!!
55. It would be fun to practice medicine again if all had access and I didn' ever again have to deal with a myriad of private insurers.
56. I presently work in a Community Health Clinic and I don't expect any change in that with a National Health Program
57. Government regulation would increase.
Quality of care would decrease further -- as it already has with lawyers and politicians forcing directed medical decisions.
Costs of actually improving medicine would go up; or worse, improvement would be impossible altogether.
58. decrease in gross income - increase in net income
59. Longer waiting times for patients to see specialists and to get necessary procedures would be a big issue. We still have the best healthcare system in the world from the standpoint of quality and access. However, it does need to be made more affordable, especially insurance and medications, so more people can be covered. I feel all children, citizens or not, should be covered. Adults, that are citizens, should also have the option to be covered, regardless of income. I do not think that adults who are non-citizens should have healthcare coverage paid for by US citizens.
60. Would consider different profession, if such changes forcefully imposed on my practice.
61. physicians should be employed by the health care facility. Competitively paid. This will reduce overhead costs, university taxes, etc. Take home pay would be better
62. retire early
63. retire early
64. None of the above apply, since I am retired and at this time only doing volunteer work.
65. Universal health care has been shown not to work in other countries. A free market model where competition plays a role is the best incentive for quality care. There is too much abuse in the current system. Going back to a lower cost model with regular private insurance perhaps on an 80/20 basis where the insurance covers 80% and patient 20% as we had years ago would be the ideal model. I do not know if I would continue practicing in a Universal Health Care system - would probably have more income potential and less regulation working at McDonalds without the stress of malpractice and over regulation.
66. I will retire.
67. I would leave medicine completely
68. At my age, I will continue to want to work. I think that medicine as a career will become less desirable.
69. None.
70. I am retired
71. I am retired
72. not sure
73. I am approaching being a Government employee now.When I was in the USAF this was fine but I have no desire for permanent government employment.My neighbor,who is a realtor, makes significantly more income than I do, working far fewer hours with much less liability.His liscensing consisted of a weekend course and a 1/2 day test...I am fellowship trained!I am not planning on encouraging my children to go into medicine and know few doctors who are....and yet people keep suggesting more goverment control will make medicine better...where will we find a physician workforce willing to do it?
74. More efficient use of my time, less incentive for unnecessary proceedures, better patient-physician interaction.
75. If there is no student loan relief, and if physician salaries decrease or expectations increase with UHC, I will no longer be able to practice medicine.
76. Whether or not tort reform is part of the plan. I would gladly earn much less in exchange for a complete reform of the tort system that puts my entire estate on the line every day I work.
77. No Comment
78. Needless appointments, taking advantage of providers, increased demand of patients "wanting" treatment vs "needing" treatment.
(referring to question 4: health care IS already available to the uninsured via ER, nonprofit clinics)
79. I have recently retired (at age 60) because I could not earn a living with 80% Medicaid practice. I would welcome discussion of UHC models, with options for purchase of more extensive care.
80. I would look for another field to work in.
81. I believe I would leave the nursing profession, and work in another area.
82. would consider changing careers.
83. You may well have fewer going into the healthcare field, especially physicians. Those who are currently benefiting( Government & large corporations would STILL be the ones coming out on top)The level of care will decrease, "appointed groups" will be playing God and deciding who deserves this or that more than him or her. I have a LARGE fear for the future of our nation and I wish I had been born in the early 1900s instead. Where is Ronald REagan when you need him?????
84. liability of government fines for not following rules, not being able to keep up with thousands of pages of regulations.
having medical care legislat
85. protection from medical malpractice suits
86. We need coverage for the many working people with no insurance. That would likely have little impact on individual practices but would prevent financial ruin of uninsured patients
87. I would definitely change my career. Most professional I know will leave the medical field as a result more unqualified workers would assume these roles and quality of care will decline dramatically.
88. If it would truly support primary care and basic health care for all, I would be very interested. The entitlement attitude that many have beliving they have a right to any care that they want is way out of reasonable, thereby raising the total costs of health insurance, Medicaid and Medicare expenses. I've covered all 3 areas and Medicare is the most transparent with policies, etc. The main thing Medicare needs is more people and better methods to track down fraud. Even a UHC will have lots of fraud in the system. We should immediately implement anti-fraud measures from day 1!
89. None I stopped direct patient care under the current system
90. Whether or not 3rd party insurers continue to keep 50% of every health care dollar for expenses, overhead, profit, etc.
91. it does not work , look carefully at the English and Swedish system, even then german system does not work anymore. We should learn from failures
92. Retire, change career
93. A more ethical environment to treat patients might tempt me to stay in practice longer.
94. Whether malpractice premiums increase
95. If private cash based practices were outlawed I would either become a crinimal or quit.
96. We would be institutionalizing mediocrity. There is no wonder why there are more MRI scanners on the USA side of the Canadian border than anywhere else on earth.
I have been treated (as has my family over the years) in England. It is the cheapest, lowest possible care at all times. I would be reluctant to make the USA another second class medical nation.
97. [No Answer Entered]
98. Lack of diagnostic tests available to make patient care decisions. Having non- medically trained, i.e. not doctors, making medical decisions about cost and patient care.
99. Virtually no impact since I plan to retire by 2010. However, should I continue some telemedicine, it would be easy to do some rural specialty work in my state.
100. Less incentive for developement of careers.
101. ACTUALLY NOT MUCH... RETIRING SOON
102. Mandated limits or restrictions on the practice of medicine's decicion making processes.
103. in the market for a new career
104. It would be tolerable to be a physicain under UHC, but intolerable to be a patient under most UHC proposals. See my discussion above
105. I will continue to see patients because I love my job. It does not matter who pays for it or why.
106. The ability to treat all of my patients equally.
107. Complex I beleive.
How much the physicians will be reimbursed for services...and also the fact that where do they practice...in expensive areas how will u factor in the fee schedules to compensae for higher overheads
Physicians job is usually full time...they cannot be generating income elsewhere to support the practice overhead which is high due to inflation etc when their fee schedules are fixed to a minimum possible
108. All of the above.
Please note that your question no.10 is not properly formulated.It should be-"no care for illegal residents".
You may not be a citizen, but be a legal resident!!!
109. N/A, I'm employed by a Prison Health System and the offenders have UHC.
110. other responsibilities
111. The degree to which healthcare includes care delivered by nonphysicians. For example, if a nurse practitioner is paid to make believe he/she can do the same thing that a physician has been trained to do, there's little incentive for physicians to remain in the business of medicine.
112. I would leave the health care arena
113. none
114. I am an Academic Medical Oncologist at State University, we see many indigent and un-insured patients who presents with advanced disease. Hopefully coverage of the 47 million uninsured and the millions who are under insured would be appropriately screened and diagnosed early to give them a better chance for cure.
I suspect that MDs in private practice may have some reductions in their income if a more universal health insurance is implemented.
115. I strongly suggest you talk with (respondent referenced individual) at the (respondent referenced institution) in the (respondent referenced geographic area) area. He is a prominent expert who disagrees with some of the assumptions in some of the answers to this survey. He has pointed out that we can have good quality and good access and good control of costs--all at the same time. The key is to organize a streamlined system. Most politicians haven't accepted his concepts even though (respondent referenced institution) is very influential among health leaders. Give him a call! (Editors note: at the time of this release Jackson & Coker had not been able to obtain permission to use the name or institute referenced in comment #115)
116. Since I specialize in providing care to the uninsured, my job might change a great deal; I might be able to participate in a practice more like most other physicians' practices.
117. since I do occupational medicine primarily, it might have little effect or it might have a lot depending on the situation. I do feel VERY STRONGLY that family physicians be the managers of any efforts to reform health care. In the late 80's my cousin applied the family practice model to medical care for the Navy as the first Family medicine trained admiral to great success. He is now helping to set up family medicine in Vietnam--everywhere else that is the model--and we have higher costs and poorer care--what does that tell you?
118. Wow! Less time on paperwork and phone calls to insurance companies, more time for patient care. Systemwide, more dollars spent on patient care, and less on obscene insurance company profits.
119. [No Answer Entered]
120. The devil is in the details. Universal healthcare in Britain is in real trouble.
The wait times and inability to select your own specialists are troubling. Americans will not stand for that. I think a modification of the AMA recommended system might work. I would select one or two insurance companies to manage the system but take the profit motive out. That is, pay for their costs of doing business but don't allow health care dollars to go to stock holders and executive bonuses. Charge each American a premium based on the usual actuarial tables but with such a large risk pool, the average premium could be quite low. Allow people to purchase high deductible plans with HSA accounts. Make the purchase of health insurance mandatory with premiums taken out of paychecks up front or added to taxes or provided for cash. Make it mandatory to have a valid insurance card. The penalty for not having one would be an amount twice the ordinary premium. Remove the strangling amount of regulations on physicians and hospitals and then build in incentives for rewarding better outcomes on a risk adjusted basis. Simplify DRG's and E&M codes. A vast amount of money is wasted on employees whose
121. I would quit.