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America’s Looming Primary-Care Crisis

newyorker.com

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Re: America’s Looming Primary-Care Crisis

#31

Post by wonder_er »

tharne wrote: post #23
dantheman wrote: post #21

Earlier quoted context omitted.

The US purposefully lowered the amount of doctors in the 90s. If anything we should be creating more need schools and creating more doctors.

That's a big claim to make without providing any evidence or even some context.

I'm not the OP; when I read OP's comment, I thought "Oh, I think the AMA's been doing this since long before the 90's".

Here's the article I read a few years back that made me think this is the case:

I know it's mises.org, so hold the pichforks until the end. Even if they're way off base, there's got to be some value to be gleaned:

https://mises.org/library/100-years-medical-robbery

Re: America’s Looming Primary-Care Crisis

#32

Post by tristor »

hippich wrote: post #20

Anecdotal data point about primary care: About a year or so ago I subscribed to "direct/concierge primary care practice". I pay $80/month and in exchange getting an access to a primary doctor who takes care of keeping an eye on me, my blood pressure, all my prescriptions (some of which used to require monthly visits to specialists). I am also getting access to really cheap prices on labs, typically 30 min visits same…

I’d be interested in enrolling in a similar service. How do you find out about these services in your area?

Re: America’s Looming Primary-Care Crisis

#33

Post by DoreenMichele »

tristor wrote: post #32
hippich wrote: post #20

Anecdotal data point about primary care: About a year or so ago I subscribed to "direct/concierge primary care practice". I pay $80/month and in exchange getting an access to a primary doctor who takes care of keeping an eye on me, my blood pressure, all my prescriptions (some of which used to require monthly visits to specialists). I am also getting access to really cheap prices on labs, typically 30 min visits same…

I’d be interested in enrolling in a similar service. How do you find out about these services in your area?

Your best bet to find a direct primary care physician is to do an online search including “direct primary care” and the name of your state.

https://www.nextavenue.org/direct-primary-care-time-with-doc....

Re: America’s Looming Primary-Care Crisis

#34

Post by prawn »

kcb wrote: post #18
fennecfoxen wrote: post #15

Earlier quoted context omitted.

> people have wacky ideas about things like economics and intelligence. Boy howdy. There are three major parts of the economy which are extensively regulated to achieve political goals: health care and higher education (on the national level with some state involvement) and housing (city-level zoning, with occasional other mandates particularly in places like California). Notice then the three areas where prices have…

You really think that those are the only three things regulated to achieve political goals?

At the time of my reading, their comment says "three major parts of the economy which are extensively regulated". I don't think that they're ignoring all others.

Re: America’s Looming Primary-Care Crisis

#35

Post by colinmhayes »

controversy wrote: post #25
dantheman wrote: post #21

Earlier quoted context omitted.

The US purposefully lowered the amount of doctors in the 90s. If anything we should be creating more need schools and creating more doctors.

The AMA corrected course on this. The problem is not a lack of schools. The problem is a lack of hospitals to train them in as part of the residency. As long as residency is a thing, we have an insurmountable bottle neck. Evidence to the limitations. https://skeptics.stackexchange.com/questions/4561/does-the-a...

Both are problems. Half the qualified med school candidates don't get accepted to any schools. Of course if we build more med schools we'd need more residencies too, but the government can just raise the subsidy they give residencies to create more.

Re: America’s Looming Primary-Care Crisis

#36

Post by hippich »

tristor wrote: post #32
hippich wrote: post #20

Anecdotal data point about primary care: About a year or so ago I subscribed to "direct/concierge primary care practice". I pay $80/month and in exchange getting an access to a primary doctor who takes care of keeping an eye on me, my blood pressure, all my prescriptions (some of which used to require monthly visits to specialists). I am also getting access to really cheap prices on labs, typically 30 min visits same…

I’d be interested in enrolling in a similar service. How do you find out about these services in your area?

"concierge primary care" might also be useful, as some places use "concierge" and "direct" interchangeably.

Re: America’s Looming Primary-Care Crisis

#37

Post by sintax2 »

briandear wrote: post #27
pengaru wrote: post #24

My understanding is that a major cause of America's burgeoning healthcare burden is the food environment. The argument I've heard smarter, better informed people than me make is: If healthcare were nationalized, it would incentivize the government to help fight the battle against itself in the context of unhealthy agricultural subsidies and policies. When the government subsidizes farming corn on a massive scale, and…

> it would incentivize the government to help fight the battle against itself in the context of unhealthy agricultural subsidies and policies. It would also incentivize the government to restrict all manor of activities in the name of “health.” Want to go rock climbing? Pay a tax. Want to ride a motorcycle? Pay a tax. Want ice cream after a hard running workout? Pay a tax. Don’t exercise enough? Pay another tax. Allo…

Surely you could afford an extra $0.10 here and there if it means millions of people would make better choices, yeah? Taxes don't work like you think they do. If you have a Coke now and then, it doesn't really affect you. If you drink three a day, it starts to add up.

If this is unpalatable, we could always just tax Coca Cola directly so they can pay for their sugar-induced health crisis.

Re: America’s Looming Primary-Care Crisis

#38

Post by NicoJuicy »

briandear wrote: post #27
pengaru wrote: post #24

My understanding is that a major cause of America's burgeoning healthcare burden is the food environment. The argument I've heard smarter, better informed people than me make is: If healthcare were nationalized, it would incentivize the government to help fight the battle against itself in the context of unhealthy agricultural subsidies and policies. When the government subsidizes farming corn on a massive scale, and…

> it would incentivize the government to help fight the battle against itself in the context of unhealthy agricultural subsidies and policies. It would also incentivize the government to restrict all manor of activities in the name of “health.” Want to go rock climbing? Pay a tax. Want to ride a motorcycle? Pay a tax. Want ice cream after a hard running workout? Pay a tax. Don’t exercise enough? Pay another tax. Allo…

> Perhaps instead of taxing food, we instead tax obesity. Put the responsibility on the individual.

You probably have better genes than my family. Lookup endomorph body type or reasons of reduced metabolism.

Evolution has inversed survival of the fattest, so it seems ;)

Re: America’s Looming Primary-Care Crisis

#40

Post by maxerickson »

tesmar2 wrote: post #30
controversy wrote: post #25

Earlier quoted context omitted.

The AMA corrected course on this. The problem is not a lack of schools. The problem is a lack of hospitals to train them in as part of the residency. As long as residency is a thing, we have an insurmountable bottle neck. Evidence to the limitations. https://skeptics.stackexchange.com/questions/4561/does-the-a...

AFAIK due to regulation, hospitals can prevent other, new hospitals from being built and it happens often. Get rid of the regulation.

In many places, the government prevents new hospitals from being built. The existing hospital doesn't have to do anything.
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