In the context of the ongoing debate about how to fix America's health care system, Mitch Daniels, the governor of Indiana, wrote an excellent, timely piece today in the Wall Street Journal that was eye-opening for me. He first highlights the benefits of health savings accounts not with partisan talking points, but with independently cited facts, figures, and good ole' common sense. Here's the link:
http://online.wsj.com/article/SB10001424052748704231304575091600470293066.html?mod=WSJ_Opinion_LEFTTopOpinion
After citing many compelling statistics, he concludes:
"The Indiana experience confirms what common sense already tells us: A system built on "cost-plus" reimbursement (i.e., the more a physician does, the more he or she gets paid) coupled with "free" to the purchaser consumption, is a machine perfectly designed to overconsume and overspend. It will never be controlled by top-down balloon-squeezing by insurance companies or the government. There will be no meaningful cost control until we are all cost controllers in our own right."
For my part, I don't think HSA's are the end-all solution for our broken health care system (tort reform and portability across state lines are necessary as well), but they would certainly go a long way towards controlling and decreasing spiraling costs, as Mitch Daniels has illustrated with Indiana's experience. I recommend that everyone read the article and comment.
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I really like HSA's for a number of reasons. If a consumer is forced to pay for the procedure out of an HSA they will be more likely to shop around, finding the best deal. For example, a recent study has shown following a heart attacks, treatments can cost from $1500 to $18,000. While quality of care is similar. If the consumer is responsible for the payment, saving money can help bring competition to health care providers, potentially bringing down costs. I liked this article and some of the examples it gave. My only problem with HSA's is I think it may deter people from seeking preventative medical care, hoping to save money. I think maybe if an employer required a yearly physical in order to make contributions to the HSA that could help. I think these type of accounts should be considered in health care reform. Thanks for a good post Devin, I think this is a good idea.
On an additional note it looks like Pres. Obama is including repub. ideas in the revised health care bill, including expanding the use of HSA's.
http://www.msnbc.msn.com/id/35656271/ns/politics-health_care_reform
Good post! I liked my HSA, but now am ineligible because we are on an employer plan.
A companion idea is allowing people to group together to purchase insurance on a basis other than employment. Back in the 80s I had coverage through the ABA.
Thanks guys, good comments. I think another positive side effect would be that having an HSA would likely encourage people to also make those life changes to improve their health, i.e. a good diet and exercise, which would decrease the need for doctor visits. I know that this doesn't remove the need for preventive care in all cases, but it certainly would help tremendously. I am currently uninsured, and I know that as a result, I definitely watch what I eat and I exercise as much as I can in hopes to stay healthy. These are things I would do anyway, but not having insurance gives me a big extra incentive.
And Obama's gesture of bipartisanship was encouraging. However, he is the President, which means that he doesn't pass the law - the Congress does. Just because he includes something in his legislation doesn't mean that the democrats in congress are going to sign on. The article Creighton cited admitted as much: "there is no guarantee that Democratic leaders will incorporate Obama's suggestions in revised legislation." I think that after the Scott Brown election, more and more democrats see the writing on the wall, and will be less likely to support this unpopular bill, ESPECIALLY if Obama urges reconciliation to get it through. These bipartisan proposals certainly help, but I doubt it will be enough to push it across the finish line.
Obama, at his inaugural address, said, "we were sent here to serve our citizens, not our ambitions. So let's show the American people we can do it together." His proposals are a step in the right direction, but reconciliation of legislation affecting 1/6 of the economy definitely makes him look like he's serving only his ambitions, not the citizens, a majority of which oppose these efforts.
I'd really like to know what republicans would say are their biggest 3 problems with this legislation. Can someone help me out with that? I'm still trying to formulate a final opinion about this legislation, and I'm really trying to get the pro's and con's from both sides.
1. Universal coverage won't decrease premiums or control health care costs, as advertised, but will do the opposite - see Massachusetts experiment with "universal health care" and their skyrocketing premiums, the fastest in the nation.
2. The government will be in charge of yet another inevitably bankrupt, unfunded entitlement program - see Medicare, Medicaid, and Social Security.
3. It substantially adds to the already unsustainable deficit - see Paul Ryan's statements at the health care summit:
http://www.youtube.com/watch?v=zPxMZ1WdINs
Interesting to note that democratic politicians have not bothered to refute Ryan's arguments or his 2.3 trillion price tag over the next 10 years, leaving that to liberal bloggers instead.
4. It's extremely unsettling for me, from an individual freedom and liberty standpoint, that the government can coerce me to purchase health insurance by fining me and throwing me in the slammer if I refuse. I seriously doubt this passes constitutional muster and I'm sure this is causing the Founders to roll over in their graves.
So I have a couple questions for you about each one of these points. Brace yourself, this is a long comment. But I definitely want a rebuttal to see where I might be mistaken or how I might change my views to be more in line with what actually will happen.
1. I haven't been able to find evidence for your claim that Mass. has the highest rising premiums in the country, in fact I found a source that said New Hampshire had the fastest rising premiums in the country, so maybe you can direct me to your source. And a situation in California makes me question this assumption. In California, Anthem Blue Cross is raising premiums by a whopping 39%. Last week the CEO of the company appeared before lawmakers to defend the decision. Wellpoint CEO Angela Braly defended the decision by citing an aging population, increasing costs of diagnostic testing, and a dwindling insurance pool due to the bad economy. When the economy took a downturn, some of the healthier customers dropped out of coverage. The nice thing for health people is they'll have no problem getting health insurance in the future, seeing as they don't have a preexisting condition. People who are sick and need continuing treatment, however, don't have this luxury. If they go uninsured for 60 days (I think that is the time limit) they risk not being able to find insurance when they come back. So you have a lot of the healthy people who are sharing the cost of the premiums dropping out with all the sick people staying in. It's no wonder that premiums are going up. So just from a common sense standpoint, if everyone has to have coverage, you're going to spread those costs amongst a wide range of people. I don't see how those premiums would rise so fast like you say they would. Plus I think with everyone having access to primary care, some conditions will be caught earlier, requiring less money to pay for the condition, rather than catching it later when it might cost more money to treat it.
2. I don't see how you think the government is in charge of all this. Medicare, Medicaid, and Social Security are all programs run by the government, but since there is no "public option," this is not another entitlement guranteed by the government. From what I have understood of this bill is that it will require everyone to have health insurance (run by the private sector) and stop some of the abusive practices that health insurance companies use to turn a profit. For those people that cannot afford health care, they will be subsidized by the government. So I'm not buying into this rhetoric that I keep hearing from the GOP about another government-run program.
3. I watched the clip and I thought it was good and the information was good (I'm not an economics major so I must admit that quite a bit of that went over my head.) My one problem is it cut off Pres. Obama's rebuttal to what this senator or congressman had said. So I'm not even sure if all the information he presented was entirely accurate, and am disappointed in not seeing what the response would have been from the other side.
4. I won't argue with number 4 because I think it is a valid point. What I have come to decide for myself is having to choose between the lesser of two evils. One, the government forces me to have health insurance, and two, millions of people without coverage or ability to get coverage will continue to go bankrupt, use the ER, and decline in health from not receiving proper medical care. For me, I have decided that #2 is the lesser of the two evils, but that's just for me.
1. As of August of 2009 ...
http://www.boston.com/news/health/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_country/
Also with point number one, you don't have to believe me that this bill will not reduce costs, but even Warren Buffet, an Obama supporter and probably the smartest numbers and money guy on the planet, said that this bill won't rein in costs:
http://www.politico.com/news/stories/0310/33693.html
Isn't this at least why Obama claims to want to pass this bill - to reduce health care costs? So if it doesn't even do that, is it worth forcing so many of his democratic congressmen and women to walk the electoral plank?
Here's another interesting article that answers this question: "If bringing Massachusetts-style 'universal coverage' to America is worth this terrible price, why doesn't Obama at least mention us once in a while?" Answer: It's killing the MA budget, killing MA residents on costs ("average Massachusetts premiums are the *highest* in the nation and rising"), and creating bizarre marketplace mutations which have led state legislators to talk about draconian price controls and "capitation." Here's the link:
http://www.bostonherald.com/news/opinion/op_ed/view.bg?articleid=1237112&format=text
2. Just because there is no public option doesn't mean that the government won't be in charge. The government will be writing the checks, passing out the subsidies, and will therefore be establishing more boards of regulators and bureaucrats who will make rules for insurers and health care providers (like they do already for Medicare). Let me ask you this, if it isn't another entitlement, then why does this thing cost so much? Where do the costs come from then? This still equates to a "top down balloon-squeezing" by the insurance companies via government mandates, and as Mitch Daniels illustrated, is still "a machine perfectly designed to overconsume and overspend."
3. You're right about the clip, I would have liked to hear what Obama had to say as well. I'm sure you could find a clip of that or at least the text of the summit online if you are not as lazy as me, haha. However, the main point I wanted to highlight with this clip was that the democratic bill that the independent CBO scored to be "budget neutral" did have some smoke and mirrors involved, mainly that the 10 year cost is only counting 6 years of operation. This point is not disputed. Even a liberal blogger for the Washington Post, Ezra Klein, agreed with Paul Ryan on this point:
"In Ryan's favor, Democrats have artificially lowered the cost of the bill by pushing its start date back to 2014, even as its 10-year budget window begins in 2010. The 10-year cost of the bill is really only counting six years of operation. This was a deceptive effort to keep the bill's price tag under $1 trillion, even as the bill's price tag was really quite a bit more. Point for Ryan."
There's more I want to say, but this comment is already too long.
I've got a #5 as well: I'm opposed to the use of the nuclear option, or reconciliation, to pass this health care bill into law as is Democratic Senator Robert Byrd of WV, who originally authored the reconciliation procedure back in 1974. In addition, Barack Obama WAS opposed to reconciliation, but has definitely flip flopped on the issue since.
Senator Byrd recently came out and said, "I oppose using the budget reconciliation process to pass health care reform and climate change legislation ... As one of the authors of the reconciliation process, I can tell you that the ironclad parliamentary procedures it authorizes were never intended for this purpose."
Barack Obama has even said previously, referring to health care reform, "This is an area where we're going to have to have a 60% majority in the Senate and the House in order to actually get a bill to my desk ... that is not just a fifty plus one majority."
In 2007, he also said that, "Maybe you eke out a victory of 50 plus one, then you can't govern. You know, you get Airforce One and there's a lot of nice perks, but you can't deliver on health care. We are not going to pass universal healthcare with a 50 plus 1 strategy."
Ironically, this will be a self-fulfilling prophecy - he may eke out a 50 plus 1 victory on this, but he won't be able to govern.
Devin, I love your comments on this post. I understand love is not normally used in this sense, but I get butterflies in my stomach and an increased heart-rate when reading. It must be love.
Creighton: in what way will this new bill reduce the cost of actual health care? Not just the assumption that regulation and competition will force health insurance companies to reduce premiums, but the actual cost of receiving care.
There were great, and terrible, comments made by both parties at the Health Care Summit. The ones with which I most agreed had to do with even the most informed person's uncertainty on how any bill will affect costs. Proposing one new bit of legislation at a time just seems more sensible and less 'I wanna make a huge statement and be the one to finally reform the health care system.'
As with most conservatives (I know I made some strong points for the bank bail-outs, but I still consider myself conservative) I think the more important things on which to focus include tort reform (I'd love your thoughts on this Devin the Law Student and Chris the Lawyer), competition across state lines (which seems tricky), a similar claims form for all health insurance companies, and reduction of fraud. Don't ask me how on that last part, but it would save the health care system billions. Those will actually reduce the cost of receiving care, and our associated costs will decrease with it.
I don't know anyone who argues we have a perfect system, but proposing thousands of changes at one time is frightening.
So I have to say my reasoning behind premiums going down comes from my extensive background in Economics, which includes high school Econ that I was late to everyday, and my teacher gave me an A because he was also my offensive line coach. I could be wrong, probably am, but it makes sense to me that if you increase the pool of people being covered by forcing everyone to have health insurance, it would either hold premiums to what they currently are, or even bring them down, simply because more money is flowing into the company to pay out on claims. A source that I think is pretty reliable unless someone tells me otherwise (factcheck.org) says that for most people premiums would stay the same, except for people who buy their own coverage, that would go up, (which sucks because that's the boat I'm in currently, but probably won't be in 5 years I'm guessing, unless insurance isn't offered through the school I attend. For medical schools, I believe it is.) However I think Obama has claimed premiums will go down, and what he's figuring into this equation is subsidies from the government to the poor to help pay for their health insurance.
What would be the GOP plan for helping the poor to get health insurance? I've heard stories about single women who work as janitors for a little above minimum wage that don't receive health insurance through their employer. A premium for a 55 year old single woman would be very expensive, I'm guessing at least $300 a month, maybe more. There are many people in that situation, what would the GOP propose to help those people?
Thanks Rich, send me the bill for those kind compliments, haha, I appreciated that.
I'll try and frame the tort reform (medical malpractice reform) problem that is one of the main problems causing everyone's premiums to go up. Plaintiff's lawyers usually work on a contingent fee, which means they get anywhere from 25-40% of any settlement or judgment they win for their clients. Many are attracted to personal injury and medical malpractice cases because jury awards are a lot higher on avg. because the defendants (hospitals, doctors, nursing homes, insurance companies, etc.) have deep pockets. Hence the stigma of "ambulance chasers" that often gets pegged on these plaintiff lawyers. Here's where the economics enter the picture...
Big jury awards against these deep pocket defendants drives up their costs to insure against malpractice. These higher costs then get passed on either directly to the consumer, or to the consumer's insurance company, who then raises its premiums. There's also another aspect to this, which is that doctors engage in "defensive medicine" out of fear of lawsuits. In other words, in order to be better protect themselves, they'll often order unnecessary and expensive tests, procedures, referrals, and consultations to cover their bases. These too cost more money, and drive up everyone's premiums. It's a vicious cycle. A recent Stanford study estimated that defensive medicine costs as much as 180 billion dollars a year, or an additional $2,000 a year for the average American family.
So what to do? I worked on some medical malpractice cases last summer at a large defense firm in plaintiff-friendly West Virginia. This state has recently passed some tort reforms aimed at making it harder for the truly "junk" med mal cases to even get to court. For example, you have to have an independent/neutral medical specialist in the same field take a look at the plaintiff's possible claims to see if they are truly valid, and he/she must sign off on them before you can file your claim. There are also strict statutes of limitation (making it so you only have a certain amount of time after discovery of the problem to file a claim) for these cases and other procedural hurdles. We actually got one junk med mal case against a doctor we were representing dismissed because the plaintiff's lawyer failed to comply with the statute of limitations. Other states have placed monetary caps on jury awards for non-economic damages. Senator Coburn of OK has also proposed the creation of specialized "medical courts," (similar to tax, immigration, or bankruptcy courts) where there is no jury but the judge is highly experienced in overseeing med mal cases.
All these proposals and possibilities are aimed at reducing the amount of defensive medicine practices, doctors fears of getting dragged into court to defend against junk med mal claims, outrageously large jury awards, med mal liability premiums for doctors, regular health insurance premiums for patients, and as a result of all of the above, the overall costs of health care could be further reduced.
Tort reform is hard to get done though, because the plaintiff's bar is one of the democratic party's biggest supporters and financial contributors. They don't want to see their huge contingency fees go down as a result of capping jury awards or making it harder for them to bring med mal suits into court.
Sorry for the long-winded tort reform comment.
Creighton, here is what I would say about your question. I think a lot of problems would be lessened if we tried to eliminate, or at least scale back on our dependency on the third party payer system in favor of direct in favor of negotiating directly with doctors for lower prices. I'll try to illustrate with a personal story.
When we were living in DC, we found out that Melanie was pregnant. We found out that there was a guy in our ward that was an OBGYN. We called him up and set up an appointment. Right off the bat, the first thing we told him was that we didn't have insurance, but that we had some money in our savings account that we could use to pay him, and that we wanted to do that. I could tell he was very excited and relieved that he didn't have to go through the hoops and hassles of dealing with an insurance company (3rd party payer) and that as a result, he'd give us a great deal on price. Visit after visit, I kept asking him to send us the bill which we would pay, but a bill never came. He actually told us on one of our last visits that he was so grateful we were honest with him about not having insurance. He ended up doing all that work, all the ultrasounds and tests, for free.
Now perhaps that was because we were in his ward, or perhaps it was because he knew I was not getting paid hardly anything as a Senate intern. Regardless, there's something to be said for a doctor's decrease in the hassle and inconvenience when he/she doesn't have to deal with billing and collecting from a 3rd party payer, but can negotiate directly with the patient. Ron Paul has a great chapter in his book that describes this, which is how it used to be a generation ago when people carried insurance only for the really big, catastrophic medical situations and negotiated with doctors for everything else. Again, as Mitch Daniels said in his article, the 3rd party payer system is perfectly designed to over consume and over spend.
Also, I don't know how it is for doctors, but the American Bar Association requires that every lawyer donate a fairly substantial amount of hours every year providing free legal services for people who cannot afford them. I think a similar program could go a long way towards helping out those 55 year old single mothers making a janitor's salary.
I'm not sure what the GOP would say, but those were just my thoughts on that question you asked.
Again I agree with the points you made Devin, and thanks for your insights on the tort reform. Creighton, the point I was trying to make was actually reducing the total expenses of the system, and not just what health insurance companies charge.
But to the point you made, you are missing a very big portion of the costs incurred by health insurance companies. They actually have to pay doctors for the services provided to their customers. I know it seems ridiculous, but it does happen. If someone with a pre-existing condition is added to Blue Cross (the company I pay $600 every month while on a very limited salary while going to school full time) and they need to receive care for cancer/diabetes/glaucoma...how would you propose my premiums would be going down? I'm sure in economics you learned that 100,000 people sharing the cost of $200,000,000 is better than 115,000 people sharing the cost of $300,000,000.
If we regulate insurance companies, things become more complicated, and the process by which everything happens has more loop holes. This increases the man hours required by the insurance companies to compete across state lines, bring in new customers, and even pay for procedures.
Including some of the points Devin made, it is much more important to actually reduce the cost of care and the total expenses in the system. Health insurance premiums will be reduced as a result. Some people don't want to pay for health insurance, but very few people actually do not have the ability. It's a matter of prioritizing and foresight.
As a final point, insurance companies make huge profits. I am not against increasing the competition of these companies to help control those profits. However, regulations and mandates may not be the answer. The open market will control how insurance companies operate and charge if made more competitive. So on that point, like I said in my first post, I agree.
And just a quick other point because I'm sick of the sob stories of people who need care. I know that seems heartless, I want EVERYONE to have the best health care available, but show me a system that could provide that. Impossible unless individuals decide to do the right thing more every situations (which government cannot force).
Anyways, what happens when you provide care to that mom you spoke of? She will get covered, GREAT! But then I'll be kicked off because i couldn't afford a $200/month jump in my premium. Then my wife gets pregnant and we have to go on Medicaid and we have a baby paid for by the tax payers. When I break my leg, oh crap for me. It is a seesaw.
And don't tell me "Canada has it!" Canada has it because the additional costs are pushed onto us. Where do you think pharmaceutical companies make their money back from? Not in most European countries, not in Canada, not from most Australians. the United States' expenses have risen due to other countries' regulations. Bahumbug
Sorry, I meant to say, " Impossible unless individuals decide to do the right thing in more situations (which government cannot force).
I would say France has it. They have the #1 health care system in the world, according to the world health organization. They also spend half (per person) on health care than we do. Their system is interesting, and I think they are generally considered to have a much healthier country than we do. Lower obesity rates, longer life spans, lower infant mortality rates, etc. It's hard to compare our two nations because I think our nation is much more diverse, and with diversity, come certain health problem tendencies. Their system isn't perfect, but it's pretty good. There's a really good article about some of the things they are doing at http://www.businessweek.com/magazine/content/07_28/b4042070.htm . Ultimately I don't think any of us are wrong, I don't think there's one right way of doing things. I like a lot of the ideas presented about tort reform, paying in cash to help reduce costs, and some of these other ideas.
On a side note I did want to thank you guys for your opposing viewpoints. I am going through an interview process at USU called the pre-health committee. I have been asked a lot about current health legislation and other political issues. Without this blog I fear I would have sounded naive and clueless. I definitely feel a lot stronger in some of my own opinions but some of them have changed over time. So far I have talked about this blog in 3 of my interviews with professors, who were all impressed, so thank you.
I feel the same way about the blog. It gives me a great excuse to think critically about my opinions by comparing them with everyone else's and doing some more research about important issues. I'm glad you've found it useful!
France does have some interesting aspects to its system, but there are a few things I want to point out. The World Health Organization study is 10 years old. I'd be interested to see if the results from a newer study would change at all.
I also think you're confusing medical care with health care. In other words, I think there is so much more that goes into obesity rates, infant mortality rates, and life spans than just the available medical care provided by each country. Look at the French lifestyle compared to ours for example. I'm not saying that medical care is a non-factor, but there's a lot more that goes into those statistics. I'd be careful about citing them in support of the claim that France has better medical care than we do.
Also, here's an in-depth, detailed counter article to the one you cited called "France Fights Universal Care's High Cost"
http://online.wsj.com/article/SB124958049241511735.html
Here's another aspect of the French system that I highly doubt you and Rich would want (we've talked about this before I believe): the avg. French physician earns 55K/year - a third of what their American counterparts earn. Each puts in 8-10 years of med school & training. Sure, the French government pays for their med school, but still, that is a huge time investment to get such a small relative return in salary.
Lastly, with the French government paying for their doctors' med training and universal health care, the French pay quite a bit more in taxes to fund all of that than we do. For me too, it's a lesser of two evils decision. I recognize that there are pros and cons to both systems, but I'd rather stick to a system more firmly rooted in free market principles and individual liberties than switch over to one administered by a much bigger, centralized, regulatory "nanny" federal government that costs much more. I'm sure we disagree on that much like we disagree about the jail time issue for failure to pay the health care mandate.
I agree with your third paragraph, I was going to include that (how their lifestyle is probably healthier than ours) but I forgot to.
While they pay more in taxes, they still pay half as much per capita than we do. Yes they pay higher taxes, but that means they don't pay for health insurance premiums. Recalling the numbers I believe Americans spend about $6500/year per person on health care while France is around $3300/year per person. So their care is still cheaper. I think the article said like 60% were satisfied with the system and 40% in the U.S. were. The pay is a downside, for sure, especially after all the effort that goes into medical school. I can only speak for myself, but I've never wanted to do medicine for the money. It's a huge perk, a bonus, but it's never been the driving factor for me. I understand it is for other people, but not for me. Right now that wouldn't work here because of the quarter million price tage associated with medical school. Making copious amounts of money is the only way physicians can pay off that debt and be financially stable.
I doubt you read the article I cited (I don't blame you - who would want to read it with the intro I gave it? "in-depth, detailed ..."). Here's a quote that undercuts one of the things you said: "In recent months, France imposed American-style "co-pays" on patients to try to throttle back prescription-drug costs and forced state hospitals to crack down on expenses." This is on top of the much higher taxes the French are paying.
And about the money, are you saying that you would willingly sacrifice 8-10 years of your life + 4 more from undergrad to only make 50K a year to be a doctor (even assuming the government paid for your schooling)?
Creighton, I think the question Devin just asked solved all of your problems. Once complete, you will have worked very hard to become a practicing physician. You, as the physician, can decide that your time is worth $50,000 a year and provide cheap or free services to whomever you decide. The cheaper we can make the total cost of health care the more services you can provide while making your desired amount. Not by just throwing in regulations to decrease insurance premiums.
I must admit I didn't, but I just barely did. I still think they pay less per capita than we do, but it seems (from this article) they are adopting some of the practices from us, which is great! I don't think their system is perfect, I don't think ours is perfect, but we can't argue a higher percentage of their citizens have access to at least some health care than we do, and there's something to be said for that.
My answer is yes I most absolutely would. I love working in health care and can't imagine doing anything else. As long as I could support my family I would do it.
Rich, the only problem becomes the US is not forking out the dough to pay for my medical school, also I believe there are other benefits making it financially better for them making that amount. Once I do become a physician I really hope to help the people that can't afford care by charging a much lower rate or doing work for free.
That's awesome Creighton. Wouldn't it be nice if all aspiring doctors were as benevolent as you? I think that the overwhelming majority of future doctors would rather be a PA, a nurse, an EMT, or something other occupation in the health care sector that allowed them to make 50K a year with less than half the required schooling/training. Heck, I bet if you worked full time doing what you're doing now, in-home hospice (very noble and charitable, I'd add), you'd be making 50K a year easy. Why go to med school then?
*some* other occupation, sorry.
I was going to make the same point. As for myself, I made a calculated decision to become a physician. Besides worrying about lawsuits (but show me a profession that doesn't have that concern), I want all the responsibilities given to a physician and all the ability to help. At the same time, there are certain 'things' i want for my family (kids tuition, horses for my wife......). I would not have switched my career this far in to add 4 years of med school and 6 years of residency to make less than I currently make.
Creighton, in our previous conversations you suggested you were looking at certain specialties because they provided the income you want while living in the area you want. Correct?
Keeping a 3.9 science GPA, working for a 34 on the MCAT, and volunteering so much time at the hospital would not be as easy for me if the job at the end of the tunnel did not provide all of my career requirements. At $55,000 a year, you would start getting the guys with 2.9 GPAs and 22s on the MCAT as our Neurosurgeons. Then we'll see what happens to our health care system.
Listen guys, you asked me if I could only make $55 g would I still want to be a physician and I said yes. That doesn't mean that I want to make $55 g a year being a physician. I've chosen this path because I feel like I've been given a specific skill set that would fit best as a physician, and that's the place where I can do the most good. Not a nurse, or a PA, or a CNA, (not saying any of those are bad, they're great). In our system, I'll make more than $55k a year, and that's great. What I was saying is if I only made $55k a year I would still do it, that's all I was saying. I never said I wanted to, I just said I still would if circumstance required. I still am very much planning on making multiples of $55k.
And as far as specializing, or not, I don't know yet. I want to do what interests me the most and where I feel like I fit in the best. If that's pediatric cardiology then that's what it is. If it's dermatology, or gastroenterology, or being a family physician I hope to make the right call when I'm in Med school. And I have said that if I can double my income by tacking on a couple extra years for extra training I would do it, if that's what I really wanted to do.
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