Wayne,
Yes it would be fraught with "legal pitfalls" in terms of your 3rd party contracts. I need to go cry over our personal business finances as I try to figure out how to get blood out of a stone to make ends meet around here. Let me think about this while properly wearing my paraniod practice manager's hat and I'll get back to ya soon.
Ya see the issue is to have insurance coverage for the real issues. If and when you need to have procedures, expensive specialist care, or hospitalization. Perhaps drug coverage too. Again I'm just amazed at the idea that the gov't regulates our rates to high hell, while they do not a thing to regulate Big Pharma and all the major vendors (other than DME) that docs and hospitals all have to purchase goods and services from. We need to finally properly regulate things like big pharma.
Hell, half the stuff they have patented, really were not their own idea anyway. We the tax payers pay for most of the basic research that they then ride the coattails of to design a slightly different version of, to then copyright and over charge us all on for years. We are the only country in the world that doesn't regulate drug prices. So we Americans are paying even more to help pay for all of these drugs to be produced for the rest of the world. I'd love to see their books so as to actually see things like how much the make or lose in Canada and Europe, what small percentage of total profits get re-invested into R&D. I hear it may actually be as little as 10%. Sure they pump tons of mony into it, but as a percentage of profits it is still a drop in the bucket. Their arguement doesn't really hold water.
But, if we all had real jobs, that pay real wages, and coverage to insure against the big, wipe you out kind of stuff, while basic office visits and the like were paid in full at time of service (that's my: PIFATOS) then the average doc could charge reasonable fees, see a reasonable number of patients and for the most part all would be right with the world again. But as long as we off-shore and falsely bring in way too many visa engineers to keep good educated Americans under and unemployed none of us can afford the cost of most goods and services at a proper rate that is in balance to our economy.
As much as I am a Jew (by culture mostly) who hates Henry Ford for his facist affiliations, and almost explicit support of the Nazi's his basic premise of the idea that his workers, and all workers needed to be able to afford to buy his car, and so we all only really thrive with a healthy successful middle class is as true today as it was almost a hundred years ago. Most of our economy and it's JOBS come from small business and yet the politicos continue to kiss the @$$ of the largest off-shore, pretend to be US based Multi-nationals is just insane. When everyone has McJobs and McBenefits then all of us small and medium, US based, make most of the jobs, hold up most of the economy businesses suffer. And so as we go, so goes the rest of the nation.
Until we have at total change in nation and international economic as well as geo-political policy, unlike anything coming out of either side we have now, we will continue to spiral downward on a free fall to the bottom. And seeing how much our business has been taken over by those who don't have neither the patients' or the doctors' best interests at heart and have been picked over faster and more than other industreis, we are sort of the Canaries in the mine. Others are close behind....
Lastly, in terms on not going into medicine again, there was a great piece of research and then article published about this a year or two ago. It was sponsored by one of the largest head hunting companies. It clearly showed that 2/3's, yeas 2/3's of all primaries wouldn't do it again, being equally split between not going into medicine at all and going into a well paid, well respected specialty. Very sad indeed. I will try and find the link as it was published in like the AMA newspaper or something similar, maybe AAFP. It'll find it and post it here soon....
Paul
