By Ben Cohen
An interesting proposal from a Daily Banter reader on how Doctors who benefit from socialized education can pay back the tax payer:
For full disclosure, for going on thirteen years now, I have provided psychological services in nursing homes; most of my reimbursment is Medicare/Medicaid, with perhaps 15% having a secondary insurance. My reimbursement rate is about 55% of what my colleagues in traditional private practice make; I still make a good living, and I love my work. So, here is my proposal to spread the love:
How would it be unfair to ask health care provider’s whose education has been subsidized by the tax payer, to pay the tax payer back by being required to provide basic services to Medicare and Medicade recipients? Why would that be unfair? (The example is regarding physicians, but the same argument applies to dentists, psychologists, clinical social workers, etc.)
Every physician, whether s/he is a psychiatrist, neurologist, plastic surgeon, gynecologist, gastro-enterologist, and so on, is trained in providing basic health care. They all know how to do a history and physical, treat strep, diagnose appendicitis; they all know how to provide basic heath care. So how could it be unfair to require every physician trained at a state-based school, wherein the taxpayer paid for half of their medical education, to carry a case-load of, say 40 Medicare/Medicaid patients for whom they are responsible for providing basic health care; they would be reimbursed at those rates, and we are talking about perhaps half a day of service every two weeks. Again, how could this be unfair?
Let us not forget those physicians whose stipend in residency was paid by the taxpayer; why should they not also pay the taxpayer back by being required to have a case-load of Medicare/Medicaid?
And again, this would apply to all health care providers whose education/internship/residency was afforded or subsidized by the taxpayer.
Their argument is they would "lose" money. Well, no, they would merely not make as much. Those are different. (Took me a long time to understand that when a business man said he would lose money on the deal that usually meant he would just not make as much profit.)
So, for what it is worth.
