Originally Posted by sonrisa

oh sweeeeeet... isn't that a B vitamin? I take B vitamins to keep my energy level up

I think depends on the amount one takes. I take 2 grams/day. The RDA is only around 15 mg.

lord if I wanted liver damage I'd just hit the bottle

Niacin taken at something like the RDA does not have that effect. I do bear and grin the flush inducing normal niacin over the long acting stuff since long acting niacin is really hard on the liver. Oh and the site I looked this up on has some garbage in their vitamins. While I do like fluorine, it's not a required nutrient. It's find for toothpaste, since the fluorine just binds to tooth enamel and helps to prevent cavities. I just don't want it anywhere else. And... I could write a book about junk herbs and junk products like "Ageless Male". Regardless of whether this product works (doubtful), I prefer the active ingredient(fenugreek) on this sauteed dish with okra,onion seed, fenugreek, and very hot peppers.

What impact would it have on the Presidential race if a couple of Democrats crossed the aisle and voted in favor of repealing the ACA, whereupon Obama vetoes it?

No one even seems to be discussing this possibility.

Originally Posted by pbrower2a

Sometimes the appropriate prescription for certain downer moods is "Symphony #6 by Jean Sibelius"... or visiting an art gallery. Nobody needs see a physician for permission for either.

A trip to the dog park works for me. Watching the dog jamboree lifts the lowest spirits.

Originally Posted by Ragnarök_62

Why stop there ? I want the Rani to be happy. I made some semblense of one of those patient guides that other drugs come with.
Drug: Ethanol:
Molecular formula: C2H6O
Molecular weight: 46.07 g/mole:
--------------------------------
routes of administration:
oral,intramuscular,topical
---------------------------
Mode of action GABA-A receptor agonist
----------------------------------------
Elimination route : hepatic
----------------------------------------------------------------------------------------------------------------
Side effects: See diagram below:

I'll drink to that chart... but only one wine or beer savored for taste. No chug-a-lugging stupidity involving rotgut whiskey or insipid American mass-market brew.

Originally Posted by Ragnarök_62

I think depends on the amount one takes. I take 2 grams/day. The RDA is only around 15 mg.

-- that's how much vitamin C I take

Originally Posted by Ragnarok

Niacin taken at something like the RDA does not have that effect. I do bear and grin the flush inducing normal niacin over the long acting stuff since long acting niacin is really hard on the liver.

-- well I just looked on the bottles (regular multivitamins & a B Booster) & between the 2 I'm getting 70mg/day so hopefully that's ok

Originally Posted by Ragnarok

Oh and the site I looked this up on has some garbage in their vitamins. While I do like fluorine, it's not a required nutrient. It's find for toothpaste, since the fluorine just binds to tooth enamel and helps to prevent cavities. I just don't want it anywhere else.

-- fluorine is a poison. It doesn't even belong in your mouth. It should be nowhere near your mouth. Which is why I watch what toothpastes I buy

Originally Posted by Ragnarok

And... I could write a book about junk herbs and junk products like "Ageless Male". Regardless of whether this product works (doubtful), I prefer the active ingredient(fenugreek) on this sauteed dish with okra,onion seed, fenugreek, and very hot peppers.

-- are you saying Dr Rosenstein is a photoshopped fake? : :

that dish sounds good I'll have to tryt it

Originally Posted by '58 Flat

What impact would it have on the Presidential race if a couple of Democrats crossed the aisle and voted in favor of repealing the ACA, whereupon Obama vetoes it?

No one even seems to be discussing this possibility.

-- you must be talking about the Senate, since Boehner & the House Dittoheads have already passed at least one repeal bill. Is a repeal on the Senate floor? My impression was that Reid won't even let one get on the floor. If he's let a repeal bill onto the Senate floor, that's telling right there

what I find interesting is the mumber of high profile Dems that are skipping the Convention in Charlotte this year. Including a NC Senator & one of the NC Reps

http://www.latimes.com/health/la-me-...5687736.column

In Washington, it's called the Affordable Care Act. In Sacramento, it could be become known as another budget buster...

The additional burden on the states is a negative aspect of the healthcare overhaul that seldom gets discussed...

Originally Posted by The Wonkette

Maybe a better analogy would be that Obamacare is like forcing auto insurance firms to accept you if you've been rear-ended by other vehicles, in a world where having someone plow into you when you are stopped at a red light can result in you losing coverage.

-No, it isn't. It's more like being forced to accept you when you have a long track record of accidents.

Originally Posted by playwrite

No, it is not an individual issue when the uninsured can get mandated care from a care provider which drives up health care prices on all of the rest of us. It is "free rider thief."...

-Nonsense on stilts. People get health care all the time without insurance. The only "free rider thiefs" are the one's who don't pay at all. Obamacare doesn't really do squat for that. Nor, of course, was it ever meant to...

Even if Playdude were right, Obamacare adds (maybe) 4 million to paying into health insurance:

Originally Posted by JDG 66

http://keithhennessey.com/2012/06/28/uninsured-tax/

...Oversimplifying a bit, for most people the tax in 2016 will be $750 per adult and $375 per kid. But while 21 million people will be uninsured, CBO said “the majority of them will not be subject to penalty.” That’s an understatement.

This gets CBO’s 21 million uninsured in 2016 down dramatically to 3.9 million who will be both uninsured and pay the tax...

Originally Posted by JDG 66

-Nonsense on stilts. People get health care all the time without insurance. The only "free rider thiefs" are the one's who don't pay at all. Obamacare doesn't really do squat for that. Nor, of course, was it ever meant to...

Even if Playdude were right, Obamacare adds (maybe) 4 million to paying into health insurance:

We're not talking about getting flu shots, dummy. We're talking about people arriving at the emergency room with broken arms, major wounds, or acute symptoms of major illnesses that costs hospitals billions of dollars in uncompensated care - that is what drives up the cost of 48 hours on a urine catheter to several thousand dollars.

If the 4 million you're talking about is the 3.9 million in your reference, you need to learn to read for comprehension. That's the number the author (who is an idiot to begin with) claims will be subject to the mandate penalty for not getting insurance - that's out of a population of 312 million - small potatoes even if the number wasn't an exaggeration to begin with.

Here's the updated numbers of 30 to 33 million more being insured under the ACA that would otherwise not have been (and that doesn't include changes to Medicare/Medicaid) -

http://cbo.gov/publication/43080

Compared with prior law, the ACA is now estimated by CBO and JCT to reduce the number of nonelderly people without health insurance coverage by 30 million to 33 million in 2016 and subsequent years, leaving 26 million to 27 million nonelderly residents uninsured in those years (see Table 3 at the end of the report). The share of legal nonelderly residents with insurance is projected to rise from 82 percent in 2012 to 93 percent in 2016 and subsequent years. That share rose to 95 percent in CBO and JCT's previous estimate.

According to the current estimates, from 2016 on, between 20 million and 23 million people will receive coverage through the new insurance exchanges, and 16 million to 17 million additional people will be enrolled in Medicaid and CHIP as a result of ACA. Also, 3 million to 5 million fewer people will have coverage through an employer compared with the number under prior law

Maybe you didn't realize but this is not Faux News; you might be able to peddle your horseshit there but obviously not here.

Originally Posted by playwrite

We're not talking about getting flu shots, dummy. We're talking about people arriving at the emergency room with broken arms, major wounds, or acute symptoms of major illnesses that costs hospitals billions of dollars in uncompensated care - that is what drives up the cost of 48 hours on a urine catheter to several thousand dollars...

-And as the figures make clear

Originally Posted by JDG 66

http://keithhennessey.com/2012/06/28/uninsured-tax/

...Oversimplifying a bit, for most people the tax in 2016 will be $750 per adult and $375 per kid. But while 21 million people will be uninsured, CBO said “the majority of them will not be subject to penalty.” That’s an understatement. You won’t have to pay the tax if:

you’re not in the U.S. legally;

you’re in prison;

you’re poor (measured two different ways);

you’re a member of an Indian tribe;

you’re in a period of being uninsured that’s less than three months long; ["you’re in a period of being uninsured that’s less than three months long" -now there's a loophole...]

your religion forbids getting health insurance; or

you get a waiver from HHS. Given HHS’ behavior in handing out waivers since the law was enacted, this waiver authority bears further observation and scrutiny.
In addition, some who are legally required to pay the tax will not do so. CBO/JCT therefore assumes a certain amount of noncompliance (aka cheating).

This gets CBO’s 21 million uninsured in 2016 down dramatically to 3.9 million who will be both uninsured and pay the tax. Total U.S. population in 2016 will be about 327 million...

-Fewer than 4 million will be contributing in any way to that expansion, making this statement of Playwrong's:

Originally Posted by playwrite

No, it is not an individual issue when the uninsured can get mandated care from a care provider which drives up health care prices on all of the rest of us. It is "free rider thief."...

WRONG.

Originally Posted by playwrite

...If the 4 million you're talking about is the 3.9 million in your reference...

-It is...

Originally Posted by JDG 66

...Even if Playdude were right, Obamacare adds (maybe) 4 million to paying into health insurance:

...to continue:

Originally Posted by playwrite

...If the 4 million you're talking about is the 3.9 million in your reference... That's the number ... claims will be subject to the mandate penalty for not getting insurance - that's out of a population of 312 million - small potatoes even if the number wasn't an exaggeration to begin with...http://cbo.gov/publication/43080.

-If they are "small potatoes", then why does Playwrite advocate forcing them to buy insurance they don't want?

Originally Posted by playwrite

...If the 4 million you're talking about is the 3.9 million in your reference, you need to learn to read for comprehension...

-Based on the above, it's Playweird who needs to learn to read for comprehension.

Originally Posted by JDG 66

-If they are "small potatoes", then why does Playwrite advocate forcing them to buy insurance they don't want? ( or can't afford.- Sonrisa)

-- becuz they're theives dontcha know?

If Playwrite were truly concerned about theives, then he'd be be-otching about the insurance thugs, uh, I mean companies, who are the big beneficiaries of this POS mess & not worrying about some poor (take it anyway you like) schlub sitting in the ER, where I can guarantee you s/he does NOT want to be

Originally Posted by JDG 66

-And as the figures make clear



-Fewer than 4 million will be contributing in any way to that expansion, making this statement of Playwrong's:



WRONG.



-It is...




...to continue:



-If they are "small potatoes", then why does Playwrite advocate forcing them to buy insurance they don't want?




-Based on the above, it's Playweird who needs to learn to read for comprehension.

There's a misunderstanding here because of your inability to communicate clearly.

Your statement was this -

Originally Posted by JDG 66

...Obamacare adds (maybe) 4 million to paying into health insurance:

It is unclear what you are trying to say here. Let me help you --

First, Obamacare adds tens of millions of people paying health insurance in large part because they are being subsidized, no longer can be denied due to pre-existing conditions, can be put on their parents insurance, and because the benefits are more standardized and transparent (and therefore will become more competitive) and thus people will be more comfortable buying coverage. And yes, some will buy insurance due to the motivation of not wanting to instead pay the penalty.

Second, what the 4 million represents is the number of people that may not buy insurance and be subjected to the penalty. It is from a Right wing nut who hates Obamacare so one can assume that it pretty much an exaggeration on the high end. Moreover, no one actually knows how many within this group will actually not buy insurance - most experts, however, believe this fear mongering will go by the wayside just like the "death panels" - and just as with the panels, the sheeple who got all riled up will never think about how easily manipulated they were and continue to be.

Third, it is peanuts from the standpoint that there are 311 million people in the country so the 4 million represent about 1% of the population, tops. It is not peanuts from the standpoint that penalizing them helps makes the entire system work by further motivating others (beyond the other reasons I stated above) to get insurance.

Fourth, without insurance, these relatively few are free-riders on the system who will receive uncompensated care at emergency rooms which has been clearly shown to raise the price of health care for all of the rest of us.

Fifth, relative to all the good that comes from Obamacare, I don't care that these free riders have to pay the penalty.

Can you comprehend this or are you going to continue to throw out meaningless nonsense?

I realize that this is an be difficult to comprehend for someone who has been on the govt teat for their own health care for their entire adult life, but do try.

Originally Posted by sonrisa

-- becuz they're theives dontcha know?

If Playwrite were truly concerned about theives, then he'd be be-otching about the insurance thugs, uh, I mean companies, who are the big beneficiaries of this POS mess & not worrying about some poor (take it anyway you like) schlub sitting in the ER, where I can guarantee you s/he does NOT want to be

I'd be one of the last to defend private health insurers, but I also don't live in magic pony land.

There is tremendous potential now for a public option if not single payer to emerge from the state and regional exchanges. In addition, there is the big fight coming, state-by-state, of Medicaid expansion which is single payer for the most vulnerable of our countrymen.

Tell me of any viable alternative in today's political climate or for the foreseeable future that has a better than a snowball's chance in hell of coming to reality that has anywhere near the potential of what is now moving forward.

Otherwise, have a good ride -



- by the way, Glick says he can get magic ponies that poop out gold nuggets. If you continue to be sweet to him, maybe he'll promise you one!

Originally Posted by sonrisa

If Playwrite were truly concerned about thieves, then he'd be be-otching about the insurance thugs, uh, I mean companies, who are the big beneficiaries of this POS mess & not worrying about some poor (take it anyway you like) schlub sitting in the ER, where I can guarantee you s/he does NOT want to be

Talk about nonsense on stilts, this is a good example.

First of all insurers are hardly the problem, they are the payer of American-style vastly overpriced health care, not the ones charging for it. If you want to look for thieves look to the folks doing the charging. Why, for example, does an MRI in America cost 5-10 times more than the same MRI done in Japan?

Why did my 20 minute colonoscopy have a $3000 price, while a 5 minute office visit with my regular doc is prices at $75? Why was the colonoscopist's charges so unreasonable compared to the family practice doc's? Simple, the insurance company paid the family practice doc $50 whereas they paid $2000 for the colonoscopy (both were "in plan").

Now, if its the insurer is the problem, why would they be willing to surrender so much more for a routine colonoscopy than they do for a routine office visit?

Look at my business, pharma. We charge American insurers lots more than we do European or Japanese insurers. Why? Because American insurers are willing to pay higher prices.

On the second point, a patient in the emergency room incurs cost. How they feel about their presence there has no impact. Why do you think it does?

Originally Posted by Mikebert

Talk about nonsense on stilts, this is a good example.

First of all insurers are hardly the problem, they are the payer of American-style vastly overpriced health care, not the ones charging for it. If you want to look for thieves look to the folks doing the charging. Why, for example, does an MRI in America cost 5-10 times more than the same MRI done in Japan?

Why did my 20 minute colonoscopy have a $3000 price, while a 5 minute office visit with my regular doc is prices at $75? Why was the colonoscopist's charges so unreasonable compared to the family practice doc's? Simple, the insurance company paid the family practice doc $50 whereas they paid $2000 for the colonoscopy (both were "in plan").

Now, if its the insurer is the problem, why would they be willing to surrender so much more for a routine colonoscopy than they do for a routine office visit?

Look at my business, pharma. We charge American insurers lots more than we do European or Japanese insurers. Why? Because American insurers are willing to pay higher prices.

On the second point, a patient in the emergency room incurs cost. How they feel about their presence there has no impact. Why do you think it does?

IMO, as I mentioned a couple dozen pages back many months ago, the source of the problem is how Americans think of medicine. people in other countries accept the prioritization of a fixed amount of time and money, even if that means that a particular person does not get the absolute best care possible. Americans don't accept that, which is why the Right is easily able to rile people up here with fears of "rationing" and "death panels". Americans think that they "deserve" the "absolute best care possible" (meaning diagnosis and treatment with all the newest and most expensive gizmos), damn the consequences. And doctors are forced to go along with it lest they get sued for malpractice.

Originally Posted by Mikebert

Now, if its the insurer is the problem, why would they be willing to surrender so much more for a routine colonoscopy than they do for a routine office visit?

Because they have no choice. No one insurance company has the market clout to require lower prices, and collusion among them to do so would violate anti-trust laws.

While one could certainly assign "blame" on a moral level to health-care providers for gouging, that's not a very useful approach. Health-care providers are for-profit corporations. That means they are dedicated instruments of naked greed, and sink to the level of depravity that they can. It's unrealistic to expect them to voluntarily play nice. If you want them not to gouge, you have to set things up so that they can't.

The only known effective way to do this is a single-payer system.

Originally Posted by Brian Rush

....are for-profit corporations. That means they are dedicated instruments of naked greed, and sink to the level of depravity that they can. It's unrealistic to expect them to voluntarily play nice. If you want them not to gouge, you have to set things up so that they can't.

Or stated another way -

“Thievery is what unregulated capitalism is all about.” --- Robert Sherrill, 1990

Pass the freedom fries, don't mind the maggots.

I've made it clear (perhaps at times, too clear) that I don't believe in magic ponies nor that single payer on a national level has a snowball's chance in hell. However, those who are for single payer have got to pound on this -

http://www.washingtonpost.com/blogs/...-in-one-chart/

The cost of the Medicaid opt-outs (in one chart)


The American Action Forum Tuesday morning released a report that looks at how states opting out of the Medicaid expansion could impact the federal budget. It predicts, if states decline to participate, the federal government would be on the hook for higher spending — even as the health-care law extended coverage to fewer people.

The federal government would see significant savings by not having to pay for the Medicaid expansion in states that choose not to participate. But it would end up spending even more covering private insurance subsidies for some of those no longer eligible for the entitlement program....

There's more detailed there at the link, but think about that - it is more costly to pay for health care coverage through private insurance than directly with single payer Medicaid. And that is with the private insurance approach not only covering less people but that the subsidies provided don't even cover the full insurance premium for many if not most people. I can't think of more real-world damning data of our health care approach.

I may see getting single payer as politically living in magic pony land, but that doesn't mean I believe what we are left with is not only tragic but very very stupid.

This is from Wendell Potter:

Wendell is a contributing writer to the Huffington Post, and also an author, media analyst and corporate watchdog. After a 20-year career as a corporate public relations executive, Wendell left his job as head of communications for one of the nation's largest health insurers and became a vocal critic of insurance company abuses.

This is a harsh reality that needs to be owned by all of us.

Only in America Could Cost of Care Bankrupt Victims of Violence Like in Aurora, Colorado

One of the reasons Americans seem so willing to tolerate the fact that close to 50 million of us are uninsured and

29 million

more of us are underinsured is that most of us who have coverage assume we are OK. That nothing truly catastrophic will happen to us, and that, even if it did, our insurance policies will pay our bills and keep us whole.

Who would think that a decision to go see a movie on a Friday morning could change our lives -- and the lives of our families -- forever? That we or a loved one, even with what we believed was decent coverage, might become a victim of violence that could leave us not only disabled for life but also potentially bankrupt and homeless?

That random act of violence in Aurora, Colorado earlier this month could have happened anywhere in America, of course -- or in any other country, for that matter -- but among the world's developed nations, we live in the only one where the families of some of the injured would have to face begging for money to pay the doctors and hospitals and keep the sheriff and his foreclosure papers at bay. Talk about American exceptionalism. This is one area where, sadly, we truly are unique.

More: http://www.huffingtonpost.com/wendel...b_1718437.html

Originally Posted by playwrite

I've made it clear (perhaps at times, too clear) that I don't believe in magic ponies nor that single payer on a national level has a snowball's chance in hell. However, those who are for single payer have got to pound on this -

http://www.washingtonpost.com/blogs/...-in-one-chart/




There's more detailed there at the link, but think about that - it is more costly to pay for health care coverage through private insurance than directly with single payer Medicaid. And that is with the private insurance approach not only covering less people but that the subsidies provided don't even cover the full insurance premium for many if not most people. I can't think of more real-world damning data of our health care approach.

I may see getting single payer as politically living in magic pony land, but that doesn't mean I believe what we are left with is not only tragic but very very stupid.

-- Medicare also has very low overhead costs. This is what I don't understand- what is so damn difficult about combining Medicaid & Medicare, lowering the age requirement to 0, & covering all income brackets?

or does that sound too much like right?

Originally Posted by sonrisa

-- Medicare also has very low overhead costs. This is what I don't understand- what is so damn difficult about combining Medicaid & Medicare, lowering the age requirement to 0, & covering all income brackets?

The opposition of health-insurance companies and health-care providers who would lose a lot of money, to the gain of most of the people.

Originally Posted by The Rani

Originally Posted by sonrisa

-- Medicare also has very low overhead costs. This is what I don't understand- what is so damn difficult about combining Medicaid & Medicare, lowering the age requirement to 0, & covering all income brackets?

or does that sound too much like right?

Ask your doctor if he/she would be able to continue practicing under those conditions.
Facilities that accept medicaid also rely on a lot of outside state funding (independent of the medicaid program.) Otherwise they couldn't stay afloat.

This is an old sad song, but one that seems to be no more valid than the myriad similar horor stories that have been floated when someone's sweet spot is invaded. In short, the system will adjust ... which is not the same as saying all the participants will. There will be a restructure of the delivery system, which is bloated, inefficient and functionally disjointed. Medicine will have to bend to the same laws of economics as manufacturing, hosptility and, well, add the category of your choice.

And let's be honest: there is nothing unique about the medical field. It has many of of the same constraints and drivers as public safety: the need to be responsive and available. The rest can be adjusted as needed. After all, other countries have been doing this very successfully for decades. Certainly we can as well.

The one thing we can't do is let the current paradigm continue, when total sociatal bankruptcy is the guaranteed end-state. To paraphrase Herbert Stein: What can't continue, won't.

While some continue the politically-fruitless debate over national single payer, your health care just got a lot saner today --


http://www.healthcare.gov/news/facts...08012011a.html

Affordable Care Act Rules on Expanding Access to Preventive Services for Women

As of August 1, 2012 -

The eight new additional women’s preventive services that will be covered without cost-sharing requirements include:

Well-woman visits: This would include an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, and additional visits if women and their health care providers determine they are necessary. These visits will help women and their health care providers determine what preventive services are appropriate, and set up a plan to help women get the care they need to be healthy.

Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. It will help improve the health of mothers and babies because women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future. In addition, the children of women with gestational diabetes are at significantly increased risk of being overweight and insulin-resistant throughout childhood.

HPV DNA testing: Women who are 30 or older will have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of Pap smear results. Early screening, detection, and treatment have been shown to help reduce the prevalence of cervical cancer.

STI counseling: Sexually-active women will have access to annual counseling on sexually transmitted infections (STIs). These sessions have been shown to reduce risky behavior in patients, yet only 28 percent of women aged 18-44 years reported that they had discussed STIs with a doctor or nurse.

HIV screening and counseling:Sexually-active women will have access to annual counseling on HIV. Women are at increased risk of contracting HIV/AIDS. From 1999 to 2003, the Centers for Disease Control and Prevention reported a 15% increase in AIDS cases among women, and a 1% increase among men.

Contraception and contraceptive counseling:Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Contraception has additional health benefits like reduced risk of cancer and protection against osteoporosis.

Breastfeeding support, supplies, and counseling:Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.

Interpersonal and domestic violence screening and counseling: Screening and counseling for interpersonal and domestic violence should be provided for all adolescent and adult women. An estimated 25% of women in the United States report being targets of intimate partner violence during their lifetimes. Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women.

There's devil in the details as, for example, these don't come into play with existing coverage until your next open season. And of course, it's all under attack by the wing nuts. Details here -

http://www.washingtonpost.com/blogs/...ptive-mandate/

- but otherwise, take a small break from arguing over what is not possible to celebrate a not-so-small victory in movement towards sanity.

Carry on.

Originally Posted by The Rani

Some people obviously want to believe that they can get the same level of medical care from physicians/PAs/nurses who get paid a lot less than they do now.

Are we sure that's how it would work out, that the lost revenue would come from doctors' pay? Who's doing the gouging today? I really don't think it's physicians and I'm dead certain it's not nurses.

Originally Posted by sonrisa

-- Medicare also has very low overhead costs. This is what I don't understand- what is so damn difficult about combining Medicaid & Medicare, lowering the age requirement to 0, & covering all income brackets?

or does that sound too much like right?

It is so right and so simple, that many conventional minds cannot grasp it. Indeed.

Originally Posted by The Rani

Some people obviously want to believe that they can get the same level of medical care from physicians/PAs/nurses who get paid a lot less than they do now.
All I can really say to that is wait and find out.

I suspect that the number of MDs will decline, the number of PAs and NPs will rise, and much of the nurisng work will be borne by CNAs under the direction of RNs. That, however, is the least of the correction. The largest will be how these people get to be "these people". I will be surprised if, 20 years from now, the cost of medical school will be borne directly by the medical student, but rather through a work-contract arangement. A surgeon with no debt needs to make a lot less than one with the kind of debt load common today. In fact, this may trickle down to nursing as well.

I also doubt that hospitals and clinics will be for-profit, unless they offer something unique. Even then, they will be outside the boundaries of "standard care", whatever that becomes by then.