January 2, 2011
So Rep Lally Favors an Increase in Health Insurance Premiums for Rhode Island?
On Thursday, the Providence Journal printed an OpEd by Dr. Joseph Cambio of Urologic Specialists of New England and RI House Deputy Majority Whip Donald J. Lally (D, Narragansett & South Kingstown). We'll stipulate for a moment the problem that they name because it sounds all too plausible.
... Rhode Island health insurers reimburse the state’s physicians at a very low rate. This is a particular problem with such medical specialties as urology. Urology is only one of many medical fields, as well as dentistry, from which we are losing our best and brightest to other states. We also have aging field of doctors. As older physicians in our state retire there are fewer and fewer newer doctors to take their place. The reason is quite simple: Why would a new physician with over $150,000.00 in debt from medical school loans set up a practice in the state if he or she could make significantly more money by going to Massachusetts, Connecticut or somewhere else?It is becoming increasingly difficult to recruit new physicians to Rhode Island. Urologic Specialists of New England had one promising young doctor recently turn down its offer when he saw that he would make significantly more for the same practice in Massachusetts.
So let's agree, in the absence of new and contradictory information, that pay for doctors practicing in Rhode Island needs to be increased. Now the question is, where does that additional money come from? Who pays for the increase?
Apologies for answering a question with a question. But maybe I'm missing something.
Within the insurance framework, is there any source for higher compensation - i.e., an increase in spending - other than rate payers?
"So let's agree, in the absence of new and contradictory information, that pay for doctors practicing in Rhode Island needs to be increased. Now the question is, where does that additional money come from? Who pays for the increase?
No, with all due respect, let's not so quickly agree. Let's hear first what the RI physicians are earning annually -- in dollars. Every complaint by doctors carefully avoids mention of those specific facts -- dollar earnings. Doctors only speak in the abstract, that they earn less than someone else or that their costs somehow are greater (and by the way, it's likely that doctors' costs in Mass. are significantly higher than in RI). They never disclose what they earn in dollars -- not even ranges of dollars.
I suspect that if we knew what each complaining physician in RI earned annually, net, in dollars, we would be appalled at their riches. And with such an overdue disclosure, the discussion would likely change quickly. The same point could and should be made in response to complaints by physicians nationwide.
In addition, perhaps an old and valid argument should be revived and finally implemented -- let's build more medical schools and stop artificially limiting the number of physicians in the U.S. In other words, let's let supply and demand naturally reduce the often outrageous fees doctors and insurers charge. And thereby bring physicians' earnings more fairly in line with those of the rest.
Posted by: Bill at January 2, 2011 12:46 PM"Now the question is, where does that additional money come from? Who pays for the increase?"
I would look first at the overhead in the insurance industry... I've heard that in some cases up to 40% of the insurance dollars going in cover administration and overhead at the insurer itself, not medical services.
There needs to be more competition in the market to keep these companies from acting like cartels or monopolies.
Posted by: mangeek at January 3, 2011 11:42 AM