Frenzied Wombat
Potato del Grande
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Dude it's common sense that applies to every industry.. People pay more for a higher skillset if they can afford it. Would you pay 3K a year to an internist fresh out of med school when you can pay that amount to a doctor with 20+ years experience and wins top 10 doc in your city year after year? It's the same with the "out of network docs". Do you think a doctor fresh out of med school, or a doctor with an average reputation, can afford to "fire" all insurance companies and go out of network for all treatment? What about a plastic surgeon that has a thriving "travel" practice where people fly into LA for surgery with a famous PS, and he has a dedicated "travel nurse" and a deal with a nearby hotel for his patients to stay at? Does your average PS just out of med school have this type of practice, or is it primarily famous plastic surgeons?
Since the American health care system is capitalistic and profit driven in nature, obviously the same rules of demand/supply apply. Great doctors that are in high demand charge more, and can afford to do away with insurance dependency. The result is that the best quality medicine is reserved for those that can afford it. Your example (unless you can cite stats) is the philanthropic exception to the rule. My stepdad does do a few medicare and charity cases per month as well, but they are the exception not the rule..
As for whether Obamacare is good or not, I honestly don't know for sure. It hasn't effected me all that much, but it did cause my internist to enact his concierge service because he couldn't make as much as he used to, so imho that's a negative. On the whole, my opinion is that you can't marry socialist principles bolted onto a capitalist system. There are some fantastic rules like the elimination of pre-existing conditions as a barrier to getting insurance, but my opinion of Obamacare as a sum of its policies is so far negative. I can tell you my stepdad despises it, but that's because it generates less money for doctors, so his opinion is biased based on his pocketbook.
