Robin Hood aka Obama will guarantee this will go down because of the disproptionate income of specialists vs generalists. Lets put it this way as someone put on the forums at auntminnie.com
New Presidential Administration with Clout + Poor Economy + Soaring Cost of Medical Imaging (i.e. this is why Cardiologists, Radiologists, and Radiation Oncologists were singled out) + Primary Care Physicians that have clamored for equal pay + AMA is on board + Medicare is on board = Done DEAL.
Anyone notice that specialties such as Anesthesiology, Dermatology, and Neurology actually get a bump in the new medicare plan?
I'll put it this way. With all of these specialties that hate Cardiologists and Radiologists this will be a laydown. Cardiology has strong political clout but their membership number dwarfs the internal medicine, pediatric, and family medicine physicians combined.
The sad thing is that Radiation Oncology got wrongfully lumped with the hated duo of Radiology and Cardiology. There are not enough radiation oncologists to fight this.
If you add it all up. The most competitive specialties in the next 5-10 years will be Dermatology, Plastic Surgery, Anesthesiology, and the new specialty known as Pain Medicine.
Radiology and Radiation Oncology will no longer attract the same caliber of students because of the huge medicare cuts. If I was attracted to Oncology I would rather go via the hematology-oncology route because of the ability to effectively medically treat the patient and take care of the patient in the hospital.
Just want to put this out there as no one seems to see this coming:
If doctors do not band together and instead fight for the scraps on obama's medicare table, we will be our own undoing. PCPs are so excited to take 5-8% from the specialists, but that just highlights how this is all about the money. Mark my words - when a study comes out and shows that a PA or NP can do the same job with similar outcomes but for less, the day of the PCP will be finished. Furthermore, the day tort reform happens is the end of radiology since tort reform is all that prevents outsourcing to India, Mexico, etc (the lawyers here have to have someone to hold liable for bad reads). While we fight for scraps from Obama's table, he and his lawyer legislature buddies reap the benefits....
Obama gets paid 400,000 plus everything is covered annually for him - so he walks out of the presidency with 1.2mil in the bank for each term.
Senators according to wikipedia:
The annual salary of each senator, as of 2009, is $174,000;[8] the President pro tempore and party leaders receive $193,400.[9] In June 2003, at least 40 of the then-senators were millionaires.[10] In addition to their salaries, senators' retirement and health benefits are identical to other federal employees, and are fully vested after five years of service.[9]
House of Rep According to wikipedia:
As of January 2009, the annual salary of each Representative is $174,000.[7] The Speaker of the House and the Majority and Minority Leaders earn more, $223,500 for the Speaker and $193,400 for their party leaders (the same as Senate leaders). A cost-of-living-adjustment (COLA) increase takes effect annually unless Congress votes to not accept it. Congress sets members' salaries; however, the Twenty-seventh Amendment to the United States Constitution prohibits a change in salary (but not COLA[8]) from taking effect until after the next general election. Representatives are eligible for lifetime benefits after serving for five years, including a pension, health benefits, and social security benefits.[9]
Where are their salary and benefit cuts like the rest of the country??? They go to law school for 3 years - three years people and then set the laws regarding our profession! They dont care about how hard we work to get into and through medical school, to get into and through residency and during work - nor do they care about our massive med school debt. You think increasing a family doc's salary from 135,000 to 150,000 will make people want to go into family med despite 200-300K in loans???? Where is our incentive to work more hours than any other profession out there?
People get paid for how much training they go through - that and supply and demand. This is why taxi drivers get paid less than PhD engineers and why docs with extensive postgrad training get paid more than PhD engineers - etc. The point is that if we do not band together as a profession and point the blame back in the direction where is belongs, we will be scape goated and sent to the slaughter.
Where does blame truly lie?
1. American people: there are consequences to your actions. In an ideal world, the government would pay for you pneumonectomy, XRT, chemo and hospice for your lung cancer (despite years of pleading with you to help you to try to quit), but the reality is that we have a limited amount of resources. For the low income, welfare lady who is G8P9, well, I am not trying to punish the kids, but get a job and stop with the kids. We all have to be smart, responsible adults. You want that flat screen TV or that house you cannot afford, but you dont think you have to pay for healthcare - well that is not how the economy works. You pay for goods and services or else you are stealing. You want your treatment for diabetic neuropathy/nephropathy/retinopathy/CAD? OK fine, but you need to make the effort to take your meds, eat right and exercise. We need to say, look well will pay for you assuming you keep you HbA1c in this range -we are not miracle workers and money does not grow on trees.
2. Insurance Companies: they are a necessary part of the system, but would have to jack prices up less if people paid for their bills. This is where number 1 plays in. You are a drunk who comes in for detox, DTs, cirrhosis every month, well, insurance cannot pay for this. In reality, insurance does not pay for this - the working population does. All insurance companies do is pool funds to allocate them when people need them. They do not make money out of thin air.
3. Drug companies - they are the only ones who do the R and D. If you want cheap drugs, taxes must be raised to support government funded R and D. People do not work for free - especially highly trained people such as the PhDs involved in R and D.
4. Lawyers - They are a necessary part of the system, but those ambulance chasers must be stopped. There needs to be legislation to disbar all lawyers found to bring frivolous suits against docs. Furthermore, people need to realize the same thing I said earlier about this - when you award a patient 14 million dollars for something that is not truly worth that cost, the rest of the working population will have to pay for this. Malpractice insurance rises, which makes hospitals, docs and insurance raise prices which makes premiums for hard working people go up. Money is not made out of thin air despite what Obama seems to say/do.
I was somewhat in the middle about Obama at the start, but this socialism and scape goating has got to stop! We need to take control of this problem NOW. He has inserted some government control into the banking, auto, housing and insurance industries - now he is proposing what is ultimately a complete take-over of medicine.