You know what, I understand everyones concern with the government picking up all of the healthcare expenditures leading to a socialized system. However, one thing should be noted about a socialized system, physicians would finally be able to really negotiate rates and be able to unionize. The Canadian Medical Association has worked hard and has increased physician pay a good amount over the past 20 years.
Unions crumble under their own weight...see current shrinking union numbers in all areas of industry in the US. Plus, a person who is "oppressed" by a car company that works on an assembly line making radiators is more sympathetic to the general public than someone who has life saving skill but does not utilize said skill until promise of payment.
I don't care if you are democrat, republican, libertarian or indy, Obama is about to be in the White House and has used physicians as a whipping boy to get there in a way...a subtle way. Obama is for universal healthcare, meaning essentially placing you and I on the government payroll. It has failed in virtually every country that it has been implemented and will fail here as well. Salaries will decrease drastically and there will be nothing that can be done about it. Furthermore, Obama is all for the American dream up to $250,000 per year. His campaign has made anyone or business making over that amount the enemy.
Even if universal healthcare is not passed right away this will hit virtually any private practice doc hard. If you are a family practice doc, your clinic will almost assuredly generate more than $250K per year. It does not have to be your salary, just what the clinic generates (collections to pay nurses, receptionist, bills...any income from collections). You will see a huge tax increase.
Obama's rhetoric sounds great until put into practice, then the wheels fall off the wagon. Here is a question as to tax rates...what if Obama simply taxes those making over $250K per year, businesses and individuals and it is not enough to pay for his many proposed entitlements and expenditures? Answer: He will move this line back to those who make $200K or $150K. This will be in addition to rolling back the Bush tax cuts.
The old docs that I work around that lived through the Carter presidency are planning on packing it in and retiring. They lived through what amounted to 70% tax rates in the late 70s. You couple a 70% tax rate with decreasing reimbursement and you pour jet fuel on a budding healthcare crisis. From a tax standpoint, Obama is trying what Jimmy Carter tried. For those of you who don't know or have read slanted historical accounts, Carter, from a fiscal and national security perspective, makes George Bush look like George Washington.
In summary, things have the potential, unless cooler heads prevail, of getting extremely out of hand. What looks great on paper is seldom the same in practice. I think Americans, when forced to wait 9 months to a year to get an ACL reconstructed under a universal care scenario, or when forced to have their family doc have less than stellar intelligence and/or skill under high tax and/or universal scenario, will decide that we have gone about this the wrong way and the CHANGE that was promised was not good change.
In all due candor, politically, I am a libertarian.
