Obamacare and PT

[HonorG2]

I think a lot of the issues concerning PT salary were prevalent before this healthcare reform bill was signed. The discussion has come up numerous times on this message board, as in all other fields that now have these coveted "clinical doctorates." IMO they increase the salaries of professors and administrators at the universities that offer them. There main purpose isn to bring some apparent light to other areas in the medical field outside of MD's/DO's, not increase salary and knowledge.

In many areas, money is maximized in the private sector owning a business. Such is the case here. However, it is becoming harder and harder to become an owner of a PT clinic. The field has grown so much that the clinics are rampant, referrals are locked down, and new enterprises will fail to thrive. That leaves the option of working within a clinic for a number of years and buying out the current owner/group of owners. Otherwise, you'll be working for meager wages (the hospital I currently work at currently starts new PT's out at $52,500, which is lower than most students in-state PT school debt) attempting to pay off loans for 30 years.

To be honest, I believe in healthcare reform from a basic human nature standpoint and personal situation (in which I was without health insurance for 9 months when I was a HS athlete because of an inconclusive stress test concerning one of my parents).

PTdad, it could be because I am in my 20's and view the world from a liberal eye. I had a great and similar discussion about politics with a businessman on a flight to Des Moines 2 years back. He shared the same sentiments you shared above. So, I respect your view. It could be mine in 20 years.

My addition to this thread is simply that this reform will not kill or hinder the profession more so than it already is. That was done with the move to the DPT and significant increase in tuition costs. Paying 70-100K for a DPT to earn 50-60K the first 5 years out of school is not a great idea in my opinion. Helping people is great, but spending countless hours helping patients function again only to stare at an empty bank account after I pay my bills is the main thing I have to consider before I send in my deposit.

---

Members don't see this ad.

 

[mtm34]

Truthseek/PTDad,
I ask your advice- I'm 21 and ready to start my DPT program this June, I've wanted to do PT since high school but this is legitamately scaring me out of it.... what would you do?

 

[PT Dad]

My advice would be to follow your passion. There was an experience you had in high school or someone along the way that motivated you to pursue your interest in PT. There will always be bumps in the road and obstacles you will face throughout your life no matter what career you go into. You have to enjoy what you do otherwise you most likely won't be successful at it. You never know where your education will lead you; perhaps you will go into research, perhaps you will invent a new medical device for amputees, patent it and become rich beyond your wildest dreams, perhaps you will want to combine a clinical practice and teach also. The possibilities are endless, so don't let what is happening currently in the news deter you from doing what you want to do. People will always need to rehabilitate when they are injured or suffering from disease, that will never change. You can't make decisions based on how you think this new healthcare scenario will play out because you will always look back and regret not getting the DPT if that is truly your passion. My intent was to get people thinking so I hope I didn't scare you off.

 

[Cyres]

I'll join this conversation.

The Federal government is paying for the bill in mainly 3 ways:

-increasing medicare tax for families making over $250,000/year. this tax will be expanded to include unearned income from investments.
-insurance companies will pay an 'excise tax'. they will be forced to pay a 40% tax on plans provided to families worth over $27,500 or $10,200 for individuals. Dental and vision plans are exempt from this.

-10% tax on indoor tanning services

Where to begin? Ok first we want to raise taxes on those earning $250,000 or more. That would be the richest 10% give or take? Seems like a good idea, after all the rich have money and they won't feel the pinch. But the CBO recently noted the top 1% of income earners in the US pay 39% of federal income taxes while earning only 18% of the pretax income. The top 5% pay 61% while earning only 31%. The top 40% of income earners paid 99.4% of federal taxes. That leaves the middle 20% to round off taxes paid to 100%, and the bottom 40% to just receive from the system. So for a population already paying the vast majority of federal taxes the solution is to... increase their taxes! Brilliant. After all they can afford it.

But let's dwell on this for a moment. What could be some of the long term ramifications of this increased taxes? Well it obviously further redistributes wealth (in this most recent case taking from those who HAVE the means to procure insurance and giving it to the those who HAVE NOT the means). And what happens when wealth is redistributed? Why the rich are no longer rich (liberals everywhere dance a happy dance). But... damn... now these rich folk aren't spending money they would have otherwise spent. So they are not purchasing the goods and services they used to-- so the car dealers, travel agents, retail stores, restaurant owners, landscapers, etc aren't receiving the income they used to and the ripple continues onward.


At the same time these rich folk might own a business, only now they can't afford to keep some employees on staff and have to let them go, or maybe they close down all together... or if they were on the verge of starting a business now they can't. So you have people not starting businesses, not producing goods and services, not employing other citizens. And now those other citizens are drawing unemployment, welfare, etc. Nothing like digging the hole deeper.


Best of all there's going to be fewer people making $250,000 and higher because of those taxes. So fewer people are paying those taxes. So they system can't support itself. So the government decides to lower the taxed level maybe to 200k, then 150k, then 100k, then 80k, and so on. But it's ok they are deemed rich and vilified... after all... they can afford it.

If families or individuals are paying that much for their health care they either 1) want a policy that good or 2) are a significant risk to insure. Insurance companies are a business. People forget that. They are a business making a calculated gamble that the fees they charge their clients will be more than what they have to pay out to providers. In our capitalist system the goal of a business is to make money. Now insurance companies only produce about 2% profit which is boarder line minimum to maintain operations in any business. So the government plan is to tax them for pricing plans as too expensive. And at the same time they have to provide coverage (without limit) to high risk clients without being able to raising their rates to sustainable levels... the money coming into their system won't equal what's flowing out. Revenue < Expenses = Out of Business.


But not to worry one can keep their insurance plan, but there's a government plan to fall back on just in case. Damn, almost like it's been planned that way.

Next, the tanning tax. I wasn't aware the tanning industry was such of powerhouse of wealth that 10% off the top could be a pillar of the government's funding trifecta. But Uncle Sam knows best.

The CBO predicts that this plan will reduce the federal deficit by about 143 billion dollars in the first 10 years.

The CBO predictions. 1) We're going to pay into the plan for years before it goes into full effect. 2) Was there an accounting for the cost of the "Doctor Fix" or the 500 billion being gutted from Medicare. 3) Social Security, Medicare, Medicaid, the USPS... the list goes on and on of the governments best intentions failing to sustain themselves. There's no way in God's green earth Obamacare bucks the trend and then goes leaps and bounds further by actually cutting the deficit.

This is an interesting point to consider and you may have a point, although the overall theories are similar, the specifics of the Massachusetts plan and the Federal reform are not. It is impossible to predict precisely what will happen. This is an extremely complicated issue and the all of the effects of this, or any, bill would be impossible to predict. Fortunately, the current health care reform bill has provisions to help Massachusetts specifically.

Precisely predict... yes. But I think we can take a gander at Canada's, Great Britain's, France's, etc. socialized medicine system and hypothesize. Or better yet we could look at other more broad forms of wealth distribution-- the USSR, North Korea, Cuba, the PRC. Models of success one and all.

As I stated before, you have the right to be worried about this bill. The bill is not perfect and your concerns and criticisms are understandable, but the cost of doing nothing is far too great. It costs us all more to have individuals uninsured.

Actually it doesn't cost anyone anything to have individuals uninsured. The free treatment of the people unable to pay for the goods and services they consume is what starts costing people money.

I'm also confused as to why you continue to call this socialist. I would be interested if you could explain to me how providing a cheap, fair alternative to low-income individuals is a socialist idea?

Dear God. Ok, the government is taking the product of one group of people labor (money from "the rich")... and giving it (redistributing wealth) to those who did not labor to have the product (in this case insurance for the uninsured). It doesn't get much more socialist than that.

Individuals can keep their private insurance if they like it.

See above regarding insurances companies.

Even if this is socialist (and I don't believe it is), is that really so bad? Did you go to public schools? That's a socialist idea. Have you ever called the police or fire department? Have you ever gone to a public library? Our society already has socialist services throughout it.

See truthseeker's reply.

I don't believe the private sector has our best interest when it comes to health care. The current system makes money by denying coverage. A fair, inexpensive government plan is required to keep these insurance companies honest and competitive.

See above regarding insurance companies.

 

[SacPT]

truthseeker,
Don't be so hard on the youngster, he/she is only 22 years old, filled with idealism and good will towards all. Not enough life experience yet to think logically. I read somewhere that the frontal lobe is not fully developed until the mid 20's.

I can't help but chuckle at that! A healthy dose of ideals. Sure, the future looks bleak, but humans have never succeeded without being challenged. The dam has burst, and it may not stop for some while, but I am convinced that something had to happen, even though we all disagree on how it should happen.

 

[pwrtrainer]

...

 

[Cyres]

What exactly do these taxes come out to be in dollars?

The figures were from the 2004 and 2005 years.
http://www.cbo.gov/ftpdocs/88xx/doc8885/effectivetaxrates.shtml#1011537

In tax dollars for the two years it would be. $4,034,138,000,000.00
http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=203

So out of 4.034 trillion:
The top 1% paid: $1,573,313,820,000
The top 5% paid: $2,460,824,180,000
The top 40% paid: $4,009,933,172,000
The middle 20% paid: $24,204,828,000
The bottom 40% paid: $0.00 and received funding.

 

[DancerFutureDPT]

The figures were from the 2004 and 2005 years.
http://www.cbo.gov/ftpdocs/88xx/doc8885/effectivetaxrates.shtml#1011537

In tax dollars for the two years it would be. $4,034,138,000,000.00
http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=203

So out of 4.034 trillion:
The top 1% paid: $1,573,313,820,000
The top 5% paid: $2,460,824,180,000
The top 40% paid: $4,009,933,172,000
The middle 20% paid: $24,204,828,000
The bottom 40% paid: $0.00 and received funding.

So basically, you either need to make a crapload of money ($500,000, let's say) so that what you're taxed isn't a huge inconvenience (you may have to drive a Lexus instead of a Bentley haha), or you have to be in that bottom 40%....the middle 20/top 40 gets screwed...no funding, and paying a lot in taxes. After taxes wouldn't that theoretically bring some of the middle 20% down to the bottom 40%? (pulling these numbers out of the air - if the bottom 20% can make a max of $35,000 per year, then someone making $36,000 is technically in that middle 20%, but they will probably pay more than $1000 in taxes for this new plan, bringing their net gain down to less than what the bottom 40% is making. And the middle isn't getting any funding/benefits from it).

Is my interpretation correct? I really never paid attention in poli-sci classes...they confused me And I really hate politics.

 

[lee9786]

In regards to the concept of the cost of doing nothing, how much is this bill going to cost in borrowed/printed money? That is my biggest concern. We don't have any money. We are in debt. We are we pretending like we aren't? Why are we pretending like we actually have money? When you have no money you save not spend. I'm starting to believe the conspiracy theories that we aren't planning on paying this back and will most likely begin a new currency. I guess with this logic, yeah why not spend as much as possible. Sure we may have to go to war with China but why not?

 

[truthseeker]

the middle 20/top 40 gets screwed...

That is EXACTLY what Karl Marx said had to happen to have a communist/socialist country. He had to destroy the middle class and make them dependent upon the state because that is where most people are.

It is really scary what could happen here.

 

[pwrtrainer]

...

 

[MotionDoc]

Churchill lived in a different time. You don't need to be 40 to espouse 'conservative' beliefs...life experience will push you one way or the other. A common ground (i.e. bipartisanship) is where we need to be. Obamacare was anything but that.

 

[Cyres]

Sorry, I meant with the taxes that are introduced with this new bill..

I did see on Fox News that those making 200K or more would see a 63% increase in their Medicare taxes. And investors would have an additional 3.5% tax on dividends and capital gains. Beyond that I'm not sure. I'll paraphrase Pelosi though: "We have to pass the bill in order to find out what's in it."

 

[superCOTA]

Every year OT and PT has to get a HUGE petiton movement signed to extend the moratorium on the medicare part B cap changes, which basically cut services considerably, and it's like prolonging the inevitable.

Now we have the goverment to insure another 30 million people....

I have been in this biz for 10 years and it's all i do halfway decent....
Anyone diving into this pool for the first time has to be crazy. You are going to take on loads of debt and time (more costly) and we have no idea what reimbursement rates will be after these reforms. Good luck because we are going to need it.

 

[ksiem]

I think PT needs to cut the umbilical cord to OT and Speech Therapy.. we aren't the same and they can worry about their own butts throughout this health care mess. We need establish our own autonomy and it's harder when your clumped with other "allied health" professions.

 

[superCOTA]

I think PT needs to cut the umbilical cord to OT and Speech Therapy.. we aren't the same and they can worry about their own butts throughout this health care mess. We need establish our own autonomy and it's harder when your clumped with other "allied health" professions.

You aren't autonomous? This really makes no sense at all.
Unless you can flesh out your plan a little better, stay on topic.

 

[ksiem]

I'm not putting down OT.. I'm merely saying that PT, Speech, and OT reimbersements have been traditionally clumped together.. it's hard for the APTA (which is a stronger lobbying organization than the two others) to pull the PT profession ahead because we are clumped with the other two. I want my profession to be recognized as a separate efficacious profession.

 

[ksiem]

In addition, I do think that what I'm saying has relevance to the thread topic..

 

[MinnDasota]

I'm not putting down OT.. I'm merely saying that PT, Speech, and OT reimbersements have been traditionally clumped together.. it's hard for the APTA (which is a stronger lobbying organization than the two others) to pull the PT profession ahead because we are clumped with the other two. I want my profession to be recognized as a separate efficacious profession.

Actually, with Medicare, OT has it's own therapy cap and PT is clumped with Speech. Most insurance companies follow medicare's lead so this is a problem. At least the exceptions rule has been extended to the end of the year.

Below is a part of what Obama signed that pertains to PT:

Patient Protection and Affordable Care Act (HR 3590)

• Extends the Therapy Cap Exceptions Process for 2010
  Authorizes a 1-year extension of exceptions process to December 31, 2010.
• Authorizes Study of Direct Access Under Medicare
  Creates the new Centers for Medicare and Medicaid Services (CMS) Innovation Center, which specifically authorizes a study on innovative models of delivery in physical therapy, including direct access to physical therapists under Medicare.
• Advances the Physical Therapy Workforce
  Includes physical therapy in the allied health recruitment and retention programs to address health care workforce issues.
• Provides Rural Payment Equity Under the Medicare Physician Fee Schedule
  Extends the Geographic Practice Cost Index floor of 1.0 for 2010.
• Establishes Rehabilitation as a Minimum Benefit
  Authorizes rehabilitation and habilitation as required minimum health care benefits as part of the health care insurance exchange.
• Non-Discrimination
  Includes strong non-discrimination language on benefits and providers as an essential element of insurance reform. This will allow patients to choose their providers and the full range of needed services, which is critical as we increase coverage and access to health care.
• Provides Guaranteed Issue, Renewal, and Choice
  Eliminates the denial or rescission of coverage based on pre-existing conditions

One concern is that the legislation does nothing to prevent the 21.2% cut in the medicare physician fee schedule effective April 1, 2010.

For some light reading check out APTA @ www.apta.org/healthcarereform

 

[DancerFutureDPT]

Actually, with Medicare, OT has it's own therapy cap and PT is clumped with Speech. Most insurance companies follow medicare's lead so this is a problem. At least the exceptions rule has been extended to the end of the year.

Below is a part of what Obama signed that pertains to PT:

Patient Protection and Affordable Care Act (HR 3590)

• Extends the Therapy Cap Exceptions Process for 2010
  Authorizes a 1-year extension of exceptions process to December 31, 2010.
• Authorizes Study of Direct Access Under Medicare
  Creates the new Centers for Medicare and Medicaid Services (CMS) Innovation Center, which specifically authorizes a study on innovative models of delivery in physical therapy, including direct access to physical therapists under Medicare.
• Advances the Physical Therapy Workforce
  Includes physical therapy in the allied health recruitment and retention programs to address health care workforce issues.
• Provides Rural Payment Equity Under the Medicare Physician Fee Schedule
  Extends the Geographic Practice Cost Index floor of 1.0 for 2010.
• Establishes Rehabilitation as a Minimum Benefit
  Authorizes rehabilitation and habilitation as required minimum health care benefits as part of the health care insurance exchange.
• Non-Discrimination
  Includes strong non-discrimination language on benefits and providers as an essential element of insurance reform. This will allow patients to choose their providers and the full range of needed services, which is critical as we increase coverage and access to health care.
• Provides Guaranteed Issue, Renewal, and Choice
  Eliminates the denial or rescission of coverage based on pre-existing conditions

One concern is that the legislation does nothing to prevent the 21.2% cut in the medicare physician fee schedule effective April 1, 2010.

For some light reading check out APTA @ www.apta.org/healthcarereform

thanks for the info! finally some straight forward fact/information (albeit still not concrete, but it's a start). I would just like to know for sure I'm not getting into a profession that won't be what I think it is.

P.S. the first 3 articles can only be accessed by APTA members, which I am not yet. Care to summarize? Or PM me and I'll give you my email address so you can forward them to me?

 

[ksiem]

Thanks for the clarification, I dthink that in the past OT and PT were also clumped together.. I could be wrong. Dancer: the PT profession may change but all I can see is a higher salary, more evals/less routine patient time, more PTAs and PT techs, hopefully more autonomy and direct access reimbersement, and probably more paperwork.

 

[honker23]

People still see govt programs as free money/free health care. They get their money from someone.....taxpayers. Frankly I'm sick of paying for others healthcare. We have to treat patients without insurance and those with no intention of paying. We have to make it up somewhere. Healthcare costs rise, premiums rise. This new plan will not pay hospitals more than they are curently, so i think costs will rise to cover what isn't paid for by this great plan...note sarcasm.

On another note PT's are grossly underpaid. 7 years and an entry-level doctoral degree to make 2 dollars more an hour than the guy in local factory with a high school diploma, makes no sense

 

[truthseeker]

People still see govt programs as free money/free health care. They get their money from someone.....taxpayers. Frankly I'm sick of paying for others healthcare. We have to treat patients without insurance and those with no intention of paying. We have to make it up somewhere. Healthcare costs rise, premiums rise. This new plan will not pay hospitals more than they are curently, so i think costs will rise to cover what isn't paid for by this great plan...note sarcasm.

On another note PT's are grossly underpaid. 7 years and an entry-level doctoral degree to make 2 dollars more an hour than the guy in local factory with a high school diploma, makes no sense

If PTs were self employed, they would make more.

 

[Hector82]

Please no more... I can't help myself from reading these new posts... I'm trying really hard to block this whole Health Care issue out of my mind.

I've been on this path for too long now to change it, I have to ride it out...for now. Starting PT school this June... Must get my mind right! Hopefully it will all work out for the best?

To ignorance!!!

 

[jbizzle]

Read up y'all. Especially if you are going to an interview. it's confusing to me. Learned a few things, but I have more to learn.

 

[markelmarcel]

Read up y'all. Especially if you are going to an interview. it's confusing to me. Learned a few things, but I have more to learn.

Kind of scary to see which ways this whole issue can tip...

 

[DCasey]

Giving this thread a bump, because I'm curious if those familiar with the topic could offer more updated insights. Thank you!

 

[Jula]

So I'm curious now, would it be a bad/risky time to go to school at DPT or other health professions in general? I know that newly grads for pharmacy are having a hard time finding jobs since the field is now saturated. I'm not sure about others though.

 

[jblil]

So I'm curious now, would it be a bad/risky time to go to school at DPT or other health professions in general?

The way I see it, healthcare professionals will be in demand for the next 40 years due to our country's unrelenting demographics. So what would be the worst case scenario if for-profit insurance companies have their way? Answer: Downward pressure on salaries.

Currently, MDs' and dentists' starting salaries are around $130K and way up if they are in a lucrative specialty, pharmacists' around $110K, optometrists' around $90K, and PTs' around $65K-$70K. Would you be ok with earning 10% less (or 15% or 20% less) when you start working?

IMO, the answer depends on how you personally like the field you're working in and on your debt load. If you don't have a humongous loan and you like being a MD/pharmacist/PT/etc not because of the money or the prestige, but because of some deeper motivation (be it "wanting to help people", or scientific curiosity, or because of a vow you made to your late parents), then go ahead.

Unless you like what you do for a living, you will not give your best and thus you won't excel.

 

[dacoaz77]

I would not mind earning 10% - 20% less at all if I could still have the opportunity to practice physical therapy. That being said, DPT programs are still wanting on average about $90,000 for tuition, on top of living expenses which can be an average of $60,000 for a grand total of $150,000. The debt to income ratio with the pat cut mentioned above would be horrible. Let me try some math with averages here:

Average starting salary for a PT: $60,000
Pay cut of 10% = $54,000 (before taxes)
Tax rate of 15% = $8,100
Take home for a starting PT = $45,900 annual ($3,825 monthly)

The above numbers are averages of course, but I think you get the point here. With only a 10% pay cut, the numbers look bleak for a student sitting on $150k loans. I don't even want to think about a %20 pay cut.

 

[jblil]

Average starting salary for a PT: $60,000
Pay cut of 10% = $54,000 (before taxes)
Tax rate of 15% = $8,100
Take home for a starting PT = $45,900 annual ($3,825 monthly)

You're very conservative in your calculations (which is good), but reality is a bit more complicated.

Starting with the gross income ($54K in your example), 6.2% for Social Security and 1.45% for Medicare are automatically withheld from it. Then the IRS allows you to subtract deductions (e.g., mortgage payments - or you can take the "standard deduction"), then personal exemptions, to arrive at a "taxable income." You only pay taxes on that amount, which will be significantly smaller than $54K.

But your point is still valid. Try to keep the loans to about one year's salary, or the payments are going to be painful.

(Disclosure: I moonlight as a tax preparer.)

 

[dacoaz77]

That is good news jblil. Could you expound a bit on trying to keep loans to about one year's salary?

 

[jblil]

Could you expound a bit on trying to keep loans to about one year's salary?

1. Go to a state school. Or if you can, relocate to NC, live there a year to establish residency and apply to East Carolina University. It has the lowest tuition I've ever seen for a DPT program (if applications surge at ECU next year, I'll contact the school to get a finder's fee since I've been touting it for the last several months ).
http://www.ecu.edu/cs-admin/financia..._fall_2012.pdf
Scroll down to "Graduate and Professional Level": $6,120/year, full-time.
So for 3 years you'll spend roughly $22-$25K in tuition + books + fees, etc.

2. Live cheaply. Get a roommate, cook your own meals, carpool, bike or walk, don't go out too often, etc. Doing that, one can probably get by on $15K/yr, as long as you don't live in a high cost-of-living city like LA or NYC or Chicago.
So 3 years of living expenses= $45K

Total tuition + living expenses for 3 years = $70K. If you have some savings, you would not even need to borrow the entire $70K.

In case you haven't seen it, I ran a survey on starting salaries for DPT new grads here:
http://dptfinances.wordpress.com/201...0/hello-world/
Use it as a reality check against the loan amount.

I did a very rough tax calculation for the example we used earlier (this is a back-of-the-envelope thing as I am too lazy to fire up the tax software).
Gross income= $54,000
Minus SS and Medicare of $4,131
Take-home pay left= $49,869
Standard deduction= $5,800
Personal exemption= $3,700 (I am assuming you're single with no dependents; these are the numbers for tax year 2011; they will go up a bit every year)
Taxable income= take-home pay minus (standard deduction + personal exemption)= $40,369
Federal income tax on above amount= $10,618

The above is just an "order-of-magnitude" estimate of your tax liability, but IMO it's probably a worst-case scenario since we're ignoring a bunch of items that will lower your taxes such as dependents, 401k/IRA contributions, state taxes and other deductions.

 

[dacoaz77]

Great stuff. Thank you for the advice! I did take a look at the survey and it helps tremendously. Kudos.

 

[jgold72288]

Really hard to predict right now given the fact that Romney stands a decent chance at getting elected and changing up health care once again.

 

[dacoaz77]

I agree with you jgold. More uncertainty is just fuel on the fire for me while trying to make a logical, educated decision for my family and I. Good times.

 

[truthseeker]

Truthseek/PTDad,
I ask your advice- I'm 21 and ready to start my DPT program this June, I've wanted to do PT since high school but this is legitamately scaring me out of it.... what would you do?

Geez, sorry, I just noticed the post.

don't be afraid. Do what you love and everything will work out. Obamacare will fall. PTs offer something that is valuable. Find the least expensive program you can and get out with as little debt as you can manage. You will be fine.

 

[lee9786]

I agree the issues of PT were prior to healthcare reform. Things like Medicare's fiscal issues. This issue is not small at all. The baby boom generation did not do well preparing for their most vulnerable years.

The basic issue is not enough money coming in as opposed to going out. This is both do to economics and demographics. Demographics is as the population of baby boomers grossly outweighs the number of Generation X,Y, etc.. Add to this the obesity epedimic among this group which pushes healthcare costs sky high due to all the comorbities correlated with being higher BMI than healthy (minus Lean muscle mass).

As for the economy, how do people think the "kids" are going to be able to support this group? The Student Loan Debt in this country is no small matter. More people are taking on more debt now more than ever. We are talking about a generation - the one that is going to be asked to pay for this healthcare. Lets not even talk about this multitrillion dollar debt and how that plays into things.

There is no production- based economy anymore in the United States anymore. We are the land of the get items cheap from outsourced countries at Walmart et al as we collect our entitlement welfare check because the jobs got moved overseas. The Government promises Government jobs such as "building bridges" which only temporarily provide jobs and come at a COST to taxpayers. We have a lot of promises to support mega corporation special interests such as the car companies, but what about all these other plants that have shut down? We could also talk about the currency issue in this country, but I won't bother expanding.

The bottom line is we are heading to a Socialistic superstate. Americans are sleeping at the wheel.

How does PT fare in a Socialistic Government? < that should be the question being asked. That's the way this is all going. The politicians in this country have sold us out to special interests, and they want Globalism.. < this is why we don't have manufacturing jobs in this country anymore. The know darn well they have manipulated the currency, and as long as the $1 happy meals are coming the public will not complain.

We know when it comes to Corporate, people become a number not a person. I'd look for Costs to be numero uno priority over health care quality. The APTA is doing all sorts of changes in certain things such as the PTA position in RC 3-11. Some PTAs were afraid of losing their position. I do not see how that would ever fly though. There is no money.

A Doctorate is nice but people pay for the skill. As in any business, the target market needs to be identified. When you are talking about a primarily Geriatric population as the target which much of which are demendent on Social Funding (Social Security) for living, how does the $200 evaluation charge set with this population? Are they going to show for PT? Or is the price charged going to go down as the DPT gots bills to pay? Price goes down and so does salary. The Debt remains though.

This issue is much more dynamic than many have thought about.

 

[rcedillo4]

Bump