Friday, July 24, 2009

Cost of a Doctor's Visit

My recent visit to an ENT specialist cost $200 for 5 MINUTES of face time!!!! All he did was look into by ear with a otoscope.

Do we need doctors with 4 yrs of medical school, 3 years of residency and 2 to 6 years sub-specializing to to this type of work? It should cost $20.

Evidence that demand already exceeds the supply of primary-care doctors ripples through the system as patients increasingly have trouble finding a new doctor, then wait weeks or months for an appointment, spend more time in the waiting room than in the examining room, encounter physicians who refuse to take any form of insurance, and discover emergency rooms packed with sick people who cannot find a doctor anywhere else.

The average annual income for family physicians is $173,000, while oncologists earn $335,000, radiologists $391,000 and cardiologists $419,000, according to recent data compiled by Merritt Hawkins, a medical recruiting firm.

The disparity results from Medicare-driven compensation that pays more to doctors who do procedures than to those who diagnose illness and dispense prescriptions. In 2005, for example, Medicare paid $89.64 for a half-hour visit to a primary-care doctor in Chicago, according to a Government Accountability Office report. It paid $422.90 to a gastroenterologist who spent about the same amount of time performing a colonoscopy in a private office. The colonoscopy, specialists point out, requires more equipment, specialized skills and higher malpractice premiums.

Wednesday, July 22, 2009

Primary Care Physicans -The Bottleneck for Obamacare

Obama's plan does not say anything about increasing the capacity (defined as the maximum sustainable patient throughput over an extended period of time) to handle the additional influx of patients into the US health care system while maintaining the current quality of care or increasing the quality of care.

From Fierce Health Care.

'If the primary-care physician shortage hasn't absolutely exploded, it seems we have your friendly immigrant doctor to thank. After all, unless something changes dramatically in the way U.S. healthcare in structured, we're not likely to see a change in the rate of new primary-care doctors coming into the profession, experts say.

As many FierceHealthcare readers already know, many U.S.-based medical students are shying away from primary care, largely because primary-care physicians make far less than specialists. As a result, many institutions are hiring foreign-trained residency graduates; in fact, more than half of all primary-care residency graduates are immigrants.'

Tuesday, July 14, 2009

Obama's Showdown with Goldman Sachs and Future of Finance

Goldman Sachs stated record revenues from proriatary trading for Q2 2009. It is an awesome display of using your scarce resouces (money, intellectual property, corporate culture) to make money in a difficult period. They have set aside $11 Billion to compensate employees (that is just for the first 6 months of the year).

This goes against the socialist philosophy of Obama who has made it clear he wants to regin in compensation and behavior of finanacial institutions. How will Obama respond? I am betting that the adminstration will fight a loosing battle and have egg on its face. Goldman is an example of what free markets can do.

From the WSJ

'The fact that Goldman has rebounded so strongly during the first half of the year could raise questions from lawmakers who have funneled hundreds of billions of dollars into the ailing financial system. Just weeks after repaying rescue funds, Goldman - a firm constantly under fire for its deep government connections - reported that compensation rose 41% to $6.65 billion since the first quarter.'

Wednesday, July 08, 2009

A Tax Problem That Might Hurt Sotomayor

From the TaxProf Blog:

'she was either doing the side legal work for free or for almost-free. Does the amount of work that she did and the income that she brought amount to a trade or business, justifying Schedule C (above the line) deductions? If she had represented the clients through the firm, then expenses either would have been the firm’s expenses (perhaps deductible by the firm but not by Judge Sotomayor) or, if she paid them herself, they would have been deductible below the line since she was an employee'

Moreover, what were the expenses? If they were minimal, who really cares. But suppose she was taking home office deductions. If my earlier presumption is correct, then the receipts from her side practice were likely to have been trivial or insignificant at best. Maybe she claimed to run a law practice out of her home so that she could take home office deductions when she was really (just) an employee whose employer provided her with an office, and the home office deductions would then have been improper. (Employees generally are not permitted to deduct the costs associated with home offices, no matter how much work they actually perform at home. But people who run businesses out of their homes often can.)

Tuesday, July 07, 2009

Swing States Loose Bling For Obama

This will be the trend in coming months. Ohio was one of the states that put Obama over the top in 2008 with a slight margin.

'President Obama's job approval in Ohio has dropped significantly in the last two months, dipping under the 50% mark for the first time, according to a new poll by Quinnipiac University. In the last Quinnipiac poll in Ohio taken in early May, Obama enjoyed a healthy 62% job approval rating, with only 31% disapproving. Today, Obama's job approval stands at 49%, with 44% disapproving - a twenty five point net drop in just eight weeks. '

Monday, July 06, 2009

The mendacity of Obama's Economic Policies

An explanation as to why the Fed's policies won't help the economy.

'Quantitative easing - expanding base money in circulation (mainly bank reserves with the central bank by purchasing government securities) - isn’t working in the US, the UK or Japan.

Credit easing - outright purchases of private securities by the central bank, which can either be monetised or sterilised - is achieving little in the US or the UK, although it has not been pushed too hard yet.

Enhanced credit support in the Euro Area - providing collateralised loans on demand at maturities up to a year at the official policy rate - is not working either.

These policies are not improving the ability and willingness of banks to lend to the non-financial sectors. They have had little positive impact on the corporate bond market. It is not surprising why this should be so, once we reflect on the actions and the conditions under which they are taking place.'