Then there is the new prohibition on doctors owning a hospital.

Somehow the politicians think it makes sense to let stock brokers, lawyers, politicians, the rest of the rabble to own a hospital, but don't let doctors do it.

Sometimes it seems like the progressives ruin everything they touch, starting with the railroads (that they claim to love so much) and now medicine.

And so there is the fundamental flaw in the entire Obamacare setup: it doesn't focus on paying doctors.

And without doing that, NO system can work.

Wow, Jim, that sounds crazy. I tried reading the bill itself, but talk about line noise. I did find this article that does a good job of explaining it and explains the claimed rationale for it: http://www.law.uh.edu/healthlaw/perspectives/2010/(CC)%20Stark.pdf

It's hard for me to understand how in the extreme form it takes that that is even constitutional (but I ain't no lawyer).

I do understand the motivation for it, about 20 years ago I broke a bone and the physician referred me to physical therapist down the hall, but it was clear that while I walked down an outside corridor, there were inside corridors linking the two businesses - they were both owned by the doctor and I am sure my insurance paid for it all and I was probably prescribed PT I didn't really need.

Still though, what a shotgun to a fly.

No, they don't plan on paying doctors--they plan on replacing them with 'cheaper' alternatives, like NPs, PAs or regular RNs. While the pay of a physician is 2-3x more (talking about primary care FPs, Internists, and Pediatricians, not sub-specialty docs), when mid-level providers start filling the gap you can bet they will want better pay (so cost difference will not be that significant between the two groups). While 90% (hell, even 95%) of medicine can be done with a clever teenager and a clipboard, it is that 5-10% you need all these extra years of education for. Things will start to get missed, tests will not be run and patients will be inevitably be harmed. But this is a feature, not a bug because it is the next step in the path to socialized medicine--you can't sue the system (just like the military medical system). The other reason your doctor will be replaced is the real reason they are so expensive: they order all those pesky tests and try to look for problems, which latter have to get solved, not to mention avoiding getting sued. If you run medicine by check box you can build limitations that avoid 'over-utilization'. Couple that with 'tort reform' and the system will truly be affordable--to the insurance companies.

While 90% (hell, even 95%) of medicine can be done with a clever teenager and a clipboard

And now you know why I self-medicate. I haven't actually had to sew stitches, so there is that. But I have superglued cuts closed, and I barely have a recognizable scar there...

Yes, we should be able to handle basics medical needs ourselves. It will become more and more necessary. Unless you're willing to wait for hours and hours, and then maybe get told to come back in 4 months.

Most Americans would be shocked by how little many general practitioners actually make.

"While 90% (hell, even 95%) of medicine can be done with a clever teenager and a clipboard, it is that 5-10% you need all these extra years of education for."

It's like airline pilots. 90% of the time it's a dull job. The other 10% is what they get paid for.

But I have superglued cuts closed, and I barely have a recognizable scar there...

I've seen that one used before, actually in an Emergency room when my kid cut her chin open by faceplanting on an icy driveway. It works really well and leaves practically no scar, as you say. I filed it under "Shit to remember" because both of my girls inherited my Klutz gene.

As for losing Dr's, it's already started, one of mine will no longer be able to see me after the first of 2014.

I don't deal with change all that well, and I like to have a Doc that knows me, so all that whining and bitching you hear coming from the Sunny Southwest followed by a big BOOM will be me, I just hope I have enough duct tape wound around my head to keep all the pieces semi-in-place.

People like me, who have chronic conditions, would be screwed.

I have Meniere's disease, and now that both parents died of cancer and had heart disease, I can look forward to one or both.

But don't worry: This misbegotten exercise in fantasy will be repealed. The hardest hits have yet to come. They begin in January.

I lived in five countries with government-run health care. It didn't work in any of them.

But Americans aren't Europeans, Venezuelans, or Japanese.

"You can always depend on Americans to do the right thing after they have exhausted every other possibility."

—Anonymous

I would have had to get stitches on a cut but used Superglue and it worked great.

As early as 1966, cyanoacrylate glues were used in the Vietnam War to close wounds.

I think we have two speeding trains about to crash head on.

The first train is the doctor shortage already created by low medicare, medicaid reimbursement rates, and the second train is the out of control expense of the higher education bubble.

I know two different women who were RN's who went back to school to become Nurse practitioners.
One did it over ten years ago, and got in at top of the demand. The other finished last year, and has had great difficulty finding a job that paid even a little bit more than what she was making as a registered nurse.
When you spend fifty K to get an advanced degree that doesn't pay, the demand for that degree is going to quickly dry up. Maybe once all the doctors quit or retire, there will be a surge in demand for the nurse practitioners. Who knows, but it is going to get ugly.

In my experience they make decent screeners, but tend to be very mechanical in their approach. The burger flippers of the medical profession perhaps? Maybe easily replaced by a computer that can take your blood pressure, and read your lab results?

In a lot of countries, physicians go straight into medical school out of high school. So getting treated by one of them, is about the same as if you were seeing a PA in the US. I would not have a lot of confidence in their diagnostics.

For about ten years now it has been prohibited for doctors to own labs. The result has been a massive consolidation of the lab industry. Other than labs that are run by hospitals, there are basically two companines in the U.S. that own nearly all of the labs in a given area. And what's happening there is that testing is being centralized; local labs are being eliminated in favor of large regional labs. There are some advantages to this, but the big, big disadvantage is that the ability to get "stat" tests done is disappearing in a lot of areas. In about another ten years, it's going to be common that, outside of the medium-to-large urban areas, all testing will be done overnight and the doctor will have to wait until the next morning to get the results, no matter how urgent the test is.

Just to give you an idea of how hard the professional medical industry is trying to keep you shucking out shekels, there is actually a special "medical grade" superglue with a slightly different chemical formula. The regular stuff gets hot, which might hurt you, and there are fumes. Oh dear. Plus the hospitals can't charge your ass off for it.

It's about 25-30 times the cost of the hardware store stuff by volume, and is supposedly only available by prescription.

"Medical" is one of those words, like "aviation", that makes the cost of anything it is attached to go up.

As usual, the story behind "medical grade" cyanoacrylate is not simple.
Look up the difference between it and "regular" cyanoacrylate, and you find allergic reactions and toxicity issues. I'm sure you want to deal with those yourself.
Also, you might recognize that just any old compound, with other junk in it, can be used to put your model airplane or whatever back together – but you don't want those impurities in medical use.