Rick's Rants - RAND Reimbursement Study

Brian K. -

As a child born from John Muir Hospital who did is EM residency at Kaweah Delta Healthcare District; I'm pretty sure EMRAP is the matrix. Those two areas are extremely different for anyone who is curious. John Muir's hospitals are in an affluent suburb of San Francisco ; KDHCD is a rural town where the hospital is the largest employer with a patient population that more than 50% qualify for Medicaid.

W. Richard B., M.D. -

Brian, I calls them like I sees them. I am but a mere conduit of the information in this study. I think the data confirm that there is a fundamental injustice in that private health insurance blatantly makes up for the deficient payments made by Medicare. And on top of it, some hospitals are seriously gouging patients/insurers while others have not learned how to do so -- as yet. What a mess..

Brian K. -

No argument from me! Tone is lacking in text, just thought it was funny the coincidence!

Bradley L., MD -

You aren’t wrong in what your saying, but the thing that diminishes what your saying, with everyone one and their piece of the pie, is it would seem you have no skin in the game, you’ve essentially worked a full career in emergency medicine and enjoyed a full piece of the pie, and now your saying younger docs lose your piece of the pie for your patients. I mean even if you spent your career in a place that serves the underserved even in those circumstances you where compensated well. The funny thing about pay decreases, I think they are coming regardless. Again your not wrong, what you say is the right and best.

J. B. L., M.D. -

om a different subject -as one of few international subscribers to EM RAP - I think it would be educational for Americans to understand socialized medicine ( do not be scared by the use of the word socialized - I am no way a socialist not subscribe to anything near that thought. True many of these systems fail, (Canada) but some don't and there a pluses and minuses to it - but one of the pluses is more bang for your buck - Americans do not get much for the GNP they spend on health care. I am available to speak on the subject i-at least the way it works in my country, Rick - if you'd like

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