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  Reply # 1803367 19-Jun-2017 12:49
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Why $63 per visit - my last trip to the doctor cost $19, and that was like a month ago. Big city surcharge ?





rb99


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  Reply # 1803368 19-Jun-2017 12:52
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MikeAqua:

 

Further at the specialists level, the supply side of labour is artificially constrained by the specialist colleges passing limited numbers of new specialists each year.  We recognise very few other countries qualifications.

 

Medical specialists (opthalmologists in Southland) in this country have actually been successfully prosecuted by the ComCom for conspiring to make it difficult for an overseas trained specialist to obtain supervision during an initial probationary period they had  to go through.

 

 

 

 

An Opthalmologist or Orthopaedic Surgeon if they are any good should command close to a million a year in public and private money.


 
 
 
 


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  Reply # 1803375 19-Jun-2017 13:08
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MikeAqua:

Further at the specialists level, the supply side of labour is artificially constrained by the specialist colleges passing limited numbers of new specialists each year.  We recognise very few other countries qualifications.


Medical specialists (opthalmologists in Southland) in this country have actually been successfully prosecuted by the ComCom for conspiring to make it difficult for an overseas trained specialist to obtain supervision during an initial probationary period they had  to go through.



Different colleges have varying numbers of training positions and number accepted into training positions, very much like the medical schools have only a certain number of places.

Surgical specialties have lesser number for many reasons, some linked to need to maintain volumes of practice. GP training has more numbers.

I'm not sure you are correct about the commerce commission comment. If you can find a link that would be useful.

The Australian ACCC took the orthopaedic college to court in Australia alleging anti competitive behaviour and lost.

mdf

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  Reply # 1803376 19-Jun-2017 13:09
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I have mixed feelings about this.

 

On the one hand, I can certainly understand the rational economic argument that university fees are probably one of the best investments you can make, particularly for higher paying vocational qualifications like doctors.

 

But equally, medicine is one of those public good qualifications that benefit everyone, not just the doctor. I certainly want my doctor to be the best and brightest possible. I worry that some will be turned away from medicine at the idea of that level of student debt, even if they are well suited to it and it would be of benefit to everyone if they became a doctor. I particularly worry about those who don't/come from families that don't have high levels of previous educational achievement (for whatever reason).

 

Having a stomach that has the rigidity of wet tissue paper (medical ops on TV make me nauseous), medicine was never ever an option for me. But I figure most medical students fall into one of these categories:

 

(a) it is my burning passion to be a doctor; I don't care what it takes/costs!
(b) I like the money and/or status of being a doctor; the university fees are a worthwhile investment.
(c) pfft, I'm not paying the fees anyway, sure, I'll enrol in medicine.
(d) yeah, I would probably be a good doctor. But $100,000 worth of debt is a *lot*. I can make almost as much money doing XYZ, the qualifications are easier to get, I won't have to do 3am shifts, and I won't have to deal with sick people all day.

 

I think we should be doing all we can to encourage the "Ds" into medicine. But equally, having seen the standard of some "eternal" university students first hand, it is also important that the individual have some stake in their ongoing education and I don't think no fees is the right response. Bonding is an option, but if Dr Jane (student debt: $100K) wants to take a year off to go volunteering in some third world country, I don't think that should be disincentivized by a great whack of interest either.

 

Perhaps we need more of a scholarship culture like North America. If you're good and you really want to do something, you apply for a scholarship. If you're good, you can usually a way. It also allows scholarships to be distributed in quite a nuanced way, rather than having blanket rules like "no fees" or "no interest as long as you're in NZ" that inevitably cause at least some issues.


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  Reply # 1803383 19-Jun-2017 13:15
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rb99:

Why $63 per visit - my last trip to the doctor cost $19, and that was like a month ago. Big city surcharge ?

Maybe you live in a high deprivation area where the practice is able to claim additional subsidies. Such a disparity is not uncommon.

 

 

At $63 per visit I'd probably rather wait out a 2-3 week lead time on non-urgent appointments or 8 hour waiting rooms to see the GP. If the enrolled and funded fee is $63 you'd really have to question how they can justify their full fee or how they spend their capitation funding. Capitation funding should only be used to subsidise patient fees not used to prop up what are essentially privately owned practices.

bmt

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  Reply # 1803442 19-Jun-2017 13:44
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That $100/hour plumber probably doesn't have many other staff (nurses, receptionists etc) to pay, or lease/rent/rates on a physical practice. And a myriad other things.

 

A lot of call outs for a plumber would be for things like a burst pipe, something is flooding, they are needed urgently etc. Hence you pay for urgency. GP visits are not generally urgent, you would go to an emergency department if so.


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  Reply # 1803443 19-Jun-2017 13:47
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I think MDF is the only one so far who hasn't made this discussion mainly about money. I don't doubt there are many doctors who chose medicine for the financial rewards but are excellent doctors anyway because they are bright and capable. But I am also certain there are many potential doctors who have a passion for medicine as a way of helping people. They are not motivated by money. They want to work in poor areas where their skills can really make a difference, or go overseas as volunteers in war zones or to combat the ravages of epidemics and famine. There actually are people like that. They do not all want to own Ferraris. For them the prospect of a $100,000 debt can be a major impediment. It is not all about money, people.

 

  





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  Reply # 1803446 19-Jun-2017 13:52
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rb99:

 

Why $63 per visit - my last trip to the doctor cost $19, and that was like a month ago. Big city surcharge ?

 

 

 

 

I pay $69/visit in Kapiti...also remember that the govt subsidises each visit...not sure by how much?


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  Reply # 1803447 19-Jun-2017 13:54
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yitz:
rb99:

 

Why $63 per visit - my last trip to the doctor cost $19, and that was like a month ago. Big city surcharge ?

 

Maybe you live in a high deprivation area where the practice is able to claim additional subsidies. Such a disparity is not uncommon. At $63 per visit I'd probably rather wait out a 2-3 week lead time on non-urgent appointments or 8 hour waiting rooms to see the GP. If the enrolled and funded fee is $63 you'd really have to question how they can justify their full fee or how they spend their capitation funding. Capitation funding should only be used to subsidise patient fees not used to prop up what are essentially privately owned practices.

 

 

 

Depends on your age as to the subsidy, if you are young or old, it seems youget it cheaper.. I believe I was charged about $50 in a small city when I last went. It seems whenever there is a change in government, the fee drops, but then gradually rises again.


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  Reply # 1803450 19-Jun-2017 14:00
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Many may not be motivated by money, but far more are likely to be put off by the very high fees, and do something else. I certainly wasn't going to do a degree that had huge course fees. Also it was only about 15 years ago when all loans had interest on them, so many doctors would have also been paying interest on their 100k loans, when they worked in NZ, and the rates were a lot higher back then. Sure, you may have the potential to earn more. But there are also many jobs that you can earn high / higher salaries without high course fees.

 

I would actually prefer that they cherry picked the best people to go into medicine, give then totally free education, as long as they stay in NZ afterwards for at least 10 years. Same with some other degrees. That is , if we do want to be treated by the same doctors that we train.


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  Reply # 1803451 19-Jun-2017 14:03
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Am thinking our practice is part of this Low Cost Access program (go Google !), which does seem to involve a Deprivation Index. Wouldn't have said it was in an area that would count as deprived, but I presume there's some kind of catchment area thing involved. Applies to all the the practices patients as far as I can tell.

 

Not that this has got much to do with student loan debt, but just thought I'd ask.





rb99


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  Reply # 1803453 19-Jun-2017 14:07
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Seeing as I benefited from a free degree, I see no reason why my children shouldn't also (and of course other peoples children, to which I would have no prob contributing too through tax). If we want to afford it we can. Might need to be a lower number if FE though, the money pit can be made deeper but would still be restricted.





rb99




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  Reply # 1803458 19-Jun-2017 14:10
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I pay about $63 per GP visit in the Wellington suburbs too. I think it's partly based on your area, and also your income.





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  Reply # 1803461 19-Jun-2017 14:16
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rb99:

Not that this has got much to do with student loan debt, but just thought I'd ask.

 

 

A large part of it does come down to the fact there is a need for more (rural) GPs, I understand that is the basis to which the medical students are asking for concessions on their loans etc. They are against bonding too so I think they are asking the government to subsidise their study fees further and hopefully some of them will choose to be rural GPs.

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  Reply # 1803503 19-Jun-2017 15:29
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I went to the GP this morning (Wellington CBD) and it was $61 for a 10-15 min appointment. Guess it may be cheaper out in the suburbs nearer to home, but since I work in the CBD it's easier to go to one close to work than have to take time off or have to get our there in the middle of the day and then back to work etc. I'd worry about the cost more if I had to go more regularly, but today was the first time for about a year.


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