On 2/27/2016 7:11 AM, dpb wrote:
On 02/26/2016 11:00 PM, Don Y wrote:
....

Do those who "give up" slip back north of the border? Or, move further
south/bigger communities?

Over the long-haul I have no way of knowing. I know of only one who went
directly back to Canada since we've returned to the family farm (15 yr now) and
that was a specific family hardship case. The others leave for "greener
pastures" within the States at least initially; East and West coasts are
primary target areas of course; anywhere but "flyover country".

So, they've voted with their wallets to stay?

W/ the changes in US medical practices, many are becoming more frustrated but
that's not restricted to the Canadian imports; it's pretty universal throughout.

From discussions with my MD and other medical professionals (connections at
one of the local hospitals), this seems to be the case.

On the one hand, you can say its sour grapes as now pressures are being
brought to bear (that hadn't previously) on how they practice medicine. The
semi-god-like reverence for doctors has faded significantly over the course
of a single career; I'm not sure that's easy to accept.

OTOH, there may now be too much of a move to "bean counting". E.g.,
the new coding system breaks things down into such fine detail
that i wouldn't be surprised if some of the codes are only "applied"
ONCE, in a year, NATIONWIDE:
"eye injury; left; fall; trip; child's roller skate; while texting"

OToOH, my peeks inside medical practices suggest they are long overdue for
rethinking. Do you REALLY need all those bodies to deliver healthcare?
How do places with fewer staff "manage to cope"?

The reductions in Medicare/Medicaid pay schedules has forced several of the
rural hospitals into closure so we have several multi-county areas now with no
emergency response facilities at all...the local is hanging on but it's "iffy"
even though while still small by city standards at least are one of the
higher-populated counties with a regional retail hub from the surrounding area
as far as into SE CO, far NE NM, and the OK and TX panhandles.

I think we have ~10 hospitals. But, only one "trauma center". The
area covered is pretty large -- most hospitals have (and use on a
regular basis) helipads to airlift patients in.

There's also a bit of "book cooking" that happens, esp with INS
involvement. E.g., a truck full of "illegals" that crashes
will have them all treated at a local facility; but, INS won't
assume CUSTODY of them until afterwards (leaving the hospital
trying to get payment from the "patients" -- which will soon
be deported).

Of course, hospitals can play that game, as well: advertising
to more affluent Mexicans that they should come up, have their
baby delivered here (US citizen!) and get in a few days of shopping
before going back across the border...