Doctors underpaid

[sirus_virus]

For those of you longing to practice medicine for a whole lot less, they are working on it.

http://www.seniorjournal.com/NEWS/Medicare/6-08-09-MedicareMoves.htm

"The Bush administration on Tuesday proposed a federal rule that would cut Medicare reimbursements for physician services by 5.1% for 2007"

And this is a Republican, imagine what the democrats are going to do.

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[Faebinder]

For those of you longing to practice medicine for a whole lot less, they are working on it.

http://www.seniorjournal.com/NEWS/Medicare/6-08-09-MedicareMoves.htm

"The Bush administration on Tuesday proposed a federal rule that would cut Medicare reimbursements for physician services by 5.1% for 2007"

And this is a Republican, imagine what the democrats are going to do.

Here is this section from the article that I LOVE...

Administration officials said the cut is necessary to offset faster-than-expected increases in Medicare spending for physician services, the Times reports (Pear, New York Times, 8/9). Medicare reimbursements to physicians increased 10% in 2005, and reimbursements for physician services and hospital outpatient services combined are expected to increase 10.6% in 2007, according to the Wall Street Journal (Zhang, Wall Street Journal, 8/9).

Hey don't worry oh great politicians, you did a good thing... now the docs will see less medicare/medicaid patients as a result of this and thus medicare/medicaid spending will be lowered or kept at same level. Great Job. *Completely ignore the fact that those same people that wont be seen in the outpatient setting will go to the ER for a $2000.00 work up for their cough/fever.*

 

[Faebinder]

Oh and I forgot to mention my favorite.... This one...

Medicare May Trade Physician Pay Cut for Quality of Care Reports

If the AMA knows what's best for it at this point they would take the pay cuts from medicare/medicaid and reduce seeing medicare/medicaid patients.

 

[Faebinder]

*I should stop reading this in the morning, all it does is tick me off*

Here.

CMS Proposes Payment and Policy Changes for Acute Care Hospital Services to Inpatients

The Centers for Medicare & Medicaid Services (CMS) today issued a notice of proposed rulemaking that would begin the transition to the first significant revision of the Inpatient Prospective Payment System (IPPS) since its implementation in 1983. When fully implemented, which is planned to occur by fiscal year (FY) 2008 and potentially earlier, the revised IPPS would improve the accuracy of payment rates for inpatient stays by basing the weights assigned to Diagnosis Related Groups (DRGs) on hospital costs rather than charges, and adjusting the DRGs for patient severity.

The estimated market basket increase of 3.4 percent in FY 2007 would increase payments to acute care hospitals by $3.3 billion. Over 1000 hospitals in rural areas would see an average increase of 6.7 percent.

I guess they want all ambulatory docs to pack up and become hospitalists.

 

[sdn1977]

Fair enough.

I will ask one thing however:

Why is the centering of healthcare quality a desireable thing? It seems like all social policy is centered around the poor. In the US, the majority of people are NOT poor. Everybody loves to quote the 46 million uninsured number. There are all sorts of reasons for this, and I will not get into that, but it also means that there are 250 million people who ARE insured. I don't believe that there is some sort of totalitarian social justice in bringing down the quality of care for 250 million in order to improve it for 46 million. I will also point out that I am independently insuring my family on far less money than many of the uninsured make. This assuredly reflects poor choices on the part of some of these people, which makes the number who are actually unable to get insurance far less.

Universal Healthcare is a politicians dream. It will be a HUGE political beauracracy, thereby allowing the politician to put is hands in EVERYTHING. When something goes wrong, the politician can blame the greedy doctors who only want money. When something goes right, the politician can greet his constituents with all of the benefits that "he" has brought them. This already happens now, and we don't have Universal Healthcare. I BEG you to look at every institution in this country that is falling apart (from education to healthcare), and you will most assuredly find that the one common denominator is heavy government involvement.

Miami....you asked a question - why is centering of healthcare a desirable thing? To me - it is to set a standard by which we decide as a society we want our minimum to be. We've already decided, governmentally, that we want to immunize our children (thus the population) & reduce diseases of overcrowding (TB), poor superstructure systems (cholera, typhoid) & otherwise preventable diseases (polio). We aren't completely successful, but we still try & actually the government has put in place protections for physicians & drug companies to protect them against lawsuits tied to some of these attempts (the vaccine protection program).

The issue you bring up with your ability to insure yourself & your family for less than others...this is so dependent on what is available for individuals to buy (or is offered thru the workplace) & what their personal medical concerns are. I may be making a huge assumption, but I'm assuming you're young & have a young healthy family with no devastating, chronic illnesses. So...the insurance you bought was & is good for your needs.

But..that is not the case for everyone. I'm a pharmacist, so I see many folks with insurance & they often have huge deductibles, limited formularies, large copays & if they have a chronic illness - they could pay HUNDREDS of dollars per month in drugs alone. We could assume these are illness due to lifestyle alone - that helps us asuage our part in it & we can say they brought it on themselves. But...many people have illness which they had no part of creating - it just happened....the asmathic, the individual with epilepsy, the person who has rheumatoid arthritis at age 13. These are expensive disease in drugs alone - not including dr visits & labwork.

Then....there is the case of a person, who like my husband. At age 33 - he had a brain tumor. He is a dentist, makes a good income, could buy health, life, disability insurance before....but with that diagnosis and resultant surgery, which was curative.....he suddenly became uninsurable - for everything & at any price. He's now 57 & still uninsurable. There was a day - long before you ever got into medicine in which insurance was not portable...meaning I had to keep my job to keep my insurance. Fortunately, congress pass the insurance portability act & I'm able to change jobs & he is still covered as long as I'm in a group plan.

Personally, I don't think its necessarily the heavy government involvement that is the bad guy in all this. It is the "dirty" aspects of government involvement. Our system of government is very vulnurable to the influences of whomever the politician pays them the most. Medicare Part D is a perfect example. You'd think this would be a good thing - gives those seniors the opportunity to buy drug insurance if their retirement health program didn't offer it (& most don't). But, allowed those who had insurance to opt out. However, it has turned out to be a royal rip off for seniors. The govt has allowed the rules to reflect the insurers interest. The formularies can change at will & without notice. So....you may have started your patient on pravastatin in January, but in July, the insurance company decides they won't allow that drug anymore & will only allow simvastatin. Who gets jerked around - the pt, you, me....who wins...the private insurance company. You don't get to determine what will work for your pt & you often don't even get to keep your pt on the drug long enough to see the effect.

There is no reason, other than self serving economics for the insurance industry, to allow this kind of behavior. Someone needs to be able to set standards & rules because the insurance industry has proven time and again they can't police themselves. I'm not sure this administration can either - they are just as vulnurable to financial influence...but certainly something needs to change. You may not need to make a choice to eat or pay for medications, but I know many who do on a monthly basis.

I don't have an answer.....but I know the system as it is now is not working.

 

[MountainPharmD]

I had a physics professor at the University of Kansas sum this discussion up nicely. He was at a University function and found himself talking to Roy Williams, now the traitorous ex-basketball coach for KU. In jest they became talking about salaries. The physics professor wondered why the highly educated, most respected, internationally know professors at KU were paid peanuts compared to the basketball and football coaches. Coach William’s reply was “Well professor, things will change as soon as you can fill a basketball arena with fans who are paying to watch you teach physics.” Summed things up nicely for me.

 

[Faebinder]

I had a physics professor at the University of Kansas sum this discussion up nicely. He was at a University function and found himself talking to Roy Williams, now the traitorous ex-basketball coach for KU. In jest they became talking about salaries. The physics professor wondered why the highly educated, most respected, internationally know professors at KU were paid peanuts compared to the basketball and football coaches. Coach William’s reply was “Well professor, things will change as soon as you can fill a basketball arena with fans who are paying to watch you teach physics.” Summed things up nicely for me.

Heh.. start putting commercial adds in clinics?

 

[Miami_med]

Miami....you asked a question - why is centering of healthcare a desirable thing? To me - it is to set a standard by which we decide as a society we want our minimum to be. We've already decided, governmentally, that we want to immunize our children (thus the population) & reduce diseases of overcrowding (TB), poor superstructure systems (cholera, typhoid) & otherwise preventable diseases (polio). We aren't completely successful, but we still try & actually the government has put in place protections for physicians & drug companies to protect them against lawsuits tied to some of these attempts (the vaccine protection program).

The issue you bring up with your ability to insure yourself & your family for less than others...this is so dependent on what is available for individuals to buy (or is offered thru the workplace) & what their personal medical concerns are. I may be making a huge assumption, but I'm assuming you're young & have a young healthy family with no devastating, chronic illnesses. So...the insurance you bought was & is good for your needs.

But..that is not the case for everyone. I'm a pharmacist, so I see many folks with insurance & they often have huge deductibles, limited formularies, large copays & if they have a chronic illness - they could pay HUNDREDS of dollars per month in drugs alone. We could assume these are illness due to lifestyle alone - that helps us asuage our part in it & we can say they brought it on themselves. But...many people have illness which they had no part of creating - it just happened....the asmathic, the individual with epilepsy, the person who has rheumatoid arthritis at age 13. These are expensive disease in drugs alone - not including dr visits & labwork.

Then....there is the case of a person, who like my husband. At age 33 - he had a brain tumor. He is a dentist, makes a good income, could buy health, life, disability insurance before....but with that diagnosis and resultant surgery, which was curative.....he suddenly became uninsurable - for everything & at any price. He's now 57 & still uninsurable. There was a day - long before you ever got into medicine in which insurance was not portable...meaning I had to keep my job to keep my insurance. Fortunately, congress pass the insurance portability act & I'm able to change jobs & he is still covered as long as I'm in a group plan.

Personally, I don't think its necessarily the heavy government involvement that is the bad guy in all this. It is the "dirty" aspects of government involvement. Our system of government is very vulnurable to the influences of whomever the politician pays them the most. Medicare Part D is a perfect example. You'd think this would be a good thing - gives those seniors the opportunity to buy drug insurance if their retirement health program didn't offer it (& most don't). But, allowed those who had insurance to opt out. However, it has turned out to be a royal rip off for seniors. The govt has allowed the rules to reflect the insurers interest. The formularies can change at will & without notice. So....you may have started your patient on pravastatin in January, but in July, the insurance company decides they won't allow that drug anymore & will only allow simvastatin. Who gets jerked around - the pt, you, me....who wins...the private insurance company. You don't get to determine what will work for your pt & you often don't even get to keep your pt on the drug long enough to see the effect.

There is no reason, other than self serving economics for the insurance industry, to allow this kind of behavior. Someone needs to be able to set standards & rules because the insurance industry has proven time and again they can't police themselves. I'm not sure this administration can either - they are just as vulnurable to financial influence...but certainly something needs to change. You may not need to make a choice to eat or pay for medications, but I know many who do on a monthly basis.

I don't have an answer.....but I know the system as it is now is not working.

The problem here is that you want to set a minimum standard with my money.

I'm sorry to hear about your situation. It is unfortunate, but honestly in his case, the system worked. He was insured, and he received treatment. Yes, it's probably hard for him to get insurance now. You also seem to have managed to keep him insured, so the system is working for you again.

The government is ALWAYS going to be moved by money. EVERY institution is moved by money. The difference is, that a private institution has to provide a valid service that people want to pay for, while the government takes money for the "social good."

I will say this, and you will hate me for saying it. How do we define social good? If a brain tumor is truly cured, the person can continue to live a good life. If the medical condition recurrs, one must ask how many brain tumors society should pay for. In a private market, without all of the government interference that already exists, you and your husband would make that decision based on what you were willing to pay. In the current system, how do we know the answer? The $250,000+ worth of treatment for a complex case would have paid for numerous treatments for other people, or food for an overtaxed family, or jobs for those that are looking.

Resources in this world are scarce. There has to be some limit on how much we will spend. On a free market, the highest efficiency will be obtained and the most good will be done on the end. Don't confuse the government backed raping of the healthcare industry by a few insurance giants as being a free market.

 

[sdn1977]

The problem here is that you want to set a minimum standard with my money.

I'm sorry to hear about your situation. It is unfortunate, but honestly in his case, the system worked. He was insured, and he received treatment. Yes, it's probably hard for him to get insurance now. You also seem to have managed to keep him insured, so the system is working for you again.

The government is ALWAYS going to be moved by money. EVERY institution is moved by money. The difference is, that a private institution has to provide a valid service that people want to pay for, while the government takes money for the "social good."

I will say this, and you will hate me for saying it. How do we define social good? If a brain tumor is truly cured, the person can continue to live a good life. If the medical condition recurrs, one must ask how many brain tumors society should pay for. In a private market, without all of the government interference that already exists, you and your husband would make that decision based on what you were willing to pay. In the current system, how do we know the answer? The $250,000+ worth of treatment for a complex case would have paid for numerous treatments for other people, or food for an overtaxed family, or jobs for those that are looking.

Resources in this world are scarce. There has to be some limit on how much we will spend. On a free market, the highest efficiency will be obtained and the most good will be done on the end. Don't confuse the government backed raping of the healthcare industry by a few insurance giants as being a free market.

I'll ignore the angry tone of your reply since I don't think you're truly angry at me....and I don't agree that resources are scarce. Natural perhaps..but the resources we have as people, techonology, knowledge & ability are endless.

And, yes, the system worked for me - just as it does for you. You are buying health insurance. You are in the group of folks who are insurable - your risk is spread among all those that are insured. You probably purchased your health insurance from a group since you're in medical school (I'm familiar with the choices...my daughter is in medical school) - so your risk is spread among all those insured. You'll continue to be able to buy it as long as you stay in the group & stay healthy.

You stated that I want to set a minimum health care standard with YOUR money. NO! We as a society have already set minimum standards with OUR tax dollar money - not just YOURS. I'd like to raise that standard as we have thoughout our history as a country. A century ago...we didn't have the standards or even the opportunity of having standards & folks were terrified of things we no longer worry about. I recall as a child mothers not allowing their children to swim in public pools in the summer for fear of polio.

I gave you immunizations as an example, we also have nutritional standards which allow food groups (which your wife & children took advantage of, but you dismiss as unnecessary), we have standards that there can be no reusable syringes & needles except under very rare circumstances, we have standards of care for hospitals to receive federal funding (& if a hospital doesn't receive Medicare its likely not going to receive private insurance payors)...we could go on and on to other standards our society has set - roads, schools, #'s of law enforcement or firefighters per thousand.....that is the role of society - to set standards.

Are you advocating we should only be able to have access to that which money can buy? Because.....your medical education is funded by part of MY tax money. Your potential income was partially funded by MY tax money. The road you drove to school on is funded by part of MY tax money. The protection & treatment if your children suffer an adverse effect from a vaccination is funded by MY tax money.

However...MY tax money is part of a whole - that of our society. It is not your money nor mine....it is ours. We all pay into the whole & as a society we choose which things are important. Obviously...in our country, healthcare is not yet one of the important things.

Finally.....no....I don't hate you for saying how much it was worth for my husband's curative surgery. It may not have been in the social good, but he has gone on to be a productive dentist (who by the way doesn't take Medicaid because of the hassle, but will see any child for anything & if the family cannot pay, he writes it off as charity). I was 33 at the time & I recall very clearly the answer the Chief of Neurosurgery at Stanford told me when I asked how much would this cost. He looked at me and asked....would it matter? I told him then & I'd say the same now...no. I knew our lives could change in an instant...we could lose our home, his business, he could be a vegetable & I could be a widow with 2 small children. But....I was willing to make that choice to lose everything.

You are young & seem very quick to judge those who are an instant away from losing everything they have. Think about how you might feel if your wife was broadsided this afternoon and one of your children was injured so severely he or she needed surgery, rehabilitation & continuing care. Could you mobilize $50,000 for surgery & 1 day of an PICU stay? Could you possibly make enough money in your lifetime for some the of cases which for no other reason than just bad luck don't turn out well. If you had to make the choice......could you honestly say no - to your child or any other child, wife, mother.....I personally feel it is for the social good we do set minimum standards of care. I would want your child rescusitated just as I would any other child.

We should not have to barter, scrape nor beg for healthcare, yet some do. Our society should have higher standards than that - just my opinion for sure. I respect yours....we just have a differing view which is why we all get to vote.

 

[fab4fan]

sdn1977: Thans for your calm and mature reply to a post that could have spun things seriously out of conrol.

I'm glad to hear that your husband is doing well and working again.

 

[NonTradMed]

Fair enough.

I will ask one thing however:

Why is the centering of healthcare quality a desireable thing? It seems like all social policy is centered around the poor. In the US, the majority of people are NOT poor. Everybody loves to quote the 46 million uninsured number. There are all sorts of reasons for this, and I will not get into that, but it also means that there are 250 million people who ARE insured. I don't believe that there is some sort of totalitarian social justice in bringing down the quality of care for 250 million in order to improve it for 46 million. I will also point out that I am independently insuring my family on far less money than many of the uninsured make. This assuredly reflects poor choices on the part of some of these people, which makes the number who are actually unable to get insurance far less.

Universal Healthcare is a politicians dream. It will be a HUGE political beauracracy, thereby allowing the politician to put is hands in EVERYTHING. When something goes wrong, the politician can blame the greedy doctors who only want money. When something goes right, the politician can greet his constituents with all of the benefits that "he" has brought them. This already happens now, and we don't have Universal Healthcare. I BEG you to look at every institution in this country that is falling apart (from education to healthcare), and you will most assuredly find that the one common denominator is heavy government involvement.

Well, centering how health care is one way to safeguard one of the most valuable commodity to a knowledge-based economy such as the US: that of human capital. I believe there have studies shown that sick people tend to cost businesses in loss of worker productivity.

Prevention and early detection is the cheapest way to avoid that cost because it makes for a healthy population. Focusing on the poor is a good thing because we are trying to 'optimize' our usage of of people. Since (presumably) the middle and upper class of people are already productive citizens and paying taxes, there is no need to give them special attention, but the talents of the 'poor' are being under-utilized and thus we, as a society, are losing out on that untapped resource. Thats' why poverty is bad for society, because it wastes a valuable resource, namely people who can become productive citizens.

Now, in US society, I can see the argument that there are many people who are poor because of poor decision making skills, and not because of circumstances. But that doesnt' mean we shouldn't try to give people equal opportunities or second chances. I have issues with our current welfare system, but social mobility is one of America's strongest points. Lack of it makes for an unhappy populace and an unstable country. It's human nature to see something and knowing that their kids may enjoy some of the good things life provides.

As for universal healthcare, I'm not a public policy maker so I'm not sure what the best way to provide for health care is in this country. However, I will say that there is a middle way between universal healthcare and the approach we have right now. I dont' think I have stated I wanted a one payer system, and just saying that the current system is bad, doesn't mean I automatically want to go the one payer system.

I understand that people dont' like to see 'heavy' gov't involvement, but I also think in some areas, too little gov't involvement is also bad. When gov't stop focusing on education and healthcare, it can be disastorous for the country. I will be visiting my grandmothers in China this coming winter break and that is a country which no longer funds either healthcare or education. Educational at all levels requires tuition, very heavy for the majority of the peasant population, and healthcare is mostly a cash based system since health insurance is scarce. There's no medicaid or medicare.

The end result is that many children can be seen on the streets working rather than going to school, and people dying literally on the doorsteps of hospitals (b/c hospital has no money for indigent patients).

Diseases such as TB and hepititis are rampant and rising again due to lack of focus on public health. And AIDS is seeing an explosion in the country b/c the gov't lacks the infrastructure (and willpower) to prevent its spread (as well as funding for education on the transmission of this disease). While the US is not nearly that negligent in its duties to healthcare, I do think the attention paid to healthcare is warranted b/c of teh severe toll on human capital if it is ignored.


Btw, I don't think our educational system is falling apart. It certainly can be improved on, but it's not all that bad. And if it is, it's not because of gov't involvement. The countries which bests us in international standarized exams such as S. Korea and Japan have very heavy gov't involvement in education including a nationalized curriculum and a series of nationwide examination system. All of this is done with more direct gov't involvement than anything in this country.

 

[Miami_med]

I'll ignore the angry tone of your reply since I don't think you're truly angry at me....and I don't agree that resources are scarce. Natural perhaps..but the resources we have as people, techonology, knowledge & ability are endless.

And, yes, the system worked for me - just as it does for you. You are buying health insurance. You are in the group of folks who are insurable - your risk is spread among all those that are insured. You probably purchased your health insurance from a group since you're in medical school (I'm familiar with the choices...my daughter is in medical school) - so your risk is spread among all those insured. You'll continue to be able to buy it as long as you stay in the group & stay healthy.

You stated that I want to set a minimum health care standard with YOUR money. NO! We as a society have already set minimum standards with OUR tax dollar money - not just YOURS. I'd like to raise that standard as we have thoughout our history as a country. A century ago...we didn't have the standards or even the opportunity of having standards & folks were terrified of things we no longer worry about. I recall as a child mothers not allowing their children to swim in public pools in the summer for fear of polio.

I gave you immunizations as an example, we also have nutritional standards which allow food groups (which your wife & children took advantage of, but you dismiss as unnecessary), we have standards that there can be no reusable syringes & needles except under very rare circumstances, we have standards of care for hospitals to receive federal funding (& if a hospital doesn't receive Medicare its likely not going to receive private insurance payors)...we could go on and on to other standards our society has set - roads, schools, #'s of law enforcement or firefighters per thousand.....that is the role of society - to set standards.

Are you advocating we should only be able to have access to that which money can buy? Because.....your medical education is funded by part of MY tax money. Your potential income was partially funded by MY tax money. The road you drove to school on is funded by part of MY tax money. The protection & treatment if your children suffer an adverse effect from a vaccination is funded by MY tax money.

However...MY tax money is part of a whole - that of our society. It is not your money nor mine....it is ours. We all pay into the whole & as a society we choose which things are important. Obviously...in our country, healthcare is not yet one of the important things.

Finally.....no....I don't hate you for saying how much it was worth for my husband's curative surgery. It may not have been in the social good, but he has gone on to be a productive dentist (who by the way doesn't take Medicaid because of the hassle, but will see any child for anything & if the family cannot pay, he writes it off as charity). I was 33 at the time & I recall very clearly the answer the Chief of Neurosurgery at Stanford told me when I asked how much would this cost. He looked at me and asked....would it matter? I told him then & I'd say the same now...no. I knew our lives could change in an instant...we could lose our home, his business, he could be a vegetable & I could be a widow with 2 small children. But....I was willing to make that choice to lose everything.

You are young & seem very quick to judge those who are an instant away from losing everything they have. Think about how you might feel if your wife was broadsided this afternoon and one of your children was injured so severely he or she needed surgery, rehabilitation & continuing care. Could you mobilize $50,000 for surgery & 1 day of an PICU stay? Could you possibly make enough money in your lifetime for some the of cases which for no other reason than just bad luck don't turn out well. If you had to make the choice......could you honestly say no - to your child or any other child, wife, mother.....I personally feel it is for the social good we do set minimum standards of care. I would want your child rescusitated just as I would any other child.

We should not have to barter, scrape nor beg for healthcare, yet some do. Our society should have higher standards than that - just my opinion for sure. I respect yours....we just have a differing view which is why we all get to vote.

I don't believe that my post was angry at all. Atleast it wasn't meant to be. You are right that we won't agree on many things, but I will point out some things that are incorrect about your assumptions.

I do not have group insurance. The cost is too high for me to include my family on my school plan, so I have us all insured independently. This costs me just under $400 a month for a plan that carries a nearly catastrophic deductable. Because I have had to do this, I have neglected treatment and observation for some of my own potentially serious health issues because I did not want to pay my deductable. I would not assume that I do not understand serious medical complications.

The tax money is Mine, and it is being taken against my will. If I chose not to pay, I would most assuredly be arrested and thrown in prison. That leaves me very little choice. Having some politician take what I own and utilize it for someone elses personal interest is not communal, and I do not feel much ownership. I agree that I drive on roads that we both paid for. I disagree with much of our funding system for things. I would love to change much of our system, but I am adamantly against taking our system further down the road of big government.

Lastly, I am not judging you. I would have done what you did in your situation, and I would have accepted aid. I'm practical in that respect. We all do what we have to do. My issue is with the system itself. I won't explain this any further. Feel free to read my blog.

Best of luck

 

[Miami_med]

Well, centering how health care is one way to safeguard one of the most valuable commodity to a knowledge-based economy such as the US: that of human capital. I believe there have studies shown that sick people tend to cost businesses in loss of worker productivity.

Prevention and early detection is the cheapest way to avoid that cost because it makes for a healthy population. Focusing on the poor is a good thing because we are trying to 'optimize' our usage of of people. Since (presumably) the middle and upper class of people are already productive citizens and paying taxes, there is no need to give them special attention, but the talents of the 'poor' are being under-utilized and thus we, as a society, are losing out on that untapped resource. Thats' why poverty is bad for society, because it wastes a valuable resource, namely people who can become productive citizens.

Now, in US society, I can see the argument that there are many people who are poor because of poor decision making skills, and not because of circumstances. But that doesnt' mean we shouldn't try to give people equal opportunities or second chances. I have issues with our current welfare system, but social mobility is one of America's strongest points. Lack of it makes for an unhappy populace and an unstable country. It's human nature to see something and knowing that their kids may enjoy some of the good things life provides.

As for universal healthcare, I'm not a public policy maker so I'm not sure what the best way to provide for health care is in this country. However, I will say that there is a middle way between universal healthcare and the approach we have right now. I dont' think I have stated I wanted a one payer system, and just saying that the current system is bad, doesn't mean I automatically want to go the one payer system.

I understand that people dont' like to see 'heavy' gov't involvement, but I also think in some areas, too little gov't involvement is also bad. When gov't stop focusing on education and healthcare, it can be disastorous for the country. I will be visiting my grandmothers in China this coming winter break and that is a country which no longer funds either healthcare or education. Educational at all levels requires tuition, very heavy for the majority of the peasant population, and healthcare is mostly a cash based system since health insurance is scarce. There's no medicaid or medicare.

The end result is that many children can be seen on the streets working rather than going to school, and people dying literally on the doorsteps of hospitals (b/c hospital has no money for indigent patients).

Diseases such as TB and hepititis are rampant and rising again due to lack of focus on public health. And AIDS is seeing an explosion in the country b/c the gov't lacks the infrastructure (and willpower) to prevent its spread (as well as funding for education on the transmission of this disease). While the US is not nearly that negligent in its duties to healthcare, I do think the attention paid to healthcare is warranted b/c of teh severe toll on human capital if it is ignored.


Btw, I don't think our educational system is falling apart. It certainly can be improved on, but it's not all that bad. And if it is, it's not because of gov't involvement. The countries which bests us in international standarized exams such as S. Korea and Japan have very heavy gov't involvement in education including a nationalized curriculum and a series of nationwide examination system. All of this is done with more direct gov't involvement than anything in this country.

If businesses were losing money due to a loss of worker productivity, they would fund the healthcare. They will do whatever makes them more money. The cost of treatment exceeds the loss incurred.

I don't know where you get your statistics on "people optimization." Please cite me any evidence that spending money on poor people creates better productivity than leaving it in the hands of those who earn it. I am NOT criticizing helping the poor. I just take issue with this argument. Charity is also something that has a proper amount, and in a free market, there is plenty of charity service. In the US, there is plenty of charity now, and I see no evidence that we are about to stop helping people without government interference.

Your example of China is flawed. The communist government has kept such a strong grip on its population that the richest, largerst, and most powerful nation in the region has lagged INCREDIBLY far behind all of its more economically open counterparts over the last 50 years. If the government stymies its economy, then takes its confiscated loot and pays for things that are not healthcare, of course healthcare will be poor. Of course, in a free market, with a thriving economy, healthcare would improve significantly without interference by the government. Healthcare is a desired commodity, and it would be funded by a free market at its true value in a free market.

As I said before, resources are scarce. Scarce doesn't mean rare, but it does mean not infinite. We repeatedly talk about how the boomers are going to bankrupt Medicare, how physician's reimbursements are dropping as demand rises, and how healthcare is approaching 20% of GDP. We are worried about these things because healthcare doesn't exist infinitely. It must be rationed in some way, and as with all things, the greatest efficiency takes place in a free market. In time, technology will improve healthcare in line with demand, but this also requires an investment of scarce economic resources, and we can all agree that 100% of GDP being spent on healthcare research would be bad for everyone. Thus, the market is necessary to determing optimal spending on this commodity.

 

[Miami_med]

sdn1977: Thans for your calm and mature reply to a post that could have spun things seriously out of conrol.

I'm glad to hear that your husband is doing well and working again.

Was my post too non-PC for you?

 

[tncekm]

Was my post too non-PC for you?

It was a great post--I have no clue how anyone could describe it as "angry" or "immature".

People just really can't handle hearing the truth, its amazing.

 

[Faebinder]

It was a great post--I have no clue how anyone could describe it as "angry" or "immature".

People just really can't handle hearing the truth, its amazing.

Agreed, I didn't think it was angry or immature... people have a hard time accepting the facts.

I tell the same to everyone ..... Everyone wants the best healthcare money can buy... and I tell them... Healthcare is like a Ferrari everyone loves to have but can't afford... you should be happy with your Toyota and shouldn't expect everyone's Taxes to pay for your Ferrari. The problem is everyone wants the Ferrari but refuse to pay for it... so the costs go for the provider.

Sooner or later the system will crack... you'll see... eventually everyone who refuses to pay for the system will end up going to the ER for everything... they already do that now anyway.... go to the ER for a monthly asthma exacerbation and get some albuterol pump there for free.

 

[Avrelian]

;4467466 Healthcare is like a Ferrari everyone loves to have but can't afford... you should be happy with your Toyota

Do you know that there are a bunch of countries where you can go and get your ferrari for $0,00 ? Oh yea I forgot... Doctors are actually NOT Gods there, they are real people and make no more than a lousy Ph.D, which is even less than average salary.

 

[tncekm]

Do you know that there are a bunch of countries where you can go and get your ferrari for $0,00 ? Oh yea I forgot... Doctors are actually NOT Gods there, they are real people and make no more than a lousy Ph.D, which is even less than average salary.

Too bad in those countries the Ferrari's are usually broken down and the free Ferrari is "free", but you've gotta wait in line. In fact, the line is so long sometimes you end up dead before you ever get that ferarri.

Doctors aren't God's anywhere, and they shouldn't be. They are a commodity. The just so happen to be a high value commodity. In laymens terms: 'they're worth *gasp* more' because *double gasp* not everyone is capable or willing to be a doctor. And, just like everything else, in a capitalistic society we get 'better commodities' (e.g. better doctors) because the best and brightest strive to be good, better, and best because of the oh-so-controversial fact that money is a great incentive for great people to do great things. If you're going to make sure that a person capable of doing great things is not only "not rewarded" but technically raped then the people who are capable of such things will sit on their asses and do as little as possible. Its human nature...socialists haven't figured it out yet.

edit: don't get me wrong. There is more to me personally becoming a doctor than money. Money is not at the top of my list, but its always a factor in anything I will do. Helping others is only nice if your personal / family life isn't ruined over it.

 

[Faebinder]

Figured I'd quote LaDoc00 on one post he made in the past about the $150K+ medical student loans that doctors have...

I want to add: Student loan debt is THE most dangerous type of debt outside of loan sharking.

Realize:
1.) It CANNOT be discharged through bankruptcy.
2.) It CANNOT be used as a state or federal income tax deduction if you make over 70K/year.
3.) It is typically does NOT have an interest rate cap. HEAL loans have been as high as 18+%, credit card APR level.
4.) It CAN cause your wages to be garnished, even if you move abroad.
5.) It CAN cause international bail bondsmen to arrest you abroad in the event of non-payment unless you reside in a non-treaty country.
6.) Loan money does NOT guarantee you will finish medical school sucessfully, get into a residency, fellowship or have a paying job in medicine. It is a RISK, not a secure investment. For many with borderline academic skills, putting 30K on black in Vegas would be a better use of your money.
7.) Student loans also MUST be paid even in the event you are permenantly disabled. Therefore you MUST carry premium professional disability insurance for the remainder of the term.
8.) It can significantly LIMIT your ability to pre-qualify for home loans. So much so in fact, you wont be able to reside in high cost of living areas within the US.
9.) Missed payments can have marked effects on your credit rating. Even if you are moving between addresses for residency, fellowship or your first job, a failure to make payments can be devasting on your FICO.
10.) Many Medical Schools do NOT care at all about your financial health or future job prospects. No more than Cheney cares about the well beings of Iraqis, dont fool yourself people!

That's a pretty accurate assessment of the risk taken by all docs. #9 is ever so dangerous...

 

[Avrelian]

[/quote] 4.) It CAN cause your wages to be garnished, even if you move abroad.
5.) It CAN cause international bail bondsmen to arrest you abroad in the event of non-payment unless you reside in a non-treaty country.[/quote]

5. And how many countries in this treaty? And what do these bondsmen will do with me, even if they have an authority to arrest me? Put me into local jail? may be they have their own, in each country of this treaty? may be they will "deport" me back to the States? And what they gonna do with me in States? This is just ridiculous.
4. Only the judge can garnish wages, whether here or abroad. I have a very hard time believing some judge say in Finland or Argentina or wherever does care about loan sharks from US of A. It takes yeeeaaars to get that done too. Meantime if such thing will ever happen your employer will fire you on the spot and hire 5 minutes later, and will ask your shark to do it again.


Finally lets imagine such a picture. You graduated from medschool, or even residency, maxed your loans, and than decided not to be a doctor anymore. Say, you want to be an artist, or a writer. You dont have a job, you dont have an income. You obviously dont pay your loans. And? What do you think they gonna do? Write you an angry letter? Force you to work in the hospital? Force you into the military? You americans talk so much about your freedom meantime you really live in an imaginary jail which you build yourselves for your own use.

 

[premediate]

I don't know if anyone else posted this information. This is a average salary of US actors (http://www.princetonreview.com/cte/profiles/facts.asp?careerID=2)

# of people in profession: 139,000
Average hours per week: 45
Average starting salary: $15,320
Average salary after 5 years: $23,470
Average salary after 10 to 15 years: $53,320

Therefore, it is known that the average doctor makes 150k-300k a year. We are still the highest paid profession. Thats the misconception that we see with whats on T.V. A lot of poor people look at enertaining (sport, acting) as an excape from poverty. However, education is the only way because the chances of you making millions as a entertainer are slim. Average salary of a NFL star is 1.1 million dollar and average career is 3 years. A doctor that works for 30 years making 300k will make 9 million in their carreer. If you invest your money right you could be a millionaire. Looks at facts not what you see on T.V. Rich people only make up 3 % of the society.

 

[Avrelian]

Too bad in those countries the Ferrari's are usually broken down and the free Ferrari is "free", but you've gotta wait in line. In fact, the line is so long sometimes you end up dead before you ever get that ferarri.

That is right only for sertain surgeries which would have cost here 200-500K.
This is a death sentence for an average American, insured or uninsured. At least there you have a chance.
I am familiar with healthcare systems of Ukraine, Russia and Argentina.
For an average surgery there are no lines. I had 2 hernias when I was a kid, I got to the hospital a week before the surgery and got out 7-10 day after. What did it cost us? My mother bought a nice book for the surgeon. She didnt have to, of course. Drugs&food were free. Probably half of her daily wages total for the book.
Couple years ago I had an ingrown nail on my foot to remove. It took 15 minutes between opening a hospital's door and a fisrt cut. That is to get an appointment, wait in line ( none ), visit itself, ets. It cost me around $2.5-2.7 to pay for drugs , bandages, ets ( the evil face of the capitalism ) I could have bought them for $2 200 yards away but usually you save the trip& let the doctor get some dough of ya. I went there probably 5 times more to change bandages, ets. In my last visit I brought a chocolate bar, but my doctor wasnt there so the nurse got it all. Oh well.

So, do you seriously think that an american surgeon in an american clinic would remove a nail or an hernia better than any other surgeon in the world? Do you seriously think that you can treat a cold , a gastritis or an ulcer better than any doctor anywhere on this planet, outside of US?

Doctors aren't God's anywhere, and they shouldn't be. They are a commodity. The just so happen to be a high value commodity. In laymens terms: 'they're worth *gasp* more' because *double gasp* not everyone is capable or willing to be a doctor. And, just like everything else, in a capitalistic society we get 'better commodities' (e.g. better doctors) because the best and brightest strive to be good, better, and best because of the oh-so-controversial fact that money is a great incentive for great people to do great things. If you're going to make sure that a person capable of doing great things is not only "not rewarded" but technically raped then the people who are capable of such things will sit on their asses and do as little as possible. Its human nature...socialists haven't figured it out yet.

In the capitalist society, (which apparently consist of US alone ) doctors are a high value commodity just becouse there are very few schools with very few students which prepare doctors + it is close to impossible for a foreign doctor to pass the bar. You thought that out of nation of 300 000 000 you can squeeze only a few thousands graduates each year? No. Its just designed this way so you can enjoy a fat living and be able to tell that one cant have healthcare if he cant "afford " to pay you whatever you think you worth. Lets suggest my name is Bill Gates and I want to build 50 medical schools designed for 1000 students each and I will even pay for their tuition+ room&board+ a stipendy. Do you really think I will have a hard time fill them up with bright enough to be a doctor people? And how much doctors as commodity will cost after those 50000 will graduate? After 500 000 will graduate? How you guys with 200K loans will compete with doctors who do not owe a thing? Now, whether I am Bill Gates or not, will I will be allowed to do that ? No. And why, if it could solve a whole bunch of healthcare problems? I am sure you know the answer.
I've been chatting recently with one doctor from Kiev. His salary is $130 a month. Average salary in Kiev is $300-400. Construction workers make more than that. Average 1 bedroom condo of 450-550 ft not too far from center is $60 000 and up to buy. Its not easier to become a doctor overthere ( 9 to 11 years after highschool) and its even harder to get into medical school, as you can apply only to 1 school at a time.

don't get me wrong. There is more to me personally becoming a doctor than money. Money is not at the top of my list, but its always a factor in anything I will do. Helping others is only nice if your personal / family life isn't ruined over it.

You also dont get me wrong, I dont want doctors to work for a candy. But
I have a hard time buying that an appendectomy should cause any bankruptcy, whether patient is insured, or not.

 

[8744]

That is right only for sertain surgeries which would have cost here 200-500K.
This is a death sentence for an average American, insured or uninsured. At least there you have a chance.
I am familiar with healthcare systems of Ukraine, Russia and Argentina.
For an average surgery there are no lines. I had 2 hernias when I was a kid, I got to the hospital a week before the surgery and got out 7-10 day after. What did it cost us? My mother bought a nice book for the surgeon. She didnt have to, of course. Drugs&food were free. Probably half of her daily wages total for the book.
Couple years ago I had an ingrown nail on my foot to remove. It took 15 minutes between opening a hospital's door and a fisrt cut. That is to get an appointment, wait in line ( none ), visit itself, ets. It cost me around $2.5-2.7 to pay for drugs , bandages, ets ( the evil face of the capitalism ) I could have bought them for $2 200 yards away but usually you save the trip& let the doctor get some dough of ya. I went there probably 5 times more to change bandages, ets. In my last visit I brought a chocolate bar, but my doctor wasnt there so the nurse got it all. Oh well.

So, do you seriously think that an american surgeon in an american clinic would remove a nail or an hernia better than any other surgeon in the world? Do you seriously think that you can treat a cold , a gastritis or an ulcer better than any doctor anywhere on this planet, outside of US?



In the capitalist society, (which apparently consist of US alone ) doctors are a high value commodity just becouse there are very few schools with very few students which prepare doctors + it is close to impossible for a foreign doctor to pass the bar. You thought that out of nation of 300 000 000 you can squeeze only a few thousands graduates each year? No. Its just designed this way so you can enjoy a fat living and be able to tell that one cant have healthcare if he cant "afford " to pay you whatever you think you worth. Lets suggest my name is Bill Gates and I want to build 50 medical schools designed for 1000 students each and I will even pay for their tuition+ room&board+ a stipendy. Do you really think I will have a hard time fill them up with bright enough to be a doctor people? And how much doctors as commodity will cost after those 50000 will graduate? After 500 000 will graduate? How you guys with 200K loans will compete with doctors who do not owe a thing? Now, whether I am Bill Gates or not, will I will be allowed to do that ? No. And why, if it could solve a whole bunch of healthcare problems? I am sure you know the answer.
I've been chatting recently with one doctor from Kiev. His salary is $130 a month. Average salary in Kiev is $300-400. Construction workers make more than that. Average 1 bedroom condo of 450-550 ft not too far from center is $60 000 and up to buy. Its not easier to become a doctor overthere ( 9 to 11 years after highschool) and its even harder to get into medical school, as you can apply only to 1 school at a time.



You also dont get me wrong, I dont want doctors to work for a candy. But
I have a hard time buying that an appendectomy should cause any bankruptcy, whether patient is insured, or not.

You were in the hospital for almost three weeks for a hernia repair? Good Lord. What did you do for the two weeks and five days that you really didn't need to be in the hospital?

There are about 25,000 medical graduates every year, not a few thousand. And if you look, there is about one doctor per 100 people. Why would you need more?

There is no doctor shortage. Just a shortage of doctors who want to live in Cousincouple, Arkansas or Boffmasister, Kansas. And there is also a shortage of patients who are willing to pay for medical care. I have patients, optimistically called "self pay," who probably spend enough money on beer, cigarettes, and other luxury items to pay out of pocket for all but the most catastrophic medical expense but don't because it's not important enough to them to make a priority. They make their payments on their bass boat, however, because the title company means business and will repo it faster than you can say "Copenhagen."

On the other hand they know that they can always go to the Emergency Department if they get really sick and nobody will ever expect them to pay a dime.

Oh, and I am familar with the health care in Greece, my ancestral homeland, where they have one of those wonderful socialistic systems. What they acutally have is a two-tier system where those who can pay for private doctors, go to private hospitals, and wouldn't be caught dead in a public hospital where the care is so substandard, by American standards, that my mother had to hire a private nurse when my grandmother was hospitalized to make sure somebody took care of her.

Additionally, doctors over there don't exactly work as hard as we do over here as they are only human and if you remove the incentive to work hard and efficiently, nobody will. The private doctors work hard becasue they get paid, usually under the table to avoid taxes. The public doctors are just the usual civil servants and treat their jobs accordingly.

Socialized medicine is great unless you are really sick.

 

[dutchman]

You were in the hospital for almost three weeks for a hernia repair? Good Lord. What did you do for the two weeks and five days that you really didn't need to be in the hospital?

There are about 25,000 medical graduates every year, not a few thousand. And if you look, there is about one doctor per 100 people. Why would you need more?

There is no doctor shortage. Just a shortage of doctors who want to live in Cousincouple, Arkansas or Boffmasister, Kansas. And there is also a shortage of patients who are willing to pay for medical care. I have patients, optimistically called "self pay," who probably spend enough money on beer, cigarettes, and other luxury items to pay out of pocket for all but the most catastrophic medical expense but don't because it's not important enough to them to make a priority. They make their payments on their bass boat, however, because the title company means business and will repo it faster than you can say "Copenhagen."

On the other hand they know that they can always go to the Emergency Department if they get really sick and nobody will ever expect them to pay a dime.

Oh, and I am familar with the health care in Greece, my ancestral homeland, where they have one of those wonderful socialistic systems. What they acutally have is a two-tier system where those who can pay for private doctors, go to private hospitals, and wouldn't be caught dead in a public hospital where the care is so substandard, by American standards, that my mother had to hire a private nurse when my grandmother was hospitalized to make sure somebody took care of her.

Additionally, doctors over there don't exactly work as hard as we do over here as they are only human and if you remove the incentive to work hard and efficiently, nobody will. The private doctors work hard becasue they get paid, usually under the table to avoid taxes. The public doctors are just the usual civil servants and treat their jobs accordingly.

Socialized medicine is great unless you are really sick.

100% correct. You take away the incentives to practice medicine and I will like to see the quality and quantity of people going to medschool.

 

[Avrelian]

You were in the hospital for almost three weeks for a hernia repair? Good Lord. What did you do for the two weeks and five days that you really didn't need to be in the hospital?

well i had 2 hernias actually, dont know if it matters. first week- analysis, blood, urine and stuff, after the surgery-- waiting till i can actually walk without ruining everything. i really dont understand your surprise. There is no shortage of hospitals in my country. When I had a minor concussion I spent in the hospital 22 days. What did I do there? Played cards with other patients, talk, walk in the park mostly. Sort of a vacation.
In Argentina they kick your ass out real fast, I know that. I guess the same here, whith the difference that you have to file bankruptcy after you get out.
Just an example . My wife has a very good health insurance. So, one day before her due date, she felt like its coming. We went to the hospital where she was supposed to deliver. Hospital sent her to her doctor, doctor showed up an hour later, and it was "too early". we went back home. after a several hours we come back again with severe paines and stuff. There is no doctor. Hospital says its too early. I mean common! She couldnt even walk! No, its too early. We driving half an hour back home. We are back in 2 hours, and she is dealated ( sorry for spelling ) 6 sms.. Actual birth happened 3-4 hours later. So, in Ukraine , she'd go to the hospital a week before her due date, and would have stayed there for 3 weeks after birth. That if there are no complications. Way more, if any. Cost= $0.00 plus some gratuity.

There are about 25,000 medical graduates every year, not a few thousand. And if you look, there is about one doctor per 100 people. Why would you need more?

Francly i doubt there are 3 000 000 MDs in USA. And it doesnt go along with 25K a year number.

There is no doctor shortage. Just a shortage of doctors who want to live in Cousincouple, Arkansas or Boffmasister, Kansas. And there is also a shortage of patients who are willing to pay for medical care. I have patients, optimistically called "self pay," who probably spend enough money on beer, cigarettes, and other luxury items to pay out of pocket for all but the most catastrophic medical expense but don't because it's not important enough to them to make a priority. They make their payments on their bass boat, however, because the title company means business and will repo it faster than you can say "Copenhagen."

On the other hand they know that they can always go to the Emergency Department if they get really sick and nobody will ever expect them to pay a dime.

People will always want to have free things. Many doctors would also gladly make you a surgery/treatment you dont need, especially if u have money to pay for it. Take a notice that a surgeon who is a public servant will never make a surgery you dont need.

Oh, and I am familar with the health care in Greece, my ancestral homeland, where they have one of those wonderful socialistic systems. What they acutally have is a two-tier system where those who can pay for private doctors, go to private hospitals, and wouldn't be caught dead in a public hospital where the care is so substandard, by American standards, that my mother had to hire a private nurse when my grandmother was hospitalized to make sure somebody took care of her.

Additionally, doctors over there don't exactly work as hard as we do over here as they are only human and if you remove the incentive to work hard and efficiently, nobody will. The private doctors work hard becasue they get paid, usually under the table to avoid taxes. The public doctors are just the usual civil servants and treat their jobs accordingly.

Socialized medicine is great unless you are really sick.

Those private doctors, before they get paid, spend years and years perfectioning their skills in public hospitals. Very good surgeons, or top-class specialists do make money in any healthcare system. There is always a line to a good surgeon-- and where is the line there is a pricetag to cut it
But, you gotta be good. And for better care, with nurses as well as with doctors, there is always a gratuity/tipping system. Works well.

 

[Avrelian]

100% correct. You take away the incentives to practice medicine and I will like to see the quality and quantity of people going to medschool.

There is no problem neither with quantity, nor with quality of people going to medschools. Proved and tested over and over all over the world

 

[8744]

well i had 2 hernias actually, dont know if it matters. first week- analysis, blood, urine and stuff, after the surgery-- waiting till i can actually walk without ruining everything. i really dont understand your surprise. There is no shortage of hospitals in my country. When I had a minor concussion I spent in the hospital 22 days. What did I do there? Played cards with other patients, talk, walk in the park mostly. Sort of a vacation.
In Argentina they kick your ass out real fast, I know that. I guess the same here, whith the difference that you have to file bankruptcy after you get out.
Just an example . My wife has a very good health insurance. So, one day before her due date, she felt like its coming. We went to the hospital where she was supposed to deliver. Hospital sent her to her doctor, doctor showed up an hour later, and it was "too early". we went back home. after a several hours we come back again with severe paines and stuff. There is no doctor. Hospital says its too early. I mean common! She couldnt even walk! No, its too early. We driving half an hour back home. We are back in 2 hours, and she is dealated ( sorry for spelling ) 6 sms.. Actual birth happened 3-4 hours later. So, in Ukraine , she'd go to the hospital a week before her due date, and would have stayed there for 3 weeks after birth. That if there are no complications. Way more, if any. Cost= $0.00 plus some gratuity.


Francly i doubt there are 3 000 000 MDs in USA. And it doesnt go along with 25K a year number.


People will always want to have free things. Many doctors would also gladly make you a surgery/treatment you dont need, especially if u have money to pay for it. Take a notice that a surgeon who is a public servant will never make a surgery you dont need.


Those private doctors, before they get paid, spend years and years perfectioning their skills in public hospitals. Very good surgeons, or top-class specialists do make money in any healthcare system. There is always a line to a good surgeon-- and where is the line there is a pricetag to cut it
But, you gotta be good. And for better care, with nurses as well as with doctors, there is always a gratuity/tipping system. Works well.

Dude. It takes about an hour to analyze your blood here in the United States. And I can dip your urine as well as any nurse in about a minute. Why, we even have a stat lab where I can get all of your blood tests back in about five minutes!

So you understand my surprise that you checked into a hospital as an otherwise healthy young patient for a simple bilateral hernia repair and they spent a week futzing around analyzing your urine before they even cut on you. Is this an example of the fantastic efficiency and competency of the medical profession in your country?

In the United States, you can get a hernia repaired, even if it requires a mesh, laproscopically (sp) and be in and out on the same day, discharged home with something for the pain and instructions not to lift anything heavy for a few weeks. It's not that expensive either. About $900 at most places which is not a lot considering you might die without it.

I bet you wherever you're from that when you get really sick, as happens to many people when they get old, you are pretty much out of luck. I know for a fact from my friends and correspondants in Europe that they don't do a fraction of the things we do for our elderly, taking as they do the more philiosphical approach that renal failure (for example) means death and not, as is the case here, a huge effort to dialyze, fem-pop-orize (I invented this word), bypass-or-rize (this one too), and otherwise flog until death finally becomes inevitable many hundreds of thousands of dollars later.

The care for the elderly is what sucks up most of our resources. Not to mention the legions of the undead we keep alive in our ICUs at a cost of $30,000 per patient per week.

What really happened to you is this. Wages are so low in your country that it costs nothing to board you at the hospital. All they have to do is pay a babushka a few kopeks to sweep the floors and maybe run a dirty mop over them every now and then. There is no lab in the hospital so they have to send the sample to some 1950s vintage central lab. Then they have trouble scheduling a surgeon. He only makes a couple of hundred dollars a month (as you proudly point out) so he's not exactly on fire to post a minor surgical procedure. To hell with it. He's not making enough to work 80 hour weeks like our surgeons.

So you languish in the hospital. Your society is not exactly dynamic so people can take a week or two off from their jobs and nobody notices or cares.

Look, your model of health care will only work in a low wage society. Everything is relative. No doctor in America is going to work for minimum wage while the night manager at Taco Bell pulls in the big salary. If your Urkranian doctor moved to the states, he'd have to start working for real money because you cannot live in the United States on peanuts. Not to mention his wife wouldn't want to live in a trailer.


Correction: There is about 1 doctor per 300 people, not 1 per 100. Still a larger number.

 

[8744]

There is no problem neither with quantity, nor with quality of people going to medschools. Proved and tested over and over all over the world

Not meaning to insult you but the few Russian and Ukrainian doctors I have met are scary. I wouldn't let them treat my dogs. I weep for the patients upon who they are inflicted. There is a difference in medical training from country to country. Indian doctors, for instance, at least the ones I have worked with, are some of the best in the world.

 

[8744]

...Take a notice that a surgeon who is a public servant will never make a surgery you dont need...

And he might not get off of his public service posterior to make one you do need.

Listen, if it's so friggin' great in the Ukraine, why are you trying to get into an American medical school to work in the US?

 

[NonTradMed]

If businesses were losing money due to a loss of worker productivity, they would fund the healthcare. They will do whatever makes them more money. The cost of treatment exceeds the loss incurred.

If businesses were able to do whatever it could to make money, that doesn't mean it's going to be good for workers. Why do you think we have child labor laws? It's more profitable to have children working in certian fields but that doesn't mean we allow it. Why do we have environment protection laws? China doesn't. Hundreds of thousands of people have gotten sick from drinking contaminated water because they were not aware that the company dumped pollutants into their rivers. Children are born with defects which have lasting consequences for the country. Business may participate in behaviour which is good for its short term profits, but it may be bad long term, or it may be bad for society as a whole. I don't believe that the free market is a pancrea for our problems.

I don't know where you get your statistics on "people optimization." Please cite me any evidence that spending money on poor people creates better productivity than leaving it in the hands of those who earn it. I am NOT criticizing helping the poor. I just take issue with this argument. Charity is also something that has a proper amount, and in a free market, there is plenty of charity service. In the US, there is plenty of charity now, and I see no evidence that we are about to stop helping people without government interference.

What I mean is that we should try to maximize potential for a population. A good teacher makes an effort to help the students who don't participate in class because they may have the potential to give back just as much as the "regular" students. I want a society which maximizes equal opportunity for all students. What I mean by people optimization is not income redistribution, but opportunity redistribution.

My father was a poor farm kid who had no chance of goingto school. Back when he was a kid living in China, the gov't provided free education to all who can do well on their entrance exam. My dad could never afford the tuition which was being charged before education was made free. But he was a smart kid, and he got a free ride from elementary school through college. He's been a research scientist for the lats 30 years now. That's what I mean by people optimization, your pool of smart, ambitious people just increases when you give everyone an equal start in life. Why limit the poor of college applicants to middle class students? Why not prepare students from poor backgrounds for that as well? And let the smartest person win and not only the person who had all the opportunities through sheer luck of birth?

Right now, in China, with the lack of funding for education (not siphoning it off, gov't just stopped funding for much of it), many kids from the same area he grew up in will never see the inside of teh school. Why? It's not profitable right now for companies to erect free local schools. Charity work is abundent in China, but it's not nearly enough to alleviate the poverty there.

If we shuttle money into programs which helps kids to leave poverty, then that person will become a productive citizen. The money invested into these types of programs helps the poor, but it also helps society overall. That's what I mean by optimizing people.

I see no evidence that any country has successfully pushed back poverty with ONLY charity. Charity is sporadic. That's the problem. Come Christmas time, everyone wants to help. The rest of the year? It's sporadic. I don't agree with the current welfare system but I also don't believe we can depend on charity. Charity will depend on people's whim. If charity was so good, people would all be out begging on the streets to pay their rent, buy their groceries.

Your example of China is flawed. The communist government has kept such a strong grip on its population that the richest, largerst, and most powerful nation in the region has lagged INCREDIBLY far behind all of its more economically open counterparts over the last 50 years. If the government stymies its economy, then takes its confiscated loot and pays for things that are not healthcare, of course healthcare will be poor. Of course, in a free market, with a thriving economy, healthcare would improve significantly without interference by the government. Healthcare is a desired commodity, and it would be funded by a free market at its true value in a free market.
interference.

Actually, healthcare was also poor before the communist came into power. It improved in the 50's and 60's with numerous campaigns to focus on prevention. Mandatory and free vaccinations cut the infant mortality rate in the country (my grandmother's first two children died before free vaccination were made available). "Barefoot doctors" was sent to the countryside to provide rural healthcare. My mother still remembers the massive health campaigns in her childhood.

Of course, most peple still had bad healthcare, but most people had *some* form of it. The government did not take the healthcare profit and channeled it elsewhere, the government has stopped funding for most of its cost.

And I shoudl remind you that China has one of the fastest growing economies in the world with a 9% growth rate for the last decade or so. But it is this free market that is driving the healthcare crisis in China. Because of the HUGE disparity between rich and poor (one of the biggest in the world), there is a large underclass that much get any healthcare while a smaller elite can get pretty decent one.

Free market says that businesses can still practice without providing healthcare to people. If someone is sick, there's always someone healthy to take their place. That can become a public health hazard when a billion people becomes the feeding ground for all kinds of diseases.

I never said healthcare isn't a desired commodity in China, I'm saying that many people can't afford it. It's not profitable because labor is abundant and cheap. You are assuming that healthcare would be funded by a free market simply because companies would value their workers so much, but that is not true in most jobs, at least not at the stage of industralization in China.

That's why funding for education and healthcare has to be taken up by the gov't. It's not profitable to a company to fund for free vaccinations or the education of elementary in a country with such cheap, abundant labor. But the country will pay for the lack of education and healthcare in the future.

AIDS is already a huge in China precisely because of the lack of gov't infrastructure to contain it. It starts out with addicts and no company will want to fund for their rehabilitation, but once it spreads to the general populace, and the disease starts affecting workers, it's too late for companies to intervene even if they wanted to. Diseases do not follow the business model and avoid the productive workers.

Education works in similar fashion. Most companies want an educated workforce, but few are going to fund free elementary education, which is critical for future budding scholars and inventors. Some things are just too longterm, too foundational, to trust the free market to disseminate.

The gov't s job is to look long term, and to investment in things that will profit the society. This may or may not coincide with the free market and where the market does not apply, the gov't steps in. Research is a good example of such a relationship (however problematic). My parents worked in basic research at university for 20 years and then made the jump to BigPharm. They do far more groundwork in basic research than they are doing in BigPharm, but BigPharm will answer the demand for current drugs while using the basic research that was funded by the government to do so. The gov't gets advance in research by funding the ground research and let the market fund the rest. Basic research is typically unprofitably because no patent can be extracted from it but it is well worth the financial investment because much of it leds to brilliant discoveries in the future.

As I said before, resources are scarce. Scarce doesn't mean rare, but it does mean not infinite. We repeatedly talk about how the boomers are going to bankrupt Medicare, how physician's reimbursements are dropping as demand rises, and how healthcare is approaching 20% of GDP. We are worried about these things because healthcare doesn't exist infinitely. It must be rationed in some way, and as with all things, the greatest efficiency takes place in a free market. In time, technology will improve healthcare in line with demand, but this also requires an investment of scarce economic resources, and we can all agree that 100% of GDP being spent on healthcare research would be bad for everyone. Thus, the market is necessary to determing optimal spending on this commodity.

I agree with most of what you say here. Healthcare is a scarace commodity, but I belive the best way to MAXIMIZE it is to focus on preventive care, and to give the poor this preventive care, and let the chips fall as it may for everything else.

I want to see multi tiered healthcare system where people cna get the most basic cares to prevent conditions from spreading or getting worse. I think that the rich should have better care if they can afford it. Right now, our system is not geared towards that ideal of focusing on preventive medicine. Instead, it's lopsided in that we give emergency and expensive care to those that are the neediest when that money can be spent on helping more people with less serious conditions.

I don't agree that the free market will determine the best care, because disease doesn't discriminate against who will be the least or most productive citizen. Sure, Bill Gates, given his productivity level, will probably be a good investment to save, but what about the budding scientist? Or the future Mozart? Do you believe that those who can't afford healthcare are just unproductive members of society? I guess I don't agree. I think everyone should be given basic care and that they will have to 'earn' their way into the top of the line care. This is unpopular b/c it puts a price on people's head, but I think, in the long run, this will maximize coverage for everyone while not bankrupting society.

 

[deleted87716]

Socialized medicine is great unless you are really sick.

I'm going to shock PB by agreeing with him.

I don't think we'll be patterning our healthcare system after the Ukraine any time soon, no disrespect intended. Twenty-two days in the hospital for a mild concussion? WTF? Most people here wouldn't even get admitted.

 

[Miami_med]

If businesses were able to do whatever it could to make money, that doesn't mean it's going to be good for workers. Why do you think we have child labor laws? It's more profitable to have children working in certian fields but that doesn't mean we allow it. Why do we have environment protection laws? China doesn't. Hundreds of thousands of people have gotten sick from drinking contaminated water because they were not aware that the company dumped pollutants into their rivers. Children are born with defects which have lasting consequences for the country. Business may participate in behaviour which is good for its short term profits, but it may be bad long term, or it may be bad for society as a whole. I don't believe that the free market is a pancrea for our problems.

I never said that the free market was a panacea. Only that it was better than any alternative. Child labor is primarily the hallmark of EARLY industrial developement. You can't simultaneously argue that high education is necessary on the part of everyone to work and that companies want to hire kids who haven't had a chance to be educated. By the time of institution of public education in the US, most kids were in School (over 90% in Boston). School was originally implemented as a way to control the Irish and Native American Populations. Child labor was already on its way out.

Environmental legislation is only necessary because of the fact that the rivers are public. My favorite example of this argument was a story about a native american tribe in Southern Maine, whose reservation was on a polluted river. If that land were just turned over to the Native Americans as a private interest, they could sue the company for damaging there property. In this case, private property would save the river.

What I mean is that we should try to maximize potential for a population. A good teacher makes an effort to help the students who don't participate in class because they may have the potential to give back just as much as the "regular" students. I want a society which maximizes equal opportunity for all students. What I mean by people optimization is not income redistribution, but opportunity redistribution.

What you still haven't shown me is any proof that this maximizes efficiency. I remember well sitting in school, incredibly bored as the teacher spent time helping students who were not up to speed. Their optimization was de-optimizing for me. Equal opportunity doesn't equal optimization.

My father was a poor farm kid who had no chance of goingto school. Back when he was a kid living in China, the gov't provided free education to all who can do well on their entrance exam. My dad could never afford the tuition which was being charged before education was made free. But he was a smart kid, and he got a free ride from elementary school through college. He's been a research scientist for the lats 30 years now. That's what I mean by people optimization, your pool of smart, ambitious people just increases when you give everyone an equal start in life. Why limit the poor of college applicants to middle class students? Why not prepare students from poor backgrounds for that as well? And let the smartest person win and not only the person who had all the opportunities through sheer luck of birth?

Education doesn't have to be formal, and 90% of formal education in this country is wasting time. I would recommend a book called "The Invisible Man," by Ralph Ellephson (sp?) All universal education has done in this country is make everyone go to really crappy school.

Right now, in China, with the lack of funding for education (not siphoning it off, gov't just stopped funding for much of it), many kids from the same area he grew up in will never see the inside of teh school. Why? It's not profitable right now for companies to erect free local schools. Charity work is abundent in China, but it's not nearly enough to alleviate the poverty there.

The poverty that has primarily arisen from a lack of real productivity under the communist regime. This is in a society where the government tried to give equal opportunity. Charity is not a substitute for real productivity. All of the government programs in the world only seem to increase urban poverty in the US. Without the entitlement however, members of the society have an incentive to move away from charity and towards productive endeavors.

If we shuttle money into programs which helps kids to leave poverty, then that person will become a productive citizen. The money invested into these types of programs helps the poor, but it also helps society overall. That's what I mean by optimizing people.

Would these be programs like welfare, head start, or any of the other programs that we have that have not ended poverty. These programs do not help society overall. They take money away from productive people and divert it towards people that might become productive.

I see no evidence that any country has successfully pushed back poverty with ONLY charity. Charity is sporadic. That's the problem. Come Christmas time, everyone wants to help. The rest of the year? It's sporadic. I don't agree with the current welfare system but I also don't believe we can depend on charity. Charity will depend on people's whim. If charity was so good, people would all be out begging on the streets to pay their rent, buy their groceries.

These people should get jobs. Perhaps they will take all of the jobs that those kids would have been working without the child labor laws. The government programs that do exist give incentive for these people to keep begging and not working. Also, most of those people down here are on drugs, and I'll be d*mned if you think that it is a good idea to make me pay for someone else's habit.

Actually, healthcare was also poor before the communist came into power. It improved in the 50's and 60's with numerous campaigns to focus on prevention. Mandatory and free vaccinations cut the infant mortality rate in the country (my grandmother's first two children died before free vaccination were made available). "Barefoot doctors" was sent to the countryside to provide rural healthcare. My mother still remembers the massive health campaigns in her childhood.

Before the communists came to power, China was in the middle of a war with Japan. Before that, healthcare was pretty poor EVERYWHERE. The difference is, healthcare has failed miserably to keep up with the likes of Japan and other more economically open countries under communist rule.

Of course, most peple still had bad healthcare, but most people had *some* form of it. The government did not take the healthcare profit and channeled it elsewhere, the government has stopped funding for most of its cost.

And I shoudl remind you that China has one of the fastest growing economies in the world with a 9% growth rate for the last decade or so. But it is this free market that is driving the healthcare crisis in China. Because of the HUGE disparity between rich and poor (one of the biggest in the world), there is a large underclass that much get any healthcare while a smaller elite can get pretty decent one.

China's economy is growing because they have finally stopped trying to stop some forms of private enterprise. Before this, everyone had bad healthcare. Now, some people don't. This is a net improvement. Are you really arguing that we should make the people who have managed to improve their situation get crappy care as well in order to promote equality? Under the communists, healthcare has been equally BAD. That is almost universal under government run programs. Countries that don't have this problem as badly are more open, and they are robbing their private sectors blind in order to pay for care. However, this has consequences to everyone else in the economy.

Remember, poverty is a bigger indicator of poor health than lack of healthcare. The #1 indicator of wealth creation comes from openness of the economy. By diverting money from the economy to healthcare, you will end up creating poor health long term.

[QUOTE
Free market says that businesses can still practice without providing healthcare to people. If someone is sick, there's always someone healthy to take their place. That can become a public health hazard when a billion people becomes the feeding ground for all kinds of diseases.[/QUOTE]

I've always held that infectious disease is an exception.

I never said healthcare isn't a desired commodity in China, I'm saying that many people can't afford it. It's not profitable because labor is abundant and cheap. You are assuming that healthcare would be funded by a free market simply because companies would value their workers so much, but that is not true in most jobs, at least not at the stage of industralization in China.

That's why funding for education and healthcare has to be taken up by the gov't. It's not profitable to a company to fund for free vaccinations or the education of elementary in a country with such cheap, abundant labor. But the country will pay for the lack of education and healthcare in the future.

Quite the contrary, development must come first. As the country develops, more money will come into people's pockets, and they can pay for these things themselves. By diverting money from productive sectors, you will halt development and likewise health.

AIDS is already a huge in China precisely because of the lack of gov't infrastructure to contain it. It starts out with addicts and no company will want to fund for their rehabilitation, but once it spreads to the general populace, and the disease starts affecting workers, it's too late for companies to intervene even if they wanted to. Diseases do not follow the business model and avoid the productive workers.

Education works in similar fashion. Most companies want an educated workforce, but few are going to fund free elementary education, which is critical for future budding scholars and inventors. Some things are just too longterm, too foundational, to trust the free market to disseminate.

#1: We spend lots of money on AIDS in the US, and it is still a big problem here.

#2: I've always said that infectious disease is the exception.

#3: I've already pointed out that formal education is NOT necessary for budding scholars at all. It was mostly a waste of my time. I learned most of what I know at home and on my own.

The gov't s job is to look long term, and to investment in things that will profit the society. This may or may not coincide with the free market and where the market does not apply, the gov't steps in. Research is a good example of such a relationship (however problematic). My parents worked in basic research at university for 20 years and then made the jump to BigPharm. They do far more groundwork in basic research than they are doing in BigPharm, but BigPharm will answer the demand for current drugs while using the basic research that was funded by the government to do so. The gov't gets advance in research by funding the ground research and let the market fund the rest. Basic research is typically unprofitably because no patent can be extracted from it but it is well worth the financial investment because much of it leds to brilliant discoveries in the future.

Big Pharm depends on the government funding for basic research because it is there. They need it, so if the government stopped paying for it, they would start. Government does a HORRIBLE job of thinking long term. Look at everything from the war in Iraq to the loose monetary policy that we have had since the early 1990s, to the national debt. Think about the social security crisis. These problems are ALL government creations, and they wouldn't be problems without government intervention. Please read my blog for more on this sort of thing.

I agree with most of what you say here. Healthcare is a scarace commodity, but I belive the best way to MAXIMIZE it is to focus on preventive care, and to give the poor this preventive care, and let the chips fall as it may for everything else.

I want to see multi tiered healthcare system where people cna get the most basic cares to prevent conditions from spreading or getting worse. I think that the rich should have better care if they can afford it. Right now, our system is not geared towards that ideal of focusing on preventive medicine. Instead, it's lopsided in that we give emergency and expensive care to those that are the neediest when that money can be spent on helping more people with less serious conditions.

I don't agree that the free market will determine the best care, because disease doesn't discriminate against who will be the least or most productive citizen. Sure, Bill Gates, given his productivity level, will probably be a good investment to save, but what about the budding scientist? Or the future Mozart? Do you believe that those who can't afford healthcare are just unproductive members of society? I guess I don't agree. I think everyone should be given basic care and that they will have to 'earn' their way into the top of the line care. This is unpopular b/c it puts a price on people's head, but I think, in the long run, this will maximize coverage for everyone while not bankrupting society.

A scientist or Mozart who will become more productive in the future can borrow against future earnings to pay for these things now. We do this now as students. I'm not against a free market in credit. The reality is that most of the people who can't afford care, are in that position because they are marginally productive or non-productive. Please come visit me down at Jackson if you need proof. I have always dedicated my time down here to help those in need (free clinics, healthcare), because I really do want to make sick people well. However, that doesn't change the fact that the reason they can't afford the care, is because they are usually not producing enough to pay for it.

It is already government intervention into the healthcare economy (from the legal system to hospital monopolies) that has driven the price of basic care up. If you want healthcare to be so cheap that the majority of poor workers can afford it, the way to start is by pushing the government OUT of healthcare. Let the economy keep growing, so that these workers will eventually be able to be paid more.

 

[45408]

What really happened to you is this. Wages are so low in your country that it costs nothing to board you at the hospital. All they have to do is pay a babushka a few kopeks to sweep the floors and maybe run a dirty mop over them every now and then. There is no lab in the hospital so they have to send the sample to some 1950s vintage central lab. Then they have trouble scheduling a surgeon. He only makes a couple of hundred dollars a month (as you proudly point out) so he's not exactly on fire to post a minor surgical procedure. To hell with it. He's not making enough to work 80 hour weeks like our surgeons.

I'm trying to keep quiet in the school library here. That was hilarious, dude.

 

[dutchman]

There is no problem neither with quantity, nor with quality of people going to medschools. Proved and tested over and over all over the world

You have to understand that this is not just any other country. I am European and I see a lot of things that work out there that will never work here. First the robust size of the US economy and growing viability of other professions creates a huge competition for the highly intelligent, and if the incentives to go into medicine are diminished you best believe the folks in this country are going to abandon that route quicker than you can imagine. How many other countries do you know where you can land 60K jobs with just an associates degree? Americans did not get to the #1 spot by being stupid i.e do more work for less money.

 

[tncekm]

You dont have a job, you dont have an income. You obviously dont pay your loans. And? What do you think they gonna do? Write you an angry letter? Force you to work in the hospital? Force you into the military? You americans talk so much about your freedom meantime you really live in an imaginary jail which you build yourselves for your own use.

Wow, you have no clue do you? Here in America if you owe a debt, and if that debt cannot be bankrupted, and if you cannot pay that debt, you're probably also in trouble with the IRS and you can end up in prison for a loooong time. No "imaginary jail" here.

We were a nation of pretty stringent laws--well, that was until we started adopting the neo-European "progressive" model which is letting child molesters and murderers out of jail (because they can be "rehabilitated ) long before a guy who had money and lost it and bounced a few checks....this place is going to hell.

 

[tncekm]

You have to understand that this is not just any other country. I am European and I see a lot of things that work out there that will never work here. First the robust size of the US economy and growing viability of other professions creates a huge competition for the highly intelligent, and if the incentives to go into medicine are diminished you best believe the folks in this country are going to abandon that route quicker than you can imagine. How many other countries do you know where you can land 60K jobs with just an associates degree? Americans did not get to the #1 spot by being stupid i.e do more work for less money.

Politically incorrect truth spoken by a European = made my freggin' day!

In all honesty, are you scared for the US like I am? I totally see this place heading down the sh1t-hole because the socialism bug has bitten the uneducated sheeple.

 

[Avrelian]

Wow, you have no clue do you? Here in America if you owe a debt, and if that debt cannot be bankrupted, and if you cannot pay that debt, you're probably also in trouble with the IRS and you can end up in prison for a loooong time. No "imaginary jail" here.

Francly I don't see any logic, no offence intended. Its the same like saying, if you happened to have a debt, and also killed a cop, they gonna fry you for it. If you are in trouble with IRS, they can send you to jail, regardless whether you owe anyone anything or not. If you do not have a trouble with IRS, they will not send you to jail, regardless if you owe anyone anything or not. Noone here in USA can force you to pay your student loans, if you dont want to pay them. Much less abroad. They might garnish your wages eventually, or take your house ( depends on state ) but they will not do it if you dont own a house or work for cash. Obviously , people dont go to graduate schools to work for cash on the side. But still.
By the way, a close relative of mine, owes probably 16-17K in student loans , last payment was made like 6-7 years ago. So what? once in 6 months she gets an angry letter. Thats it. A few months ago she got a very high-end state job in the same state she had her studies. I mean she was ready to pay all her debts off with cash, probably 30K total, if her credit record had any potential threat to prevent her from getting that job. No. Didnt matter. She still got it, out of over 200 aplicants.

 

[Avrelian]

And he might not get off of his public service posterior to make one you do need.

Listen, if it's so friggin' great in the Ukraine, why are you trying to get into an American medical school to work in the US?

Well, I live here , for staters. And cannot move
though I want to, for family reasons.
By the way I will call my Mom for details of that surgery, it was 1982 so may be I am wrong somewhere there .

 

[Avrelian]

I know for a fact from my friends and correspondants in Europe that they don't do a fraction of the things we do for our elderly, taking as they do the more philiosphical approach that renal failure (for example) means death and not, as is the case here, a huge effort to dialyze, fem-pop-orize (I invented this word), bypass-or-rize (this one too), and otherwise flog until death finally becomes inevitable many hundreds of thousands of dollars later.

Just a question, do you want to say that every seniour in this country gets treatment worth hundreds of thousands dollars to keep him alive, regardless of how much money/property he has, whether he insured or not ets?

 

[flighterdoc]

Just a question, do you want to say that every seniour in this country gets treatment worth hundreds of thousands dollars to keep him alive, regardless of how much money/property he has, whether he insured or not ets?

Thats right. Unless the individual takes affirmative steps to indicate that they do NOT want 'heroic lifesaving measures' taken via a 'Do Not Resucitate' order, they get everything that medicine has thrown at them to keep them alive. No cost to the individual.

 

[Miami_med]

Just a question, do you want to say that every seniour in this country gets treatment worth hundreds of thousands dollars to keep him alive, regardless of how much money/property he has, whether he insured or not ets?

Though I disagree with this philosophy, everyone in the US over 65 gets Medicare, which pays either directly or through specific Medicare HMO plans for care. Sometimes there are co-pays, but I have NEVER heard of an elderly person not getting care. The government will pay. Many of our medical shortages, in beds and personel, can be directly attributed to the fact that people who are inevitably going to die will nevertheless receive $100,000s of care in their last month of life. That is in THIS country.

 

[8744]

Just a question, do you want to say that every seniour in this country gets treatment worth hundreds of thousands dollars to keep him alive, regardless of how much money/property he has, whether he insured or not ets?

Let me give you an example. I am currently rotating in the ICU (intensive care unit). I have an 87-year-old patient who has had, in the last 15 years, both knees replaced (one twice), a hip replacement, two bypasses (CABG) with one a four vessel CABG, three heart caths with stents, a nephrectomy, many, many ICU stays, and is currently on dialysis three times a week since 2003. And that's just the short list.

He is here for an STEMI (heart attack) and we are "flogging" him shamelessly to keep him stable. We will probably discharge him to his nursing home eventually (believe it or not) until a month or two from now when we repeat the whole procedure.

This guy has probably used two or three million dollars worth of health care in the last ten years. An ICU stay alone is billed at four thousand dollars a day. He has nothing but medicare which is our home-grown socialized medicine.

There is nothing unusual about this guy except he is a little healthier than the guy in the room next door.

If you think in Europe, Russia, the Ukraine, or Outer Eulopotamia they would have done a fraction of what we have done for this guy you are delusional. In Greece he would have been lucky to get a bypass, let alone a knee replacement.

I think we are wasting our money on this guy today but fifteen years ago when the whole process started he was pretty functional and had a good quality of life. Maybe the ten good years we bought him were worth the millions of dollars for his care. I think they were, even though somewhere in the last year we crossed a line where it has become futile.

So, with respect, shut the **** up about your superior health care in the Ukraine. It's superior until you get old and maybe don't want to die at 68 for something that our little old imperfect medical system in America can fix.

 

[tncekm]

 

[Avrelian]

If you think in Europe, Russia, the Ukraine, or Outer Eulopotamia they would have done a fraction of what we have done for this guy you are delusional. In Greece he would have been lucky to get a bypass, let alone a knee replacement.

Of course not! Its a no-brainer. They wouldnt do even a fraction of that becouse noone needs it to be done- including himself. And the only reason you do it here is becouse you have a federal boob to suck on. Thats why you run around with old farts so much-- becouse of the public dough ready to be waisted. I'd like to see how will you replace a knee for 17 years old guy with no insurance.

So, with respect, shut the **** up about your superior health care in the Ukraine. It's superior until you get old and maybe don't want to die at 68 for something that our little old imperfect medical system in America can fix.

First of all I've never said that healthcare in Ukraine is superior, or better, than in states. What I've said is that its better to have your nail removed for $2, rather than for $2000. What I've said is that in Ukraine, same as in many, many, many countries of the world healthcare is for everyone, regardless of how much money they have, ets, and private healthcare is affordable, becouse they have to compete with a free one. There are 1.3 mln people working in healthcare overthere, with over 220269 MDs, for barely 47mln people. And they plan to train and hire 16-17000 more. In usa, there are 680 000 MDs.
So, as soon as USA will stop waisting those 2-3000 000 dollars on the undead you mentioned and the like, ( and it will , dont even doubt it, eventually, of course ) and will start investing the same amount of money in medical education , buildings for new hospitals/clinics, equipment, drugs, ets, all those of you who came here for the money ( an apparently many did ) will be up for a b-i-g surprise! So, stock up on vaseline right now, while its cheap

 

[dutchman]

Of course not! Its a no-brainer. They wouldnt do even a fraction of that becouse noone needs it to be done- including himself. And the only reason you do it here is becouse you have a federal boob to suck on. Thats why you run around with old farts so much-- becouse of the public dough ready to be waisted. I'd like to see how will you replace a knee for 17 years old guy with no insurance.



First of all I've never said that healthcare in Ukraine is superior, or better, than in states. What I've said is that its better to have your nail removed for $2, rather than for $2000. What I've said is that in Ukraine, same as in many, many, many countries of the world healthcare is for everyone, regardless of how much money they have, ets, and private healthcare is affordable, becouse they have to compete with a free one. There are 1.3 mln people working in healthcare overthere, with over 220269 MDs, for barely 47mln people. And they plan to train and hire 16-17000 more. In usa, there are 680 000 MDs.
So, as soon as USA will stop waisting those 2-3000 000 dollars on the undead you mentioned and the like, ( and it will , dont even doubt it, eventually, of course ) and will start investing the same amount of money in medical education , buildings for new hospitals/clinics, equipment, drugs, ets, all those of you who came here for the money ( an apparently many did ) will be up for a b-i-g surprise! So, stock up on vaseline right now, while its cheap

Yes the US will someday look at Ukraine and say "hell why don't we try that Ukrainian style of medicine? all we have to do is let our seniors die, stop paying doctors and we have a solution".

How many times does socialism have to fail before you guys get the point? Is it not enough that most of the former Soviet union is reeling in poverty?
Look, the United states runs their system with money not bull****.

 

[flighterdoc]

Of course not! Its a no-brainer. They wouldnt do even a fraction of that becouse noone needs it to be done- including himself. And the only reason you do it here is becouse you have a federal boob to suck on. Thats why you run around with old farts so much-- becouse of the public dough ready to be waisted. I'd like to see how will you replace a knee for 17 years old guy with no insurance.



First of all I've never said that healthcare in Ukraine is superior, or better, than in states. What I've said is that its better to have your nail removed for $2, rather than for $2000. What I've said is that in Ukraine, same as in many, many, many countries of the world healthcare is for everyone, regardless of how much money they have, ets, and private healthcare is affordable, becouse they have to compete with a free one. There are 1.3 mln people working in healthcare overthere, with over 220269 MDs, for barely 47mln people. And they plan to train and hire 16-17000 more. In usa, there are 680 000 MDs.
So, as soon as USA will stop waisting those 2-3000 000 dollars on the undead you mentioned and the like, ( and it will , dont even doubt it, eventually, of course ) and will start investing the same amount of money in medical education , buildings for new hospitals/clinics, equipment, drugs, ets, all those of you who came here for the money ( an apparently many did ) will be up for a b-i-g surprise! So, stock up on vaseline right now, while its cheap

Well, not too many 17 year olds need knee replacements, but those that do get them for free too: Children under 18 are covered by medicare as well - never mind EMTALA. So, what exactly is your point, if you have one?

 

[8744]

Of course not! Its a no-brainer. They wouldnt do even a fraction of that becouse noone needs it to be done- including himself. And the only reason you do it here is becouse you have a federal boob to suck on. Thats why you run around with old farts so much-- becouse of the public dough ready to be waisted. I'd like to see how will you replace a knee for 17 years old guy with no insurance.



First of all I've never said that healthcare in Ukraine is superior, or better, than in states. What I've said is that its better to have your nail removed for $2, rather than for $2000. What I've said is that in Ukraine, same as in many, many, many countries of the world healthcare is for everyone, regardless of how much money they have, ets, and private healthcare is affordable, becouse they have to compete with a free one. There are 1.3 mln people working in healthcare overthere, with over 220269 MDs, for barely 47mln people. And they plan to train and hire 16-17000 more. In usa, there are 680 000 MDs.
So, as soon as USA will stop waisting those 2-3000 000 dollars on the undead you mentioned and the like, ( and it will , dont even doubt it, eventually, of course ) and will start investing the same amount of money in medical education , buildings for new hospitals/clinics, equipment, drugs, ets, all those of you who came here for the money ( an apparently many did ) will be up for a b-i-g surprise! So, stock up on vaseline right now, while its cheap

You are an ass. I guess in the Ukraine when you have an MI (heart attack) at age 62 you are just out of luck. Oops, sorry. Our wonderful socialized health care only covers you if you are not actually sick. Hang nails? Terrific! Come on in to one of our Potemkin Hospitals and spend a month or two!

There is a difference between treating someone who is old but otherwise has a good quality of life and the expectation for many more years and treating someone who is terminal. I can tell the difference. Your society obviously cannot. No wonder the life expectancy in the former Soviet Republics is much less than in the West and all of the non-moslem former states are declining in population at an astounding rate. Who's going to take care of all your old people twenty years from now?

Nobody.

 

[flighterdoc]

You are an ass. I guess in the Ukraine when you have an MI (heart attack) at age 62 you are just out of luck. Oops, sorry. Our wonderful socialized health care only covers you if you are not actually sick. Hang nails? Terrific! Come on in to one of our Potemkin Hospitals and spend a month or two!

There is a difference between treating someone who is old but otherwise has a good quality of life and the expectation for many more years and treating someone who is terminal. I can tell the difference. Your society obviously cannot. No wonder the life expectancy in the former Soviet Republics is much less than in the West and all of the non-moslem former states are declining in population at an astounding rate. Who's going to take care of all your old people twenty years from now?

Nobody.

I guess a 62-year-old in the Ukraine is pretty much done for anyway....so they have no concept of quality of life.

 

[deleted87716]

I guess a 62-year-old in the Ukraine is pretty much done for anyway....so they have no concept of quality of life.

From the World Health Organization (WHO):

WHO estimates that a person born in Ukraine in 2003 can expect to live 68 years on average: 74 years if female and 63 years if male. Life expectancy for males in 2003 was five years shorter than in 1986. Life expectancy for females in 2003 was two years shorter than in 1989. Compared with the Eur-A averages for males and females, male life expectancy in Ukraine is 14 years lower and female life expectancy is 8 years lower. Life expectancy for Ukrainian males remains two years less than Eur-B+C average life expectancy, while for females it is practically equal to the average. WHO also estimates that Ukrainians spend about 12% (eight years) of their average life span with illness and disability.

As the length of life increases, older people can respond with lifestyle changes that can increase healthy years of life. Correspondingly, health care systems need to shift towards more geriatric care, the prevention and management of chronic disease and more formal long-term care. Since people are living longer, measures to improve health and prevent disease need to focus on people of working age.

Source: http://www.euro.who.int/eprise/main/WHO/Progs/CHHUKR/sum/20041126_2

 

[mshheaddoc]

I am going to ask that the personal insults stop between users and that you maintain a professional tone in this thread. If you can't handle yourself in a professional manner I'll either close the thread or start throwing out infractions. You guys have handled this thread thus far in a professional manner. Can we please get back to that? Thanks.