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You know what a straw man is? Might want to google it.
I am a PGY-1 psychiatry resident with a plan to go into academic medicine. I'm not exactly motivated by the pursuit of wealth. And I doubt I'm too different from a number of other posters in this thread who disagree with single-payer insurance.
While you're googling straw man you might also want to google entitlement. Entitlement is the belief that simply because of who you are, you deserve something. No one here is arguing that. We are arguing that based on the years of self-sacrifice, the high stresses and demands of the job, and the carefully cultivated ability through years of practice and education, that we deserve to be recompensed accordingly.
Entitlement is probably a better label to use for people who believe in socialized medicine by whatever stupid lexical game you play when you label it. People who believe that healthcare should be taken care of by the rest of society without any input from themselves. People who believe they have a 'right' to other peoples' pocketbooks to take care of their health, but don't believe they have a responsibility to husband their own health and make cost-effective decisions.
You're damn right I went into medicine to help people. Gave up my dream job to be here. I love working with low-income folks, believe it or not. And would rather shoot myself than take care of the whining, walking well. But I didn't go into medicine so I could be walked all over like I'm a freaking welcome mat. I'll treat your GERD, sure, but if you don't even attempt to work at reducing the 100lbs of abdominal obesity raising your IAP and overwhelming the physiologic LES, don't expect me to keep escalating your level of care, all the while demanding that someone else pay for it. I'll work with you on your diabetes, advocating lifestyle change and helping you to implement it, but don't expect me to just say 'oh that's ok that you're lazy. I guess metformin won't cut it. time to break out a 7000 dollar a year solution where willpower would suffice.'
My job--my calling--is to help people and more importantly to help them help themselves. Anyone who preaches rhetoric that takes away from this, anyone who tries to setup a system which disincentivizes this model, is my enemy.
After you're done googling entitlement and straw man arguments, you might want to read back through this thread. Almost no one has supported the status quo. Most of us have talked about reducing the demand for healthcare in the first place. Not giving more money to insurance, but reducing the amount we spend on both insurance and healthcare in general.
When people ask me what my goal in life is, I usually tell them it's to become useless. Obviously, that will never happen. But all the same, I want to live in a world where patients have become so damned good at taking care of their own health that our reliance on healthcare is reduced drastically.
Cute, you bring up econ but you clearly missed the first lesson. Which is basical supply and demand. We are demanding more and more healthcare at every turn. Look at how fancy treatments are getting for just about anything. For marginal gains. Is januvia really a better drug than metformin? Is celebrex more effective than meloxicam? Look at how we eat away at our own health. 7 of the top 10 most expensive conditions are largely if not entirely preventable. Furthermore, effective lifestyle management will significantly reduce the costs of all of those.
The higher the demand the higher the price the market is willing to bear.
And the 'insurance' system which is really about health maintenance only exacerbates the problem since it conceals those costs in large part. Socialized medicine would be even worse since it conceals the costs entirely.
Metformin costs 4 dollars a month. It's pretty darn effective. Some of the newer diabetes meds cost hundreds a month. And aren't really any more effective.
Meloxicam costs 4 dollars a month. Celebrex costs 150 a month. Again, no real difference in efficacy.
When I first broke down and started taking something for my severe spinal arthritis, I had good health insurance. My doctor suggested celebrex, since ibuprofen had absolutely no effect on me except water retention. With a 'real' cost (to insurance) of 1800 dollars a year. My personal cost? 120 a year. When I switched insurance plans, I lost prescription coverage for 6 months. I converted to mobic. ABSOLUTELY NO DIFFERENCE IN EFFICACY OR SIDE EFFECTS. Which is backed up in studies, where mobic has been shown to have no greater side effect potential than placebo. 48 dollars versus 120 isn't a big difference, which is all I saw.
Most people when faced with that small of a difference would say 'well, let me use the newer one, just because." If faced with 1800 versus 48 for virtually the same efficacy, they'd go with 48.
Guess what? With millions of people every day making similarly blinded decisions (aciphex instead of prilosec or even famotidine, pristiq instead of venlafaxine, combo pills instead of the separate medications), it's not very hard for the costs to mount dramatically. IT's just that we as the consumer don't see it due to copays. We DO see it in our premiums.
And of course we haven't gotten into the matter of lifestyle prevention. Minimal exercise is twice as effective as statins in reducing ischemic events, among many other well-documented benefits including increase in on-the-job productivity, decreased sick days, longer productive life, lower rates of cancer, dementia, arthritis, etc. Those that engage in such things see no monetary reward. While those that don't see no monetary loss.
On my health insurance plan, I, a guy who eats a solid diet, watches his bodyweight, exercises regularly, etc, pay exactly the same premium as the morbidly obese turtles trundling around the hospital.
Here again, the cost of being obese or simply not taking care of oneself is concealed because there are people like me who subsidize their lifestyles.
Your tired little simplistic arguments are old. It's amusing that you find yourself resorting to profanities when logic breaks down. Which isn't surprising since there isn't a ton of logic in your posts.
Everyone's talking about 'bending the cost curve down'. It doesn't take a genius to realize that the easiest way of reducing total healthcare costs is reducing total demand for healthcare, whether it's choosing older standbys that cost orders of magnitude less than newer fancier drugs that offer marginal--if any--benefits, or simply reducing the need for healthcare intervention by living healthier.
I am a PGY-1 psychiatry resident with a plan to go into academic medicine. I'm not exactly motivated by the pursuit of wealth. And I doubt I'm too different from a number of other posters in this thread who disagree with single-payer insurance.
While you're googling straw man you might also want to google entitlement. Entitlement is the belief that simply because of who you are, you deserve something. No one here is arguing that. We are arguing that based on the years of self-sacrifice, the high stresses and demands of the job, and the carefully cultivated ability through years of practice and education, that we deserve to be recompensed accordingly.
Entitlement is probably a better label to use for people who believe in socialized medicine by whatever stupid lexical game you play when you label it. People who believe that healthcare should be taken care of by the rest of society without any input from themselves. People who believe they have a 'right' to other peoples' pocketbooks to take care of their health, but don't believe they have a responsibility to husband their own health and make cost-effective decisions.
You're damn right I went into medicine to help people. Gave up my dream job to be here. I love working with low-income folks, believe it or not. And would rather shoot myself than take care of the whining, walking well. But I didn't go into medicine so I could be walked all over like I'm a freaking welcome mat. I'll treat your GERD, sure, but if you don't even attempt to work at reducing the 100lbs of abdominal obesity raising your IAP and overwhelming the physiologic LES, don't expect me to keep escalating your level of care, all the while demanding that someone else pay for it. I'll work with you on your diabetes, advocating lifestyle change and helping you to implement it, but don't expect me to just say 'oh that's ok that you're lazy. I guess metformin won't cut it. time to break out a 7000 dollar a year solution where willpower would suffice.'
My job--my calling--is to help people and more importantly to help them help themselves. Anyone who preaches rhetoric that takes away from this, anyone who tries to setup a system which disincentivizes this model, is my enemy.
After you're done googling entitlement and straw man arguments, you might want to read back through this thread. Almost no one has supported the status quo. Most of us have talked about reducing the demand for healthcare in the first place. Not giving more money to insurance, but reducing the amount we spend on both insurance and healthcare in general.
When people ask me what my goal in life is, I usually tell them it's to become useless. Obviously, that will never happen. But all the same, I want to live in a world where patients have become so damned good at taking care of their own health that our reliance on healthcare is reduced drastically.
Cute, you bring up econ but you clearly missed the first lesson. Which is basical supply and demand. We are demanding more and more healthcare at every turn. Look at how fancy treatments are getting for just about anything. For marginal gains. Is januvia really a better drug than metformin? Is celebrex more effective than meloxicam? Look at how we eat away at our own health. 7 of the top 10 most expensive conditions are largely if not entirely preventable. Furthermore, effective lifestyle management will significantly reduce the costs of all of those.
The higher the demand the higher the price the market is willing to bear.
And the 'insurance' system which is really about health maintenance only exacerbates the problem since it conceals those costs in large part. Socialized medicine would be even worse since it conceals the costs entirely.
Metformin costs 4 dollars a month. It's pretty darn effective. Some of the newer diabetes meds cost hundreds a month. And aren't really any more effective.
Meloxicam costs 4 dollars a month. Celebrex costs 150 a month. Again, no real difference in efficacy.
When I first broke down and started taking something for my severe spinal arthritis, I had good health insurance. My doctor suggested celebrex, since ibuprofen had absolutely no effect on me except water retention. With a 'real' cost (to insurance) of 1800 dollars a year. My personal cost? 120 a year. When I switched insurance plans, I lost prescription coverage for 6 months. I converted to mobic. ABSOLUTELY NO DIFFERENCE IN EFFICACY OR SIDE EFFECTS. Which is backed up in studies, where mobic has been shown to have no greater side effect potential than placebo. 48 dollars versus 120 isn't a big difference, which is all I saw.
Most people when faced with that small of a difference would say 'well, let me use the newer one, just because." If faced with 1800 versus 48 for virtually the same efficacy, they'd go with 48.
Guess what? With millions of people every day making similarly blinded decisions (aciphex instead of prilosec or even famotidine, pristiq instead of venlafaxine, combo pills instead of the separate medications), it's not very hard for the costs to mount dramatically. IT's just that we as the consumer don't see it due to copays. We DO see it in our premiums.
And of course we haven't gotten into the matter of lifestyle prevention. Minimal exercise is twice as effective as statins in reducing ischemic events, among many other well-documented benefits including increase in on-the-job productivity, decreased sick days, longer productive life, lower rates of cancer, dementia, arthritis, etc. Those that engage in such things see no monetary reward. While those that don't see no monetary loss.
On my health insurance plan, I, a guy who eats a solid diet, watches his bodyweight, exercises regularly, etc, pay exactly the same premium as the morbidly obese turtles trundling around the hospital.
Here again, the cost of being obese or simply not taking care of oneself is concealed because there are people like me who subsidize their lifestyles.
Your tired little simplistic arguments are old. It's amusing that you find yourself resorting to profanities when logic breaks down. Which isn't surprising since there isn't a ton of logic in your posts.
Everyone's talking about 'bending the cost curve down'. It doesn't take a genius to realize that the easiest way of reducing total healthcare costs is reducing total demand for healthcare, whether it's choosing older standbys that cost orders of magnitude less than newer fancier drugs that offer marginal--if any--benefits, or simply reducing the need for healthcare intervention by living healthier.
