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- inactive, on 11/18/2008, -36/+276Here's the problem with the whole "health care is a human right" canard: Tell that to the doctor who spent 10 or more years of his life getting the education, working through medical school, and working in the trenches of internship. Tell him how you have a right to his services, and that it is your right to have him provide those services at the rate the government is willing to pay him.
Then watch the most qualified individuals choose another line of work. Just. Like. Teachers. - digitronix, on 11/18/2008, -37/+214Here is a blog post from a surgeon friend of mine (for an example of a doctor's perspective):
http://web.me.com/feucht/Der_Feuchtster/FeuchtBlog ...
The kind and ever gracious benevolence of our dear politicians wishes to provide for your’s and my healthcare. They will make the rich pay. The rich are anybody that are not buried six feet under. When I put on my libertarian Ron Paul hat, I demand that the health care system be as far removed from government as humanly possible. There are several problems with that.
1) The feds require that health care be provided for all. Though the emergency room is only for emergencies, eventually every disease will become an emergency, in which you can go to an emergency room and demand care for free.
2) The feds have imposed massive rules on health care that make it nearly economically unstable. These rules are most prevalent in hospitals, governing the most inane items, such as initials that have been used for orders since the development of medicine, and are uninterpretable only to the clueless, like lawyers.
3) The legal profession has defined an ethereal standard of care which forces maximal possible care in all situations, and makes you guilty even when right.
4) The feds have defined pricing for all but the most elective procedures, such as plastic surgery and dermatology procedures. This means that we have absolutely no control over pricing. We take what we can get, and rarely is it comparable to other highly professional services rendered and always without the extreme risks that are assumed by the physician.
5) The feds have removed value from the cost of medicine, forcing costs to sky-rocket.
6) The third party payor system has removed cost impact on the health care consumer, thus removing any sense of value to any drug or procedure performed. How much is an appendectomy worth? What about a perforated appendectomy in 500 lb diabetic smoker with heart disease that stays in the hospital for 2 weeks. Under medicare, the surgeon gets about $400 for any case of appendicitis, slightly more if the appendix is ruptured. That is barely enough to cover overhead costs. Medical care no longer has value, and the public expects it for free.
7) Our current system was based on a historically previous better economic arrangement for physicians, which allowed them to often render services for free, such as caring for indigent patients or offering their time as “community service” to the hospital as call. With the loss of any margin to health care, most physicians (especially surgeons) can no longer freely give of their time, creating extreme tension between physicians and hospitals, with physicians now demanding to be paid for their hospital service call and hospitals insisting that such care continue to be rendered for free.
The only difference between the current US health care system and most European health care systems, such as that in Great Britain, is that the socialized system in the US is funded mostly by entrepreneurial private dollars, while that the socialized system in Great Britain or Canada funded by public funds. In reality, we are giving the feds a very foolish deal. They can carry on the most asinine regulatory actions, pretend to offer tort reform, offer grandiose promises to the public, and act truly sincere about caring for the health care provider. They reluctantly save the health care system at the last moment after doctors throughout the nation have kissed the derriere of their local politician with begging and pleading not to enact Medicare cuts (which still is a cut, since current inflation is estimated at between 3-16%) thinking that we should be ever grateful for them. As a response to decreased Medicare reimbursement, private enterprise is trying to become increasingly creative about making a profit. Historically, our response to decreasing reimbursement was simply to work harder. Now, we are working as hard as possible in order to maintain financial equity. Several years ago, a colleague announced that he was going to take a week a month off, since that would then give him the equivalent of an eighty hour work week and provide some sanity to his life. Several months later, his revenues plunged to not even supporting his overhead. He is now back to much less time off, and making a modest profit, though his investments are probably more financially rewarding that his profession itself, and he rarely ever seems to be happy or enjoying himself at work.
With all of this under consideration, I have several proposals.
1) Private enterprise quit funding federal health care programs. We should back out of investing in health care, whether it be for our own private offices, or for community driven ventures.
2) We should encourage medical care to go to a purely socialized venue like Canada. This will force the feds to live by the insane rules that they create, since they will be creating them for themselves. This will also not allow for “boutique” practices, which is healthcare that tries to escape from the “system”.
3) We should quit funding the entire bureaucracy through taxes. The state is currently sucking us dry. If you count all the taxes that we are forced to pay, including Medicare, income, property, sales, telephone use, vehicle, and many other taxes, all but the most poor are paying over 50% of our income into taxes. Stop working. Retire. Go on Medicare. Leave the country. Find another profession. Live off the inheritance you were planning on giving to your children.
4) The final solution (Enderlösung!) is to find a system whereby the hospital or state assumes all of your overhead, and truly pays you on a per hour basis that is commensurate with your skills and level of training. This would also allow you to work as much or as minimally as possible without incurring major debts through massive overhead. Sadly, such a system doesn’t exist. If physicians would uniformly refuse to continue funding the system and allowing to hold us in forced servitude and quit, go on strike, shut down, or terminate virtually every state and third party payment, the system might be forced to correct itself. Until then, the fed is going to be content with letting private enterprise fund their health care follies.
With all of this under consideration, it would be best for me to get out of medicine altogether. Yet, I continue to look for alternatives, with less stress and less work hours. I will not be a sacrificial lamb to the state. - sheeplescareme, on 11/18/2008, -6/+137i used to be a nurse and every healthcare professional i know feels that way, including myself (note: used to be a nurse). the paperwork, the poor pay, lack of recognition and respect, and the long hours do not conspire to make happy workers. one of my own doctors was so disgusted with the system that he recently left his practice after twenty years to go back to college.
- inactive, on 11/18/2008, -79/+209ObamaCare will solve all this.
The doctors will work for less money, less respect, have less ability to make decisions, and have more paperwork.
It will be just like Soviet Russia, but cooler and hip. - CaptCarrot, on 11/18/2008, -1/+91There's a doc in St. Louis who now advertises his services for house calls. He's officially retired, and has left the system. No insurance taken. For something like $50, you get him for a solid half hour.
- inactive, on 11/18/2008, -35/+111Well, it looks like another problem for our benevolent government to solve, doesn't it? Why so glum? Have faith!
They do everything else so well, they'll fix up this health care debacle in a jiffy, and then all the doctors, nurses, and patients will be happy.
Surely, more government involvement in health care IS the answer. - RogerStrong, on 11/19/2008, -7/+56>> We should encourage medical
>> care to go to a purely socialized
>> venue like Canada.
Except that Canada doesn't have socialized medicine.
In socialized medical systems, the doctors work directly for the state. In Canada, doctors run their own private practices, just like they do in the US. Most hospitals are privately owned too.
The difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.
The proper term for this is "single-payer insurance." For you Americans, the better phrase is "Medicare for all."
If that insurance isn't enough, nothing stops you from getting additional private insurance, as I do through my employer. Insurance that costs a lot less than in the States, because of what the public system covers. - niradg, on 11/19/2008, -18/+63I like how people are blaming a socialized system that doesn't exist here for our current woes.
- 8347, on 11/19/2008, -15/+58When I lived in France the doctors were working an average of 72 hours a week. They had to fly to England to go on strike because it was illegal for them to strike in their own country.
Socialized medicine has a lot of problems that for whatever reason don't get mentioned in the media. - InfernoX, on 11/19/2008, -10/+51What the ***** are you talking about? Last I checked socialized healthcare didn't deny anyone the care they needed it regardless of the circumstances.
- CaptCarrot, on 11/18/2008, -9/+47But what happens when people don't want to become doctors anymore?
Perhaps promising high school students will be drafted into some sort of civilian service where they'll be sorted out by their aptitude into careers the government feels they should fill? Nah, that'd never happen. - JigoroKano, on 11/19/2008, -5/+41Right now they work for what the insurance companies are willing to pay them. The insurance companies basically dictate what care a patient receives by what procedures they are willing to pay for under what circumstances. Insurance companies will find any excuse to deny coverage. For instance, say if some insured dope head comes in after getting in an accident. The doctor will not test for drugs. Do you know why? Because then the insurance company will deny coverage. So this idiot gets off, when maybe they should be in jail.
What you describe isn't good, but the current system is also bad. The insurance companies and the government can both take away the Doctor's ability to practice medicine has they see fit. - govsucks, on 11/19/2008, -4/+40Soon to be arrested and charged with a crime I'm sure. That is the way it should be. Government and the rest of the collectivists stay out of the individuals business. But collectivists don't like minding their own business very much, after all they are right and the individual is wrong in all instances.
I only wish we could return to a time with more freedom when you could have a doctor come to your home for a checkup for 50 -100 bucks.
I went for a cat scan a few weeks ago and they charged my insurance company 8,500.00
It took maybe 2 minutes and the guy running the machine clicked the mouse a couple of times and proceeded to talk to another guy while the machine did its job. Even if that freaking machine cost 10 million dollars you would only have to scan 1,100 people to pay for it in full at 8500 a pop. Its a ***** rip off. - TheLoneWolf071, on 11/19/2008, -2/+37The problem is health insurance. It's made the whole field unreasonable. You used to go to the doctors office, get checked out, and pay your $25, now a visit costs $250, but since we have insurance we don't care.
- digitronix, on 11/18/2008, -7/+40@jsffive
What a ignorant and condescending comment.
What is your job? How much red tape do you put up with? How many trial lawyers are at your throat every time you make a mistake? How frequently do you make life or death decisions in your job? How many hours do you work for no pay clients? How many millionaire doctors do you know that are not cosmetic surgeons?
I bet you'd change your rhetoric if you just one day contract cancer, and all the doctors are driven out of business by trial lawyers and bureaucrats. Maybe nobody should shed a tear for you when that happens. - commenter01, on 11/19/2008, -6/+38"foreigners who can not relate to the patients and their concerns"... ouch, easy there on the xenophobia.
- inactive, on 11/18/2008, -17/+47Yes we can...receive inadequate government healthcare!!!
- pennvneff, on 11/19/2008, -3/+33It's the goddamn insurance companies, those ***** are taking their pound of flesh from everyone.
- inactive, on 11/18/2008, -11/+41This came from CNN? Wow.
Great Britain has had this exact problem for years. It's the reason why they've been hiring
Asian, see Muslim, doctors and nurses. The terrorist caught at Glasgow International Airport in a failed car-bomb attack where the only victim was the perp who severely burned himself and was beaten-up by an airport employee, was a doctor employed at a local hospital. - gr8spAcstr, on 11/19/2008, -0/+29It is amazingly disheartening to learn that a career as an RN is more like waiting tables at a busy diner than a rewarding career helping others. There are the few patients who you feel benefited from your hard work, but most times its churn and burn, there are others waiting. This will NOT be helped when the aging boomers get sick and the diminutive number of Gen X healthcare workers are called upon to care for them. Do the math, its bad and getting worse by the minute. Anyone know of any diners hiring?
- XtheXlanternX, on 11/19/2008, -3/+32Healthcare can be cheap if you take out all the adminstrators and bureaucrats within the insurance companies. The doctors aren't getting rich when you pay a few thousand dollars to get X-rays.. the insurance companies and huge healthcare corporations are. The majority of the pay should go to the doctors and the actual providers of care (nurses, aides, etc) not to administrators and bureaucrats. If you cut these (mostly) unnecessary people out of the chain, you're saving massive amounts of money. My mother has been a nurse her whole life. She has seen nurses lose jobs and her workload increased (pay slightly too to be fair) while the CEO of the hospitals makes millions of dollars to do pretty much nothing. Just like every other American business, hospitals and insurers are far too top heavy.
- Ellipsys, on 11/19/2008, -5/+32I don't think any of this happens in Sweden or any other country with civilized socialized medicine. The alternative theory is..
EVERYONE does something that puts them at risk for something. Thus, everyone gets care. We'll pay for your carpal tunnel syndrome you got from working on a PC all day, and we'll pay for the construction worker's broken leg when he slips off the roof. There's no reason to deny care for anyone - its a fallacy that socialized medicine HAS to lead to an ever-shrinking list of covered symptoms. However, when you bring profit into it, like the current system, insurance companies can just deny you for whatever the ***** you feel, creating a barrier to care.
My father is a physician, and I'd probably be one myself by now if it wasn't for my chronic illness. We both agree that insurance companies and foolish regulations are to blame for the state of medical care, but think that a smart socialized program would be the best option. - degree, on 11/19/2008, -0/+26k, well you better get to work then. first, get a degree in bio or pre-med (remember you need good grades). do well on the mcat, hit up a few years of med school, grind through several as a resident.....grats now you are a doctor. you will always be on call, often be making very serious decisions, and don't mess up b/c not only will you have someone's suffering/death on your conscience, but your malpractice insurance (which you are already payin for balls deep) will go up.
oh yeah, your kids will hate you because you're never there, your wife will cheat on you with some dude who got a com degree, and you will get HIV from a homeless man spitting blood in your eye as he turns into a zombie and bites a nurse's face. - seedofc, on 11/19/2008, -7/+33Wrong. There are libertarians in emergency rooms.
The difference is that they actually understand that the doctor(s) treating them spent thousands upon thousands of dollars, as well as several years in school to do what they are doing for them. Libertarians realize that these doctors pay an insane amount of money for medical malpractice insurance, and spend hours upon hours dealing with terrible insurance companies and poorly managed government programs (i.e. medicare). They realize the sacrifice and they are grateful. Can you say the same for yourself? - inactive, on 11/19/2008, -18/+42I will be applying to med schools next year. The astronomical cost of student loans combined with the dwindling pay for doctors has pushed many people out of the medical field. Every resident physician i know has told me to do something else and forget med school. I am not going to med school for the money or the prestige. those days are over. I am doing it because med schools today are pumping out morons and foreigners who can not relate to the patients and their concerns. I want to make a difference in this world and its a damn shame i will be driven into poverty trying.
- Singularitarian, on 11/19/2008, -2/+26Seriously, why does it have to suck so much to be a doctor? Why the insane hours? What is it about medicine in particular, as opposed to say aerospace engineering, that would require such torturous working conditions?
This is a serious problem. There are a lot of very smart people who choose not to become doctors because the hours suck. We need those people in medicine. It's hurting us to lose them. Why can't we have doctors who work forty hour weeks?
(Do they say it's because there's not enough doctors? I suggest there aren't enough doctors because doctors don't work forty hour weeks.)
A doctor will stay up for 30 hours straight, lucky to catch 20 minutes of sleep here or there, and then he will operate on your brain.
Doctors don't even get paid well. They have massive debt when they leave med school, and then they work making $40,000 a year or so for several years during their residencies. Only then do they start to get paid well.
Most doctors are either too saintly or too macho to launch a seriously rebellion against their miserable schedules. But this only perpetuates the problem. - inactive, on 11/19/2008, -2/+25Great. Now how will OBGYNs able to practice their love with women?
- reaper527, on 11/18/2008, -2/+24i think you missed his sarcasm.
i think you hit the nail on the head though carrot. we have a very bleak future if we don't fix the healthcare system, and nationalizing it is making the problem worse, not better. it will mean more regulation, and less incentive to become a doctor. this will be combined with a larger pool of patients. more patients and less doctors will in turn mean worse healthcare for everyone. - Striker101, on 11/18/2008, -5/+27So good, the docs are heading for Galt's Gulch!
- BlueAyez, on 11/19/2008, -23/+45You are losing sight of the benefits of Universal Health Care:
Education:
Low cost education for promising med students
National Health care service instead of student loans
Financial:
No need to deal with insurance companies
No profiteering on patients' misery
No need for extremely expensive malpractice insurance
Negotiated drug costs instead of charging Americans 4 to 400 times what they charge internationally
Payments for results
No more medical bankruptcies to add to the banking misery.
More of what Doctors say they want from the profession:
More personal time
Less red tape
More patient time
One regulatory agency instead of dozens
Benefits to the patients:
Comprehensive preventative medicine
Health education
No more medical bankruptcies
Neighborhood care
Neighborhood employment
Getting to know your doctor instead of being shuttled around every time someone drops your HMO
Set co-pays for services
Integrated medical social services
Faster diagnosis because your MD has known you for years
Better support for programs like addiction recovery, birth defect detection and elder care. - dcmjzero, on 11/19/2008, -13/+35We should just get the government out of everything! Who needs socialized medicine, socialized schools, socialized fire departments, socialized police... We should all just fend for ourselves!
- grantface, on 11/19/2008, -14/+35The federal government really shouldn't be involved in medicine at all... along with a lot of other things.
- dcmjzero, on 11/19/2008, -14/+35Socialized medicine would be worth it if we never had to hear the words "health insurance" again.
- XtheXlanternX, on 11/18/2008, -0/+21While I do think our taxes are very high and mostly unnecessary, the problems with the medical system are due moreso to the things he mentioned, like how doctors can't charge how much they want... they can only charge what the insurance companies/government will reimburse them for. I just think the taxes argument is a fight we can handle another day. The system is so screwed up right now. It is bad for health professionals and bad for patients. It is good for the insurance companies though, so we will have a hard time changing it.
- digitronix, on 11/18/2008, -1/+21It's more of an 'evade taxes' argument than an 'abolish taxes' argument. Taking as many tax breaks as possible, finding loopholes. I know for instance that he drives down to Oregon (from Washington State) to take advantage of the fact they have no sales tax. Things like that.
- karolisonline, on 11/19/2008, -5/+24it is strange how this type of health care can work in any country except USA...
tomorrow i'm going to the doctor and i'm happy that i wont have to pay any money to him.. later i will take government paid two weeks out of work to get healthy and in shape.. oh and by the way second major degree in university is as free as was the first diploma..
all this is in price of bigger taxes, but when government is holding health care business for example it is doing it without profit and that is why public and social service run by government is more effective and cheaper all in all. - stoanhart, on 11/19/2008, -4/+22I don't understand your argument. What you describe sounds like the privatized healthcare in the US. Here in Canada, if a roofer falls off a roof and breaks his legs, he will receive medical treatment, employment insurnace while recovering from his injury, and will then be encouraged to return to his job.
- sheeplescareme, on 11/19/2008, -0/+17ironic that you said that. i went from working in a trauma unit to tending bar part-time and going back to school. i never had a problem with my patients (to be honest, i miss that interaction quite a bit) but the mounds of paperwork, expensive malpractice insurance, and mandatory overtime was a killer (and not just a shift here and there, but almost daily).
- Ymeg, on 11/19/2008, -4/+21Less red tape with Government health care?
If the government controls the industry, the government will cut back on its regulations? - durruticolumn, on 09/18/2009, -7/+24
"It will be just like Soviet Russia, but cooler and hip."
Yeah, Sweden's health care sucks! /s - BlackJackJester, on 11/19/2008, -1/+17and they pay 4 to 5 times the amount in student loans,and spend their entire 20's in school. They are also smarter than 90% of the population, and face the most serious moral and ethical decisions of any profession. You want the person choosing if you live or die making as much as a carpenter? I don't think so. These people deserve every dollar they make, as their job is quite literally life or death.
They deserve the money they make.
A good accountant, manager, or salesman makes just as much, and they aren't dealing with people's lives. - economicbob, on 11/19/2008, -3/+19This is funny because people like Kerry Clark (CEO of Cardinal Health) still gets his 9.7 Million at the end of the year, all while our first year doctors start out with 100,000 in debt. Not to mention students who want to enter the medical field can no longer get loans. I propose we forget about education. We continue to give the banks more money, we ignore the congresses call to help home owners, we continue to neglect the auto industry and stop asking top execs to give up their bonus pay.
Thanks Cardinal Health.
http://greengostar.com/kerry-clark-cardinal-ceo-co ... - zeitgueist, on 11/19/2008, -4/+19Less of it, per capita, goes to healthcare than the US.
- OECD - TRMarchesano, on 11/18/2008, -5/+20jsffive
you are the glaring example of everything wrong in America today..... you don't have a clue about what you say - emazur, on 11/19/2008, -5/+20There is an article from usatoday in 2002 that gives quitting doctors a mention:
http://www.africa.fnst-freiheit.org/webcom/show_pa ...
http://pqasb.pqarchiver.com/USAToday/access/191959 ...
"Anecdotes abound about physicians leaving the medical profession because they can't afford malpractice insurance even though they have never been sued, says Edward Hudgins, Washington director of the Objectivist Center."
Striker101 is correct about Galt's Gulch, this is exactly the kind of thing Ayn Rand warned about. Key paragraphs from this article:
"Of the 12,000 respondents, 49 percent said they'd consider leaving medicine. Many said they are overwhelmed with their practices, not because they have too many patients, but because there's too much red tape generated from insurance companies and government agencies.
To manage their daily work schedules, many survey respondents reported making changes. With lower reimbursement from insurance companies and the cost of malpractice insurance skyrocketing, these health professionals say it's not worth running a practice and are changing careers.
And as Ray mentioned, med school students are shying away from family medicine. In a survey published in the Journal of the American Medical Association in September, only 2 percent of current medical students plan to take up primary care.That's because these students are wary of the same complaints that are causing existing doctors to flee primary care" - Wargala, on 11/19/2008, -15/+29And to top it all off, many of you all out there see healthcare as a "right" rather than a "privilege" that it is. Because of that, you want healthcare to be free or extremely low cost. These people didn't get into being doctors and such, taking out hundreds of thousands of dollars in student loans, work 80+ hour work weeks just to do it all for minimum wage.
- TheFinaleofSeem, on 11/19/2008, -0/+14There's a doctor I recently took the wife to (nasty and infected ingrown toenail) who got ***** sick of all the ***** and now does not accept any kind of insurance. If you have insurance, you pay him when services are rendered and then you can take it up with your insurance. As a result, he's a lot cheaper than any other doctor in the area. It's still not cheap (it was about $250 for the toe, but that also included cutting half the nail off and burning the base with phenol, anesthesia, and an antibiotic prescription), but if you're not insured or poorly insured, then it's not a bad idea at all.
- dsmx, on 11/19/2008, -3/+17All those issues the NHS deals with in the UK and the NHS treats everyone regardless.
You can bash socialised medicine all you want but the fact remains that every country with socialised medicine in the developed world is higher up the healthcare rankings according to the WHO. Hell even a country like cuba has managed to put a healthcare system that is becoming better than the US system., - XtheXlanternX, on 11/19/2008, -1/+15If the healthcare system was orchestrated properly, doctors and patients could both be happy. Currently, insurance companies win while doctors and patients lose. The government plan could be better, but it probably will just be a glorified health insurance plan, making the rich richer and poor poorer and in the end making our care worse. Lots of people say "I'm moving to Canada" or whatnot, but seriously, I am moving out of this country to test the waters the first time I get an offer (working on my 3rd language and resume).
- TheFinaleofSeem, on 11/19/2008, -1/+15Doctors are under a pretty big load. ***** of time and money to actually get into the profession. Then you deal with bitchy people all day who expect you to work miracles, work with the threat of getting your ass sued off at the drop of a hat, make life or death decisions all the time...the list goes on. Sure, the burger flipper may hate his job, but his job is nothing like a doctors.
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