Why national health care is not the answer for America

[Mormon Red Death]

Originally Posted by tooblue

Mike, the Hippocratic oath be dammed, I’m jacking up the price on PsychMike version 2.0 due out this Spring!

Social ethics being key here!

Hey Mike... Wouldn't you be happy to start your own practice only to have the government decide how much you can charge? hey there is nothing about that... that is just a sacrifice you should be willing to make..

[Mormon Red Death]

Originally Posted by non sequitur

Where do you come down on price gouging? If I own a store and my town gets hit by a hurricane, what right does the government have to tell me that I can't sell rolls of toilet paper for $10 a piece and bottles of water for $20? If I own an oil company, why does the government have the right to tell me I can't get together with the owners of all the other oil companies and agree that everyone should sell gas for $10 a gallon? Is the government acting immorally in those cases?

I have your response tomorrow ... the wife and kid want to go to dinner..

[MikeWaters]

Becoming a doctor is hardly just two years of extra school.

It's basically a minimum of seven, and can go up easily past 12.

All for bright people that have friends who are making 6 figure incomes many years before they are making anything.

Now one legit issue is whether we should be importing so many doctors (from India, etc.).

[Mormon Red Death]

Originally Posted by hyrum

Rates are already highly regulated in the US through the pricing structure established by CMS (Centers for Medicare and Medicaid Services) and the AMA (through its CPT list of procedure codes). Aren't most insurance reimbursements linked to these rates?

As with the Indian medical tourism you mention, medical care is becoming globally commoditized. US hospitals and doctors are quite fortunate that travel for sick patients and the myth of the "greatest health care in the world" are such barriers.

you will notice that I mentioned that we have a half gov/half market system. Most insurances use DRGs (Diagnostic related groups) for inpatients and Cpt-4 codes for Outpatients. they negotiae their own rates for all that info. There are some that still base their payments on % of Charge.

[Mormon Red Death]

Originally Posted by non sequitur

Where do you come down on price gouging? If I own a store and my town gets hit by a hurricane, what right does the government have to tell me that I can't sell toilet paper for $10 a roll and water for $20 a bottle? If I own an oil company, why does the government have the right to tell me I can't get together with the owners of all the other oil companies and agree that everyone should sell gas for $10 a gallon? Is the government acting immorally in those cases?

My rule of thumb is that anytime the government gets involved things gets worse....

If a store chooses to raise their price due to catastrophe that is their choice. However, after a crisis would you ever go to a place that did that raised their prices like that?

In michigan after 9-11 the governor gave a whole bunch of speeches about how she was going to get all the price gougers.... Not one of them were tried (apparently its pretty hard to prove .

There was a gas station by my inlaws house that raised their gas prices to $10 a gallon. A couple weeks after 9-11 there were people protesting outside the gas station. That place soon went out of business.

I say let the market decide...


As for the oil companies getting together ... well wouldn't that just mean that the car companies would come up with more electric cars or steam cars or whatever... people would take more public transportation

I guess I could go on and on but I am going to bed...

[Venkman]

Originally Posted by BarbaraGordon

I'm curious as to whether national healthcare is Constitutional. I'm no lawyer but it seems like it's pushing the tenth amendment. Anybody know?

Lol, what gov't program over the last 70 years hasn't?

[SoonerCoug]

Originally Posted by jay santos

An extra couple years of school and a standard deviation higher IQ shouldn't justify a salary 6 X the national average.

Jay Santos: A lot of med students are in school or training until they are ~34-37 years old. My path is a little longer since I'm doing a PhD plus an MD, but it's not unusual for training to take about this long even without a PhD. During the last 5 years I'll be making ~40,000 a year while working 80 hour weeks. Most med students end up with $100K-200K debt on top of that. If salary is a motivation for career choice, there are much quicker and less painful ways to make six figures. On top of that, many specialists have a very difficult lifestyle throughout their career.

Do you really think doctors don't deserve a 6 figure salary with this kind of lengthy training?

Think about it this way: for many specialties, the period from high school graduation to private practice is longer than the entire period of kindergarten to high school graduation. For me, I'll have been in school and training for 17 years since high school graduation (not counting my mission)...versus the 13 years from kindergarten to high school graduation.

[jay santos]

Originally Posted by SoonerCoug

Jay Santos: A lot of med students are in school or training until they are ~34-37 years old. My path is a little longer since I'm doing a PhD plus an MD, but it's not unusual for training to take about this long even without a PhD. During the last 5 years I'll be making ~40,000 a year while working 80 hour weeks. Most med students end up with $100K-200K debt on top of that. If salary is a motivation for career choice, there are much quicker and less painful ways to make six figures. On top of that, many specialists have a very difficult lifestyle throughout their career.

Do you really think doctors don't deserve a 6 figure salary with this kind of lengthy training?

Think about it this way: for many specialties, the period from high school graduation to private practice is longer than the entire period of kindergarten to high school graduation. For me, I'll have been in school and training for 17 years since high school graduation (not counting my mission)...versus the 13 years from kindergarten to high school graduation.

A couple responses:

1. Many types of doctors are making $300,000 much sooner than your 17 years post high school. I do believe that number is artificially high due to the supply choke on # of doctors U.S. medical schools can produce.

2. It shouldn't take 17 years of post high school training to treat more than 50% of what you end up treating, if you go into private practice. We need a more flexible model where most issues are treated with people with master's degrees making <$100K per year. More complicated issues can be handled by doctors, and with the decrease in demand and increase in supply, prices will go down on that stuff too. Same kind of reform needs to take place on the facility side as well. It shouldn't cost $500 to set a broken bone after hours.

[SoonerCoug]

They already have people with "master's degrees" who treat patients, handle easier cases, set broken bones, etc. Those people are called Physician's Assistants. They make less than 6 figures, just like you prefer.

[SoonerCoug]

My first choice for reform would be to eliminate insurance companies altogether and replace them with a government middleman who doesn't make a profit.