Should we have single-payer healthcare?

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Yes, substantially worse off. The difference between Canadian and American wages is PROFOUND, especially for specialists. Canadian anesthesiologists earn $193,906 CDN ($148,688.38 USD) while their US counterparts earn $358,000 USD. That is SUBSTANTIALLY worse off. That's over 7 million dollars plus year-over-year stock returns in difference over a working lifetime. That's enough income that, if you invested it all, your children AND grandchildren would be well taken care of via trusts, having their college paid for, etc. And if you don't have kids, that's the difference between being able to retire at 45 versus 65. That's a lot of money to lose, and is the difference between being wealthy or being a wage slave that depends on their paycheck until they die.

Heaven forbid anesthesiologists make less than 360k. Those backwards Canadians. They should be emulating US not the other way round!

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Heaven forbid anesthesiologists make less than 360k. Those Canadians are really backwards.
What it comes down to is this, to me: what is most important to you, your family or society as a whole? Traditionally, that answer has always been family. The difference one can make to their family with that much greater of an income is profound, particularly with the level of debt physicians have today. I've actually broken down the math before, but at 150k, my after-tax and student loan income would be a mere 45k/year. If you think that is worth 14 years of training, you're insane.
 
Although the free market is a great tool for providing the public with the best, cheapest TV set, washer/dryer or car, maybe it doesn't work for healthcare, which is part of the reason countries with "socialized" medicine end up with much cheaper care and comparable results.
Many of the elements that make a free market efficient are simply not present in healthcare :
1) The person making the decision to consume a certain drug or medical procedure (doctor) is most often not the person paying for it (patient or insurance co). Often, the person making that decision doesn't even know the cost of the drug or procedure or at worst, is in conflict of interest.
2) People are not rational agents when it comes to healthcare : When facing death or suffering, most people will be willing to spend fortunes on things that only offer very marginal benefits. Few people would buy a car that is 10 times more expensive but gives you 5% better odds of surviving an accident. Yet when it comes to pharmaceuticals, such a marginal effect is enough for a drug to become the new guideline (especially in oncology), no matter the cost of that drug.
3) Reliance on ever longer patents : succesful lobbying and tinkering with certain molecules have allowed pharmaceutical to prolong the patents on blockbuster drugs. The prices are then arbitrarily set by these pharma co (see the Shkreli case) who rarely have to justify themselves. Competition only enters the picture when generics are allowed, often only after decades.
4 ) Limited ability to compare options : Altough it is always possible to get a second opinion for elective operations or treatment fo chronic diseases, that is simply absent for all urgent care. Furthermore, most people do not know enough to adequatly compare the different options available to them and simply rely on the authorithy of a trusted healthcare provider (which again is often in a position of conflict of interest).

Furthermore, patients have the most expensive healthcare in the world in the US, but we are ranked 31, and below many countries in terms of patient outcome. It's not working for the vast majority of Americans. It just isn't.

This is why healthcare in general, including drug development and production, should be managed by the state, that has an interest in having the healthiest population for the least amount of money, instead of simply higher profits for the shareholders.

Aren't you glad you started this thread?
 
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I've debated both sides of this issue extensively in the past and @sb247 has been too busy or uninterested in pre-allo lately to bother posting, so I figured I'd play the libertarian POV on this one because I've grown pretty tired of the bleeding heart sounding board that is pre-allo and figured the issue was worth someone debating.

My actual view on this is that an ideally managed system would be fine, so long as there were a parallel private system as Germany and many other developed nations have to keep the system honest. Unfortunately, I really do believe our politicians are too incompetent to be trusted to properly craft and fund such a system, so I much prefer the devil I know.
 
I've debated both sides of this issue extensively in the past and @sb247 has been too busy or uninterested in pre-allo lately to bother posting, so I figured I'd play the libertarian POV on this one because I've grown pretty tired of the bleeding heart sounding board that is pre-allo and figured the issue was worth someone debating.

My actual view on this is that an ideally managed system would be fine, so long as there were a parallel private system as Germany and many other developed nations have to keep the system honest. Unfortunately, I really do believe our politicians are too incompetent to be trusted to properly craft and fund such a system, so I much prefer the devil I know.
I try to stay out if I can... I don't care what the commodity/service is, people should pay their own way. I don't have a right to take from others to fund my needs.
 
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I try to stay out if I can... I don't care what the commodity/service is, people should pay their own way. I don't have a right to take from others to fund my needs.
And I honestly think there's a lot of merit to what you're saying, and I really don't think there's anything wrong with your position on it. It's unfortunate, because people have become so attached to "insurance" that they can't think about alternative models that would be both more affordable than what we have now and not require some expensive government program to be forged to fund them. But that's not even a discussion pre-allo is capable of having, so I'm just going to not even get into it.
 
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What it comes down to is this, to me: what is most important to you, your family or society as a whole? Traditionally, that answer has always been family. The difference one can make to their family with that much greater of an income is profound, particularly with the level of debt physicians have today. I've actually broken down the math before, but at 150k, my after-tax and student loan income would be a mere 45k/year. If you think that is worth 14 years of training, you're insane.

While I agree with your sentiment, your take-home would be closer to 88k if your base salary was 150k and you were using PAYE to pay back loans. This also assumes you had zero deductions.

If you're using a 10-year repayment plan and the loans are more than $150k, then yeah you wouldn't be making very much.
 
While I agree with your sentiment, your take-home would be closer to 88k if your base salary was 150k and you were using PAYE to pay back loans. This also assumes you had zero deductions.

If you're using a 10-year repayment plan and the loans are more than $150k, then yeah you wouldn't be making very much.
The trouble is, PAYE has a tax bomb on the end of it that would wipe out my retirement savings if I used it for the life of my loan. So it's either pay now and live poor but be able to retire, or don't pay now and then get taxed for hundreds of thousands of dollars later (my tax bomb on PAYE would be nearly half a million dollars at 200k, I can't even imagine how large it would be at 150k).
 
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I try to stay out if I can... I don't care what the commodity/service is, people should pay their own way. I don't have a right to take from others to fund my needs.
Healthcare is a right
 
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Healthcare is a right
How can a right require other people to provide a service for you?

Like, you can have a right to healthcare, and that's fine, but how can you have a right to the services of people that provide that care? Because they also have the right to freedom in regard to both their conditions of employment and their career, so you can't have a right to health care without either forcing someone else to provide it (and thus violating their rights) or by finding enough willing providers to not violate anyone's rights.
 
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The trouble is, PAYE has a tax bomb on the end of it that would wipe out my retirement savings if I used it for the life of my loan. So it's either pay now and live poor but be able to retire, or don't pay now and then get taxed for hundreds of thousands of dollars later (my tax bomb on PAYE would be nearly half a million dollars at 200k, I can't even imagine how large it would be at 150k).

I wouldn't worry too much about that. You'll have a tax liability for sure but not as high as quick math might think, and even less after you factor in inflation.

When I worked in finance we had plenty of clients push losses around from multiple years prior to avoid tax liabilities from capital gains. Same concept here, a lot of nice accounting work that can be done if you plan for it.
 
I wouldn't worry too much about that. You'll have a tax liability for sure but not as high as quick math might think, and even less after you factor in inflation.

When I worked in finance we had plenty of clients push losses around from multiple years prior to avoid tax liabilities from capital gains. Same concept here, a lot of nice accounting work that can be done if you plan for it.
The trouble is, under socialized medicine physician income would be expected to significantly undershoot inflation, so adjusting figures for inflation doesn't really work when your income is taking slower than inflation and your debt is growing faster than inflation. The future about having a smaller relative value doesn't matter if my wage's relative value has also not increased. Plus there's the psychological impact of having a high debt burden, and the effects of such debt on everything from your credit (they recently changed lending formulas for housing, for instance, which will make traditional loans unobtainable for many physicians, and doctor loans would likely cease to exist without doctor monies still being large enough to make us an attractive lending target).

Regardless, I'm big on retiring early and bring financially independent, so my plan has always been to bust my ass while living like I'm poor for 10 years post-fellowship, then holing up overseas and living off of a sustainable 4% withdrawal rate and a returns from a small real estate portfolio indefinitely. Keeping 7 figures of debt around is dangerous for a person with fixed assets that are largely invested, so passing down my loans is priority one.
 
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Healthcare is a right

How do you figure? Like @Mad Jack said, why should any physician be forced to provide services based on an education that usually they paid for themselves (via loans and the repayment of these loans with interest)?

Why should I have to pay for someone else's health care when they don't want to pay for it themselves? Like the whole 'insurance needs to cover my birth control pills' argument, why should I have to pay something that costs less than $10 a month for an individual? Take responsibility for yourself, save your money for times when you might need it, and don't mooch off me and other productive citizens.

(In before the move to SPF:

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I had this argument with someone the other day. I said that if you can afford a luxury product like an iphone then you can afford a $30 copay. If you can't come up with $30, but can continue paying for phone data then it is on you for not budgeting properly. He replied that smartphones are a necessity nowadays and it wouldn't be fair for someone to have to give one up to pay for their healthcare...?

There are major problems with our system and costs need to be made more reasonable and clear and accessible. But I don't understand this mentality that it is unreasonable to spend money on your health when that money could instead be going to entertainment products. If you cease to exist then the entertainment goes away. It's up to you to prioritize

Prioritizing budget?

$30/month copay?

Kaiser Foundation: "The average annual premiums in 2015 are $6,251 for single coverage and $17,545 for family coverage. The average single and family premiums increased 4% in the last year. The average family premium has increased 61% since 2005 and 27% since 2010."

"If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”
 
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Prioritizing budget?

$30/month copay?

Kaiser Foundation: "The average annual premiums in 2015 are $6,251 for single coverage and $17,545 for family coverage. The average single and family premiums increased 4% in the last year. The average family premium has increased 61% since 2005 and 27% since 2010."

"If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”

Rising costs like this were thanks to Obamacare... The people who wrote that disaster were also thinking that healthcare was a right.
 
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I had this argument with someone the other day. I said that if you can afford a luxury product like an iphone then you can afford a $30 copay. If you can't come up with $30, but can continue paying for phone data then it is on you for not budgeting properly. He replied that smartphones are a necessity nowadays and it wouldn't be fair for someone to have to give one up to pay for their healthcare...?

There are major problems with our system and costs need to be made more reasonable and clear and accessible. But I don't understand this mentality that it is unreasonable to spend money on your health when that money could instead be going to entertainment products. If you cease to exist then the entertainment goes away. It's up to you to prioritize

While I agree people could certainly budget better and spend less on entertainment, to reduce the cost of healthcare to just copays is not a great argument. Most of the time the guy isn't choosing iPhone data over a $30 copay, he's choosing iPhone data over a $300 routine bloodwork visit because he hasn't hit his deductible yet -- which he would have to forfeit 10 months of phone data to afford. On a good year my family of 3 will pay an average of $12k/yr in healthcare costs without any chronic ailments; and this is below the national average. I'm fortunate enough to be able to afford this, but try having a $60k/yr job -- roughly $45k/yr after tax with modest deductions -- and fitting $12k/yr in your budget. Trying to fit all other expenses for a family of 3 with ~$30k/yr take-home is not middle class, that's poverty.

I tend to be very conservative and I believe wholeheartedly in a free market economy, but even I can see this is a fundamental problem that goes beyond proper budgeting.
 
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Right. Silly me, I forgot how happy you guys were handcuffing yourselves to a 200 year old document written by people who didn't think abolishing slavery was worthy of the ink. But given the prominence of a 2000 year old document in your politics, shouldn't really be surprised.

Look, I love America, it just needs work, just like Canada, I was just hoping to find more progressives in a place like this for a field like the one we're pursuing. It just saddens me it isn't the case.

Ironic considering your ideas are from a 150 year old book.

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I try to stay out if I can... I don't care what the commodity/service is, people should pay their own way. I don't have a right to take from others to fund my needs.

Sounds like you should have been a business major. Affording
Yes, substantially worse off. The difference between Canadian and American wages is PROFOUND, especially for specialists. Canadian anesthesiologists earn $193,906 CDN ($148,688.38 USD) while their US counterparts earn $358,000 USD. That is SUBSTANTIALLY worse off. That's over 7 million dollars plus year-over-year stock returns in difference over a working lifetime. That's enough income that, if you invested it all, your children AND grandchildren would be well taken care of via trusts, having their college paid for, etc. And if you don't have kids, that's the difference between being able to retire at 45 versus 65. That's a lot of money to lose, and is the difference between being wealthy or being a wage slave that depends on their paycheck until they die.

So be a doctor for the money and prestige, the big paychecks and retirement funds? It is an absolute travesty if a doctor makes less than 360k but on the saving lives part, that's not so important. Sounds like you should have been a business major. Doctor to poor mom: You need important bloodwork done now. (will cost $300 before you hit your deductible even if you can't afford to feed your kids for the week. I'll pretend like you can afford it.)
 
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Ironic considering your ideas are from a 150 year old book.

Hahaha I love American rhetoric, applying socialist principles? You pinko Marxist heathen commie scumbag!

Too bad that holdovers from the Cold War are still so entwined in your political culture.
 
Sounds like you should have been a business major. Affording


So be a doctor for the money and prestige, the big paychecks and retirement funds? It is an absolute travesty if a doctor makes less than 360k but on the saving lives part, that's not so important. Sounds like you should have been a business major. Doctor to poor mom: You need important bloodwork done now. (will cost $300 before you hit your deductible even if you can't afford to feed your kids for the week. I'll pretend like you can afford it.)
Can you articulate the right you claim to people's goods and services?
 
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Sounds like you should have been a business major. Affording


So be a doctor for the money and prestige, the big paychecks and retirement funds? It is an absolute travesty if a doctor makes less than 360k but on the saving lives part, that's not so important. Sounds like you should have been a business major. Doctor to poor mom: Pay $300 for your important bloodwork before you hit your deductible even if you can't afford to feed your kids for the week, I need my retirement savings.
You want to save lives on the cheap, be my guest. Some of us expect to be paid commensurate with our experience and training. What the government should do to encourage me to take care of such people is actually give me tax breaks for providing free care, something physicians don't currently have. I fully intend to provide charity care in my free time, it's an important thing to me, but when I'm working, I'm working to get paid.
Right. Silly me, I forgot how happy you guys were handcuffing yourselves to a 200 year old document written by people who didn't think abolishing slavery was worthy of the ink. But given the prominence of a 2000 year old document in your politics, shouldn't really be surprised.

Look, I love America, it just needs work, just like Canada, I was just hoping to find more progressives in a place like this for a field like the one we're pursuing. It just saddens me it isn't the case.
Are you American? Because you certainly don't sound American.

That "200 year old document" is what makes us a Republic. You are operating under the principles that America is a Democracy that is obligated to do what the people demand. That, however, is not the case- we are a Constitutional Republic, in which the government is obliged to follow the rule of law rather than the rule of majority, and the constitution is the bedrock of that law, and the very reason that, for instance, people of a minority opinion or group cannot have their rights infringed upon by the majority deciding to vote in a manner that violates their rights. Republics are designed to protect the people from themselves, and prevent mob rule and irrationality from overriding core, foundational principles upon which a nation should operate.
 
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You want to save lives on the cheap, be my guest. Some of us expect to be paid commensurate with our experience and training. What the government should do to encourage me to take care of such people is actually give me tax breaks for providing free care, something physicians don't currently have. I fully intend to provide charity care in my free time, it's an important thing to me, but when I'm working, I'm working to get paid..

I don't advocate working for almost nothing. This obsession with protecting 360k salary and having enough retirement funds for a lavish lifestyle is slightly nauseating. Canadian practitioners are just as competent as their US counterparts, and their salaries don't reflect working for cheap, they are paid well and their entire population is better served than the United States.

Hippocratic Oath: 'I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."
 
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There is an interesting idea that the general public has towards health insurance that is different from any other insurance. For things like your car, you gladly (or not) pay out of pocket for small things like changing the oil or fixing a fuse and you consider it the cost of having a car. Your car insurance is for more extreme or catastrophic such as a crash or sudden failure of the car. The same goes for goes for homeowners insurance. You pay out of pocket to maintain your home and use your homeowners insurance to pay for more acute issues.

For some reason, the view on the role of insurance differs when the public looks at health insurance. Most people are frustrated that they need to pay for anything at all, whether it be a copay or small fee for diagnostics, when they have health insurance. I've seen a large patient base that neglects their healthcare because they have to pay a fee as small as $20. Many people do not want to pay for maintenance measures at all and forego the process altogether. I believe the paradigm use to view health insurance needs to be shifted towards being used for acute injuries or cases while the patient pays to maintain their own health regularly. Public health outcomes are improved when the population actively participates in preventive medicine and maintenance.

That being said, I believe that everyone needs to have access to healthcare but I don't think it needs to free (it isn't free either way due to taxation). This is all easier said than done and I understand that. In the end, I want people to be able to get the treatment they need and I want to be compensated fairly for the years of education and sacrifice that it took me to become an expert in my field.

P.S. - there are some shared cost models that are doing decently well. Look it up as I do not want to give a plug for any companies on this site.
 
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Look, I love America, it just needs work, just like Canada, I was just hoping to find more progressives in a place like this for a field like the one we're pursuing. It just saddens me it isn't the case.


By "needs work", you really just mean "steam-rolling" over the opposition of your enemies.

I'll leave a quote from one of your intellectual forefathers up here:

Lenin said:
A great mass struggle is approaching. It will be an armed uprising. It must, as far as possible, be simultaneous. The masses must know that they are entering upon an armed, bloody and desperate struggle. Contempt for death must become widespread among them and will ensure victory. The onslaught on the enemy must be pressed with the greatest vigour; attack, not defence, must be the slogan of the masses; the ruthless extermination of the enemy will be their task; the organisation of the struggle will become mobile and flexible; the wavering elements among the troops will be drawn into active participation. And in this momentous struggle, the party of the class-conscious proletariat must discharge its duty to the full.”
 
Hahaha I love American rhetoric, applying socialist principles? You pinko Marxist heathen commie scumbag!

Too bad that holdovers from the Cold War are still so entwined in your political culture.

No seriously, go look up the history of "democratic socialism". Your and Sander's ideas of capital and labor and rejection of neoclassical economics are directly taken from Marx.

Also, socialism and communism are disgusting philosophies that have killed a hundred million people. Thru the centralization of power, they destroy competing private institutions and force individuals into monopolistic government institutions (Eg. Soviet medicine, Veterans Admin, etc.) that kill them over time thru the denial of care. They rightfully deserve to be denounced.
 
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Can you articulate the right you claim to people's goods and services?

"As human beings we are all valuable social entities whereby, through the force of morality, through implicitly forged covenants among us as individuals and between us and our governments, and through the natural rights we maintain as individuals and those we collectively surrender to the common good, it has been determined by nature, natural laws, and natural rights that human beings have the right, not the privilege, to healthcare access."

The right to healthcare access can be examined from the perspective of western thought, specifically through the works of Aristotle, Immanuel Kant, Thomas Hobbes, Thomas Paine, Hannah Arendt, James Rawls, and Norman Daniels

From US National Library of Medicine, National Institutes of Health by Thomas Papadimos in philosophy of ethics and humanities
 
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I don't advocate working for almost nothing. This obsession with protecting 360k salary and having enough retirement funds for a lavish lifestyle is slightly nauseating. Canadian practitioners are just as competent as their US counterparts, and their salaries don't reflect working for cheap, they are paid well and their entire population is better served than the United States.

Hippocratic Oath: 'I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."
That oath is just some liberal garbage that has little to do with the traditional Hippocratic Oath- calling it the Oath is a lie.

I swear by Apollo the Physician and Asciepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

Many people have attempted to mold the Oath to their personal values and beliefs as to what the physician should be for society, but none of them holds true to the original oath, which was very specific in its requirements of physicians. None of those requirements involved seeing patients for free, nor did they imply a great duty to "society." The traditional bond described in the oath is between a physician and his patient, not a physician and society.
 
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"As human beings we are all valuable social entities whereby, through the force of morality, through implicitly forged covenants among us as individuals and between us and our governments, and through the natural rights we maintain as individuals and those we collectively surrender to the common good, it has been determined by nature, natural laws, and natural rights that human beings have the right, not the privilege, to healthcare access."
You still haven't answered how you expect to force physicians to provide their services to provide that "right." How can you have a right to someone's services without simultaneously making that person a slave to your needs?
 
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"As human beings we are all valuable social entities whereby, through the force of morality, through implicitly forged covenants among us as individuals and between us and our governments, and through the natural rights we maintain as individuals and those we collectively surrender to the common good, it has been determined by nature, natural laws, and natural rights that human beings have the right, not the privilege, to healthcare access."

The right to healthcare access can be examined from the perspective of western thought, specifically through the works of Aristotle, Immanuel Kant, Thomas Hobbes, Thomas Paine, Hannah Arendt, James Rawls, and Norman Daniels

From US National Library of Medicine, National Institutes of Health by Thomas Papadimos in philosophy of ethics and humanities
bull...

My natural rights specifically preclude you from demanding any particular good/service from me.
 
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The vast majority of physicians do not make $360K. And I believe Mad Jack made a good point. We are expected to pay out hundreds of thousands of dollars of our own money in order to become physicians. Current salaries allow us to pay off our debt and then make enough money to catch up to our peers who have been working other fields the whole time we were training and paying off our debt. That is a fair trade off. That is the point he was making.

And you are forgetting that health care workers have rights as well. If everyone has a right to healthcare from their gov't, then it is up to the gov't to pay us a fair price to treat everyone. It doesn't give the gov't the right to violate our rights by forcing us to treat patients no matter the reimbursement. That is what you are missing. If the gov't wants to fund our education in exchange for providing services to them, then we can choose to enter into that agreement of our own volition.

It is the government's obligation, for the common good to reduce the cost of medical education in the United States.
With a six-year estimated program time and an average €500 yearly cost to attend, students can expect to pay a total cost of around €3000 or more to obtain a medical degree within Germany, close to $3,500.

Health insurance is compulsory for Germany's entire population. Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee. Private insurance also exists in Germany, with a majority of Germans accounted for by the pubic system.

Adjusted for purchasing-power parity, US primary care physicians in 2008 earned an average of $186,582 before taxes and after expenses, compared with $159,532 in the United Kingdom, $131,809 in Germany, and $95,585 in France.

That is not working for cheap, especially considering the cost of medical education in these countries.
 
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It is the government's obligation to reduce the cost of medical education in the United States.
With a six-year estimated program time and an average €500 yearly cost to attend, students can expect to pay a total cost of around €3000 or more to obtain a medical degree within Germany, close to $3,500.

Health insurance is compulsory for Germany's entire population. Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee. Private insurance also exists in Germany, with a majority of Germans accounted for by the pubic system.

Adjusted for purchasing-power parity, US primary care physicians in 2008 earned an average of $186,582 before taxes and after expenses, compared with $159,532 in the United Kingdom, $131,809 in Germany, and $95,585 in France.

That is not working for cheap considering the cost of medical education in these countries.
it's not the govts role to reduce the cost of anything arbitrarily.....something is worth what people will pay for it
 
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It is the government's obligation, for the common good to reduce the cost of medical education in the United States.
With a six-year estimated program time and an average €500 yearly cost to attend, students can expect to pay a total cost of around €3000 or more to obtain a medical degree within Germany, close to $3,500.

Health insurance is compulsory for Germany's entire population. Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee. Private insurance also exists in Germany, with a majority of Germans accounted for by the pubic system.

Adjusted for purchasing-power parity, US primary care physicians in 2008 earned an average of $186,582 before taxes and after expenses, compared with $159,532 in the United Kingdom, $131,809 in Germany, and $95,585 in France.

That is not working for cheap, especially considering the cost of medical education in these countries.

Government keeps pushing out more and more money for student loans - both medical and undergraduate. Because of this, universities keep raising their rates, because hey, free money! So really the rising costs of school really rests on the government already. And here you are wanting government to be the one to just fix things.

What exactly do you believe is the job of the government? Should everyone get a free phone and plan? Free internet? Free school? Free healthcare? Free everything?

Ultimately you end up having productive people paying for all of these freeloaders. I don't want that and neither should you.
 
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It is the government's obligation, for the common good to reduce the cost of medical education in the United States.
With a six-year estimated program time and an average €500 yearly cost to attend, students can expect to pay a total cost of around €3000 or more to obtain a medical degree within Germany, close to $3,500.

Health insurance is compulsory for Germany's entire population. Germany has a universal multi-payer system with two main types of health insurance. Germans are offered three mandatory health benefits, which are co-financed by employer and employee. Private insurance also exists in Germany, with a majority of Germans accounted for by the pubic system.

Adjusted for purchasing-power parity, US primary care physicians in 2008 earned an average of $186,582 before taxes and after expenses, compared with $159,532 in the United Kingdom, $131,809 in Germany, and $95,585 in France.

That is not working for cheap, especially considering the cost of medical education in these countries.
I'd rather pay more money now to get my degree to make more money later, personally. And you've still failed to tell me how you plan to compel physicians to provide people with their "rights" to healthcare. How do you ethically force someone to provide a service if they do not want to provide it?
 
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Government keeps pushing out more and more money for student loans - both medical and undergraduate. Because of this, universities keep raising their rates, because hey, free money! So really the rising costs of school really rests on the government already. And here you are wanting government to be the one to just fix things.

What exactly do you believe is the job of the government? Should everyone get a free phone and plan? Free internet? Free school? Free healthcare? Free everything?

Ultimately you end up having productive people paying for all of these freeloaders. I don't want that and neither should you.


I agree with you it's time for the government to stop handing out excessive student loans that puts the debt burden on students. Let's look at this from a different perspective- Germany.

How does Germany afford free tuition for undergrad Americans, international students, with significantly cheaper med schools for all?
Germans simply agree to pay higher taxes. Germany also has a lower percentage of students that go on to college than we have here in the U.S.- it's more competitive and difficult to get into university in the first place; they also have more trade schools and highschools that find what student's talents are early on and capitalize on them to find where they will most likely succeed.

US higher education is a disaster, the loan situation is completely unsustainable.
 
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I agree with you it's time for the government to stop handing out excessive student loans that puts the debt burden on students. Let's look at this from a different perspective- Germany.

How does Germany afford free tuition for undergrad Americans, international students, with significantly cheaper med schools for all?
Germans simply agree to pay higher taxes. Germany also has a lower percentage of students go on to college than we have here in the U.S.

I'm not sure that each German just simply agrees about all those taxes. Just like I'm just most Americans aren't really happy about all the taxes we have to pay.

The tax rates are higher in Europe than in the US for the most part. Germany is also a much smaller country compared to the US. They also don't have some of the obligations of a normal country like the US in regards to items such as Defense. The US has basically provided for European defense since WWII. That freed up those economies to direct money into other areas instead. Even then, you get countries like Greece that are going bankrupt with all the free stuff and handouts.

Do I want a European style government? No way. I also do not want an unaccountable set of bureaucrats making laws like the EU does. I want to have freedom to live my life as I see fit according to the rules of the land (the Constitution). We already have too much government interference as it is here. That has led to many of the problems we face today and your answer is more government...
 
I'm not sure that each German just simply agrees about all those taxes. Just like I'm just most Americans aren't really happy about all the taxes we have to pay.

The tax rates are higher in Europe than in the US for the most part. Germany is also a much smaller country compared to the US. They also don't have some of the obligations of a normal country like the US in regards to items such as Defense. The US has basically provided for European defense since WWII. That freed up those economies to direct money into other areas instead. Even then, you get countries like Greece that are going bankrupt with all the free stuff and handouts.

Do I want a European style government? No way. I also do not want an unaccountable set of bureaucrats making laws like the EU does. I want to have freedom to live my life as I see fit according to the rules of the land (the Constitution). We already have too much government interference as it is here. That has led to many of the problems we face today and your answer is more government...

Is the student loan situation in the US sustainable, yes or no?
 
I agree with you it's time for the government to stop handing out excessive student loans that puts the debt burden on students. Let's look at this from a different perspective- Germany.

How does Germany afford free tuition for undergrad Americans, international students, with significantly cheaper med schools for all?
Germans simply agree to pay higher taxes. Germany also has a lower percentage of students that go on to college than we have here in the U.S.- it's more competitive and difficult to get into university in the first place; they also have more trade schools and highschools that find what student's talents are early on and capitalize on them to find where they will most likely succeed.

US higher education is a disaster, the loan situation is completely unsustainable.
German schools are also substantially inferior to the top American institutions. They have larger class sizes, do not allow you the freedom to switch majors, do not allow you to enter many majors if your entry exam scores are not high enough, etc. They basically track a student right out of high school into whatever they'll do for the rest of their life, something most Americans would be against, and in a manner that is completely antithetical to our liberal arts based education system. Of the top 100 universities in the world, a third are American, which shows we're doing something right.

But we should get the government out of student loans- when schools don't have enough bodies to fill their classrooms, they'll lower tuition. When less people are getting college degrees, the value of college degrees increases. This idea that everyone should go to college is kind of nonsense- the vast majority of careers could be done without a college education. If anything, what the government should do is provide more useful skills in high school so that people come out prepared to actually do something (welding, programming, baking, whatever) rather than giving them a useless piece of paper that qualifies them for exactly nothing aside from entering college, a four year period that most students piss away learning nothing, so that they can get a piece of paper that means nearly nothing, and get a job that is completely unrelated to their prior studies that could have easily been done by someone without a degree twenty years ago. But thanks to the government, we've got useless high schools and degree deflation.
 
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Of the top 100 universities in the world, a third are American, which shows we're doing something right.
Bit of a strange argument. We have a lot of incredible high schools, I'll wager many of the best in the world, but it doesn't follow from there that we're doing a great job in high school education as a whole.

They have larger class sizes, do not allow you the freedom to switch majors,
There are world class institutions with massive sizes (UCs for example) and many of our elite private schools block switching many majors (try switching to Wharton at Penn or into BME at Hopkins).

When less people are getting college degrees, the value of college degrees increases.
This would be true if the degree was useful, but you seem to think it's just "a four year period that most students piss away learning nothing" so businesses need not react at all to applicants no longer having it on their resume.
 
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Bit of a strange argument. We have a lot of incredible high schools, I'll wager many of the best in the world, but it doesn't follow from there that we're doing a great job in high school education as a whole.


There are world class institutions with massive sizes (UCs for example) and many of our elite private schools block switching many majors (try switching to Wharton at Penn or into BME at Hopkins).


This would be true if the degree was useful, but you seem to think it's just "a four year period that most students piss away learning nothing" so businesses need not react at all to applicants no longer having it on their resume.

@efle has entered the thread!

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I try to stay out if I can... I don't care what the commodity/service is, people should pay their own way. I don't have a right to take from others to fund my needs.

That is a very interesting way of putting it that I have never seen before. I don't have the right to your money.
 
Bit of a strange argument. We have a lot of incredible high schools, I'll wager many of the best in the world, but it doesn't follow from there that we're doing a great job in high school education as a whole.


There are world class institutions with massive sizes (UCs for example) and many of our elite private schools block switching many majors (try switching to Wharton at Penn or into BME at Hopkins).


This would be true if the degree was useful, but you seem to think it's just "a four year period that most students piss away learning nothing" so businesses need not react at all to applicants no longer having it on their resume.
The trouble is, businesses do believe a degree has inherent value, as, even if it didn't teach a person any useful skills, they at least stuck out four years of whatever the hell they were doing to get that piece of paper. Having less degrees around makes those that are around more valuable, and simultaneously raises the value of merely having a high school education, as there will not be enough college graduates to fill all available positions. Right now, we've got a surplus of the useless degrees, so employers figure, "why not, might as well pick one of those kids that might maybe know a thing or two more than the next guy."

As to German education: http://www.forbes.com/sites/ccap/20...ing-as-a-free-college-education/#44d50ef94c6e
 
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The trouble is, businesses do believe a degree has inherent value, as, even if it didn't teach a person any useful skills, they at least stuck out four years of whatever the hell they were doing to get that piece of paper. Having less degrees around makes those that are around more valuable, and simultaneously raises the value of merely having a high school education, as there will not be enough college graduates to fill all available positions. Right now, we've got a surplus of the useless degrees, so employers figure, "why not, might as well pick one of those kids that might maybe know a thing or two more than the next guy."

As to German education: http://www.forbes.com/sites/ccap/20...ing-as-a-free-college-education/#44d50ef94c6e
The solution to the problems mentioned there isn't necessarily to kill off free tuition. You could say only the first 4 years are covered to fight moral hazard. You could offer it only to people who earn admissions - I'm also of the opinion far fewer people need/use their degree than have it, so I'm fine with this meaning many people who would currently go to college dont.
 
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