Socialized Medicine and its consequences

[Chulito]

http://www.netscape.com/viewstory/2...xml=/news/2007/05/10/ncancer10.xml&frame=true

Good thing that the healthcare is free in the UK. Unfortunately, this doesn't help the cancer patients who don't get treated.

The article states that the UK does poorly in comparison with other European countries and the US. Within Europe, they specifically cite Spain, Germany, Italy, France, Austria and Switzerland as providing much better access to new medications, all countries with universal coverage, some quite close to truly socialized medicine. It doesn't sound as if the problem is universal health care, but the NHS in particular. (I'm sure that they do better than other countries in other areas, of course.)

No system is perfect, but some are better than others; and none is without its own particular problems (including ours, obviously). A system of universal coverage in the US would not be a wholesale adoption of any one other system, but rather an attempt to conceive of a new program that would work here and that would avoid the most egregious problems experienced in other countries who have attempted such systems. Since they have gone before us, we'll have greater insight and foresight thanks to their trailblazing. You may not think that universal health care is the best solution here, but you can't just point to countries that have some form of it and say, "Look, they have problems too." Of course they do. That doesn't mean that our system is necessarily better over all, and, more importantly, it doesn't mean that we couldn't come up with a better system of universal coverage if we seriously put our minds to it.

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[Miami_med]

Just a counter-report to all of the statistics blindly put up here as reasons why we should go socialized. I also noticed that they left out US stats. They mentioned that the US was in the study, talked about why we were good at cancer, and then left us out. I'm not trying to argue that this might not be an unintentional oversight, but um...

 

[QuikClot]

Just a counter-report to all of the statistics blindly put up here as reasons why we should go socialized.

Why "blindly"? What is it about the way they are using statistics that you object to, other than the fact that they are cited to support an argument you disagree with?

This article -- I couldn't find the report itself online -- says that British cancer survival rates are poor, and of the four best countries in delivery of the newest cancer drugs, only three, rather than all four, are "socialist."

I'm glad to hear that the US healthcare system does a good job of delivering the newest cancer drugs to those who can afford them. But I don't think the fact that we manage to do this one thing well, which a bunch of other socialized systems manage also to do well, is really a counter-argument to the statistics cited in support of universal care, which usually revolve around who can get access to care, whether that care is affordable and whether the system is sustainable in the future. If anyone is saying the US healthcare system does absolutely nothing well, this report undercuts that.

On the other hand, it's kind of like the Winston Churchill anecdote; this article is published in a British medical journal, reported in the British press. Going forward, presumably the NIH makes more of an effort to trains its physicians in the latest cancer therapies and makes sure the drugs are in stock. And this time next year, Britian's use of cancer drugs is more like ours. But we will still have the most expensive healthcare system in the world delivering 3-5 fewer years of healthy life than Western European countries, and 50 million uninsured. They will be sober, and we will still be ugly.

 

[Miami_med]

Why "blindly"? What is it about the way they are using statistics that you object to, other than the fact that they are cited to support an argument you disagree with?

This article -- I couldn't find the report itself online -- says that British cancer survival rates are poor, and of the four best countries in delivery of the newest cancer drugs, only three, rather than all four, are "socialist."

I'm glad to hear that the US healthcare system does a good job of delivering the newest cancer drugs to those who can afford them. But I don't think the fact that we manage to do this one thing well, which a bunch of other socialized systems manage also to do well, is really a counter-argument to the statistics cited in support of universal care, which usually revolve around who can get access to care, whether that care is affordable and whether the system is sustainable in the future. If anyone is saying the US healthcare system does absolutely nothing well, this report undercuts that.

On the other hand, it's kind of like the Winston Churchill anecdote; this article is published in a British medical journal, reported in the British press. Going forward, presumably the NIH makes more of an effort to trains its physicians in the latest cancer therapies and makes sure the drugs are in stock. And this time next year, Britian's use of cancer drugs is more like ours. But we will still have the most expensive healthcare system in the world delivering 3-5 fewer years of healthy life than Western European countries, and 50 million uninsured. They will be sober, and we will still be ugly.

#1: By blindly, I simply meant without considering the reasons for those statistics. As Mark Twain Said, "There are lies, damned lies, and statistics." I actually wasn't referring to you.

#2: You are correct that countries with universal healthcare are better at giving universal healthcare than the US. Of course, that's circular logic. It says nothing as to if universal healthcare is good, just, or worth it.

#3: I'll say it again, that these minor differences in life expectancy are clinically insignificant and can be more than explained by non-healthcare related factors. In Europe, the person is more likely to be healthy without intervention. In the US, the person is likely to both receive and have to pay for intervention. This is a lifestyle issue and a topic for a different thread.

I'll try and find the statistic again that perfectly coordinated obesity rates negatively with life expectancy in all industrialized democracies.

 

[QuikClot]

#1: By blindly, I simply meant without considering the reasons for those statistics. As Mark Twain Said, "There are lies, damned lies, and statistics." I actually wasn't referring to you.

I didn't think you were referring to me; it just seemed like a generic negative thing to say about the other side without a clear point of disagreement. I know you're better than that, so I thought I'd ask about it.

#2: You are correct that countries with universal healthcare are better at giving universal healthcare than the US. Of course, that's circular logic. It says nothing as to if universal healthcare is good, just, or worth it.

That's true, but that could also be said about this one system's difficulty in treating cancer. It says nothing about whether universal care is good, or just, or worth it. If you could show that no universal care plan treated cancer well, you might make an argument related to "good." But that wasn't what the report said. And it has no bearing on whether it is just. (Since our non-"socialist" system costs more than any of the socialized systems, should the last question be whether non-socialism is "worth it," since we're the ones paying more?)

#3: I'll say it again, that these minor differences in life expectancy are clinically insignificant and can be more than explained by non-healthcare related factors.

Several years of health life seem very significant to me. How else does one measure a healthcare system other than by looking at measures of health? To calculate DALE, statisticians look at the mortality and morbidity of all the major killers. Bottom line, "socialized medicine" delivers better outcomes. Look at the VA, a mini-NHS. Better outcomes for less money, which is exactly what the European statistics show.

I'll try and find the statistic again that perfectly coordinated obesity rates negatively with life expectancy in all industrialized democracies.

Please. Of course, primary care physicians also follow your weight, can counsel you on diet and exercise, screen, prevent and treat conditions -- from musculoskeletal injuries to diabetes -- which increase your risk of obesity. So you might also want to look at the correlation between obesity and lack of access to primary care.

Big picture, we have this one measure -- delivery of cancer drugs -- at which we don't suck. And there may be many reasons for that. And on much broader measures, such as how long you are likely to live, whether you will be healthy and able to work, how much the system costs -- we suck. And there may be reasons for that, too. But I don't think you can trumpet this one result as a victory for American healthcare while disparaging all the other comparisons as simplistic. You can't draw broad conclusions from statistics you like, then deploy Twain to cover your retreat. Especially when one set of statistics refers to one measure of the treatment of one disease by one country, whereas the others reflect the success or failure of societies at reducing the burden of all disease, and are consistant across many countries.

Good to talk to you. How did the boards go?

 

[Miami_med]

I didn't think you were referring to me; it just seemed like a generic negative thing to say about the other side without a clear point of disagreement. I know you're better than that, so I thought I'd ask about it.



That's true, but that could also be said about this one system's difficulty in treating cancer. It says nothing about whether universal care is good, or just, or worth it. If you could show that no universal care plan treated cancer well, you might make an argument related to "good." But that wasn't what the report said. And it has no bearing on whether it is just. (Since our non-"socialist" system costs more than any of the socialized systems, should the last question be whether non-socialism is "worth it," since we're the ones paying more?)

Which really proves that point that before we can even have a debate as to which system is better, we have to decide what is actually the goal of the system. That is actually where we disagree.

Several years of health life seem very significant to me. How else does one measure a healthcare system other than by looking at measures of health? To calculate DALE, statisticians look at the mortality and morbidity of all the major killers. Bottom line, "socialized medicine" delivers better outcomes. Look at the VA, a mini-NHS. Better outcomes for less money, which is exactly what the European statistics show.

Down here, the same surgeons have worse outcomes at the VA than at the public hospital with a non-compliant immigrant patient population down the street. I've been in the VA, I've watched what goes on in there, and I'm not convinced that they're doing anything better. Show me the statistics.

Please. Of course, primary care physicians also follow your weight, can counsel you on diet and exercise, screen, prevent and treat conditions -- from musculoskeletal injuries to diabetes -- which increase your risk of obesity. So you might also want to look at the correlation between obesity and lack of access to primary care.

I don't have the stat, but there was atleast one study I read that showed no correlation between obesity and access to primary care. Somehow I doubt that the 2/3 of overweight America is an annual physical away from a good diet.

Big picture, we have this one measure -- delivery of cancer drugs -- at which we don't suck. And there may be many reasons for that. And on much broader measures, such as how long you are likely to live, whether you will be healthy and able to work, how much the system costs -- we suck. And there may be reasons for that, too. But I don't think you can trumpet this one result as a victory for American healthcare while disparaging all the other comparisons as simplistic. You can't draw broad conclusions from statistics you like, then deploy Twain to cover your retreat. Especially when one set of statistics refers to one measure of the treatment of one disease by one country, whereas the others reflect the success or failure of societies at reducing the burden of all disease, and are consistant across many countries.

All stats are biased. I simply offer the counter argument because of the aggressive posting of statistics that pain the US in such a terrible light that is just simply not true. I have MANY MANY friends down here who come from the "superior" health systems in Canada and Cuba and Western Europe, and the word on the street doesn't match the statistics in the newspaper. I'd happily throw out all the statistics that come from random agencies trumpeting certain systems or government entities trying to pander to constituents with their "superior healthcare scores." I'm just trying to show both sides of the argument, and I would be equally appalled if someone attempted to take anything I show to heart without doing some leg work.

By the way, I've NEVER attempted to argue that we have a good system. I advocate free market, and our government pays 48% of the bills. That's hardly free market. I really am trying to show how socialism isn't a panacea, and tie that to the belief that many people have that individuals should actually have responsibility for their own actions.

Good to talk to you. How did the boards go?

Man, I take them in 10 days. No pressure. I'll let you know

 

[sosarah]

If the Supreme Court has determined that prisoners have the right to basic health care based on its interpretation of the "cruel and unusual punishment" clause of the 8th Amendment to the Constitution, then why can't all Americans be granted this right?

Probably because that's the same supreme court that allows fetal homicide to be a crime while still considering abortion to be completely legal....

 

[Pharmavixen]

I work in a jail in Ontario, and prisoners get free health care just like everybody else. But I hear that in US prisons, they will sometimes expedite the sentences of criminals with serious (ie expensive) illnesses, getting them back on the street faster so that the correctional system doesn't have to pay for their treatment.

Back O/T: I've heard this guy's story before, and I'm sceptical. He says he waited 4 months for an MRI despite exhibiting serious symptoms. In this same province, I waited 5 weeks for an MRI because I have chronically sore hips and back.

When I was 25, I was found to have a rapidly-growing abdominal tumour. I got in for surgery inside of a month.

The Canadian health care system is far from perfect, and it's possible this guy slipped between the cracks. But I've lived most of my life in Ontario, seeing family members through various serious illnesses and surgeries, including my own, and I'm a pharmacist who has worked in Canadian hospitals. And that guy's story stinks to high heaven.

There are people who would love to get their mitts on Canadian health care so that they can rip off an additional 30 million N. Americans. Harrowing brain cancer stories are certainly riveting - if they are in fact true. Maybe we'll see some children with cancer trotted out before the cameras next.

 

[Pharmavixen]

One more point: criticisms of health care often can't be refuted because of confidentiality. The guy's story could be total bull****, and he could keep going on You-tube as much as he liked while his doctors' hands would be tied.

 

[gasping81]

Look I agree that a lot of your tax money goes to things that I don't agree with. However 'market forces' will not provide for everything, like 'public goods.' Left to the market and people's interests we would not have a police force or an army or a good infrastructure such as nice paved roads........Personally I agree with a smaller, less bureaucratic central gov't so that people are left to their own. Gov'ts job is to hold order and provide things that the citizens cannot (or would not) provide for themselves. For this reason you should not have a major say in where your taxes go.

I think that providing services to the people without taking away incentives to work is possible. Instead of HMOs, what if we had a system where counties were responsible for care, fire, police? Then, you see what happens when policies stink. For example, Mass made universal care + doctor tax and now docs really don't have an incentive to go into their private world. People leave the states and go to non-crisis states where salaries are good and environment is safe (less malpractice). That is the less government world that Ron Paul speaks of.

As physicians, we will never win. NEVER unless we collectively strike, but many of you bleeding hearts are willing to overlook your own financial future. SO we will never get ahead. As long as physicians out there think everybody should get the same care regardless if they can cough up the beans for it, we will self implode. When your daughter is the ER and has to wait because you supported the idea that she was the same as the crackhead waiting in front of her (unless she is a crackhead), the bulb will go off. The other issue is docs only look out for their own specialty. BIG PROBLEM. A whole board of medical docs in Wisconsin didn't care to defend anesthesiologists from nurse encroachment. Why? I assume that 1. it won't affect me and 2. they don't do anything anyways aka player-hater mentality. Somehow radiologists just sit on their butt and drink coffee. Somehow psychiatrists just keep talking for hours and do nothing (per Scientology). Somehow internists just write long notes and never get anything done. Somehow PM&R are just glorified therapists. Somehow neurologists just do good exams and never provide any therapy. Somehow the anesthesiologist doesn't have a plan to deal with major risk factors which can cause problems in the OR and just flips some switch. (Anesthesia ON!). THIS REALLY PI**ES ME OFF because some surgeons can't define their limitations or work with you. They don't get that you might be saving their behind many times and they don't even know about it. This is what has turned me away from the specialty because I never saw this discordance amongst internists and consultants....the list could keep going.

Here's my plan.
1. Payoff the 98K loans NOW, already started.
2. Just cut my losses for wasting 8 years of my life.
3. Make sure to tell every college kid to avoid medical school like heroine.
4. Go work some 40-45K job somewhere and live off the Obama socialism benefits.

You know it's coming. Robin from Da Hood will certainly pander to that owe me mentality. Tell all of your children, cousins to avoid medicine because it will not get better when a civil rights a.k.a trial lawyer becomes your president with a liberal Congress. GOP is toast for now because the maverick is not maverick enough. I can only look forward to see if other countries are going to entertain a rookie president starting Jan 10, 2009.

OR hopefully socialized medicine deters all lawsuits because big brother will be the employer. I can finish my quota and leave for the day like most lazy gov't workers.

 

[Chizwheel]

Amen Gasping81...

The day socialized healthcare comes and doctors are made to do salaried work for the government is the day I become indifferent to my work. If healthcare is a right, and that is FORCED upon me, then I say when 5:00 rolls around...I'm leaving like every other government worker. If that means you are left in the waiting room with a bladder tumor and blood coming out your urethra, well you should have thought about that before you voted for Hillbama.

 

[Coldfusion079]

The impact of socialized medicine:

http://www.youtube.com/watch?v=X_Rf42zNl9U&eurl

You convinced me!!

Seriously, I'd hate to be your patient.

 

[Coldfusion079]

As physicians, we will never win. NEVER unless we collectively strike, but many of you bleeding hearts are willing to overlook your own financial future. SO we will never get ahead. As long as physicians out there think everybody should get the same care regardless if they can cough up the beans for it, we will self implode.

You better not have told your medical school interviewer that you wanted to become a doctor to help people.

 

[aneuploidy157]

I think I big problem that people have when they approach this problem is they come in with a moral argument. "Health care is not a right" "They can afford it, they chose not to" and so forth. Think about it logistically. First of all, health insurance is fundamentally flawed in and of itself. Insurance is defined by paying to protect yourself from something that may be catastrophic, but has a low probability of happening. Less than one percent of all people who own fire insurance will need to use that fire insurance someday, where as probably 100 percent of everyone who has health insurance needs to use it at some point or another. So how do health insurance companies make money. Well, first off they call them selves HMO, to defend themselves from this very argument. They have to cut costs, i.e. they cut care and make doctors and patients jump through all sorts of hoops to get it.
Furthermore, whether these people are choosing not to buy health care or not is irrelevant. Bottom line is they don't have it. A man who needs perscription drugs for hypertension can't afford them, or maybe he can and choses to buy crack instead, irrelevant, bottom line is he's not taking his medication and would be if that service was provided to him. Consequently he has a bleed in his brain. You've taken a 5 dollar a month problem, and turned into to a 50,000$ problem, which he obviously can't afford. He goes bankrupt, the hospital has to eat the cost, and we've taken a productive member of society and turned him into a drooling limping leech.
This is not to say that a "free" market or whatever (its not really free with medicare) is all bad. Things can get done, and get done quickly. If you need to get your gal bladder removed, in the U.S. you could probably be in the O.R. the next day. Pay for procedure, **** gets done. Whereas in Canada, a procedure like that, not life threatening, but certainly necessary, you may wait a year, hell you could die waiting. (Granted if you have cancer or something more serious they would take very good care of you).
Essentially there needs to be balance. HMO's need to be consolidated and made non profit. Or something, I don't ****ing know.

 

[medisforme]

I think I big problem that people have when they approach this problem is they come in with a moral argument. "Health care is not a right" "They can afford it, they chose not to" and so forth. Think about it logistically. First of all, health insurance is fundamentally flawed in and of itself. Insurance is defined by paying to protect yourself from something that may be catastrophic, but has a low probability of happening. Less than one percent of all people who own fire insurance will need to use that fire insurance someday, where as probably 100 percent of everyone who has health insurance needs to use it at some point or another. So how do health insurance companies make money. Well, first off they call them selves HMO, to defend themselves from this very argument. They have to cut costs, i.e. they cut care and make doctors and patients jump through all sorts of hoops to get it.
Furthermore, whether these people are choosing not to buy health care or not is irrelevant. Bottom line is they don't have it. A man who needs perscription drugs for hypertension can't afford them, or maybe he can and choses to buy crack instead, irrelevant, bottom line is he's not taking his medication and would be if that service was provided to him. Consequently he has a bleed in his brain. You've taken a 5 dollar a month problem, and turned into to a 50,000$ problem, which he obviously can't afford. He goes bankrupt, the hospital has to eat the cost, and we've taken a productive member of society and turned him into a drooling limping leech.
This is not to say that a "free" market or whatever (its not really free with medicare) is all bad. Things can get done, and get done quickly. If you need to get your gal bladder removed, in the U.S. you could probably be in the O.R. the next day. Pay for procedure, **** gets done. Whereas in Canada, a procedure like that, not life threatening, but certainly necessary, you may wait a year, hell you could die waiting. (Granted if you have cancer or something more serious they would take very good care of you).
Essentially there needs to be balance. HMO's need to be consolidated and made non profit. Or something, I don't ****ing know.

Enjoyed the above post.

My two cents:
Many who are uninformed assume that certain flaws in different health care systems are due to the fact that it is because they are "socialized" or because it is "private insurance" or whatever, when in reality the shortcomings that some health care consumers experience have nothing to do with the general form of health care.
I am from Canada, and I am the first to admit that we have shortcomings in our system, but the majority of them can be attributed to dysfunctional organization and lack of communication/connectedness between different sectors. This has absolutely nothing to do with so called "socialized" health care.
As an example witness how various provinces in our country handled the flu epidemics that hit in the late 90's/early 2000's. Areas (ie. Sask) which had organized health authorities handled it much better than areas (ie. greater Toronto) that didn't. This could be measured by ER backlog and
mortality stats of nursing homes. Those in the media examined only the Toronto area and used the story as an example of the failure of nationalized health care (while at the same time not reporting on how well other areas of the country were handling the epidemic), when in reality nationalized health care had nothing to do with the failure of the greater toronto area to handle the flu epidemic.
People tend to use the "socialized" vs. "private insurance" argument as a way of communicating their political/idealogical beliefs usually while having little to no idea of the various regional and local reasons for healthcare shortcomings.

 

[AFSmiley]

Enjoyed the above post.

My two cents:
Many who are uninformed assume that certain flaws in different health care systems are due to the fact that it is because they are "socialized" or because it is "private insurance" or whatever, when in reality the shortcomings that some health care consumers experience have nothing to do with the general form of health care.
I am from Canada, and I am the first to admit that we have shortcomings in our system, but the majority of them can be attributed to dysfunctional organization and lack of communication/connectedness between different sectors. This has absolutely nothing to do with so called "socialized" health care.
As an example witness how various provinces in our country handled the flu epidemics that hit in the late 90's/early 2000's. Areas (ie. Sask) which had organized health authorities handled it much better than areas (ie. greater Toronto) that didn't. This could be measured by ER backlog and
mortality stats of nursing homes. Those in the media examined only the Toronto area and used the story as an example of the failure of nationalized health care (while at the same time not reporting on how well other areas of the country were handling the epidemic), when in reality nationalized health care had nothing to do with the failure of the greater toronto area to handle the flu epidemic.
People tend to use the "socialized" vs. "private insurance" argument as a way of communicating their political/idealogical beliefs usually while having little to no idea of the various regional and local reasons for healthcare shortcomings.

So, staying in this stream of thought, I think that increasing market forces would decreases a lot of the " dysfunctional organization and lack of communication/connectedness" in the US system.

 

[medisforme]

So, staying in this stream of thought, I think that increasing market forces would decreases a lot of the " dysfunctional organization and lack of communication/connectedness" in the US system.

Ok, so in your opinion - numerous insurance and health companies working independantly of each other - whose only goal is to make money and who have no incentive to communicate with each other will have better communication and connectedness than consolidated health authorities.
My advice to you is to do just a modicum of research on this topic before you even consider posting anything else.

 

[AFSmiley]

Ok, so in your opinion - numerous insurance and health companies working independantly of each other - whose only goal is to make money and who have no incentive to communicate with each other will have better communication and connectedness than consolidated health authorities.
My advice to you is to do just a modicum of research on this topic before you even consider posting anything else.

We have publich health agencies who deal with epidemics and other public health issues.

Tracking flu epidemics and patients accessing our healthcare system for their own individual problems are two very different issues.

 

[medisforme]

We have publich health agencies who deal with epidemics and other public health issues.

Tracking flu epidemics and patients accessing our healthcare system for their own individual problems are two very different issues.

My original post wasn't about tracking flu epidemics, it was about being prepared for them. Regional health authorities enable seemless communication between hospital ER's, long term care facilities, nursing homes, public health agencies etc...
The parts of Canada that were prepared for flu outbrakes - for example public health nurses going to nursing homes to administer flu vacciniations, having standing orders for the correct dose of amantadine for all nursing home clients in case of an outbreak, scaling back elective surgery in hospitals when flu epidemics are expected to hit to save ICU beds, increasing home care nurses to take patients from overloaded hospitals, communication between different ER's to make sure there is always one that can take emergencies if others are backed up with flu cases etc... have had excellent responses.
The fact of the matter, which I mentioned in my previous post is that you don't have this type of communication in a private system. While I am sure public health agencies are very active, you don't have the connectedness between various levels of health care institutions - they are all operating independantly trying to make a profit.

 

[PhDStudentEMR]

I am a doctoral candidate conducting a research study to identify and analyze the medical profession’s perception of the EMR process and to ascertain how its generalization may impact health care providers and their patients.

This is a critical study at this juncture for two reasons: the generalization of EMR seems to be inescapable, and it is placed on the backdrop of what may become a pivotal change in how health care will be ultimately delivered in this country.

Participation in this survey does not require any identifying information.

You can be certain that all information collected in this study will be kept strictly confidential.

It will not cost you anything to participate.

The average time to complete the survey is 5 minutes.

Please and follow this link to the on-line survey:

https://www.surveymonkey.com/s.aspx?...2OEAcdhw_3d_3d

 

[ThinkTooMuch]

I think that providing services to the people without taking away incentives to work is possible. Instead of HMOs, what if we had a system where counties were responsible for care, fire, police? Then, you see what happens when policies stink. For example, Mass made universal care + doctor tax and now docs really don't have an incentive to go into their private world. People leave the states and go to non-crisis states where salaries are good and environment is safe (less malpractice). That is the less government world that Ron Paul speaks of.

As physicians, we will never win. NEVER unless we collectively strike, but many of you bleeding hearts are willing to overlook your own financial future. SO we will never get ahead. As long as physicians out there think everybody should get the same care regardless if they can cough up the beans for it, we will self implode. When your daughter is the ER and has to wait because you supported the idea that she was the same as the crackhead waiting in front of her (unless she is a crackhead), the bulb will go off. The other issue is docs only look out for their own specialty. BIG PROBLEM. A whole board of medical docs in Wisconsin didn't care to defend anesthesiologists from nurse encroachment. Why? I assume that 1. it won't affect me and 2. they don't do anything anyways aka player-hater mentality. Somehow radiologists just sit on their butt and drink coffee. Somehow psychiatrists just keep talking for hours and do nothing (per Scientology). Somehow internists just write long notes and never get anything done. Somehow PM&R are just glorified therapists. Somehow neurologists just do good exams and never provide any therapy. Somehow the anesthesiologist doesn't have a plan to deal with major risk factors which can cause problems in the OR and just flips some switch. (Anesthesia ON!). THIS REALLY PI**ES ME OFF because some surgeons can't define their limitations or work with you. They don't get that you might be saving their behind many times and they don't even know about it. This is what has turned me away from the specialty because I never saw this discordance amongst internists and consultants....the list could keep going.

Here's my plan.
1. Payoff the 98K loans NOW, already started.
2. Just cut my losses for wasting 8 years of my life.
3. Make sure to tell every college kid to avoid medical school like heroine.
4. Go work some 40-45K job somewhere and live off the Obama socialism benefits.

You know it's coming. Robin from Da Hood will certainly pander to that owe me mentality. Tell all of your children, cousins to avoid medicine because it will not get better when a civil rights a.k.a trial lawyer becomes your president with a liberal Congress. GOP is toast for now because the maverick is not maverick enough. I can only look forward to see if other countries are going to entertain a rookie president starting Jan 10, 2009.

OR hopefully socialized medicine deters all lawsuits because big brother will be the employer. I can finish my quota and leave for the day like most lazy gov't workers.

is the sky falling too?

some of you are so deeply entrenched in this issue your sense of reality is completely lost. you all live in lala land. snap out of it!!!!!!

 

[brittnic2008]

After reading some of these posts, I have lost a lot of respect for posters on here. Since when did the medical field become all about making money rather than helping people?

If all you want is money, go practice law. I read complaints that in a single-payer system a physician may make only 180K rather than 250K+!!!??? "I would rather flip burgers at Wendy's!!??? Give me a break!! If that is seriously your stance, than get out of this field for the sake of any unfortunate pt who may fall under your care.

I do what I do because I want to help people and I believe that in today's society, healthcare is a fundamental right. Was it a fundamental right when the Framers wrote the Constitution? Of course not. But it is today's society it is. As an American why would you not want that right? Imagine if you were on the other side of the hospital bed.

Also, why hasn't there been any talk about the VA system, which IS a successful, tried-and-true government-run system. The VA is on the cutting edge with a computerized patient records system (CPRS). If a pt's PCP is in Leavenworth, KS and shows up in an ER in Washington D.C. while on vacation, their records are available with a few mousestrokes -- labs, consults, allergy assessments -- it is all there. How does this NOT cut on waiting times and unneccesary spending?? The VA system was created because healthcare for veterans is a RIGHT and this system is the answer to a lot of our healthcare problems.

Bottomline, the US healthcare system is embarassing in many respects, and can be improved drastically. If you don't think we have a problem, you are probably making good money and have a good insurance plan. Also, if you are a doctor or medical student who is just in the profession for the money, do us all a favor and find a new line of work.

 

[goprisko]

http://www.pnhp.org/
The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 46 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment though a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

*********

http://www.pnhp.org/news/2007/february/migration_of_canadia.php
Over the past five years, the proportion of Canadian physicians moving in and out of the country has decreased by 30.6%. While both the number leaving and the number returning to the country are on the decline, Canada has seen a larger decrease in the number of physicians leaving the country. As a result, the proportion of physicians returning to the country is now greater than the proportion leaving.

I am of the opinion that MDs, that's us can change this.

Were we to shift to a model in which patients join our practices as members of non-profit medical assns, with a specified level of benefits commensurate with the membership subscribed for, and were we to shift the emphasis of primary care from fixing things that are broken, to wellness and prevention, supported by
inhouse diagnostics, outpatient surgery where ever possible, home delivery of babies where ever possible, provision of non adulturated foods to our members, fitness facilities, dietary counseling, psych counseling

With patient hospitalization provided through contractual arrangements with hospitals

So insurance companies are dispensed with,

I am of the opinion we could meet the needs of our patients at 1/3 the current
cost / citizen while improving MD salaries to $500k for IMs and FMs with more for specialists.

INDY

 

[AFSmiley]

Also, why hasn't there been any talk about the VA system, which IS a successful, tried-and-true government-run system. The VA is on the cutting edge with a computerized patient records system (CPRS). If a pt's PCP is in Leavenworth, KS and shows up in an ER in Washington D.C. while on vacation, their records are available with a few mousestrokes -- labs, consults, allergy assessments -- it is all there. How does this NOT cut on waiting times and unneccesary spending?? The VA system was created because healthcare for veterans is a RIGHT and this system is the answer to a lot of our healthcare problems.

I'm just going to skip the moral-ethical stuff.

There are definitely positives to the VA system- nationwide accessible computer records, and pretty respectable outcomes. But I think some of your points are oversimplified.

-Not every veteran gets healthcare without direct costs to the patient- it is a strictly regulated program based on '% disabled', income level, etc. Don't for get that the diversity of patients in the VA system if often less than what you see in civilian practice - you have a lot WWII age vets with similar comorbidities, Vietnam vets with similar comorbidities, etc.
-In 2009, the VA cared for 8 million Vets, at a cost of 44 billion, which by my simple math is about $5,500 per patient, not too far off from the 2008 $7500 in 'adjusted' costs per medicare patient- significant but not mindblowing.
-This is only anecdotal, but having worked in other practice settings as well, I imagine there is a signficant number of the American population who would have trouble dealing with many of the frustrations which are a part of life in a VA hospital.