Avoid stating certain opinions in interviews?

[Knickerbocker]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

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[ChymeChancellor]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

I was talking to a resident who was from India and he was telling me about the health care system there. I guess the government pays for all health care from what I hear. But the care they give is not good. So, if you want better care you go to a "private" hospital and pay yourself. This is what might happen if the government takes over medicine here.

Disclaimer: This is just what I heard and I have no real data to back it up.

 

[janedoe4]

My understanding has always been that the Indian health care system is pure fee-for-service, pay-as-you-go. The government doesn't pay for care for anyone. Essentially the opposite of what the OP is talking about.

I have no particular insight about interviews (having never been on a med school interview myself either), but my inclination would be to not bring up your views on universal healthcare if you think they might hurt you, but if you're asked something about the subject give your opinion. Some interviewers will agree with you, some won't, but having a different opinion than your interviewer about something shouldn't be fatal. Just be prepared to handle disagreement in a respectful, thoughtful way.

 

[MinnyGophers]

I was talking to a resident who was from India and he was telling me about the health care system there. I guess the government pays for all health care from what I hear. But the care they give is not good. So, if you want better care you go to a "private" hospital and pay yourself. This is what might happen if the government takes over medicine here.

Disclaimer: This is just what I heard and I have no real data to back it up.

Lol another political topic to talk about!

In France, and many other European countries, healthcare is basically free, for everyone. The care is good, none of that privatized crap. However, the catch is much higher taxes for citizens to pay for that universal healthcare.

 

[ChymeChancellor]

My understanding has always been that the Indian health care system is pure fee-for-service, pay-as-you-go. The government doesn't pay for care for anyone. Essentially the opposite of what the OP is talking about.

Really? I must have misunderstood what he was saying or something.

To the OP, just make it sound like you want to give access to healthcare to the most people and to serve the underserved... They'll eat that up if they believe you. You only have to act like this to gain admissions, once your in you can start thinking and acting for numero uno.

 

[MinnyGophers]

Really? I must have misunderstood what he was saying or something.

To the OP, just make it sound like you want to give access to healthcare to the most people and to serve the underserved... They'll eat that up if they believe you. You only have to act like this to gain admissions, once your in you can start thinking and acting for numero uno.

Or they could tell him, how does he think he's going to do that without angering the Republican majority in the Senate? That could be a double edged sword...

 

[ChymeChancellor]

Or they could tell him, how does he think he's going to do that without angering the Republican majority in the Senate? That could be a double edged sword...

Wow... I sure don't hope politics doesn't come up in my interviews. I know barely anything about it.

 

[Looque]

Lol another political topic to talk about!

In France, and many other European countries, healthcare is basically free, for everyone. The care is good, none of that privatized crap. However, the catch is much higher taxes for citizens to pay for that universal healthcare.

That's only scratching the surface of the problems with universal health care. Yes, our privatized system is flawed--the number of un- and underinsured citizens in the US is terrible. However, the universal systems of Europe and Canada also have some major problems that I would like to see addressed before we go full steam ahead to implement it here. The dialogue is far too bipolar; no one is talking about a potential compromise between the two systems.

 

[cdngirl80]

I would think it would be ok to mention that but maybe make sure you know the pitfalls of universal healthcare. I totally agree with you about nationalized healthcare especially after moving here to the US but I also know that there are pros and cons to the healthcare system that exists in Canada. I think if you can show how nationalized healthcare vs. capital-based healthcare is better (in your opinion) then I would think you'd be good to go in an interview.

 

[ChymeChancellor]

I would think it would be ok to mention that but maybe make sure you know the pitfalls of universal healthcare. I totally agree with you about nationalized healthcare especially after moving here to the US but I also know that there are pros and cons to the healthcare system that exists in Canada. I think if you can show how nationalized healthcare vs. capital-based healthcare is better (in your opinion) then I would think you'd be good to go in an interview.

OK, someone give me the pros and cons of both!

 

[Law2Doc]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

You can talk about it. All interviewers are receptive to this topic and most ask about it in some fashion (often caged as how one would fix US health care). Even the opponents of universal healthcare recognize it as inevitable.

 

[CavalierMD]

Listen to this.

It talks about the step towards a universal system in MA... akin to the way everyone is required to have auto insurance. Just some food for thought.

 

[MinnyGophers]

That's only scratching the surface of the problems with universal health care. Yes, our privatized system is flawed--the number of un- and underinsured citizens in the US is terrible. However, the universal systems of Europe and Canada also have some major problems that I would like to see addressed before we go full steam ahead to implement it here. The dialogue is far too bipolar; no one is talking about a potential compromise between the two systems.

That is because if there was one, they would be jumping on it

A privatized system is flawed because not everyone has access to affordable healthcare, and everything is mostly run by insurance companies. However, the government doesn't have to spend large amount of money ( it doesn't even have) on it.

A universal healthcare is flawed because people are paying a huge amount of taxes, and the government is also dragged down by its contribution. It's one of the biggest issues in France currently, because the government doesn't have the money to keep up with free healthcare, it has less money to spend on everything else. Basically, people want change, they want the government to spend more money than it has, and yet refuse to at least partially give up free healthcare.

It seems you can't have your cake and eat it, too...

 

[Law2Doc]

It seems you can't have your cake and eat it, too...

That's good because obesity is a major component of US health care costs. We shouldn't be eating so much cake.

 

[bearMD]

some of my most passionate classmates are a bit socialist themselves. of course some are libertarian to the core. im guessing most doctors would be anti universal care... so bottom line..steer clear of opening up the box yourself but if they ask you a question on it state your opinion, acknowledge there's other opinions, back it up with the best facts you have and stick to your guns, and realize that no one has ever graduated medical school without thinking the only right opinion is their own.
ps..best interview advice is to imagine yourself on a first date and be yourself..unless who you are is a sucky person..then dont

jmr MS 4

Current Rotation:Radiholaday

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

 

[maestro1625]

meh, I know a lot of doctors that are set against the idea of universal health care, but many are strongly for it. At the risk of sounding like a Michael Moore movie, here in the Flint area, a lot of doctors are more or less realzing that many of thier patients simply can't pay. It does no one any good to leave dibilitating conditions completely untreated so really, a lot of doctors are saying that the government should provide for some very basic necessities in healthcare. Obviously private coverage will be much better, but minimum coverage is better than none at all, and it's not like we're at risk for a Quebec-like system that the Canadian supreme court recently shot down.

 

[MinnyGophers]

It' all fine and dandy that the underprivileged should receive care for free, and that those who can afford it should pay. The only problem is to tell those millions of people who can pay that they have to pay while some get it free.

The huge problem however lies in government funding for this free healthcare. The government, especially right now, doesn't have the money to contribute. Another solution would be to raise taxes, but Dubya promised he wouldn't, and most conservatives are opposed to it.

Finally, in France and other free healthcare countries, doctors salaries are VERY low compared to docs in the US. While many US doc are willing to take a slight pay cut, I doubt most would accept one as large as those forced upon "Free healthcare doctors".

It always comes down to money...

Either way, either the government/docs or the underprivileged are getting the short end of it...

 

[cdngirl80]

OK, someone give me the pros and cons of both!

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared

This does a pretty decent comparing the pros and cons. Also having been able to shadow doctors in both systems there is definitely a difference in the way medicine is practiced. In Canada you'll never be asked if you have insurance, whereas when I shadowed a physician here every patient insurance was brought up and the physician had to check to see what drugs he could prescribe them based on what type of insurance they had. Plus the other thing was that some of his patients couldn't have a physical done or wahtever because their insurance wouldn't cover it. This is definitely something that is not an issue in Canada. However, the big pro for the US is that there is like no wait times. I hate when I volunteer in the ER and patients are complaining about being in the ER for 3-4hours (and they've seen a physician by this time) and I'm thinking you don't know what waiting is...you can wait at least 3-4hours just in the waiting room in a Canadian ER. Just from what I've seen I definitely am pro universal healthcare coverage and I know everyone says that physicians would have to take a pay cut but its not like Canadian physicians are destitute. They definitely have a nice living and I'm sure they're not hurting for cash.

 

[Darth Asclepius]

Really? I must have misunderstood what he was saying or something.

To the OP, just make it sound like you want to give access to healthcare to the most people and to serve the underserved... They'll eat that up if they believe you. You only have to act like this to gain admissions, once your in you can start thinking and acting for numero uno.

I'm no expert on healthcare in India, but I worked with a grad student who had recently moved here from India and he said that there were government run hospitals that were free but if you coud afford it at all you would not want to go there. He said that there was really a huge difference between the private and government hospitals and it was quite scary.

 

[TCIrish03]

And in Europe, you have to wait over a year and a half for an operation, then sue for negligence once it's done. (so my college frined from England says)

It' all fine and dandy that the underprivileged should receive care for free, and that those who can afford it should pay. The only problem is to tell those millions of people who can pay that they have to pay while some get it free.

The huge problem however lies in government funding for this free healthcare. The government, especially right now, doesn't have the money to contribute. Another solution would be to raise taxes, but Dubya promised he wouldn't, and most conservatives are opposed to it.

Finally, in France and other free healthcare countries, doctors salaries are VERY low compared to docs in the US. While many US doc are willing to take a slight pay cut, I doubt most would accept one as large as those forced upon "Free healthcare doctors".

It always comes down to money...

Either way, either the government/docs or the underprivileged are getting the short end of it...

 

[zach1201]

There are larger forces at work as to why universal healthcare isn't implemented within the United States. Most of them are social forces, which are very difficult to overcome once in place. Capitalism is one reason why the healthcare system is the way it is, the power that the AMA had in the past is another reason.

FYI, universal healthcare was almost enacted in the United States in the 1970's by President Nixon. It never came to fruition because of Watergate.

 

[notdeadyet]

\In France, and many other European countries, healthcare is basically free, for everyone. The care is good, none of that privatized crap. However, the catch is much higher taxes for citizens to pay for that universal healthcare.

Myth. If you actually look in to it, you'll see the tax rates in countries like those in Scandanavia are only about 10% higher than in the U.S. And for that extra 10%, they have a pretty extensive social network of free services to the citizenry.

 

[macadamianut]

You can talk about it. All interviewers are receptive to this topic and most ask about it in some fashion (often caged as how one would fix US health care). Even the opponents of universal healthcare recognize it as inevitable.

Universal health care is not even close to being inevitible. In fact, the opposite is true.

 

[coralfangs]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

it wont bring down the salaries imo
there are a crapload of things affectin their salaries

 

[butmylipshurtrealbad]

I was asked about this and talked about it in a majority of my interviews. I'm sure it had some to do with my PS that talks about my interest in underserved care, as well as my ECs, but still, I think it is definitely okay to talk about as long as you have an informed opinion, otherwise be honest about what you do and don't know; this topic is very easy to start rambling on.

 

[ryandote]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

You shouldn't be dinged for your opinion, especially if it is informed, calculated, carefully weighed, etc. Basically, if you can describe your opinion in a way that people can see your point of view (even if they don't necessarily agree with you) than you should be fine. Incidentally, there are some compelling economic reasons why a more socialized system makes sense. (And by "economic" I mean efficiency, distribution, preferences....the social science and not just money)

Disclaimer: Take care to notice all the "shoulds" and "shouldn'ts" in the above paragraph !

 

[mvenus929]

You shouldn't be dinged for your opinion, especially if it is informed, calculated, carefully weighed, etc. Basically, if you can describe your opinion in a way that people can see your point of view (even if they don't necessarily agree with you) than you should be fine. Incidentally, there are some compelling economic reasons why a more socialized system makes sense. (And by "economic" I mean efficiency, distribution, preferences....the social science and not just money)

Disclaimer: Take care to notice all the "shoulds" and "shouldn'ts" in the above paragraph !

I think the only opinions you should not state are those that are very uninformed. If you can't back something you say up, you probably shouldn't bring it up in the first place.

 

[Law2Doc]

Universal health care is not even close to being inevitible. In fact, the opposite is true.

I'm just telling you what the perception of interviewers and other members of medical acedemia will be. Most of these clinicians you will talk to in this process accept additional insuritization as the inevitable next step. All the ones I spoke to did. Even those that adamantly would prefer not to go that direction.

 

[DropkickMurphy]

What about "I'd really like to be the doc at executions!" How do you think that would go over? I imagine this would go over great at University of Missouri

 

[MinnyGophers]

Myth. If you actually look in to it, you'll see the tax rates in countries like those in Scandanavia are only about 10% higher than in the U.S. And for that extra 10%, they have a pretty extensive social network of free services to the citizenry.

Don't tell me myth. I lived in France, and I know how much money we had to pay out of our salaries every months The contribution from the government is also only about 80%.

There's a sales taxes of about 20%!!! (compare this to the U.S 6-7%).. You have to pay taxes for television ( about 120 euros/year), habitation taxes ( it doesn't matter whether you rent or own), property taxes, and a lot of other local taxes and also a system that doesn't have money to pay doctors a huge salary....
France taxes rates are the highest in Europe.

I don't know about Scandinavia, but maybe the systems are a bit different. Our taxes in France pretty much include free higher education, mostly free healthcare, and a lot of other things.. Salaries over there are fairly low compared to what someone in the U.S. might earn for the same jobs. Doctors don't even make that much, either, because, of you guess it, taxes.
It's a huge problem in France right now. There are huge unemployment rates, the governemnt wants to maybe curtail the socialist system a bit so that it has more money to spend on giving work to people, especially the youth, but people aren't willing to give up free care.

Also, 10% is not a small amount.
If you increased taxes in the U.S. by 10%, there is going to be an uproar from the lower socio-economic classes and the middle class, if you increase taxes for only the wealthy, the republican side will not allow it.

 

[MinnyGophers]

And in Europe, you have to wait over a year and a half for an operation, then sue for negligence once it's done. (so my college frined from England says)

Ahaha, unlike the U.S., people can't sue as they please

 

[macadamianut]

I'm just telling you what the perception of interviewers and other members of medical acedemia will be. Most of these clinicians you will talk to in this process accept additional insuritization as the inevitable next step. All the ones I spoke to did. Even those that adamantly would prefer not to go that direction.

The thing is that those doctors aren't making policy. With consumer-directed health plans (read HSAs+high deductibles) and pay-for-performance taking off, the emphasis right now is a more market-based, more privatized health care. If you look at the Medicare prescription drug benefit, you can see how powerful an interest Pharma is, and of course the insurance companies. There's no way, at least, that we can recreate Canada's single-payer system. Just because Massachusetts is attempting "universal health care," does not mean other states want to or can afford to follow.

 

[kypdurron5]

Lol another political topic to talk about!

In France, and many other European countries, healthcare is basically free, for everyone. The care is good, none of that privatized crap. However, the catch is much higher taxes for citizens to pay for that universal healthcare.

Don't forget Canada. The flip side is that one of the biggest issues constantly in the news in those countries is about how those systems are always running out of money. I just spent the last month in France and had one day with a family that had a girl my age about to go into French medicine. Thus, the mother was very interested in how things are different in the US. Obviously the first one is money. Medical education in France is completely free, but the downside is that doctors make nothing compared with many other professions including most business-based professions. They begin thier medical education right out of high school but have a few extra years (but still not the 4 for undergraduate we have). I suppose you might say the upside is that doctors are still more respected in France, and I think we have lost a lot of that in this country. In the US medicine becomes so much more of an economic decision that we end up treating ourselves more often than not rather than seeing a doctor. When we see our doctors we know what we want, which is why pharmaceutical companies advertise to consumers rather than just medical professionals. In comparison, even pharmacists have more power in France. In fact, you will not find any sort of medicine-containing substance in the (pharmacy) store itself, you have to describe your needs and let the pharmacist decide what medications you need...this includes the most simple stuff like decongestants.
Obviously a system like this does indeed suck for doctors. They go through everything we go through and yet don't have the upside of a high-paying profession. The benefit to patients is debatable. I've heard good arguments that while healthcare is better on the preventative side, major healthcare issues like transplants are better performed in the US as they are under-funded and under-staffed (why uber-specialize when the salary potential is not that much better anyway?). In some ways we have socialized medicine on the state level. Every state has some sort of medicaid program for the poor. I'm not saying this provides the same preventative care as something like universal healthcare, but it certainly isn't like we're saying "if you can't pay, you can't have healthcare." There's nothing wrong with liking socialized medicine, but it's not the utopia Canadians would have us believe >). As for the OP, as long as you can recognize these issues and provide a well-rounded argument I don't see a problem. Interviews are not about making you defend a position though, they are about making sure you're a critical-thinking, intelligent person who would make a good doctor. The only way you could really burn yourself on this issue is to staunchly defend an "I support universal healthcare" stance without recognizing any of the downsides.

 

[kypdurron5]

the republican side will not allow it.

Hey hey, there are many wealthy democrats as well...to use your words "Don't tell me myth" . Most of the democratic leaders talking about these issues on behalf of low-income or middle class families make more money than most of us will ever see in our lifetimes. The idea that rich democrats want to be disproportionately taxed is insane. Don't get me wrong, there has always been, is still, and will always be disproportionate taxing in this country. No matter how many tax breaks the wealthy (democrats, republicans, and independants) get, they will always pay disproportionately higher (i.e. not just higher by amount, but also percentage) income taxes. This is just necessary, no one disputes that (well, proponents of flat-tax might). The only issue in the news is whether we are going to increase this disparity, decrease it, or keep it the same. The lowest tax rate is around 10% while the highest is around 35%. The 35% is for people over 200,000/yr, which isn't all that much by the way. This means that if you make over this you pay a tax percentage which is 250% more than the lowest level. This means people > 200,000 /yr not only pay more taxes, but also pay a much higher PERCENTAGE of thier money in taxes. On top of this there is the Alternative Miniumum Tax which adds even more taxes into the equation if you make above a certain level. Have no dilisions, the weathy are very well taxed in this country.

 

[MinnyGophers]

Hey hey, there are many wealthy democrats as well...to use your words "Don't tell me myth" . Most of the democratic leaders talking about these issues on behalf of low-income or middle class families make more money than most of us will ever see in our lifetimes. The idea that rich democrats want to be disproportionately taxed is insane. Don't get me wrong, there has always been, is still, and will always be disproportionate taxing in this country. No matter how many tax breaks the wealthy (democrats, republicans, and independants) get, they will always pay disproportionately higher (i.e. not just higher by amount, but also percentage) income taxes. This is just necessary, no one disputes that (well, proponents of flat-tax might). The only issue in the news is whether we are going to increase this disparity, decrease it, or keep it the same. The lowest tax rate is around 10% while the highest is around 35%. The 35% is for people over 200,000/yr, which isn't all that much by the way. This means that if you make over this you pay a tax percentage which is 250% more than the lowest level. This means people > 200,000 /yr not only pay more taxes, but also pay a much higher PERCENTAGE of thier money in taxes. On top of this there is the Alternative Miniumum Tax which adds even more taxes into the equation if you make above a certain level. Have no dilisions, the weathy are very well taxed in this country.

Well I meant in general, the republicans wouldn't, but I know for sure some would while many democrats wouldn't either.

I know the wealthy are taxed a lot more but the number of wealthy people is disproportionately lower than lower/middle class. So it doesn't really help if they increase taxes only for the higher bracket... Also, you also run the risk of people trying to evade taxes either illegally or moving elsewhere ( like Switzerland heh )... However, if you increase taxes for everyone, then the lower class won't be able to afford it. With all the push for increasing the minimum wages..etc.. it's all a huge evil cycle.

 

[MinnyGophers]

Don't forget Canada. The flip side is that one of the biggest issues constantly in the news in those countries is about how those systems are always running out of money. I just spent the last month in France and had one day with a family that had a girl my age about to go into French medicine. Thus, the mother was very interested in how things are different in the US. Obviously the first one is money. Medical education in France is completely free, but the downside is that doctors make nothing compared with many other professions including most business-based professions. They begin thier medical education right out of high school but have a few extra years (but still not the 4 for undergraduate we have). I suppose you might say the upside is that doctors are still more respected in France, and I think we have lost a lot of that in this country. In the US medicine becomes so much more of an economic decision that we end up treating ourselves more often than not rather than seeing a doctor. When we see our doctors we know what we want, which is why pharmaceutical companies advertise to consumers rather than just medical professionals. In comparison, even pharmacists have more power in France. In fact, you will not find any sort of medicine-containing substance in the (pharmacy) store itself, you have to describe your needs and let the pharmacist decide what medications you need...this includes the most simple stuff like decongestants.
Obviously a system like this does indeed suck for doctors. They go through everything we go through and yet don't have the upside of a high-paying profession. The benefit to patients is debatable. I've heard good arguments that while healthcare is better on the preventative side, major healthcare issues like transplants are better performed in the US as they are under-funded and under-staffed (why uber-specialize when the salary potential is not that much better anyway?). In some ways we have socialized medicine on the state level. Every state has some sort of medicaid program for the poor. I'm not saying this provides the same preventative care as something like universal healthcare, but it certainly isn't like we're saying "if you can't pay, you can't have healthcare." There's nothing wrong with liking socialized medicine, but it's not the utopia Canadians would have us believe >). As for the OP, as long as you can recognize these issues and provide a well-rounded argument I don't see a problem. Interviews are not about making you defend a position though, they are about making sure you're a critical-thinking, intelligent person who would make a good doctor. The only way you could really burn yourself on this issue is to staunchly defend an "I support universal healthcare" stance without recognizing any of the downsides.

Great post. I absolutely agree.
When I grew up in France, what really made me want to become a doc was my family practitioner. He didn't make much, worked in the burbs ( which are basically ghettos but not as bad as in the U.S.), and yet was respected by everyone because he provided care to disadvantaged youth.
I'd say most people there don't go on and become physicians for the money, because, it's really not that much for al the hard work. But as you said, docs are a lot more respected there than how I feel docs in the U.S are perceived...
There are good sides and bad sides to both systems, and there is a lot more to it than just say that everyone should be able to afford healthcare...

 

[browniegirl86]

My understanding has always been that the Indian health care system is pure fee-for-service, pay-as-you-go. The government doesn't pay for care for anyone. Essentially the opposite of what the OP is talking about.

I volunteered in Indian hospitals, public and private, for two months.

Here's how it worked, at least in rural Tamil Nadu.

Patients could get free basic care in the public hospital. Surgeries, etc. were pay-as-you-go, but much MUCH cheaper than the private hospital.

The private hospital was all pay-as-you-go, and in my opinion the care was exactly the same as the public hospital EXCEPT for surgeries, when the public hospital generally had better facilities. The public physician spots are actually the most coveted, because the doctors only work 1/2 the day and then get to maintain a private practice in the afternoon. They're salaried for the public spot and then get the pay-as-you-go money for their private practice, meaning that they end up making more money. So the physicians in the public hospitals were actually closer to the top of their field.

Disclaimer: this is only from my own experience comparing a few different hospitals in a small area of rural southern India. I did like that anyone could get care, but there are plenty of other problems with the system (patient overload, poor sanitation/lack of technology, money coming from the government which has plenty of problems of its own, impenetrable beaurocracy and the ever-present corruption, etc) and I'm not well-informed enough to make judgments on how a similar system would apply to the U.S.

Now, back on topic.

 

[sfnix]

i'll try to keep my post to only two ideas: the medical bureaucracy and the UN.

1- the administrative problems that are caused by ONE private practicing physician having to hire MULTIPLE administrators, just so the physician will have a group well versed in every kind of insurance available, are ridiculous. If medicaid was a mandatory state sponsored health insurance for all living in the US (illegal or legal regardless), physicians would save an obscene amount of $$$ on administrative personel. There could still be optional private insurance (as in germany, australia, and some other countries) in addition to the mandatory, but this would only be available to persons/families making more than 250,000 per se.

2- The UN releases a list of the countries where the citizens are most likely to be happy (or something like that). Norway has taken the cake for almost a decade now as number one. more telling is that other social democracies (mainly scandinavian countries) are habitually taking spots 1-5. United states has been falling since this report began to be issued, and now lies below most western countries. apparently there might be something to combing socialism and democracy. will look for an online version of this and post later.

 

[MinnyGophers]

The main problem I see for the U.S. if they wanted to switch their healthcare system to model Scandinavia, Canada, the rest of Europe...etc.. is that it will require a HUGE change in the economic structure of our country. I highly doubt that people, no matter what economic class they belong to, are going to be willing to be subject to a sudden large increase in taxes, as well as the government not having the money to contribute its share.

For countries like Norway and Scandinavia, who are always the most highly ranked countries to live, people do pay out of their arse to keep up universal healthcare and free education, but people do not live "large" lives. There's not a huge discrepancy between the wealthy and the lower class, like in the U.S.

 

[kypdurron5]

Well I meant in general, the republicans wouldn't, but I know for sure some would while many democrats wouldn't either.

I know the wealthy are taxed a lot more but the number of wealthy people is disproportionately lower than lower/middle class. So it doesn't really help if they increase taxes only for the higher bracket... Also, you also run the risk of people trying to evade taxes either illegally or moving elsewhere ( like Switzerland heh )... However, if you increase taxes for everyone, then the lower class won't be able to afford it. With all the push for increasing the minimum wages..etc.. it's all a huge evil cycle.

Indeed, and the problem with increasing minimum wage is that it leads to an increase in inflation and thus higher prices; it negatively affects people most who are already working above minimum wage.

 

[sanche60]

Ok, I'm still a long way off from interviews (assuming I get any), but I've been worrying that some of my opinions might keep me from getting in (no, nothing like the troll in the thread about women doctors).

I am in favor of a universal health care system. My personal opinion is that those who can pay should pay, but those who can't should be helped though government programs. I understand that such a program would bring down the salaries of doctors to some degree.

Back in the Clinton years, when we came closest to having a universal system, the biggest opponents of the idea were doctors themselves. That said, should I keep semi-socialist views to myself?

At one of my interviews, it was going great and the guy was like wow im really impressed with you.(his actual words) Then he asked me about problems with healthcare and we started talking about options like nationalized healthcare, blah, blah, blah. I said something along the lines that nationalized healthcare in this country was an utopian idea because the companies making billions off of healthcare would never allow it. He didnt seem to happy with that comment. Needless to say, waitlist. Try and keep it positive and avoid talking about salaries of physicians in any way. Just my advice though, so do what you want.

 

[ND2005]

I would say the biggest thing is not to overstate your own knowledge of the situation. Don't approach the "what's wrong with US healthcare?" question as if you have the perfect answer, because I promise you you don't.

Know the limits of your own understanding of the situation. Engage in the question in such a way that it becomes conversational, and the interviewer can share his opinions (which, due to the fact that he/she has probably been practicing medicine for a while, will likely be interesting/informative).

 

[MinnyGophers]

I would say the biggest thing is not to overstate your own knowledge of the situation. Don't approach the "what's wrong with US healthcare?" question as if you have the perfect answer, because I promise you you don't.

Know the limits of your own understanding of the situation. Engage in the question in such a way that it becomes conversational, and the interviewer can share his opinions (which, due to the fact that he/she has probably been practicing medicine for a while, will likely be interesting/informative).

Agreed, the best way is to NOT go in there with a set point of view. Know both sides of the issues and be ready to discuss them. Then hopefully the adcomm will go in a rant either way, and you'll know his/her opinion on the issue. The point is that you personally, shouldn't be ranting about it.

 

[Law2Doc]

The thing is that those doctors aren't making policy. With consumer-directed health plans (read HSAs+high deductibles) and pay-for-performance taking off, the emphasis right now is a more market-based, more privatized health care. If you look at the Medicare prescription drug benefit, you can see how powerful an interest Pharma is, and of course the insurance companies. There's no way, at least, that we can recreate Canada's single-payer system. Just because Massachusetts is attempting "universal health care," does not mean other states want to or can afford to follow.

I think your post actually makes my point, but not in the way you understand it. You are missing the big evil picture. Universal Health care coverage will happen PRECISELY because Pharma and the insurance companies are so strong. It will not be in the form you are thinking though (i.e. run through the state, like MA is attempting or Canada has done), it will be run through insurance companies, much like HMOs are, but with money coming from the government/taxpayers. This is both why it is bad for doctors and why it is inevitable. This is the version of universal health care that insurance companies are pushing hard for, ready willing and able to implement, and will at some point, given no other viable options, will happen. Pharma loves it too because suddenly they get to sell prescription drugs to folks who previously had no coverage. Doctors don't like it because the way insurance companies frequently pass on this kind of cost is to pay less on reimbursements, forcing physicians to up their volumes to keep financial pace.

 

[notdeadyet]

Don't tell me myth. I lived in France, and I know how much money we had to pay out of our salaries every months

The tax rate in France got as high as 48.9% for the top tax bracket. I paid about 40% in the U.S. at my peak earnings. So it's about 10% higher there. Sorry. I just did a spot check and found a couple places that confirmed. Here's one.

The good news is that they're dropping it to about 40%, which is more in line with other countries in Europe.

France taxes rates are the highest in Europe. :

Wow. If that's true, then Scandanavia must have dropped theirs, because I think that they were pushing 50%. Bummer about the health system not being better in France.

If you increased taxes in the U.S. by 10%, there is going to be an uproar from the lower socio-economic classes and the middle class, if you increase taxes for only the wealthy, the republican side will not allow it.

Ain't that the truth. Sad, but true...

 

[notdeadyet]

I would say the biggest thing is not to overstate your own knowledge of the situation. Don't approach the "what's wrong with US healthcare?" question as if you have the perfect answer, because I promise you you don't.

I agree as well. Arrogance is the killer. Show that you know enough that you've asked the right questions, not that you've come up with solutions.

 

[MinnyGophers]

The tax rate in France got as high as 48.9% for the top tax bracket. I paid about 40% in the U.S. at my peak earnings. So it's about 10% higher there. Sorry. I just did a spot check and found a couple places that confirmed. Here's one.

The good news is that they're dropping it to about 40%, which is more in line with other countries in Europe.


Wow. If that's true, then Scandanavia must have dropped theirs, because I think that they were pushing 50%. Bummer about the health system not being better in France.


Ain't that the truth. Sad, but true...

Those are just statistics for INCOME tax. But like stated in my post, the French pay taxes for pretty much everything. Sales tax there is 19.6% ( compare that to the US 7.5%) on most expenses, it's a bit reduced for food. There are wealth taxes ( which is not that high at 4%), property tax ( whether you rent or own) , even inheritance taxes...

I looked up tax levels online:

France: - 54% income tax
-36.6% corporate tax
- 45.3 total % tax / GNP

USA: - 39.6% income tax
-35% corporate tax
-27.9% total % tax/ GNP

Those figures are a few years old, and they might have dropped the income tax a bit in France, but just by looking at the total tax %/GNP, which include ALL taxes, France does tax a lot more than the U.S.

Highest income tax countries in Europe are Netherlands ( 60%) and Sweden (57%)

Highest total % tax/GNP in the world is Denwark with 51.3%
USA's is the lowest of all first tier countries with 27.9%, and then Japan with 28%.

There is a BIG difference. To be able to sustain a mostly free healthcare + free education for 60+ millions people, that's how much they pay.

 

[kypdurron5]

I said something along the lines that nationalized healthcare in this country was an utopian idea because the companies making billions off of healthcare would never allow it. He didnt seem to happy with that comment. Needless to say, waitlist.

The biggest problem with that response is that it's too "conspiracy theoristic." It implies that corporate America runs the country. While the largest corporations may have some influence through political donations, the idea that they actually "control" policy is simply not true. The other problem is that your response also pawns all our healthcare problems off on corporate America. That is thinking too simplistically, and that is the bigger problem. If lawmakers wanted to switch to socialized medicine they could do so, large corporations do not have veto power on any legislation. Even if we did go to a socialist system these companies would still make the money because our taxes/government would fund these services. Socialized medicine does not mean companies must all of a sudden start providing their services free of charge, it simply changes where the money comes from.

 

[Law2Doc]

The biggest problem with that response is that it's too "conspiracy theoristic." It implies that corporate America runs the country. While the largest corporations may have some influence through political donations, the idea that they actually "control" policy is simply not true.

Who do you think controls healthcare right now? Pretty much all physicians work for reimbursements from insurance companies. They are the bosses now. As soon as someone funds healthcare for the uninsured, there will be more clients but the bosses stay the same - the insurance companies still benefit. Both you and the prior poster are looking at this the wrong way -- the big companies would love universal coverage because it doesn't take them out of the picture, it gives them more clients, more control. They are the middleman for medical care, and are quite entrenched -- they won't be replaced in such a system, the government will work through them.

 

[Law2Doc]

I agree as well. Arrogance is the killer. Show that you know enough that you've asked the right questions, not that you've come up with solutions.

In every interview I've been in where the topic was raised, I was asked how I would solve this problem if I was eg., the Surgeon General. Having solutions would be a good thing.