biggest problem in US health care system?

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Ahhh a very good point...
There is no sense on focusing on the cost of health care if access to a health care facility is a bigger issue. This is a comment coming from someone who lives where there is 1 hospital servicing approx. 155,000 people. Yes 1 local hospital (the other 2 hospitals are only for military personnel).
 
It's not an attack. it's my opinion.

Don't attack us because we want to make a good living.

Get back to us after you graduate college and see how you feel about whatever career you go into and compensation for said career.

P.S. Do your parents know you're on the internet?

I'm not trying to attack you, just defend myself, so sorry. I'm not naive, and I know that with all the debt you accumulate after med school you can't possibly live on minimum wage, but if you could, I would. I don't need bimmers and 3 million dollar houses to make me happy. Obviously, minimum wage isn't realistic, but neither is $200,000 a year.
 
I don't need bimmers and 3 million dollar houses to make me happy. Obviously, minimum wage isn't realistic, but neither is $200,000 a year.

The current physician salaries don't allow people to get 3 million dollar houses. Those days are gone. Many physicians already earn far less than $200k. There was an article posted on SDN a few weeks back about family med doctors who had to get second jobs to pay their bills. So obviously (to most) when you talk about slashing incomes significantly, people get nervous.
 
It's not an attack. it's my opinion.

Don't attack us because we want to make a good living.

Get back to us after you graduate college and see how you feel about whatever career you go into and compensation for said career.

P.S. Do your parents know you're on the internet?

P.S. Hahahahahah! You're hilarious. Really 🙄
 
The current physician salaries don't allow people to get 3 million dollar houses. Those days are gone. Many physicians already earn far less than $200k. There was an article posted on SDN a few weeks back about family med doctors who had to get second jobs to pay their bills. So obviously (to most) when you talk about slashing incomes significantly, people get nervous.

I don't believe that. What kind of bills could they possibly be paying that they couldn't afford on a $70,000+ paycheck?
 
I don't believe that. What kind of bills could they possibly be paying that they couldn't afford on a $70,000+ paycheck?

Malpractice for one.

Edit: http://www.med.umich.edu/opm/newspage/2005/obgyn.htm

So some premiums are almost $200K. Then physicians also have to pay for continuing ed, clinic overhead, etc. (if they own a practice).

Bills for house, car, etc. can be managed but if a physician can afford it, why not get a nice car or house? Doesn't have to be a mansion, but it's not illegal to own nice things (or a sin for that matter).
 
P.S. Hahahahahah! You're hilarious. Really 🙄

It's pretty obvious that you're debating based on emotion, but don't really know enough about the profession to make valid points.

I know L2D is already a physician, and I've owned my own therapy practice for a few years now. So we speak with a lot of healthcare experience, not just anecdotal stories of what we've heard. We've seen it, lived it, experienced it, and gotten our hands dirty.

You are welcome to your opinion, but personally it's hard to see it as educated coming from a 17-year-old who doesn't have much experience working in healthcare. We've all had the POV as a patient, but it's a much different perspective when you're actually the one delivering health care.
 
Ahhh a very good point...
There is no sense on focusing on the cost of health care if access to a health care facility is a bigger issue. This is a comment coming from someone who lives where there is 1 hospital servicing approx. 155,000 people. Yes 1 local hospital (the other 2 hospitals are only for military personnel).

Oops message above is in response to this comment. Only my second post (not including the very first intro. I'll get better)

"The biggest problem is access.

There are 50 million people in this country with inadequate access to healthcare. But you'll never hear about that on SDN because there are so many CHILDREN here that are concerned about making as much money as possible. I love reading the stuff about socialized medicine, etc. Nobody is talking about what is best for patients. Its frightening."
 
It's pretty obvious that you're debating based on emotion, but don't really know enough about the profession to make valid points.

I know L2D is already a physician, and I've owned my own therapy practice for a few years now. So we speak with a lot of healthcare experience, not just anecdotal stories of what we've heard. We've seen it, lived it, experienced it, and gotten our hands dirty.

You are welcome to your opinion, but personally it's hard to see it as educated coming from a 17-year-old who doesn't have much experience working in healthcare. We've all had the POV as a patient, but it's a much different perspective when you're actually the one delivering health care.

Please stop quoting my age. I mean no offence.
Just ask yourself this: "If you were paid half as much as you are now, would you still be a doctor?"
 
Please stop quoting my age. I mean no offence.
Just ask yourself this: "If you were paid half as much as you are now, would you still be a doctor?"

Unfortunately, age is a relevant factor for experience. So I will continue to address it as long as you bash physicians for the money they make. You should be careful in what you publicly reveal.

And the answer is yeah, I would. I make a lot of money as it is.

But if I didn't there would have to be a lot of other factors for me to work for a lot less pay. I enjoy medicine, but I'm not stupid (or naive).
 
Oops message above is in response to this comment. Only my second post (not including the very first intro. I'll get better)

"The biggest problem is access.

There are 50 million people in this country with inadequate access to healthcare. But you'll never hear about that on SDN because there are so many CHILDREN here that are concerned about making as much money as possible. I love reading the stuff about socialized medicine, etc. Nobody is talking about what is best for patients. Its frightening."

I don't believe there is inadequate access to health care. I live in a rural area, although not as rural as say South Dakota, but I will speak of what I know here in IL.

People have access to hospitals and clinics - by law they can't be turned away from the ER or urgent care. There are also a lot of physicians around here that take the "medical card" meaning public aid. Unfortunately they are booked months in advance so the wait time is the killer.

If by access you mean car or other transportation, if they have means to buy groceries, cigarettes, and alcohol, they have means to get to the doctor.

If the reimbursement rate was better for physicians through public aid, then I'm sure more physicians would accept it as a form of payment. Unfortunately medicine also entails an administration aspect to keep a clinic in operation, and the overhead can eat up a lot. IL doesn't like to pay for much, which is why the state is in a "state" of crisis right now with the budget. Who knows when state employees will get paid (including medical claims made through public aid - which incidentally is 75% of my caseload 😱)

So, in working in a close environment with physicians and other therapists, and what I've said before, is that there is no lack of "access" but more so lack of follow-through. Plus, I think there is a lot to be said for preventive medicine. If people would understand smoking, excessive drinking, and eating poorly lead to exacerbation if not the cause of most of the cases routinely seen then maybe the "50 million" number would dwindle.

Personally, I think the healthcare system as it is screws the middle-class, not the poor or wealthy. The poor beat most "sliding fees", the wealthy can pay out-of-pocket, but the middle-class have so many responsibilities and less financial breaks than the other classes.
 
Benign tumors and cysts can still wreak havoc in addition to cancer and can behave the same way as cancerous tumors.

Even so, thyroid cancer or pre-cancer isn't as rare as you'd think. In fact, 5 immediate family members of mine have had 5 different kinds of thyroid cancer. My tumor was the size of a golf ball so it was kinda hard to say there wasn't anything there. The cancer itself was malignant, but contained within the thyroid, so didn't metastasize and considered benign compared to the rest of the body. Had they left it for later, even a few weeks, and my lymph nodes would have been in trouble. The entire time from initial palpitation to removal was about 3 weeks. That sucker grew fast.

I never had any lab tests but did have an ultrasound and biopsy. I shudder to think what may have happened if it was not treated aggressively. It always reminds me that not everything that seems less important is indeed less important. It was potentially very life-threatening. I was lucky. 30 years ago my father was not. He also had thyroid cancer which indeed metastasized to his lymph nodes. He underwent grueling chemo and has a nasty scar from collarbone to jawbone. He wasn't expected to live but but he grace of God made it through. His doctor was aggressive as well, and he'd be dead if the doctor wasn't.

I probably take exception to this line of conversation because I experienced it.

A palpable tumor in a person with a first degree relative with thyroid cancer is a different kettle of fish. And having 5 family members with thyroid cancer tells me nothing about the incidence of thyroid cancer in the general population. Among white women, the annual incidence of thyroid cancer is 6 out of 100,000. Annual deaths from thyroid cancer among white women is 3 in a million.

Furthermore, 5-10% of the population have insignificant thyroid carcinomas that are found at autopsy. We can leave these alone and the patient will never be bothered by them or we can go nuts working up eveyone and his brother.

The point I was making is that when physical exam skills atrophy and physicians depend on diagnostic imaging rather than history & physical, you are going to spend a lot of money on work-ups with no decernable improvement in the health of the population. This is the sort of thing that explains why we pay so much more than other industrialized countries yet have poorer health of our population.
 
Oops message above is in response to this comment. Only my second post (not including the very first intro. I'll get better)

"The biggest problem is access.

There are 50 million people in this country with inadequate access to healthcare. But you'll never hear about that on SDN because there are so many CHILDREN here that are concerned about making as much money as possible. I love reading the stuff about socialized medicine, etc. Nobody is talking about what is best for patients. Its frightening."

50 million people... yeah ok, so we are talking what 50 million invisible people, i would like you to name 10 places in the continental us that you cannot get healthcare.... waiting
 
Malpractice for one.

Edit: http://www.med.umich.edu/opm/newspage/2005/obgyn.htm

So some premiums are almost $200K. Then physicians also have to pay for continuing ed, clinic overhead, etc. (if they own a practice).

Bills for house, car, etc. can be managed but if a physician can afford it, why not get a nice car or house? Doesn't have to be a mansion, but it's not illegal to own nice things (or a sin for that matter).

And I'm not saying it is!
 
A palpable tumor in a person with a first degree relative with thyroid cancer is a different kettle of fish. And having 5 family members with thyroid cancer tells me nothing about the incidence of thyroid cancer in the general population. Among white women, the annual incidence of thyroid cancer is 6 out of 100,000. Annual deaths from thyroid cancer among white women is 3 in a million.

Furthermore, 5-10% of the population have insignificant thyroid carcinomas that are found at autopsy. We can leave these alone and the patient will never be bothered by them or we can go nuts working up eveyone and his brother.

The point I was making is that when physical exam skills atrophy and physicians depend on diagnostic imaging rather than history & physical, you are going to spend a lot of money on work-ups with no decernable improvement in the health of the population. This is the sort of thing that explains why we pay so much more than other industrialized countries yet have poorer health of our population.

OK I see what you are saying now.

Unfortunately I was #2 in my family, the rest came later and my dad 30 years before. But like I said, a golf ball sticking outside of my neck that wasn't a goiter was a big tip-off.

But if I came in complaining of lethargy, weight gain, hair loss, sensitivity to cold, etc. I would hope that my physician would do some lab testing and if abnormal results investigate a little further - which would seem the appropriate and normal protocol you were suggesting. (I think).
 
Unfortunately, age is a relevant factor for experience. So I will continue to address it as long as you bash physicians for the money they make. You should be careful in what you publicly reveal.

Well, can you tell me how to hide it? I'm still new at this thing.

And the answer is yeah, I would. I make a lot of money as it is.

There you go. That's all I'm trying to say.

But if I didn't there would have to be a lot of other factors for me to work for a lot less pay. I enjoy medicine, but I'm not stupid (or naive).

I'm not saying you should work for minimum wage, and file for bankruptcy the next year. But you have to admit, some doctors are overpaid.
 
Well, can tell me how to hide it? I'm still new at this thing.



There you go. That's all I'm trying to say.



I'm not saying you should work for minimum wage, and file for bankruptcy the next year. But you have to admit, some doctors are overpaid.

Doctors are overpaid? 😵

To make such blanket statments are crazy. No doctor today gets to buy million-dollar homes. Go attack other professions like business executives and lawyers. They DO get overpaid.
 
Well, can tell me how to hide it? I'm still new at this thing.



There you go. That's all I'm trying to say.



I'm not saying you should work for minimum wage, and file for bankruptcy the next year. But you have to admit, some doctors are overpaid.

You can curtail your naivety by doing research and not shooting from the hip about something you have no experience with.

You asked if I would be a physician for half of what I make now - well you don't know how much I make, and I also put in the caveat that there would have to be other factors involved (such as free education, limited malpractice costs, job security, no economic inflation) but it's not going to happen.

I try to stay out of political conversations because I don't know enough about them to argue effectively. I sure have my opinion, but what's it worth if it's not informed?

I don't feel doctors are overpaid. Think what you want, but it's not bad to want to make a good salary doing something you enjoy.
 
The big problem with health care is that more people are getting sick and needing treatments there is money being pumped into the system to treat all of them. This leads to both access and cost problems. Switching to universal health care will not solve our problems but only shift problems into other realms. Universal health care will obviously improve access to care, but will also lead to reduced quality of care and increased taxes. For universal health care to work, the tax money from healthy people go toward treating sick people. So, what happens when there are more sick people than healthy people? That's what's going to happen as soon as we switch to universal health care. In other words, were screwed no matter what system we use. I think the only effective approach to health care should be to find ways to prevent unnecessary spending. Patients need to maintain health through good lifestyle choices. Doctors need incorporate cost-benefit analysis in their medical decisions. There is really no solution. We just need to do what we can as individuals to make the best of the problem. (Just like recycling, energy conservation, etc.)
 
50 million people... yeah ok, so we are talking what 50 million invisible people, i would like you to name 10 places in the continental us that you cannot get healthcare.... waiting

that's not the point. we have about 45 million people without health insurance and, without it, are severely limited in the health care they can receive. then you add the number of people with health insurance that are limited in their access to medical care because of various reasons like physical constraints, or are impeded because their health insurance sucks. the "access" mentioned is a broad term.
 
Man @ 17 I was out partying 5 days a week... Howd u end up in a medical forum?? haha
 
spend a lot of money on work-ups with no decernable improvement in the health of the population. This is the sort of thing that explains why we pay so much more than other industrialized countries yet have poorer health of our population.

exactly. we use MRI and CT scans like it's free. you want exploratory surgery? you can get it if you ask around. it's ridiculous.
 
exactly. we use MRI and CT scans like it's free. you want exploratory surgery? you can get it if you ask around. it's ridiculous.

Well, that's because they are also extremely reliable as well. And we're in an age of semi-defensive medicine where if an ER doc didn't order a CT and something was missed? He gets sued to hell!

Honestly, because an ER doc can't refuse you if you can't pay, there's also clauses of negligence to do what ever is reasonable to help a patient, regardless of their financial status. Until we can fix that, anyone who comes through the ER is going to get a CT and an X-ray at some point if doctors think it might be useful.
 
Well, that's because they are also extremely reliable as well. And we're in an age of semi-defensive medicine where if an ER doc didn't order a CT and something was missed? He gets sued to hell!

Honestly, because an ER doc can't refuse you if you can't pay, there's also clauses of negligence to do what ever is reasonable to help a patient, regardless of their financial status. Until we can fix that, anyone who comes through the ER is going to get a CT and an X-ray at some point if doctors think it might be useful.

There is a large and growing science of medical decision making aimed at determining when and how diagnostic procedures and treatments should be applied in clinical settings.
There is much more to the usefulness of diagnostic imaging than their reliability. There is both the sensitivity (the proportion of those with the condition are correctly identified) and the specificity (the proportion of those without the condition who are correctly identified) and one must also factor in the pre-test probability of the condition. An excellent measure in a situation where the pre-test probability is exceedingly low can be a complete waste of time and money as it provides little information that can drive a medical decision to act.

No one ever got sued for failing to order an unnecessary test. The trick is to identify in advance which tests (CTs MRIs) are not necessary in the diagnosis of the patient and not do the test.

So, for example, an elderly person presents to the emergency department with delirium. Do you get a CT right off the bat because it could be an organic problem in the brain or do you look for one of the most likely causes of delirium in that setting: urinary tract infection or pneumonia. Only after those and some others are ruled out does it make sense to go to the CT. Failing to get a CT of the head in someone with a bladder infection is not going to get anyone sued.
 
50 million people... yeah ok, so we are talking what 50 million invisible people, i would like you to name 10 places in the continental us that you cannot get healthcare.... waiting
I don't believe there is inadequate access to health care. I live in a rural area, although not as rural as say South Dakota, but I will speak of what I know here in IL.

People have access to hospitals and clinics - by law they can't be turned away from the ER or urgent care. There are also a lot of physicians around here that take the "medical card" meaning public aid. Unfortunately they are booked months in advance so the wait time is the killer.

If by access you mean car or other transportation, if they have means to buy groceries, cigarettes, and alcohol, they have means to get to the doctor.

If the reimbursement rate was better for physicians through public aid, then I'm sure more physicians would accept it as a form of payment. Unfortunately medicine also entails an administration aspect to keep a clinic in operation, and the overhead can eat up a lot. IL doesn't like to pay for much, which is why the state is in a "state" of crisis right now with the budget. Who knows when state employees will get paid (including medical claims made through public aid - which incidentally is 75% of my caseload 😱)

So, in working in a close environment with physicians and other therapists, and what I've said before, is that there is no lack of "access" but more so lack of follow-through. Plus, I think there is a lot to be said for preventive medicine. If people would understand smoking, excessive drinking, and eating poorly lead to exacerbation if not the cause of most of the cases routinely seen then maybe the "50 million" number would dwindle.

Personally, I think the healthcare system as it is screws the middle-class, not the poor or wealthy. The poor beat most "sliding fees", the wealthy can pay out-of-pocket, but the middle-class have so many responsibilities and less financial breaks than the other classes.


Come live in LA where most people arent white and where minorities flood the free healthcare market.
Going to the ER to receive medical attention is the PROBLEM with our system. Access to health care should be defined as having insurance, having regular visits with physicians, and practicing preventive medicine (<-- a situation that's similar to yours I'm sure). Because the ER in Illinois is forced to see anyone who comes through the ER, doesn't not mean that healthcare services are adequately caring for everyone in the area. I work at Venice Family Clinic in Los Angeles, It's the nations largest free healthcare provider, most people are homeless, poor, drug addicts, but face barriers to seeing a doctor regularly- like language, financial, and some fear it because of their immigrant status.. Go interview someone from or go work at a clinic that serves people 200% below the federal poverty level and who dont have health insurance and you'll be very surprised to see the Problems that America faces in trying to provide services to everyone.

America Does face healthcare access problems... check out poverty rates in NYC, LA and even MIAMI and other cities where the black and latino populations are big and things are much different than in your part of town.
 
It's pretty obvious that you're debating based on emotion, but don't really know enough about the profession to make valid points.

I know L2D is already a physician, and I've owned my own therapy practice for a few years now. So we speak with a lot of healthcare experience, not just anecdotal stories of what we've heard. We've seen it, lived it, experienced it, and gotten our hands dirty.

You are welcome to your opinion, but personally it's hard to see it as educated coming from a 17-year-old who doesn't have much experience working in healthcare. We've all had the POV as a patient, but it's a much different perspective when you're actually the one delivering health care.


I thought L2D was a medstudent but whatever
 
50 million people... yeah ok, so we are talking what 50 million invisible people, i would like you to name 10 places in the continental us that you cannot get healthcare.... waiting

Sure you can get health care.....but it will financially cripple you if you decide to get it. Take the average uninsured person who needs to go to the ER because they had an accident like breaking their leg, car accident, etc. The hospital isn't going to turn them away, they are going to treat them regardless if they have health insurance or not. However, once that uninsured patient leaves they are going to be hounded by collection agencies for their $50,000 bill. The hospital would most likely set up a monthly payment plan with this uninsured person, but that uninsured person's quality of life afterwards would be severely diminished with having to pay such a huge amount in bills all simply because they needed emergency medical treatment.


The cost of medicine imposes a HUGE barrier to access to medicine for millions of people. If you can't see that, you are completely blind. The uninsured and even the INsured skip out on recommended drug treatments, follow up visits, and diagnostic tests simply because they cost too much. As a result, they end up later on needing to be rehospitalized, retreated, or end up in the ER which wastes even more money than if they would have been able to afford the proper preventative care/treatment in the first place.
 
The biggest problem is that americans are fat, lazy and like to smoke and drink.

If they werent, CAD, Diabetes, Cancer would all go way down.
 
The biggest problem is that americans are fat, lazy and like to smoke and drink.

If they werent, CAD, Diabetes, Cancer would all go way down.

i agree 100%. i started writing this essay when i first got it and just let myself write whatever i thought of and i basically said that americans are fat and lazy and need to take responsibility for their health and well being and until they do that medical care will be very very expensive. so i decided to bring up the topic here instead of submitting that. (even though it is indeed the biggest problem in america).
 
Stony Brook asks you to identify the biggest problem facing the US health care system. I should have no problem with this essay seeing as I have an MPH... but that is actually making it more difficult. I could write a 30 page dissertation on this. They want like a page. How do I wrap up the biggest problem in the US health care system? I don't want to come off sounding like an idiot writing a paper for a class. But I probably will anyway.
How complicated a discussion are you guys going to get into in one page?

frickin sick people
 
Sure you can get health care.....but it will financially cripple you if you decide to get it. Take the average uninsured person who needs to go to the ER because they had an accident like breaking their leg, car accident, etc. The hospital isn't going to turn them away, they are going to treat them regardless if they have health insurance or not. However, once that uninsured patient leaves they are going to be hounded by collection agencies for their $50,000 bill. The hospital would most likely set up a monthly payment plan with this uninsured person, but that uninsured person's quality of life afterwards would be severely diminished with having to pay such a huge amount in bills all simply because they needed emergency medical treatment.


The cost of medicine imposes a HUGE barrier to access to medicine for millions of people. If you can't see that, you are completely blind. The uninsured and even the INsured skip out on recommended drug treatments, follow up visits, and diagnostic tests simply because they cost too much. As a result, they end up later on needing to be rehospitalized, retreated, or end up in the ER which wastes even more money than if they would have been able to afford the proper preventative care/treatment in the first place.

you just described the back-door socialized medicine system

we are all paying for those who cannot already

healthcare is indeed available to anyone who needs it
 
think long and hard before ever saying any American is overpaid.

ponder that for awhile, seriously.
 
pt. ignorance😡

I don't disagree with that, but want to suggest that there's a parallel physician arrogance that doesn't help much either---I've been to a doc and had a pretty good idea what my diagnosis might be and had the doc blow me off like dandruff, only to discover waaaaaaaaaaaayyyyyyyy later that I was correct. Lesson: you may have a parade of dolts through your exam room all week long but not every single patient is worthy of your disdain and dismissal. But that isn't the biggest problem in healthcare today. Carry on.
 
you just described the back-door socialized medicine system

we are all paying for those who cannot already

healthcare is indeed available to anyone who needs it



If we are all paying for it then why are 50% of all bankruptcies in the US triggered by medical care costs?

People are selling their homes, their cars, all of their retirement savings, property, and all of their other assets just to pay off bills from receiving medical care.
 
I'm not naive, and I know that with all the debt you accumulate after med school you can't possibly live on minimum wage, but if you could, I would. I don't need bimmers and 3 million dollar houses to make me happy. Obviously, minimum wage isn't realistic, but neither is $200,000 a year.

AHAHAHAHAHAH. I had a great laugh at this.

Get a reality check. Please.
 
If we are all paying for it then why are 50% of all bankruptcies in the US triggered by medical care costs?

People are selling their homes, their cars, all of their retirement savings, property, and all of their other assets just to pay off bills from receiving medical care.

Not so fast. I assume you're referring to the study which claims that 54.5% of bankruptcies have a "medical cause" and 46.2% have a "major medical cause." For a discussion of why this study is misleading:

http://rightcoast.typepad.com/rightcoast/2007/07/junk-social-sci.html

Among the features of the study noted in this link are:
1. Gambling or drug addiction and birth or adoption of a child are considered medical causes. In a sense, yes, you might say these are medical bills. But its not quite the same as going bankrupt over, say, a stroke or paying for your statins.
2. Also this guy says there are bankruptcy safeguards in place specifically for medical bankruptcies. This I don't know much about - anyone care to chime in about whether this guy is correct?
3. Deceptive definitions: "Major medical cause" for bankruptcy was defined as having $1000 in accumulated out of pocket medical expenses over 2 years even if they themselves did not cite the medical bills as the reason for their bankruptcy. (Average per capita out of pocket medical expenses in 2001 were $683 - not too much less than $1000). So, and this is their example, "a bankrupt [sic] with $1001 in uncovered medical expenses and $50,000 on a Bloomingdale’s card would constitute a 'medical bankruptcy' in their study."

You can read more for the rest of the details but basiclaly they conclude that there aren't that many medical bankruptcies.
 
Um, every politician running for office is talking about what is best for patients (at least those who vote); often at the expense of physicians -- the very cogs that make this machine work. I wouldn't worry as much about patients -- they are one group that is currently being spoken for in the current healthcare battle. The real issue is which group gets screwed in an effort to make things best for patients -- the doctors, the insurance companies, the pharmaceutical indusry or the taxpayer (or most likely several of the above). Of these groups, the doctors are the weakest fighters. So you really need places like SDN to advocate the physician/future physician side of things, because frankly, this is the group that is most likely going to get trampled in someone's march to the whitehouse. Read last weekend's NYTimes article attacking physician salaries and it will give you a taste of where the discussion is going to go between now and the next election.

Very well said. We need to act collectively, as the next generation of physicians, to stick up for ourselves. It seems that behind every criticism, suggestion, and political manuever is an effort to screw doctors. It is ridiculous. We deserve, based on years of dedication and the premium intellect should demand, to receive very high compensation. We should have the right to operate with the added bonus of profit. This should not be deemed as nefarious or heartless, but rather as an ADDITIONAL and DESERVED motivating factor.

Many of our politicians do not value the worth of a doctor, but we certainly should understand and espouse an accurate assessment of our value.
 
Very well said. We need to act collectively, as the next generation of physicians, to stick up for ourselves. It seems that behind every criticism, suggestion, and political manuever is an effort to screw doctors. It is ridiculous. We deserve, based on years of dedication and the premium intellect should demand, to receive very high compensation. We should have the right to operate with the added bonus of profit. This should not be deemed as nefarious or heartless, but rather as an ADDITIONAL and DESERVED motivating factor.

Many of our politicians do not value the worth of a doctor, but we certainly should understand and espouse an accurate assessment of our value.

It is hard for docs to stick up for themselves because we are always pigeonholed based on our job description. We will always be manipulated due to our role in the system. When we argue for our pay, which would probably be much higher than it is now under a free market system, we get labeled as greedy. People point to a few million dollar houses and say look what they've got. It is called "hater syndrome."

Physicians should not demand a certain pay in this economic system, but instead, the system inherently would pay us more if we didn't have insurance companies and government meddle with us all the time. Like Ron Paul says, working people should have a contract with physicians county by county. Then, physicians will move around based on who offers better, and then people would compete for us. Your life's value is not quickly negotiable.

Another big thing is values in this society. Teachers get f'ed all the time even though they stay late to educate YOUR children, but do they ever get a pat on the back for doing a great job laying down the future? NO or hardly ever. They get yelled for at going on strikes, and guess what, that is what will happen to doctors in the future if UHC goes through. We will be striking like them from time to time to ask for stuff. Basically, government will replace the HMO.

If you want to avoid the misery of medicine, now is the time to explore other fields. Do not expect the big paycheck anymore because your fellow ignorant American values Michael Vick more than they will ever value you in the white coat. I find myself everyday doing the job because more and more for the technical knowledge than the natural process. I may get a thank you now and then but I don't count on people ever valuing my work or understanding me when something goes wrong. I expect people to sue me because I have dollar signs written all over me (meaning the hospital insurance fund, not me as a resident), and so why not make some quick money to get out of that 9-5 job?

People in this country don't want to work hard and don't care about those who do. Remember, physicians don't get scheduled coffee breaks, breakfasts, lunches, dinners, etc. We don't get to get off work at a set time so we can spend time with our family. We don't get to pursue outside interests. AND WE CERTAINLY DON'T roll around in exotic sports cars. That's for the CEOs of hospitals and insurance companies. Yet, the focus is never on them.

Sorry for my rant of despair. Look at England, more than half of the physicians under national care would have chose a different field if they knew what they were going to expect. Maybe Americans docs need a massive strike as the last counter measure (except the kids hospitals).
 
I'm serious here. People do not take responsibility for themselves. They want to do as they please & get baled out by health care system which just means that they want everyone to chip in to pay for problems of their own making. The is evidenced not only by the rising proportion of obese and overweight adults in America but in the use of alcohol, cigarettes, drugs and risky sexual behavior.

Obesity is a risk factor for a wide variety of disabling conditions. Wipe out obesity and you reduce the number of heart attacks, hip and knee replacements, even breast cancer (associated with higher body weight after adjusting for height).

One of the problems of the health care system that leads to obesity and other preventable problems is that we are totally designed as a one-on-one system designed to treat problems when they arise rather than a system that identifies and prevents potential problems (pediatrics is an exception to this rule with most pediatricians doing a lot of anticipatory guidance and prevention including vaccines).


One of the problems of the health care system that leads to obesity and other preventable problems is that we are totally designed as a one-on-one system designed to treat problems when they arise rather than a system that identifies and prevents potential problems (pediatrics is an exception to this rule with most pediatricians doing a lot of anticipatory guidance and prevention including vaccines).

yes yes yes👍👍👍
 
50 million people... yeah ok, so we are talking what 50 million invisible people, i would like you to name 10 places in the continental us that you cannot get healthcare.... waiting

About 50 million people do not have health insurance in the US. These people have problems with accessing healthcare. The following quote is from "MYTHS AS BARRIERS TO HEALTH CARE REFORM
IN THE UNITED STATES", by John P. Geyman, who is Prof Emeritus at U of Washington.

1. “Everyone gets care anyhow”
Purveyors of this myth assume that the uninsured and underinsured are able to access health care within an extensive safety net of community health centers; emergency rooms and outpatient clinics of public hospitals and not-for-profit community hospitals; local health departments; or other public sector clinics and hospitals, such as the Veterans Administration or National Health Service Corps. While this belief may absolve their guilt about serious access problems within the present system, it is a total misperception on many counts. Access to health care is more complex than it may appear, even for the insured. Eisenberg and Power (28) have drawn the analogy between access to health care and electrical current passing through resistance—even for the insured, access suffers with each voltage
drop, whether their needed services are actually covered, their choice is informed and available, or primary and specialty services are available.
How should acceptable access be measured? Access to medical and surgical
services is one measure, but how about preventive care, prescription drugs,
glasses, mental health care, and dental care? Does a visit to an overwhelmed
emergency room for a nonemergent problem, or to an urgent care clinic where the physician “sees” 60 or more patients during a 12-hour shift without continuity (and often without access to their medical records), compensate for the lack of primary care? While the plight of the uninsured is more obvious, there are many misperceptions here as well. For example, 80 percent of the uninsured live in working families, and still cannot qualify for or afford health insurance (29). Whether insured, underinsured, or uninsured, people suffer serious outcomes of lack of access to primary care. Three examples make the point. A 1997 study of low income patients hospitalized for preventable or avoidable conditions found, for example, that 60 percent reported receiving no care before admission, while only 17 percent had been seen in an emergency room (30). A 2001 study by Baker and colleagues (31) of 7,500 adults aged 51 to 61 who lacked continuous health insurance found that almost three times as many persons experienced a decline
in their health or functional status if continuously uninsured than if insured. In
another recent study of 1,900 Medicare beneficiaries, only 4 percent without
prescription drug coverage were receiving statins, compared with an estimated 60 percent who could benefit from their use (32).
 
I don't believe there is inadequate access to health care. I live in a rural area, although not as rural as say South Dakota, but I will speak of what I know here in IL.

People have access to hospitals and clinics - by law they can't be turned away from the ER or urgent care. There are also a lot of physicians around here that take the "medical card" meaning public aid. Unfortunately they are booked months in advance so the wait time is the killer.

If by access you mean car or other transportation, if they have means to buy groceries, cigarettes, and alcohol, they have means to get to the doctor.

If the reimbursement rate was better for physicians through public aid, then I'm sure more physicians would accept it as a form of payment. Unfortunately medicine also entails an administration aspect to keep a clinic in operation, and the overhead can eat up a lot. IL doesn't like to pay for much, which is why the state is in a "state" of crisis right now with the budget. Who knows when state employees will get paid (including medical claims made through public aid - which incidentally is 75% of my caseload 😱)

So, in working in a close environment with physicians and other therapists, and what I've said before, is that there is no lack of "access" but more so lack of follow-through. Plus, I think there is a lot to be said for preventive medicine. If people would understand smoking, excessive drinking, and eating poorly lead to exacerbation if not the cause of most of the cases routinely seen then maybe the "50 million" number would dwindle.

Personally, I think the healthcare system as it is screws the middle-class, not the poor or wealthy. The poor beat most "sliding fees", the wealthy can pay out-of-pocket, but the middle-class have so many responsibilities and less financial breaks than the other classes.

Yes, the system screws the middle class. But not as much as the poor. Read my last post. Also, there is an awful lot of literature out there that suggests that access is a problem, regardless of your impression based on ones person's perspective in SD.

The 50 million number is the approximate number of people without health insurance. (I think it is actually 46.) Anyway, while not smoking would be good for them, it will not help their access problems.
 
I don't believe that. What kind of bills could they possibly be paying that they couldn't afford on a $70,000+ paycheck?

Wow this reeks of someone with no real world experience. Ok how about health insurance, car payment, mortgage, homeowners insurance, property tax, county tax, school tax, student loans, water, electricity, gas, groceries, incidentals (who knows when the car is going to break down or the roof will leak), clothes, children's school, food, clothing..... The list goes on, $70,000 will not get you very far especially with the way housing costs are now!
 
Yes, the system screws the middle class. But not as much as the poor. Read my last post. Also, there is an awful lot of literature out there that suggests that access is a problem, regardless of your impression based on ones person's perspective in SD.

The 50 million number is the approximate number of people without health insurance. (I think it is actually 46.) Anyway, while not smoking would be good for them, it will not help their access problems.

My perspective is in IL, not SD.
 
Just glancing through this post before my interviews next week...so, if somehow all 46-50 million uninsured Americans were magically given insurance, who would treat them?

It isn't like doctors' offices and hospitals are empty waiting for customers. Seems like this would flood the system and possibly make things worse for a time until more facilities and personnel (mainly on the primary care side of the house) could be made available to treat the patient load.
 
Stony Brook asks you to identify the biggest problem facing the US health care system. I should have no problem with this essay seeing as I have an MPH... but that is actually making it more difficult. I could write a 30 page dissertation on this. They want like a page. How do I wrap up the biggest problem in the US health care system? I don't want to come off sounding like an idiot writing a paper for a class. But I probably will anyway.
How complicated a discussion are you guys going to get into in one page?

The biggest problem? I had an otherwise healthy patient last night in the Emergency Department whose chief complaint was constipation for 12 hours as well as the subjective sensation that a "turd was stuck up there." I am a patient man but after a brief history and physical exam I asked him, "So, Mr. Smith, what do you expect us to do for you today?"

Blank expression. "Well, I need some help getting the turd out."

"Fiber, Mr. Smith, fiber."

I spent a minute telling him how to access a Wal Mart and how to find the aisle with all of the fiber products and laxatives for those who don't want to eat fruits and vegetables.

Number one problem: A Totally ignorant patients accessing a system that has had the common sense beaten out of it by lawyers raising the costs for everybody.
 
For the young Vera:

Expenses:
$1200/mo = loan payment (for med school debt, as I understand it, this is a consolidated loan, and will be paid for a very long time, eg, till your KIDS are in med school)
$1500/mo = mortgage (in my neighborhood, for a 3 bd townhouse, 1500 sq ft)
$400/mo = elec, phone, cable, gas
$400/mo = car (gas, insurance, payment, maintenance, for a honda civic, good driving record)
$1000/mo = preschool for one child (this is cheap where I live)
total = $4500

lop off 25% of that 70,000 for taxes, leaves you with: 52,500
divide that by 12 (for each month): 4375

That means, in my neighborhood, you're already in debt by $125 every month on $70G/year, and that's before you've even shopped for groceries or bought yourself a new whitecoat for work.

This may sound terribly pessimistic, but I assure you, this is a conservative estimate for each expense listed, and I've left out a lot of expenses.
 
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