Contemporary Problems in Medicine

[DrChandy]

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Greetings All,
What are the some of the problems facing physicians in American society at present? (I've been informed about declining physician autonomy, healthcare issues, and high malpractice insurance rates). From my interactions with physicians so far, the responses have been quite interesting. Can anyone elaborate on these issues?

 

[mikedc813]

During my interview at USF the head of the admissions committee asked me what I think is the most pressing issue medicine is facing today. I said that I thought it was the state of our healthcare system, and elaborated on my opinions. He said he agreed and that most people he interviews think that malpractice is the biggest problem, which he disagrees with. If you want more info about healthcare, I would recommend taking a basic college healthcare class like I did. Medicaid and Medicare are complex policies, and those are only a few of the things wrong with our system. Hope this helps.

mike

 

[UseUrHeadFred]

I think Malpractice Insurance is the largest problem facing america right now.

 

[DMBFan61]

The USF prof didn't think malpractice is the biggest problem because he doesn't have to worry about it. The school makes sure he is covered on thier insurance. Ask any private practive physician and they will tell you malpractice is out of control

 

[UseUrHeadFred]

Karma for DMBFan!

If there was any karma 🙁

 

[mikedc813]

I agree that malpractice is out of control. Undoubtedly. But if you look at our overall healthcare system it's incredibly flawed - 44 million uninsured Americans without any way to pay for basic healthcare. This is widespread epidemic essentially restricts them from any healthcare at all. Have you seen the movie John Q with Denzel Washington? That's a great example of his son needing a heart transplant and his HMO not giving him the coverage. Basic stuff like preventive care and life-saving procedures can't be accessed if people aren't insured and they're left to suffer on their own. You can't pay, you don't get treated. Malpractice just adds another huge layer on top of it all. There is the debate between our current system and a universal plan like is in place in Canada and the UK, but that's another issue.

 

[mikedc813]

The USF prof didn't think malpractice is the biggest problem because he doesn't have to worry about it. The school makes sure he is covered on thier insurance. Ask any private practive physician and they will tell you malpractice is out of control

I think your reasoning is flawed. My dad is a privately practicing surgeon and he fully agrees that our basic health care system is really screwed up. I don't mean to argue, I'm just clarifying for those who might have to discuss this issue in future interviews.

 

[Amy B]

I think that there is a big problem facing patients and doctors...it is the shrinking supply of affective antibiotics. There are so many infections that we can no longer treat due to the rising problem of resistant bacteria. It is going to be a major crisis in the foresee able future.

I brought this up during my interviews when asked this question. My interviewers agreed with me and talk abit about the topic.

 

[UseUrHeadFred]

Try having a baby without an Obstetrition in a 150 mile radius. Then tell me it's worse to not have insurance.

You don't have insurance, but have an emergency, you still get treated. You don't have a doctor, there is no treatment.

 

[synapse lapse]

Another pressing issue, and the one I am most interested in: Bioethics.

 

[DMBFan61]

Try having a baby without an Obstetrition in a 150 mile radius. Then tell me it's worse to not have insurance.

You don't have insurance, but have an emergency, you still get treated. You don't have a doctor, there is no treatment.

game, set, and match

 

[Shangal]

I think its physicians paying their college tuition. Maybe if the government takes care of our loans when we graduate we'll have less greedy doctors out there. And then medical bills will go down and health care will be available to more people.

 

[Shangal]

Another problem is stem cell research, we need more liberal lawmakers

 

[TRUE]

I think its physicians paying their college tuition. Maybe if the government takes care of our loans when we graduate we'll have less greedy doctors out there. And then medical bills will go down and health care will be available to more people.

While doctors do get paid a lot, I don't think it is because they are greedy or their education cost a lot of money. Perhaps it's the fact that work hours aren't so great. Or that we have to go through so much education to actually even start working (let's face the fact that most of us won't be earning a real salary until we're 30 or so).

Also, while doctor's salaries are high, what about the cost of medical supplies? drug-coated stents cost thousands of dollars. prescription drugs cost a ton as well. what about these costs?

 

[Shangal]

Still, its not fair for doctors to make so much money. I guess I don't have that capitalistic mentality that since I worked my ass off for a decade I deserve to be rich, even if that means there will be millions of uninsured people out there. I mean, shouldn't medicine be an altruistic profession, why taint it with money. You might as well be a lawyer with that mentality.
It's sad to know that many countries out there like sweden, canada, and many other european countries have superior health care when we are ahead of the world in technology and research. The only reason our health care sucks is because millions of people out there can't afford it.

 

[docjolly]

bump

I'm very interested in learning more about all of your arguments..but I have one question: What do Sweden and Canada do to aid those who cannot afford health insurance (or afford to be medically treated)?

 

[indo]

We pay a tax that creates a pool of money that provides senior citizens, rich or poor, with health care. We are promised a trust fund as a repayment but there is no money behind the trust fund. We're going to end up paying ourselves back.

 

[docjolly]

can anyone recommend any websites where I can go to learn more?

(I've done the google search, and soooooo many websites pop up) Thanks 🙂

 

[dmoney41]

Still, its not fair for doctors to make so much money.

Why? Who, then, is allowed to become rich without it being unfair? Nobody?

 

[bonez318ti]

Studying for an orgo finals right now.. but figure i'd pipe up with some thoughts.. (i need a break anyway! 😀 )

ok.. here goes:

the cost of healthcare as a whole has risen, but not because procedures and/or drugs are getting more expensive.. rather it is because these technology is making these things cheaper. the lower cost opens more of these procedures to the everyday person, where as in the past, people wouldn't even look at the elective (or even recommended) procedures due to the cost. So rather than have a 100 procedure xxx's a year at $30,000 a pop, procedure xxx is now available for $10 or 12,000 (perhaps the low cost even induced insurers to include it as part of their plans) as a result, more procedures are being done. thus although the cost per procedure has dropped, the over cost to the system (ie: insurers, medicare etc) has risen.

now, one thing that differs between our form of medicine and a socialized form of medicine is that we have more choices. in the US, if you are covered via insurance, you can basically do whatever you want to do. ie: if you have cancer at the age of 78 and you are insured, you can go into some kind of therapy, whereas in britain, you would be told to go home because there isnt much they can do (ie: cost benefit of using public dollars to treat you, who has a short life expectancy, vs using those dollars to treat someone else who may be able to get more benefit from the same dollars). ive talked to people from abroad who have used our system of health care, as well as people from the states who have used a socialized system of healthcare, and they all agree that the US has be best system around, hands down.

now to bring in the underinsured/noninsured.. to have our form of medicine (ie: to have so many choices).. we need someone to pay for it, thats where all the different types of insurance plans come in.. if you want more choices, you pay a higher premium. conversely, if you cannot pay into this private insurance, you have to get by with what the government provides..

the problem i see with our form of medicine may be rooted in our system of low deductibles. for the people who have health insurance, they tend to take advantage of it whenever they can... using it for whatever they can whenever they can.. because by and large, deductibles are so low.. i mean.. when you pay 5$ to visit a doctor, you think that healthcare is cheap.. that the incremental cost for practitioners are negiligible.. also.. since deductibles are so low, people do not price shop, which inhibits competition from setting a market rate for procedures... with low deductibles, people use more services, driving up the cost for insurers, and that is passed along to us as higher premiums.

so my suggestion? raise the deductibles.. i feel that this will make people realize the value of healthcare.. it will slow the overall rise in the cost of healthcare, since people will think twice/ shop around for providers.. and when the people realize that healthcare isnt free (or cheap), they will learn to take care of themselves better... which is ultimately the real reason why we are going into medicine, right?

 

[docjolly]

Still it's not fair for doctors to make so much money

Compared to who?

Compared to many of the high paying jobs in America, I believe physicians are at the bottom of the tottem poll..Professional athletes, highly ranked business execs. Hollywood actors/directors, and some singers make a hefty chunk of change..and for doing what? They don't sacrifice their lives for the things they do..most don't spend years drowning in and suffocating from educational loans....When cast members of a show can demand to get paid $1 MILLION per episode (ahem..you know which show I'm talking about) or some other obscene amt. of money, and in the end succeed in their ridiculous demand, THAT IS NOT FAIR.

I understand your pt. about how medicine should be an altruistic profession. However, physicians invest a great amt. of emotional, financial, and educational time into saving lives..I see no problem in them wanting to have financially secure and happy lives (especially when getting a large paycheck is not the doctor's main goal for doing what she does..)

Just my opinion..

 

[bonez318ti]

Why? Who, then, is allowed to become rich without it being unfair? Nobody?

the fact is that there are always going to be poor people around, and yes, as a health care provider, i'll do my part to make sure they get seen (for free)..

but for those people who can pay for it (even if they may view it as expensive), they will pay whatever i charge if they want me to treat them. I see nothing wrong with charging a fair price for my services. (but then again, i have no interest in going into private practice.. i left business and came into medicine to get away from the whole debate about haves and have nots. my goal is EM.. i'll treat whoever comes through the doors, and let the admin worry about how to pay the bills. 😀)

 

[mikedc813]

bump

I'm very interested in learning more about all of your arguments..but I have one question: What do Sweden and Canada do to aid those who cannot afford health insurance (or afford to be medically treated)?

Universal health care systems make basic healthcare coverage a RIGHT, not something that has to be bought. So everyone gets medical care, just like people get free education through the public school system. Taxes would be a little higher, but the overall cost savings would be astronomically higher. That's why Canada doesn't have 44 million uninsured people like the US does.

 

[curlycity]

taxes would be a "little" higher?

People in Canada and England are leaving the country to get surgeries they would otherwise have to wait around for; people in Canada are even going to veterinarians.

The system(s) all suck because they're imperfect, created by imperfect people. But I'd still rather live here. Even when my family was dirt poor there were state programs in place; "uninsured" doesn't mean "out on the street to slowly die a horrible death from tooth decay."

Just my personal opinion.

 

[ken37]

Universal health care systems make basic healthcare coverage a RIGHT, not something that has to be bought. So everyone gets medical care, just like people get free education through the public school system. Taxes would be a little higher, but the overall cost savings would be astronomically higher. That's why Canada doesn't have 44 million uninsured people like the US does.

But Canadians with money come to the US to get better and faster treatment, vs waiting months for a schedule slot to open up.

 

[mikedc813]

But Canadians with money come to the US to get better and faster treatment, vs waiting months for a schedule slot to open up.

You are missing the point here. The point is the POOR, not those with money!!!!! The issue at hand is what is the biggest problem in medicine, right? Ok. So it's not that people are crossing into America to spend their money for faster treatment. Granted, yes, universal care means longer waits. But the biggest advantage by far that addresses what America lacks is UNIVERSAL coverage, hence the name universal health care. The 44 million uninsured Americans are working people, no just bums. They're the people who work at your grocery stores and people who serve you on a daily basis in other places. These people have no insurance because they simply aren't poor enough and below the federal poverty line enough to qualify for Medicaid. So universal care helps these people by giving them medical coverage no matter how poor you are.

Yes, the middle and upper classes have the money to spend to get better care than is provided by the basic national plan. That's totally true, and they do use it to get past the long waits for treatment. But the fact is that Canada treats all of their people while we certainly don't here.

 

[docjolly]

taxes would be a "little" higher?

People in Canada and England are leaving the country to get surgeries they would otherwise have to wait around for; people in Canada are even going to veterinarians.

Curly,

How does the universal coverage approach to healthcare in places like Canada cause this problem? Is it caused by the fact that everyone has access to healthcare? I know nothing on the subject, so forgive me if my question seems a little foolish..

Thanks.

 

[docjolly]

Curly,

How does the universal coverage approach to healthcare in places like Canada cause this problem? Is it caused by the fact that everyone has access to healthcare? I know nothing on the subject, so forgive me if my question seems a little foolish..

Thanks.

nevermind..i see mike's previous post before my own..

But another question (for anyone who can answer), if you don't mind 🙂

If the universal health care approach used by Canada works well in dealing with those who cannot afford medical care, then why won't the U.S. simply adopt that type of plan? I'm going to research this a bit more, but I'm under the assumption that Canada's approach to solving health care issues is successful..

 

[curlycity]

I believe it's due to long waits for surgeries that aren't 'critical,' like knee replacements for painful arthritis, etc. was the example I read about of a man from England going to India because he was in so much pain. Eliminating the market system unfortunately removes the responsiveness of supply to demand, creating lengthy waits.

I'm not saying any system is perfect. Those are just some of the problems with federally socialized medicine. We do have somewhat socialized medicine here in the US at the state level.

 

[mikedc813]

Yeah long waits are definitely a drawback to the universal plan. You insure everyone and obviously it is harder to get around to everyone at the same time. Some pretty major surgeries have to be pushed back if it's not "critical" so everyone can't be squeezed in.

 

[curlycity]

Another thought for the OP:

End-of-life issues, e.g. the Florida case, or euthanasia in Oregon. Our culture is not coming up with a consensus on how to best handle this. Maybe it isn't always directly the doc's problem, but some docs do serve on ethics boards at hospitals. I discussed this in one of my interviews.

 

[Shangal]

docjolly, I am not saying that doctors are not worthy of being rich or that they didn't go through alot to get their degrees. It's just that I believe that our healthcare system is not the best one out there and something should be done about it. And lets be honest, no one gets hurt if raymond makes 2 million bucks or if Bryant makes 10, but their are consequences of making alot of money as a physician, like not being able to pay for health insurance.
Politicians should think less about the rights of the pharmaceutical and insurance companies and even AMA and more about the people they represent. And lets be honest, there is poverty all around america and as a consequence you have a lot of un/underinsured people out there. And since healthcare should be a right and not a previllage I guess something should be done about, like having lower caps on procedures and limiting the amount of seminars a doctor can go to to promote a new drug.

 

[curlycity]

Incompetent doctors should not receive the same salaries as skilled, brilliant, maybe even famous physicians. Sometimes in life you DO get what you pay for. Because *patients* are free to become wealthy in this country, practicing physicians are also free to receive payment in accord with the demand for their talents.

I still think it's tacky to park your sports car next to the door of the ER where the indigent patients are entering, and I'm a financially modest person living well within my means (the used car's paid for!). I just don't agree that the government needs to directly regulate a doctor's income. Lawyers also provide life-altering services, sometimes pro bono or at governmentally set pay rates, but as a profession they are free to set their own rates for privately provided legal services.

The things we want and need are not automatically rights in a free society, where 'the right to swing my fist ends where your nose begins.' Our right to take the incomes of others in the form of taxes has limits.

 

[mikedc813]

Bill Clinton actually proposed a universal system, so did Harry Truman. I believe the first to do so was Coolidge. Anyways, the market system is a wonderful system, in MOST cases. It doesn't work for healthcare, period. Insurance companies certainly are against a universal plan because they would lose money. There are more detailed facts...but so far no one has come up with a simple, clear plan within the government that has been passed. Clinton's plan was certainly too complicated for anyone to understand. Critics said that his plan didn't give people choices for insurance companies - it actually gave people at least 3. So who knows...hopefully this upcoming election brings some of these issues to light. Kerry has a pretty good plan in my opinion.

 

[Shangal]

what's kerry's plan?

 

[freaker]

Some of you seriously need to do some research. I need a brushup and am not done researching this out, but it's a bit disconcerting to see the level of (apparent) naivity out there.

It's sad to know that many countries out there like sweden, canada, and many other european countries have superior health care

Superior healthcare? I'm really not sure what you're using as your measuring stick, but in terms of the 5-year cancer survival rates, no, these countries have vastly inferior healthcare systems when compared to the US. Let's just take colorectal cancer. Five years down the road, 60% of US patients are alive and kicking. In the UK? How about 36%? Yes, you read that right. Check it out.

http://news.bbc.co.uk/1/hi/health/272078.stm

Just from a simple economic perspective, allowing money to circulate through the system is a smart move. The more money changes hands, the more likely an economy is to grow. Paying money out in taxes, on the other hand, is not a formula for increasing productivity or stimulating economic growth. People need to feel as if they are in control of their money. It breeds optimism. It increases entrepreneurship, and it increases overall wealth. In the end, more economic growth equals more tax dollars. (this is way too simplified, I know, but how else are you going to try to summarize?)

But to move away from the more theoretical, national healthcare causes a lot of problems. In the UK, waiting lists are so long that patients in need of transplants, for instance, are now being backed up to the point where they will be in critical condition before they receive a transplant. Doctors are leaving the national system because they are over-worked and undercompensated and can make more money in private practice. Getting people to commit to medicine is becoming more difficult.

IMHO, the biggest problem facing American healthcare today is the growing number of illegal immigrants and our decreasing birthrates. People, if you haven't figured it out, those who can pay for healthcare in our country and those who have insurance aren't reproducing. At the same time, illegal immigrants are pouring across our borders and essentially showing up in the ER and taking healthcare for free while racking up tremendous bills. They pay very little in taxes and expend exhorbitant sums of money this way. I heard on the radio that 11 of the 30 hospitals in the San Fernando Valley had to shut down due to financial losses while the population of the area was sky-rocketing. And you people say just offer healthcare to everyone? That will fix things? Are you trying to put us 6 feet under? Just FYI, there are more illegal residents in our country than there are people in Georgia (our ninth most populous state) and Montana combined.

Another problem that comes with relying on a national healthcare plan is that it requires such a huge commitment and a steady tax base. Right now birthrates in this country are declining. The nations of Europe, if they do not amend their ways, will face economic collapse and a healthcare disaster in a few decades. The birthrates in Spain and Italy? Less than 1.20 children per mother. In former East Germany, rates are as low as .83 children per mother. Replacement rates are 2.10 children/mother. In the US, we're down to 2.07. You see what I'm saying? In a few decades, the average European is going to be 53 years old. Price of healthcare changes in which direction as we age?

http://news.bbc.co.uk/1/hi/world/734123.stm

Declining birthrates are due to a number of reasons. The increased number of households living on two incomes, increasing levels of hedonistic behavior (having a family wasn't seen as a sacrifice 50 years ago), the decline in religious observance, and also to a general weakening of the concept of family.

On the problems in Canada:

http://www.csmonitor.com/2002/0228/p07s02-woam.htm

On decline and aging of world population:

http://www.kstatecollegian.com/issues/v104/fa/n039/opinion/opn.roney.friday.html

More problems in the UK. Have cancer? Wait 10 months and we'll start to treat you.

http://news.bbc.co.uk/1/hi/health/675968.stm

 

[mikedc813]

Some great reading to learn about the basics of healthcare and its problems:

Our unsystematic healthcare system by Grace Budrys
Mama Might Be Better Off Dead by Laurie Abraham
Sociology of Health and Illness: Critical Perspectives by Peter Conrad
The social transformation of American Medicine by Paul Starr

Happy reading!

 

[jeremyh42]

Another problem is stem cell research, we need more liberal lawmakers

Just cuz' they're liberal doesn't make them necessarily support stem cell research- a guy I know recently (last month) had the opportunity to ask Dennis Kucinich if he supported stem cell research using donated embryos left-over from IVF, with the couples' consent, and he said that he doesn't

 

[curlycity]

It is pretty ridiculous to compare the U.S. to some of the tiny and/or homogeneous countries that have implemented socialized medicine. Something run at the state level but mandated by the feds, like the public school system, is the closest I would want to get to adding more bureaucracy to healthcare. That could be something as simple as raising the funding for programs like Medicaid and CHIP, which Texas already allegedly can't afford and continues to cut. Among the problems in healthcare, doctor salaries are only a tiny piece of the puzzle; there's also lawmaker discrimination against the poor who don't pay taxes and don't vote, our exploitation of illegal immigrants, corporate profit motive overturning medical ethics, and the lack of education of the public on managing their own health care and what health services should be 'worth' to them.

And I agree with the person who posted about 'moral hazard' - that is, when insuring against something makes it more likely to happen (which is why most life insurance policies have a suicide exclusion for some period of time), such as no deductibles making it more likely patients will seek unnecessary care. It is an important concept to incorporate into health insurance.

 

[PublicEnemy]

hey guys, a lot of the posts have focused on the healthcare system as being the biggest problem facing medicine today. without doubt this is a problem, but what about serious flaws with current medical practices. perhaps associated with shortages of physicians, what about overbooking, i'm talking about the 15 minute rule. i think this is a serious problem affecting primary care in this country. doctors only spend so much time or expend so much effort during patient visits, be it regular checkups, or because of illness. seriously, you go to the doctor and complain of congestion and a cough, they put you on the scale, put a thermometer down your throat, listen to your chest for a couple secs and you're out the door with a prescription for some antibiotics that "should do the trick".

The way primary care is setup in this country, there is a huge emphasis on emergency or urgent care, and rightfully so, but I think preventive medicine is largely neglected. Perhaps working in a clinical lab in cancer biology and only seeing people in stage 4, I have a skewed view. But I think too many people in this country that even do have healthcare covereage don't get adequate treatment. With any medical condition, the earlier the diagnosis, the better, the better the treatment and management options, but all too often it doesn't happen. Heart disease isn't discovered until people complain of severe chest pains or even have a major heart attack. Cancer isn't diagnosed until its progressed considerably. How can conditions be diagnosed more effectively without making considerable testing standard practices? How can this be done in 15min or less? I wish our primary care physicians could somehow do more during patient visits.

I honestly don't know what the solution is, I've looked at this from both sides, and I'm empathetic of both sides, maybe I'm just coming back full circle to the whole healthcare issue, but I guess I wish more testing was commonplace and this might just not be happening because of costs. Blood tests, stress tests, cardiac catheterizations, colonscopys, I wish these were more commonplace.

 

[curlycity]

One more for the OP: I've recently read about physicians concerned with bioterrorism and being 'drafted' to assist; in particular, a girl showed up in an ER with smallpox or some kind of pox and some of the doctors did not want to treat her because, even though they'd been vaccinated, they had small children at home and simply weren't comfortable around smallpox. Some doctors are concerned that anyone getting the vaccine would be automatically required to assist in an emergency situation. Don't know how valid that concern is, just passing it along.

I think another problem facing physicians is the nursing shortage and poor regulation of nursing education. This directly correlates with patient outcomes - nurse/patient ratio in the ICU for example...and likely translates to increased liability for the physician. I *heart* good nurses, and their problems are affecting all of us.

 

[lessismoe]

I think another problem facing physicians is the nursing shortage and poor regulation of nursing education. This directly correlates with patient outcomes - nurse/patient ratio in the ICU for example...and likely translates to increased liability for the physician. I *heart* good nurses, and their problems are affecting all of us.

I *heart* good nurses too! Here's a question for you, though, Curlycity:

I honestly don't know this, and it sounds like you are more knowledgeable about nursing education than me. What are the problems with regulating nursing education?

I know that there are different kinds of nurses (LVN, RN, RN Bachelors, RN Masters, etc.). Are theses levels standardized to some national standard?

 

[curlycity]

I read one article about this in Reader's Digest, of all places, and one problem was - don't flame me - some schools were actually implementing "affirmative action" admissions lotteries, forming classes where ANY applicants with a C or above average were randomly admitted. They were trying to avoid discriminating, but over time their graduation rates declined and students were taking 3 years to finish 2 year curriculums due to problems with basics like math and reading comprehension. There have also been problems with qualified/certified nurses (e.g. RN's) being replaced by less-qualified nursing staff or nursing aides as cost-cutting measures by HMOs or hospitals. I'm also pretty sure the regulations vary from state to state as far as procedural training and licensing, but not totally sure. I believe RN's feel under threat from cost-cutting measures and the new legions of undertrained/underqualified lower-level staff members swamping their hospitals. They end up burdened with a lot of work and responsibility the other staffers can't or don't handle. The various nursing associations in the U.S. have issued statements on the nursing crisis, available on their web sites. There's a campaign called "R.N. = Real Nurse," for example.

 

[nachoDoc]

Try having a baby without an Obstetrition in a 150 mile radius. Then tell me it's worse to not have insurance.

You don't have insurance, but have an emergency, you still get treated. You don't have a doctor, there is no treatment.

It's called natural birth. There may also be mid-wives.

HMO's also have problems:
Life-threatening emergencies must be treated / stabilized, then transferred. The patient is the one who suffers most. If you are involved in an auto accident and sustain multiple fractures and BFT,but are not near your HMO facility, these are not considered life-threatening and arrangements are made with your HMO to transfer you to the closest facility. It is not a fun trip. I've had to accompany several, just in case they coded, en route. One did and was pronounced after we arrived.

So we do have a healthcare crisis in this country.

🙁

 

[curlycity]

It's called natural birth. There may also be mid-wives.

That sounds about as fun as 'natural'-style gangrenous limb amputation or decayed tooth removal! 🙁

 

[PublicEnemy]

It's called natural birth. There may also be mid-wives.

HMO's also have problems:
Life-threatening emergencies must be treated / stabilized, then transferred. The patient is the one who suffers most. If you are involved in an auto accident and sustain multiple fractures and BFT,but are not near your HMO facility, these are not considered life-threatening and arrangements are made with your HMO to transfer you to the closest facility. It is not a fun trip. I've had to accompany several, just in case they coded, en route. One did and was pronounced after we arrived.

So we do have a healthcare crisis in this country.

🙁

wow, thats a serious problem. coding and dying, seems somewhat life threatening to me. thats essentially gross negligence and wreckless manslaughter on the part of the HMO.

hmm, bad healthcare policies leading to bad healthcare practices leading to people dying leading to lawsuits which ends with increased premiums for everyone, less people covered and malpractice insurance rising for physicians. healthcare is at the heart of it.

somebody fix this.

 

[UCLAMAN]

hospitalist vs. traditionalist system of healthcare.

 

[nina512]

Some great reading to learn about the basics of healthcare and its problems:

Our unsystematic healthcare system by Grace Budrys
Mama Might Be Better Off Dead by Laurie Abraham
Sociology of Health and Illness: Critical Perspectives by Peter Conrad
The social transformation of American Medicine by Paul Starr

Happy reading!

That's funny...these were on my reading list for my med-sociology class.
Read Abraham's book. If you're entering medicine to help people, this book identifies those who need it most.

 

[UCdannyLA]

Some of you seriously need to do some research. I need a brushup and am not done researching this out, but it's a bit disconcerting to see the level of (apparent) naivity out there.



Superior healthcare? I'm really not sure what you're using as your measuring stick, but in terms of the 5-year cancer survival rates, no, these countries have vastly inferior healthcare systems when compared to the US. Let's just take colorectal cancer. Five years down the road, 60% of US patients are alive and kicking. In the UK? How about 36%? Yes, you read that right. Check it out.

http://news.bbc.co.uk/1/hi/health/272078.stm

Just from a simple economic perspective, allowing money to circulate through the system is a smart move. The more money changes hands, the more likely an economy is to grow. Paying money out in taxes, on the other hand, is not a formula for increasing productivity or stimulating economic growth. People need to feel as if they are in control of their money. It breeds optimism. It increases entrepreneurship, and it increases overall wealth. In the end, more economic growth equals more tax dollars. (this is way too simplified, I know, but how else are you going to try to summarize?)

But to move away from the more theoretical, national healthcare causes a lot of problems. In the UK, waiting lists are so long that patients in need of transplants, for instance, are now being backed up to the point where they will be in critical condition before they receive a transplant. Doctors are leaving the national system because they are over-worked and undercompensated and can make more money in private practice. Getting people to commit to medicine is becoming more difficult.

IMHO, the biggest problem facing American healthcare today is the growing number of illegal immigrants and our decreasing birthrates. People, if you haven't figured it out, those who can pay for healthcare in our country and those who have insurance aren't reproducing. At the same time, illegal immigrants are pouring across our borders and essentially showing up in the ER and taking healthcare for free while racking up tremendous bills. They pay very little in taxes and expend exhorbitant sums of money this way. I heard on the radio that 11 of the 30 hospitals in the San Fernando Valley had to shut down due to financial losses while the population of the area was sky-rocketing. And you people say just offer healthcare to everyone? That will fix things? Are you trying to put us 6 feet under? Just FYI, there are more illegal residents in our country than there are people in Georgia (our ninth most populous state) and Montana combined.

Another problem that comes with relying on a national healthcare plan is that it requires such a huge commitment and a steady tax base. Right now birthrates in this country are declining. The nations of Europe, if they do not amend their ways, will face economic collapse and a healthcare disaster in a few decades. The birthrates in Spain and Italy? Less than 1.20 children per mother. In former East Germany, rates are as low as .83 children per mother. Replacement rates are 2.10 children/mother. In the US, we're down to 2.07. You see what I'm saying? In a few decades, the average European is going to be 53 years old. Price of healthcare changes in which direction as we age?

http://news.bbc.co.uk/1/hi/world/734123.stm

Declining birthrates are due to a number of reasons. The increased number of households living on two incomes, increasing levels of hedonistic behavior (having a family wasn't seen as a sacrifice 50 years ago), the decline in religious observance, and also to a general weakening of the concept of family.

On the problems in Canada:

http://www.csmonitor.com/2002/0228/p07s02-woam.htm

On decline and aging of world population:

http://www.kstatecollegian.com/issues/v104/fa/n039/opinion/opn.roney.friday.html

More problems in the UK. Have cancer? Wait 10 months and we'll start to treat you.

http://news.bbc.co.uk/1/hi/health/675968.stm

What do you think is the best solution to the current healthcare problem?
And, is there anyway to prevent "long waits" in the universal healthcare system?

I hear a lot of experts saying that the U.S would save a considerable amount of money and reduce the number of uninsured via adoption of "universal access to healthcare." Are "long waits" the only drawback?

 

[docjolly]

bump bump bump bump

After having read both sides of the debate, I feel as though I have a strong understanding of socialized vs. nonsocialized healthcare...But I still am having trouble choosing one side of the issue, and coming up with a solid idea about what the government should do to help the 44Million uninsured people...

Is it realistic to think that the U.S. should implement certain aspects of socialzed medicine (such as universal health care for all citizens), yet adjust it in a way so that that the waiting period for patients is shortened, and the economy does not suffer?