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If you work in universal health care, this is what you can expect to make

Discussion in 'Topics in Healthcare' started by MacGyver, Dec 19, 2005.

  1. MacGyver

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    Under the UK system, the average doctor (across all specialties) made about 85,000 pounds. For comparison sake, the average wage in teh UK is about 40,000 pounds, meaning the average doc makes about double the average salary.

    The average salary in the US is about 30k per year.

    The implication is that it would be reasonable to expect double that for the average doctor, or about 60k per year. Remember, thats across ALL specialties including neurosurgery, radiology, etc

    The UK is a good system too, compared to the Canadian model. In the Canadian model, docs are lucky if they get a salary thats 30% higher than the national average.

    When govt bureaucrats run healthcare and doctors complain about salary, the sanctimonious bureaucrats always reply with "what are you griping about, you make double the average income so deal with it"

    Discuss amongst yourselves.....
     
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  3. Trismegistus4

    Trismegistus4 Worried Wellologist
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    U.S. Senators and Representatives, meanwhile, will of course continue to make $160,000 per year with a $5000 raise every year.
     
  4. Gut Shot

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    Can you reference your stats on Canadian physician salary? The figures I have seen indicate that their specialists earn somewhat less than those in the US, but their primary care doctors make comparable money. If they are only pulling in 30% more than the Canadian national average, then Canada must have an incredibly high national average.

    Also of interest, for the first time in 30 years, more physicians are entering/returning to Canada than leaving (Source). Has our system gotten so bad that even Canada is looking appealing?

    While we're at it, do you really mean "universal coverage" or are you talking about socialized medicine? Depending on how it is implemented, universal coverage in this country could be a huge boon to doctors, as we would have a source of billing for everything we do. Physicians, particularly primary care docs, spend a lot of time and resources treating people who have no insurance and cannot pay any or all of the bill. If everyone had coverage we could reap the financial benefits.

    I don't have the reference here, but as an example I would point to the Canadian province of Saskatchewan, which was the first to enact the national health insurance act in 1963. The following year physicians incomes increased 35% as they were actually getting paid for all their services.

    Oh, and one more thing. As of this morning, 40,000 pounds converts to $70,443 USD. The average income in the UK is significantly higher than in the US, largely because they do not have the "extremes of income" that we do. If you want to estimate what we would make under "universal coverage" then you will have to find a less absurd fudge factor.
     
  5. chef_NU

    chef_NU G-Unit
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    Or because they pay a lot of it back to the state in taxes.
     
  6. cheech10

    cheech10 Member
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  7. Gut Shot

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    Yeah, but come on. $70,443 USD/40,000 pounds vs. $30,000?

    Let's examine the UK's income tax rates:

    0 - 4,895 pounds ($8,584) = 0%
    4,896 - 6,985 pounds ($12,250) = 10%
    6,986 - 37,295 pounds ($65,410) = 22%
    37,296 and up = 40%

    At an income of 40,000 pounds you will shell out 7,959 pounds (19.9%) in income tax.

    Per this handy income tax calculator, a stateside income of $70,443 will generate $13,026 in taxes (18.5%).

    Granted, this ignores all deductions, as well as entitlement, state and local taxes in both countries, but I hope it illustrates that the UK's income tax system is more progressive than many give it credit for. In summary, all else being equal, I'll take 40K pounds with UK taxes over 30K dollars with US taxes any day.
     
  8. dilated

    dilated Fought Law; Law Won
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    Considering that, besides the ~20% income tax, the standard-rate VAT in the UK is in the 18% ballpark, it starts to get a whole lot closer. Average purchasing power between the UK/US is probably pretty similar.
     
  9. Gut Shot

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    Since half of my family resides in the UK, the last thing I am going to do claim that their overall tax burden is the same or lower than ours. It's not, it's higher. But "a whole lot closer"? Someone making $70K/40K pounds would have to be taxed to the tune of 57% before even making it to $30K. I'll still take the $70K in Britain.
     
  10. QuantumMechanic

    QuantumMechanic Avatar=One of the Greats
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    If the average American doctor's salary dipped to a level that was perhaps slightly double the average American's salary (thus 60-70K for doctors), would students still go into medicine? Realistically, would there be enough people willing to take that income for the level of education and training required to reach that end point? Also, if fully trained physicians had this low of a salary, would residents make a much lower income than they do now?

    Although I don't see doctors in America ever being as well paid as they were in the past, I believe that their pay can only decrease to a certain level as it becomes more economically feasible for prospective doctors to choose other professions. The quality of care will decrease if the pay decreases too much, and Americans will doubtfully accept lower standards of care from their physicians. Any thoughts? Am I wrong in my argument? This issue is of great interest to me since many doctors have flat out told me to stop being a premed (for these economic reasons) despite my desire to enter the medical profession.
     
  11. ExtraAverage

    ExtraAverage This is new and exciting
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    Sorry to get off the OP's original topic here, but I feel some clarifications need to be made.

    I don't know about "average wage," but average per capita GDP (most commonly used by economists to measure income and wealth between countries, see the CIA World Factbook Website www.cia.gov) is much higher for the US than the UK: $40,100 vs. $29,800.

    OP can you reference us your wage numbers (e.g. 40,000 pound average wage in UK or $30,000 average wage in U.S.)?
     
  12. Gut Shot

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    Don't hold your breath.
     
  13. MacGyver

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    Uhh newsflash, those numbers are TOTAL AGGREGATE PAYMENTS TO DOCTORS, not income figures. Those figures assume that the doctor has zero overhead, zero office expenses, zero malpractice insurance cost, zero ancillary support staff costs, zero taxes, etc.

    Get back to me when you find real income numbers.
     
  14. CaveatLector

    CaveatLector Senior Member
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    40,000 pounds is/was the average UK income? I think not. That sounds WAY high to me. I'll bet it is half that. I'll eat my words if I'm wrong but that seems very outrageous.
     
  15. DropkickMurphy

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    No matter which if any of these figures are correct- this is one reason a national health system would not work. Anything below what physicians make now is too pathetic to adequately compensate for the crap that docs have to put up with.
     
  16. CaveatLector

    CaveatLector Senior Member
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    The chart at the bottom of the page on this link indicates the breakdown of income tax rates in the UK. Seems to me they are comparable to U.S. income tax rates. Furthermore, if you do the math based on the average total income tax paid then you will see that the average UK income is about 21k pounds give or take a few hundred. So, once again, comparable to U.S. numbers.
    http://www.tutor2u.net/economics/content/topics/poverty/incomes.htm
     
  17. CaveatLector

    CaveatLector Senior Member
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    Actually I'm wrong. That 21k pounds is the average HOUSEHOLD income not individual income... In other words, UK docs earn about 4 times the income that the average UK HOUSEHOLD earns. That, of course, is considering that the average income of a UK doc is indeed 85k pounds as asserted by the OP, and I don't know about the veracity of that assertion.
     
  18. Gavanshir

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    Why don't you just give it to us? I'm curious to know.
     
  19. MikeyLu2010

    MikeyLu2010 UT Longhorns Alumni
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    wow..mcguyver..your the one that started the post..so why dont you show us REAL INCOME NUMBERS...ass.
     
  20. cheech10

    cheech10 Member
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    Average overhead and other expenses up here are 30%, with big savings in administrative costs since we only have to deal with 1 payer and ALL our billings are payed out; malpractice is negligible (unlike your screwed up system) since it is partly covered by the provincial health plans, and we are all covered by the CMPA for legal advice and representation meaning more big savings, especially compared to the unlucky Americans that get sued. I'm quoting income figures, which obviously don't include taxes (as opposed to take-home pay), and taxes in Canada are comparable to those in New York and other northeastern states. Yes our salaries are slightly lower than in the US, but it's nowhere near the "30% over the average income" you suggested, and frankly not dealing with HMOs or your malpractice climate is well worth it, IMO.
     
  21. Beau Geste

    Beau Geste yah mo b there
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    Lately, Praetorian, I have been agreeing with you. And I agree with you on this one, too!
     
  22. blotterspotter

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    "malpractice is negligible (unlike your screwed up system)"

    I wonder if many Canadians realize that they benefit from the military expense the United States bears. Sure, they can get away with a semi-functional socialist system, but try not having the good ol' USA backing you up in case of any military hardship. If Canada didn't have the USA to its border, they'd have to tax the crap out of their citizens to afford defense AND would not be able to provide their healthcare system.

    Also, yes many lawsuits are insane, but MANY MORE of them actually protect patients from the malpractice that doctors commit (yes, I know it's hard to believe, but doctors screw up). Personally, I like knowing that a doctor has to be extra careful and can't take anything for granted with a life. If you don't like the American system, don't practice here.
     
  23. Blue Dog

    Blue Dog Fides et ratio.
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    If that's the average overhead across all specialties, consider that overhead varies tremendously from one specialty to another. In the U.S., overhead in primary care tends to be higher (50-60% of revenue) than most other specialties, and I imagine the same is true in Canada. Cognitive fields, such as psychiatry, tend to have the lowest overhead (in the 30-40% range), with many surgical subspecialties, such as orthopedics, in the 40-50% range.

    I have no doubt, however, that one benefit of a single-payer system will be a reduction in overhead. To the practitioner, it may be the only benefit.
     
  24. Gut Shot

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    Mind you, it would also eliminate charity care, which is not an insignificant benefit for many practicing physicians.
     
  25. Blue Dog

    Blue Dog Fides et ratio.
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    Ultimately, it would depend on how physicians were compensated under a single-payer plan. If the single-payer fee schedule looked like Medicare (or, God forbid, Medicaid), we would probably not be better off, even with reduced overhead.
     
  26. Gut Shot

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    Well duh. ;)
     
  27. Blue Dog

    Blue Dog Fides et ratio.
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    I'm really not trying to state the obvious. ;) Your post suggested that eliminating charity care under single-payer would benefit physicians. However, this would only be true in the context of the bottom line. Most physicians have no qualms about providing a certain amount of free care, as long as they're making enough from paying patients to do the requisite cost-shifting.
     
  28. Gut Shot

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    From the AMA: Physicians say uninsured a major problem

    July 21, 2005

    A third of physicians said the number of uninsured patients in the United States has reached the crisis level, while 60 percent consider it a major problem, according to the results of an AMA Member Connect® Survey on the uninsured.

    The members-only survey generated one of the highest responses to date for an AMA Member Connect Survey. It sought physicians' perspectives on: the severity of the uninsured problem and priority segments of the population for increased health coverage; physicians' experiences in treating the uninsured; medical students' and residents/fellows' opportunities to address the issue; and opinions on potential short-term programs for the uninsured the AMA could support.

    Perhaps as evidence of the reported severity of the issue, more than a third of physicians provide five or more hours of charity care in a typical week, and 16 percent of them provide 10 or more hours per week.

    Fully 87 percent of physicians provide some level of charity care in a typical week, but providing that care poses significant difficulties, the survey showed. Of the physicians who care for uninsured patients, 33 percent said ensuring prescriptions get filled ranked first among difficulties; 27 percent said securing diagnostic tests and procedures is the greatest difficulty. Securing routine follow-up care (13 percent) and obtaining specialists referrals (11 percent) were also cited as significant problems.

    In addition to providing charity care, in 2004, 32 percent of physicians incurred more than $50,000 of debt for patients who did not pay for medical care, and 21 percent incurred more than $75,000 of such debt.

    The survey also showed the contrasting affect the issue has on medical students and resident/fellow physicians view of their future in medicine. While 55 percent of medical students said the issue motivates them to make a difference, only 39 percent of residents/fellows were so motivated. Conversely, while 45 percent of residents/fellows said the issue of the uninsured makes them less optimistic about practicing medicine, only 30 percent of medical student said it makes them less optimistic."
     
  29. oldManDO2009

    oldManDO2009 Senior Member
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    My 2 cents....to fix this problem I would implement the following reforms:

    Tort reform - limit the kinds of suits that can be brought to a court and limit damages for cases that are not directly due to criminal neglect (e.g. operating while intoxicated). The reform would have to include some common sense approach to healthcare in that you are sick and you could die - but we will try the medications and procedures that may or may not cure the disease. It never ceases to amaze me that patients sue because the medication they took caused some negative side effect - it happens and you have to assume the risk. A lifetime of fast food has it consequences and the medication you take could induce diabetes - your lack of concern for your healthcare is no reason for multi-million dollars lawsuits. This step alone would reduce the cost of medicine.

    Anytime the federal government is responsible for a large program - budget shortfalls and losses are just charged to the taxpayer in the form of higher taxes. That said, the government should not be in the business of healthcare. The taxes that we pay for Medicare and Medicaid should be combined into a single healthcare benefit payout for all citizens. The government would pay the insurance company of your choice an annual healthcare premium that is risk adjusted. So the 70 year old with end-stage renal disease might receive 70K a year and the healthy 20 year old might receive 3 K a year in the form of premium payment to the insurance company of choice. If you did not like the company because they provided poor customer service and denied healthcare request you could switch to another company. When the government runs the healthcare system you do not have a choice and care can be compromised. Just go visit your local county hospital.

    This step alone would make us more competitive in the global market since the average car has about 3000 dollars worth of healthcare expense incorporated into the cost of manufacturing. Business would save billions in healthcare cost and healthcare retirement benefits.

    This could be enhanced by making a few minor changes to the current HIPAA laws and create a national clearing house for payments. Currently all insurance companies are required to accept a standardized electronic invoice for services. A few minor changes could create a clearinghouse that accepts all bills and forwards them to an insurance company and payments are sent electronically (which is in place now but not via a single entity - instead invoices are sent to the insurance company). I would also add to this function a requirement to submit patient data in an HL7 format and encrypted so that physician could access (WITH PATIENT PERMISSION) medical data such as recent x-rays, labs, CT scan, etc. This would reduce the cost of repetitive diagnostic imaging and labs. Additionally, physicians would have less overhead since the data is stored in a repository and not in their offices and the reduced paperwork and billing requirements would reduce overhead.

    So your average doctor could see a patient, review records, not worry about litigation and avoid practicing defensive medicine, and get paid for their services.
     
  30. Gut Shot

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    Interesting suggestion. How do you feel about means testing for said payouts? When Bill Gates turns 70 and has ESRD will he get 70K a year?
     
  31. oldManDO2009

    oldManDO2009 Senior Member
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    That is an excellent point - but I think universal health coverage paid by taxes (that ol Bill already paid) would limit means testing. The current tax system is another nightmare that deserves an overhaul but is outside the scope of this discussion.

    Another point I saw on another post in respects to national healthcare is worth mentioning again, and again, and again...

    In a national healthcare system physician may not have a choice with whom to do business with - the government would be the ONLY choice. In that scenario - our reimbursement is tired to the legislator which has a long track record of cutting reimbursement and limiting services.

    In the universal healthcare scenario in my previous post, physician could choose not to do business with certain companies just as enrollee could choose to switch companies.

    The government has a long track record in healthcare and most of it is abysmal - so I would say be careful what you wish for we may just get it

    The idea proffered in the previous post came from a fortune magazine editorial – I cannot in good conscious take credit for the idea
     
  32. Gut Shot

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    Outside the scope, sure, but certainly of interest. I've been pondering the benefits of a flat tax recently. The experiences that small European nations have had with it really tempts me to wonder if it could work here. The big criticism of it is that to raise equivalent revenue would require a flat tax rate that's much higher than its proponents suggest, but I dunno. If one eliminates the IRS and destroys the ease of most tax evasion, perhaps it could work.

    Indeed, that's the kicker.

    To play devil's advocate, two things. First, many (if not virtually all) insurance companies peg their reimbursement to Medicare rates. Some are higher, some are lower, but when you add it all up one could make a strong argument that doctors are effectively getting reimbursement from a single fee schedule already. The difference is that private, for-profit insurance companies have a strong incentive to make payment a miserable process for the doctors.

    Also, if everyone is covered under a national plan, all of a sudden everyone is going to have a stake in its funding. That might make it very hard for politicians to cut reimbursements without significant fallout from the voters who depend on it. Despite Medicare's enormous popularity with seniors, and their high rate of voter turnout, let's face it: if you're not 65+ or getting paid by Medicare then you really don't give a rat's ass if it's slashed to pieces.
     
  33. oldManDO2009

    oldManDO2009 Senior Member
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    Good points - I agree with your position.

    I also like the idea of a flat tax. Just think; if there was a flat tax then politicians would have to come back to the voters to raise taxes at their own political peril. As it stands now, many taxes are hidden in fees and levies, including sales tax, gasoline surcharges and all those annoying fees on your phone bill. This structure allows the government to raise money without declaring new taxes to fund all that pork.

    Just think of all the billions save in IRS enforcement and accounting - the incredibly rich would pay the same 15% as the lowest wage earner and deductions would be a thing of the past. I don't think politicians have the courage to support such a radical agenda. Every accounting and lawyer lobbyist would be out in force to protect their cut of the always frustrating and complex tax season. :laugh:
     
  34. Law2Doc

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  35. cheech10

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    Canadian dollars, of course. With current exchange rates, $190,000 US.
     
  36. john182

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    Regarding GDP income averages, which were mentioned above, this is what NAtionMaster says:

    #1 Luxembourg $66,463.78 per capita
    #2 Norway $54,467.23 per capita
    #3 Switzerland $47,999.07 per capita
    #4 Ireland $45,707.17 per capita
    #5 Denmark $44,742.82 per capita
    #6 Iceland $41,720.45 per capita
    #7 United States $39,452.74 per capita
    #8 Sweden $38,480.78 per capita
    #9 Japan $36,285.57 per capita
    #10 Finland $35,726.02 per capita
    #11 Austria $35,443.98 per capita
    #12 United Kingdom $35,421.29 per capita
    #13 Netherlands $35,183.76 per capita
    #14 Belgium $33,754.34 per capita
    #15 France $33,015.40 per capita
    #16 Germany $32,929.58 per capita


    If you work out taxes, you'll see that the US and UK are very similar. While there was a comment above on the Canadian doctor income not including taxes, expenses, etc., it's also the same for US doctors.

    A large portion of current US expenditure pays for private jets and fancy offices for insurance executives.
     
  37. almost_there

    almost_there Senior Member
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    Interesting ideas. A few comments:

    1. Malpractice, while a significant expense to individual practitioners (and depending on specialty), only constitutes a tiny % of all health care dollars spent (on the order of 1%). So tort reform, while helpful, wouldn't really do much to control expenses.

    2. With the risk-adjusted payouts by the government to the insurance companies of your choice, the incentive still exists for the insurance companies to cherry-pick the "best" customers. If I'm an insurance company, why the heck should I pick up the old guy with ESRD, even with a $70K pay-in, if I face a significant risk of incurring greater costs than the paid premiums? Too much volatility for my taste. This could result in a population of undesirable uninsured, same as today, and government may very well be the insurer of last resort, as today.

    Thoughts?

     
  38. oldManDO2009

    oldManDO2009 Senior Member
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    good points....I think there would have to be some thoughtful consideration as to insurability and the right of an insurer to refuse a person based on health - There are many programs that currently provide insurance to the elderly and that would be a good place to look for guidance

    Even though malpractice overall is small portion of overall healthcare expenditure - it can be huge portion of the individual physician expenses. A single unjustified (ambulance chasing - lotto mentality) law suit could result in huge premium increases and that is why I had mentioned it as an element of needed reform.
     
  39. QuikClot

    QuikClot Senior Member
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    From the British government (http://www.britishembassy.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&c=Page&cid=1025627696102&aid=1059131256447):

    Historically, the exchange rate is about 1.5 dollars to the pound. These number would seem to suggest that it is more lucrative to be a GP in Britian, but less so to be a specialist. Which is reasonable set of incentives, since GPs are what everyone wants more of these days.

    Also note the eight weeks paid vacation per year, lifetime employment, and ability to work on the side. Not a bad deal.
     
  40. QuikClot

    QuikClot Senior Member
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    France, lifted from a blogger with his **** together (I was impressed):


    $55,000. OUCH. Silver lining number one: in terms of results, it kicks our cowboy-hat-wearing asses.

    Silver lining number two: the fact that French physicians under "socialized medicine" make between one-third to one half what English physicians make under "socialized medicine." Which illustrates the fallacy of taking one country and extrapolating from that what physicians must make under any scheme of universal care. Clearly, there is no necessary relationship between universal care and physician salaries.
     
  41. QuikClot

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  42. oldManDO2009

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    some points worth mentioning...

    doctors make to much, hummm? After 11+ years of school with zero savings towards retirement, nauseating debt and a reduce work window - the comments are meritless.

    Government healthcare and grey waiting rooms and drab government officials - go visit your local under-funded over-taxed county hospital.

    Anything Ted Kennedy recommends should be immediately ignored.

    I am no expert on the tax rates of the countries in question and the national spending per capita on individuals as they pertain to outcomes and longevity. One thing is clear America is fat and that has a huge toll on health and the cost of healthcare.

    Anytime you start talking about preventative care - all of the eye of newt and slippery elm freaks start promoting their agenda as if that is the answer - less science and more absurd "alternative" treatments (e.g. add H2O2 to your asthmatics child's bath to increase oxygenation ??? - thank you N.D)

    Why copy a system full of problems this is America - we have corupt politicians with agenda that do not include their constituents concerns. I am sure that each of those utopian healthcare systems in Europe has their dark side and it is pointless to import their baggage.

    Our politicians do not have the spine to implement sensible healthcare reform when so many lobbyist say otherwise - no more 3 million dollar law suits because you were depressed, took Effexor, ate Twinkies and got diabetes! How will lawyers siphon off the majority of the lottery winnings leaving the "victim" with a few bucks and a bag of Twinkies if there is reform?

    Then there are us evil doctors dedicating 11 years of our lives to serve "humanity" as we endure verbally abusive patients, long hours, reduced reimbursement and 10 hours of paper work and phone calls for 37.50 from the insurance company. They might take away this dream job if there is reform...

    I think of all the times between jobs where I have had to consider my family's needs and being uninsured was not an option - but then I realized I had a responsibility. I don't know - does the guy on the corner with the "work for food" sign really care if he has health insurance, he apparently doesn’t care he is unemployed? And before you go off on his victim status - I have had to endure some really crappy jobs -BECAUSE I had obligations. What is his excuse?

    Rant done
     
  43. QuikClot

    QuikClot Senior Member
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    And that, finally, is what all the anti-universal care arguments boil down to: knee-jerk right-wing partisanship that ignores the facts. :laugh:
     
  44. oldManDO2009

    oldManDO2009 Senior Member
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    Call me right wing if I want to protect my income, avoid excessive taxes (paying for those that don't feel inclined to), and avoiding more government intervention where they clearly have a long track record of failure.

    If you think you are not paying enough taxes you should volunteer to pay more, you could redistribute your wealth. As for me, social security will be non existent, and Medicare will eventually go through some dramatic changes because the current system is unsustainable and both parties are to blame. I see it as my personal responsibility to fund my own retirement and my children's education.

    Apparently, you see the government responsible for healthcare, and maybe everything else. That equates to higher taxes and more government waste, surely you have heard of pork barrel spending. It is idealist to think the government would reform and become responsible like many of the citizens of this country. Today they are just spending and leaving future generations (my kids) with the bill. This is the only consistent behavior demonstrated by both parties - The only solution is to keep them out of your wallet. You may not agree and think the government should spend more on social programs...that is what makes this country great, you can disagree and not end up in a ditch with a bullet in your head (circa pol pot)

    Which leads me to my rightful opinion that nothing good comes from Ted Kennedy
     
  45. QuikClot

    QuikClot Senior Member
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    This thread is about physician salaries under universal care. The fact that you can't talk about that without babbling about Ted Kennedy illustrates that you are an ideologue, not a problem solver. And as your wont, you are ignoring the facts:

    1. Universal care is cheaper.
    2. It is the present system that has a long track record of failure. Universal care beats the US system in every metric.

    If you have some useful information about the thread topic, I'm all ears. If it's just the usual right-wing whining about Big Brother, believe me, we've heard it all before.

    [mutters] Can't talk about physician salaries without dragging in Pol Pot . . . why do I bother?[/mutters]
     
  46. oldManDO2009

    oldManDO2009 Senior Member
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    Physician salaries under Medicare are often cut or held at previous year’s levels because of budgetary crisis created by our elected officials.

    A strictly single payor source that includes government run facilities (e.g. county hospitals) with absolutely no choice by physicians as to who they do business with is a bad system - because as our fees are cut we have nowhere else to go - except complain to "elected" officials who do not have our interest as a primary concern.

    Social medicine supporters are quick to point to our enlightened European brothers but fail to mention the tax structure (top bracket in France 50%) and the increasing cost or poor services

    In France they have a mix of private and state funded systems that are enacting gatekeepers and struggle with cost

    The UK system does not rely on the technology that has come to be expected in this country - try and get a CT scan in the NHS system - you might die first.

    These countries can only manage cost overruns by increasing taxes, we have seen that in the Medicare & Medicaid systems here in the US and it can only get worse. Governments are more likely to increase taxes then force system improvements

    I have no problem combining Medicaid, Medicare and employer contributions for current workers (not retirees) and funding a single payor risk adjusted system where a choice of insurance companies, physicians, and hospitals are part of the deal. Physicians can choose not to do business with insurance companies that have poor reimbursement practices for physician payment (try that with the government)

    I don't think the European systems of socialized medicine are in the best interest of physicians , a French doctor makes 55K US, I would never be able to repay my loans, A UK doctor makes more but the NHS system lacks resources

    Everyone is quick to bash the US system of healthcare but it is the best in the world and we should create a universal healthcare system that rivals that healthcare system. I don't think copying another system is very innovative.

    People will point out how France has better outcomes, we have different populations and there is always the French paradox - America is fat and is only getting fatter. I would like to see apple to apple comparisons of say CAD outcomes in both systems with comparable patients and comorbity, then I might be convinced French healthcare is superior to US healthcare.

    It all boils down to political will and there is a severe lack of imitative in Washington.
     
  47. blotterspotter

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    Thanks for the good info. Who knew people lived so well in Iceland?!
     
  48. UserNameNeeded

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    I love it when jingoistic Americans bring up this point. :laugh:

    You know what, if it wasn't for the US, most, if not all, of the military hardships Canada is supposedly shielded from probably wouldn't even exist if it wasn't for the US and its policies. Attacking Canada is akin to attacking Greenland--no one in their right mind would care to invade and attack Greenland!
     
  49. BlackNDecker

    BlackNDecker Paid da cost 2 be da bo$$
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    For a second I misread that as "no one in their right mind cares about Canada." :laugh:
     
  50. john182

    john182 Member
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    The above reference to French doctor's earnings is inaccurate, and is actually the lowest average for primary care doctors (it represents the bottom earnings).

    The following is the summary of selected countries from May 2004 for NERA (National Economic Research Associates)
    Hospital Doctors Primary Care
    Highest average Lowest average Highest average Lowest average All

    Australia 203,132* 59,789 86,226* 60,641 65,252
    Canada 154,3153 * 117,197* 117,191* 81,0173 * 101,667
    Denmark 73,2364 49,278 106,251 71,090 52,324
    France 116,0775 104,056 67,221 57,319 61,441
    Germany 56,455 35,465 71,443 55,426
    Italy 81,414 74,300
    Netherlands 175,155 64,053 92,226 57,064
    New Zealand 118,276 81,103
    Spain 67,785 42,254 46,012 35,407
    Sweden 56,816 56,543 61,221 56,816
    UK 127,285 * 102,964* 92,118
    USA 267,993 165,1129 151,682 136,260 126,648

    Sorry about the formatting, it's from a PDF converted to txt. The first two columns are the highest and lowest averages for hospital doctors (specialists) and the third and fourth columns are the highest and lowest averages for primary care doctors (GPs, Family Practice).

    As you can see, it varies widely. Mostly, I think that public sector salaries are determined by local policies regarding private enterprise, etc., but even that doesn't hold up. I am in Ireland which has far higher public sector salaries that are higher than both US and UK (private or public).

    So "universal" or "social" health care has nothing to do with earnings potential. It is more to do with local lobbying and political influence by doctors that get you high salaries in a public service health system. Ireland's public service pays far in excess of the above salaries and has a mix of public and private service, with unlimited public service and free prescriptions (e.g., for psychiatric patients, and so on) and also half of the country has voluntary private health insurance. Overall, the salaries are around double the US (for residents and specialists). It is a universal health system with parallel private care if you can pay for it.

    A public health care system is essential in a civilised world. What you get paid depends on your negotiating skills with the people who pay you.
     
  51. blotterspotter

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    Yep, you're absolutely right man. The United States created Nazi Germany, the Soviet Union, Red North Korea, and all the other tyrannical governments that existed BEFORE there was a United States. Or maybe it was President Bush. War has not existed for thousands of years, and man has not been seeking power at the expense of others for even more. But then again, maybe it's all America's fault :rolleyes: If you don't like "jingoistic" Americans, don't come here. We don't care. Most Americans are good people that sympathize with the rest of the world.
     

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