Interesting article

BU Medical Sciences
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Fair enough- what do you think is a good solution?
 
Reality check: this group represents about 1% of the doctors in our country. What is just as telling is that the other 99% chose not to support this group or this plan.
 
Yeah, it's not widely accepted for a reason. I was just wondering what everyone thinks is a good direction for medicine to head in now.
 
A single payer system? If you look into the system of England, you will notice several things, many months of waiting for surgeries, many more primary care physicians than specialists, poor facilities, and a lack of the advanced technologies that we see in America. The government is already using nearly twice its GDP on health care than England and is only covering a tiny percent of our population (medicare, medicaid, military/government employees). If you think putting the government in charge of everyone is going to reduce costs or make anything better, then I ask you, how? More canadian doctors are leaving to work in america than americans leaving to work in canada. Does this show physician satisfaction especially when considering the statistical influence of population sizes? I don't have the exact number for the emigration rate with me, though I will post it when I get home. Anyway, please consider these problems before endorsing this system.

~AS1~
 
"Fair enough- what do you think is a good solution?"

what is the problem?

If the problem is that some people dont have access to health care, than the solution would be to fix their LIVES so they arnt to damned poor. A reformed welfare for one. Make it clear that you cannot ride the system your whole life.
Less money in forein aid, more money toward getting our own homeless to work and be productive.
If you get the bottom 5% of the country to get theit sh1t together you would not only be able to collect more taxes, but they could pay for their own healthcare.

We must preserve the idea that working hard will lead to a better life. A better life ethicaly, spiritualy, in your relationship and monetarily. Once we start giving people who CHOOSE not to work out of laziness health care....once we start telling asians that you can work as hard as you want to but AA is going to still kick you in the nuts.......once we start, though government policy, telling people that hard work is merely NICE, we are no longer america.

I live in tallahasse and have ben here for four years....the exact same people have been homeless for 4 years..I have meet a few of them because Im a sucker for handing out money, and with a few notable exeptions, they are all mentaly sane and of perfectly normal intelligence. They are not cripled or have children. They CHOOSE to be where they are, because they dont want to put forth the effort to work.
If one of these people needs a 250K heart transplant does he deserve it? no
who is going to pay for it? Me? no

I think people who are mentaly disabled or cripple and cannot contribute to society out of physical imposobility, we should take care of these people, and you can tax me to do it.
 
Yikes- you only DESERVE a heart transplant if you make money (assuming you are able to)? Medicine gets pretty sticky when you talk about "deserving" healthcare.
 
Well what entitles you to anything?

If you and i were on a desert island and you slept for a week while i worked to build shelter and collect food.
You start to get hungry and come to me for food, I give you some of my food and then offer to teach you how to collect foood of your own. You refuse and say that you will be fine on your own. Two days later your back and need more food, would you be entitled to my stuff? nope. Now if i was chairitable i wouldnt let you die, but your needs would definitly come second to mine. Im still a human and would not let you starve out of spite. But if there came a day that even I, having looked everywhere, was low on food, you ass is going to die. end of story.

Same with heart transplants. There are only so many that can be done and only so cheaply. Im not going to let an able bodied person who wont work hard about to afford health insurance get a heart transpant over my child. I am busting my butt so that my kids will have everything they need. If others dont want to thats fine, its a free country, just dont expect me to bail you out when the going gets tough.
 
"Well, what entitles you to anything?"

So money doesn't entitle you to anything, then?

What's the difference between the person who doesn't make money and needs a transplant and someone who does?
 
"So money doesn't entitle you to anything, then?

What's the difference between the person who doesn't make money and needs a transplant and someone who does?"

Money does entitle us to some things.

A person who doesnt make money because they truly cannot, cant make enough money, must rely on the humanistic good will of others. Men are not wolves and we have the capacity and maybe even a responsibility to help those who cannot help themselves. Bet these people are still a financial drain on society, and that is what sets them apart from those who can pay for their own expenses. Im saying that what makes us human is our capacity for charity. What makes us american and capitalist is our expectation that everyone at least TRY to pull their own weight.

We must never forget that cars dont run of fairy dust and starlight. Your AC doesnt run on love, and truly free health care was when jesus gave sight to the blind guy in the bible.

Nothing is free, everything has a price and SOMEONE must pay it.
The idea that, there is enough of the best of everything to go around is fallacious.
 
The problem with the scheme proposed in the article is that it would OUTLAW all insurance providers besides the government. Rich people, who wont want to join in a socialized medical system, will not have a choice--they will be forced in because all HMOs and all private health insurance companies will be forbidden by law.

To make socialized medicine work, you have to FORCE everybody to use it--otherwise it wont be able to capture enough of the market and the bargaining power of the single-payer (i.e. govt) will be reduced.

The dirty little secret of universal health care is that it TAKES AWAY CHOICE. Of course you will never hear that from the proponents, they have the attitude of "we know whats best for everybody so you'd better shut up and get in line"
 
In Ireland and the UK, costs are significantly depressed by locking in the number of consultants (ie, attendings or full-on private practicioners). To be blunt, it's cheaper because people don't get the "real" salary for the field until their mentor dies.

... not that much fun a system, from what they told me.
 
All these solutions are attempts to tie down an elephant with scotch tape. Socialized healthcare is impractical, and the richest will still have priority over care because they'll be able to come up with the biggest bribes. It'll become like the old Soviet system: "You pretend to pay us, we'll pretend to work."

The real problem, lets face it, is overpopulation. We're expanding way too fast for the resources at our disposal right now. That, and America's self-righteous sense of entitlement and wasteful inefficiency. I read a quote somewhere, by heidegger or some other european philosopher that seems fitting: "Americanism is the most dangerous form of boundlessness - one cannot reason with it; it can't understand, it has no memory, no genuine sense of history. An unvarying impulse towards consumerism only pulls along a mass of flabby mediocrity. The idea of quantity divorced from quality has taken over and grown into a boundless et cetera of indifference and always-the-sameness."
 
Originally posted by MacGyver


To make socialized medicine work, you have to FORCE everybody to use it--otherwise it wont be able to capture enough of the market and the bargaining power of the single-payer (i.e. govt) will be reduced.

The dirty little secret of universal health care is that it TAKES AWAY CHOICE. Of course you will never hear that from the proponents, they have the attitude of "we know whats best for everybody so you'd better shut up and get in line"
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This I don't understand. Do Americans really have "choice" right now? For those on HMOs, the doctors have to be on a "network", and employees have at most 2 different choices for which healthcare plan they choose. Would entitling everyone to at least a basic standard of healthcare through federal intervention really be so bad?
 
Originally posted by spumoni620
Would entitling everyone to at least a basic standard of healthcare through federal intervention really be so bad?
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Yes! At least according to 99% of America's doctors.
 
Originally posted by ankitovich
Yes! At least according to 99% of America's doctors.
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That's a bogus statistic: Where the heck do you get 99% from?
Ask the frustrated FPs who deal with HMOs day in day out. You have no way of telling what doctors think as a group without doing a scientific study. The idea of a national system is more popular than you want to believe.


Originally posted by MacGyver
To make socialized medicine work, you have to FORCE everybody to use it--otherwise it wont be able to capture enough of the market and the bargaining power of the single-payer (i.e. govt) will be reduced.

The dirty little secret of universal health care is that it TAKES AWAY CHOICE. Of course you will never hear that from the proponents, they have the attitude of "we know whats best for everybody so you'd better shut up and get in line"
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In a a single payer system, no one is FORCED to use it. In Canada, we do have private insurers that some companies use to provide healthcare to their employees (without recieving payment from the government for services). Obviously, these private networks are on the fringe up here, but for you to think that people are forced into anything is ridiculous.

Just realize that the American system could not be any more inefficient than it is now. America spends more money administering Medicare and Medicaid per capita than Canada spends per capita to cover its entire population (see OECD data if you don't believe me).

Interestingly, when the entire population is provided with a basic level education, healthcare and reasonable housing, the result is not "laziness", but the opposite- you provide more hope and optimism to the entire population, as everyone has a greater chance in life. Could things be any worse in America in terms of health care, crime rates, poverty, and so called "laziness" etc. than they are now?
 
Originally posted by Mike59
The idea of a national system is more popular than you want to believe.
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As bad as HMOs are for doctors, a universal care system is even worse.

From a doctors perspective, the less government intervention there is, the better off doctors are.

I guarantee you that if universal care comes to be in the US, the salary of doctors will drop by at least 50%, and probably more.

In a single payer system, there is no market forces to keep reimbursements in line with economics of business. Basically, the reimbursement is dictated by bureaucrats. If the bureaucrats decide that doctors should only get paid $30,000 per year, then bingo its a reality and the only recourse of doctors is to quit the profession. If an HMO tried that, they'd be quickly forced out of business because their doctor network would disappear.

HMOs control doctors salaries to an extent, but at least they have some modicum of competition with other HMOs for doctors. Wtih a single payer system, competition is absolute zero.



Interestingly, when the entire population is provided with a basic level education, healthcare and reasonable housing, the result is not "laziness", but the opposite- you provide more hope and optimism to the entire population, as everyone has a greater chance in life.
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Thats absolute crap. Soviet Union had all of the above, and I would hardly call their citizens optimistic. Cuba has all of the above, and yet the people are hardly shouting out of joy on the streets.

Hell just take a look at public housing in America. Are you HONESTLY telling me that those people are more productive after being moved into a public project? You've got to be joking.

When you provide things at zero perceived cost to the public, it doesnt INSPIRE anything, it results in less productivity as you just sit back and take whats been offered.

Again, there has NEVER been a socialist/communist country which had a greater productivity per capita than a free market country.

That should tell you something.


Could things be any worse in America in terms of health care, crime rates, poverty, and so called "laziness" etc. than they are now?
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Yet in spite of all this, we have more immigrants to our shores than all other nations combined.

Clearly to them America is not as bad as you are making it out to be.
 
Contrary to common belief most uninsured peole are not destitute or unemployed. According to U.S. census data 54% of the working poor do not have heath coverage. Many employees of small businesses remain unisured because their employers cannot afford insurance and many people who work one or even many part-time jobs remain without coverage. (More interesting info on this at the U.S. census website and coveringtheunisured.org)

And if you feel that you don't want to subsidize health care for the unisured, you already are. People who lack insurance are more likely to seek costly emergency care rather than visit a doctor or benefit from preventative care. NO one saves money when people go without health coverage.
 
54% of the working poor"

You mean the 30 years onds i see working at Mcdonalds.
Tell me why i should pay for someone to be 30 and working at mcdonalds?

But good point about the emergency care vs primary care thing. I know an er tech and he says that alot. Homeless calling the ambulance just so they can sleep in the hospital.
No reason to think that i would be cheaper to give them all free health insurance though. You know how much it would cost to insure a drug addict? ALOT. And yes most homless are either drug addicts or alcoholics (In my city at least).
 
Originally posted by Mike59
That's a bogus statistic: Where the heck do you get 99% from?
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Well this assclown obviously hasn't read the article. This group claims to represent the 8000 physicians who support this sort of policy. By the group's own estimation, there are 800000 physicians in the United States. Therefore, there are 792000 physicians that do not support this movement or this group. That's a lot of doctors.
 
Originally posted by ankitovich
Well this assclown obviously hasn't read the article. This group claims to represent the 8000 physicians who support this sort of policy. By the group's own estimation, there are 800000 physicians in the United States. Therefore, there are 792000 physicians that do not support this movement or this group. That's a lot of doctors.
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You sure have mighty extrapolation skills (and impressive math skills). You are brilliant, absolutely logical and brilliant! :clap:

51% of the people voted for Gore in 2000 AND everyone else who didn't show up to vote were opposed to Bush - Therefore, 80% of the population did not support this movement or this group. That's a lot of people.

:laugh:
 
Originally posted by MacGyver


The dirty little secret of universal health care is that it TAKES AWAY CHOICE. Of course you will never hear that from the proponents, they have the attitude of "we know whats best for everybody so you'd better shut up and get in line"
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MacGyver what choice do you have now? You can only select the health plan(s) your employer provides for. Surely you would rather have a little say( natn'l) than no say (current).
 
Originally posted by MacGyver
I guarantee you that if universal care comes to be in the US, the salary of doctors will drop by at least 50%, and probably more.
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What many ppl fail to realize is the potential overhead saving a national health care system provides. Sure there may be declining reimbursements, but physicians will undoubtedly make up much of the difference by chiefly billing only one company. In a recent visit to my othropedist office there was 14 billing personnel for 3 doctors. Medicare is far more efficent than any private insurance, processing claims in less than half the time and with only 3% overhead vs 20% avg for the private sector. www.pnhp.org
 
If the problem is that some people dont have access to health care, than the solution would be to fix their LIVES so they arnt to damned poor. A reformed welfare for one. Make it clear that you cannot ride the system your whole life.
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OMG...I'm laughing my butt off over here. Did it ever occur to you that the majority of the more than 40 milliion uninsured in this country actually WORK!!!!! The solution is not to fix their lives, but to 'fix' big business and demand that they provide health care insurance to their employees. Where is it written that the CEO of target 'deserves' 19.5 million a year (up 3.5 million from last year) while at the same time cutting health care benefits for his employees?

My mother (and yes, I've talked about this in a previous thread) was divorced from my father a few years back. She has worked full-time her entire adult life...but was in a job where she was not offered health care benefits. It was alright because she was covered by my father....Unfortunately, the costs of her continuing with my dad's insurance on her own were more than a mortgage payment and so she was unable to keep the health insurance. She searched for a job with benefits for a couple of years...one that would offer her both a decent salary and benefits (she has a master's degree, btw!). In the meantime, she had to pay for breast surgery to remove/biopsy a lump and was diagnosed with rheumatoid arthritis. This is all of course now considered a pre-existing condition by her new insurance company 🙄 so she will continue to have to pay out of pocket. My mother is also a vietnam veteran and was denied VA services because she earned over 25k a year.

This is not an example of a woman who is lazy, has a screwed up life or just needs to stop being so darn poor 🙄 This is the reality for the middle class in this country.

Example 2: Our nextdoor neighbor lost his job in the computer industry a year ago..He and his wife had 5 children and he had been a loyal employee for years. The company had to downsize to keep being able to payout for the rich stockholders...and his department was eliminated/consolidated. Unfortunately, the IT industry being what it was, he was out of work for a year.....this means no health insurance for his wife and 5 kids, etc....they filed bankruptcy, lost their house....and finally he got a part-time job 3 states away that 'may' end up turning into full-time...so they moved this summer. Still...no healthcare benefits...but better than nothing.

Again...not a lazy man....worked hard all of his life and has a college degree...

What do you propose to fix these kinds of situations...because, you see, the majority of the 40 + million uninsured do indeed happen to have jobs and work...some of them even work two jobs!!!

Not everyone can be a doctor, lawyer or scientist, etc...not everyone can end up with a cushy state job that provides good benefits....how do you propose insuring people who work in the field of customer service, restaurant and food industries, etc....Someone has to serve your meals, rotate your tires, ring up your wal-mart purchases.....who will take care of those people?

Forget about the people without jobs...they're already covered by medicaid.....

I want to hear about some real solutions to the real problems...not the boohoo people are so lazy and stupid and they just should get off their butts and work BS....lets figure out how we are going to force industry cEOs to insure the millions and millions of employees that build their companies up before they pay themselves the multimillion dollar paychecks each year.

kris
 
You mean the 30 years onds i see working at Mcdonalds.Tell me why i should pay for someone to be 30 and working at mcdonalds?
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Wow..the arrogance.....At least that 30 year old is working and is not trying to suck off of the system!

You know...not everyone is cut out to be a doctor, etc.....why shouldn't a 30 year old who works at McDonalds have healthcare insurance offered to them? If they are working hard and contributing to society (obviously, they are handing you your much-desired big-mac) then they deserve to be able to go to the doctor if they are sick....Not everyone has your superior intellect and abilities 😛 .... if a 30 year old is doing his best at McDs...holy cow...at least make it so that he can go to the doc if he needs to...or quit eating at McDonalds altogether if you think the job is so unimportant.

Perhaps you think that the only people who should work at McDonalds are 16 year old teen-agers who should be at home studying instead of working all night to earn a few measly bucks to make a car payment?

I know...lets start a list of jobs that a 30 year old could have that would make them 'deserving' of healthcare coverage...or better yet...jobs that aren't 🙄

kris
 
You know...I worked at mcdonalds when I was 16, and I think most of the 30 year olds are maangers. There are a few who weren't...but most were. Also, I do believe mcdonalds offers benefits.

~AS1~
 
Originally posted by AlternateSome1
You know...I worked at mcdonalds when I was 16, and I think most of the 30 year olds are maangers. There are a few who weren't...but most were. Also, I do believe mcdonalds offers benefits.

~AS1~
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That is so NOT even the point. :laugh:

But a really good argument was made about the tremendous waste that goes into running private health care organizatons. Canada spends less than 10 cents of every health care dollar on administraton costs. The US spends over 25 cents of every health care dollar on billing and non-medical expenses. And I have to concur that the average Joe Blow doesn't have that much "choice" when it comes to their health, even down to the provider they have to see. Its either covered or its not... the only people with the option to avail themselves of all of the fancy bells and whistles of technology are the independently wealthy.

Suddenly a single payer system doesn't look so much like socialism, just one big HMO with the fat trimmed.
 
Forget what the US spends.

"The US spends over 25 cents of every health care dollar on billing and non-medical expenses"

Its all money that is staying in the US no matter is it goes to a person with the title "payment collector" or whatever, its not like it disapears.


Mom you give alot of situations that are sad. The economy isnt so hot right now and things are getting hairy. Some hard working people are doing without. I think that soicalism is not so bad of a thing in times like these. I dont know the people you speak of but I'm sure they are hard workers and they "deserve" heath care.

But the reality remains that to give to one peson you must take from somone else.

I know that as humans we care for people just because we can but still...

Should I be resonsible for supporting a 40 year old lady with an 85 IQ with no hope of ever doing much more than making 5-6 bucks an hour? I dont know....tough questions....

What i clear is that it is charity...i dont know if i should be forced to give up the fruits of my labor so that other people can remain mediocre...

The tough question that i grapple with is "Are these people capable of more and it up to capitalism to just give them the nessacary incentive?" or " Are these people really working as hard as I am, but because of lack of ability, they will always preform at their curent level, so capitalism is not giving them any usable incentive."

I dont know. Do athletes deserve big money? I dont have thier god given abilities. Should they share their money with me?

Would a tierd system be aceptable. A humane minimum of care for those who cannot afford care?

I still say that somone who has kids who is not financialy solid is a screwup. Unless it was REALLY accidental (birth control failure)
 
mom, what do you think is a fair salary AFTER taxes for a Neruosurgeon? Also assuming that school detbs are non-exitant as in other countries.

For a career Mcdonalds worker?

Does a person deserve only what they produce or do they deserve the Gross national profit divided by the population?
 
i dont know.. wouldnt public healthcare greatly reduce the salary of physicians?

hehe that would really deter allot of you to find another career. like law. or business.
 
show me one socialized medicine country that has doctor salaries within 30% of US doctor salaries, after all expenses have been taken out including malpractice insurance and overhead costs.

Here's the list:






Make no mistake about it, if/when a single payer model takes over, doctor salaries will absolutely plummet.

Maybe that doesnt bother you, but dont be fooled cause thats exactly what will happen.

After all, if I'm the fed govt and I want to cut spending, why pay doctors $100,000 when I can pay them $50,000? Why pay them $50,000 when I can pay them $30,000? After all the national average is only 25k or so, so paying doctors $30k still puts them above average.

Thats the kind of logic you will have to deal with under a universal system.
 
yeah, i dont think this is going to happen. and if it does, it'll be 20 years from now, then after its been approved its gonna take another 20 to enforce it.

which by then all of us will be retired or dead.
 
Originally posted by Doc Ivy Suddenly a single payer system doesn't look so much like socialism, just one big HMO with the fat trimmed.
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Your logic makes zero sense here.

Whenever the federal government controls 100% of a commodity (healthcare is a commodity) then its de facto socialism.

If the fed government passed a law which said all fast food restaurants were to be owned/operated by the fed govt, then we would have a socialized fast food system.

With medicine under a single payer model, the fed govt controls 100% of the money/expenditures--therefore its socialized.

Its pretty simple really
 
Originally posted by mdterps83
What many ppl fail to realize is the potential overhead saving a national health care system provides. Sure there may be declining reimbursements, but physicians will undoubtedly make up much of the difference by chiefly billing only one company. In a recent visit to my othropedist office there was 14 billing personnel for 3 doctors. Medicare is far more efficent than any private insurance, processing claims in less than half the time and with only 3% overhead vs 20% avg for the private sector. www.pnhp.org
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The 50% figure is based on net income after expenses like malpractice and overhead are taken out.

You are absolutely foolish if you dont think doctor income is going to fall drastically under a single payer model.

Think about it for a sec. Lets say that you are the fed govt in charge of the healthcare system. Keep in mind that you control 100% of all healthcare money spent in the United States.

Every year, your boss, the secretary of the dept of health and human services, comes to you and tells you that you have to cut costs.

You see docs making 150k per year, so the first year you drop it to 120k. No congressional bill required, no legislation necessary, you just sign an order as the national healthcare administrator and bam its done.

Next year, your boss comes back to you and says you have to cut costs again. You look at docs and see that they are making 120k per year. They look ripe for another cut. So you cut it down to 100k.

Repeat this process a few years and you will see docs scratching out at 50k. When the doctors start screaming about it, you will simply look at the Dept of Labor database and calmly note that the average US citizen makes only 25k, therefore docs have no reason to complain. Then you give them another pay cut down to 40k.

Of course, it wont be THAT bad, the socialized medical guru tells you. After all when the single payer model takes over, all medical schools will be funded by the US govt so tuition will be zero.

You tell me which is better: 100k of med school debt with an average income of 150k over 30 years, or 0k of med school debt with an average income of 50k over 30 years. Just for the hell of it, lets also say that under universal system all malpractice insurance is paid by the govt.

Trust me, you'd rather have the med school debt and the malpractice insurance, as bad as it might be. The proponents of a single payer model keep chirping about how you'll be so much better off because you will have no debt. Dont take their word for it, you do the math and I promise you after you look at the calculations you will see that doctors are MUCH worse off under a single payer system.

Another thing to look forward to is the rapid realignment of residency slots. With a single payer model, all residency slots will be under federal control. You think its tough to get into a neurosurgery residency now, just wait till they cut the number of programs back to 15 for the whole freakin country. It will be nice competing for a dermatology residency when the fed govt in all its wisdom decides that the residency slots need to be pared down to 30% of their size today.

Of course, it will be easy to get a FP residency slot in rural Oklahoma... those slots will be massively increased.
 
Originally posted by Doc Ivy
That is so NOT even the point. :laugh:
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Yeah, but it was funny!

But a really good argument was made about the tremendous waste that goes into running private health care organizatons. Canada spends less than 10 cents of every health care dollar on administraton costs. The US spends over 25 cents of every health care dollar on billing and non-medical expenses. And I have to concur that the average Joe Blow doesn't have that much "choice" when it comes to their health, even down to the provider they have to see. Its either covered or its not... the only people with the option to avail themselves of all of the fancy bells and whistles of technology are the independently wealthy.

Suddenly a single payer system doesn't look so much like socialism, just one big HMO with the fat trimmed.
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Thats not true though. HMO's are being forced to cover new technology and procedures (even those that are not thoroughly tested, which I disagree with) because of laws being passed to require the coverage. Right now there is at least some incentive to stay current. Employers want to offer the best benefits packages possible so that they can attract the best employees possible. That creates competition among HMO's and insurance companies. Now, if you go to a social system, what exists to keep the level of coverage high? If the government is paying, you don't think they will be willing to cut out whatever is expensive in order to save cash? Where else will people go to get care? Well, one person suggested that Canadians can go to private doctors. If you think a poor person who needs and expensive procedure that ends up not being covered can just run off to another physician, then you are being a bit naive. The system ends up restricting everyone except for the richest, who can pay anything they want out of pocket. I like the fact that competition exists.

Another argument was made suggesting that doctors are just upset about possible paycuts. I will say straight up, if you want to cut doctors salaries to the point where it is impossible to pay for school loans and medical insurance, yes I would mind. If a system was set up where all medical schooling was paid for, and all insurance was covered, I would be happy to take home 40,000 a year. This is one reason why I am looking into becoming a military physician.

Now before someone rails me about not liking social medicine but liking the military's system, you have to first consider that the level of care that the goverment provides in this situation is still in competition with the free-market. They also control their employee base with physical testing, so their patient base is already fairly healthy, which makes things much cheaper. The other factor is that all of their doctors are salaried, and make around 45,000 - 55,000 dollars per year, with some variation for rank and time served. These cost cuts again make their system much more affordable than a standard single-payer system.

If you want to cut costs in our health system, get rid of sick patients. This seems obvious if you consider that the 20% of the population that doesn't see a doctor throughout the year requires 0% of the money expended. If you got people to exercise, not smoke, and cut the fatty diets, can you imagine the amount that would be saved on diabetes, COPD, and heart disease alone? If you managed to reduce the amount of unsafe sex and drunk driving, imagine the amount saved on STD treatment and emergency operations. A lot of the problem with the current health care system comes from the fact that doctors are rewarded (paid) based on the number of procedures that they perform. Have you ever heard of a doctor getting paid by the number of patients they cure, or the number of patients they keep from ever getting sick? I haven't, and I believe this negatively effects our health care. I don't claim to be an economist, and I am really not sure the best way to put such a rewards system into place, but I do believe that is a route which needs to be explored before we consider switching to social health care.

~AS1~
 
Why is it that every time a discussion starts about the issue of healthcare and the uninsured in this country that we get off on socialized medicine? Why not just start out by requiring big companies to offer healthcare benefits to all of their employees..and find a way to help small companies do the same through some type of tax incentives, etc? I say keep the government out of it as much as possible!

How could we pay for that? Oh...I don't know...maybe we could forbid anymore of our multibillion dollar corporations from setting up a dozen tax shelters in different countries so that they can avoid paying taxes in the US but can have all the benefits of being a US company? Or maybe companies like Enron that screw the people and do illegal things would be levied huge fines that would go into a fun to help small business? Or maybe US companies that fire their empoyees here to go and open up a shingle in Korea to save money and boost their profits should be required to pay out big levees to the government here? After all, they ARE putting hard-working, patriotic Americans out of work.

The idea that everyone who isn't a doctor and who works at McDonalds had an IQ of 85 or whatever was said is just ludicrous.....

I don't think doctor's salaries would fall at all...as a matter of fact, having more people with health insurance would actually lower the cost of health care....you may not think that you are paying more for the uninsured now, but you are...one of the many reasons that healthcare costs are so high is that those of us with healthcare insurance are paying more for services to make up for those that can't.....so we may see a decrease in what we pay for our own healthcare....doctors would be compensated for seeing all patients, not just those with insurance...they might not be so quick to turn down those with poor paying insurance or no insurance...would perhaps be viewed as being more caring and maybe they'd be sued less often so it would potentially lower the cost of malpractic insurance?

As to the questions that I was asked:



mom, what do you think is a fair salary AFTER taxes for a Neruosurgeon? Also assuming that school detbs are non-exitant as in other countries.
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Compensation for physicians is a sticky issue right now and one that my husband and I are actually embroiled in as the system that he works for finally moves into the RVU playing field. This could be an entire topic of its own. I see a lot of problems with physician compensation within the medical profession period..ie right now what gets paid the most is a 'procedure'. For example, our friend the radiologist brags about sitting downstairs and getting something like $70 a pop for reading simple chest x-rays which he does in 5 minutes....He works 9-5 (actually more like 9-3.30, but who's really counting) and takes in over 450k annually. My husband, on the other hand, is an ID physician who is fellowship trained. He doesn't work 9-5, takes regular call, and has gone in at 12.30am to see patients who were deathly ill after surgery or who come in with systemic meningitis, etc....He doesn't care whether a patient has health insurance or not....he feels that this is his obligation to society. 😉 He earns 170k before taxes (which are 42% for us, btw). Some people would argue that reading the x-ray is more important and hence makes the radiologist more 'deserving' of the 450k salary....some would argue that the surgeon that operated on the leg was more 'important' and his sacrifice worthy of more money...and my husband might argue that despite the read of the x-ray and the surgery, if he hadn't intervened and treated the massive sepsis that ensued, that the patient would have died and therefore he is 'equally as important' and should be compensated equally for his effort.....

What is fair compensation? The pediatrician can't bill for procedures and yet their job is 'important' and they are well-trained and have invested years in their education. How do we decide which physician and specialty is the most significant and deserving of the most pay? I don't know .... you tell me...You'd probably vote for the neurosurgeon...but if you're a neurosurgeon and your patient develops a fungal infection of the brain after surgery I bet you a million bucks you'd be calling the ID guy stat 😉 It's a tough call, and one that I can't answer. Do physicians deserve to earn more than individuals with less education who have invested less in their careers and themselves...hell yes!


For a career Mcdonalds worker?
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I would say that before tax minimum wage should probably be doubled....in order to do that, we would have to pay about .10 cents more for each hamburger, etc, and I'd be willing to do that...after all...I'm likely to pay an extra .10 on my burger anyway just to line the pockets of the owners... The reason that I have is that I think the minimum wage should be a 'living' wage. Do the math...at about $6/hr before taxes, a full-time worker is bringing in about $240/week or about $960/month. What does this mean for someone trying to support just themselves? I don't know about the average apt. rent where you are, but in this area, we are talking about $450 for pretty much a dump...that doesn't include electricity, phone, groceries, gas, car payment, etc. Consider that if you have this kind of a job, you also aren't likely to have a 401k plan or any healthcare benefits....certainly not dental benefits...if you do, they are likely to be of the lowest quality as well.....

I think that anyone that is willing to work hard, regardless of the type of job that they have, should have the right to have some dignity and pride in the work that they do...even if they are only answering phones for a big corporation, are working as telemarketers (YUCK), or are slinging your fries in the back of a greasy restaurant.....We should have a minimum of what is acceptable...and I think offering working people in this country a living wage should be a priority...aren't we America the Greatest Nation in the World? 🙄

You know...if a young man gets a job at a shoe shop and ends up becoming an excellent shoe salesman....ie learns all there is to know about the different types of shoes, the leathers that they are made from, the types of soles that are best for different types of feet...if he can help you pick out the best dress shoe, the best work shoe, the best leisure shoe...and if he treats you with respect and dignity and takes pride in a job well-done...if he cleans the store, puts out the shoes, and takes pride in taking good care of his customers...should he earn $6/hr, or should we consider him a shoe selling professional? Sounds like a novel idea, but really its' not...He is a professional...just on a different end of the spectrum. What are his services worth?


Does a person deserve only what they produce or do they deserve the Gross national profit divided by the population?
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My guess is that you read my nickname 'commymommy', which is a joke, btw, and are trying to get me to say that we all deserve to earn the same amount? I don't believe in that type of an economic system...I think that we should be paid for our productivity....that being said...that isn't what happens in this country. For the most part, a very wealthy population does everything that it can to hold onto its wealth..this means cutting benefits, for employees, moving companies overseas, cooking the books...we've heard it all this past year even.....People aren't being compensated fairly for their productivity right now.


But here are some interesting questions...how would YOU measure who was being more productive? How would you measure which type of productivity was the most important and deserved the most compensation? Would you trust the capitalist 'market' that allows companies to fire their hardworking US employees to move overseas and pay workers in Taiwan .10 for every 1.00 they would have had to pay an american...so that the CEOs can continue to get wealthier and companies can show a bigger profit...thus lifting the stock market and making people believe that the company is really doing great? Would you say that that CEO 'deserves' to earn say.....12 million dollars for that year because their company appears so productive....even if they put 10,000 US workers out on their butts...because that is how our market tends to 'determine' someone's value....


kris
 
I like the way this thread is going.

"Do physicians deserve to earn more than individuals with less education who have invested less in their careers and themselves...hell yes!"

That is why a neurosurg deserves more than a family practice doc.
I do think rads is overpaid. 170 for family pracite sounds OK with me.

"Why not just start out by requiring big companies to offer healthcare benefits to all of their employees"

I dunno I havnt though about that. Sounds good though. Im pretty sure that most everywhere offers it though. I worked as a waiter in a hilton reasturant and if you are full time for 6 months you get health/dental and whatever else i never bothered looking into. Im not sure about other jobs though. I think waffle house has benifits too.

To double minimun wage......I dunno, i am 22 and dont know many adults, but I would just have to belive that adults who are not total screw ups can do somthing alot better than a min wage job. No one should have to support themselves on that.

My parents have a decent amount of money but i, because of an argument (imagine than) decided that i didnt need their help and I could make it on my own. I ate protien powder and water for a week out of my car and slept on a beach. I had nowhere to go. Within two weeks I was making enough to rent a room from a coworker for 450 a month. Within two months i was making nearly 3 grand a month, all of this at 19 years old. I saved up and financed my college education. I could only get 2K a semester in loans because the gov assumed my parents were giving me money. People who are truly poor would be BETTER OFF that i was. I did it. I came from NOTHING. literaly i had 50 bucks and a tank of gas....and I put myself through college at 19 years old. Why cant some 30 year old mcdonalds worker figure out you are NOT SUPPOSED to only be a fast food worker all your life??

But like i said, I havnt thought about the consequences of doubling min wage.

"The idea that everyone who isn't a doctor and who works at McDonalds had an IQ of 85 or whatever was said is just ludicrous....."

I didnt say that non-doctors had low IQs or that all mcdonalds workers did. I just presented a hypothetical person and trieds to imagine what types of obligations, as a human, i would have towards them.

"
I don't think doctor's salaries would fall at all...as a matter of fact, having more people with health insurance would actually lower the cost of health care....you may not think that you are paying more for the uninsured now, but you are...one of the many reasons that healthcare costs are so high is that those of us with healthcare insurance are paying more for services to make up for those that can't.....so we may see a decrease in what we pay for our own healthcare....doctors would be compensated for seeing all patients, not just those with insurance...they might not be so quick to turn down those with poor paying insurance or no insurance...would perhaps be viewed as being more caring and maybe they'd be sued less often so it would potentially lower the cost of malpractic insurance?"

This makes no sense. How would giving health insurance to people who dont have it now make things cheaper? You assume that people with no insurance still get health care. this is only true a fraction of the time.

People sue because the value of ward work is meaningless, thanks to many things but in part due to the "entitlement" attitude that is growing in our country. People sue because it lets them fanisize that they DESERVE what the dont have. A good friend of mines gf sued someones insurance company and rightly so, she was injured and it was the other guys fault. But she would stop at getting reimbursed for health costs/time missed at work/ and a reasonable amount for pain, she tried to squeeze every dime our of the situation she could, simply because she could. She was poor and had been blaming everyone but herself, and this was her chance to stick it to the figment of her imagineation keeping her down.


"I think that anyone that is willing to work hard, regardless of the type of job that they have, should have the right to have some dignity and pride in the work that they do...even if they are only answering phones for a big corporation, are working as telemarketers (YUCK), or are slinging your fries in the back of a greasy restaurant.....We should have a minimum of what is acceptable...and I think offering working people in this country a living wage should be a priority...aren't we America the Greatest Nation in the World"

I suppose we need these services and as such we must be willing to support those who fulfill that need.

"how would YOU measure who was being more productive? How would you measure which type of productivity was the most important and deserved the most compensation?"

Free market supply and demand. How can one human say to another...I am work more than you? I could...but im an ass....better that the invisible hand of capitalism tell them their worth.

Also, you mention big companied lining their pockets. the middle class own the companies. I own the companies. I have stock in nearly every blue chip out there. (very little, its sort of a good habit im trying to build). When Walmart makes a dollar, I make money. Its not like there are that many independant billionares out there trying to screw the little guy. They are trying to be efficient. If you think that all companies care about is upping the stock price than put your money where you mouth is and buy some stock!

What do i think about jobs leaving for other countries? I dont think I like it but i really just havnt given it much thought, so ill keep my big mouth shut.
 
Well I think that people are getting confused on this thread, because you all are mixing up problems with solutions. The problems with the current institutions of health care include:

- Too many uninsured Americans.
- Out of control malpractice litigation system.
- Unavailability of private insurance.
- Inefficiencies in public insurance.
- Lack of public prescription drug benefit.
- Dependence of private insurance coverage on employment.

The problems with the proposed single payer solution include:

- The cost.
- It would never pass the House or the Senate, ever.
- The demonstrated inability of government to run anything efficiently.
- The reprecussions of a lack of competition on price (because the government is the single consumer).
- The reprecussions of a lack of drug innovation due to government price controls.

The promising aspects of a possible solution include:

- Disconnect health benefits from employment. Instead of giving businesses tax incentives to buy employees insurance, give those tax incentives to the consumers themselves. This relieves the burden on businesses (like the "HMO on wheels" GM) and reempower the individual consumer. Let the people who pay taxes, and who live and work in this country legally control their own fate.
- Slowly privatize government entitlement programs like medicare. This will encourage innovation in drugs, add a new demographic to the private insurance industry clientale, and the folks will recieve better and more insurance care (not to mention a prescription drug benefit), that only a private insurer can command from health care providers and pharmaceutical companies.
- Institute caps on punitive damanges on cases of medical malpractice (but no caps on injury awards). This will solve the issue and drive down malpractice premiums, costs of care, and health care insurance premiums. This will encourage more people to enter the health care sector as providers, allow current doctors to see more patients, and will provide the insurance industry more revenue and earnings to cover the folks they take on from medicare.
- Remove the insurance industry's immunity from Sherman Antitrust regulation. It is high time since insurance providers are no longer regional. They are vehicles of interstate commerce, and should be subject to the same laws as everybody else. This layer of oversight will better regulate the industry and everybody wins there.


Okay, I'm open to flames now. Everybody needs to sacrifice, including the insurance companies, the lawyers, the doctors, the pharmacists and the pharmaceutical companies. We need to take care of this problem without sacrificing our way of life as Americans. That means preserving free market competition, reasonable taxation and the freedom of choice. The ultimate end here is that our grandparents and our grandchildren should be taken care of.
 
mommd,

I'm calling BS on your income/tax figures.

The highest federal tax braket is 33%. Somebody grossing 170k who is married is in the 28% bracket.

Are you SERIOUSLY telling us that Minnesota has a 14% state income tax?

If so, thats the most ridiculously high tax rate I've ever heard of. A typical state has a state income tax rate of 5 or 6%
 
As far as income vs tax goes, MacGyver....all I can say is you will figure it out when you get there too. We pay federal taxes, social security, state and local taxes and at the end of the day, a whopping 42% is Gone....believe it...or not.....

When my husband first started this job making substantially less, we made the exact same assumption in regards to taxes....we purchased a home, made plans for paying off loans, etc...and when he got his first pay stub in his box he called me nearly in tears....because we had made similar calculations to you. We were sorely disappinted.

As to
That is why a neurosurg deserves more than a family practice doc.I do think rads is overpaid. 170 for family pracite sounds OK with me.
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I agree...though I have yet to meet an FP who earns more than about 130-140k (not that I've met all of the FPs in the country though 😀 ). My husband is a fellowship trained ID specialist, not a family practitioner.

but I would just have to belive that adults who are not total screw ups can do somthing alot better than a min wage job. No one should have to support themselves on that.
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No one should have to, but there are adults who are...screw ups, as you say...who maybe grew up in a different environment and had a different kind of a life....who perhaps have learning disabilities or other kinds of life issues holding them back. Maybe they were the kids in your classes that fell between the cracks.. What do they deserve? I know that we don't want them all sucking off of the system and claiming disability, right? So if they are willing to work, why not provide benefits?

This makes no sense. How would giving health insurance to people who dont have it now make things cheaper? You assume that people with no insurance still get health care. this is only true a fraction of the time.
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Of course people with no insurance get health care 😕 ...all of the time, as a matter of fact...they go through the ERs where they can't be turned down, wait until they are very, very sick and end up having expensive ICU bills that they can't pay, etc.....Do you actually believe that people without health insurance don't seek out healthcare and receive it?

Case in point....a few weeks ago, my husband treated a 19 year old girl who had no health insurance. She worked in a casino and was saving money for school...her plans were to enroll this Fall. She had no health insurance and because she wasn't a student yet, she was not covered by her parent's plan, I guess. In any case, she came through the ER at midnight with a high fever and suspicion of meningitis and no health insurance. My husband went in at 12.30am and saw her....he diagnosed systemic meningitis and transferred her to the ICU where she was treated aggressively. He came home at about 3.30am only to return again in the morning. She lived in the ICU for 10 days before dying. Who do you think pays the ICU bills? Obviously, this 19 year old can't..and even if she had survived she would never have managed to pay off the substantial amount that had accrued in just that short period of time...plus the physical therapy and prosthetic devices she would have needed. If she had survived, she would have lost both feet, both hands and her nose 😱 Who would have paid for that? Do you really think that the hospital would have kicked her out without treating her? Do you think that is what she deserved because she had no health insurance? At the end of the day, these costs will be passed on to you, the consumer with healthcare insurance.....in the form of increased costs and higher insurance premiums.

Also...a lot of companies offer health insurance benefits...but they make them very difficult for their employees to get and are very watered down....ie they cover very few services and have a low cap.

Here is another example for you:

A family in my daughter's girlscout troop has two children. Both parents work full-time in 'blue collar' type jobs...the mom is a secretary at a radio station and the father works in maintenance for the school system. They are very nice, hard-working, likeable people. This year, their almost 2 year-old little boy was involved in a horrible accident. He had to be life-flighted to the twin cities and was in the ICU for nearly 2 months...He survived and is now undergoing physical therapy, etc...and will mentally be fine....The family had health care insurance that maxed out after something like 2 weeks ICU....They OWE the rest of the money.....For some reason, the Life Flight was not covered and it cost more than $5000...they OWE that money. This is a family that otherwise has worked hard (though ok...they aren't doctors, lawyers or famous journalists), has hung up 'Support our Troops' signs in their windows, etc, etc.....They are selling their home and are losing everything. Do they deserve this because they are working in professions that are less-regarded? Perhaps they could even be considered "screw-ups"?

She was poor and had been blaming everyone but herself, and this was her chance to stick it to the figment of her imagineation keeping her down.
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I agree with much of you assessment, but one of the reasons that I personally think that this sense of entitlement and lack of personal responsibility is evolving the way it is is because there is just an increasing disparity between the wealthy and the poor. People are working harder for less money, they fear losing their jobs, have no or poor healthcare coverage. They see massive layoffs and lying CEOS and then they see their bosses getting huge raises.

Free market supply and demand.
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Who determines free market supply and demand? Sure...we buy certain goods that we value...the problem is, we will continue to buy those goods and shop at the good stores even though the companies may be mistreating their employees.... Do I still shop at Target? Yes.... am I prepared to boycott the company because of their practices with their employees. No...then the employees will lose out even more...management will keep their fluffy jobs and just fire more of the hard-working americans already getting screwed. Is that the best way to manage things...the free market?

I own the companies. I have stock in nearly every blue chip out there.
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Hey...good for you...I speak as a 33 year old mom of three and for my 38 year old husband...we own 0% of any company because we've been using all of our financial resources to survive medical school, residency and fellowship and now to pay off massive loans. I suspect that very few Target or Wal-Mart employees own nearly every blue chip out there or have much of a say-so in what goes on...and if YOU own the companies, will YOU please FIX this situation...after all...ownership must come with some benefits 😉

What do i think about jobs leaving for other countries? I dont think I like it but i really just havnt given it much thought, so ill keep my big mouth shut.
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Maybe it is time to start thinking about it since you own stock in many of these companies,...after all, if the free market is going to determine what is acceptable, I guess the morally 'right' thing to do is to pull out your stocks in those companies that bankrupt hardworking US citizens to move overseas and keep paying dividends to the stockholders, regardless of how much money you would lose out on.
 
Originally posted by MacGyver
show me one socialized medicine country that has doctor salaries within 30% of US doctor salaries, after all expenses have been taken out including malpractice insurance and overhead costs.

Here's the list:
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Canada.
Physician salaries are commensurate with what doctors make in the US. Sorry to burst your bubble. No Canadian physician makes 50k or anything nearly so abysmal. (unless they are working part time)
Contrary to your belief physicians are NOT starving here. The more entrepreneurial MDs even manage to get wealthy. Fee for service medicine does exist here, but meat and potato health care is accessible to all.

Forget what the US spends...Its all money that is staying in the US no matter is it goes to a person with the title "payment collector" or whatever, its not like it disapears.
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Oh and hightump, just because the wasted monetary resources stay within the system doesn't make it right. If more money was spent on devliering health care, instead of paying paper-pushers, hardworking Americans wouldn't be routinely denied diagnostic and therapeutic tests and procedures etc because it doesn't fit the HMO's bottom line.
 
show me one socialized medicine country that has doctor salaries within 30% of US doctor salaries, after all expenses have been taken out including malpractice insurance and overhead costs.
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Germany may not really count as socialized medicine, but it is a heck of a lot closer than we will ever be.

Salary for a resident after they survive the first 18 months of financial hell is much higher than here. You have a base salary and then are compensated for your 'call'...imagine that 🙄 One of my husband's closest friends is a surgical resident (PGY5) and he is earning the equivalent of ~$62,000 annually. For this, he also does NOT have q2 call like his US counterparts here in the twin cities (yah, yah..it's illegal, we all know it but do nothing about it) AND he has 6 weeks of PAID vacation a year. Things that make you go hmmmm.

Also, my husband was a first year senior house officer (resident) in the UK before we came to the US and he earned 43,000/annually and had 5 weeks of PAID vacation. I don't know what his post-training salary could have been there....but I imagine that it was more than a resident's salary 😉

In Germany, post-training, salaries are also quite similar to the US and the graduates are not saddled with student loans like students here. For example, an internist in Stuttgart that we also know earns the equivalent of 150k (in US dollars) annually. This is hardly the boo-hoo, we'll only earn 40k that some people fear...couple that with no student loans, and there are plenty of docs in germany driving their BMWs.

Another example...Toronto Canada...a friend of ours is a radiologist there....he earns over 400,000 canadian dollars. Not 40,000....400,000. He found a job opportunity for my husband there as a general internist making nearly 350,000...we didn't apply because my husband is not interested in working as an internist....but to say that doctors in Canada are earning 40,000 a year all over just isn't true. I'm sure that you can find them...but you can also find doctors working for much less than the market value here in the US...try academia, the VA, health clinics, etc. I'm also positive that not every radiologist in Canada is earning 400,000 canadian dollars....but the point is that salaries are not as flat as you think.
 
The promising aspects of a possible solution include:

- Disconnect health benefits from employment. Instead of giving businesses tax incentives to buy employees insurance, give those tax incentives to the consumers themselves. This relieves the burden on businesses (like the "HMO on wheels" GM) and reempower the individual consumer. Let the people who pay taxes, and who live and work in this country legally control their own fate.
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Interesting ideas..I'm curious...How would disconnecting health care from business help anyone but the wealthy? Lets say you earn....$25,000 annually. How much of a tax incentive will you be given to put towards purchasing and maintaining health insurance and what kind of a policy could you realistically afford for yourself or your family? A family earning 100k annually (for example) could more easily afford the best insurance money could buy with their tax incentive. They pay more taxes, so they'd get more back as an 'incentive', right?...a family earning 25k or even 40k annually might be able to afford some watered-down version of healthcare if they were really lucky....you'd have to really give them a larger chunk of their tax money back, and then who is going to pay for all of these new bombs that we are building, for the school systems, etc.. ? I'm just not convinced that handing the consumer a blank check for $1500?? a year (or what amount would you suggest?) would pay for health care insurance for an individual or a family. Convince me 😛 !

- Slowly privatize government entitlement programs like medicare. This will encourage innovation in drugs, add a new demographic to the private insurance industry clientale, and the folks will recieve better and more insurance care (not to mention a prescription drug benefit), that only a private insurer can command from health care providers and pharmaceutical companies.
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Interesting...but what do YOU think might be some of the pitfalls of privatization? Take the other side of the issue for a minute...I'll start you...

It might also make benefits dependent on the stock market's ups and downs......

- Institute caps on punitive damanges on cases of medical malpractice (but no caps on injury awards). This will solve the issue and drive down malpractice premiums, costs of care, and health care insurance premiums. This will encourage more people to enter the health care sector as providers, allow current doctors to see more patients, and will provide the insurance industry more revenue and earnings to cover the folks they take on from medicare.
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I agree 100%
- Remove the insurance industry's immunity from Sherman Antitrust regulation. It is high time since insurance providers are no longer regional. They are vehicles of interstate commerce, and should be subject to the same laws as everybody else. This layer of oversight will better regulate the industry and everybody wins there.
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Agreee
 
Great salary figures. I would certianly trade making 500K a year for 400K a year to be able to give everyone health care and have a little better pay in residency. But im sure there are limitations that i am ignorant of. Maybe after taxes, since these countires probably have insane tax rates, that 500 will be 250 and that 400 will be 100K. Big differnce once you acount for taxes. btw i just guessed the 75% tax rate. I know northern europe is like 80% right?
 
Originally posted by Doc Ivy

Canada.
Physician salaries are commensurate with what doctors make in the US. Sorry to burst your bubble. No Canadian physician makes 50k or anything nearly so abysmal. (unless they are working part time)
Contrary to your belief physicians are NOT starving here. The more entrepreneurial MDs even manage to get wealthy. Fee for service medicine does exist here, but meat and potato health care is accessible to all.
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Bad example. Canadian docs DO NOT MAKE anything comparable to a US doctor. US docs average 160k according to the US Labor Dept.

That 160k figure is AFTER malpractice insurance and all overhead costs, and before taxes.

Canadian tax rate is significantly higher than the US tax rate.

In terms of earning power after taxes and after expenses (even malpractice insurance), a Canadian doc is lucky to earn 60% of what a US doctor makes.

Of course that makes sense given the massive flux of Canadian docs to greener pastures across the border.

http://www.imshealthcanada.com/htmen/3_4_10_1.htm

Canadian physicians are earning 55% of the average US doctor-and this is before taxes.
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http://www.caribbeanmedicine.com/article9.htm

Dr. Maher said when he travels to visit doctor friends in the United States and explains he makes the equivalent of $55,000 U.S. a year, they don't believe him because that is what nurses earn there.
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With take-home pay lower than some auto plant workers, no fringe benefits and increasing overhead, many family doctors are asking themselves why anyone would want their jobs.
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I essentially make what my plumber or auto mechanic earns once I have paid my overhead," said Daniel Maher, a Glebe physician who has been practising medicine since 1991. "Why spend nine years in university for all the responsibility and risk of lawsuits to make what a beginning engineer would earn?"
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Other tradespeople can earn more than $75,000 a year, as much or more than a doctor working a 40-hour week.
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http://www.expresshealthcaremgmt.com/20010831/international2.htm

According to a recent Statistics Canada study, 19 doctors imigrate to the US for every one American doctor who heads north of the border.
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http://www.canada.com/ottawa/ottawa....html?id=94D38554-9FEA-43E6-9DCA-DA589C431590

They are saddled with tens of thousands of dollars in tuition debt and earning no more than a skilled labourer.
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For example, in 1996-97, the University of Toronto graduated 100 family doctors and 34 of them immediately left for the United States.
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Highest tax bracket is 35% which starts at $311,951. FICA takes away around 6% up until around $80K. Medicare will take away around 1%. And, of course, sales tax takes away another 8% or so. We're taxed too much, damn it 😡

Thanks for the links, MacGyver
 
Originally posted by mommd2b
Salary for a resident after they survive the first 18 months of financial hell is much higher than here. You have a base salary and then are compensated for your 'call'...imagine that 🙄 One of my husband's closest friends is a surgical resident (PGY5) and he is earning the equivalent of ~$62,000 annually. For this, he also does NOT have q2 call like his US counterparts here in the twin cities (yah, yah..it's illegal, we all know it but do nothing about it) AND he has 6 weeks of PAID vacation a year. Things that make you go hmmmm.
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Who cares about residency salary, thats totally irrelevant. The Germans can have their 65k resident salary, I'll take a lower resident salary in the states and have double their income for 30 years.

Which is better?

1. Making 65k as a resident and then making 80k the rest of your life

2. Making 30k as a resident and then making 160k the rest of your life.

You do the math. Keep in mind that Germany's tax rate is also MUCH higher than the United States.

Also, my husband was a first year senior house officer (resident) in the UK before we came to the US and he earned 43,000/annually and had 5 weeks of PAID vacation. I don't know what his post-training salary could have been there....but I imagine that it was more than a resident's salary 😉
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Sure it was more, but it wasnt double or triple the amount like here in the States.

Getting an extra 30k for 5 years of residency training DOES IN NO WAY COMPARE to getting an extra 80k for 30 years of practice.

But while we're at it, lets look at the UK:

http://www.britischebotschaft.de/en/news/items/030313.htm

For Consultants salaries start at Euro 80,000 and go up to Euro 105,000 over a 5 years.
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105,000 Euros = 120k US dollars.

UK tax rates are almost double that of the US.

For docs with similar experience, they can expect to make anywhere between 150k and 500k depending on specialty.


In Germany, post-training, salaries are also quite similar to the US and the graduates are not saddled with student loans like students here. For example, an internist in Stuttgart that we also know earns the equivalent of 150k (in US dollars) annually. This is hardly the boo-hoo, we'll only earn 40k that some people fear...couple that with no student loans, and there are plenty of docs in germany driving their BMWs.
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This is absolutely wrong. German docs make nowhere near their American counterparts after residency.

Just because they make more during residency (a brief 5 or 6 year period) is irrelevant in comparison to a 30 year career outside of residency.

I know a German doc making 60k per year. We can throw out anecdotes all day long but that doesnt change the fact that on average, when adjusted for cost of living, earning power, currency, taxes, and overhead costs, German docs make far less than their american counterparts.

Another example...Toronto Canada...a friend of ours is a radiologist there....he earns over 400,000 canadian dollars. Not 40,000....400,000. He found a job opportunity for my husband there as a general internist making nearly 350,000...
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The average general internist in Canada makes NOWHERE NEAR 350k. The average is more like 60-80k when adjusted for currency exchange, cost of living, earning power, taxes, etc.

As for radiologists, they are few and far between in Canada compared to the US.
 
Hey,

Canadian docs DO NOT MAKE anything comparable to a US doctor.
Click to expand...
Canadian doctors make much less than American doctors do. But nowhere near the $50-k'ish numbers that you were quoting beforehand! Physicians are amongst the most highly paid professionals in Canada. Certainly enough to live a very comfortable lifestyle.

Canadian tax rate is significantly higher than the US tax rate.
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In the highest tax bracket, Canadians take home somewhere around 52% of their salary. (After taxes and all the other things that get taken off of paycheques). So, say around 48% taxes. That's not TOO different from the 44% quoted earlier in this thread.

Lower salaries for doctors and higher taxes for high income earners is a trade-off against making sure that every person gets healthcare. It's not arbitrarily bad or good. As compared to being a doctor in the US, I have to give up a whole bunch of things. I'll give up a higher salary. I'll pay more in taxes. I'll have to wait longer for routine procedures.

But if I have a life-threatening illness, my care will be exactly as good as in the US. And that will apply to EVERY CITIZEN of Canada.

It's a tradeoff that Canadians want to make, and Americans don't. It's about values. Do I think the Canadian healthcare system if perfect? Of course not! Do you think the American one is perfect? Of course not! I doubt that there's one country in the world which is perfectly happy with their healthcare system. The debate rages in Canada (and presumably in Germany and other countires) about how to "fix" our system, just like it does in the US...

It's not like there's one mythical best-case-perfect-system out there that we should all aspire to - it depends on the values of the people living in the particular country. Good healthcare is expensive, and giving it to as many people as possible is even more so. We're never going to like the costs involved.
 
Which is better?

1. Making 65k as a resident and then making 80k the rest of your life

2. Making 30k as a resident and then making 160k the rest of your life.

You do the math. Keep in mind that Germany's tax rate is also MUCH higher than the United States.
QUOTE]

Which is better....hmmmm...

1. making 65k as a resident and having a life where you actually see your family, take vacations and enjoy living life while you learn and then making 100k+....(maybe you know of a doc earning 60k, but I think there was an optho here who posted something about only earning 70 or 80k in the US and we all chose to disregard that...so I'm throwing out the 60k...I've not heard of such a low physician salary in germany....sorry) with no student loans to pay back.

The tax rate for someone making that kind of a salary would be about....425% or so...hmmmm.....but...no student loans to rip off $2000 a month, no pesky consumer debt to get yourself through residency and help you pay for the thousands of dollars for board exams and state license fees as well as multiple moves.....

or

2. Making 30-40k as a resident in the US and working your a$$ off to take q3 call for years and trudge through in less time than your european counterparts because you owe 150k in student loans that just won't defer themselves forever....sleepless nights, lack of family time, financial struggles when it comes to financing moves, paying for your license fees, etc....

and then earning between 100-170k annually before taxes. Lets face it....most physicians are not earning well above 150k...unless you are a surgeon, radiologist or a specialist, you will be earning much less...think pediatrician, family practitioner, psychiatrist, internist, hospitalist, etc. You can go to all of the little statisitics sites that google will hand you, but the real 'proof' is what the market is paying physicians. Also, consider that many of the stats are after someone has been in practice for many years and is established as a partner..

BTW...MacGyver, lets dispel your Canada myth...thanks for the links...now here is some info for you:

http://www.cmps.ca/

Permanent Practice Opportunity #23011
Internal Medicine
Red Deer, Alberta, Canada
Canadian Medical Placement Service

Summary

Opportunity Calls in Central Alberta! High Income, High Tech Surroundings Quality of Life, Permanent or Locum We are the search consultants for the David Thompson Health Region and want to reach you about outstanding opportunities available for General Internists matching your qualifications. Subspecialties in Cardiology, Oncology, Rheumatology and Intensive Care are of particular interest. This established facility presents an opportunity to work with an excellent team of committed physicians in a well-equipped environment. The opportunity offers the following: ? Population draw of approximately 290,000 within a rapidly growing community ? Challenging case opportunities ? Fully equipped and well staffed hospital ? Established clinics in anti-coagulation, hepatitis C, renal, cardiac function ? Completion of a major hospital addition which includes additional beds, state of the art Emergency Ward, MRI, Spiral CT Scanner, Full Rehabilitation Program. ? Income potential up to $600K with the lowest taxes in Canada ? No fee caps or restrictions ? Bonuses include moving expenses, interest free loan, additional bonus for Alberta graduates Live in this gem of a city! . Its rapid growth offers all the amenities for a satisfying professional and personal lifestyle. Its size offers the safety of a close-knit community. Schools, colleges, churches, cultural arts, recreational facilities, spousal employment opportunities all contribute to its attraction. An easy drive to the beach or the ski hill. Just over an hour?s drive to Calgary or Edmonton.



or

Internal Medicine
Lindsay, Ontario, Canada
Canadian Medical Placement Service

Summary

Re: Exceptional Internal Medicine Opportunity with High Income; Attractive Call Schedule; Quality Lifestyle in Scenic Vacation District, Lindsay Ontario ? ?Gateway to the Kawarthas? As medical search consultants for the Ross Memorial Hospital, we invite you to respond to this excellent opportunity for an Internal Medicine Specialist matching your qualifications. Located east of Toronto (within 1 ? hour drive), you would join dedicated personable colleagues, serving a community of over 80,000 in this well equipped 156 bed full-service community hospital. (A major expansion to be completed in early 2004 will see the hospital grow to 218 beds.) This quality position offers the following: ? Fee for Service: $300,000 - $350,000 ? Attractive Call ? On Call Incentive Revenue (to $21,000) ? Fully accredited 218 Bed Hospital ? CT Service ? Expansion includes enhanced ER; 30 additional inpatient beds; 10 bed palliative care program; new 16 bed rehabilitation unit; new 15 bed mental health unit; ? Spousal employment opportunities ? Two school boards, public and private schools (French immersion programs) Lindsay Ontario, ?Gateway to the Kawarthas?, is a valued-historic tourist destination with year round recreational and cultural activities and events. With 13 golf courses in the immediate area, 2 downhill ski venues, 8 cross country trails, numerous 4-season recreational trails, 2 sailing clubs, 9 marinas, 9 public beaches, 2 provincial parks, a flourishing arts community with Summer Shakespeare fest, jazz and classics, Lindsay offers the opportunity for an active quality lifestyle. The appeal of affordable housing is a major attraction. Churches of all denominations are located throughout the area, and well established synagogues and mosques are nearby. This may be even better than you initially thought so we encourage your reply if you or indeed someone you know is interested in learning more about this exceptional opportunity. Please call toll free 1-800-991-6661 or fill in email form to respond. Your reply will be handled confidentially.
Date Required: , Negotiable

or

Internal Medicine
Medicine Hat, Alberta, Canada
Canadian Medical Placement Service

Summary

As search consultants for the Palliser Health Authority, we would like to draw your attention to this existing opportunity for an Internist with special interest in Oncology or Geriatrics. Activities will be concentrated in the Medicine Hat Regional Hospital, a 190-bed regional referral centre, in a community of 55,000 and a referral area with a population of 105,000. An ability to handle ICU cases would be essential to allow for on call scheduling. ....
Financial Package & Incentives
Salary Range: $300,000 +
Bonuses: signing bonus


or

Internal Medicine
Northwestern, Ontario, Canada
Canadian Medical Placement Service

Summary

GOLDEN OPPORTUNITY IN INTERNAL MEDICINE! HIGHEST INCOME IN ONTARIO! MANY INCENTIVES! PERMANENT AND LOCUM POSITIONS AVAILABLE! We are the search consultants for a large modern well-equipped Regional Hospital located in a thriving lakeshore resort city in Northwestern Ontario. You would join your colleagues and have privileges at this modern Hospital site with affiliations and linkages to major teaching Centres in Ontario. The community is designated as under serviced. Earn great income and other incentives without restrictions while trying something new. Under serviced area program incentive grant of up to $40,000 plus tuition reimbursement available to qualified applicants! Income guarantees for locums! Accommodations provided and travel paid for locums! Brand new state of the art hospital under construction to open in 2002! fully trained support staff included. Full range of specialty services with large referral base. Excellent fully equipped modern facilities and offices. Candidates must be certified by the royal college (FRCPC) and meet the licensing requirements of the College of Physicians and Surgeons of Ontario and the credentialling and privileging requirements of the hospital. Involvement with research programs and affiliations with major teaching, academic and research centres in southwestern Ontario is available.
Salary Range: $500K plus
I
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