Interview Question: "What is the single biggest problem with Healthcare today"

[attaboybambeeks]

Interview Question: "Based on your experiences, what do you think is the single biggest problem with Healthcare in the US today?"

I fumbled with this one a bit. I think its a great question. I wanted to bring it to the forum and ask you all how you would go about it.

I mentioned ideas like culturally sensitive care for our globalized world: such as culturally informed preventative health campaigns, addressing the uninsured etc.

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[golftrippy]

In US...got to go with 40 million uninsured

 

[little_late_MD]

Lawyers

 

[ASDIC]

has become a commercialized commodity, that goes to people who can afford it rather than to the who need it.

 

[themadchemist]

Access. Access, access, access.

 

[jbrice1639]

the med school admissions process.

 

[NismoZ32]

In US...got to go with 40 million uninsured

Second. And be prepared to answer how you would solve this problem. I guarentee you will be asked this in at least one interview.

 

[FrkyBgStok]

but how can a lone doctor actually help this. i understand the theory but... in reality it is much different

 

[Apparition]

but how can a lone doctor actually help this. i understand the theory but... in reality it is much different

One doctor can't change anything but if every doctor devoted about 10% of the time taking people without insurance, the uninsured would at least have somewhere to go. Of course, it's not a good solution. It's up to the government to make these changes but the government isn't too concerned.

 

[Suppuration]

One doctor can't change anything but if every doctor devoted about 10% of the time taking people without insurance, the uninsured would at least have somewhere to go.

It's not exactly every doctor giving 10%, but it's been going on for a long while, and it's not a good thing: http://www.ama-assn.org/ama/pub/category/15330.html

"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,"

And it ain't just a matter of our time...

"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."

 

[doctorFred]

access to healthcare is a very popular answer and is, of course, an important issue. but i think far more important, and far more overlooked, is the idea of preventitive medicine. it's overlooked because it involves simple notions like exercise, proper diet, etc. access to medical care becomes important as problems develop, but an emphasis on preventative care can cut the problem off at the pass, so to speak.

 

[Uncle_Tbag]

One doctor can't change anything but if every doctor devoted about 10% of the time taking people without insurance, the uninsured would at least have somewhere to go. Of course, it's not a good solution. It's up to the government to make these changes but the government isn't too concerned.

They do have somewhere to go:

1. ED
2. Doctor's Free Clinic
3. Medicaid

People act like if you don't have insurance in the US you'll be left out on the street to die and that's not true.

 

[Suppuration]

They do have somewhere to go:

1. ED
2. Doctor's Free Clinic
3. Medicaid

1. The most expensive, inefficient way to administer care, particularly for chronic problems.
2. Completely inadequate
3. Not if you have anything resembling an income

People act like if you don't have insurance in the US you'll be left out on the street to die and that's not true.

You're right, most folks manage to make it to the ED first.

 

[Uncle_Tbag]

1. The most expensive, inefficient way to administer care, particularly for chronic problems.

The question at hand was not efficiency nor expense to the taxpayer, but rather access.

2. Completely inadequate

I'm sure it varies by clinic, but in my experience they provide an adequate level of care. Almost every doctor in my town rotates through the free clinic (yes even the good ones!).

3. Not if you have anything resembling an income

I agree the threshold should be lowered a bit for medicaid enrollment, but many people neglect coverage for themselves and dependents in order to live a more luxurious life. When they get sick it's their fault they aren't covered. I don't want to be forced into socialized healthcare and see the overall quality of medicine in the US dumbed-down because of these people.

 

[EctopicFetus]

How about doing a 45K cath on a 95 yr old woman when medical management B Blockers, etc would have been just as effective. There is a great answer... Wasting money..

 

[dabigv13]

The question at hand was not efficiency nor expense to the taxpayer, but rather access.


I'm sure it varies by clinic, but in my experience they provide an adequate level of care. Almost every doctor in my town rotates through the free clinic (yes even the good ones!).


I agree the threshold should be lowered a bit for medicaid enrollment, but many people neglect coverage for themselves and dependents in order to live a more luxurious life. When they get sick it's their fault they aren't covered. I don't want to be forced into socialized healthcare and see the overall quality of medicine in the US dumbed-down because of these people.

Despite the fact that the US vastly outspends every other country in the world on health care per capita, we lag behind in many metrics.

Life expectancies, heart attack recovery rates, mostly favor or are equal in countries with socialized medicine. So perhaps health care might be "dumbed down" with more primary care and preventitive medicine, but that doesn't mean it's less effective.

I think the structure of our current health care system is doomed to fail. You can take your pick of problems. 46 million uninsured, steadily rising national spending, nursing shortage about to really explode, and the baby boomers are only going to make it worse when they retire and start needing care paid on the dime of a diminished workforce. In ten years, health care spending will probably represent 20% of our GDP, up from 13.5% (I think) currently. That's only a couple years out of residency for us folks, and I don't think we can sustain that sort of upward growth in spending.

 

[pagemmapants]

One of my responses would be overuse and underfunding of emergency departments; possibly stems from lack of adequate insurance and the necessity of said uninsured to make use of the "Treat first, ask questions later" policy that most ERs are required to adopt.

 

[Law2Doc]

Life expectancies, heart attack recovery rates, mostly favor or are equal in countries with socialized medicine.

Agreed. Those few countries with socialized medicine that have better stats, also have smaller populations, less poverty, better nutrition, fewer homeless, less drug abuse, and are really thus much easier to manage. To point to eg. Canada and say that is something we need to implement here is too simplistic -- like saying you are going to fix a gaping chest wound with a bandaid. However most interviewers you will come across will believe that a move to a single payer universal health care system is likely inevitable, and that physicians will need to learn to thrive in such a system.

 

[LabMonster]

access to healthcare is a very popular answer and is, of course, an important issue. but i think far more important, and far more overlooked, is the idea of preventitive medicine. it's overlooked because it involves simple notions like exercise, proper diet, etc. access to medical care becomes important as problems develop, but an emphasis on preventative care can cut the problem off at the pass, so to speak.

I agree. It seems preventative medicine has too many intangables - nothing firm to grasp and treat versus a disease that can be directly treated with drugs or surgery.

Of course, the money comes from surgical procedures and diagnostics...

 

[LabMonster]

Life expectancies, heart attack recovery rates, mostly favor or are equal in countries with socialized medicine. So perhaps health care might be "dumbed down" with more primary care and preventitive medicine, but that doesn't mean it's less effective.

It is difficult to compare performance metrics without also including differences in lifestyle, likely because including lifestyle would involve so much data it would be almost impossible to compile and analyze.

So when I see reports comparing the US sytem to other systems, I find myself asking "What didn't they take into account?"

A nation's health is not based soley on it's health care system, there are many other variables to consider as well.

 

[BooMed]

One thing I wonder about here is the tremendous gap in between what we all know is healthy what we do. I mean, at this point, everyone knows they need to exercise at least a little bit, and yet almost nobody does. We have a cultural problem in the US, and it's killing us.

 

[gujuDoc]

I may be wrong here, being that I am not a doctor or even a nurse, but a premed student..............

But my take is that access as others have pointed out would be the biggest problems as divided into two subcategories:


1. lack of access due to lack of doctors in the area, (i.e. disadvantaged areas like rural communities which a lot of people shy away from).

2. lack of insurance for many poverty stricken or lower income members of society, leading to inefficient access to proper healthcare.

How to solve these two problems is another question, and one I'd have to research more.

 

[emeraldcity]

Our current free-market system for Medical Care.
capitalism just doesn't work when it comes to people's health.

 

[Shredder]

ill give a different answer that ive been thinking about:

the shortage of doctors. the artificial shortage, i should add. the whole "job security" of medicine isnt related instrinsically to the healthcare industry, its bc the supply of docs is always kept low. you never hear of docs who are unemployed like other jobs. ppl say there are always sick ppl so you always need docs. but there is only a limited supply of sick ppl. if the healthcare market was flooded with docs, competition would jump up and costs and access would become much better i think.

so what do you think, solution: open the med student/dr floodgates instead of trying to make planned decisions about how many docs society will need. ppl never learn lessons about the shortcomings of centralized planning

i guess the problem is the battle between capitalism and socialism in healthcare, in a phrase. also the insurance system and incentives are all screwed up, HMOs have helped some from what ive learned. socialism doesnt work when it comes to healthcare either--observe the ER in any county hospital for an example of what the whole country would be like

 

[Iwy Em Hotep]

One thing I wonder about here is the tremendous gap in between what we all know is healthy what we do. I mean, at this point, everyone knows they need to exercise at least a little bit, and yet almost nobody does. We have a cultural problem in the US, and it's killing us.

Bingo. I think lack of personal responsibility is the number one problem.

 

[gujuDoc]

Bingo. I think lack of personal responsibility is the number one problem.

You know you bring up a point, that I never even considered.

Lack of eating right, lack of exercise, living in a culture where too many people live off of fast food and too much fried food or portion sizes much bigger then needed at restaurants, smoking and drinking too much, etc. contribute to many of the problems like obesity, diabetes, heart problems, lung problems etc.

 

[Shredder]

You know you bring up a point, that I never even considered.

Lack of eating right, lack of exercise, living in a culture where too many people live off of fast food and too much fried food or portion sizes much bigger then needed at restaurants, smoking and drinking too much, etc. contribute to many of the problems like obesity, diabetes, heart problems, lung problems etc.

i agree that these contribute, but i think the problem in healthcare boils down to economics. you have to consider this: why dont you ever hear of problems or crises in any other sectors of the economy? i think the answer to the OP is--what makes healthcare different than those other sectors? as for solutions, how can we make healthcare more similar to the other sectors that magically seem to work themselves out?

all of these points you mention, guju, have analogs in automobiles and driving. yet there are no crises there. incentives, incentives...any economists around?

 

[LTrain1]

OP, some of these responses in this thread were so ridiculous you shouldn't even listen to them. The worst thing you could do is bring up a socialized universal healthcare system because virtually everyone you will interview with is against it, especially doctors.

 

[CerealBox]

I agree its a problem with incentives... but I see the situation a bit differently.

People do not always value their health as maybe you'd think they should. Lots of people will pay for cable tv before they pay medical bills. They could have shortness of breath or on and off chest pain... but would they rather be able to watch tv or look into these problems? It's hard to make people think of the long term future and have them base their current decisions on future situations.

Therefore I think preventative care would only work if it were free. If government decides it values preventing future health problems.... because individuals sure as heck don't.

In fact I think the major problem with health care is just that people have different priorities than the healthcare profession thinks they should. They don't care as much about their health as they "should"

How do we get them to care more? Is it possible?

 

[LTrain1]

I agree its a problem with incentives... but I see the situation a bit differently.

People do not always value their health as maybe you'd think they should. Lots of people will pay for cable tv before they pay medical bills. They could have shortness of breath or on and off chest pain... but would they rather be able to watch tv or look into these problems? It's hard to make people think of the long term future and have them base their current decisions on future situations.

Therefore I think preventative care would only work if it were free. If government decides it values preventing future health problems.... because individuals sure as heck don't.

In fact I think the major problem with health care is just that people have different priorities than the healthcare profession thinks they should. They don't care as much about their health as they "should"

How do we get them to care more? Is it possible?

going along with this, I read a report that said the majority of uninsured people in this country have cell phones, so it is definetely a problem with priorities

 

[Shredder]

In fact I think the major problem with health care is just that people have different priorities than the healthcare profession thinks they should. They don't care as much about their health as they "should"

How do we get them to care more? Is it possible?

intriguing point. why bother getting them to care then? do we force ppl to care about other things? its up to them what kind of health they want to be in. i only think they should be forced to care if other ppl's taxes are being used to subsidize their unhealthy lifestyles and subsequent treatment. in which case all of such taxes should be revoked, and leave it to private charity to bail them out when theyre dying. laissez faire forever!

www.marketmed.org

 

[PreMedMommy]

Unfortunately, (I give you my permission to call me pessimistic) there may not be any solutions to America's healthcare problems. Anyone think of that? We may improve a bit here and there, but fix??? I don't think our world is that idealized.

 

[Iwy Em Hotep]

intriguing point. why bother getting them to care then? do we force ppl to care about other things? its up to them what kind of health they want to be in. i only think they should be forced to care if other ppl's taxes are being used to subsidize their unhealthy lifestyles and subsequent treatment. in which case all of such taxes should be revoked, and leave it to private charity to bail them out when theyre dying. laissez faire forever!

www.marketmed.org

No one wants to be poor. If you are poor, society should provide a reasonable safety net to allow you to escape poverty and support yourself. One can argue how large that safety net should be, and no doubt people who have managed to pull themselves from poverty will say that the safety net is too large and that we provide too much charity in the government. But those people got to where they are through some degree of luck too. If you don't believe so, just ask yourself where you'd be if you were hit by a car while on your way to work, with no one to support you.

 

[LabMonster]

ill give a different answer that ive been thinking about:

the shortage of doctors. the artificial shortage, i should add. the whole "job security" of medicine isnt related instrinsically to the healthcare industry, its bc the supply of docs is always kept low. you never hear of docs who are unemployed like other jobs. ppl say there are always sick ppl so you always need docs. but there is only a limited supply of sick ppl. if the healthcare market was flooded with docs, competition would jump up and costs and access would become much better i think.

so what do you think, solution: open the med student/dr floodgates instead of trying to make planned decisions about how many docs society will need. ppl never learn lessons about the shortcomings of centralized planning

i guess the problem is the battle between capitalism and socialism in healthcare, in a phrase. also the insurance system and incentives are all screwed up, HMOs have helped some from what ive learned. socialism doesnt work when it comes to healthcare either--observe the ER in any county hospital for an example of what the whole country would be like

So if the number of doctors produced were increased, do you think healthcare costs would really decline?

The cost of a medical education is expensive to a student, but the costs incurred by the institution educating them is also ludicrous - I'm fairly certain educating future doctors is a losing business proposition. How much do schools spend on each student, from MS1 to MS4? There would be added cost to the university by increasing class sizes and that would have to made up elsewhere.

But perhaps, if the change were made gradually, an increase in the number of doctors is the right way to go. That way, institutional costs could be comfortably absorbed while increasing supply. The effect would be lower salaries for physicians though. I'm willing to work for a smaller salary as a physician, as it has been mentioned many times, if you want to be rich, you don't need to go to medical school.

There isn't a single, easily targeted variable in solving our health care crisis. But by starting with economics, 1) increase physicians 2) letting the market determine cost by directly involving patients in their own care, well, it's a start.

 

[Suppuration]

you have to consider this: why dont you ever hear of problems or crises in any other sectors of the economy?

You do, if you happen to be listening. Take the California energy crises a few years ago. Classic deregulation of an industry that's not amenable to free market forces. Like it or not, the sectors that have traditionally been considered "public utilities" are not ripe for market capitalism. There is just no good way to have competition for tap water. Furthermore, water and electricity aren't things you can realistically live without. It's not like choosing a toaster oven. If you look at the global experiences with privatizing public utilities, a common theme emerges: service declines, prices increase, and profits soar... for the companies. The powers that be deregulated electricity in this state five years ago. Result: more "choices” and higher bills. Woohoo!

Healthcare is resistant to free market capitalism for a variety of reasons. Not the least of which is that real competition is impossible for most of the country. A 1993 NEJM article (328:148) estimated that the minimum number of enrollees for a feasible HMO is about 400,000. If you consider the smallest market that can sustain competition must have three HMO's, the math dictates that less than half of the country lives in markets large enough to sustain such a situation. Twenty six states have no such market at all.

In any case, the free market was handed the keys to healthcare over twenty years ago, and it has been a disaster. Cost containment has failed miserably, coverage has tightened, and everyone involved is generally more pissed off now than in the past.

all of these points you mention, guju, have analogs in automobiles and driving. yet there are no crises there.

Considering that domestic market share is at its lowest point in history, and that American manufacturers are shifting plants to Canada to escape healthcare costs, I'd say we have a wee problem brewing.

 

[Suppuration]

So if the number of doctors produced were increased, do you think healthcare costs would really decline?

That's what I don't get, either.

If one wants to improve physician numbers in rural and underserved areas, the reimbursement schedules need to be revamped for primary care. If small town FP's start pulling in 250K you will see things change really fast. Our reimbursement bias for procedures has gone a long way towards creating this monster of over-specialization.

 

[medgator]

That's what I don't get, either.

If one wants to improve physician numbers in rural and underserved areas, the reimbursement schedules need to be revamped for primary care. If small town FP's start pulling in 250K you will see things change really fast. Our reimbursement bias for procedures has gone a long way towards creating this monster of over-specialization.

Exactly.... Once someone is diagnosed with cancer, we pay the oncologists much more $$ to intervene after the fact. If a primary care doctor could have stopped that person from smoking in the beginning through smoking cessation medications/programs, imagine the savings to our system. Of course it takes a lot of effort for a GP to do that, and of course he/she isnt reimbursed for this huge preventitive/cost-savings measure. There are dozens of examples like this throughout medicine (uncontrolled BP and cholesteral leading to coronary artery disease that has to be fixed through expensive bypasses and caths etc). As stated elsewhere on this thread, the simple fact is this: We reward intervention, not prevention. But then again, we can measure and quantify the former.... the latter is much more vague.

 

[Chrissy]

for the last 11 months i have worked for Americorps under the corporation for national community service. My program site is an urban community health clinic. Throughout the year we have various trainings and many have shared a common theme...it has been drilled into our heads that the number one problem in American healthcare is the discrepancies in ACCESS to healthcare.

 

[Depakote]

Interview Question: "Based on your experiences, what do you think is the single biggest problem with Healthcare in the US today?"

Expectations that a single pre-medical student can fix what the greatest minds in healthcare have struggled with for years...

>_>

 

[gujuDoc]

i agree that these contribute, but i think the problem in healthcare boils down to economics. you have to consider this: why dont you ever hear of problems or crises in any other sectors of the economy? i think the answer to the OP is--what makes healthcare different than those other sectors? as for solutions, how can we make healthcare more similar to the other sectors that magically seem to work themselves out?

all of these points you mention, guju, have analogs in automobiles and driving. yet there are no crises there. incentives, incentives...any economists around?

True true. You make some excellent points. I suppose, going back to the economics of things, this is why I brought up the lack of distribution of doctors in certain areas and also lack of adequate healthcare to poorer individuals. How to solve these problems is beyond my scope of understanding, without more research on the topic. But the blatant problems I see in thse two particular issues is the economic problems that are intetwined with these two issues.

For instance, the only way I would see more doctors going to rural areas is if there were more benefits and pay involved. But generally speaking, those in that kind of area, don't have that kind of money and there are not other incentives to make up for lack of money, causing that problem to exist.

Same could be said with the problem of uninsured. Often people are reluctant to take on uninsured people because if they take too many uninsured people because of economics involved in such issues. Again, the question remains to how we solve such problems though.

 

[CerealBox]

So if the number of doctors produced were increased, do you think healthcare costs would really decline?

Supply and demand, my friends. If more doctors graduate from med schools, there will be more competition to get the limited number of sick patients in a community to come see them (be their customers) over other doctors (competitiors). Docs will have to do more marketing and slash prices to try and capture more of the market. (More docs will probably also be more willing to see lower income patients for less money... Maybe they'll fnd a way to convince them to pay for screenings, etc.). In doing this, their profits will go down. And then, they will need to decide whether its even worth it for them to go through all of the expensive and demanding schooling to get an MD degree to practice medicine. The people willing to work for less will probably keep going to med schools... while others will look for other job opportunities.

 

[CerealBox]

For instance, the only way I would see more doctors going to rural areas is if there were more benefits and pay involved.

...or higher incentive of any kind

But generally speaking, those in that kind of area, don't have that kind of money and there are not other incentives to make up for lack of money, causing that problem to exist.

Well, their definitely are destitute peoples who have absolutely nothing, and they need help getting healthcare. But I bet a lot of rural families have cable tv, computers, cell phones, etc. Which is fine. They like and value those things. But there IS a little bit of disposable income which could potentially be distributed in another way towards their healthcare) if they were some how convinced to make healthcare a higher priority than cell phones.

If the competition between docs was higher (see previous post), and docs needed to look past urban centers to find areas of maney-making potential, I bet a lot would move to rural areas and start thrying to market their services to new potential customers there.

Same could be said with the problem of uninsured. Often people are reluctant to take on uninsured people because if they take too many uninsured people because of economics involved in such issues. Again, the question remains to how we solve such problems though.

What do you mean by "economics involved"? I think you mean they do not have money they are willing to spend on healthcare. Yes, this is a problem. Again, its about balancing supply and demand ...and convincing people to place higher value on their future (and current) health.



Note: I, by the way, am not a right-wing republican. I am in fact a very liberal voter... And I believe in social safety-nets. I just also believe that the economics of health care is messed up because of things other than just plain poverty.

 

[Suppuration]

Supply and demand, my friends. If more doctors graduate from med schools, there will be more competition to get the limited number of sick patients in a community to come see them (be their customers) over other doctors (competitiors). Docs will have to do more marketing and slash prices to try and capture more of the market. (More docs will probably also be more willing to see lower income patients for less money... Maybe they'll fnd a way to convince them to pay for screenings, etc.). In doing this, their profits will go down.

Now HERE is someone with zero understanding of the issue.

 

[dabigv13]

The problem isn't doctors payment. What's driving up costs isn't doctors fees, its the costs of expensive procedures and meds. All those MRI machines cost a pretty penny. And as patients paying a lot of money for private health insurance, you DEMAND access to them. And a GP is going to write off that procedure because he needs to cover his ass for malpractice.

Creating more doctors is not the problem, though creating more generalists would help. We DO need more nurses, but they're not exactly lining up for the jobs.

Free market economics do not apply to health care for several reasons. One, because the doctor is the one creating supply. He says you're sick and you need X, which costs $Y. You don't break your leg, and then shop around. Two, for those with insurance, the patient wants the most high-tech expensive care, because he isn't paying for it. He wants a Beta blocker, or an ACE inhibitor for his high blood pressure, when some plain old diuretics will do the trick just as well. This drives up the cost of insurance, and so the premiums become more and more out of reach for those who can't afford it.

Basically, there are a lot of problems with the health care system as it stands. Not enough doctors would be pretty low on my list though. And no, socialized medicine isn't necessarily the answer. People who cite our culture as being a big problem are right- people need to eat better and exercise more. But that applies to Canada and Germany just like it does here.

 

[Uncle_Tbag]

I see the issue of competetion and doctors advertising to bring in more income, I don't think that would be good for the system. That really only affects self-pay and elective procedures in more competetive markets.

Physicians and healthcare in general are suffering because of reductions in reimbursement. I don't think reducing reimbursement even further is the way to go, I think that's a recipe for disaster. Someone here said we should look at doctors now and how unhappy they are. Why are they unhappy? Long hours? Beligerant patients? Morning traffic? No, these are things most doctors come to peace with and accept as being part of the lifestyle. What pisses them off is seeing medicare slash payments by 30% in one year and watching private payers do the same.

I work in a very high tech clinic with some of the most advanced imaging equiptment in the state. The private owners of this clinic put their livelihoods on the line in order to provide an amazing service to a semi-rural community. If you want to see this type of excellence in care go away and be a thing of the past in the US, cut physician salaries and socialize medicine. THen we'll have a crappy system that we can celebrate because at least everyone will share equally in the crap.

 

[SailCrazy]

Supply and demand, my friends. If more doctors graduate from med schools, there will be more competition to get the limited number of sick patients in a community to come see them (be their customers) over other doctors (competitiors). Docs will have to do more marketing and slash prices to try and capture more of the market. (More docs will probably also be more willing to see lower income patients for less money... Maybe they'll fnd a way to convince them to pay for screenings, etc.). In doing this, their profits will go down. And then, they will need to decide whether its even worth it for them to go through all of the expensive and demanding schooling to get an MD degree to practice medicine. The people willing to work for less will probably keep going to med schools... while others will look for other job opportunities.

Now HERE is someone with zero understanding of the issue.

Suppuration, I hope that you're identifying yourself as the person with zero understanding, because there is an awful lot of truth to what SPB described.

Whether or not it is an appropriate solution, if the market were flooded with doctors, price would certainly be one of the factors physicians used to distinguish themselves from others. (Quality would likely be another.)

Part of the problem with the free market theory of supply and demand for physicians is that many/most assume that there is a minimal level of care that must be assured in providing medical care. If someone is an incompetent plumber and they screw up job after job it might be a big problem for their customers, but no one dies and sooner or later that plumber will end up out of business.

If you apply that same supply/demand logic to doctors the drawbacks are obvious.

 

[SailCrazy]

...For instance, the only way I would see more doctors going to rural areas is if there were more benefits and pay involved. But generally speaking, those in that kind of area, don't have that kind of money and there are not other incentives to make up for lack of money, causing that problem to exist...

Shredder's theory works too. If there are more doctors in the market, eventually urban areas will be saturated with physicians. If there are not enough patients in the cities, some of those who want to practice medicine will move to rural areas.

I highlighted some of the drawbacks to this theory above, but it does provide an alternate (if theoretical) answer to some of the questions raised.

 

[Suppuration]

Suppuration, I hope that you're identifying yourself as the person with zero understanding, because there is an awful lot of truth to what SPB described.

No, there isn't. The number of doctors in this country (per capita) has increased significantly over the last 25 years... have costs declined over this period? Are costs less in areas of the country with higher physician densities?

Here is an interesting tidbit about physician numbers and health care spending in New York, which has a high number of physicians per capita. An excerpt:

"The study also noted that growth in the supply of doctors has an effect on spending. Nationally, from 1980 to 2000, national spending on physician services rose 508 percent, the report noted."

Given that physician wages have been stagnant/declining for a long time, the absurd increases in healthcare costs cannot be blamed on us. Flooding the market with more doctors isn't going to accomplish anything, either. I'm sure the insurance companies would be thrilled because they could lowball the providers with even worse reimbursement rates. A massive increase in the number of doctors would drive most of them either 1. out of business, or 2. into veritable indentured servitude at the hands of the insurance companies.

No, the giant sucking sound is emanating from 1. more expensive technology (that, I might add, is often of questionable utility), and 2. the expansion of bureaucracy that has been brought on by for-profit healthcare. From 1970 to 1998 total healthcare employment in the US increased by 149%. During this same period the number of managers in healthcare increasesd by 2,438%. If you want to cut costs, why not eliminate the need for some of those jackoffs?

Have a nice day.

 

[gujuDoc]

Quietly walks away from this discussion.

Note: I might be wrong about my opinion above on the biggest problem with healthcare, but from my limited experience those were my two things that I came up with.

As someone so wisely said on here, a premed should not be expected to know the answer to a question that experts have struggled with determining over several years.

 

[Shredder]

Quietly walks away from this discussion.

Note: I might be wrong about my opinion above on the biggest problem with healthcare, but from my limited experience those were my two things that I came up with.

As someone so wisely said on here, a premed should not be expected to know the answer to a question that experts have struggled with determining over several years.

every premed is wrong, the idea is to stimulate discussion and test knowledge of current healthcare issues. screw suppuration, ive had him on ignore from day one