Medicare for all and physician salaries

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I listened to this guy on a certain Podcast. He seems to have put more thought into his position than most! (I actually downloaded the full text of his proposal months ago, but haven't read it in its entirety yet, because.... MS1)

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The link I posted is the summary of his plan - I'll admit to not reading his full 40-ish page proposal, but the I think the summary is a relatively easy read.

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Depending on your metric, it can explain a lot of them. And I'd wager I could find data that would explain almost any metric you care to bring up.

Let's look at basic facts. If you exclude violent deaths we have about the highest life expectancy in the world (or did 8 years ago).

We have the best cancer survival rates in the world.

When people talk about health care metrics its generally things like cardiac disease (directly related to both obesity and diabetes), surgical complications (directly related to both obesity and diabetes), maternity care (directly related to obesity and diabetes) and neonatal (that one is more related to pre-maturity which again is related to obesity and diabetes).

Much of what you say here is conjecture. I don’t disagree overall with the idea that obesity and the things that follow (diabetes, heart disease, etc) have major far reaching impacts, I do however find a problem with your less than fact based reasoning above. How about data to support your perspective?
 
I listened to this guy on a certain Podcast. He seems to have put more thought into his position than most! (I actually downloaded the full text of his proposal months ago, but haven't read it in its entirety yet, because.... MS1)

need moar like dis

See also this review of 49 studies. Conclusion: The single-payer system performs better in terms of healthcare equity, risk pooling and negotiation, whereas multipayer systems yield additional options to patients and are harder to be exploited by the government. A multipayer system also involves a higher administrative cost. The findings pertaining to the impact on efficiency and quality are rather tentative because of methodological limitations of available studies.
 
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Look what happened to Venezuela once socialism was implemented full force. That is the way these things head, slowly but surely. The difference in populations and politics will not matter once the hive mentality takes over, as it did in Russia, China, and other ethnically and socially diverse places.

You know what I can’t stand? Entitled, arrogant Americans who have never experienced the thing they want the United States to become, as I have. That is why I use examples from my life: I’ve f***ing lived it, and escaped it. These government-worshipping idiots would be the first ones on a boat out of here if it actually happened.

And the reason, as I have said before several times, why I do not say my home country is because there aren’t many female academic orthopedic trauma surgeons with my ethnicity out there. It is a privacy issue.

I hear you, but you’ve just proved my point even more. We’re not Venezuela we’re not these other countries you describe. I don’t disagree with your overall sentiment that socialism can be a scary thought, but your points of attack on “ive seen it, it’s terrible,” ring hollow. Attack based on substance. What are some of the alternatives you think would work better?
 
Much of what you say here is conjecture. I don’t disagree overall with the idea that obesity and the things that follow (diabetes, heart disease, etc) have major far reaching impacts, I do however find a problem with your less than fact based reasoning above. How about data to support your perspective?
Pick some specifics areas where we are not doing so well and I'll find it.

In the mean time, here are a few from areas that I mentioned:

Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. - PubMed - NCBI Obesity and surgical site infections risk in orthopedics: a meta-analysis. - PubMed - NCBI - Obesity increases SSI for abdominal and orthopedic surgery

Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research - Diabetes is a major cause of CV disease
 
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See also this review of 49 studies. Conclusion: The single-payer system performs better in terms of healthcare equity, risk pooling and negotiation, whereas multipayer systems yield additional options to patients and are harder to be exploited by the government. A multipayer system also involves a higher administrative cost. The findings pertaining to the impact on efficiency and quality are rather tentative because of methodological limitations of available studies.
This part seems important for some reason
 
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Yes, hence why I said SS is in trouble. I never said bankrupt, unfixable, or anything like that. Read better.

Finland is an interesting place, education wise. What Americans Keep Ignoring About Finland's School Success - The Atlantic

Interestingly the approach that Finland takes is much more aligned with what many of our private schools do, most notably the Montessori schools, but what our public schools are doing less and less of.

That's fine, but you were saying it was in trouble in a broader point about how public things don't work well by definition. I disagree with that implication and wanted to demonstrate how that is not absolutely the case. People always use SS as an example of how socialist things dont work and fail to discuss how easy it is to fix.

"You know what I can’t stand? Entitled, arrogant Americans who have never experienced the thing they want the United States to become, as I have. That is why I use examples from my life: I’ve f***ing lived it, and escaped it. These government-worshipping idiots would be the first ones on a boat out of here if it actually happened."

What's interesting to me is im not sure how many people on boats have tried to escape literally every european country. Maybe I missed those. Oh I forgot they are all basically like communist Vietnam. So thats what you're talking about. You got me! Socialism is evil and capitalism rules!!!!!!
 
I don’t disagree with your overall sentiment that socialism can be a scary thought, but your points of attack on “ive seen it, it’s terrible,” ring hollow. Attack based on substance.

Hollow?? It’s not “can be a scary thought,” don’t patronize us as if we’re children talking about the bogeyman. It IS a scary thought. In its final form, socialism has killed more people than any other ideology, and all of them combined. There is no greater “substance” than the experience of people who have actually lived with this system, who have had the government (instead of physicians) decide on their health, and have had close family members die as a result of it. I myself almost died from ecoli poisoning because we couldn’t bribe the hospital officials for antibiotics. I can’t put it any more forcefully than that. And if you think it cannot happen here because the United States is somehow different, you don’t really understand the poison of socialism. It will destroy a diverse and powerful country, it has in the past, and the United States is no exception.
 
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Pick some specifics areas where we are not doing so well and I'll find it.

In the mean time, here are a few from areas that I mentioned:

Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. - PubMed - NCBI Obesity and surgical site infections risk in orthopedics: a meta-analysis. - PubMed - NCBI - Obesity increases SSI for abdominal and orthopedic surgery

Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research - Diabetes is a major cause of CV disease

Infant and maternal mortality surrounding child birth. That’s more related to areas with poor access to care than direct result or even indirect result from dm2 and obesity
 
That's fine, but you were saying it was in trouble in a broader point about how public things don't work well by definition. I disagree with that implication and wanted to demonstrate how that is not absolutely the case. People always use SS as an example of how socialist things dont work and fail to discuss how easy it is to fix.

"You know what I can’t stand? Entitled, arrogant Americans who have never experienced the thing they want the United States to become, as I have. That is why I use examples from my life: I’ve f***ing lived it, and escaped it. These government-worshipping idiots would be the first ones on a boat out of here if it actually happened."

What's interesting to me is im not sure how many people on boats have tried to escape literally every european country. Maybe I missed those. Oh I forgot they are all basically like communist Vietnam. So thats what you're talking about. You got me! Socialism is evil and capitalism rules!!!!!!
I was saying no such thing. You should try reading what the words say and not what you think they say.

My concerns about increasing the government's (our government specifically) control over anything is based on a history of them doing it poorly.

Let's take public education for the moment. We currently spend more than almost anyone else in the world on a per student basis: The Condition of Education - International Comparisons - Finances - Education Expenditures by Country - Indicator May (2018) yet our middling outcomes at best. We've known that our schools were not doing as well as they should be for quite some time now. The solutions have been either more of the same (more testing, more teaching to the tests, more homework) or new but awful ideas (No Child Left Behind). In the 20 years I've been paying attention, nothing new, innovative, or actually worthwhile has been done in public education in the US. Why is that?
 
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Hollow?? It’s not “can be a scary thought,” don’t patronize us as if we’re children talking about the bogeyman. It IS a scary thought. In its final form, socialism has killed more people than any other ideology, and all of them combined. There is no greater “substance” than the experience of people who have actually lived with this system, who have had the government (instead of physicians) decide on their health, and have had close family members die as a result of it. I myself almost died from ecoli poisoning because we couldn’t bribe the hospital officials for antibiotics. I can’t put it any more forcefully than that.

You’re responding to what you want to respond to. I’m saying attack the health care plans (could’ve been more clear) because you were making general statements about how bad socialism is. Well then, we can agree there, but as far as health care proposals, let’s have a substantive debate. You’ve offered 0 alternative to what’s being proposed, and given your background I’d be curious how you would recommend we improve our health care system
 
I hear you, but you’ve just proved my point even more. We’re not Venezuela we’re not these other countries you describe. I don’t disagree with your overall sentiment that socialism can be a scary thought, but your points of attack on “ive seen it, it’s terrible,” ring hollow. Attack based on substance. What are some of the alternatives you think would work better?

Also, it's a little disingenuous to equate communist eastern Europe or China to socializing medicine. There are plenty (a majority, even) of democratic capitalist or democratic socialist countries with universal healthcare schemes that are just fine. Pointing at any country in a vacuum and saying, "look, they are communist and healthcare sucks there" is simplifying to an absurd degree and completely ignores the social/political/economic dimensions of life.

Further, just by looking at popular and effective socialist politicians across the world it should be readily apparent that the (western) socialist movement has learned from the failed experiments of the 20th century. We know through history that massive, top-down government administration across all spheres of economy leads to horrible political and human rights abuses. That is indisputable. Modern socialist politicians (Jeremy Corbyn, for one) are instead taking a bottom-up approach, e.g. worker ownership of enterprise. I don't think anyone in this thread disagrees with the notion that doctors should be the ones administering healthcare.

The problem is trying to come up with half-baked solutions like public-private partnerships or means-testing that combine the worst of both worlds in some kind of Frankenstein-esque monster of bureaucracy. Any system that maintains private insurance as the majority provider of coverage and supplements it with some kind of means-tested catastrophic medicare coverage is doomed to generate a byzantine morass of red-tape and bureaucracy.
 
Also, it's a little disingenuous to equate communist eastern Europe or China to socializing medicine. There are plenty (a majority, even) of democratic capitalist or democratic socialist countries with universal healthcare schemes that are just fine. Pointing at any country in a vacuum and saying, "look, they are communist and healthcare sucks there" is simplifying to an absurd degree and completely ignores the social/political/economic dimensions of life.

Further, just by looking at popular and effective socialist politicians across the world it should be readily apparent that the (western) socialist movement has learned from the failed experiments of the 20th century. We know through history that massive, top-down government administration across all spheres of economy leads to horrible political and human rights abuses. That is indisputable. Modern socialist politicians (Jeremy Corbyn, for one) are instead taking a bottom-up approach, e.g. worker ownership of enterprise. I don't think anyone in this thread disagrees with the notion that doctors should be the ones administering healthcare.

The problem is trying to come up with half-baked solutions like public-private partnerships or means-testing that combine the worst of both worlds in some kind of Frankenstein-esque monster of bureaucracy. Any system that maintains private insurance as the majority provider of coverage and supplements it with some kind of means-tested catastrophic medicare coverage is doomed to generate a byzantine morass of red-tape and bureaucracy.

I hear you. But I also believe there is a system that could work that isn’t what we have now and isn’t single payer only. We have some extremely intelligent health care policy makers that can and have been involved and I’d be optimistic after having the experience of aca that they could do better
 
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That's fine, but you were saying it was in trouble in a broader point about how public things don't work well by definition. I disagree with that implication and wanted to demonstrate how that is not absolutely the case. People always use SS as an example of how socialist things dont work and fail to discuss how easy it is to fix.

"You know what I can’t stand? Entitled, arrogant Americans who have never experienced the thing they want the United States to become, as I have. That is why I use examples from my life: I’ve f***ing lived it, and escaped it. These government-worshipping idiots would be the first ones on a boat out of here if it actually happened."

What's interesting to me is im not sure how many people on boats have tried to escape literally every european country. Maybe I missed those. Oh I forgot they are all basically like communist Vietnam. So thats what you're talking about. You got me! Socialism is evil and capitalism rules!!!!!!

America subsidizes most other nation's pharmaceuticals, and sometimes medical devices:

US drug prices higher than in the rest of the world, here's why

So that's yet another reason why your baseless comparisons fall short.

Other nations spend less on peacekeeping and pharma because Americans are subsidizing it.
 
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Medicare is legally not allowed to negotiate with pharmaceutical companies. That's why we spend so much here. It's pretty simple. To assume that, if pharmaceutical and device manufacturers could not get the insane prices they do here, they would charge more overseas, is insane. Thats not how capitalism works. You charge as much as the market will pay. They won't pay it in other countries, so they don't. We do pay it here, so we do.

To assume that pharmaceutical and device manufacturers purposefully make less in other countries because they're making "enough" here like its sum zero-sum game is to completely misunderstand the workings of capitalism.

Furthermore, other nations spend less on peace keeping because they are less interested in being a world superpower and are not as corrupt as we are here in the US, with the military-industrial complex whose best interest is to take government dollars and pour it into B-52s that sit there unused.
 
Medicare is legally not allowed to negotiate with pharmaceutical companies. That's why we spend so much here. It's pretty simple. To assume that, if pharmaceutical and device manufacturers could not get the insane prices they do here, they would charge more overseas, is insane. Thats not how capitalism works. You charge as much as the market will pay. They won't pay it in other countries, so they don't. We do pay it here, so we do.

To assume that pharmaceutical and device manufacturers purposefully make less in other countries because they're making "enough" here like its sum zero-sum game is to completely misunderstand the workings of capitalism.

Furthermore, other nations spend less on peace keeping because they are less interested in being a world superpower and are not as corrupt as we are here in the US, with the military-industrial complex whose best interest is to take government dollars and pour it into B-52s that sit there unused.

So your argument is that if we contractually force pharma to lower prices here, they are just going to take a hit to their bottom line?

They aren't going to ramp up prices in other markets or reduce overhead (aka not find the next big cure)?

I think you're the one who doesn't understand how capitalism works.
 
Infant and maternal mortality surrounding child birth. That’s more related to areas with poor access to care than direct result or even indirect result from dm2 and obesity
Yes, and no. I'm going to focus on infant mortality mainly.

Why Is Infant Mortality Higher in the United States Than in Europe?

Basically in the first month after delivery we're about the same as everyone else. Its months 1-12 that skews the numbers (it really should be separated out to neonatal mortality and infant mortality). The infant mortality is a combination of higher SIDS rates and higher abuse rates more than anything. You remove those and the numbers are much closer.

For maternal mortality we really don't know why at the moment. Lots of theories, very little data that I can find just yet (since this was really only noticed as a major problem within the last handful of years).
 
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So your argument is that if we contractually force pharma to lower prices here, they are just going to take a hit to their bottom line?

They aren't going to ramp up prices in other markets or reduce overhead (aka not find the next big cure)?

I think you're the one who doesn't understand how capitalism works.

My argument is that if you allow negotiations, the buyer will get a better price. Yes, they will take a hit on their bottom line, but they will have no choice because we are a huge market here.

My question for you is why you think that pharmaceutical companies currently have the opportunity to profit more overseas, but choose not to because they think they are making "enough" off of the United States. How does that make any sense? If they could raise prices overseas they would. Even the article you cited said the same thing.

"Perhaps the most common explanation for why drug prices are high in the U.S. is what economists call “free riding.” The argument goes like this: because the U.S. is willing to pay higher prices for drugs, other countries don’t feel the ‘need’ to do so and therefore don’t.

This explanation is overly simplistic and misses the two key economic issues at stake.

First, pharmaceutical companies are concerned with global profits, not the profits from any single country."
 
My question for you is why you think that pharmaceutical companies currently have the opportunity to profit more overseas, but choose not to because they think they are making "enough" off of the United States. How does that make any sense? If they could raise prices overseas they would. Even the article you cited said the same thing.

You've gotta' read the rest of the article, hombre.

You are correct that if they could raise the prices overseas they would. Part of this is due to contracts like the NHS, and part of it is that some countries simply cannot pay more.

Because in the US we don't have those contracts, they recoup more profit margin here. If that goes away and the profits here dry up, what do you think is going to happen?

My argument is that if you allow negotiations, the buyer will get a better price. Yes, they will take a hit on their bottom line, but they will have no choice because we are a huge market here.

Now you're arguing for full-blown capitalism sans government interference. I don't think this is the argument you want to use. :rofl:
 
Yeah, part of the reason they pay less overseas is because the government contracts (negotiates)??? That’s what I’m saying we should do here! You’re proving my point for me.

I think that when we pay the same prices other countries do, there will be less profits, and as a result American healthcare spending will go down.

And yes, capitalism can work very well and efficiently in many contexts. Which is why I’m confused you don’t agree that we should allow for negotiations. Imagine you are no longer allowed to negotiate for things you purchase. Is that capitalism? No, it’s insane.
 
Yeah, part of the reason they pay less overseas is because the government contracts (negotiates)??? That’s what I’m saying we should do here! You’re proving my point for me.

I think that when we pay the same prices other countries do, there will be less profits, and as a result American healthcare spending will go down.

And yes, capitalism can work very well and efficiently in many contexts. Which is why I’m confused you don’t agree that we should allow for negotiations. Imagine you are no longer allowed to negotiate for things you purchase. Is that capitalism? No, it’s insane.
Yeah pretty much everyone I've talked to is OK with letting Medicare negotiate for drugs. I didn't realize this was still an issue.
 
I think that when we pay the same prices other countries do, there will be less profits, and as a result American healthcare spending will go down.

I think we agree that price negotiation would decrease the amount CMS pays.
I don't think that "there will be less profits" though.

Megacorporations who own politicians don't just shrug and accept assaults against their bottom line.

Overall I think we agree though: Allow competition to drive prices down on drugs.
 
Yeah I think that there is a lot of agreement.

I also agree re: politicians. But I think that the main issue is a politician who actually says we should let Medicare negotiate and believes it. So the profits will go down if negotiation is allowed. So the main issue is how does a person who believes that manage to make it into power in spite of corporate interests otherwise.
 
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Not every issue with our outcomes can be attributed to higher obesity, higher car wrecks, and higher diabetes. To extrapolate that those things explain it all is ridiculous.

Yes, pretty much every issue.
 
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Yeah I think that there is a lot of agreement.

I also agree re: politicians. But I think that the main issue is a politician who actually says we should let Medicare negotiate and believes it. So the profits will go down if negotiation is allowed. So the main issue is how does a person who believes that manage to make it into power in spite of corporate interests otherwise.

Kind of a sidebar, but utilizing a (free) social media presence to encourage voters is now a thing. Sanders and AOC have capitalized on young voter turnout who follow them on twitter and facebook, and it's no longer something that gets laughed off.

Please note, I'm not a fan of AOC, but it is important that someone with little political capital was able to make it that far. We need physicians in her generation to pick up the helm and go into the public sector helping to make good decisions.

Like workable, reasonable healthcare reform.
 
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Kind of a sidebar, but utilizing a (free) social media presence to encourage voters is now a thing. Sanders and AOC have capitalized on young voter turnout who follow them on twitter and facebook, and it's no longer something that gets laughed off.

Please note, I'm not a fan of AOC, but it is important that someone with little political capital was able to make it that far. We need physicians in her generation to pick up the helm and go into the public sector helping to make good decisions.

Like workable, reasonable healthcare reform.

As stated before...there will be a generational shift. The next group of politicians will be millennials that have been broken by:

1) Outrageous healthcare premiums. Maybe they had 1 or 2 friends/friends of family/family that went bankrupt and or died due to the costs of healthcare.

2) No homes because of inflation, stagnant wages, and cost of living increases. The boomers however have 2-3 houses condos whatever...because back then it was cheaper. Now? Good luck trying to do a 8-5 minimum wage job and affording anything.

3) Paid SS/Pension plans that are slowly getting scrapped for IC and 401k plans that an employer MAY offer.

4) Outrageous college tuition costs

Basically the baby boomers didn't really have to experience stagnant wages with rising cost of living, healthcare premiums, a non paid SS/pension, college tuition. But guess who has experienced all this? The millieniels have experienced all this.

Right now, we are still playing by the boomer's rules...which is fine for me. I'm a high earner and can afford luxuries. I have a house, a practice, a fully vested 401k, I work 4 days a week and go on 5 weeks vacation...that's great.

But the next generation will want to change this. They have seen how healthcare has destroyed the system of America here. There will be more Ocasio Cortez who will push for universal healthcare. There will be more taxes on the rich in order to balance the budget and make homes or whatever more affordable. Who knows what our generation will come up with...but I see a future Europe type of economy.

What that means for you is that doctors like you will most likely have their wages cut in half, work 10x as hard, still be targeted by the media/social media for being "rich old doctors," and deal with 10x more entitled people. So save and work hard while the money capitalism still reigns.

A good example of this divide is the state of the union. Go watch it.
 
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As stated before...there will be a generational shift. The next group of politicians will be millennials that have been broken by:

1) Outrageous healthcare premiums. Maybe they had 1 or 2 friends/friends of family/family that went bankrupt and or died due to the costs of healthcare.

2) No homes because of inflation, stagnant wages, and cost of living increases. The boomers however have 2-3 houses condos whatever...because back then it was cheaper. Now? Good luck trying to do a 8-5 minimum wage job and affording anything.

3) Paid SS/Pension plans that are slowly getting scrapped for IC and 401k plans that an employer MAY offer.

4) Outrageous college tuition costs

Basically the baby boomers have rigged the system that has screwed the next generation. They didn't really have to experience stagnant wages with rising cost of living, healthcare premiums, a non paid SS/pension, college tuition. But guess who has experienced all this? The millieniels have experienced all this.

Right now, we are still playing by the boomer's rules...which is fine for me. I'm a high earner and can afford luxuries. I have a house, a practice, a fully vested 401k, I work 4 days a week and go on 5 weeks vacation...that's great.

But the next generation will want to change this. They have seen how healthcare has destroyed the system of America here. There will be more Ocasio Cortez who will push for universal healthcare. There will be more taxes on the rich in order to balance the budget and make homes or whatever more affordable. Who knows what our generation will come up with...but I see a future Europe type of economy.

What that means for you is that doctors like you will most likely have their wages cut in half, work 10x as hard, still be targeted by the media/social media for being "rich old doctors," and deal with 10x more entitled people. So save and work hard while the money capitalism still reigns.
This just shows the problem with a democracy when compared to a constitutional republic, if you have no skill to ply there should be zero expectation that you can buy a home and pay for 4 people. Get a skill

The mob voting themselves into everyone else’s pocket is dangerous
 
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Exactly. In the hospital and ambulance example… There won’t be any ambulances. My father returned to our home country recently. The same dilapidated building he grew up in looks exactly the same nearly 50 years later. The elevator has not run for 20 years, the front hall is partially collapsed… And people still live there. And scavenge trash from the nearby landfill. Yay socialism!

I am sure the political elite though are living in complete luxury. Yet the poor get to live in dilapidated buildings that technically provide shelter.

But it’s free!

This is the natural end result of socialism. Socialism rewards the rich and punishes the poor while proudly proclaiming the exact opposite. When the state controls the media, it’s a lot easier to get away with that lie.
 
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Social security is not bankrupt. It can pay out benefits until 2034 at which point it can pay 75% of benefits. And regardless, it is very easy to make completely solvent, but you have one party whose goal is to cut it to the bone.

Issue with the police force is violence against some groups of people, but overall we are protected.

Army is inefficient, but we are still protected.

Public school system has given hundreds of millions a fair shot at the American dream. You think a fully private system is better?

Overall, there are issues with publicly funded things of course, but they are much better than the alternatives. Yet again, you provide no one provides any statistics or data to back up their arguments.

Public schools provide a bare minimal level of education just barely not qualifying as child abuse. It effectively ends up being state sponsored daycare keeping your children alive while you go to work.
 
Also you stated the insured rates reversed and are nearing pre ACA levels. Really? It’s super easy to find that data. It’s closer to the nadir than the peak uninsured levels. Slightly disengious if you. Would say a more factual statement would be that they’ve ticked up since legislation revealed individual mandate AND specific actions have been taken to weaken the aca as above

Wrong.

Uninsured rates have reversed and are climbing back to the peak.

Trump’s policies have nothing to do with insurers deciding years ago that the ACA’s terms were untenable financially and backing out of the marketplace.

The individual mandate was still in effect as of a month ago.

It is disingenuous to suggest that there isn’t something else going on.

The individual mandate was unconstitutional regardless of the effect it had.
 
Wrong.

Uninsured rates have reversed and are climbing back to the peak.

Trump’s policies have nothing to do with insurers deciding years ago that the ACA’s terms were untenable financially and backing out of the marketplace.

The individual mandate was still in effect as of a month ago.

It is disingenuous to suggest that there isn’t something else going on.

The individual mandate was unconstitutional regardless of the effect it had.

Did you read the website you included as your evidence? I guess not
 
You keep implying that care in these countries is worse. If the United States is so great, why don’t we have the best healthcare outcomes? These countries, whose physicians you’re comparing to high school dropouts, have healthcare systems that are better ranked than ours.

The truly silly thing is your opinion which isn’t based in facts at all, but feelings.

Equally funny is OrthoMds anecdotes about growing up in Yugoslavia or something and implying it’s the same as literally every other country with universal healthcare, and the US if we joined them.

We do have the best outcomes, by far. Are we efficient in getting these outcomes? Not even close. But at least we have them.

And that’s the second out-of-nowhere jab at ortho’s ethnicity as an argument to discount her experiences in this thread. Leftists showing their true colors.
 
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I did! Even! Please show me evidence that uninsured rates are not rising.

I was talking about the absolute numbers (peak around 19% drop to 12.7 up to 15.5 now. Closer to nadir than peak). Also in regards to the reasons why the authors believe the uninsured rates are rising again. You have every right to your own opinion, but I myself will side with the non partisan data than your partisan analysis
 
I was talking about the absolute numbers (peak around 19% drop to 12.7 up to 15.5 now. Closer to nadir than peak). Also in regards to the reasons why the authors believe the uninsured rates are rising again. You have every right to your own opinion, but I myself will side with the non partisan data than your partisan analysis

Hats off to you, sir.

I asked you to show me evidence that uninsured rates were not rising and you provided numbers showing an increase from 12.7 to 15.5. True enough, 15.5 is closer to 12.7 than to 19.0. Nothing else to see here!

So what’s the most recent number?

As an aside, I am a strong proponent of calculus being a prerequisite for medical school admission. Rates of change, inflection points, and all that...
 
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Does anyone practice medicine because it is their calling, their vocation, the thing they see themselves doing, and cant think of doing anything else, until they die, not 60, 65, or 75, but until they drop dead?

get to know Dr Michael DeBakey and Dr Denton Cooley, both renowned surgeons who literally worked until the day before they died in their 90s

Michael DeBakey - Wikipedia

https://www.chron.com/news/health/a...renowed-heart-surgeon-dead-at-96-10622963.php

Have you lost your vision for who you are, why you were created and your role in the grand scheme of things, regardless of income bracket?

We are physicians, not celebrities. We are supposed to have a soul and do the caring and healing that no one else can do. There is a recompense for that. It is called satisfaction.
“We” aren’t physicians. You haven’t applied yet

When you are farther down the road, you will have some more context
 
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Have you lost your vision for who you are, why you were created and your role in the grand scheme of things, regardless of income bracket?

We are physicians, not celebrities. We are supposed to have a soul and do the caring and healing that no one else can do. There is a recompense for that. It is called satisfaction.

No one goes into medicine solely for the satisfaction of seeing patients do well in bad situations. Let's not pretend that everyone in a white coat is Mother Teresa.

Every medical student has made the gamble that his post-training salary will be high enough to pay off hundreds of thousands of dollars in student loans which can't be discharged in bankruptcy.

You are arguing that physicians should be okay with being, essentially, indentured to the government for the privilege of practicing medicine.

I, like many others in this thread, did not go into medicine to become rich. That said, I have no desire to let the government legislate my salary.
 
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No one goes into medicine solely for the satisfaction of seeing patients do well in bad situations. Let's not pretend that everyone in a white coat is Mother Teresa.

I'd hope that few of us are as monstrous as mother Teresa.
 
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Does anyone practice medicine because it is their calling, their vocation, the thing they see themselves doing, and cant think of doing anything else, until they die, not 60, 65, or 75, but until they drop dead?

get to know Dr Michael DeBakey and Dr Denton Cooley, both renowned surgeons who literally worked until the day before they died in their 90s

Michael DeBakey - Wikipedia

https://www.chron.com/news/health/a...renowed-heart-surgeon-dead-at-96-10622963.php

Have you lost your vision for who you are, why you were created and your role in the grand scheme of things, regardless of income bracket?

We are physicians, not celebrities. We are supposed to have a soul and do the caring and healing that no one else can do. There is a recompense for that. It is called satisfaction.

Some would find it offensive for you to come preaching, implying that we are in medicine to become "celebrities."

It is reductionist to believe that we cannot enter a medical career in order to help people AND expect to have a decent quality of life at the same time.

When Denton Cooley went to medical school, tuition was $200 at Penn Med.
Tuition and Mandated Fees, Room and Board, and Other Educational Costs at Penn | University Archives and Records Center
 
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Raise a family, have a successful marriage of 30+ years, send your kids off to college and have 25+ years in the profession of medicine as a clinician, then talk to me about context of life.

This is why my senior pre-professional health advisor at my state university suggested not joining SDN. She told me it was toxic, combative, high on subjectivity and she advises her pre-meds not to come here.

Note to @Lee ....if you want your forum to grow and be healthy, make sure your “prolific” members model the type of behavior you need to attract new members.



A few surgeons on my team stoop down on the dirty floor to pick up bone chips, push a dirty mop to help turn over a room and pray with their patients prior to surgery. There are a few monstrous Mother Teresa physicians and not a few volunteer at the local indigent clinic helping immigrants, the poor, the hopeless and HIV patients gratis. They exist. They are an inspiration

Cheers
What did you expect to happen when one of your first posts was trying to shame all of us?
 
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A few surgeons on my team stoop down on the dirty floor to pick up bone chips, push a dirty mop to help turn over a room and pray with their patients prior to surgery. There are a few monstrous Mother Teresa physicians and not a few volunteer at the local indigent clinic helping immigrants, the poor, the hopeless and HIV patients gratis. They exist. They are an inspiration

They'd have a lot more common with that "saint," it they started taking pharma buy offs and refused to give their patients any pain management... or treatment while they fleeced the patients down.
 
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Raise a family, have a successful marriage of 30+ years, send your kids off to college and have 25+ years in the profession of medicine as a clinician, then talk to me about context of life.

This is why my senior pre-professional health advisor at my state university suggested not joining SDN. She told me it was toxic, combative, high on subjectivity and she advises her pre-meds not to come here.

Note to @Lee ....if you want your forum to grow and be healthy, make sure your “prolific” members model the type of behavior you need to attract new members.
You aren’t the only old one here

Your prior post is the stereotype for the wide eyed young premed who has no concept about the effort, economics, and motivations of physicians. Working near doctors for a long time doesn’t relay that information either. Again, when you get farther along I think you will have some more context. No hard feelings, you just don’t know how much you don’t know
 
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Does anyone practice medicine because it is their calling, their vocation, the thing they see themselves doing, and cant think of doing anything else, until they die, not 60, 65, or 75, but until they drop dead?

get to know Dr Michael DeBakey and Dr Denton Cooley, both renowned surgeons who literally worked until the day before they died in their 90s

Michael DeBakey - Wikipedia

https://www.chron.com/news/health/a...renowed-heart-surgeon-dead-at-96-10622963.php

Have you lost your vision for who you are, why you were created and your role in the grand scheme of things, regardless of income bracket?

We are physicians, not celebrities. We are supposed to have a soul and do the caring and healing that no one else can do. There is a recompense for that. It is called satisfaction.


No I absolutely would not have considered it if I couldn’t make a good living at it. Forget it. Life is too short to spend it struggling financially. If medicine all of a sudden paid 100k/year, I’d go find a better paying job.

That said, I really enjoy the work. I would enjoy it a lot less if I had to worry about how I’m going to pay my bills.
 
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Does anyone practice medicine because it is their calling, their vocation, the thing they see themselves doing, and cant think of doing anything else, until they die, not 60, 65, or 75, but until they drop dead?

get to know Dr Michael DeBakey and Dr Denton Cooley, both renowned surgeons who literally worked until the day before they died in their 90s

Michael DeBakey - Wikipedia

https://www.chron.com/news/health/a...renowed-heart-surgeon-dead-at-96-10622963.php

Have you lost your vision for who you are, why you were created and your role in the grand scheme of things, regardless of income bracket?

We are physicians, not celebrities. We are supposed to have a soul and do the caring and healing that no one else can do. There is a recompense for that. It is called satisfaction.

Give me a break.
 
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Back on topic, I’d love to hear workable solutions to these problems. I have some solid local politicians who are surprisingly open to communication with constituents (aka I chat with my reps on social media regularly), and it would be great if I could present better options that are well-articulated.

Like I said, it’s easy to point out problems, harder to propose workable solutions.
 
Back on topic, I’d love to hear workable solutions to these problems. I have some solid local politicians who are surprisingly open to communication with constituents (aka I chat with my reps on social media regularly), and it would be great if I could present better options that are well-articulated.

Like I said, it’s easy to point out problems, harder to propose workable solutions.
Do you mean “workable” as in appropriate? Or “workable” as in would pass and still get someone elected?
 
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All proposals that I have seen / heard combine some mechanism for central funding with cost reductions. Usually the argument goes:

We want to ensure that everyone has health care paid for.
Other countries do this at lower cost, so there must be some way for us to do so.
Creating a single payer system will generate cost savings, because less bureaucracy.
We also have lots of waste/fraud/abuse in our system which can be cut.
Better early healthcare is cost saving in the long run.
The costs of most medical services is too high, and can be reduced.
Combining these four (bureaucracy, waste, early care, and overall decreased costs), we save enough money to pay for everyone.

Whether this is actually true is unclear. First, cutting "waste" or "bureaucracy" sounds like a good idea, but remember that any cut in healthcare spending is reducing someone's income somewhere. Perhaps it's not your income, so you don't care. But that person will care. Much like the coal industry collapsing.

Decreasing costs is similar. If MRI costs decrease from $1000 to $350 (I made those numbers up), that loss of revenue has to come from somewhere.

No matter what we do, any change will create winners and losers. This is always true. Hence it's hard to say whether any plan is "good" or "workable", it will totally depend upon where in the healthcare system you are.
 
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There are two plans that, whether you agree with them or not, are at least published out there with enough detail to be worth discussing.

Bernie Sander's Medicare for all: Medicare for All: Leaving No One Behind - Bernie Sanders
Ryan Newhofel's PHA's:

Sanders plan is the all-in Medicare for all. Private insurance could still exist, but everyone would still pay in to the new Medicare (so only the very wealthy could afford private insurance). His plan is somewhat vague on details -- he states that all co-insurance, deductibles, and donut holes would go away and medicare would pay for everything. As far as I can see in his plan, there would be no out of pocket costs for anyone. He states, with no plan how, that this would somehow cost less than current Medicare. I don't see how this is possible, other than large payment cuts.

Newhofel's plan is interesting. He advocates for forcing everyone to save a least $2000 per year in a PHA -- those who were poor would have it funded by the gvernment, those more wealthy would fund personally / employer sharing. Then, all first-dollar costs come from your PHA. He would then add a medicare-for-catastrophic-for-all on top of this -- if your PHA runs out of money or your costs are high enough, it kicks in. There's also a deductible that's also means tested. The idea with this plan is to allow patients to shop around -- instead of medicare setting prices, individual physicians could charge whatever they wanted (theoretically). Ultimately medicare would need to decide how much they pay for any event (for those that have medicare kick in), that will still drive prices it seems. He also wants to renegotiate how specialty care is paid for (i.e. he wants to decrease payment). He's very vague on how much this will all cost, guesses that a 7% medicare tax would pay for it (unclear if this would also pay for funding all the PHA's). But he does have a nice section where he shows you who the winners and losers are likely to fall, and it does allow for some market competition because people will be saving their own money to spend. And this plan is likely to make everyone unhappy -- which actually IMHO is a good sign.
 
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There are two plans that, whether you agree with them or not, are at least published out there with enough detail to be worth discussing.

Bernie Sander's Medicare for all: Medicare for All: Leaving No One Behind - Bernie Sanders
Ryan Newhofel's PHA's:

Sanders plan is the all-in Medicare for all. Private insurance could still exist, but everyone would still pay in to the new Medicare (so only the very wealthy could afford private insurance). His plan is somewhat vague on details -- he states that all co-insurance, deductibles, and donut holes would go away and medicare would pay for everything. As far as I can see in his plan, there would be no out of pocket costs for anyone. He states, with no plan how, that this would somehow cost less than current Medicare. I don't see how this is possible, other than large payment cuts.

Newhofel's plan is interesting. He advocates for forcing everyone to save a least $2000 per year in a PHA -- those who were poor would have it funded by the gvernment, those more wealthy would fund personally / employer sharing. Then, all first-dollar costs come from your PHA. He would then add a medicare-for-catastrophic-for-all on top of this -- if your PHA runs out of money or your costs are high enough, it kicks in. There's also a deductible that's also means tested. The idea with this plan is to allow patients to shop around -- instead of medicare setting prices, individual physicians could charge whatever they wanted (theoretically). Ultimately medicare would need to decide how much they pay for any event (for those that have medicare kick in), that will still drive prices it seems. He also wants to renegotiate how specialty care is paid for (i.e. he wants to decrease payment). He's very vague on how much this will all cost, guesses that a 7% medicare tax would pay for it (unclear if this would also pay for funding all the PHA's). But he does have a nice section where he shows you who the winners and losers are likely to fall, and it does allow for some market competition because people will be saving their own money to spend. And this plan is likely to make everyone unhappy -- which actually IMHO is a good sign.

I posted Neuhofel's plan several days ago, are you doing this on purpose???

Kidding of course, I'm just happy that someone outside of the DPC community has actually read and is familiar with his plan.
 
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