Political agends in med school

[Reecit]

The school I attend has a unique, mandatory, 0 credit class that does not appear on our transcripts. While this class is held under the guise of 'health policy', the only thing we learn about is how terrible America's health care system is and why every other country's system is better than ours. The professor spends any time we have discounting 'myths', and students' questions, about the health care legislation (and singing its praises now that it has passed). Regardless of their political position on health care reform, many of my classmates feel like this course does not belong in our medical education, especially since it isn't an elective.

Does anyone else have a course like this at their school?

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[xanthomondo]

The school I attend has a unique, mandatory, 0 credit class that does not appear on our transcripts. While this class is held under the guise of 'health policy', the only thing we learn about is how terrible America's health care system is and why every other country's system is better than ours. The professor spends any time we have discounting 'myths', and students' questions, about the health care legislation (and singing its praises now that it has passed). Regardless of their political position on health care reform, many of my classmates feel like this course does not belong in our medical education, especially since it isn't an elective.

Does anyone else have a course like this at their school?

I'm guessing most schools have a health care policy course. The amount of political charge in the course is probably course-director specific, though. I've noticed a very liberal slant coming through most lectures though, not just from a single course.

 

[njbmd]

The school I attend has a unique, mandatory, 0 credit class that does not appear on our transcripts. While this class is held under the guise of 'health policy', the only thing we learn about is how terrible America's health care system is and why every other country's system is better than ours. The professor spends any time we have discounting 'myths', and students' questions, about the health care legislation (and singing its praises now that it has passed). Regardless of their political position on health care reform, many of my classmates feel like this course does not belong in our medical education, especially since it isn't an elective.

Does anyone else have a course like this at their school?

You and your classmates can either do something quietly during that class (not participate) while you petition your administration to make the course an elective or complain. If you feel the class is not worth your time or is taking away from your study time for other subjects, then present your reasons in a petition with objective statements (not liking the politics of the presentors is not objective) and present ways to make the course more useful and informative.

If you disagree with a political agenda, then disagree and give reasons why you disagree backed up with information from peer-reviewed journals. Any "political" issues are open to debate and opinion in a civilized manner. Utilize this class to put forth your opinions in an informative manner which might make the class more informative and useful to you in the long run.

 

[mordounhas]

My classmates were up in arms about having a 3-hour lecture on health care reform during a test week, I can't imagine something like this would sit well at all. I can't speak for every school, but we don't have any kind of organized health care policy class at Ohio State.

 

[MilkmanAl]

While this class is held under the guise of 'health policy', the only thing we learn about is how terrible America's health care system is and why every other country's system is better than ours.

Just to play devil's advocate for a second, have you stopped to consider that maybe they are better than ours in many ways? Based on the rest of your post, it sounds like this professor is certainly a bit biased, but I thought I'd throw out some food for thought. I don't know enough about other countries' health plans to make a call either way.

That aside, I'd go with njbmd said. A useful complaint will take you a decent amount of time to put together, so you'll have to decide whether or not it's worth your effort. If attendance is required, you could always sign in and leave like...some people here might do.

 

[FutureDoc4]

Just to play devil's advocate for a second, have you stopped to consider that maybe they are better than ours in many ways? Based on the rest of your post, it sounds like this professor is certainly a bit biased, but I thought I'd throw out some food for thought. I don't know enough about other countries' health plans to make a call either way.

That aside, I'd go with njbmd said. A useful complaint will take you a decent amount of time to put together, so you'll have to decide whether or not it's worth your effort. If attendance is required, you could always sign in and leave like...some people here might do.

While I agree that our healthcare system has numerous problems, these type of lecturers spew out the SAME information, we have heard a 1000x (unless you are completely uneducated about the US healthcare system and/or live under a rock)

It's not like you go and hear something new. I can sum up all of these lectures in the following outline:

a) US is one of the only modern countries without a national healthcare system

b) People don't think we have government run healthcare but we do (Medicare/VA)

c) Look at our awful infant mortality rate

d) Canada is awesome

e) Look at our life expectancy compared to other countries.

f) England is awesome

End of talk.

They never delve into...well, what happens when we control for homicide and motor vehicle accidents to mortality rates. How does the diversity of the United States and our very board range of socioeconomic classes and distribution of resources effect our outcomes.

No one has a frank discussion what the numbers really mean.

All in all. All they say is US=Bad healthcare. I honestly, there is some truth in things we could do better. But, I am tired of hearing this "speech" already and don't buy into at least some of the spin people put on this healthcare debate.

 

[MilkmanAl]

While I agree that our healthcare system has numerous problems, these type of lecturers spew out the SAME information, we have heard a 1000x (unless you are completely uneducated about the US healthcare system and/or live under a rock)

That's been my experience, too, but most of them have left out c, d, and f or at least not talked about them in any depth. There was actually a really good health care reform talk at the national AMA meeting this summer. It's the first time I ever came out feeling like I'd learned something.

 

[ParamedicMan]

I guess my school is a bit of an anomaly, but our school is VERY conservative, with a obvious slant towards the right. Our state-funded school is also very religious. A recent lecturer was the Rev. XXX talking about "Satan: Who He is and What He Does. " (Not joking, wish I was).
We also have a health policy course, but ours highlights the evils of the new health care policy, as well as the evils of many social policies, to the point where we are instructed to counsel patients that abstinence only is the only way, and condom use (if having premarital sex) is not an option. It is the south, so...
Anyways, just showing that there can be bias and agendas in both directions.

 

[MilkmanAl]

Man, I'm in Arkansas, and things here aren't even that intense. They generally keep the pontificating and ridiculous religion-based health care suggestions confined to the CMA meetings, fortunately.

 

[AlexMorph]

I guess my school is a bit of an anomaly, but our school is VERY conservative, with a obvious slant towards the right. Our state-funded school is also very religious. A recent lecturer was the Rev. XXX talking about "Satan: Who He is and What He Does. " (Not joking, wish I was).
We also have a health policy course, but ours highlights the evils of the new health care policy, as well as the evils of many social policies, to the point where we are instructed to counsel patients that abstinence only is the only way, and condom use (if having premarital sex) is not an option. It is the south, so...
Anyways, just showing that there can be bias and agendas in both directions.

yikes...

 

[MossPoh]

Just grit your teeth and go through it. There are so many things you will encounter in life you will either believe and buy into or disagree to the world ends regardless of the information given. It is well documented you will disregard info that doesn't support your beliefs. We all do it.

I've had to listen to so much bs that I don't buy into, but I just smile and learn the crap for the test. It just becomes a joke later on.

 

[Maybeknot]

Call up the White House or the DNC; in a week, he'll be out of your lecture hall and on MSNBC.

My favorite "politics in lecture" experience was when a senile old attending showed us a video talking about how evil big pharma was. The video, of course, was starring him.

 

[FutureDoc4]

I guess my school is a bit of an anomaly, but our school is VERY conservative, with a obvious slant towards the right. Our state-funded school is also very religious. A recent lecturer was the Rev. XXX talking about "Satan: Who He is and What He Does. " (Not joking, wish I was).
We also have a health policy course, but ours highlights the evils of the new health care policy, as well as the evils of many social policies, to the point where we are instructed to counsel patients that abstinence only is the only way, and condom use (if having premarital sex) is not an option. It is the south, so...
Anyways, just showing that there can be bias and agendas in both directions.

Ugh, I hate some of the agendas of the far left, but the above would drive me off the wall. Not sure I could actually sit through that peacefully.

 

[BTC]

Yeah, I think you just have to suffer through it. You will probably find that there will be an antithetical commentary coming from many attendings during third year anyway.

It has been my experience that most people don't really want an honest health policy debate in medical school. I think of myself as an open minded and reasonable person who finds a lot wrong with both sides of the political spectrum, especially when it comes to health policy. Any time I have spoken up among peers to offer a contrasting opinion, it has rarely been met with open mindedness. More often with a condescending remark or quiet scorn.

So just suffer through it. The real world will do plenty to void the inflated ideals these health policy courses seem to perpetuate.

 

[BTC]

Is there some SDN political agenda that prompted a moderator to bury this thread in some unknown message board?

 

[cpants]

I guess my school is a bit of an anomaly, but our school is VERY conservative, with a obvious slant towards the right. Our state-funded school is also very religious. A recent lecturer was the Rev. XXX talking about "Satan: Who He is and What He Does. " (Not joking, wish I was).
We also have a health policy course, but ours highlights the evils of the new health care policy, as well as the evils of many social policies, to the point where we are instructed to counsel patients that abstinence only is the only way, and condom use (if having premarital sex) is not an option. It is the south, so...
Anyways, just showing that there can be bias and agendas in both directions.

Are you serious?! I hope that's not the only instruction you get on contraception and STD prevention. I would fire off a letter to Planned Parenthood or something. They are always looking for something to make a stink about, and your school deserves a stink for this.

 

[badasshairday]

One of our lectures was about the history of health care reform policy. Basically at the end he highlighted that physicians usually oppose things like this, but then end up gaining big time. Ie. Medicare's creation led to big incomes in the 70's and 80's. Although, I'm pretty sure that this time won't be the same.

 

[MOHS_01]

Here's a simple, easy, and quick suggestion: if enough of you feel this way, make a short and sweet petition requesting that the discussion be balanced. Request someone who takes a less statist / social justice / whatever label you want to throw on it approach to have equal time (make sure they know WTF they are talking about, though)....... if this is met with deaf ears, politely remind them that this is a hall of higher education, not an indoctrination camp... or a re-education camp... and point out the rather simple fact that you pay a metric ass ton of $$$$ for this "privilege"... with all signs pointing toward a diminished future return on your investment.

 

[MOHS_01]

...on further thought, while a petition may carry more weight, it is not necessary to warrant the representation of opposing views -- assuming that enlightenment, rather than indoctrination is the goal. They are not your parents and you are not children incapable of formulating a reasoned opinion based upon the relative merits of varying positions.

 

[Reecit]

Thanks everyone for your responses - I was just curious how prevalent classes like this were... this topic would make for an interesting study in medical education.

I'm pretty over the class, it's just frustrating knowing that you are paying money for something that has absolutely no benefit to future patients. If I'm a political activist but cannot help someone figure out how to pay for their treatment, well what good am I as a health care provider?

Call up the White House or the DNC; in a week, he'll be out of your lecture hall and on MSNBC.

My favorite "politics in lecture" experience was when a senile old attending showed us a video talking about how evil big pharma was. The video, of course, was starring him.

Andee - Our prof has already prostituted himself out to Colbert, HuffPo, MSNBC and every other media outlet that will give him five minutes of fame. Sadly, the school still keeps him around.

 

[Slack3r]

d) Canada is awesome

I read somewhere recently that Canada's system is starting to run into trouble and they're considering re-privatizing some sectors. I can't find the damn article again though, but kinda funny when you think about it.

 

[DrYoda]

I read somewhere recently that Canada's system is starting to run into trouble and they're considering re-privatizing some sectors. I can't find the damn article again though, but kinda funny when you think about it.

Yep, Canada's health care has $$$ problems as well.
http://www.reuters.com/article/idUSTRE64U3XO20100531

 

[Coastie]

Med schools have been infiltrated by liberals for years now, thus the deterioration of medicine in the form of Obamacare, Midlevel takeovers, lowered standards/quality of product..

The school I attend has a unique, mandatory, 0 credit class that does not appear on our transcripts. While this class is held under the guise of 'health policy', the only thing we learn about is how terrible America's health care system is and why every other country's system is better than ours. The professor spends any time we have discounting 'myths', and students' questions, about the health care legislation (and singing its praises now that it has passed). Regardless of their political position on health care reform, many of my classmates feel like this course does not belong in our medical education, especially since it isn't an elective.

Does anyone else have a course like this at their school?

 

[Pharmavixen]

I read somewhere recently that Canada's system is starting to run into trouble and they're considering re-privatizing some sectors. I can't find the damn article again though, but kinda funny when you think about it.

Uh, no; generally speaking, we like our system. And it's cheaper - why would we go to a more expensive system, like a private system - to save money. How does that work?

If the American right wing needs to trash our system in order to support their ideology, they've run out of ideas.

 

[Slack3r]

Uh, no; generally speaking, we like our system.

Whether the Canadian population enjoys getting their healthcare for free (and who wouldn't?) doesn't have anything to do with the fact that the Canadian government is having a hard time paying for state-sponsored health care. If the money isn't there, it really doesn't matter what the population likes or dislikes.

 

[bronx43]

Whether the Canadian population enjoys getting their healthcare for free (and who wouldn't?) doesn't have anything to do with the fact that the Canadian government is having a hard time paying for state-sponsored health care. If the money isn't there, it really doesn't matter what the population likes or dislikes.

The other part of her response was questioning whether or not privatizing health care would save money in the long run. If you take the US as an example, then the answer is obviously no.

 

[Slack3r]

The other part of her response was questioning whether or not privatizing health care would save money in the long run. If you take the US as an example, then the answer is obviously no.

Well it's apparent the nationalization of healthcare is unsustainable as well (whodathunkit?) So it seems that passing a trillion dollar healthcare bill wasn't the best idea to save money either, now was it?

 

[thedrjojo]

Med schools have been infiltrated by liberals for years now, thus the deterioration of medicine in the form of Obamacare, Midlevel takeovers, lowered standards/quality of product..

While I am not going to argue against there being more liberals in medical school than in previous times, to blame liberals in medical school (and thus liberals as doctors) on midlevel takeovers (that would be liberals in politics, as well as conservatives who won't let us collectively bargin), or to state that medicine nowadays has lower standards/quality of product over any previous time (where as the admission standards are higher than ever, test scores are higher than ever, step pass rate is better, the education level of physicians is higher than ever, health care meassures are better than ever... plus, if it was decreased, the fact that there are liberals in medical school wouldn't be the cause, maybe the increased restrictions on what students/residents can do or how long they can do it would be a better point to argue). Obamacare, well, if any doctors were involved in actually crafting it, they probably wouldn't have removed the SGR fix nor the public option, and probably would have included some form of tort reform... again, you can blame that on liberals (and conservatives) in congress, but not in medical school.

What the change from medical school being uber conservative to more liberal is a change in the philosophy of medicine, and more matches the changes by society and the response to it. In the old day, Doctors were the prestigue and authoritative figure, revered, and thus more fitting of the conservative characture. As society begin viewing it more as a service position, and began wanting to have more input and information in their care, the conservative paternalistic figure was less drawn to medicine and the liberal social servant figure became more drawn to medicine, thus being represented in the current dogma of medical school.

 

[cpants]

While I am not going to argue against there being more liberals in medical school than in previous times, to blame liberals in medical school (and thus liberals as doctors) on midlevel takeovers (that would be liberals in politics, as well as conservatives who won't let us collectively bargin), or to state that medicine nowadays has lower standards/quality of product over any previous time (where as the admission standards are higher than ever, test scores are higher than ever, step pass rate is better, the education level of physicians is higher than ever, health care meassures are better than ever... plus, if it was decreased, the fact that there are liberals in medical school wouldn't be the cause, maybe the increased restrictions on what students/residents can do or how long they can do it would be a better point to argue). Obamacare, well, if any doctors were involved in actually crafting it, they probably wouldn't have removed the SGR fix nor the public option, and probably would have included some form of tort reform... again, you can blame that on liberals (and conservatives) in congress, but not in medical school.

What the change from medical school being uber conservative to more liberal is a change in the philosophy of medicine, and more matches the changes by society and the response to it. In the old day, Doctors were the prestigue and authoritative figure, revered, and thus more fitting of the conservative characture. As society begin viewing it more as a service position, and began wanting to have more input and information in their care, the conservative paternalistic figure was less drawn to medicine and the liberal social servant figure became more drawn to medicine, thus being represented in the current dogma of medical school.

Offensive caricatures of liberals and democrats. Let me get this straight. Conservatives are paternalistic, authoritative, prestige-******, while liberals are "social servants". Wow, and I thought it was just that we had different ideas about the role of government. BTW, you forgot that conservatives are racist and hate women.

 

[thedrjojo]

Offensive caricatures of liberals and democrats. Let me get this straight. Conservatives are paternalistic, authoritative, prestige-******, while liberals are "social servants". Wow, and I thought it was just that we had different ideas about the role of government. BTW, you forgot that conservatives are racist and hate women.

Oh yeah, forgot that one... thats why there were no women in medical school before and there are more women then men nowadays... thanks...

Was my post any more rediculas than the one I responded to? Jeez, can't a guy go a little stereotypical without getting the nth degree?

And really, you think the only difference is role of government? So both sides agree on abortion, stem cell research, evolution, death penalty, gay marriage, immigration, just to name a few.

 

[glade]

Wrongo. Liberals ARE to blame for mid-levels. Liberals ensured medicine was NOT "pay for play" and introduced third-party payers which destabilized the fee structure. They demanded that all people get treated for emergencies, which meant that life-saving measures get reimbursed LESS than elective ones (e.g., cosmetic surgery). This drove people into sub-specialties and the idiotic ROAD specialties. (Why perform surgery when you can make almost as much for sitting around while someone else does the surgery?) This led to a shortage of primary care. BINGO.

 

[PharmaTope]

Wrongo. Liberals ARE to blame for mid-levels. Liberals ensured medicine was NOT "pay for play" and introduced third-party payers which destabilized the fee structure. They demanded that all people get treated for emergencies, which meant that life-saving measures get reimbursed LESS than elective ones (e.g., cosmetic surgery). This drove people into sub-specialties and the idiotic ROAD specialties. (Why perform surgery when you can make almost as much for sitting around while someone else does the surgery?) This led to a shortage of primary care. BINGO.

BINGO!!!!!!!!!


i just cant understand how some people in medicine are bleeding heart liberals. they just dont get that they are jeopardizing themselves and their profession until it is too late.

this is so freakin bad for patients

 

[thedrjojo]

Wrongo. Liberals ARE to blame for mid-levels. Liberals ensured medicine was NOT "pay for play" and introduced third-party payers which destabilized the fee structure. They demanded that all people get treated for emergencies, which meant that life-saving measures get reimbursed LESS than elective ones (e.g., cosmetic surgery). This drove people into sub-specialties and the idiotic ROAD specialties. (Why perform surgery when you can make almost as much for sitting around while someone else does the surgery?) This led to a shortage of primary care. BINGO.

My argument was not that liberals were not to blame for midlevel takeovers (if you read my post, I actually state that it was liberals that are to blame), but that liberals in medical school were not to blame, since it was politicians and not medical students...

EMTLA... demanding people get treated... was passed in 1986 under Ronald Reagan... I can't find exactly what congressmen introduced it, but I wouldn't be surprised if it was bipartisan. And if you are going to just randomly assign things to liberals without evidence, I can do the same for conservatives.... HMO's, which is really one of the downfalls of medical payment, seems to me to be a much more conservative minded thing than a liberal thing (you know, cost containment)... Liberals always wanted a single payer system, it was Nixon working with the AMA (a bunch of conservatives back then... and the President Elect to the AMA was a neurosurgeon at my alma mater and I know he is not conservative and vehemently opposes single payer and instead wants a swiss system in the US - or so he has debated with the PNHP individuals several times about it) that set up our current model of healthcare... it was private corporations (health insurance companies), set on PROFIT (you know, the whole freemarket that conservatives don't want to regulate at all) that become the real profitters on health care and began driving down physician wages to increase their profit margins... and as long as the insurance industry is privatized, they will continue to work exactly as they are because they are not broken, they are working perfectly... and this healthcare bill didn't do enough (or really anything) to reign in the insurance company control of medicine (but if it did, it would have traded it for government control of medicine, which most of you out there think would be even worse, a group whose stated objective would have been the health of the population vs a group whose stated objective is to make as much profit as possible... because whoever has the money, has the power)

And @ Pharmatope, if you use my ultradramatic stereotypes of the conservative vs liberal characture, then its me who can't see how any conservative would want to enter the profession of medicine... you know, the selflessness, the compassion, the sacrificing ones time and energy for the betterment of others, without the respect and dignity it once had... yeah the pay is nice (although not as nice as it once was)... it is more the conservative mindset (ie, doing it for the wrong reasons) that is driving the ROAD specialties, where as liberals like myself (although I am being told I am more and more libertarian... I claim social liberal and fiscially moderate) and my wife (who is a boardline socialist) pick fields where we feel we are either the most interested or feel we can do the most good (which is surgery, either Transplant or SurgOnc for me, and OBGYN, possibily reproductive choice for her)...

 

[glade]

Just so you know, Ted Kennedy championed HMOs (and then later pretended he had nothing to do with them when it suited him). So your assumption was quite incorrect.

 

[Regnvejr]

Whether the Canadian population enjoys getting their healthcare for free (and who wouldn't?) doesn't have anything to do with the fact that the Canadian government is having a hard time paying for state-sponsored health care. If the money isn't there, it really doesn't matter what the population likes or dislikes.

But then our system has even more serious financial problems. Be careful to not sound like a partisan, blind hack here.

 

[Regnvejr]

Well it's apparent the nationalization of healthcare is unsustainable as well (whodathunkit?)

Actually, no that is not apparent. It is apparent that if your country choses to ignore care for its poorest 12-15% of the population, then it also can afford to do cardiac bypass on 90-year-olds.

So it seems that passing a trillion dollar healthcare bill wasn't the best idea to save money either, now was it?

If we for a moderate increase can increase coverage, then it is a great idea.

You may worry about money, but my main concern is coverage for my patients. So unless you have some other idea for how to cover my uninsured patients, then I welcome the new system, and wish it would go even further.

 

[Regnvejr]

Offensive caricatures of liberals and democrats. Let me get this straight. Conservatives are paternalistic, authoritative, prestige-******, while liberals are "social servants". Wow, and I thought it was just that we had different ideas about the role of government. BTW, you forgot that conservatives are racist and hate women.

I'm glad you got the Conservative fundies pegged so well, but you forgot to include that they are homophobes. Then we have the full picture of them.

 

[Regnvejr]

...this is so freakin bad for patients

To leave them untreated? Suuureee. Doubleplusgood, right!

 

[thedrjojo]

Just so you know, Ted Kennedy championed HMOs (and then later pretended he had nothing to do with them when it suited him). So your assumption was quite incorrect.

Nixon also supported and championed HMO's, introduced his own HMO plan in 1970 (which didn't pass) and signed Kennedy's 1973 HMO Act (a bill that got bipartisan support). The envisionment of HMO's in the 70's is much different than what they have become today... as soon as you let them garner a profit, they seek more of a profit and down the spiral we go. The state of healthcare today is an economics/market caused problem (3rd party companies sucking 30% of the money spent as profit just for handling money and assuming marginal risk that they then shun off and make every attempt to minimize) and not a liberal probel (trying to get everyone covered and trying to handcuff these private corporations)

 

[Slack3r]

it is more the conservative mindset (ie, doing it for the wrong reasons) that is driving the ROAD specialties, where as liberals like myself (although I am being told I am more and more libertarian... I claim social liberal and fiscially moderate) and my wife (who is a boardline socialist) pick fields where we feel we are either the most interested or feel we can do the most good (which is surgery, either Transplant or SurgOnc for me, and OBGYN, possibily reproductive choice for her)...

Ah yes, anesthesiology is completely useless. Radiology, too.

If you wanted to do the most good, shouldn't you be going into FM or general surgery? Didn't you hear we have a shortage?

But then our system has even more serious financial problems. Be careful to not sound like a partisan, blind hack here.

Care to elaborate? I believe the biggest financial strain on our medical system is Medicare/caid. Aren't those government run?

 

[MOHS_01]

.... Be careful to not sound like a partisan, blind hack here.

 

[thedrjojo]

Ah yes, anesthesiology is completely useless. Radiology, too.

While I am not calling them completely useless, and in fact will be relying on them greatly during my career.

The above poster claimed that:

Wrongo. Liberals ARE to blame for mid-levels. Liberals ensured medicine was NOT "pay for play" and introduced third-party payers which destabilized the fee structure. They demanded that all people get treated for emergencies, which meant that life-saving measures get reimbursed LESS than elective ones (e.g., cosmetic surgery). This drove people into sub-specialties and the idiotic ROAD specialties. (Why perform surgery when you can make almost as much for sitting around while someone else does the surgery?) This led to a shortage of primary care. BINGO.

so I was simply stating that it was the conservative mindset of those individuals driven to the ROAD specialties. There are plenty of noble people who go into it ROAD specialties because of genuine interest and desire to help in those fields, and I commend them for that and would desire the entire field to be made up of them. But there is the acronym for a reason and there are some out there that pursue them for the "lifestyle" and "riches" of them. No one pursues any other surgical subspecialty (gotta give Optho its props for being surgical) for "lifestyle".

If you wanted to do the most good, shouldn't you be going into FM or general surgery? Didn't you hear we have a shortage?

First off, I am doing a general surgery residency. I was being overly simplistic in my reasoning for doing my specialty, but was more emphasizing that future compensation didn't weigh into mine or my spouses career decision.

Care to elaborate? I believe the biggest financial strain on our medical system is Medicare/caid. Aren't those government run?

On a per subscriber basis, I believe the private insurance companies drain much more resources than Medicare/caid. The sheer size of Medicare/caid makes it one of the largest payers, its underfunding/low payment structure strains the doctors that rely on it, but if all the money paid to insurance companies was shifted to medicare/caid and every person was insuraced by medicare/caid, the financial situation of the medical system would be in a better situation than it currently is (then we would have a canadian type of system with twice per capita funding of it). Whether or not the financial situation of doctors, or the health of patients would be in a better situation is highly debatable. My 2 cents would be doctors paid less on a whole, bigger hits to the highly paid subspecialties and either no hit or possible increase in PCP's, and, IMO, better overall health outcomes in a 80:20 split (80% of time better outcomes, 20% worse outcomes). But it is all theoretical bs that we will never be able to find out the answer... people on both sides of the argument use Canada as its example for why their idea is right...

 

[MOHS_01]

....

On a per subscriber basis, I believe the private insurance companies drain much more resources than Medicare/caid. The sheer size of Medicare/caid makes it one of the largest payers, its underfunding/low payment structure strains the doctors that rely on it, but if all the money paid to insurance companies was shifted to medicare/caid and every person was insuraced by medicare/caid, the financial situation of the medical system would be in a better situation than it currently is (then we would have a canadian type of system with twice per capita funding of it). Whether or not the financial situation of doctors, or the health of patients would be in a better situation is highly debatable. My 2 cents would be doctors paid less on a whole, bigger hits to the highly paid subspecialties and either no hit or possible increase in PCP's, and, IMO, better overall health outcomes in a 80:20 split (80% of time better outcomes, 20% worse outcomes). But it is all theoretical bs that we will never be able to find out the answer... people on both sides of the argument use Canada as its example for why their idea is right...

Suggestion: read a little more before spouting off about **** you apparently know nothing about. Look at the number of MC/MA enrollees and compare that to the number of private insurance enrollees. Next look at total healthcare expenditures. Try to draw an intelligent conclusion after looking at this set of figures.

Next -- study a little on the theory of subjective value -- as that is how all goods and services are valued in the world outside of state edict. Who died and granted you judge and jury domain over the relative merit of another's motivation or value scale? Surely by now you can appreciate the arrogance and inappropriateness of enforcing your particular value scale and priorities onto another who does not share in them?

 

[glade]

The above poster claimed that:
so I was simply stating that it was the conservative mindset of those individuals driven to the ROAD specialties.

Yeah, and you missed the point, dude. Look, YES, it's the "conservative" side of people that drives them to ROADs. They're looking to make a lot of money for relatively little work. BUT you're analyzing that much too superficially. The question is then to step back and say "why is it that ROADs exist?" That is the real question. Look, in the rest of life, risk/work is linked to reward. People don't mind working hard if it pays off. But in medicine, thanks to liberals, work has nothing to do with reward. NOTHING AT ALL. In many cases, actually, people who work MORE get paid (relative to the amount they work) LESS because their work is deemed "essential" and therefore must be accessable to all.

Read that again. The more essential you are to healthcare, the LESS you make. So a dermatologist can make tons of money treating acne and wrinkles from 10 - 2 PM from Tues to Fri. Meanwhile, an Interventional Cardiologist may make, say, 75% as much, sure. But working weekdays 7 AM to 6 PM and coming in for emergencies. To liberals, that "makes sense." So of course people will go to ROADs and I DON'T BLAME THEM. I blame the system for being ******ed.

This is like how liberals say "we'll punish the rich by increasing their taxes" and they think that the rich will just take it. No, they'll hide their money, they'll move out of state, they'll shelter things. Whatever it takes. And liberals then turn around and say "those f**king rich people, f**kers." No, LIBERALS are the f**kers, the rich people are just playing the game that the liberals set up. Same thing with medicine. Liberals set it up thinking that people will just blindly go into primary care "because we said so." Turns out nobody is that dumb, so liberals get mad at people for not being lemmings and going along with their Master Plan.

 

[MOHS_01]

Yeah, and you missed the point, dude. Look, YES, it's the "conservative" side of people that drives them to ROADs. They're looking to make a lot of money for relatively little work. BUT you're analyzing that much too superficially. The question is then to step back and say "why is it that ROADs exist?" That is the real question. Look, in the rest of life, risk/work is linked to reward. People don't mind working hard if it pays off. But in medicine, thanks to liberals, work has nothing to do with reward. NOTHING AT ALL. In many cases, actually, people who work MORE get paid (relative to the amount they work) LESS because their work is deemed "essential" and therefore must be accessable to all.

Read that again. The more essential you are to healthcare, the LESS you make. So a dermatologist can make tons of money treating acne and wrinkles from 10 - 2 PM from Tues to Fri. Meanwhile, an Interventional Cardiologist may make, say, 75% as much, sure. But working weekdays 7 AM to 6 PM and coming in for emergencies. To liberals, that "makes sense." So of course people will go to ROADs and I DON'T BLAME THEM. I blame the system for being ******ed.

This is like how liberals say "we'll punish the rich by increasing their taxes" and they think that the rich will just take it. No, they'll hide their money, they'll move out of state, they'll shelter things. Whatever it takes. And liberals then turn around and say "those f**king rich people, f**kers." No, LIBERALS are the f**kers, the rich people are just playing the game that the liberals set up. Same thing with medicine. Liberals set it up thinking that people will just blindly go into primary care "because we said so." Turns out nobody is that dumb, so liberals get mad at people for not being lemmings and going along with their Master Plan.

You need to recheck your math, my friend -- compare what a general dermatologist makes to what the interventional cardiologist makes.... and you will find that you really need to rewrite this post. Derm is competitive because of its controllable lifestyle -- not the $$. Yes, a good wage can be made doing dermatology, but it is not interventional cardiology.....

 

[morning]

Yeah, and you missed the point, dude. Look, YES, it's the "conservative" side of people that drives them to ROADs. They're looking to make a lot of money for relatively little work. BUT you're analyzing that much too superficially. The question is then to step back and say "why is it that ROADs exist?" That is the real question. Look, in the rest of life, risk/work is linked to reward. People don't mind working hard if it pays off. But in medicine, thanks to liberals, work has nothing to do with reward. NOTHING AT ALL. In many cases, actually, people who work MORE get paid (relative to the amount they work) LESS because their work is deemed "essential" and therefore must be accessable to all.

Read that again. The more essential you are to healthcare, the LESS you make. So a dermatologist can make tons of money treating acne and wrinkles from 10 - 2 PM from Tues to Fri. Meanwhile, an Interventional Cardiologist may make, say, 75% as much, sure. But working weekdays 7 AM to 6 PM and coming in for emergencies. To liberals, that "makes sense." So of course people will go to ROADs and I DON'T BLAME THEM. I blame the system for being ******ed.

This is like how liberals say "we'll punish the rich by increasing their taxes" and they think that the rich will just take it. No, they'll hide their money, they'll move out of state, they'll shelter things. Whatever it takes. And liberals then turn around and say "those f**king rich people, f**kers." No, LIBERALS are the f**kers, the rich people are just playing the game that the liberals set up. Same thing with medicine. Liberals set it up thinking that people will just blindly go into primary care "because we said so." Turns out nobody is that dumb, so liberals get mad at people for not being lemmings and going along with their Master Plan.

Capitalism plays a huge part in how much doctors are being screwed over. Medicare reimbursements drop, but insurance companies see the opportunity and drop as well. No one is forcing these medical schools to charge $55,000 a year for tuition only. They do it for the profit. And every second you spend on the phone arguing with an insurance company is designed to maximize their profit at your expense. Malpractice lawsuits? That's capitalism via lawyers. Don't like NPs and PAs doing physician jobs for half the price? That's capitalism, too...if a hospital can save money by having PAs staff the ED instead of physicians, that has nothing to do with the libruls. Don't like the money the resident receives? Ask the hospitals why they don't give them more considering they get more money for them. Look at what residents make in Canada.

Doctors are being assaulted from all sides. Witness the SGR tomfoolery. Republicans proposed it, Republicans voted for it, Republicans own it, Republicans filibustered a fix. They had 8 years in power, at least 4 of those in TOTAL power (both chambers of Congress plus the executive branch) and they did not a single thing to improve your situation whatsoever.

Secondly, "risk/work is linked to reward" is almost totally untrue. You don't get paid some fantasy ideal of what you deserve to get paid. You get paid based on how much it will take to retain your employment. You honestly think that everyone else in America is getting paid what they deserve? Maybe business owners and those I-bankers, but that's about it.

I've said this before...physicians are stuck in a game where they are the only players. They are not allowed to embrace capitalism, but everyone else around them IS, and that screws them over. A doctor is expected to take what they can get and are not allowed to unionize, while in the meantime, everyone around them, above them, under them, and suing them are chasing every single $$ they can possibly get their hands on.

 

[Slack3r]

You need to recheck your math, my friend -- compare what a general dermatologist makes to what the interventional cardiologist makes.... and you will find that you really need to rewrite this post. Derm is competitive because of its controllable lifestyle -- not the $$. Yes, a good wage can be made doing dermatology, but it is not interventional cardiology.....

I saw that too. However, you could replace "interventional cards" with FP (or general surgery, perhaps) and it'd still be a valid statement.

 

[glade]

Capitalism plays a huge part in how much doctors are being screwed over. Medicare reimbursements drop, but insurance companies see the opportunity and drop as well.

Right, but again, you just missed the point. Sure, insurance companies DO "see the opportunity" and drop as well. But the reason they CAN drop is because OF THE GOVERNMENT DROP. The government doesn't follow free markets. They just say "hey, we're giving you this, take it or leave it. And if you 'leave it,' you still have to see our patients." You blamed capitalism but you missed the socialism right in front of your eyes.

Malpractice lawsuits? That's capitalism via lawyers.

Nope. Law suits have nothing to do with capitalism. See, now you're just confusing "money" with "capitalism." What you have with law suits is NOT capitalism because if it was, we'd have tort reform. You lose a law suit, you pay for it. Right now, we have "sue all you want, you lose then no consequence, you win then you get millions (to the lawyer)."

Don't like NPs and PAs doing physician jobs for half the price? That's capitalism, too...if a hospital can save money by having PAs staff the ED instead of physicians, that has nothing to do with the libruls.

Again, not capitalism because it's not "free market." It's "free market AFTER government regulations are imposed." The only reason we have NPs/PAs is because of everything we all talk about on here. First off, it's lower quality BUT MDs are forced to be the "safety net." So if an NP/PA messes up, guess who cleans up? Second of all, the reason we have a need for NPs/PAs is due to MALDISTRIBUTION of physicians, not really a "physician shortage." And that's because reimbursements are generally fixed. Sure, you'll make a LITTLE more in rural Montana, but not a free market amount. If they paid you a million to go to Montana, someone would go. THAT'S capitalism.

In summary, you're blaming capitalism for something that has nothing to do with capitalism every time.

P.S. You guys clearly don't know what Dermatologists make, relative to how much they work. Why don't you find out before you tell me that I made a mistake? Thanks.

 

[morning]

Nope. Law suits have nothing to do with capitalism. See, now you're just confusing "money" with "capitalism." What you have with law suits is NOT capitalism because if it was, we'd have tort reform. You lose a law suit, you pay for it. Right now, we have "sue all you want, you lose then no consequence, you win then you get millions (to the lawyer)."

What? So the way to make malpractice more capitalist would be to heavily regulate it and create artificial consequences?

Again, not capitalism because it's not "free market." It's "free market AFTER government regulations are imposed." The only reason we have NPs/PAs is because of everything we all talk about on here. First off, it's lower quality BUT MDs are forced to be the "safety net." So if an NP/PA messes up, guess who cleans up? Second of all, the reason we have a need for NPs/PAs is due to MALDISTRIBUTION of physicians, not really a "physician shortage." And that's because reimbursements are generally fixed. Sure, you'll make a LITTLE more in rural Montana, but not a free market amount. If they paid you a million to go to Montana, someone would go. THAT'S capitalism.

But they don't have to pay you a million to go to Montana. That's the point. They don't have to because someone else is willing to work for less. ...You should be EXTREMELY grateful for the regulations keeping any foreign physician who wants to from setting up shop in America.

 

[glade]

What? So the way to make malpractice more capitalist would be to heavily regulate it and create artificial consequences?

No. Lawsuits have nothing to do with capitalism at all ever. The only capitalism involved with lawyers is when they charge their clients. You pay a fee for their service. The rest of it has nothing to do with markets or whatever because it's just a determination of whether you did something wrong or not (in theory).

But so far as it's a lottery system with no penalty for being wrong, THAT'S a problem. And that INDIRECTLY leads to problems, such as cost (e.g., defensive medicine) and distribution of services (i.e., lower in areas with no tort reform).

But they don't have to pay you a million to go to Montana. That's the point. They don't have to because someone else is willing to work for less. ...You should be EXTREMELY grateful for the regulations keeping any foreign physician who wants to from setting up shop in America.

Again, you missed the socialism. The reason someone "else" is willing to work for less is purely due to socialism. Sounds convoluted, so let me explain. In general, there is relatively little deviation in reimbursements. For many reasons, and some of them complex. But let's over-simplify for the sake of understanding and say that you make ABOUT the same working in Montana as you do in New York City. (That's not entirely accurate, but it's OK for now.) So with that in mind, what to do? Because physicians won't go to Montana and liberals are unwilling to free the markets. Well, bring in these mid-levels, who are less qualified, but will work for less as a stop-gap. It's a capitalistic patch to a system broken by socialism. Then YOU bust on the capitalism and totally ignore the system that broke everything. See what I mean?