...and they are working a helluva lot harder to keep the loss to that low %. Physicians are the only class of professionals who have seen their real incomes decline over the past decade.
Yep, what other industry have you seen a yearly decline with simultaneous increase in demand for production in the manner we see with healthcare. What other industry have we seen an arbitrary 20% salary cut in this manner... without cuts in service?
...yet per capita cost continues to skyrocket. Patients and physicians are losing.
You make ~this statement in the other thread. I am not sure what you are basing this on or where you draw these conclusions? Yes, there is plenty of room for improvement. Just not sure about your "per capita" extrapolations/references.
Instead of looking at a gross number, i.e. per capita, consider what might be available at that expenditure. Say we pay more per PCP then in Canada. Is there a trade off for that discount in ... maybe delay in care (i.e. "access to care")? Say we pay more oncologic surgeon and/or oncologists and/or treatment is there a trade-off in survival? Do you have some conversion as to what that trade-off should be? For example, if we pay double for cancer care, do you expect double the survival rate or is a 1, 2, 5, 10% improved survival acceptable? I dare say that most of my cancer patients would mortgage their house for a 2% increase in their chance of survival. These questions are fairly rhetorical and not seeking answers. Rather, I hope they provide you with an additional manner of viewing this issue.
In the USA, we deploy greater amounts of technology per patient then is even available abroad. We provide more "hail Mary" interventions. Our patients are covered ealry for even the basic things such as Pap smears. Our cancer survival is actually better. How long does it take you to get a PCP and/or be seen by a PCP? (in some countries there can be a
several years wait for a PCP... to be assigned!) If you herniate a lumbar disk.... how long do you think it will take you to be seen by a physician... PCP, ortho- or neuro-spine? How long do you think you will wait for an MRI? If you are 75, do you think you will get access to hip and/or knee replacement abroad? How long will you have to wait? etc...?
I know you have a beef with business administrators and executives. What about the malpractice issue... small detail.You are training to be a physician (aka scientist). I encourage you to think hard about your conclusions and on what numbers you base them and who generated these numbers? How were they generated? i.e. our infant mortality numbers includes infants/births that are not even counted and/or treated abroad in numerous countries....
Keep in mind the basic principle of "voting with your feet". When poled, the vast majority interested in relocating want to relocate to USA. When looked at, significant foreigners, Europeans, Canadians, etc..... travel to the USA for their care. Aside from wealthy, hollywood, artist types, that refuse standard of care cancer therapy and place their hair at higher priority to their life/treatment until their disease is widely metastatic, I don't know of many folks rushing to Europe for cancer care.
JAD
