Universal Health Care

[mellsworth21]

I was reading about Borak Obamas plan for universal health care, in "6 years." I was wondering what affects that would have on us, as future (hopefully) MD's? Any info would be appreciated. -Matthew Ellsworth

---

Members don't see this ad.

 

[notdeadyet]

You'll get lots of folks chiming in about doom and gloom of universal healthcare. But it's undisputed that we currently have the most expensive and least inclusive healthcare system of the industrialized western world.

That said, any approach to universal healthcare will probably result in physicians taking a paycut. I don't think that's very debatable either.

 

[DropkickMurphy]

I don't have a problem with the current system. It's better than any "universal" program we could see in the forseeable future.

BTW, you might want to NOT put your real name on the ends of your posts.

 

[spicedmanna]

I haven't read his proposal; do you have a link to it?

Based on material that I've read on the subject, I think any realistic approach is going to involve some sort of overt rationing. Heck, we are already rationing healthcare, why not bring it out into the open, instead of doing it covertly at the bedside, where everybody, except the insurance companies, is losing out?

 

[Cirrus83]

Love the concept but I'm sure they'd also have to pay for all our med school tuition if they ever try to implement this.

But, politics being politics, it's probably not going to happen just yet, lol. Too much money in D.C. to let it ever happen.

 

[Shah_Patel_PT]

I was reading about Borak Obamas plan for universal health care, in "6 years." I was wondering what affects that would have on us, as future (hopefully) MD's? Any info would be appreciated. -Matthew Ellsworth

The impact of socialized medicine:

http://www.youtube.com/watch?v=X_Rf42zNl9U&eurl

 

[gotmeds?]

I think it would be tragic for doctors to have to take a pay cut so that the people they said they were going into med school to help could actually get access to decent healthcare. I so had my heart set on a BMW 500 series and now I may have to settle for a 300. Well, at least it will help me to better relate to the plight of the poor.

 

[Cirrus83]

The impact of socialized medicine:

http://www.youtube.com/watch?v=X_Rf42zNl9U&eurl

Well, I've worked in England for the NHS (as an intern), and while it's true that wait times can be really horrible, on the flip side it was also interesting how everyone counted healthcare as a right.

Anyways, in England you can pay for private healthcare (and even buy private insurance), I'm not entirely sure why Ontario would outlaw private options completely.

But, I guess in one sense it kind of undercuts the single payer system if nobody uses it because all the wealthy just go and buy private healthcare.

Truth is that the US system isn't so great, but the Canadian system isn't perfect either. But that doesn't neccessarily mean that it's not better overall.

Oh and most of the longer wait times are probably in very crowded cities. At least in England I know you could get an MRI almost right away if you happened to live in a more rural area, because they still have to have that MRI machine, but there's only so many people who'll ever need one at any given time. If you live in a more crowded area, they still just have that one MRI machine.

You could probably have a better funded single payer system with less horrible wait times and still have cheaper medical care and universal coverage, but it'd be more money than the current Canadian system. But that doesn't mean that Canada isn't addressing the problems-the people of Canada and the UK are well aware of the problems a single payer system can have.

Anyways, there's also plenty of people who got really great healthcare under the Canadian system, so showing this one video of (literally) the worst case scenario is somewhat unfair. I'm sure you could find plenty of examples where people in the US can't afford advanced treatments-trust me when I say that you don't get the greatest healthcare on Medicaid.

I got to see PLENTY of worst-case scenarios when I was in England btw, since I worked in their equivalent of a patient's advocate office. So...I know full well the kind of horrible wait times you can have in a single payer system, but that doesn't really mean that our system is super kickass either.

Oh and the video does seem to point out that at least in Canada you can file for the government to pay you back on your cross-border healthcare, and then appeal and sue them if they don't wanna pay. Try doing that when you HAVE NO HEALTHCARE AT ALL in the US.

 

[OncoCaP]

The impact of socialized medicine:

http://www.youtube.com/watch?v=X_Rf42zNl9U&eurl

This advertisement focuses on one patient's situation. Here in the U.S. there are many people who cannot get care at all, let alone slow care. Don't get me wrong, the U.S. healthcare system is really nice for me and my family. Yes, universal health care will make things worse (harder to get an appointment, etc.) for those of us who have great care now; at the same time, it will make life better for those who don't get healthcare now.

 

[dutchman]

I have said that it is not a problem if they socialize everything including malpractice premiums and college tuition (down to undergrad) for doctors. But they won't do that. They want universal access while maintaining high volumes of medmal lawsuits, and they don't want anything to do with malpractice insurance either, that one is best served by private insurers.

 

[OncoCaP]

I have said that it is not a problem if they socialize everything including malpractice premiums and college tuition (down to undergrad) for doctors. But they won't do that. They want universal access while maintaining high volumes of medmal lawsuits, and they don't want anything to do with malpractice insurance either, that one is best served by private insurers.

When the socialize medicine, we can all quit our horrible physician jobs and start driving cabs; that'll be great. We'll be independent subcontractors who can set our own hours and get paid by the mile. Heck, let's drop out of this horrible medical system now and avoid all the trouble. With universal health care, we'll get exactly the same care as the CEO of ExxonMobil .

 

[dutchman]

When the socialize medicine, we can all quit our horrible physician jobs and start driving cabs; that'll be great. We can set our own hours and get paid by the mile. Heck, let's drop out of this horrible medical system now and avoid all the trouble .

You don't need to drive a cab, you could always take up a job as a nurse(if the nurses union lets you).

 

[Stolenspatulas]

im all for uinversal health care but not at the expense of doctors' salaries.

i seriously think doctors and surgeons SHOULD make at least 150k. what other jobs require all night calls, long hours, expensive training, etc, etc.

its ridiculous. i want to be able to pay for my kids college education and live comfortably.

 

[dutchman]

im all for uinversal health care but not at the expense of doctors' salaries.

i seriously think doctors and surgeons SHOULD make at least 150k. what other jobs require all night calls, long hours, expensive training, etc, etc.

its ridiculous. i want to be able to pay for my kids college education and live comfortably.

But as a doctor you are only a political tool used to pacify the public and lock down votes. Your own personal walfare is the least of their worries. Even if you complain, who really sympathizes with doctors?

 

[OncoCaP]

You don't need to drive a cab, you could always take up a job as a nurse(if the nurses union lets you).

Yes, true. I'm sure there are plenty of jobs we could take. My point is ... find a job you like (or one that you hate the least). Changes to the healthcare system seem quite likely, and it's certainly possible that these could reduce physician salaries. The motivations for changing healthcare are pretty strong. If you're going into medicine for the (well-deserved) money, the pot of gold may not be there as much after changes are made.

 

[dutchman]

Yes, true. I'm sure there are plenty of jobs we could take. My point is ... find a job you like (or one that you hate the least). Changes to the healthcare system seem quite likely, and it's certainly possible that these could reduce physician salaries. The motivations for changing healthcare are pretty strong. If you're going into medicine for the (well-deserved) money, the pot of gold may not be there as much after changes are made.

I don't need a pot of gold. I also don't need to be that doctor with 200k debt and no real way to come out of it. Do not under-estimate how much of a reduction in pay "wild swing" policies like this could bring.

 

[OncoCaP]

I don't need a pot of gold. I also don't need to be that doctor with 200k debt and no real way to come out of it. Do not under-estimate how much of a reduction in pay "wild swing" policies like this could bring.

Yup, I'm expecting that schools would reduce medical school tuition in a case like that because otherwise they couldn't get anyone to go through the system just to earn $70K as a neurosurgeon (is that what they earn in Canada? or is that in Europe; I'm not sure). Only people who really want to do the work would go into it. They would have plenty of applicants, I'm sure. There is no lack of people who want to be a doctor.

 

[Amemus]

Hmm, sounds like most of you are equating universal health care with a single payer system, which is only one of four methods (and of course, there are many, many variations on all of these).

I also find the term "socialized medicine" funny. The term was actually spread by the AMA because they were worried that a universal health care system would mean pay cuts for them. So they called it socialized medicine, not really because the system is socialized, but because the first country to have universal health care was Germany.

 

[DropkickMurphy]

You don't need to drive a cab, you could always take up a job as a nurse(if the nurses union lets you).

I'll just go back to being an RT if my income drops too much as a doc.

 

[Towelie]

BLAHBLAHBLAH. How many times have we had this F$!@ing conversation? I'll fill in the rest:

-the profession of medicine is screwed
-we are at war with everyone
-you will get into debt and never get out
-doctors will make the minimum wage 10 years from now
-Etc.

Run, don't walk away from medicine before it is too late. You are headed down a path of misery and financial peril.

 

[Chuckwalla]

Eh, I believe everyone should have healthcare, especially children. If I was about the money I would have been a business major.

 

[OncoCaP]

Hmm, sounds like most of you are equating universal health care with a single payer system, which is only one of four methods (and of course, there are many, many variations on all of these).

I also find the term "socialized medicine" funny. The term was actually spread by the AMA because they were worried that a universal health care system would mean pay cuts for them. So they called it socialized medicine, not really because the system is socialized, but because the first country to have universal health care was Germany.

Yes, you're right. I shouldn't call it socialized medicine. However, "universal healthcare" carries some baggage as well. If you can't get an appointment when you need it is it still "universal"? Maybe I'll start calling it "universally rationed healthcare" ... maybe that's more accurate.

 

[dutchman]

Yup, I'm expecting that schools would reduce medical school tuition in a case like that because otherwise they couldn't get anyone to go through the system just to earn $70K as a neurosurgeon (is that what they earn in Canada? or is that in Europe; I'm not sure). Only people who really want to do the work would go into it. They would have plenty of applicants, I'm sure. There is no lack of people who want to be a doctor.

Thats the point. If people are willing to do it regardless, then why should the medical schools drop their pants? If you are willing to "do the job" regardless of compensation, society will hold you to it. Do not for a second think that they will sympathize with you either. Expect the same amount of harrassment from their lawyers.

Trust me, political trickery is at work, and the last thing doctors need is to fall asleep on some idealist pillow only to wake up to a gang rape. In a democracy you fight for your own, and hopefully you can reach a compromise.

 

[gotmeds?]

Yes, you're right. I shouldn't call it socialized medicine. However, "universal healthcare" carries some baggage as well. If you can't get an appointment when you need it is it still "universal"? Maybe I'll start calling it "universally rationed healthcare" ... maybe that's more accurate.

Let's call it "single risk pool" and go from there. As someone else pointed out, there are several ways to accomplish this, only one of which is socialized medicine.

 

[wolfram241]

I was reading about Borak Obamas plan for universal health care, in "6 years." I was wondering what affects that would have on us, as future (hopefully) MD's? Any info would be appreciated. -Matthew Ellsworth

Oh please. Don't tell me you were inspired by the black Paris Hilton of politics. Hillary was the champion of universal healthcare long before the media first got their collective panties wet over My Balls Hussein Obama. Vote Rodham in 08.

 

[OncoCaP]

Thats the point. If people are willing to do it regardless, then why should the medical schools drop their pants? If you are willing to "do the job" regardless of compensation, society will hold you to it. Do not for a second think that they will sympathize with you either. Expect the same amount of harrassment from their lawyers.

Trust me, political trickery is at work, and the last thing doctors need is to fall asleep on some idealist pillow only to wake up to a gang rape. In a democracy you fight for your own, and hopefully you can reach a compromise.

It's really hard for me to just totally ignore the fact that we pay more for our healthcare per capita than other countries and have some of the worst care for the population overall, with many people with virtually no access to care whatsoever.

I realize that in many cases we could blame the poor for their own unwise decisions or lack of work ethic (there are also many poor who are poor through no fault of their own, of course). I'm just under the impression that the current system is not serving this country as well as it should. In my own opinion, universal rationing of healthcare could actually increase physician salaries because demands for their services would increase significantly.

I'm all for mounting a great political strategy that helps physicians. I would hope that we can also provide better equity in the delivery of healthcare. Well-to-do Americans can afford to get pretty much the best that medicine has to offer, including a lot of elective procedures such as cosmetic laser hair removal, etc., while a significant fraction of Americans can't get sufficient or competent care for serious health issues such as diabetes, etc.

 

[OncoCaP]

Let's call it "single risk pool" and go from there. As someone else pointed out, there are several ways to accomplish this, only one of which is socialized medicine.

I'm not sure that people would know what I was talking about if I said something like "single risk pool healthcare" ....

 

[dutchman]

Eh, I believe everyone should have healthcare, especially children. If I was about the money I would have been a business major.

You will be surprised how much money you actually need as a doctor if you decide to take take loans out for medschool. How can you start a career in such a deep financial -ve, and not worry about money?

BTW, since you like children, remember your own children deserve a good life too. where their parents are not ridden with overwhelming debt and have to resort to abandoning their roles as parents just to work off the debt.

 

[DropkickMurphy]

It's really hard for me to just totally ignore the fact that we pay more for our healthcare per capita than other countries and have some of the worst care for the population overall, with many people with virtually no access to care whatsoever.

Then people need to learn to work harder so they can afford health insurance.

 

[Towelie]

You will be surprised how much money you actually need as a doctor if you decide to take take loans out for medschool. How can you start a career in such a deep financial -ve, and not worry about money?

BTW, since you like children, remember your own children deserve a good life too. where their parents are not ridden with overwhelming debt and have to resort to abandoning their roles as parents just to work off the debt.

Even if you max out on loans, your payments will amount to about $20K in take-home income each year. This wouldn't require you to sacrifice you or your childrens' well-being.

 

[OncoCaP]

Then people need to learn to work harder so they can afford health insurance.

What irritates me is that ~50% of the uninsured could buy health insurance but choose not to. Lots of Americans just take their chances, and then the rest of us get to pay when the get hit riding a donorcycle because they wanted to save some extra beer and cigarette money (I'm not talking about the people who cannot afford it)....

 

[Towelie]

Then people need to learn to work harder so they can afford health insurance.

Dumbest. Argument. Ever.

 

[DropkickMurphy]

What irritates me is that ~50% of the uninsured could buy health insurance but choose not to. Lots of Americans just take their chances, and then the rest of us get to pay when the get hit riding a donorcycle because they wanted to save some extra beer and cigarette money (I'm not talking about the people who cannot afford it)....

Exactly my point. I don't see why I should take a paycut because of Joe Bob deciding that a carton of cigarettes is more important than his kids' health.

Dumbest. Argument. Ever.

See above.

 

[OncoCaP]

Exactly my point. I don't see why I should take a paycut because of Joe Bob deciding that a carton of cigarettes is more important than his kids' health.

What sucks even more is that carton of $5 menthols causes all kinds of other health issues, so not only does Joe Bob not pull his weight in shouldering the cost of healthcare, but he has extra money to ruin his health with cigarettes and beer further increasing the burden on those who are actually paying for insurance. My hope is that with a more tax-like health insurance premium, Joe Bob's share of health insurance gets taken out of his check before he has a chance to waste it on something non-essential or worse: something that ruins his health at another's expense for treatment.

 

[DropkickMurphy]

What sucks even more is that carton of $5 menthols causes all kinds of other health issues, so not only does Joe Bob not pull his weight in shouldering the cost of healthcare, but he has extra money to ruin his health with cigarettes and beer further increasing the burden on those who are actually paying for insurance. My hope is that with a more tax-like health insurance premium, Joe Bob's share of health insurance gets taken out of his check before he has a chance to waste it on something non-essential or worse: something that ruins his health at another's expense for treatment.

I don't care what they do to provide coverage so long as doctor's salaries don't drop below acceptable levels.

 

[dutchman]

What irritates me is that ~50% of the uninsured could buy health insurance but choose not to. Lots of Americans just take their chances, and then the rest of us get to pay when the get hit riding a donorcycle because they wanted to save some extra beer and cigarette money (I'm not talking about the people who cannot afford it)....

About 80% actually. A few years ago when I was uninsured, I could actually afford it but it was the least of my priorities. Someone probably counted me as a "no access" member of the public. Somewhere along the line politicians have managed to translate "uninsured" to mean handicapped. We probably need to help the needy, but uninsured does not mean poor.

 

[dutchman]

Even if you max out on loans, your payments will amount to about $20K in take-home income each year. This wouldn't require you to sacrifice you or your childrens' well-being.

What if after the cuts you cannot afford 20k a year?

 

[OncoCaP]

I don't care what they do to provide coverage so long as doctor's salaries don't drop below acceptable levels.

I'm (perhaps naively) hoping that increased demand for physician's services under universal rationing of healthcare will actually raise physician salaries (for the sake of the profession -- I'm not chasing $$) and provide opportunities for negotiating better working conditions. I guess one can always hope for the best and do what's possible to bring it about.

 

[Amemus]

There are proposals that require health care providers to keep costs from rising, but give them the option as to how they may accomplish this. They may take pay cuts, form health maintenance organizations, use more efficient computerized medical records.. there are a lot of options.

 

[justin5790]

Then people need to learn to work harder so they can afford health insurance.

I am amazed that this is the attitude of some people who intend on becoming physicians. How old are you, 21, 22? You need to get out and live in the real world for a while and work at a low paying job like a significant portion of the population does. Most of the time you can't afford to pay for insurance, or the company you're working for doesn't even offer it. Forty seven million uninsured people in the US certainly suggests a larger problem than sheer laziness. I was uninsured for a few years, and know firsthand the challenges that come along with it...putting off treatment because you can't afford it, medical debt, etc. Do us all a favor and quit spewing nonsense about subjects you obviously have no knowledge of or experience with, and PLEASE rethink your medical aspirations. Oh, and for the record, I would gladly take less money to solve the problem of the uninsured.

 

[Stolenspatulas]

I am amazed that this is the attitude of some people who intend on becoming physicians. How old are you, 21, 22? You need to get out and live in the real world for a while and work at a low paying job like a significant portion of the population does. Most of the time you can't afford to pay for insurance, or the company you're working for doesn't even offer it. Forty seven million uninsured people in the US certainly suggests a larger problem than sheer laziness. I was uninsured for a few years, and know firsthand the challenges that come along with it...putting off treatment because you can't afford it, medical debt, etc. Do us all a favor and quit spewing nonsense about subjects you obviously have no knowledge of or experience with, and PLEASE rethink your medical aspirations. Oh, and for the record, I would gladly take less money to solve the problem of the uninsured.

I agree with your whole post besides the last line. Doctors shouldnt be placed in a position to make a sacrifice such as this. We already will sacrifice most of our waking lives for other people, why should money go? If im going to be in debt 200k+, I definitely hope I can make enough money to pay it back somewhat fast.

 

[DropkickMurphy]

Actually I have a lot more healthcare experience than you probably do (I'm a non-trad who actually has worked full time in ED's and ICU's for several years). Once you realize that the BS premeds spew about altruism- because they feel obligated to do so to appear more competitive to ADCOMs- is so phony and easy to see through that it is laughable, things will be a lot simpler for you.

 

[justin5790]

Your healthcare experience doesn't change the fact that you have probably never lived in poverty, been uninsured for one day of your life, or that your previous remarks were incredibly ignorant.

 

[DropkickMurphy]

Your healthcare experience doesn't change the fact that you have probably never lived in poverty, been uninsured for one day of your life, or that your previous remarks were incredibly ignorant.

Actually both my parents combined make less than half what I currently do as an RT, we never had health insurance when I was growing up, and that is the reason I feel that it is largely the fault of the people and we shouldn't have to suffer for it. You don't know me and you don't know my background so I would recommend you not speak of my experiences unless you know them.

 

[mellsworth21]

Oh please. Don't tell me you were inspired by the black Paris Hilton of politics. Hillary was the champion of universal healthcare long before the media first got their collective panties wet over My Balls Hussein Obama. Vote Rodham in 08.

Now Now.. I have not been inspired yet, that comes later. The fact is, Universal Health care is a bit scary, does anyone know John Edwards take on this?

 

[McPoyle]

wow, lots of passionate arguments. Seems pretty evident that this is not an issue that will be resolved any time soon. And it is because of this that we can probably rest comfortably knowing that this will not change any time soon.
With the obvious pitfalls of "socialized" medicine, it would be political suicide for a reputable (i.e. not Hillary) politician to push this issue. Once their constituency sees how this would really affect them, the issue would be squashed before we know it.
The only way for the healthcare system to change is for it to basically fall apart, total chaos. Once that happens we can rebuild it in a new fashion.... possibly something like a two tiered system....

 

[wolfram241]

Now Now.. I have not been inspired yet, that comes later. The fact is, Universal Health care is a bit scary, does anyone know John Edwards take on this?

No healthcare will be needed with JFKv2.0 in office. Brother John will heal all, and people like Christopher Reeve will get out of their wheelchairs and walk again.

 

[Gut Shot]

I don't care what they do to provide coverage so long as doctor's salaries don't drop below acceptable levels.

I posted this in another thread, but I think it's worth repeating here. Constrast this to the current slow salary erosion in the United States. Please note, Canada has this annoying habit of reporting physician compensation without deducting overhead.

From the London Free Press (as in London, Canada, for the geographically impaired):

Soaring doctor salaries defended
Ontario Health Minister George Smitherman said the increases helped ease a physician shortage.

The Ontario government allowed the number of doctors earning more than $476,000 annually to jump 56 per cent last year -- some averaging salaries upward of $718,000 -- to ease the pressure of a shortage of physicians, Health Minister George Smitherman said yesterday.

 

[Gut Shot]

And in the UK as well:

Sick pay: Massive rise in GPs' salaries worsens NHS cash crisis

The average GP now earns £118,000 a year. This is a staggering rise of 63% in three years. And it gets better: instead of having to care for patients all day, every day, they are now just responsible during office hours (weekdays only). Is it any wonder the NHS is unwell?

 

[chevaliermalfet]

I've read most of your arguments back and forth, and I suppose it's time for me to toss my two-cents in, if not from a policy/implementation perspective, but at least against the detractors of "universal healthcare".

There are many, many ways that universal healthcare can be organized, and I agree that there may be no one right way. However, I (the 21-year old, upper-middle class pre-med that I am) really believe that heathcare is a right, and not a privilege. It is the government's duty to look after its citizens, either by protecting them from foreign threats, by providing free education, with a safety net if we screw up find ourselves with no income, and yes, by providing free healthcare to EVERYONE.

And when I say everyone, I mean the poor, the stupid and even the lazy. Granted there is a certain point where the idealism has to meet the real world, but can you really look someone in the eye, and even knowing that he is dying of lung cancer from 30 years of spending health insurance money on cigarettes, tell him that you're not going to help him? *shrugs* I don't know that I can. The point I suppose I am trying to make is that as people, everyone deserves to receive healthcare. Even if you are stupid or poor or lazy. It doesn't need to be laser hair removal or plastic surgery, but if you are sick, you should not have to get sicker because you cannot afford help. But for a lot of people, you get sick, you can't afford medical care, so you get sicker and find yourself in someone's emergency room for something that could have been healed years before.

I am no policy specialist, so I can't speak to the specifics of how this ideal can be implemented. But it needs to happen. 47 million is too many.