Universal Health Care

[deleted128562]

Physician's should fight pay cuts. But any physician against the idea of health care for all has pretty funny morals.

I'm all for health care for all. That's why I think it's so great that people who aren't poor have the freedom to give up their cable tv and beers and purchase a health policy if they so choose. And that truly poor people are able to get Medicaid.

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[aglaiaer]

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[melissainsd]

have you purchased health care for yourself (& family) yet? and have you purchased health care that isn't subsidized by your occupation or school? because it can be quite a bit more expensive than cable tv and beer, especially if you want more than bare bones catastrophic insurance (that is, if you want a deductible low enough to handle and maybe some coverage of preventative care; don't even think about dental or vision for a reasonable price, ain't gonna happen). you should check out blue cross/blue shield for your state - and don't believe the 'quotes' they your info, once you enter your health history those numbers can doubl or triple, and I'm a pretty healthy person in my mid-20s. npr had a story on the other day about a woman who had previously had cancer and her insurance was going to be $3000/month. that's more than cable tv and beer.

I agree- and do not underestimate the possibility of being turned down for private healthcare. I have a relatively harmless heart condition, but it was recommended by one of my cardiologists that I get a pacemaker. I opted for medication, but now I have been turned down for private health insurance.

 

[deleted128562]

have you purchased health care for yourself (& family) yet? and have you purchased health care that isn't subsidized by your occupation or school? because it can be quite a bit more expensive than cable tv and beer, especially if you want more than bare bones catastrophic insurance (that is, if you want a deductible low enough to handle and maybe some coverage of preventative care; don't even think about dental or vision for a reasonable price, ain't gonna happen). you should check out blue cross/blue shield for your state - and don't believe the 'quotes' they your info, once you enter your health history those numbers can doubl or triple, and I'm a pretty healthy person in my mid-20s. npr had a story on the other day about a woman who had previously had cancer and her insurance was going to be $3000/month. that's more than cable tv and beer.

Yep, I have. For a family of 4. Catastrophic plan.... which is what insurance should be for anyway, IMO.

 

[Gut Shot]

Yes I'm all for the universal healthcare....because the federal government is soooo efficient at running things.

Depends on how you define "running things." A single private hospital may indeed provide better care in a more efficient and cost effective manner than a given VA Hospital, but that's not the problem.

The problem is that a single system, however inefficiently it is administered, would have a difficult time being worse than the endlessly complex, cobbled-together labyrinth of private insurers and providers that exist in this country.

Besides, we are a highly innovative and enterprising country, when we have to be. Who says that universal coverage equates to direct Federal management of the healthcare apparatus? I reference an article from JAMA (emphasis added):

Consumer-Driven Health Care
Lessons From Switzerland
Regina E. Herzlinger, DBA; Ramin Parsa-Parsi, MD, MPH
JAMA. 2004;292:1213-1220.

Switzerland's consumer-driven health care system achieves universal insurance and high quality of care at significantly lower costs than the employer-based US system and without the constrained resources that can characterize government-controlled systems. Unlike other systems in which the choice and most of the funding for health insurance is provided by third parties, such as employers and governments, in the Swiss system, individuals are required to purchase their own health insurance. The positive results achieved by the Swiss system may be attributed to its consumer control, price transparency of the insurance plans, risk adjustment of insurers, and solidarity. However, the constraints the Swiss system places on hospitals and physicians and the paucity of provider quality information may unduly limit its impact. The Swiss health care system holds important lessons, including evidence about its feasibility and equity, for the United States, which is now embarking on its own consumer-driven health care system.

 

[Chuckwalla]

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.

What do you mean like children? It has nothing to do with liking them, it has to do with the fact that children are dependent on their parents for healthcare. If their parents can't get that for them they shouldn't have to suffer for it.

I don't know why you assume universal healthcare would hurt doctor salaries. We've blown 100s of billions on a war and tax cuts for corporations. If we had just put some of that into getting healthcare for those who needed it we could have made it happen.

Even more we could have used some of that to make med school less expensive. It is ridiculous that we bury some of our most important members of society under mountains of debt.

 

[notdeadyet]

I'm all for health care for all. That's why I think it's so great that people who aren't poor have the freedom to give up their cable tv and beers and purchase a health policy if they so choose. And that truly poor people are able to get Medicaid.

You seem to think that Medicaid is for those who can't affor insurance. That's not true. It's for the absolute butt-poor. There are millions of Americans that make too much to qualify for Medicaid but do not make enough to be able to afford insurance.

My wife is a teacher and has to pay $450/month for pretty poor insurance due to exposure she had to TB once upon a time, even though she does not have the disease.

A friend had a heart condition that was covered by his insurance, but was laid off and was not able to find a new job with benefits in time to transfer over his policy. He can now not find decent coverage due to his "pre-existing conditions".

These are not unusual stories. The reason we have such trouble with any kind of social reform is that folks try to make judgements looking at their own life without the ability to see how things affect others.

Our health policy works great if you're an employed, middle-class or higher healthy American. Otherwise, it sucks.

 

[notdeadyet]

Yep, I have. For a family of 4. Catastrophic plan.... which is what insurance should be for anyway, IMO.

And this is why we have such a health crisis in this country. Folks view health insurance as a "just in case" to cover in case of catastrophe, which limits how much preventative medicine they get.

 

[dutchman]

Physician's should fight pay cuts. But any physician against the idea of health care for all has pretty funny morals.

Good point. However some peole here believe they ought to take a pay cut to prove their higher level of sophistication.

Here are examples of people fighting for their own.

Your lawmakers(working 26hrs/week) who believe doctors should take a paycut, fighting for their own.

http://www.boston.com/news/globe/ed...4/congress_helps_itself_to_another_pay_raise/
"Congress helps itself to another pay raise.........A HAPPY NEW YEAR? For US senators and representatives, it certainly is: As of Jan. 1, their salary is $158,100 -- an increase of $3,400 over the amount they collected last year."

Your Judges who BTW earn their salaries lifetime, fighting for their own.

http://www.washingtonpost.com/wp-dyn/content/article/2006/12/31/AR2006123100709.html
"Chief Justice Urges Pay Raise for Judges....Roberts will continue to be paid $212,100 a year, with associate Supreme Court justices at $203,000, appeals court judges at $175,100 and federal district judges at $165,200."


Lawyers, fighting you for their own.

http://www.ncpa.org/pd/law/pdlaw/pdlaw16.html
"Legal observers report that plaintiffs' trial lawyers are waging a fierce war against efforts by state legislatures to reform the tort process."

Even illegal immigrants are fighting for their own

http://abcnews.go.com/US/wireStory?id=1908788&page=3
"Immigrants Plan Nationwide Day of Protest"

Yet when doctors try to fight for their own interests fellow members of the medical community want to call them greedy. This is democracy, no one but you is going to fight for your interests, and if you offer yourself for sacrifice, you will get sacrificed.

 

[Steve203]

Good point. However some peole here believe they ought to take a pay cut to prove their higher level of sophistication.

Here are examples of people fighting for their own.

Your lawmakers(working 26hrs/week) who believe doctors should take a paycut, fighting for their own.

http://www.boston.com/news/globe/ed...4/congress_helps_itself_to_another_pay_raise/
"Congress helps itself to another pay raise.........A HAPPY NEW YEAR? For US senators and representatives, it certainly is: As of Jan. 1, their salary is $158,100 -- an increase of $3,400 over the amount they collected last year."

Your Judges who BTW earn their salaries lifetime, fighting for their own.

http://www.washingtonpost.com/wp-dyn/content/article/2006/12/31/AR2006123100709.html
"Chief Justice Urges Pay Raise for Judges....Roberts will continue to be paid $212,100 a year, with associate Supreme Court justices at $203,000, appeals court judges at $175,100 and federal district judges at $165,200."


Lawyers, fighting you for their own.

http://www.ncpa.org/pd/law/pdlaw/pdlaw16.html
"Legal observers report that plaintiffs' trial lawyers are waging a fierce war against efforts by state legislatures to reform the tort process."

Even illegal immigrants are fighting for their own

http://abcnews.go.com/US/wireStory?id=1908788&page=3
"Immigrants Plan Nationwide Day of Protest"

Yet when doctors try to fight for their own interests fellow members of the medical community want to call them greedy. This is democracy, no one but you is going to fight for your interests, and if you offer yourself for sacrifice, you will get sacrificed.

Exactly dutchman, you hit the nail right on the head. I don't know about any of you, but I would not stand for a single paycut; not even a penny. If that makes me a bad physician or a horrible person, then so be it.

 

[Ryo-Ohki]

And this is why we have such a health crisis in this country. Folks view health insurance as a "just in case" to cover in case of catastrophe, which limits how much preventative medicine they get.

How many miles did you run this week?

I just took the exercise pill. I love preventative medicine.

 

[Ryo-Ohki]

Yep, I have. For a family of 4. Catastrophic plan.... which is what insurance should be for anyway, IMO.

HSA

Just one stop towards removing the third party payer system.

 

[gary5]

Yes I'm all for the universal healthcare....because the federal government is soooo efficient at running things.

What??? You don't believe me?? What about...

Post Office??? (because nothing ever gets lost in the mail)

Public Schools??? (because they are so great)

The IRS??? (because everybody always pays their taxes)

Immigration Services??? (don't even get me started)


Just imagine how well run all these services are....now imagine the government running health care too!!

That will be great!


(and before you make assumptions, my parents are immigrants, and yes I went to public school, and my family never had health care)

You are so right. Government is one of the most incompetent parts of society. If you want something done poorly, let govt manage it.

 

[deleted128562]

You seem to think that Medicaid is for those who can't affor insurance. That's not true. It's for the absolute butt-poor.

Are you kidding me? The cuttoff in my state (middle America state, not terribly high cost of living) is $34,000 per year for a family of 4. That may not be riches, but it sure as heck ain't butt poor. It translates out to about a $17 an hour job.

 

[BarrySanders]

the poverty line in America is about $20,000 a year for a family of 4. So $34,000 a year for a family of 4 may not be "butt-poor" but its not that far from it. It is a FACT, and does not need to be argued, that many working class families cannot afford insurance for their families, and contrary to popular belief, all working class and poor families aren't off wasting their limited pay checks on beer, cable tv, expensive clothes and other things they can't afford.

 

[deleted128562]

Well, we're making $31,000 a year while I get through school and we're doing just fine. Plenty of food on the table, a decent roof over our heads, 2 cars, and healthcare (not Medicaid incidentally, even though we qualify). Not to mention money going into the bank each month in savings. We've learned how to BUDGET our money, we've decided that we're OK living within our means (we don't go out very much but that's alright), and have also decided not to go into all sorts of credit card debt for things we don't really need.

So it is a FACT, and need not be argued, that a family of 4 can make it just fine on $31,000 a year. We're doing it. So with the Medicaid cutoff at $34,000 for a family of 4, I have yet to see what the big problem is (other than people living beyond their means). The poor in this country live far more lavishly than the middle class in many other countries. Go count the number of big screen TV's and boats in any given trailer park community. You'll be surprised.

 

[Cirrus83]

For all of you who think everyone should have insurance and 80K a yr is enough.. here is what I want you to do.. put your money and your time where your mouth is..

When you become an attending and are making your "amazingly high" salary live on 80K per yr.. spend 50K a yr on your loans if you have them and then spend the rest on buying for an paying for insurance for the uninsured. Put an ad out in the paper and spend the rest of your money paying for insurance for whoever calls first. Once you put your money where your mouth is then come and talk to me.

Universal healthcare is dumb, has been dumb and continues to be dumb.

We have tons of problems other places dont. I dont think it has been mentioned on here but how about all the trauma we deal with in this country. No European country sees as much of it as we do. Heck a month in the SICU will run a couple of hundred thou and on top of that there is the cost for all the surgeries and other little things.

We arent Europe and we should be thankful. I was born in Europe and let me tell you they are little softies for the most part. The parisians didnt even stop eating their croissants and drinking coffee until the germans were marching down the Champs elysee.. We should look at them and their system as another option.... a bad option...

It would make more sense putting your money into a fund to further the political goal of universal healthcare instead of blowing it on super high per person insurance prices.

Oh and US docs don't work the same hours as docs in most places with universal healthcare, so to make it a truly fair comparison you'd have to work less hours too. Which would really just mean that you wouldn't have much money left to buy more than 2-3 people healthcare coverage anyway.

Anyways if you don't like universal healthcare because our lawmakers want to make physicians eat the costs, then just say that. You're basically damning the whole idea of universal healthcare based on what appears to be trashing the French for eating croissants. Clearly, the best way to figure out healthcare policy.

 

[Cirrus83]

Just out of everyone arguing against universal healthcare, I'm curious what their thoughts are on:

* Medicare/Medicaid- this was our step towards universal coverage in the sixties. Should we get rid of that while we're at it?
* School lunch programs- why do we feed poor kids if we aren't going to care for their health?
* Social Security- why should I subsidize the elderly lifestyle/

etc. etc. etc.

I agree that universal healthcare should be rolled out intelligently and carefully, but I don't see how you can support public schools and libraries and national parks if you think healthcare shouldn't be a right as well.

You know, I think you're right. Education isn't a right! And this public system has just lead to a shortage of decent teachers since the pay is too low. So what we should do is privatize all education. People make enough money to pay for their kids education, and if they can't afford it they should give up their cigarettes so they can.

 

[Cirrus83]

I'm all for health care for all. That's why I think it's so great that people who aren't poor have the freedom to give up their cable tv and beers and purchase a health policy if they so choose. And that truly poor people are able to get Medicaid.

Are you also oblivious to the fact that healthcare costs have literally skyrocketed in the last couple of decades? It's already eating up DOUBLE DIGITS OF OUR GDP (16% in 2004).

Go scope out how much it is just to cover YOURSELF with healthcare. Then imagine if you had kids too, and go see how much a policy is. Really easy to spout off about how people should just stop watching cable TV when you ignore the fact that insurance will cost you more than a very very nice car per year for a family of 4.

Hell you want to know how much it costs me, a SINGLE PERSON, for insurance? It costs $400 a month for health and dental. That's $4800 a year. For ONE PERSON. Oh and the dental only costs $50/month, so the absolute majority is my healthcare (this is Aetna if you care).

And sure maybe we can still afford it now, but the price goes up 8% a year, so just wait a few years when it's costing you $20K a year to cover your family, and you only make $30K a year after taxes. Yeah I guess you better give up your cable then huh. And your car, and why bother to have a house, you can live in a studio apartment with your kids. And who needs food right?

You obviously have NO CLUE how much money healthcare coverage is in the US. Which makes it all that more ridiculous that you're arguing about it.

 

[Cirrus83]

So it is a FACT, and need not be argued, that a family of 4 can make it just fine on $31,000 a year. We're doing it. So with the Medicaid cutoff at $34,000 for a family of 4, I have yet to see what the big problem is (other than people living beyond their means). The poor in this country live far more lavishly than the middle class in many other countries. Go count the number of big screen TV's and boats in any given trailer park community. You'll be surprised.

Right, so what happens when you make $40K a year and insurance costs $20K a year? Is your solution for everyone to be on Medicaid? Or merely for the entire middle class to be as poor as people on Medicaid because they have to spend 1/3rd of their income on healthcare. Good idea.

 

[Ryo-Ohki]

Right, so what happens when you make $40K a year and insurance costs $20K a year? Is your solution for everyone to be on Medicaid? Or merely for the entire middle class to be as poor as people on Medicaid because they have to spend 1/3rd of their income on healthcare. Good idea.

The same thing you do when you think something costs too much. You don't buy it. Lower demand causes the price to go down.

 

[deleted128562]

You obviously have NO CLUE how much money healthcare coverage is in the US. Which makes it all that more ridiculous that you're arguing about it.

Earlier you brought up the public education system - perhaps we should get rid of public education because apparently it has not taught you how to read. If you would go back and look at my posts you would see that, as I have already stated,

1) I have a family of 4
2) I pay for our own health insurance
3) I therefore apparently do have a clue how much money healthcare coverage costs in the USA
4) I make less money per year than the Medicaid eligibility line
5) I still don't need it and still have a decent lifestyle because:
6) I know how to budget my money and realize, unlike many people that:
7) You really actually won't die without cable tv, a nice cell phone, or eating out

Can I possibly spell this out any more clearly for you?? Do I need to make it into a book on tape?

 

[45408]

You seem to think that Medicaid is for those who can't affor insurance. That's not true. It's for the absolute butt-poor. There are millions of Americans that make too much to qualify for Medicaid but do not make enough to be able to afford insurance.

That may be, but half of the children in my state who don't have insurance DO qualify for Medicaid. They're just not willing to go through the red tape to get it. here's the article - http://www.jsonline.com/story/index.aspx?id=553005

It's even worse nationwide - 74% of uninsured children are eligible for health care. I dare say that the parents, not the system, are the problem.

 

[Towelie]

That may be, but half of the children in my state who don't have insurance DO qualify for Medicaid. They're just not willing to go through the red tape to get it. here's the article - http://www.jsonline.com/story/index.aspx?id=553005

It's even worse nationwide - 74% of uninsured children are eligible for health care. I dare say that the parents, not the system, are the problem.

Blaming the parents doesn't get these kids insured. And what about the other 26%?

 

[deleted128562]

Blaming the parents doesn't get these kids insured.

You're right. Heck, I think I'll drop my kids insurance tonight and just wait for society to take care of them. I've got plenty of things to do besides worry about the welfare of my own kids.

 

[OncoCaP]

Exactly dutchman, you hit the nail right on the head. I don't know about any of you, but I would not stand for a single paycut; not even a penny. If that makes me a bad physician or a horrible person, then so be it.

I'm not sure that anyone here is arguing that we should take a pay cut. If anything, the current system does not serve patients very well and is leading to stagnant pay of physicians. Ask physicians if they are happy with salaries under the current system. Many aren't.

A better system (such as a universal rationing of health care that requires everyone to either buy insurance or pay an extra tax that will subsidize a government program that randomly assigns the non-conformers to minimal plans) would lead to an increase in physician pay because it increase demand for certain services (such as primary care, presumably). Yes, a healthier population might not require as many procedures and reduce compensation, but overall population growth could very well keep all procedures growing. Some people are assuming that universal rationing of healthcare will lead to reduced physician pay; I don't see the connection.

 

[Amemus]

I'm not sure that anyone here is arguing that we should take a pay cut. If anything, the current system does not serve patients very well and is leading to stagnant pay of physicians. Ask physicians if they are happy with salaries under the current system. Many aren't.

A better system (such as a universal rationing of health care that requires everyone to either buy insurance or pay an extra tax that will subsidize a government program that randomly assigns the non-conformers to minimal plans) would lead to an increase in physician pay because it increase demand for certain services (such as primary care, presumably). Yes, a healthier population might not require as many procedures and reduce compensation, but overall population growth could very well keep all procedures growing. Some people are assuming that universal rationing of healthcare will lead to reduced physician pay; I don't see the connection.

First, I'd like to say I like the way you think. But did you know Clinton's Health Security Act was very similar to what you were describing? And that not only did it fail, it crashed and made more Americans question whether universal health care should be the goal?
What's next, then?

 

[BarrySanders]

Mr Hat does your wife not work? Do you live in a small town area with inexpensive expenses?
I'mnot trying to be smart, just questions.

 

[Doctor Bagel]

HSA

Just one stop towards removing the third party payer system.

That reminds me -- I have about $1k in my HSA from work but don't really know where it is. I got a letter saying it would be reassigned to new account after I quit my job. However, I haven't heard anything after that. So far, HSA has equaled a PITA. Also, have you looked at allowable expenses for them. You can use it to pay Cobra premiums, but you can't use it to pay premiums for private insurance or for another group plan. I naively thought I could use the money to pay my premiums for my insurance this year, but no, it's not allowed.

Also, since I don't have much money in it and am no longer part of a group, I'm guessing whoever is holding that money has charged the hell of it leaving me with maybe $500.

As a working stiff, it's also pretty hard to build up any significant amount of money in one. My previous insurance that was coupled with the HSA had a $3k deductible. I was able to donate $100/month to it. Basically, that meant I'd have to wait a hell of a long time before I reached a point where I wasn't facing huge out of pocket payments.

 

[Cirrus83]

Earlier you brought up the public education system - perhaps we should get rid of public education because apparently it has not taught you how to read. If you would go back and look at my posts you would see that, as I have already stated,

1) I have a family of 4
2) I pay for our own health insurance
3) I therefore apparently do have a clue how much money healthcare coverage costs in the USA
4) I make less money per year than the Medicaid eligibility line
5) I still don't need it and still have a decent lifestyle because:
6) I know how to budget my money and realize, unlike many people that:
7) You really actually won't die without cable tv, a nice cell phone, or eating out

Can I possibly spell this out any more clearly for you?? Do I need to make it into a book on tape?

I read everything you wrote, including the fact that you make less than the Medicaid eligibility line. So do you mean you purchase your own separate private health insurance even though you qualify for Medicaid? How am I supposed to assume that from anything you wrote before?
I think you're the one who needs to learn how to write, instead of whining about how other people can't read your mind.

You never explicitly wrote that you had private healthcare that you purchased yourself-you only said that you made less than the Medicaid cut-off. Which I dare say most people would have interpreted as meaning that you were on Medicaid. Since this doesn't seem to be the case, you should provide a little more detail of how exactly you make $31K a year and am still able to purchase your own private healthcare for your entire family. Because otherwise you're just trolling people.

So if you did in fact, purchase separate private health insurance, tell me how much your premiums are for your family of 4, and why you don't just file for Medicaid if you do qualify for it. If you get healthcare benefits from your job, that doesn't count because you wouldn't actually be shouldering the cost of your own healthcare coverage. And while you're at it, why don't you tell us what your plan is for stopping the rising cost of healthcare, since even if people could barely afford it now, those same people might not be able to afford it in 10 years when it's over 2x the current price.

And for the record, I didn't actually bring up the educational system, I was responding sarcastically to someone else who had brought it up.

 

[deleted128562]

Mr Hat does your wife not work? Do you live in a small town area with inexpensive expenses?
I'mnot trying to be smart, just questions.

No worries, they're good questions. My wife does not work. I wouldn't say we live in a small town area - we live in a pretty populated region, and expenses are probably pretty average as far as the country goes.

 

[deleted128562]

I read everything you wrote, including the fact that you make less than the Medicaid eligibility line. So do you mean you purchase your own separate private health insurance even though you qualify for Medicaid? How am I supposed to assume that from anything you wrote before?
I think you're the one who needs to learn how to write, instead of whining about how other people can't read your mind.

You never explicitly wrote that you had private healthcare that you purchased yourself-you only said that you made less than the Medicaid cut-off. Which I dare say most people would have interpreted as meaning that you were on Medicaid. Since this doesn't seem to be the case, you should provide a little more detail of how exactly you make $31K a year and am still able to purchase your own private healthcare for your entire family. Because otherwise you're just trolling people.

So if you did in fact, purchase separate private health insurance, tell me how much your premiums are for your family of 4, and why you don't just file for Medicaid if you do qualify for it. If you get healthcare benefits from your job, that doesn't count because you wouldn't actually be shouldering the cost of your own healthcare coverage. And while you're at it, why don't you tell us what your plan is for stopping the rising cost of healthcare, since even if people could barely afford it now, those same people might not be able to afford it in 10 years when it's over 2x the current price.

And for the record, I didn't actually bring up the educational system, I was responding sarcastically to someone else who had brought it up.

Go back through my posts and you will find where I said something to the effect of "we qualify for medicaid although we are not on it". Why? Because 1) we're fine without it 2) I want as little government in my life as possible 3) seems a waste to ask taxpayers to pay our insurance if we don't really need it. 4) To be completely honest, I'm a little prideful and don't want to be on any kind of welfare.

I currently pay roughly $700/mo. for healthcare (big time catastrophe plan, big deductible and all). Yeah it hurts but we make it work. I am hoping to have employer health insurance soon though to be completely forthright.

My plan? First, more personal responsibility. If all who could afford health insurance would buy it that would go a long way and then maybe we could talk about covering those that remain. I do not pretend to be an expert on how we should solve this problem - I just don't think that universal coverage is the way to go. Is the system great now? No. Will it be better with universal coverage? I don't think so. Maybe more people will be "insured" but when that coverage gets Mr. and Mrs. Previously Uninsured subpar care with a 2 month wait, I'm not sure how much better it is than free care in the ER....

Just my opinion. I do apologize for being snippy/rude with you earlier. I've had a rough day (ironically the kids are sick) but - that still doesn't excuse it so I am sorry.

 

[45408]

Blaming the parents doesn't get these kids insured. And what about the other 26%?

And so now imagine they have insurance. They're still not going to bring their kids to the doctor. Should we send a school bus around to pick up their kids? How about you schedule all of their shots? Actually, why don't we just take all the children and have the government take care of them, a la Socrates? You can only do so much for someone who doesn't want your help.

 

[instigata]

The same thing you do when you think something costs too much. You don't buy it. Lower demand causes the price to go down.

Actually the health care system doesn't operate on the supply/demand law. Hospitals are constantly competing with each other to have the most updated technology to draw in more patients. With greater technology come greater health costs. This applies to lower demand, where hospitals will keep upgrading their equipment to increase demand, and thus spiral up costs. It's a very peculiar system, this health care.

 

[DropkickMurphy]

**puts gun to head of this thread and pulls trigger twice**

 

[MirrorTodd]

**puts gun to head of this thread and pulls trigger twice**

??? Are you Chuck Norris? It was a good thread I thought. I always enjoy reading everybody's soapboxes. Good job people!

 

[Vox Animo]

300K is far more than any medical school in the country. How did you get this much debt? This is probably more debt than 99.999% of medical students in the country take on. So it's not really a realistic example.

And can't you pay these off in 20 years rather than 10? I believe 20 years is the norm for most loan repayments. If you do this, then you will be paying only ~25K per year, giving you a salary of 80-85K. This gives you plenty of room (especially with a working spouse) for retirement, savings and house payments.

Primary care payments are projected to go UP, not down.

If you decide to go to a private school rather than a cheaper public school, the debt may impact your ability to enter subspecialties like FP and Peds. These are considerations that should be taken before going to medical school. If you want to do academics or a low paying specialty, it might be good to go to the cheapest school possible.

Actually my school's estimated cost is 60K a year. Most private school cost that much. AT least all the ones i applied too. And the average medical school debt for students graduating NOW is 160K. 4 years ago it was 100K. For the 2010 class the average debt will be well over 160K, closer to 220-250. And that 160K is the average debt. That takes into account all medical studments, many of which come from wealthy families who pay for their school, or some part of it. I only have 17K from undergrad. Any medical student who is taking all loans, 60K a year for 4 years is 240K, plus undergrad, plus the interested that accrues, should plan on being 300K when they get out.

If you are single, and have no help from outside sources, this is the debt you should expect to take on.
You aren't even in medical school yet are you?

 

[Towelie]

I would go to a state school over a private school that charged so much. I'm not in medical school yet, but I will definitely not pay over $150K to go there (if that means I have to go to a state school that I'm not crazy about, so be it). Remember, you chose to put yourself into that kind of debt, knowing how precarious physicians' salaries are.

There is not one school in the country with an AVERAGE debt that even approaches 200K, nevermind 300K. Look at the US News data on this. Most people with no financial assistance at all choose cheaper options, like state schools. You are in a very small minority.

 

[Towelie]

And so now imagine they have insurance. They're still not going to bring their kids to the doctor. Should we send a school bus around to pick up their kids? How about you schedule all of their shots? Actually, why don't we just take all the children and have the government take care of them, a la Socrates? You can only do so much for someone who doesn't want your help.

Riiiight. They won't bring their insured kids to the doctor. And you write this based on no evidence whatsoever.

 

[Doctor Bagel]

I would go to a state school over a private school that charged so much. I'm not in medical school yet, but I will definitely not pay over $150K to go there (if that means I have to go to a state school that I'm not crazy about, so be it). Remember, you chose to put yourself into that kind of debt, knowing how precarious physicians' salaries are.

There is not one school in the country with an AVERAGE debt that even approaches 200K, nevermind 300K. Look at the US News data on this. Most people with no financial assistance at all choose cheaper options, like state schools. You are in a very small minority.

Well, you're blessed to have the option to go to a cheap state school. My state school (OHSU) charged $30k year instate and gave very marginal preference to instate applicants on top of having a very random admissions process. Consequently, they rejected my a&&, so it wasn't an option. Lots of us in that position. Believe me, borrowing that much doesn't make you part of a small minority anymore.

 

[dutchman]

And that is why physicians need to fight paycuts to the death. The politicians need to understand the plight of the actual people in the trenches. Trust me when I say they dont.

 

[Mr. Itchy]

You guys arguing about this makes me chuckle. My cousin spends his entire paycheck on his car and apartment; hydraulics and candy paint for his ghetto-blaster and big speakers, etc... He doesn't have health insurance and I doubt he ever will.

Make all the socio-political arguments you want. He will be laughing all the way to the bank off your hard earned money. If you don't mind that, its quite alright with me... You pay for it, and leave me and mine alone and leave my charity MY choice, not yours.

 

[Vox Animo]

I would go to a state school over a private school that charged so much. I'm not in medical school yet, but I will definitely not pay over $150K to go there (if that means I have to go to a state school that I'm not crazy about, so be it). Remember, you chose to put yourself into that kind of debt, knowing how precarious physicians' salaries are.

There is not one school in the country with an AVERAGE debt that even approaches 200K, nevermind 300K. Look at the US News data on this. Most people with no financial assistance at all choose cheaper options, like state schools. You are in a very small minority.

IF you are entering medical school in 2007, and have no financial assistance, at a private school your debt will be over 200K. IF you say no schools have an average debt that high, you missed my point entirely for the third time. I will repeat myself, these are expected debt projection for people entering medical school this year, with no outside assistance. Private schools cost between tuition, cost of living ect about 60K a year. When you apply to school, you will know this.I didn't think that that was so hard to understand. Im not complaing about my debt, i knew it coming in. I was explaining to an original post some 3 pages ago that the amount you have to pay back is a much larger than expected. Keep in mind in addition to the 200K in loans, most people ahve undergrad debt, mine is very low at 17K. Also, interest accrues while you are in residency because most people can't afford to pay on the 40-50K salary. So 7% interest over 3-5 years adds up.

You may not of the choice of going to a state school. They may not accept. I know it sounds weird but it happens. Most people would prefer state school tuition, but there is not enough room for everybody. However, state tuition is rising, so you may not be able to get out of any school with 150K in debt. No offense, but do some research. The average debt of medical students was around 100K in 2002. For 2006 grads it was 170K. See the trend? tuition everywhere is rising out of control.

In fields like Primary care, you have to plan on at least a third of your salary going to pay back your debt for 10-15 years.

 

[Cirrus83]

Go back through my posts and you will find where I said something to the effect of "we qualify for medicaid although we are not on it". Why? Because 1) we're fine without it 2) I want as little government in my life as possible 3) seems a waste to ask taxpayers to pay our insurance if we don't really need it. 4) To be completely honest, I'm a little prideful and don't want to be on any kind of welfare.

I currently pay roughly $700/mo. for healthcare (big time catastrophe plan, big deductible and all). Yeah it hurts but we make it work. I am hoping to have employer health insurance soon though to be completely forthright.

My plan? First, more personal responsibility. If all who could afford health insurance would buy it that would go a long way and then maybe we could talk about covering those that remain. I do not pretend to be an expert on how we should solve this problem - I just don't think that universal coverage is the way to go. Is the system great now? No. Will it be better with universal coverage? I don't think so. Maybe more people will be "insured" but when that coverage gets Mr. and Mrs. Previously Uninsured subpar care with a 2 month wait, I'm not sure how much better it is than free care in the ER....

Just my opinion. I do apologize for being snippy/rude with you earlier. I've had a rough day (ironically the kids are sick) but - that still doesn't excuse it so I am sorry.

Well, I was responding to that one post I quoted of yours, so that's why I didn't know you were paying for your own insurance. I do understand the pride though, lol. Back in the day my own family was pretty broke and it definitely hurt my mother's pride when your income qualifies you for free lunch at school (personally I didn't care, since there were plenty of other kids on free lunch at school, but in my mother's mind it was a huge deal). And in retrospect, we probably could have gotten some help from actual welfare or whatever, but we didn't.

Anyways, it makes a lot more sense that you're paying for catastrophic coverage, because you have to realize that in my mind I was thinking about regular coverage (the kind with a $10 deductible)-which would be pretty hard to swing for a family of 4 on $31K a year (it's pretty hard just for me to swing my own healthcare plan, let alone a whole family). At least you're doing the responsible thing for your family.

Anyhow, we can disagree on how to handle increasing healthcare costs, but seriously, there definitely needs to be some kind of actual solution, and universal healthcare is at least proven to work, even if it's also been proven to provide crappy wait times for more expensive tests. But yeah, it's not optimal either (and I've seen the horrible wait times at the NHS first-hand, if you think a 6 month wait is bad, wait until you have a patient who finally comes in after 6 months only to find that their doctor is on vacation and they have to wait another 6 months thanks to the red tape...they get pretty angry let me tell you).

But yeah, seriously you shouldn't be too prideful to take advantage of Medicaid, or if your state has one of those child healthcare coverage programs (I know NY state provides healthcare to pretty much all children). If it really bugs you, just think of how much money in taxes you'll end up paying when you're finally a doctor, lol. It's not like you'll just be taking government money and leeching off of the government forever, you'll definitely give back WAY more in taxes than anything you'll ever take now, so you shouldn't really feel like you're a leech just because you're on Medicaid. Because while catastrophic is great for keeping your family out of deep financial doo-doo (this is a technical term of course ), it's definitely a lot harder to stomache regular visits to the doctor when you have to pay a ton of money out of pocket. Plus, hospitals/doctors mark up visits if you don't have healthcare coverage anyway, which just makes it that much more painful (although if you have a nice doctor who knows you don't have insurance they might give you a break on that instead of forcing you to haggle every visit). Mostly I'm saying this because having only catastrophic coverage tends to make people put off regular visits, which is bad because people end up having problems that could have been caught earlier when it wasn't such a big deal-this doesn't neccessarily apply to you, since you might very well keep up with regular visits and whatnot, but in general I know I'd personally put off seeing the doctor about little things if I had to pay $150 each time I went over there.

 

[Cirrus83]

You guys arguing about this makes me chuckle. My cousin spends his entire paycheck on his car and apartment; hydraulics and candy paint for his ghetto-blaster and big speakers, etc... He doesn't have health insurance and I doubt he ever will.

Make all the socio-political arguments you want. He will be laughing all the way to the bank off your hard earned money. If you don't mind that, its quite alright with me... You pay for it, and leave me and mine alone and leave my charity MY choice, not yours.

lol, how is your charity your choice when your tax dollars end up going towards his insane emergency room bills anyway?

The argument about universal healthcare isn't really about whether it'd cost us more money, it's really just about whether the cost savings and universal coverage are worth the crappier wait times. And, in terms of this forum/thread, paranoia about physician salaries.

There's no way a universal healthcare system would increase how much of our money goes towards "charity", lol. If anything it'd lower how much money each person ends up spending on the healthcare of others, not increase it.

Anyways, I think this thread is dead. If you don't like universal healthcare, that's fine. If you want to learn about healthcare costs but think of it from a capitalistic viewpoint, just read whatever healthcare articles the Wall Street Journal has-they're not big fans of universal healthcare on Wall Street, lol. But posting complete nonsense like this doesn't really argue against universal healthcare. There are some fairly intelligent arguments out there for HSA's and whatnot as a way of containing the cost of healthcare, and that's what one would expect to see in such a thread as arguments against universal healthcare.

I remember going to a debate on this, and one of my favorite professors was arguing against our university president about this (he's also a professor). And the university president made a lot of really strong arguments against single-payer universal healthcare. His argument was strong because he actually provided alternatives though, and explained how similar alternatives worked in other countries. For example, China doesn't have universal healthcare like Canada does, it has a totally different system where each person gets a certain amount of money they can use (sort of like an HSA but not exactly), and he used that as an example. And while I'm not a huge fan of the Chinese system (mostly because of the experiences of my relatives there), I could see how it could be improved so that it would be a somewhat viable system in the US.

Anyways, I guess now I'm debating myself, so this thread is really dead lol.

 

[Eric Lindros]

I would go to a state school over a private school that charged so much. I'm not in medical school yet, but I will definitely not pay over $150K to go there (if that means I have to go to a state school that I'm not crazy about, so be it). Remember, you chose to put yourself into that kind of debt, knowing how precarious physicians' salaries are.

There is not one school in the country with an AVERAGE debt that even approaches 200K, nevermind 300K. Look at the US News data on this. Most people with no financial assistance at all choose cheaper options, like state schools. You are in a very small minority.

Not everyone has the luxury of choosing what school he or she wants to attend. Not everyone is from states who have cheap medical schools. The cheapest state school in Pennsylvania, for example, will put you at 150k easily, maybe even higher. Yeah, that's the CHEAPEST state school at IN-STATE tuition.

You can't really use averages for these types of arguments because many students get scholorships to attend schools. Some students also have their medical schools paid for by other people. Those reported average debt numbers do not take these things into consideration.

Try to look at it from a different perspective, because yours seems a little narrow. 200K+ debt is actually a reality for many people (including me) And no, I don't have any other choice.

 

[saftab]

Hence my argument that socialism is EASY to concieve but never works. It is cute to run arround and say "let us take care of everyone". The capitalist system is what has put the U.S on top of the world economically, but socialism will bring it down.

What many of you people do not seem to understand is that healthcare is more than a moral, civic, or political issue, it is a pertinent economic issue. Healthcare, for all intensive purposes, should be considered and inelastic good. This is why insurance companies are able to profit so much. Furthermore, private providers are completely cost ineffective. The administrative costs of these insurance companies is about 10 times more than that of medicare and medicaid!! Healthcare has such a tremendous impact on the economy that nearly half the people that file bankruptcy in this country do so because of medical bills!

Additionally, our corporations cannot conceivably compete with foreign competition if they have to pay billions of dollars to provide healthcare to their employees. For example, it costs an additional $2000 for every car that GM produces because of the high healthcare costs the company has to pay for its employees. How can these companies be expected to compete against companies like Toyota which is based in Japan where they have universal health coverage.

Why should the economy be important to doctors? Well I hope this isn't a question I should even have to address.

 

[ryandote]

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.

There is your problem. Guess what? There isn't enough to go around.

 

[novawildcat]

wow my 30 min. visit to the ER after my car accident to see the PA and a get a pill of asprin cost $3000. That is definitely the best pill of aspirin I have ever taken.

 

[gary5]

The net result is very predictable: (1) higher taxes for everyone who is already insured, and (2) lower pay for physicians. So really, physicians will get hit twice, hit from both ends.