What needs to happen to make socialized healthcare viable?

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sirus_virus

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With the impending legalization of 20 million illegals, the U.S is clearly heading towards becoming a one party system(Democrat), seing as republicans like Tancredo have pretty much guaranteed that non of those immigrants will be voting republican.

At that point, I believe it will no longer be a question of "if" but "what type" of socialized medicine we will be operating under. So I was just thinking about what needs to happen to make socialized medicine viable, or at least fair to physicians. Some of my suggestions include:

-Free medical education, and any outstanding debt owed by practicing physicians needs to be eaten by the government.

-Dramatic increase in resident doctors' salaries.

-Drastic tort reform, or just let the government pay for physicians' medical malpractice insurance.

-Creation of a national physicians union.


Any other suggestions?

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Any other suggestions?

Don't give amnesty to illegal aliens, begin actually enforcing our borders, begin deporting illegals which will spark a movement among many of them to leave of their own volition. Then, come up with a solution to the health care "crisis" that doesn' involve turning over control to the federal government.
 
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ultra-liberalize the country :sleep:

let's face it, its not going to happen.

Seems inevitable IMO; the question is -- how will this affect physicians? I am saying this because, it is very possible that they might half ass the system to where physicians will be in double jeopardy.
 
Seems inevitable IMO; the question is -- how will this affect physicians? I am saying this because, it is very possible that they might half ass the system to where physicians will be in double jeopardy.

Am I on everyone's ignore list?

Why is it inevitable? Given the massive grassroots uprising against the latest disastrous immigration bill, it's entirely possible that the American people are waking up on this issue, and will vote to expel the illegals rather than granting them citizenship. If that happens, it will be far from inevitable that 20 million new Hispanic voters will vote socialized medicine into existence.
 
Personally, I think we need to make Americans look outside our borders on the socialized medicine issue. Everywhere that socialized medicine has been institutionalized, the health care systems have deteriorated, at least to some degree. Look at England and any of the scandinavian countries. Taxes through the roof...substandard care (just look at England's dental program)... and the problem of access will simply persist because the government has no incentive to expand the current infrustructure. Anyone who has lived under socialized medicine can tell you that it is terrible for all parties involved (for government, for healthcare professionals, and for the average joe). My PI grew up and did her graduate work in England and she has nothing good to say about their system...and additionally is constantly applauding our current system over here, not because it's perfect but because it actually does it's job.

Panda Bear will agree with me on this...that socialized medicine also will bring in corruption to a huge degree in our medical system. He once cited the Greek system, with which he is familiar, but for this purpose I am going to cite the US Military medical system. Our military currently is run under a system of socialized medicine and one only has to look as far as the controversy surrounding the Walter Reed Hospital in DC to see that corruption, inefficiency, and substadard care will be fostered, not eradicated, in a socialized system.

And as far as the question at hand, what needs to be done to make a socialized system fair to physicians my answer is nothing can be done. The government may start out with fair wages for physicians and may begin to fairly compensate the owners of private practices for their property, but lets face it...our government doesn't have the best credit history. They are in the black by trillions of dollars. As soon as things go economically south in the country...compensating physicians properly will be the first thing to get the ax in the budget shaving extravaganza that inevitably ensues. So if our country enters socialized medicine I will be pursuing a new career, possibly in research, or I will attempt to get certified to practice in another country that does not have a socialized medical system. I love medicine and I love working with patients, but not enough to convince me that working as a physician in a socialized system is a good idea.
 
Don't give amnesty to illegal aliens, begin actually enforcing our borders, begin deporting illegals which will spark a movement among many of them to leave of their own volition. Then, come up with a solution to the health care "crisis" that doesn' involve turning over control to the federal government.

Have you noticed that every country in the world claims to have a "healthcare crisis". I was talking to my friend in the UK, and he used the same exact words. Germans are saying the same thing. I just thought it was interesting.
 
Have you noticed that every country in the world claims to have a "healthcare crisis". I was talking to my friend in the UK, and he used the same exact words. Germans are saying the same thing. I just thought it was interesting.

Yes, I've remarked on that before. Our health care system has been routinely described as being in "crisis" and on the cusp of "implosion" for more than 20 years now. Some crisis, eh?
 
Have you noticed that every country in the world claims to have a "healthcare crisis". I was talking to my friend in the UK, and he used the same exact words. Germans are saying the same thing. I just thought it was interesting.

I'm not familiar with the German situation, but the UK really is in a crisis. American voters need to take note, that if a country with a fairly high standard of living and fairly high gdp like England cannot support the money sink that is socialized medicine, maybe it's also a bad idea for us.
 
In all seriousness I think that many people interpret mortality and its various consequences as "crisis".
 
I would speculate that if the UK was spending as much as we are per capita, they would not have a crisis.

Then they would have to tax them even more than they already are. Now that would be a crisis.
 
Once the smoke clears, if we see any significant change at all (which is a big if), my guess is that we are going to see some form of mandatory private health insurance with government subsidies for the poor. We are already paying for healthcare for everyone (by cost shifting, Medicare, Medicaid, etc.). It's just a matter of making the system more efficient & effective. The pharma, health insurance, and hospital lobbies are so strong that I don't see any plan in the future that would cause them to make even one dime less. Physicians could potentially benefit as well, although that is far from certain.
 
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The pharma, health insurance, and hospital lobbies are so strong that I don't see any plan in the future that would cause them to make even one dime less. Physicians could potentially benefit as well, although that is far from certain.

exactly, too much of our economy is tied up in having health care in its current status. Socialized health care in America is a pipe dream like the flat tax or national sales tax...it sounds good to a large part of the population, but economically the country is reliant on the status quo. All this SDN nonsense is chicken little bull****.
 
Once the smoke clears, if we see any significant change at all (which is a big if), my guess is that we are going to see some form of mandatory private health insurance with government subsidies for the poor. We are already paying for healthcare for everyone (by cost shifting, Medicare, Medicaid, etc.). It's just a matter of making the system more efficient & effective. The pharma, health insurance, and hospital lobbies are so strong that I don't see any plan in the future that would cause them to make even one dime less. Physicians could potentially benefit as well, although that is far from certain.

As much as I hate the concept of socialized medicine, I hate the healthcare insurance companies even more. They have found a way to squeeze themselves into the middle of this mess, and now they are screwing both patients and physicians. But those are some powerfull muthaf%ckers though, and they got the whole country by the nutz. At least pharma companies can claim they are doing some research or whatever, but healthcare insurance companies and HMOs are simply looting the crap out of the system.
 
Seems inevitable IMO; the question is -- how will this affect physicians? I am saying this because, it is very possible that they might half ass the system to where physicians will be in double jeopardy.

we live in a free society...should the unfortunate occurence happen that your industry becomes socialized you have two options: work for the pay you get or find another job. You know going into med school that taking a debt incurs a large amount of risk, no one ever made any guarantees to you.

Nobody will force you to be a doctor just because you have an MD. If your pay drops that much, then too ****ing bad, you either work for what the market or the government dictates or you can find a job in another field. If salaries begin to decline as dramatically as you seem to think that they would, then a large portion of the older physician population would likely go into early retirement as the marginal benefit they receive from the pay decreases to a point where where working does not justify the marginal cost of not having time to pursue hobbies/other jobs/interests. At the same time, fewer people would be willing to enter medical school to incur the lost earning potential/additional debt/worse potential pay (don't give me the "all seats will still be filled regardless" argument since if pay declines as much as you assume it will in a nationalized system, then people will stop taking the 'risk' of incurring the med school education to not get paid at an appropriate level.

In the end, this will leave a physician shortage which will cause an overall decrease in the quality of care, leading to either a reprivatization of the medical system or an appropriate increase in physician compensation by the government.
 
we live in a free society...should the unfortunate occurence happen that your industry becomes socialized you have two options: work for the pay you get or find another job. You know going into med school that taking a debt incurs a large amount of risk, no one ever made any guarantees to you.

Nobody will force you to be a doctor just because you have an MD. If your pay drops that much, then too ****ing bad, you either work for what the market or the government dictates or you can find a job in another field. If salaries begin to decline as dramatically as you seem to think that they would, then a large portion of the older physician population would likely go into early retirement as the marginal benefit they receive from the pay decreases to a point where where working does not justify the marginal cost of not having time to pursue hobbies/other jobs/interests. At the same time, fewer people would be willing to enter medical school to incur the lost earning potential/additional debt/worse potential pay (don't give me the "all seats will still be filled regardless" argument since if pay declines as much as you assume it will in a nationalized system, then people will stop taking the 'risk' of incurring the med school education to not get paid at an appropriate level.

In the end, this will leave a physician shortage which will cause an overall decrease in the quality of care, leading to either a reprivatization of the medical system or an appropriate increase in physician compensation by the government.

Good take, except for this part

Nobody will force you to be a doctor just because you have an MD.

The bank you owe money will.
 
At the same time, fewer people would be willing to enter medical school to incur the lost earning potential/additional debt/worse potential pay (don't give me the "all seats will still be filled regardless" argument since if pay declines as much as you assume it will in a nationalized system, then people will stop taking the 'risk' of incurring the med school education to not get paid at an appropriate level.

Nonsense. France pays their physicians like 75k a year in a country with a far higher tax burden and they still have no trouble filling medical school classes. Obviously a lot of the best people will go into something else, but finding warm bodies is never a problem. Whether or not they're the warm bodies you want operating on you may be a matter of debate.

I suspect what will happen if single payer were to occur would be that the best physicians will want nothing to do with it and only accept private insurance or cash. This is why many of the single payer plans (like PNHP) want to force physicians to accept their plan. Free society indeed.
 
Nonsense. France pays their physicians like 75k a year in a country with a far higher tax burden and they still have no trouble filling medical school classes. Obviously a lot of the best people will go into something else, but finding warm bodies is never a problem. Whether or not they're the warm bodies you want operating on you may be a matter of debate.

I suspect what will happen if single payer were to occur would be that the best physicians will want nothing to do with it and only accept private insurance or cash. This is why many of the single payer plans (like PNHP) want to force physicians to accept their plan. Free society indeed.

With their shrinking economy and high unemployment, I am surprised they even pay anybody that much.

I don't see how any sane human being will take a 150K loan(basically 400K in a 30yr repayment) on a 75K income 7+ years down the road. Especially with this type of economy, where people are making bank with just a 2 year associates degree. Remember that in a lot of these countries where doctors are working for peanuts, being a doctor is still the best deal.
 
I suspect what will happen if single payer were to occur would be that the best physicians will want nothing to do with it and only accept private insurance or cash. This is why many of the single payer plans (like PNHP) want to force physicians to accept their plan. Free society indeed.

In Japan:

Everyone has health insurance, administered by the government and paid for mostly by employers (if you have one) and taxes (if you don't). Taxes are higher as a result, but because they aren't paying as much per capita as one does here for private insurance, the net impact on take-home pay is less.

Doctors are not required to accept national health insurance, but compensation through the system is excellent. Funds are not wasted to pay people to find ways to deny payment. There are no 8-digit salaries to pay for executive administrators. Nor is money wasted on marketing.

Private health insurance is available for those who want it, although it pretty much covers things that aren't necessary for good care (private hospital rooms, etc.)

Because it is not necessary to pay for the future health care costs of malpractice victims (who all have national insurance coverage), the malpractice system is much more reasonable.

Because everyone is insured, hospitals are able to make money off of every patient, instead of overcharging some to compensate for those that get emergent care and are unable to pay.

Doctors also do not have to waste their time arguing with nonmedically trained insurance company staff regarding what treatment is best for their patients.

When a patient has a physical complaint, they do not have to gamble by weighing the benefits of early treatment against the financial burden of treating something that might not progress to something worse.

For a doctor, even the best of the best, to accept only cash is exceedingly rare (such a doctor would probably be better off moving here). Patients get excellent care with national insurance and can choose any doctor or specialist without a referral. Doctors use their strong ties to each other and the ruling political party to ensure fair compensation for their work.

I don't see what's nonviable about this. It has been working for decades.
 
Free society indeed.

I agree...this "right to healthcare" (although suspect) is all well intentioned and positive until it meets the right for physicians to their own property. The physician's property is his medical supplies, knowledge, and services. He/She worked hard through medical school and residency to earn these things, and should be at his/her own liberty to sell them. We live in a capitalist society and as such, goods and services are exchanged for money and at the consent of BOTH parties involved.

You don't see a poor person, regardless of how hungry they are, walk into a deli and order a sandwich for free. Why is it ok for that same person to walk into an Emergency Department and get free treatment for their ear infection?!?!? :confused:

Good call Dilated...free society indeed.
 
In Japan:

Everyone has health insurance, administered by the government and paid for mostly by employers (if you have one) and taxes (if you don't). Taxes are higher as a result, but because they aren't paying as much per capita as one does here for private insurance, the net impact on take-home pay is less.

Doctors are not required to accept national health insurance, but compensation through the system is excellent. Funds are not wasted to pay people to find ways to deny payment. There are no 8-digit salaries to pay for executive administrators. Nor is money wasted on marketing.

Private health insurance is available for those who want it, although it pretty much covers things that aren't necessary for good care (private hospital rooms, etc.)

Because it is not necessary to pay for the future health care costs of malpractice victims (who all have national insurance coverage), the malpractice system is much more reasonable.

Because everyone is insured, hospitals are able to make money off of every patient, instead of overcharging some to compensate for those that get emergent care and are unable to pay.

Doctors also do not have to waste their time arguing with nonmedically trained insurance company staff regarding what treatment is best for their patients.

When a patient has a physical complaint, they do not have to gamble by weighing the benefits of early treatment against the financial burden of treating something that might not progress to something worse.

For a doctor, even the best of the best, to accept only cash is exceedingly rare (such a doctor would probably be better off moving here). Patients get excellent care with national insurance and can choose any doctor or specialist without a referral. Doctors use their strong ties to each other and the ruling political party to ensure fair compensation for their work.

I don't see what's nonviable about this. It has been working for decades.


#1: Comparing Japan to the United States is almost incomparable in terms of social issues, culture, and population dynamics.

#2: A strong enough physician lobby could make a lot of money in a socialized system, but that doesn't mean that it is best for the country. Everything comes from somewhere, and other industries are suffering as a result (as they always do).

#3: The physician "lobby" in the US is a joke, meaning that we wouldn't even be good at stealing money to make ourselves rich.

#4: The comparison is also to the US now, as opposed to a true free market system. Thus, any current failures of the US system could as easily be blamed on the current haphazard, but equally significant, government intrusion into the system. Thus, the fact that some (I repeat some) things are probably more functional at this time in Japan doesn't really prove that they are ideal.
 
Nonsense. France pays their physicians like 75k a year in a country with a far higher tax burden and they still have no trouble filling medical school classes. Obviously a lot of the best people will go into something else, but finding warm bodies is never a problem. Whether or not they're the warm bodies you want operating on you may be a matter of debate.

I suspect what will happen if single payer were to occur would be that the best physicians will want nothing to do with it and only accept private insurance or cash. This is why many of the single payer plans (like PNHP) want to force physicians to accept their plan. Free society indeed.

It would be truly a landmark occasion in this country if physicians were forced to accept any form of insurance or pay. Doctor or not, I don't the government should "force" anyone to provide a service. What's next, plumber's are forced to hook up my water supply for half their normal charge?

THe day I'm forced to accept any particular form of payment by law is the day I walk away from medicine forever.

It surprises me that healthcare is a right, yet electricity, water, sewer, garbage pickup and clothing are priveleges that no one argues we should pay for.
 
With the impending legalization of 20 million illegals, the U.S is clearly heading towards becoming a one party system(Democrat), seing as republicans like Tancredo have pretty much guaranteed that non of those immigrants will be voting republican.

At that point, I believe it will no longer be a question of "if" but "what type" of socialized medicine we will be operating under. So I was just thinking about what needs to happen to make socialized medicine viable, or at least fair to physicians. Some of my suggestions include:

-Free medical education, and any outstanding debt owed by practicing physicians needs to be eaten by the government.

-Dramatic increase in resident doctors' salaries.
I don't think they would need to improve the conditions for residents. I agree with Dilated. They will probably have to decrease standards but they'll be able to fill the spaces without having to decrease costs for students or pay for residents.
-Drastic tort reform, or just let the government pay for physicians' medical malpractice insurance.
I have long thought that the single good thing about socializing medicine would be getting rid of med mal. But remember that the lawyers are very powerful. It's very possible that healthcare would be socialized but doctors would be treated as independent contractors to that system and would still be targets. If we socialize that's how the lawyers will want it. I suspect that eventually the politicians who are totally beholden to the lawyers would have to enact protections as they have to fund the socialized program. Given the choice of screwing doctors or lawyers they'll screw the doctors every time. Given the choice of screwing the lawyers and raising taxes more and screwing themselves with the voters they'll stick it to the lawyers.
-Creation of a national physicians union.
I don't know that there'll be a lot of good from a union if we are socialized. There'd certainly be a lot less than there would if we unionized now and unionizing now is debatable. If we socialize health care we would be trying to collectively bargain with the government. Few have had any success with that. Right now it's illegal for us to form a union. That wouldn't change under socialism. In fact it would probably be specifically illegal for us to strike and we'd get the same treatment as the air traffic controllers did under the Reagan administration.
 
With the impending legalization of 20 million illegals, the U.S is clearly heading towards becoming a one party ......a national physicians union.


Any other suggestions?

Socialized medicine is already affordable: cleeck here. We just have to get our priorities straight and shunt through some of that money into saving our own democracy.
 
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