Don't think it would change much there. The system currently handles their urgent and critical care and in many cases much more through county clinics and prob even medicaid. And it's not like you'd walk into any medical office w/o an id after universal care. It will be debated as part of the process. (And let's not forget that many illegal aliens pay taxes on each paycheck, along with subsidizing the farm and construction industries) Valid fear, but unlikely to hurt like you think. It will be a giant tug of war to see who pays for what, but since small businesses have fueld so much innovation and growth in recent years it's doubtful anyone would want to kill the golden goose. $2 trillion is spent on health care each year and if the system is fixed... total expenditures can actually be reduced. Very very valid concern, but to date they've done a pretty good job only involving themselves as needed w/ Medicare and Medicaid. One exception, not terribly bad in itself but shows a potential for gov mistakes, was legislation to guarantee minimum hospital stays after healthy normal births. It was not medically necessary, but it probably got some legislators some votes. Further, these mothers are now exposed more to a host of nasty, antibiotic-resitant nosocomial (hospital-induced) infections (this happened to my aunt). More care is not equal to better care.
I know in Breast Cancer the latest big developments have come from Great Britain, and other cancer treatment as well. This is from 1999 They are developing new treatments and innovations all the time. [ A centuries-old university is using the latest technology to combat breast cancer. Oxford University's eDiamond grid computing project will pool and distribute information on breast cancer treatment, enable early screening and diagnosis, and provide medical professionals with tools and information to treat the disease. Oxford researchers called it eDiamond because, like a cut gemstone, the project is multifaceted and is intended to help patients and doctors on a daily basis as well as advance medical research. "It is amazing," said Paul Jeffreys, director of e-Science at Oxford University. "EDiamond combines health care, technology, academics and science, and then extends the results of this merger out to society." EDiamond is part of the United Kingdom's e-Science program, a nationwide initiative to "make access to computing power, scientific data repositories and experimental facilities as easy as the Web makes access to information," Prime Minister Tony Blair said in a statement. At the heart of e-Science are computer grids that provide supercomputing power on demand, allowing labs, universities and businesses to share computing resources that users can tap into when they need them. Grids also allow remote access to databases and expensive scientific instruments, allowing scientists to collaborate and share information and tools easily. Under construction since last December, eDiamond will give patients, physicians and hospitals fast access to a vast database of digital mammogram images. Traditional film X-rays are often scattered among various medical facilities, making them hard to locate at a moment's notice, Jeffreys said. EDiamond will help ensure that all of a patient's vital data is provided to physicians quickly and securely, allowing for earlier detection and treatment of breast cancer. http://www.wired.com/medtech/health/news/2002/10/55736?currentPage=all[/quote]
I wasn't whining, and who said I was concerned more about myself than society? I'm just stating that there is only so much I can do in a certain amount of time, and as anyone gets more fatigued throughout their work day, the quality of care is going to be reduced. Yes, I am concerned about wages and what not, but I'm more concerned about patient care. Wouldn't you want a doc who sees you more as a patient instead of "after you, 40 more to go"? That's what it's coming down to. I see the field first hand, and this way of going on a lot more than you think it is. If you think your doc just absolutely loves all of these rules and regulations put on him by the government, just ask. You may be surprised. Oh, and teachers, cops, firefighters, don't go to school for 8 years and accumulate $250,000 in debt. So it's bad for me to want some sort of financial compensation? Tell that to any med student and see the responses you get.
First, I won't defend Hillary but her plan is a method to finance care for all using the existing carriers, medical groups and independent providers. It's no threat to your independence. And I don't understand how you argue that government involvement in healthcare is what caused inflation. Do you know what kind of mechanisms CMS (the old HCFA) has implemented over the years to attack billing tricks from the provider community (and also outright fraud)? Yes, many physicians can reap rewards under the existing, broken system, but even you admit the work doesn't appear so rewarding. What we see is a result of the problems which need to be addressed. Universal care is a great start to fix some of the problems. As you mention, being able to reimburse providers for their value (not just quantity) is critical but it requires the ability to quantify quality (which is developing but will never be 100% accurate). Quite blaming the government for this mess. Although providers may be the best part of the system with their devotion to patient care they also may be the worst part when they put on their revenue-maximizing hat. In a way, the providers created managed care and increased government involvment when the existing (blank-check) system resulted in runaway inflation. If there are any concerns for providers, in the future (years from now) there will be extreme stress placed on providers (particularly when they're of the same non-primary care specialty) when they mass in a given geographic area. Presently, instead of price competition (as w/ a normal industry), service volume tends to increase. When the system is 'fixed', prices will either drop or the supply will need to be reduced. So some providers could lose options on where they can set-up there new practice, but that's just like any other business. The other question is what constitues the (up to) 30% of the $2 trillion in annual healthcare expenditures that is unnecessary or inappropriate. As this gets squeezed, theoretically some players may feel it. In reality, it will take decades to resolve a reasonable percentage of it and is unlikely to cause a great hardship on any stakeholders during the gradual improvement. All that said, I have confidence that the major problems will be resolved and physicians will spend more time practicing an improved form of medicine, have less administrative headaches, and still have equity in their practices. Try to have some empathy for the 40 million or so w/o any insurance.
This is fantastic post, from an insider with good information. It's an informed post. Thank you for sharing.
The point was they all have a duty to society that goes beyond their paycheck... same as docs... and they all choose that profession knowing the duty is part of it. For example, let's assume there's a major flu epidemic that is killing millions. As a doc, you're going to forsake regular hours and paying patients and go work where the need is most acute. Cops and firefighters and soldiers do jobs that are risky to life and limb... a risk for which they are not adequately compensated... how much would it take for you to get shot at or walk into a fire? Teachers have the responsibility of helping move kids towards a life of learning and societal contributions, which often means more time and effort then is accounted for in their salary. For all these jobs (and others) there is a burden and responsibility that is not reflected in salary, but is freely chosen because people either like the work or want to make a difference. The worst of each of these professions are the people who end up on a power trip or do it for selfish reasons. All I'm saying is don't become one of those doctors, even in appearance.
Does it bother anyone else that Hillaroid is taking ~ 1/7th of the US economy and nationalizing it? BACK IN THE USSR
The primary reason that cops, firefighters, and teachers are undercompensated is because they are primarily employed by government entities. (Cops and firefighters by necessity.) My industry employees a large number of firefighters, and has no problem paying them much more than almost all municipalities, and probably the forest service (Isn't that who you work for?). In my opinion, it isn't necessary to socialize healthcare, so it shouldn't be necessary to require doctors to make that sacrifice. They should be payed according to what the market values their service.
I guess we should pay the soliders according to the market too I suppose. Unless you are living in an anarchy, there are functions that the society need that is not dictated by market force. Things such as food can be subsituted rather easily, if I have the money, I can eat steak, lobster and whatever I want; if I don't have money I can eat just bread and penut butter, but I will live. If I am sick, I can go to doctor or sit at home or pray that I don't die. There is no easy substitute for health care, and people are willing to spend whatever money they have for it, such things are not really suited for market as the demand is relatively inelastic.
Your missing the point. I'm not arguing for "socialized" medicine or paying doctors what teachers get. I'm saying if you're a doctor you also have a societal responsibility that goes beyond that of other occupations, say a salesman.
But healthcare is a market anomaly. It doesn't function like other industries. Most industries have a clear supply/demand situation. Health care has almost virtual inelastic demand. If you need a doctor, you'll need one regardless of the cost. Your illness won't disappear if the doctor raises his price, hence the inelastic nature of health care. This means that prices will always grow, there's a market incentive to increase them until demand falls to a point where profit declines. But in health care, that generally doesn't happen. On the opposite spectrum police and firefighters face positive externalities meaning that people profit off of them without compensating them. My neighborhood is safer because the cop drove by, but I didn't pay him for that drive by my street. The market works in the opposite direction by not compensating these types of industries properly, hence the need for government run police forces and firefighters in order to correct market failures. The markets are not perfect and there are plenty of industries that defy the markets and create problems. Health care being one of those industries.
Healthcare demand is certainly elastic. Maybe not for emergency treatment, but certainly for routine treatment. I learned this when my health insurance changed to a high deductible plan. When I had an HMO, doctors or clinics would just charge my plan whatever the going rate was, and give me whatever treatment they made the most money off of. Now, when I go into a clinic or doctor's office, and tell them that I'm paying cash, they offer me choices and explain them. I was amazed by the difference in the way I was treated.
I haven't read the entire thread but dude you're out of touch. do you know how much your employer is paying to give you cheap healtcare. why don't you ask your nemisis, Major, since he is an employer. if you think companies are going to keep footing the bill you need to be touched.
i dont think you can just lump firemen, teachers and doctors together. There is a significant difference in skillset and ability. Its like lumping up intramurals sports with professional. if those who become a doctor arent sufficeintly rewarded for their work and skillset then the quality will diminish and in turn the patients will suffer. you mention teachers...how is the education of todays youth anyways?
yeah. emergency care is inelastic. But healthcare is certainly somewhat elastic. If i have a cut and it could use a couple of stitches, but it would cost me $10K, im just going to bandage it up myself. If it cost $500, i would be getting stiches.
These minor things sure, you will suffer but you won't die. What about heart attack or other major illness? It is eastic in the sense you can only pay what you have, or you can die. People in Africa die from aids everyday, not because they don't want treatment but they just don't have the money for it, so they just die, if they had more money they certainly would seek better treatments like pople in the US.
