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Not a Liberal/Conservative Problem, but a Government/Bureaucracy Problem

Discussion in 'BBS Hangout: Debate & Discussion' started by Rocketman1981, Jan 22, 2015.

  1. xcrunner51

    xcrunner51 Member

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    Sounds simple in concept but it would be incredibly different to execute meaningfully.

    I assume in your hypothetical skill exam a foreign doctor is only testing for his/her preferred speciality. So the surgeon isn't taking a psychiatry skills test.
    So every single specialty has its own test; now you have a crap-load of different examiners, sites, locations. (i.e. expensive bureaucratic nightmare).

    Take the surgeon, how do you test his skills? Simulation? That's gonna be real expensive to design, implement and maintain. Is successfully completing 1 simulated lap cholecystectomy or lap appendectomy adequate to demonstrate sufficiency over all of general surgery? Where is the line drawn?

    Take the radiologist, is finding hemangiopericytoma on a single test brain MRI sufficient to grant a foreign doctor a Certificate in Qualification (CIQ) in Neuroradiology?

    What doing/redo'ing a residency ensures is that the trainee meets minimum case requirements to confidently practice in the US. You'd be hard-pressed to come up with a system that comes close to that level of quality assurance in a single test. Is it overkill sometimes? Yes. But I'd rather err on the safe side of deeming someone competent to practice medicine.

    Not trying to sound obnoxious but the general public doesn't have a good enough understanding of healthcare to come in dictate changes. It's like all these business owners that buy NBA teams and think they're gonna implement radical ideas and win the championship in a few years. It never works; sooner than later they realize they don't know jack**** about the system and start listening to their basketball people.
     
  2. Rocketman1981

    Rocketman1981 Member

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    When 80% of the top 10 salaries in the US are physician specialties combined with the lowest unemployment rate of any major career, it smells of a shortage.

    It may not be a nefarious conspiracy but nonetheless the effect is a pernicious lack of physicians resulting in excess compensation and lack of access to affordable and efficient healthcare providers.

    And I'm talking about one very specific piece of healthcare that is incredibly inefficient.

    Think about it in this simple manner: You have around a million physicians in the US that are making much more than their developed country counterparts....lets say that excess amount due to what I have discussed is $100,000 extra a year in physician compensation so that gross number divided by the US population is around $330 per year per American to subsidize your excess income beyond the competitive global service you provide.
     
  3. xcrunner51

    xcrunner51 Member

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    Again, not an apples to apple comparison. There's not a single other country in the Western world that allows physicians to graduate with such levels of student debt. Most completely finance medical education.

    Additionally, the majority of other countries pay the physicians' social security taxes which is a substantial percentage of an American physicians salary. When appropriated accounted for, American physicians still make more but not nearly as significantly as you think.

    You keep trying to simplify this situation, when in fact it's an incredibly complicated system. I don't understand why you can't admit you know don't know squat about global healthcare models and are just jealous about how much doctors make.
     
  4. Kim

    Kim Member

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    So both of y'all would agree to opening more medical schools, increasing the number of doctors, and potentially having lower long-term salaries with higher unemployment if the debt burden for medical students was eased?
     
  5. Rocketman1981

    Rocketman1981 Member

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    4 Years of Medical School plus a few years of Residency income versus a lifetime of virtually guaranteed employment in the highest paid jobs in America with a $300k in Student loans

    versus 3 Years of Law School at $200k in loans, and/or 2 years of an MBA program at $150k of loans.

    The financial tradeoff is still superior in the medical field.

    If it was not a financially lucrative situation, acceptance rates would be falling.
     
  6. Rocketman1981

    Rocketman1981 Member

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    Ahh..the personal attack and it must be jealousy. Then entitled young doctor's true colors come out.

    Anyone that says it is simply JEALOUS.

    Lets analyze your life decisions...after you complete your training you will go to a box of an office and do one of 10 procedures, and be paid per procedure you do like an assembly line worker. The next day you will do 10 procedures again including cutting someone open, having their bodily fluids flung all over you again. The next week, month, year and decade will be this simply monotony.

    Doing the same 3-10 procedures, 5-10 times a day for 30 years. That is your life. To me that is a repetitive stress injury of the mind. Not a creative and or scalable existence but a mouse in a cage doing the same thing over and over for little bits of cheese.

    Instead I am an entrepeneur and own and expand businesses....what I do today is expanded on what was done years and years ago....a creative, evolving professional life. That is what drives me.

    This all came to light as I am responsible for my many employees and saw the needs of people and the costs and the lack of ability to see doctors and recieve healthcare in the manner it would be provided. Understanding failed systems, cartels and finding ways to break them is a passion of mine.

    I believe bringing down prices to consumers and providing choice is the greatest moral achievement one can accomplish. By doing that you leave a few extra dollars a day in their pocket which over time can result in wealth, an education or starting a business and being part of a middle class.

    But you go ahead and think that the extra income you make relative to what the value you provide is just coming out of thin air and not off the backs of Americans that are being chipped away.

    But i'm just jealous of course. :rolleyes:
     
  7. xcrunner51

    xcrunner51 Member

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    All you've done is attack numbers on a page without any significant insight into how it's generated. It's hard to think you have any other beef than with just the salary involved.

    You've repeated argued that access to healthcare needs to be increased; I've concurred (repeatedly).

    You've argued that accreditation standards and barriers to entry should change/drop without any concept of how or how it would directly impact patient care.

    I've cited again and again the contribution of physician salaries to national healthcare expenditures, something you've repeatedly ignored. If you had taken any time to see how much an individual doctor makes for a single action and correlatively how much money is spent on the other parts of a medical bill, you might actually understand. A total knee replacement might cost $15k to the patient; the actual reimbursement the orthopedic surgeon makes is $500. Cutting the physicians fee is neglible compared to the cost of the orthopedic hardware ($10,000), the OR time, the anesthesiology professional fee, the cost of drugs and post-op recovery.

    Your description of being an entrepeneur is no less nacissitic than any Wall Street Goldman Sachs "we make the economy run" belief.
     
  8. Rocketman1981

    Rocketman1981 Member

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    So if a Physician reimbursment is $500 because of a lack of supply of orthodpedic surgeons, you are able to do 5 a day at a margin of 80%,
    that is $2,000 a day, $10,000 a week and $40,000 a month or $480,000
    a year.

    I would like to see that slashed by 50% and I still don't believe it would be a travesty if Orthopedic Surgeon's salaries dropped to $240,000 for 5 procedures a day.

    If you don't think $240,000 a year for doing five procedures a day, five days a week is enough for a repetitive, unimaginitive profession then I don't know what to say.

    If there were twice the number of ortho surgeons it would probably work but as of now the wait is till weeks to see these guys. More doctors at lower salaries is better all around.
     
  9. xcrunner51

    xcrunner51 Member

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    Can't do 5 a day. Can't operate 5 days a week (gotta do some clinic). Gotta take trauma call.

    You make all these gross generalizations like you know exactly what doctors do. You have no appreciate with the technical nature of the work that takes years to build or the mastery to handle both intraoperative or post-operative complications. Basically you have no respect for medicine.
     
  10. xcrunner51

    xcrunner51 Member

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    I'm done.

    This is the same entitled "I deserve all the healthcare in the world and don't want to pay anything for it" bull**** I see in patients everyday.
     
  11. Rocketman1981

    Rocketman1981 Member

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    The irony from the entitled surgeon crying about having 100%
    Job security, the country and people subsidizing his salary and then
    Crying about when wants to get paid closer to the value of
    What he brings to the table at $240,000 a year.

    I'm all for huge incomes if value is provided beyond ones compensation.

    The relative value for your service is inflated in the US because a lack of supply

    Enjoy the good times till someone puts a sledgehammer through the cartel you defend.
     
  12. Rocketman1981

    Rocketman1981 Member

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    Physicians are the highest paid profession in the country.

    Someone is paying you to see these people that you're seeing.

    You're more entitled sounding then any of them.
     

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