[inthebox]

Hello again, El:

You're very good at hyping conservative ideology. However, as we learned from the Bush and Reagan years, when put into actual practice, it fails.

I don't disagree that many people WON'T become doctors because they can no longer get rich. I DO disagree that the new class of doctors pursuing the field will be less qualified that their predecessors.

excon

Every country with universal health coverage has a larger percentage of primary care physicians [ pcps] [ internal medicine, pediatricians, family practice, OB-GYN, some may include general surgery ] than specialists, this is not true in the US. The US is perhaps top heavy in specialists ] The US will have and does have a shortfall of pcps, especially in rural areas. Specialists make more money and because reimbursement is rewarded for the more you do, especially procedures, rather than the more you think, for which all that schooling is required, areas with a high percentage of specialists tend to be higher in healthcare expenditures. Pcps also deal more with preventative health and management of chronic illnesses like diabetes and high blood pressure. It is cheaper and better for the person to have a pcp manage and control such things as high blood pressure and diabetes, thus preventing or delaying a complication, like a heart attack. The cardiologist generally does not see the person till after they have had a complication, like a heart attack. In other words, prevention and disease management by pcps is better and cheaper than the needed specialist care for a complication.

I say this because.with the aging baby boomer population this compunds the problem of a shortage of pcps. "free " universal health care will only increase the demand for pcps. Cash for clunkers demonstrates this.


The question is, where are all the pcps going to come from?

Only 2% of medical school students say they are going into primary care? Are 98% greedy money grubbing sobs? No doubt some are, every group of people hhas them.

Factor in, more women are in medicine than a generation ago, women tend to work less hours than men and are still mom to children, the time demands of being a pcps are huge, so a lot of students will choose "lifestyle" - less hours [ < 50 per week ] in fields like radiology, opthamology, dermatology rather than in primary care.

Factor in large student debt not only from medical school but also undergraduate college. Imagine having to pay easily over $ 1000 dollars a month on school loans.

Factor in that there are easier ways to make potenetially more money- like banking. Getting an MBA is shorter, though may be as difficult, than getting an MD







G&P

[inthebox]

Hello again, El:

It's like I was telling in, when our market goes, there's no elsewhere to go. They could try banking. They could use some of the "best".

excon

You keep referring to the quote "market" ? This means the free market with regard to healthcare? At least you are being transparent.

But kiss goodbye to innovation and technologic advancement, other than in IT to monitor every individuals finances and personal medical record.

In the 1990s eye surgery to correct nearsightedness began. It was literally by microscalpel, radial keratotomy. It cost about $3000 per eye, out of pocket, totally free market. The cost of a machine to do this ran in the millions of dollars. With competition, and better technology LASIK is perhaps half this cost with better results. This was not in some government cost benefit analysis or comparative value scale.

There are already guidelines by NIH, CDC, and various medical societies that state what is standard of care, but this leaves out what is the future - knowledge will stagnate as some cookbook protocol determines your care and what the doctor can legally do. Believe it or not but plenty of surgical advancements have come under the duress of the operating room or the battlefield. Critical thinking, vision, and doing ALL YOU CAN for the person at hand is ALL THAT MATTERS. Will the a governmental medical cookbook allow this?





G&P

[ETWolverine]

Hello again, El:

You have to win all sides before you can claim victory... The part you're missing, is that people who would have had to work for Wal Mart, are gonna be able to go to medical school. Cause being a doctor, even under socialized medicine will still pay better.

Sorry, Wolverine. Wrong again.

excon

First of all, medicine in soicialized medicine countries does NOT pay better than Wal-mart. Sorry to break that to you, but there's a reason that people don't become doctors in those countries, and PAY is the major factor.

Second: you can spend 12 years working 60-hour weeks for slave wages, and then MAYBE get a market rate for your wages that manages to cover your day-to-day costs of living that have been building up for those 12 years (for which medical students will have to take out loans to cover, even if their medical school bills are covered --- my brother has more student loans to cover his rent and utility bills than to cover his medical school tuition, and he is not unusual), or you can go straight to Wal-mart and work for a market wage right away that MAYBE will cover your day-to-day cost of living.

If it's the same "maybe", I might as well not work as hard and get the same thing. Why be a slave for 12 years first, if all I'm going to be doing is "just getting by". I can do less work and get the same gain.

That's the problem with socialism in a nutshell.

And that's the problem with Obama's health plan.

Elliot

[NeedKarma]

But kiss goodbye to innovation and technologic advancement,

Wrong. If they proceed like they do in Canada then they have a department set up for just that (Science and Research - Main Page - Health Canada) to benefit all Canadians, not just the elite who can afford it.

[ETWolverine]

Wrong. If they proceed like they do in Canada then they have a department set up for just that (Science and Research - Main Page - Health Canada) to benefit all Canadians, not just the elite who can afford it.

What has that Science and Research department actually produced?

Something like 75% of all medicines, medical technologies and medical innovations in the world come out of the USA. Many come from Israel, which also has a free market medical system with a public option safety net for catastrophic care only (the Kuppat Cholim system). It is one of the few places where medical technology and medical R&D is stronggly pursued. They get credit for about about 10-15% of all medical innovation. Pretty good given the size of their economy compared to the USA's.

Japan does another 5-10%, and much of it is good stuff. For them it's a cultural thing as much as a business thing... the need to be productive in society. But the money is the real incentive, and because Japan doesn't filed the cost of a full-up army like most other countries do, they can afford to subsidise more of their medical system from the government, which makes it more cost effective to be in medical R&D and medicine in general in Japan than in other socialized medicine countries. But they still don't come anywhere near the USA's level of production, despite their very large economy. They don't even produce as much as Israel, despite being a much larger economy.

The rest of the world combined only produces about 10% of all medical innovation. That includes Canada and all of Europe and Asia.

So yes... there is SOME medical R&D in Canada... but not much. There's just no money in it.

Elliot

[NeedKarma]

ET,
Answer my previous question about the text that shows the Dems want death panels.

[ETWolverine]

Interestingly enough, the site that NK linked to regarding Canadian medical research has a little blurb at the bottom in which they try to take credit for "helping develop" the vaccine for Polio... a vaccine first invented by Jonas Salk, an American. A second vaccine, an oral one, was developed by Albert Sabin, naturalized American Citizen born in Bialostock, Poland in 1921. As far as I can tell, Canada had nothing to do with it.

So what, exactly, has Canada's medical R&D establishment done since curing Polio?

Elliot

[ETWolverine]

ET,
Answer my previous question about the text that shows the Dems want death panels.

If they didn't they'd change the wording. The fact that they don't change the wording means that they LIKE the wording. Which means that they WANT death panels.

[excon]

You keep refering to the quote "market" ? This means the free market with regard to healthcare? At least you are being transparent.

Hello in:

I am NOT a lover of government services... But, when the private system breaks down, the government is the only one left. I'm NOT anti profit. I'm anti stealing. When the insurance companies, with government help, set themselves up as the ONLY providers in a given area, they no longer compete. They steal. That's called a monopoly, and that's a license to rip us off. That's exactly what's happening...

I said the same thing about the bankers who looted the country while we weren't looking...

Yes, there will be an evening out in the medical services industry. It remains to be seen what will happen when the profit motive is removed... There IS a societal price to pay when we let ourselves get ripped off that way. Maybe having the best and the brightest gointo banking instead of medicine is one of them.

But, I'm a glass half full kind of guy. I see opportunity for people who could NEVER have gone to medical school, suddenly being presented with that opportunity. I don't know. But, there is NOT doubt that if we don't make major changes in it, it'll BANKRUPT us.

excon

[ETWolverine]

ET,
Answer my previous question about the text that shows the Dems want death panels.

Already did, several times. You have simply ignored it. I'm not going to do your homework for you. The people who really want to know will see where to read it. For those who wish to ignore what it says in the bill, I don't have time to post linkes 10 times to have you ignore them each time.

And by the way, you completely ignored section 1233 in your own post. Care to explain that?

Again, does that make you a liar as you accused Speech?

[zippit]

Major changes
On suday morning G M A
Ran a piece on Robot Doctors
Showed a robot controlled by a doc making rounds at a hospital

[excon]

showed a robot controlled by a doc making rounds at a hospital

Hello again, zip:

Cool. Ain't technology grand.

excon

[inthebox]

Wrong. If they proceed like they do in Canada then they have a department set up for just that (Science and Research - Main Page - Health Canada) to benefit all Canadians, not just the elite who can afford it.

Formularies and Reimbursement Restrictions - Pharmacare in Canada: Issues and Options - Health Policy Research Working Paper 01-01

This is all beureacratic mumbo jumbo that has more to do with management than hard core clinical advancements and results..




G&P

[ETWolverine]

Hello again, zip:

Cool. Ain't technology grand.

excon

Yes it is.

It'll be a pity when there's no more of it being created.

[inthebox]

Hello in:

I am NOT a lover of government services... But, when the private system breaks down, the government is the only one left. I'm NOT anti profit. I'm anti stealing. When the insurance companies, with government help, set themselves up as the ONLY providers in a given area, they no longer compete. They steal. That's called a monopoly, and that's a license to rip us off. That's exactly what's happening...

I said the same thing about the bankers who looted the country while we weren't looking...

Yes, there will be an evening out in the medical services industry. It remains to be seen what will happen when the profit motive is removed... There IS a societal price to pay when we let ourselves get ripped off that way. Maybe having the best and the brightest gointo banking instead of medicine is one of them.

But, I'm a glass half full kinda guy. I see opportunity for people who could NEVER have gone to medical school, suddenly being presented with that opportunity. I dunno. But, there is NOT doubt that if we don't make major changes in it, it'll BANKRUPT us.

excon

Let us take medical helicopters

Medical helicopter needs funding - Yahoo! Canada News

Kentucky has more medical helicopters than Canada - Latest News - Kentucky.com

KY with less population, less area, less total income than Canada has 6 more medical helicopters!!

Private system broken down? I know for a fact that, very sick pediatric patients get flown from western KY to Kosairs in Louisville, a 3 hour car ride, regularly. This is regardless of ability to pay, some may argue this adds to the cost of healthcare, but what price do you pay?

Transport of the Critically Ill Pediatric Patient

Notice there is no mention of checking with any third party payors or analyzing comparative effectiveness.

What is the problem with Canada? FUNDING - that is the bottom line. Not severity of illness. Natasha Richardson may have had a fighting chance if helicopter was available.


BTW, at my hospital , due to a shortage of neurologists, we already have a robot, with the neurolgists at U of L. And don't forget the equipment and maintenance costs for all this, aside from the fact that, a comprehensive neurological exam for a condition like a stroke or a seizure is not physically possible through a robot, but has to be done through a nure practitioner.


G&P

[ETWolverine]

Hello in:

I am NOT a lover of government services... But, when the private system breaks down, the government is the only one left. I'm NOT anti profit. I'm anti stealing. When the insurance companies, with government help, set themselves up as the ONLY providers in a given area, they no longer compete. They steal. That's called a monopoly, and that's a license to rip us off. That's exactly what's happening...

You mean as opposed to the government setting themselves up as the only providers in the entire country...

How brilliant.

I said the same thing about the bankers who looted the country while we weren't looking...

You mean the bankers who were required under Federal Regulations to make 60% of their loans to people who they knew couldn't pay those loans back... under penalty of being shut down? Those bankers?

But, there is NOT doubt that if we don't make major changes in it, it'll BANKRUPT us.

Excon

By what mechanism will that occur? How will we go bankrupt if we don't change the system?

Over 90% of Americans are covered by medical insurance. 5% are uninsured for less than 4 months, which essentially means that they are covered as well, except for a short period. The other 5% are long-term uninsured.

How is that 5% going to bankrupt us? What is the mechanism by which that will occur?

And is there NO OTHER WAY to solve the problem of covering that 5% of the population than nationalizing EVERYONE'S health care?

Typical Democrat thinking. If there's a broken window that needs repair, demolish the entire house and rebuild it SMALLER than before, but for a higher cost. Don't bother just replacing the broken window, which would solve the entire problem.

Elliot

[excon]

By what mechanism will that occur? How will we go bankrupt if we don't change the system?

Hello again, El:

From the website of the National Coalition on Healthcare;

--------------------
National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product (GDP). By 2018, national health care expenditures are expected to reach $4.4 trillion—more than double 2007 spending.

National health expenditures are expected to increase faster than the growth in GDP: between 2008 and 2018, the average increase in national health expenditures is expected to be 6.2 percent per year, while the GDP is expected to increase only 4.1 percent per year.
----------------------

If, as a banker, you don't see bankruptcy looming, it's no wonder our banks went bust..

excon

[ETWolverine]

Hello again, El:

From the website of the National Coalition on Healthcare;

--------------------
National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product (GDP). By 2018, national health care expenditures are expected to reach $4.4 trillion—more than double 2007 spending.

National health expenditures are expected to increase faster than the growth in GDP: between 2008 and 2018, the average increase in national health expenditures is expected to be 6.2 percent per year, while the GDP is expected to increase only 4.1 percent per year.
----------------------

If, as a banker, you don't see bankruptcy looming, it's no wonder our banks went bust..

excon

And Obama wants to spend $23 Trillion to set up nationalized health care.

You tell me which system is more likely to bankrupt us.

You see, I CAN do basic math. $23 Trillion is MORE than $4.4 Trillion.

Game, set and match.

Elliot

[zippit]

I knew the robot would help