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Support for national health insurance


Rob_Mayes

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My "side" is that the current system is not a free market. Those who favor it clearly favor government intrusion into medical care, which is ironic, given what they -- you included -- keep writing here.

 

that's the thing about irony Greg, it's so ironic. lmao.giflmao.gif

 

Me, I'd prefer to see the government out of everything but the military and let market forces with minimal oversight take care of things, but, since that ain't happening...

Maybe the government should form an insurance company and offer an essential HMO that can be indexed to income, and w/few specific conditions. It's a paid premium, but could work...

 

The state of FL did something like that with their own home insurance program with the major players started backing out of the market here. It could work...

 

Oh, and Ken:

Anyone here have an elderly parent, chronically ill or handicapped child or sibling? Are they all capable of, 'will work/preform service for insurance/healthcare'?

 

Yes, there are. I have my 77 year old father, my 75 year old step mother and my 48 year old mentally handicapped step sister. All of whom could and would do Community Service if necessary for coverage. But, that would only happen if my brothers and I were unable to assist them.

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Most physicians don't really set their own fees. ( At least where I live.) The insurance companies do. I could charge anything I want, but I'm only going to get paid what the insurance company has "allowed" for a particular service or procedure. If I want to continue seeing patients with that insurance, I have to accept their "allowable" charge. I can charge the patient the difference ( balance billing ) but I won't be seeing patients with that insurance any longer. Your overhead, staff expenses, malpractice insurance, etc. continually goes up, but you cannot increase your charges to offset those costs because the insurance company ( the payors ) really don't care. They're still going to pay what they allow.

 

Yes, patients without insurance get charged more, because the insurance companies "negotiate" lower fees for their insured patients. Usually it's presented as a take it or leave it type offer. Will you collect the higher fee from the uninsured? Usually not. When I would see a patient without insurance, I would give them the same discount I gave my lowest paying insurance company if they would just pay their bill. They still don't have the money, so it doesn't really matter. They just can't pay it without going terribly in debt or bankrupt.

 

I'm one of the 59% of doctors who favor a national healthcare system. Probably many physicians would have a pay cut, especially the higher earning ones like cardiac surgeons, pathologists, anesthesiologist, radiologists, and ER docs. The average doc in the trenches would probably break even, but at least the patients would get the care they need instead of choosing to go without.

 

Medicine is a balance between quality, access, and cost. If you change one, then one or both of the others has to change to compensate. You can lower the cost by reducing quality or access, but would you want it? It really is not a free market system. It's a system that is highly regulated by the insurance companies and to a lessor extent the government. It is a broken system, but won't get improved because so many people have their hands in the pot.

 

My $.02 worth. Flame away.

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russell_bynum

I've got to say, I find some of the cold-hearted cruel attitudes expressed by some of the people in this thread really, really disturbing.

 

And now for something completely different. smirk.gif

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Quote:

Thank you, thank you, thank you, for your comments Whip, RightSpin, Bheckel169, Mike, and BMWDUDE on this potential national healthcare debacle. Just ask France, England, and Canada how they like their national healthcare system. THE ONES THAT CAN AFFORD IT ARE COMING TO THE U.S. TO BE TREATED.

 

 

 

I love ours. I do not need to fear any illness as I know I will receive treatment at no cost - or for dental treatment at a capped cost. When I my audiologist wanted a diagnostic MRI I had to wait 10 days, not bad for a non-urgent test. There was a slight delay whilst an urgent case was slotted in.

A few months back when I had an infected cat bite I was admitted to hospital half an hour after seeing my GP, and operated on the next morning. My week-long hospital stay with three operations under general anethesetic cost me not one penny at the point of delivery.

 

I now have an employer-provided health insurance scheme in addition to that national scheme. The only difference is that for non-urgent care I will get faster treatment.

 

Andy

 

I agree with Andy, I'm very happy with our system overall, despite some slanted media coverage we have a particularly well developed primary health care system in the UK, which provides a great deal of support to people on a range of issues. This is of very real benefit to people like my Stepfather who is severely disabled, he has a lot of care provided to him in his own home at no direct cost.

 

I spend a fair amount of time in France and I'm not aware that the French have any great problems with their system and seem happy with it.

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steve.foote

My "side" is that the current system is not a free market.

 

Greg, does this mean you are open to free market reforms?

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steve.foote

But those kind of ideas make the broad sweeping generalization that everyone is capable. Walk into any hospital, elderly care facility, mental health facility and other similar care settings and tell me the people there can go out and perform "community service."

 

Oh, here we go again. Ken, your assignment for the day is to take a field trip to your local Goodwill Industries processing facility and report back what you have learned.

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Ken H.,

Clearly there will be some who are unable to perform even the simplest tasks. Let's not strike the "disbelief" note so strenuously. I'll put my charitable donations up against anyone and feel blessed that I have the ability to help those less fortunate, but I will also say the families have the responsibility and "moral" responsibility to take care of their sick and disabled parents, grandparents, etc.. I don't think it is necessarily the obvious fallback position to go straight to the government teat for help first.

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but I will also say the families have the responsibility and "moral" responsibility to take care of their sick and disabled parents, grandparents, etc.
Last estimate I read was that a retiree should plan on $225,000 in health care expenses... and that is above and beyond Medicare.
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but I will also say the families have the responsibility and "moral" responsibility to take care of their sick and disabled parents, grandparents, etc.
Last estimate I read was that a retiree should plan on $225,000 in health care expenses... and that is above and beyond Medicare.

 

So if ya live 20 years beyond retirement........$937.50 a month........or 5% interest return on $225,000.

 

 

Not too bad.

 

 

Once ya break it down......

 

 

Whip

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My "side" is that the current system is not a free market.
Greg, does this mean you are open to free market reforms?
Well, I'm not Greg, but I'm guess I don't understand how shifting the money to the employee increases the number of consumers in the market? Even if everyone purchased your talking a 1 to 1 ratio here. Reality seems to indicate that most younger people would not continue to purchase insurance and instead simpley absorb the extra money as income - which in turn would shrink the pool of consumers driving up costs to those that remain. And how do you address those that don't have insurance today?

 

What other free market reforms do you propose?

This is the "when Steve is king" plan.

 

First, we have to identify the actual cost to employers of company paid health insurance per employee. Whatever this figure is, it's part of that employee's compensation and must be known so it can be returned to the employee as part of their compensation.

 

For example, let's say Bob earns $52,000 a year from XYZ corporation. His employer pays $4,200 annually for the medical insurance it provides for him. At the cutover time for decentralization, Bob's pay would be increased to $56,200 and his company would discontinue paying insurance. Simultaneously, Bob would shop for and aquire his own insurance.

 

The effect here would be to increase competition by increasing the number of individual consumers in the market. If Bob want's a better plan, he might pay more for it. But, if Bob want's to save some of his own money, he has the option of purchasing a lower cost plan. In the end, it's his choice.

 

--------------------

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I'm one of the 59% of doctors who favor a national healthcare system. Probably many physicians would have a pay cut, especially the higher earning ones like cardiac surgeons, pathologists, anesthesiologist, radiologists, and ER docs. The average doc in the trenches would probably break even, but at least the patients would get the care they need instead of choosing to go without.

 

Al,

Considering what Medicare/Medicaid pay, do these even cover your costs of service?

If this was taken to the universal level, what do you think the impact would be?

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$937.50 a month.

No, not too bad. And if the parent can't afford it then every child should be able to spare that to fulfill their moral obligation.

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steve.foote

Well, I'm not Greg, but I'm guess I don't understand how shifting the money to the employee increases the number of consumers in the market? Even if everyone purchased your talking a 1 to 1 ratio here. Reality seems to indicate that most younger people would not continue to purchase insurance and instead simpley absorb the extra money as income - which in turn would shrink the pool of consumers driving up costs to those that remain.

 

I don't understand your math above, but I'm sure you are not saying that connecting insuree's directly to insurers is reducing the amount of consumers in the market.

 

Here is how I see it. If you increase competition for a good or service, prices will become more reflective of the actual cost of bring such a good or service to market. More players, more competition. As it stands right now, we have many more employees than we have companies, and those companies are the entities who are negotiating with the insurance companies. If the individual employee is "set upon" the insurance industry, you would see competition much like you do with life, disability, auto, and homeowners insurance. It's this competition which brings down prices and increases choice.

 

And how do you address those that don't have insurance today?

 

We already are. There are a plethora of entities, public and private, already addressing these needs. The goal of healthcare reform should be to create the most efficient system for the most people. If we continue to chase the "what about this one" senereo's, we'll never see reform. There will never be a perfect 100% system.

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steve.foote

What other free market reforms do you propose?

 

I would like to see some reforms in the medical malpractice arena. This is one of the major factors in the cost of healthcare.

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Lets_Play_Two

Where does tort reform fit into this discussion? We can't ignore the cost of 1. lawsuits and 2. procedures undertaken, needed or not, because of the threat of lawsuits.

 

And, no, I am not suggesting that drs. be exempt from lawsuits, but we all know what litigation has done in many areas of our lives.

 

Locally we had an 18 year old die during breast augmentation surgery. Her parent's lawyer and her parents, within 10 days, have already been on Good Morning America and other TV shows. Guess what they are talking about?

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Locally we had an 18 year old die during breast augmentation surgery.
It was corrective surgery, and it is questionable whether she received a standard level of care. But why should a court be allowed to meddle in that when we already have it so nailed down?
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$937.50 a month.

No, not too bad. And if the parent can't afford it then every child should be able to spare that to fulfill their moral obligation.

 

That's the way it works in my family..........is it too late for you to adopt me.....

 

 

grin.gif

 

 

Whip

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The math was simple, I took your earlier statement to mean an actual increase in consumers ... but that's not what you meant.

 

So, you discount the likely possibility that many younger consumers would not be "set upon" the insurance industry and simply absorb the extra income?

 

And given your auto/homeowners insurance example, would you favor mandatory participation since those systems currently work 'cause you can't finance a car or a home withouth insurance.

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Al, Considering what Medicare/Medicaid pay, do these even cover your costs of service?

If this was taken to the universal level, what do you think the impact would be?

 

Considering Medicare, not Medicaid, was one of my best payors (compared to HMO's, PPO's), I don't think there would be much change. I considered Medicaid as my service to the community. I lost money on those patients, but never refused to see them. That would be fixed with one national healthcare system.

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Al, Considering what Medicare/Medicaid pay, do these even cover your costs of service?

If this was taken to the universal level, what do you think the impact would be?

 

Considering Medicare, not Medicaid, was one of my best payors (compared to HMO's, PPO's), I don't think there would be much change. I considered Medicaid as my service to the community. I lost money on those patients, but never refused to see them. That would be fixed with one national healthcare system.

Why do you believe that would be fixed?

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steve.foote
The math was simple, I took your earlier statement to mean an actual increase in consumers ... but that's not what you meant.

 

I see where we are misunderstanding. From the insurance company's point of view, the consumer (customer), is the company who buys the policy for its employees, not the employees themselves. I favor making the employees themselves the consumer.

 

So, you discount the likely possibility that many younger consumers would not be "set upon" the insurance industry and simply absorb the extra income?

 

And given your auto/homeowners insurance example, would you favor mandatory participation since those systems currently work 'cause you can't finance a car or a home withouth insurance.

 

Choice is part of the equation. I'm willing to let people opt out of the system, but I'm also willing to decline service to them if they do (fully understanding that I am probably in the minority on this one frown.gif ). What I don't support is allowing people to opt out, then service them anyway. If that is going to be the case, then compulsory insurance would be necessary, leaving only the question of who would provide that insurance, which brings us full circle.

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Jerry_75_Guy
Al

I am curious to know what is the average income of a medical doctor in private practice in the U.S.?

 

That's a little tough since the income potential can range so greatly between specialities, and individual practices, but the last data point I ran acrossed (bear in mind that this is ~3yrs old) was an estimate claiming that a family physician in the U.S. averaged about $120,000/yr, and avg. work week was 50 to 70hrs long, after being in school until at least age 28, and finding themselves in debt to the tune of ~$150,000.

 

And I don't know whether that figure was gross income prior to paying malpractice ins., or net income.

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Lets_Play_Two

"it is questionable whether she received a standard level of care"

 

Questioned by who? And it was augmentation surgery whether corrective or not. My point has nothing to do with the court being involved, it has to do with the behavior of the lawyer and the parents, and probably the media. The Drs., right or wrong, have already been tried in the media.

 

Where did you get your information about it?

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Where did you get your information about it?
Well since I don't know the family personally I guess the only thing left is news reports.

 

I'm not going to get into the specifics of the case because neither one of us is competent to discuss it. My only point is that we just might not yet be in possession of enough facts to necessarliy use the case as a poster child for frivilous lawsuits.

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I've got to say, I find some of the cold-hearted cruel attitudes expressed by some of the people in this thread really, really disturbing.

 

Many of us find your attitude disturbing, too, Ken. It seems that you are willing to reach into anyone else's pocket as well as your own (I assume that you contribute heavily to all the right moral crusades) to gratify your sense of what's right. Even if I share your idea about moral responsibility to my fellow man, I condemn the method you propose. Most places, it's called stealing and the government has no business doing it for you.

 

As to "cold-hearted cruel attitudes," you have no idea what our attitudes are about our fellow man. You draw a conclusion based on your narrow vision of obligations one to the other and how they should be carried out.

 

Pilgrim

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Greg, does this mean you are open to free market reforms?

 

Yes. However, first that requires a free market for medical services. I don't know how we get there.

 

I find the whole mess an awful conundrum. The government tightly regulates the market for medical services. As part of that regulation, supply is constrained and cost of services provided is high. Basically, our current system pretends to be applying free market principles with preventing the existence of an actual free market.

 

As a result, many people can't afford medical coverage.

 

I don't see how the King Steve plan solves the core market issues. It opens up the insurance market, but not the market for the services that insurance is paying for.

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Many of us find your attitude disturbing, too, Ken. It seems that you are willing to reach into anyone else's pocket as well as your own (I assume that you contribute heavily to all the right moral crusades) to gratify your sense of what's right. Even if I share your idea about moral responsibility to my fellow man, I condemn the method you propose. Most places, it's called stealing and the government has no business doing it for you.
You know I'm almost getting the idea that many here aren't in favor of the government being charged with a responsibilty to assist the needy. If so then what alternative is proposed? (assuming that one doesn't buy into the fantasy that all will be remedied by the largesse of the wealthy once they are freed from their crippling tax burden.)
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Many of us find your attitude disturbing, too, Ken. It seems that you are willing to reach into anyone else's pocket as well as your own (I assume that you contribute heavily to all the right moral crusades) to gratify your sense of what's right. Even if I share your idea about moral responsibility to my fellow man, I condemn the method you propose. Most places, it's called stealing and the government has no business doing it for you.
You know I'm almost getting the idea that many here aren't in favor of the government being charged with a responsibilty to assist the needy. If so then what alternative is proposed? (assuming that one doesn't buy into the fantasy that all will be remedied by the largesse of the wealthy once they are freed from their crippling tax burden.)

 

 

Easy Dad.

 

How am I gonna be able to help ya if the government takes all my money???????

 

$937.50/month.......is all I got.

 

 

grin.gif

 

Whip

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You know I'm almost getting the idea that many here aren't in favor of the government being charged with a responsibilty to assist the needy. If so then what alternative is proposed? (assuming that one doesn't buy into the fantasy that all will be remedied by the largesse of the wealthy once they are freed from their crippling tax burden.)
<crickets>
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Need can't be the a significant criteria in crafting public policy. Hardly any of you have held a publicly elected office, which is something I'm quite grateful for. grin.gif I have, and need has to be balanced with ability, responsibility, and long-term outcome.

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Jerry_75_Guy
You know I'm almost getting the idea .......

 

"Almost" ? wink.gif

 

But seriously, while I wouldn't claim to try and speak for anyone here, I have quite a few friends and family members who proudly accept the label of conservative, and will openly (and with some vigor, I might add) assert that they feel nearly any form of governmentally supplied relief (particularly welfare) is an abomination, should be terminated, and that nearly all participants in such programs are wholly undeserving of any such benefit.

 

I'm certain this isn't the perspective of all those with 'right leaning' ideological perspectives, but it hasn't been an uncommon one amoung those comfortable enough to discuss such topics with me.

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steve.foote
You know I'm almost getting the idea .......

 

"Almost" ? wink.gif

 

But seriously, while I wouldn't claim to try and speak for anyone here, I have quite a few friends and family members who proudly accept the label of conservative, and will openly (and with some vigor, I might add) assert that they feel nearly any form of governmentally supplied relief (particularly welfare) is an abomination, should be terminated, and that nearly all participants in such programs are wholly undeserving of any such benefit.

 

I'm certain this isn't the perspective of all those with 'right leaning' ideological perspectives, but it hasn't been an uncommon one amoung those comfortable enough to discuss such topics with me.

 

That would be because it is an abomination. While trying to present a picture of empathy, we have instead created an entire class of dependants. Great progress confused.gif. Now, food stamps go out to more people than at any time in our history.

 

I would really like for someone from the other side of the aisle to explain how we help people by flipping them an impersonal stipend once a month, instilling in them the belief that they can't take care of themselves without our "generous" help. Welfare, along with other government handouts, is a poison which kills the soul of an individual.

 

Jerry, I know you are a well meaning guy, but please, please spare us the pious lectures about how caring you are when you support the remote control destruction of an entire class of Americans simply because you want to feel like you are doing something worthy. Look at the results of decades of the welfare state. So, who has benefited from this outpouring of generosity? Certainly not the intended recipients.

 

Government isn't the solution. It never has been. I'm afraid that's as far as I can go without further crossing the limits of this forum.

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I would really like for someone from the other side of the aisle to explain how we help people by flipping them an impersonal stipend once a month, instilling in them the belief that they can't take care of themselves without our "generous" help. Welfare, along with other government handouts, is a poison which kills the soul of an individual.

 

Jerry, I know you are a well meaning guy, but please, please spare us the pious lectures about how caring you are when you support the remote control destruction of an entire class of Americans simply because you want to feel like you are doing something worthy. Look at the results of decades of the welfare state. So, who has benefited from this outpouring of generosity? Certainly not the intended recipients.

It is a gross and inaccurate generalization to say that every person who cannot afford enough food for their family or adequate medical care has necessarily been 'created' by social assistance programs. That view only reinforces what Jerry just said.

 

Social welfare programs are imperfect, I don't know how to design a perfect one. What we have in place now is a start and no argument that we should always be looking to minimize waste and ways to improve their effectiveness. But for anyone who would like to toss them out entirely I would really like to hear what you would assemble to replace this role of government (if anything.)

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steve.foote

Seth, that arguement is a red herring. I've already explained my view on this. It's not necessary to repeat it when one could simply go back through the thread and read it for himself.

 

Let me flip it back to you. Tell me about the successes of the system.

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Let me flip it back to you. Tell me about the successes of the system.
No, don't flip it back at me, answer it. I don't see how a straight answer would represent any repetition as I haven't yet seen anyone propose any alternative other than a belief that adequate assistance will somehow magically appear if the government would only get out of the business. Please humor me and let me know what you would propose (and that's an open question to anyone who would like to be responsive.)
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steve.foote

I'm not going there, girlfriend. You can spend the rest of this thread asking for answers, links, evidence, etc., adnausium, but I'm not going there anymore. I've said my piece about this and you can either choose to accept what I said, or disagree with it. I'm fine either way.

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Dave McReynolds

I would really like for someone from the other side of the aisle to explain how we help people by flipping them an impersonal stipend once a month, instilling in them the belief that they can't take care of themselves without our "generous" help. Welfare, along with other government handouts, is a poison which kills the soul of an individual.

 

I assume the original issue we were discussing, health care, is buried somewhere in your statement, but you've somehow broadened it to include too many things to respond to in one post.

 

But to return to healthcare, my feeling is that we're already paying the bill; we're just doing it very inefficiently. People can sit in emergency rooms until they are finally attended to, and then walk out without paying the bill, which eventually finds its way back to the rest of us. People can get expensive operations or cancer treatments that they have no ability to pay for, and then go bankrupt, and we pick up the costs for that. People can go without treatment and infect the rest of us, or they can get so sick and weak that they can't work and have to go on the public dole.

 

As far as the resource is concerned, I don't know of any doctors who are sitting around on their a$$es. Most of them take my tax busy season and extend it all year round.

 

So essentially as many people are getting treated as we have resources to treat, already. But the mechanism for allocating those resources to the areas they're needed the most, and compensating for those resources is hopelessly broken.

 

As has been mentioned previously, those of us in favor of a comprehensive healthcare plan for all Americans simply would like to change the view of healthcare from a commodity that is traded in the marketplace to a resource that is allocated based on where it will produce the most benefit. We believe that universal coverage will result in more people being treated at less cost than under the current system. And, it looks like that's where we're headed.

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Jerry_75_Guy
Jerry, I know you are a well meaning guy, but please, please spare us the pious lectures about how caring you are when you support the remote control destruction of an entire class of Americans simply because you want to feel like you are doing something worthy.

 

Wow.

 

I must have struck a nerve there. Much as you must be sure that was the intention, it really wasn't.

 

No one answered Seth's question, so I passed on what friends and family have said, and I know for a fact that they'd stand behind those words.

 

You make an awful lot of really inaccurate of assumptions about me in your statements.

 

If any mods feel what I said was in any way inappropriate, please delete my post; I don't want to cause any hard feelings.

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steve.foote

Of course it struck a nerve, Jerry. It was a slap in the face. You may not have meant it that way, but nonetheless, that's the way it came across.

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I am curious to know what is the average income of a medical doctor in private practice in the U.S.?

 

Kieth. I honestly don't know, as I haven't looked at the numbers since I retired (burned out, actually). I suspect Jerry_75's numbers are close to correct. Primary care docs (family practice, pediatrician, internists) probably make about $120,000. Proceduralists (surgeons, gastroenterologists, cardiologists) make much, much more because they do procedures which are always reimbursed at a higher rate than cognitive services. As mentioned, AFTER college, I went to four years of medical school, three years of internal medicine residency, and then another three years of heme/onc fellowship. So I was around 32 or 33 before I started earning a living and paying back educational debt. Then worked 60-70 hours a week until I retired. Sounds like I'm bitch'n, but I loved it. The insurance crap just became too much of a hassle.

 

Considering Medicare, not Medicaid, was one of my best payors (compared to HMO's, PPO's), I don't think there would be much change. I considered Medicaid as my service to the community. I lost money on those patients, but never refused to see them. That would be fixed with one national healthcare system.

 

 

Why do you believe that would be fixed?

 

With universal healthcare, there would be no need for Medicaid. The 20% or more of each healthcare dollar wasted on administration would go towards patient care. Like I said, many doctors would take a pay cut and many would quit working 70 hours a week. You loose a little and gain a little.

 

After I retired, I was the medical director for Medicare in Utah. So I guess I didn't really retire. I took the job because I really believe in a Medicare-like system for everyone. I'll gladly debate anyone the merits of Medicare. It isn't perfect, but it takes care of a bunch of people who otherwise would be without. And it's a bargain for the tax payers.

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Government isn't the solution. It never has been. I'm afraid that's as far as I can go without further crossing the limits of this forum.

 

thumbsup.gif

+1

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DavidEBSmith

Government has never been the solution? Not the solution to the foundation of modern civilization by the Greeks and the Roman Empire, independence from Britain, the elimination of slavery, the destruction of the Third Reich, the Erie Canal, the land-grant college system, the Manhattan Project, the Interstate highway system, and keeping those hordes of Canadians from invading and stealing our stuff . . .

 

All right, but apart from the sanitation, medicine, education, wine, public order, irrigation, roads, the fresh water system and public health, what have the Romans ever done for us?

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steve.foote

I see your point, David. After 40 years and trillions of dollars, we must be closer to ending poverty than I originally thought. Hopefully, we will be at least as successful with our new nationalized healthcare system.

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I see your point, David. After 40 years and trillions of dollars, we must be closer to ending poverty than I originally thought.
Of course that wasn't David's point at all. But if there is a way to end poverty it remains a well-kept secret.
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Jerry_75_Guy

I have to admit, that's the first time I've had a person concede, energetically agree with, and even restate the point I was making, then upbraid me for making it in the first place, plus bonus points for calling me 'pious'. Nice touch.

 

...please spare us the pious lectures about how caring you are when you support the remote control destruction of an entire class of Americans simply because you want to feel like you are doing something worthy.

 

'support the destruction of an entire class of Americans to make myself feel better'?? (or more 'pious', I suppose?)

 

"Slap in the face"?

 

Pot...Kettle...Black.

 

At least mine wasn't intentional.

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