Oh, sorry got lost for a minute, what I meant to say was "Oh, look..another screwup brought about by socialized medicine"

http://news.bbc.co.uk/2/hi/europe/3939289.stm

Evidently the health care system in France(I'm not singling you out, honest!) is so great that the surgeons in the country are, well, moving to other countries and even have planned a mass "exile" for a week in protest of their working conditions.

All children in the United States should have health care. period. If that means the Govt has to pick up the tab for poor children, so be it.
Drug companies need to be reigned in. There is no reason the American public needs to pay 4x the amount as canadians.
In HMOs, only doctors should make health care decisions, not lawyers or accountants. There needs to be a check or balance against medicinal decisions being made on cash concerns, but medical integrity.

Free enterprise is good and it works in the medicine field. But that does not mean it cannot be improved or is by any means perfect. Whatever is happening in france has nothing to do with the above. There are many, many ways to do things. The goal is to constantly refine and improve and change and find what works best.
And this is the most important thing.
Profits are not the most important thing.
The most important thing is the health of our people and the quality of care availble for the widest number of people, a "for profit" system works the best so it is employed. BUT. If profit making ever takes precedent over the health of people of the United States, then that system is failing and needs to be overhauled. We arent there. But we need to be vigilant to avoid falling into that. Changes and safeguards and improvements need to be made

/nods

Anyone who slugged through 8 years of Higher Education and took the Hypocratic oath should really be in it for the patients imho.

Drug companies are HUGE crooks, I liken them to OPEC in many ways in my own thoughts.

Socilized medicine is a failing system in many countries. Ever hear the horror stories of the wait to see a doc in Canada?

Fandros

Doctors and medical personal migrating is a wordwide phenomenon.

There are estimates that about 150 doctors leave Hungary (Central Europe) each month for Western European countries because of better working and living conditions. And right now about 25% of nurses currently working in Hungarian hospitals are from eastern europe (Romania, Ukraine, Bulgaria etc).

So, I don't think French hospitals will be in trouble, there are a lot of gifted, well trained young doctors who just pack their bags and take their fresh degree (which they got for free as your first degree is payed by the government here) and going to work there.

Condition is a relative word. Conditions in France might be questionable but still lightyears better than in Hungary and Hungary is still leages better than Romania etc etc.

Y'know, I sorta like living in a country where I don't have to rely on an insurance company's whims to save my life. I like knowing that if I get in a car crash I won't have to declare personal bankrupcy due to medical bills. I like being able to go to the dentist even if I'm currently not employed, thus lacking a dental plan.
I like knowing that even the poor in Sweden can afford their medicine due to state subvensions.

I like the fact that every child in Sweden recieves their vaccines free of charge. I like the fact that we have free medical care incorporated into the school system, providing kids with free medical consultation and treatment. Did I mention I like having the best public schools in the fucking world, and not having to worry about affording sending my kids to college? No wait, this was healthcare.

Did I mention that I like the fact that anyone with the capability to become a doctor can be one in Sweden without becoming indebted hundreds of thousands of dollars just to pursue what can only be described as a calling?

EDIT: Just had to add that I like the fact that doctors don't have to shell out thousands of dollars a month just to protect themselves against lawsuits, and taking it out on patients in the form of fees.

And Fanny... Hippocratic oath. Doctors aren't hypocrits by default :)

Y'know, I sorta like living in a country where I don't have to rely on an insurance company's whims to save my life. I like knowing that if I get in a car crash I won't have to declare personal bankrupcy due to medical bills. I like being able to go to the dentist even if I'm currently not employed, thus lacking a dental plan.
I like knowing that even the poor in Sweden can afford their medicine due to state subvensions.

I like the fact that every child in Sweden recieves their vaccines free of charge. I like the fact that we have free medical care incorporated into the school system, providing kids with free medical consultation and treatment. Did I mention I like having the best public schools in the fucking world, and not having to worry about affording sending my kids to college? No wait, this was healthcare.
You're addicted to the free candy the government has you hooked on.

Actually, I think you're government is a complete failure. Why do you have to pay for your food? That's a human necessity (much more so than medical care), so why do you have to pay for it? Aren't you angry at the farmers and cattle ranches for making you pay for your food?

And why do you have to pay rent or take out a loan to buy a home? Everyone needs a roof over their heads, the government should pay for that too.

And why do you have to look for a job? The job should be done by the government, afterall, you might get in a horrible accident on the way to work and not be able to suck off the government's tit anymore. Can't have that can we?

I'd better not get into this one.

Why do you have to pay for your food? That's a human necessity (much more so than medical care), so why do you have to pay for it?
On the whole, socialized medicine (at least, to the extent of France's system) is a bad idea. There are lots of reasons why they don't work, and lots of arguments you can make against them, but comparing it to the cost of food isn't one, in my opinion.

Why not? Food can easily be budgeted it out. Heart disease, cancer and adolescent onset diabetes cannot be. There are plenty of hardworking Americans who, even with the health care their company provides them, would be unable to pay for those conditions. Factor in the overall decline of health care in the US, and you have a bit of a problem.

While we're still comparing the food industry to the medical industry, let's compare their profit margins. Your average grocery stores have pretty small profit margins; anywhere between 0.5%-6%. Your average pharmaceutical company? Try about 12%-28%.

You're addicted to the free candy the government has you hooked on.

Actually, I think you're government is a complete failure. Why do you have to pay for your food? That's a human necessity (much more so than medical care), so why do you have to pay for it? Aren't you angry at the farmers and cattle ranches for making you pay for your food?

And why do you have to pay rent or take out a loan to buy a home? Everyone needs a roof over their heads, the government should pay for that too.

And why do you have to look for a job? The job should be done by the government, afterall, you might get in a horrible accident on the way to work and not be able to suck off the government's tit anymore. Can't have that can we?
There's nothing free about our system. It costs me 1/3rd of my income to maintain. And I gladly pay it.
As for my government being a complete failure, and then going on a ramble describing the Soviet Union at the pinnacle of its' socialized existence, I see no point in arguing with that. The Swedish political system is entirely centristic. Whether you vote "left" or "right", all you'll get is different flavors of the same values. We're capitalists. We're neo-socialist. We're liberals. But foremost, we're humanitarians.

Just had to add that I like the fact that doctors don't have to shell out thousands of dollars a month just to protect themselves against lawsuits,

/chuckle

That is actually one of the gripes the French surgeons have, skyrocketing insurance costs.

But foremost, we're humanitarians.
http://www.christianaid.org.uk/news/media/pressrel/010323p1.htm

http://www.soulsearching.ie/sssudanoil.shtml

Sorry to change the subject. I'm sure Sweden has a great record on human rights since some questionable positions during WW2, but I wish they had taken some action on Lundin at some point.

Could be Crist0. We don't have the same system they do.

And Winterworg, that's an individual privately owned company. Sweden practices free market economics. I told you we were capitalists. I was talking about our political system (ie: our political parties) as a whole, and the nature of the Swedish society. There'll always be contradictions and dissidents, naturally. But for example, in my philosophy 101 I was the only person in a 50 man classroom that advocated capital punishment for certain crimes.

Look up our foreign aid system. Check up how much we give out per capita.

All children in the United States should have health care. period. If that means the Govt has to pick up the tab for poor children, so be it.
Drug companies need to be reigned in. There is no reason the American public needs to pay 4x the amount as canadians.
In HMOs, only doctors should make health care decisions, not lawyers or accountants. There needs to be a check or balance against medicinal decisions being made on cash concerns, but medical integrity.


You are in luck LL, poor children do have health care coverage and it is infact paid for by the government. Its available in in every state. Its called the charity system. No expense is denied. Care is never denied. And doctors see these patients for free with knowing no reimbersment is coming.

I agree that the drug companies are making alot of money but they are also the ones researching new medicine. It would be very hard to search for new drugs if your bottom line is small. Also, all drugs become cheap once the patent is expired. A few years ago Zantac and other drugs like it were by perscription only. Now its over the counter and cheap. Mainly because the patent expired (ie Other companies can make their version of the medicine and compete).

I agree with you on your last point to a certain degree. Doctors should be given the power to decide how care should be administered. I believe the best remedy against abuse is an informed patient. Let the patient question the care and the cost. I know I am much more vigilant about things when you are playing with my money. Currently the patients have an HMO and abuse the system not caring what they are paying and just wanting every test done or wanting to stay in the hospital an extra day for whatever. Patients are as much to blame as the HMO's imo.

Anyone who slugged through 8 years of Higher Education and took the Hypocratic oath should really be in it for the patients imho.
Fandros this is a response to your statement but not directed at you per se.

I agree that the hippocratic oath is not to be taken lightly. But when you think about the true sacrifice a doctor makes for his chosen profession its unthinkable that they shouldn't be compensated well.

First- 4 years: First of all they go thru under grad school and have to excel in courses that are not easy (like art 101 or basket weaving). Keeping their grades up so getting into a medical school (which they compete against other trying to do the same thing) is a viable option.

Second- 4 years: Next, after getting into a medical program they spend countless hours learning even harder stuff and trying to do well so that when they apply to there residency they will have a chance to get in.

Third- 3-7 years: Now they get into their residency program. Depending on what kind of doctor they want to be the next 3-7 years they do finally get an income (modest one of course).

So now the doctor has it made.... they pass the boards..... its all gravy right? WRONG

To this point in their life the average medical student has managed to accumulate 100k in student loans. They are 28-33 years old if they went straight to college and got in all the subsequent programs exactly on time etc....

So now they want to start a practice..... they are looking at running a buisness (which medical school doesn't teach you to do) and getting into even more debt starting that buisness...... 500-700k more.

Okay so now you are hundred's of thousands of dollars in debt and in practice. You are have to meet overhead every month, pay bills, pay employees, pay mal practice insurance ... most docs work 15 days to pay overhead before they take home any money at all.... then what they take home is cut virtually in half by taxes.....

Now if you are Joe Blow who goes to 4 year college gets in 15k in debt then goes to work making 40 grand at 22 years old with no risk. Joe Blow has 10 years of making 40-50k (500k) income by the time the MD is ready to test the waters of his small buisness. Joe Blow has put 15% into his retirement all these years. MD is just now earning money to start saving (while he is trying to pay off 800k debt).

Anyway you get the idea. Medicine is the only field where people expect to be treated for free.

Go to the grocery store, fill up your basket, head to the check out line and then tell the cashier than you dont have the money to pay but you will be taking the merchandise anyway.

Go to an attorney and tell him you dont have any money but you need about 30 min of his time for some advice that you may or may not sue him over later if he turns out to be incorrect or makes some sort of mistake.


States like Mississippi are losing physicians faster than France. You dont have to look far.

I could go on and on but I will sum up with this..... The absolute worst care in USA is 10 times better than any other country. You dont see people flying to Canada for health care..... they fly to the USA. The 'charity' system in the USA in light years ahead of 90% of the world if not more. And it is free if you are poor.

Insanely exaggerated. Very few doctors open up a private practice. The vast majority join an established practice or an organization such as Group Health. Since there are so many regions in need of medical providers of all types, there are outstanding incentive programs to get you to move there, such as loan repayment incentives, low interest home loans, etc... I worked for two rural docs making over 400k per year each and they guaranteed me a job there when I graduated. Their problem wasn't loans or expenses. Their problem is that their insurance costs increases year by year mean that their income decreases by a large amount every year, and because the doctor/patient relationship is considered seduciary, their personal assets are all liable in the case of a lawsuit.

Don't forget that you're actually paid during your residency/internship. Sure its not a lot, especially considering the hours you're putting in, but that's why you shouldn't go into medicine for the money. If you're not doing it because you love working with people and helping people, you're gonna be miserable anyway and probably a bad doctor. Medical schools for years have been focusing more on applicant's interviews, volunteer service history, etc and de emphasizing scholastic achievement. Most of my class didn't even have a science oriented undergraduate major.

We need tort reform. We need congressmen to stop blocking tort reform. We need to get the insurance companies off of the state review commitees. We don't need free medical education.

In relation to the Swedish health care system... studies show that American consumers wouldn't put up with the restrictions inherent with universal health care. However, insurance companies and HMOs have already begun that type of transition in our thinking, and so maybe in a few more years it will become more acceptable. Right now though, if you tell a 70 year old American patient wanting a hip replacement that he'll have to wait for 2 years to get it or drive 300 miles to where he can get it in 6 weeks, you're going to have an awfully pissed off old codger. Without tort reform we'll eventually get there, but I hope not because the US is an entirely different question than a smaller, more homogenous country like Sweden. We also have a huge population of people flying under the tax radar, yet recieving entitlements. The cost of our medical service is directly related to service rather than quality. Hospitals compete for patients leading to an unnecessary duplication of services and expensive equipment, and also to overutilization of medical services. These are definite problems. I know it will never happen for many reasons but I wouldn't at all mind seeing experiments with State by State health care systems independent of Federal control.

For Kivorn... I totally understand. But you see the US has not allowed American companies to trade with the Sudan even though it was an American oil company that originally did the exploration for oil there and had the inside track on oil rights. Why? Because they were trying to get the international community to join in with them to put pressure on the government of the Sudan to reform itself and stop it's human rights abuses and sponsoring of terrorism. Come on now... if it was an American company instead of Lundin in there turning a blind eye to, and in fact directly exploiting the mass murder and displacement of innocent people, would you be saying oh well it's just an American company the US isn't responsible at all?


It's well publicized for ex., that approximately 2% of total US GDP goes into private charitable contributions. This figure far exceeds most of the world and has been relatively constant for a few decades (plus or minus a few basis points). Now obviously this figure isn't exclusively allocations to international relief but my point remains the same - the orgs that publish these statistics for political ends don't readily look towards this type of charity by the common man. They only count "state" activity because they are statists themselves and are angling for influence on its apparatus.

I'm not going to spend any more time trying to find Sweden's per capita contributions. However, no one could ever accurately estimate how much is given privately by US citizens' contributions to NGOs, and contributions made by US corporations. From my point of view, it's not my government's place to be giving my money away to foreign countries unless it's necessary strategically. We have a vast supply of private charitable organizations that will do a better job of it.

Insanely exaggerated. Very few doctors open up a private practice. The vast majority join an established practice or an organization such as Group Health. Since there are so many regions in need of medical providers of all types, there are outstanding incentive programs to get you to move there, such as loan repayment incentives, low interest home loans, etc... I worked for two rural docs making over 400k per year each and they guaranteed me a job there when I graduated. Their problem wasn't loans or expenses. Their problem is that their insurance costs increases year by year mean that their income decreases by a large amount every year, and because the doctor/patient relationship is considered seduciary, their personal assets are all liable in the case of a lawsuit.

Don't forget that you're actually paid during your residency/internship. Sure its not a lot, especially considering the hours you're putting in, but that's why you shouldn't go into medicine for the money. If you're not doing it because you love working with people and helping people, you're gonna be miserable anyway and probably a bad doctor. Medical schools for years have been focusing more on applicant's interviews, volunteer service history, etc and de emphasizing scholastic achievement. Most of my class didn't even have a science oriented undergraduate major.

We need tort reform. We need congressmen to stop blocking tort reform. We need to get the insurance companies off of the state review commitees. We don't need free medical education.
Winter, I am fully aware of the incentives to practice medicine in rural area. Usually a hospital will offer a form of loan forgiveness for docs with the understanding that they practice in an underserved area for X amount of years. That money is still considered income and you have to pay taxes on it.

Why do you think very few doctors open up a private practice? Because it costs to much and there is to much risk.

I do beg to differ with you on the scholastic achievements.... if you say the MCAT is de-emphasized then we differ greatly. You dont have to be a genius to be a doctor but you need to beat out the other people in an over all competition to get accepted to medical school. While most of your class didn't have science degree's Im willing to bet they had the classes that helped them prepare and pass the MCAT.

You mention that expenses weren't a problem but then you say " Their problem is that their insurance costs increases year by year mean that their income decreases by a large amount every year " . If that isn't a good example of 'expenses' then I don't know what is. If I had to pick my top pet peeve of the 'expenses' it is the way insurance companies and medicare medicaid reimburse so poorly that it makes it hard to run a buisness.

I don't know what state you practice (or are going to practice in) but here in Louisiana there is a cap. And I can gaurantee you that you can protect your personal assest in different ways. I do find it deplorable that lawyers use a 'shotgun' tactic when filing a suit.... they find out who has money to be taken and then tailor the suit around targeting "Mr Deeppockets". Ironically they find out who has the best liability insurance and that is who they go after. So we agree that any reform would be welcome.

You mention that you are getting paid in residency... if you can make a 1300 a month payment to your student loan on a 30k a year salary then you are doing better than me. We got ours deferred but the amount owed kept rising during that time.

I don't buy your statement regarding not going into a field if you are concerned with being compensated adequately. If you really believed that you would not be complaining about losing your assest in a lawsuit because the only thing that really matters is that you helped people at the end of the day.... not that you can pay your light bill or your kids can get braces. I'm sure that the auto workers at the Ford company don't go to work because they love to make cars. They go to work to be productive and provide for their family.



I did use ball park figures in my original post but far from insanely exaggerated. My personal experience was alot better but I have seen what I described happen to more than one person graduating medical school/residency. Are you a resident or in medical school? Maybe I can be more specific once I know where you are coming from. My wife is a Doc (family practice) and I am a RN. I have been around and seen alot.

Let me throw out just a for-instance..... you go Tulane undergrad then you get into Tulane medical school. 4 year undergrad and 4 years medical school can easily run you 250k in student loans...... say that doc becomes a Pediatrician.... they average 110-130k in the first couple years.... cut that in half for taxes and see how much of that 250k you can pay off or see how much of it you get someone to pay back for you. Its not all rainbows and sunshine no matter how you look at it.

But after saying all that I wouldn't want to be in the medical field in any country but the good ole USA. I wouldn't want be in a situation where healthcare was rationed. I wouldn't want to live in any other country period. To all you who think you have it good in your country with your free health care I have but three things to say to you..... J P 3 (winterword should get that :) )

I'm an M3. The average GPA of medical schools across the country went down dramatically in the 90s as a result of a greater emphasis being placed on 1) volunteer work, relative experience, and life experience being given greater importance 2) cultural diversity programs 3) interview process.



I don't buy your statement regarding not going into a field if you are concerned with being compensated adequately. If you really believed that you would not be complaining about losing your assest in a lawsuit because the only thing that really matters is that you helped people at the end of the day.... not that you can pay your light bill or your kids can get braces.

Having your personal assets taken in a lawsuit is kind of beyond the realm of what I'm talking about. What I'm saying is that if you're in it for the money over a regard for your patients, there are probably things you can do other than medicine in which you won't be working 60plus hour weeks on a regular basis and be similarly compensated and out of the emotional meatgrinder. There's a reason why doctors and dentists have the highest rate of alcoholism and suicide amongst all white collar professions.


While most of your class didn't have science degree's Im willing to bet they had the classes that helped them prepare and pass the MCAT.


True. Many take it once freestyle, then take a class for it the second time. I think the majority of people now are not accepted on their first try, and their use of their time in the year before their second application becomes a big issue. The year I was accepted there were 160 spots at my school and over 4000 applicants. I believe about half of those applicants were accepted at some school. I only applied to one.

Student loan payments can be consolidated easily, especially the federally guaranteed ones. I worked through undergraduate and escaped that debt free, but of course I'm racking it up now. 90 percent of it is at 4 percent interest but the juice doesnt start running until residency. Generally, during residency there is free housing and sometimes food available too. Doesn't work as well for married students sometimes but its getting better. The residents I've talked to have been able to get along just fine, and there is extreme flexibility in the system. They know they'll get their money eventually.

When I say expenses aren't the problem I mean that for instance, when I join a practice, like theirs, I won't have the startup costs you talked about with opening a private practice. I can't see why it should be at all the norm for graduates to be able to open up a private practice immediately. It should be this way. There's a lot to be learned from joining a group of more experienced docs both in terms of patient care and business management. When you join a practice, your expenses are your insurance (which is lower if you are in a group usually) and loan repayment. The said they were offering 20k per year in loan repayment, and other perks I can't remember at the moment. On top of that you immediately have a trained staff, and guaranteed patients.

You're right about medicare of course. According to all the info I've heard from most family medicine clinics, the clinic loses 12 dollars for every patient they see. In effect they're doing charity, and they have a quota of medicare patients they can see per week. In the practice I've been talking about they set aside one day per week. This is a clinic with 4 docs and 4 PAs. In WA state, PAs can function the same as a family doc in most cases depending on extra accreditation they can get.

I'll escape with about 100k in debt, and my repayment will be about 500 per month. At 4 percent interest rate I'll be letting it ride for awhile. If you have a spouse with an income and live within your means, then really you could pay it off pretty quickly really. Residency is about 30k per year. As dumb as it sounds... I can't remember if you can defer your loans through residency. Still over a year away for me. Haven't thought that much about it, I just take whatever money they'll give me.

Your numbers were 500-700k so that's what I considered exaggerated because it relies on someone going out and establishing a practice which is a supreme rarity.

Sure tort reform would be welcome. We need stiff penalties on frivalous lawsuits, a cap on punitive damages, and a review of the seduciary relationship statutes. I got in a heated conversation with a lawyer who came to talk to our class about malpractice issues. According to her the reason they apply the seduciary title in malpractice suits is because if they changed it it would inherently change the relationship between doctor and patient. I'm like... huh? What is changing the relationship between doctor and patient is that a doctor has to look at each patient in terms of their potential to want to sue them. I wanted to be able to do Obstetrics as part of my practice but its becoming increasingly impossible because of malpractice issues. Courts are awarding damages based on emotions rather than facts.

I'm actually not sure what you mean by JP3 and its making me feel self conscious so please relieve my anxiety.

http://msnbc.msn.com/id/4750786/

I think you are wrong Bise. While there may be a level of care for poor children, in many cases it is below standard. Decisions are often made on the economic viability. That extra test isnt encouraged or allowed, that specialist isnt accessed, that medication isnt prescribed. But if Blue Cross/Blue Shield was picking up the tab, then Oh Hell Ya, we got all stuff.
What im saying is that a doctor should never have to say in his head "Damn, Id love to do this test/procedure/medication/treatment for this kid, but I have no idea how they would pay for it or if the Hospital would allow it without better health care"

LOL
I got this from a feedback
Should get sick overseas in these utopian places you like so much. You would enjoy the care they provide
The funny thing is I never mentioned ANYWHERE else. I dont GIVE A FUCK about anywhere else. I live here.
It always amazes me how people can look at injustice or something that is broken, and instead of the urge to improve it or make it better, take the disgusting and intellectually lazy approach that "Hey, its still better than alot of places"

"Hey Mom, ya I know I got a C-, but so many kids got F in my class, you should be happy Im not one of them"!!

I suppose the complete bliss one can achieve from having very low expectations is a bonus

I think you are wrong Bise.

"Damn, Id love to do this test/procedure/medication/treatment for this kid, but I have no idea how they would pay for it or if the Hospital would allow it without better health care"



From my experience for fear of not providing quality care and being sued, the doctors will order what ever it takes no matter what the cost. After all the doctor does not get paid anymore or less if they order, say, an MRI or if they prescribe a more expensive drug. This is ecspecially true in the charity system. I have worked in that system and in 'private' hosptials. The funny thing is the 'charity' type patients are in the same rooms as the Blue Cross patiens AND have the same doctors. And this is in the 'private' hospital I currently work at.

The article you mention cites immunizations as one of the deficiets. IMO that is hardly anything more than the parents not taking responsibilty and getting their kids to the doctor at the appointed times for the correct shots. I know for a fact that all immunizations can be obtained for free at the state clinic if you are deemed poor.

The real crime in this country is the middle class that pays for the Blue Cross policy at great financial pain. They don't qualify for all the 'free' government programs. They have a 500 dollar deductible. They have a co-pay. They have to miss work to go to the doctor appointment. And they get the same care and tests as someone who is doesn't work for what ever reason who hasn't contributed to the system.... and then hear about how the poor and the indigent don't get the same care on TV while they are sitting in the same waiting room waiting to be seen by the same doctor as them.

I would beg to differ respectfully with you that health care is not relative. The charity system is in place and will be there for those who need. We are that kind of a country. We provide many services that other places would never dream of. But if you can pay for a better service (because that is ultimately what you get, not better health care) via insurance etc... then you have earned what you can pay for.

LOL
I got this from a feedback
heh, L2 I promise it wasnt me :)

Where do you go see if you have feedback on something?

Shouldnt give someone negative feedback because you don't agree with them.


I agree... its the middle class that is being shafted by the system if anyone.

Minor correction:


Go to an attorney and tell him you dont have any money but you need about 30 min of his time

It's called pro bono, and they do precisely that :)

Very good points and ideas in this forum. Keep it up guys.

My mother is a doctor in a public hospital ( gyneco)

My father is a doctor in a private hospital ( surgeon)


Lots of talking about articles in this thread huh.

So here is the deal, my mom works for a public hospital which has some advantage and some problems::

1) she can't be sued, well technically she can but the hospital cover everything so she doesn't have to pay assurance.

2) The pay check ( around 60k euros by the end of your career, you start with about 24K) + the number of work hours ( which these days due to the lack of doctors are something like 70 hours a week up to 130 during summer, happened just last week). Those 2 things make that students don't take the specialists profession, they all finish their general studies then goes on either generalist job or the easy stuff ( radiology/psy etc).

3)Pay check in the public are merely purely based on seniority. They did try this year to pay her sup hours ( supposed to only work 35h hahah) which actually doubled her salary for the month of january but then they can't do that every month because they would explode the budget of the hospital within 6Months. She has yet to finish taking her 2002 vacations.


My dad works in private hospital:

1) Pay check is higher ( I don't know exaclty I think its something as 125/150 k euros a year but haven't asked). The hours of work can be lower since you are mostly your own boss but thats not his case anyway ( actually 15 years ago he became toxico because he alternated sleeping pills and excitant in order to be able to work and sleep afterward, he is clean now tho ).

2) You have to pay every year 15k euros just for your assurance because people took that thing that came from the usa that if something wrong happens you HAVE to sue the doctor, after all it is forced that he screwed up huh.

3) Pay check is based on merit mostly.

All in all the major problems are the lack of doctors which boost the work hours by a shitload, the fact that a lot of young people don't want to put up with having to stay at hospital 4/5 night of a month, the pay check which is just sad considering the responsability the profession has. The fact that people are suing left and right forcing assurance to jack up prices.

If you go on strike as a doctor you still have to work, else the gov sue you for non assistance to people in danger. Pretty much means its useless now doesn't it? They just have a panel on their chest with written : doctor on strike and they keep working normally.

Second one the syndicates kind of spent their time fighting each other for years and beeing gov puppet, now its different but the question is isn't it too late.

Doctor is a wonderfull job, but you have to love it to do it right now because its just not worth wasting your health and beeing underpaid for otherwise. My mom has been doing the following hours for the last 2 years: wake up at 6.30 leave at 7 and go work, comes back home at 1 am. I have had to force her to take vacations because she was totally exhausted.

Anyway Socialized health care works great, its probably one of the best system in the world. People that can't pay assurance can get health care regardless. I m sure if you are selfish you can just see it as wasting 25% of your salary each month I guess until the day you actually get to use it and then you're happy because one day in hospital is hella fucking expensive. Naturally some people abuse it but thats a given and thats the government job to limit and fix it. Its not perfect but after reading on how work some other countries ( like england, worst ever) I m glad to have it as it is and hope its never going to change.


Edit: you don't get in debt during your 14 years of studies considering schools are public btw. Was just rereading the thread.

I'm an M3. The average GPA of medical schools across the country went down dramatically in the 90s as a result of a greater emphasis being placed on 1) volunteer work, relative experience, and life experience being given greater importance 2) cultural diversity programs 3) interview process.

My wife was president of her Pre-professional club in undergrad and if I remember correctly she said it goes in cycles. So for a while it gets really competitive then people kinda lose interest and it gets easier. I remember her doing all the things you list above though. I will have to defer to you on recent trends though.



Having your personal assets taken in a lawsuit is kind of beyond the realm of what I'm talking about. What I'm saying is that if you're in it for the money over a regard for your patients, there are probably things you can do other than medicine in which you won't be working 60plus hour weeks on a regular basis and be similarly compensated and out of the emotional meatgrinder. There's a reason why doctors and dentists have the highest rate of alcoholism and suicide amongst all white collar professions.

Okay : )


Student loan payments can be consolidated easily, especially the federally guaranteed ones. I worked through undergraduate and escaped that debt free, but of course I'm racking it up now. 90 percent of it is at 4 percent interest but the juice doesnt start running until residency. Generally, during residency there is free housing and sometimes food available too. Doesn't work as well for married students sometimes but its getting better. The residents I've talked to have been able to get along just fine, and there is extreme flexibility in the system. They know they'll get their money eventually.

You are very lucky to be borrowing at a time when intrest rates are at an all time low. Man, if they give you free housing and food at your residency that would be great. I have never heard of a program doing that.


When I say expenses aren't the problem I mean that for instance, when I join a practice, like theirs, I won't have the startup costs you talked about with opening a private practice. I can't see why it should be at all the norm for graduates to be able to open up a private practice immediately. It should be this way. There's a lot to be learned from joining a group of more experienced docs both in terms of patient care and business management. When you join a practice, your expenses are your insurance (which is lower if you are in a group usually) and loan repayment. The said they were offering 20k per year in loan repayment, and other perks I can't remember at the moment. On top of that you immediately have a trained staff, and guaranteed patients.

My wife did basically just that coming out of residency. She and 3 other new docs joined an established practice. After the first year contract was up they decided they could do a better job at running the show than the older docs (overhead was way to high). Buying land , building a facility to practice in, and getting equipment can (and did) run over ~750k. They always think long term. I won't bore you with the actual contracts they negotiated with the participating hospital on the web site but if you are interested I would be happy to email ya. In your expenses you left out probably the biggest one of all...... Overhead. That is what it costs you to run your buisness and it usually the real killer to a medical practice. You have to buy band-aids and gloves. You have an array of staff you have to pay, front office people, billers, medical assistants, lab and xray techs, you have to have machines like a computer system..... you get the idea. You have to run a tight ship in the market today to make it. If you are getting into an established practice with no "buy-in" they must be super desperate to get you in at all costs.

If I had some advice for you it would be to pay attention to the buisness side as much as possible while getting your first year under your belt. Ask question and then ask more questions.




You're right about medicare of course. According to all the info I've heard from most family medicine clinics, the clinic loses 12 dollars for every patient they see. In effect they're doing charity, and they have a quota of medicare patients they can see per week. In the practice I've been talking about they set aside one day per week. This is a clinic with 4 docs and 4 PAs. In WA state, PAs can function the same as a family doc in most cases depending on extra accreditation they can get.

That sounds like a big practice. You should do fine. But remember, its not how much money you bring in ... its how much you keep after all the bills are paid.


I'll escape with about 100k in debt, and my repayment will be about 500 per month. At 4 percent interest rate I'll be letting it ride for awhile. If you have a spouse with an income and live within your means, then really you could pay it off pretty quickly really. Residency is about 30k per year. As dumb as it sounds... I can't remember if you can defer your loans through residency. Still over a year away for me. Haven't thought that much about it, I just take whatever money they'll give me.

To answer the last part first, yes you can defer then through residency but the interest starts to accumulate. You can, of course, pay just the interest but I would recommend not paying anything. Work it out so that someone else pays that off for you. If you are going into some form of primary care you not only deserve this but you will need it. I wish interest rates were lower when she and I went through school but at it worked out we didnt have to pay the 100k back so its all good.


Your numbers were 500-700k so that's what I considered exaggerated because it relies on someone going out and establishing a practice which is a supreme rarity.


Well lets agree that if you wanted to be your own boss, run your own show, and have your own buisness that it would cost this much for a 4 man group.


Sure tort reform would be welcome. We need stiff penalties on frivalous lawsuits, a cap on punitive damages, and a review of the seduciary relationship statutes. I got in a heated conversation with a lawyer who came to talk to our class about malpractice issues. According to her the reason they apply the seduciary title in malpractice suits is because if they changed it it would inherently change the relationship between doctor and patient. I'm like... huh? What is changing the relationship between doctor and patient is that a doctor has to look at each patient in terms of their potential to want to sue them. I wanted to be able to do Obstetrics as part of my practice but its becoming increasingly impossible because of malpractice issues. Courts are awarding damages based on emotions rather than facts.

Amen to that. My wife wanted to do OB to but she quickly changed her mind after seeing the malpractice for that..... plus none of her partners wanted to do it so it was mute. On call 24/7 to that beeper would suck.


I'm actually not sure what you mean by JP3 and its making me feel self conscious so please relieve my anxiety.

hehe, Well I forgot why I mentioned that but a JP3 is a foreign doc who did his medical school in his country of origin. There are tons of these guys trying to get into residency's so they can practice in USA. They realize that USA is the place to either practice. That is why you end up with someone from Pakistan in small city in the middle of no where in Montana. They have to serve some time in an under privledged area.

My wife sounded just like you as a third year medical student. Its actually great to hear it. Its just that once you get out its a different animal. I come across as complaining in text but its still great on many levels. Keep kickin' )

I would have responded earlier but I didn't see your post... I have to hit the refresh key or I dont get all the non-read posts.

Minor correction:


It's called pro bono, and they do precisely that :)
haha ya right. I have yet to get those magical words to come out of my attornies mouth.

I'm interested in hearing what progress tort reform has made in the last few years. My father is a doctor, and my work involves dealing with physicians who contract with the state. Malpractice insurance and outrageous lawsuits are a top concern to them all.

Yup. Very true. You want to fix the medical field and make it affordable, its not the medical professionals who should take the pay cut. Its the lawyers who trouble the medical professions with unwarranted litegation and outrageous plaintiff awards, of which the so called legal professional takes a very large percentage. Next is the pharmaceutical makers who overcharge the comsumer, the government and HMOs. Put the care providers and medical professionals back in a more controlling interest of the business of lifesaving, as opposed to the lawyers, accountants and insurance companies, and there may be a more streamlined, affordable system to be found without having to turn it all over to the Government to regulate.

Remember, the United States has alot more citizens than Canada or most European nations with socialized medicine. Such programs on smaller scales can work well because there is less red tape and less room for abuse. Still, one has to applaud such programs because it on the long run saves the consumer money and removes alot of the worry from daily life. Knowing you are covered in the event a medical problem strikes is very soothing.

Ya right now in france in the private sector lawsuits are getting a real problem. People see it work in usa and are starting to ask for insane things here too... So fix it in usa that will fix it here too :p

130 during summer

That's nuts 5-1/2 full days on in a single week. Infact, that's illegal in the US (probably mostly due to malpractice lawsuits - a tired doctor is an easy target).

A doctor or even a nurse that works more than 70-80 hours a week is required to take a day off the next week by some healthcare companies.

They did try this year to pay her sup hours ( supposed to only work 35h hahah) which actually doubled her salary for the month of january but then they can't do that every month because they would explode the budget of the hospital within 6Months.

My mom has been doing the following hours for the last 2 years: wake up at 6.30 leave at 7 and go work, comes back home at 1 am. I have had to force her to take vacations because she was totally exhausted.

nyway Socialized health care works great, its probably one of the best system in the world.
So your government run healthcare system works by running its doctors into the ground, which it doesn't even pay them for because it would bankrupt everything...

But it works great, best system in the world.

I'm sure the quality of care doesn't suffer at all either, and that patient coming in at 12:30am after the doctor has been working 17 1/2 hours straight gets treated just as well as the guy who comes in at 7:30.

Drug companies need to be reigned in. There is no reason the American public needs to pay 4x the amount as canadians.
Sure there is. Canadians have socialized medicine, and pay for their drugs in their taxes, as part of that system.

Here in the US, we don't have to pay those taxes, so we don't get subsidized drugs, unless we have insurance to do it.

Even then, odds are very good you are paying a monthly fee for that insurance- and the insurance company is banking on the fact that more people will pay into the fund than need to draw out of it.

The bottom line in all of this is nothing is free. Someone, somewhere is paying for those medical services and those drugs, be it through taxes, insurance or some other means (benefits of military enlistment, perhaps). As noted above, some even "pay" for it in the form of working for lower wages- in effect, donating their time and acumen as doctors at a reduced rate so that cost is lower.

Even the "free" humanitarian aid given by some doctors in impoverished countries are often paid for by outside organizations, either through private donations, charitable acts of humanitarian groups or the actions of religious groups (which is almost insidious in a way).

Nothing is free. Nothing is free. (keep repeating that until you undersand it).

Costs are relative. Hell, how much does 3.7854 litres of gasoline cost in Canada or Sweden? How much does a gallon cost in the US on average (Something like $1.85 right now?)?

So your government run healthcare system works by running its doctors into the ground, which it doesn't even pay them for because it would bankrupt everything...

But it works great, best system in the world.

I'm sure the quality of care doesn't suffer at all either, and that patient coming in at 12:30am after the doctor has been working 17 1/2 hours straight gets treated just as well as the guy who comes in at 7:30.
France is suffering through extreme problems with their labor politics. The symptoms you're pointing out as problem areas (and rightly so!) is a combination of many factors. One of the largest problems France is having right now is how the 35h work week has totally frazzled their industrial economics, and this strikes a blow in many other areas as well.

You're not getting it, they aren't running doctors into the ground, there aren't enough doctors period.

And yep its still probably the best system in the world. Doctor only play a part in the CMU ( couverture medicale universelle). It also cover drugs/hospital days/urgency etc. What you're not getting is that the CMU has nothing to do with doctor problems MOSTLY. I already explained them and health care doesn't enter that, its a pay check and work hours problem that isn't relied to CMU along with stupid lawsuits in private sectors. Its still by far the best system in the world, you don't suffer like a poor rat if you can't pay yourself a dental plan. Once again the 17h of work are extreme cases for a FEW professions, its not the majority of the docs its mostly gyneco/surgery and cancerology. Past that patient that come at 12.30 AM is most likely getting taken care of by a fresh doctor but I m not going to get on specific because its hospital dependant.

It work great and naturally there are a few abuses that the government is trying to fix all the time. You have found the bad person to argue that with because not only do I live it ( well its known I m french) but both my parents work in the sector so I have a good idea of the different problems.

Kivorn is right tho, the last socialist gov kind of killed economy with the 35h which is bullshit and right now the gov is looking at removing it. Several companies already switched back to 36/37 for the same pay check so they wouldn't leave the country. I m sure we ll be back to 39 if not more soon enough.

Are you telling me that in France doctors work 35 hours a week? That is considered part time here.... geez.

Bise, in france everyone's supposed to work 35 hours a week. In Sweden, as in many european countries, it's 40. Everything past that is considered overtime.

And no, french doctors don't work 35h a week. They're happy if they get away with 60, just like everywhere else in the world. Like kinu said, they're out of doctors. But then again, everyone is. Except Norway.

Bise, in france everyone's supposed to work 35 hours a week. In Sweden, as in many european countries, it's 40. Everything past that is considered overtime.

And no, french doctors don't work 35h a week. They're happy if they get away with 60, just like everywhere else in the world. Like kinu said, they're out of doctors. But then again, everyone is. Except Norway.
Why not just pay the general public by the hour? Or by the service? Then it wouldn't matter.

I already posted it, the one time they tried to pay her her overtime hours they exploded the budget. You have to understand that it would quad her pay check which the hospital can't handle especially since she isn't alone. In france you can choose which doctor you want to see and where there is no limitation to what you assurance enable you to.

The problem with the 35h is that basically once you go over 35h the companies get to pay tax to the gov for having people work overtime. Not including the fact that they have to pay people the double. The right wing gov is already nuking the tax the companies have to pay for over 35H and most likely they will kick out the 35 directly soon enough.

Bise, every job I know of is paid for by the hour.
It's just that past 40h you're automatically on overtime, so companies aren't allowed to set their own policies on schedules without the employee agreeing to take on overtime.
In essence, it forces companies to pay the employees acceptable wages for the time they put in. 40h a week is, as you realize, 8h for five days.

In Sweden though we don't levie the companies with additional taxes if they break the limit. They just have the pay their employees more, not the government.

Like kinu said, they're out of doctors. But then again, everyone is.
Not everyone.


I already posted it, the one time they tried to pay her her overtime hours they exploded the budget.
And that is a massive flaw with your health care system, it not only allows gross underpayment of the health care professionals, it depends on it. The only reason your health care system isn't completely bankrupt is because it refuses to pay(by your own admission) for over half of the work the doctors are doing.

That is not a success story, that is like a medical sweat shop, a step above servitude...which in turn is likely the cause of your shortage.

Well I m happy to live in what you consider a failure I guess. Everyone get medical care here not just people with cash, althought if you are very selfish type of guy I can understand why it bother you.One last time tho, the hours of work and pay check have nothing to do with the socialized system and all to do with the fact that they weren't enough students in medecine for the last generation. Althought its going much better since 2 years the next 8 years will be harsh. I never said the system was perfect, its in constant evolution and trying to improve it but at least its there. Its not fully private and go die if you don't have the good assurance.

Public = monthly pay check regardless of numbers of acts ( althought once you go over 35h you get sup hours). The government pay them not the socialized system, you seems to think its the exact same thing but its not. You're right I did say they would explode budget paying her full hours every time. Mainly because every hour over 35 is paid double + tax. Long overwork hours only happens during summer when people take vacation. It doesn't happens during the rest of year especially that since may there are 2 more doctors in the service she works in.

Private = paid for each act ( which explain why they get much more money but then they can get fired and sued). Thanks to the usa the lawsuits have gone so high that assurance jacked up price a ton.

There, I think I gave my opinion, past that I ll let you guys talk and argue about it but since I won't change any opinion of anti french people I don't see the point discussing this further.

Have a good day.

Its not fully private and go die if you don't have the good assurance.

Surely you can't really beleive in the US that if you dont have insurance that they "just" let you die? Your sadly mistaken if you do. Having people with in my family who are handicapped with no job and no insurance..they are taken care of from our government/tax paying citzens. They go to the doctor when ever they need and get their medication/therapy when its needed as well.

Funny thing is I sit across from a person at work who has insurance but refused to go to the doctor out of stupidity and hes has some serious medical problems atm because of it..prostate cancer which has progressed to far.

Some one show me some links of people dieing because of lack of insurance...Id like to see it. Flat out DIED because they were refused medical attention with out insurance.

Im starting to like this Ibudin guy......

Some one show me some links of people dieing because of lack of insurance...Id like to see it. Flat out DIED because they were refused medical attention with out insurance.

Watch out. They are going to dig up that thing where the heart transplant went to the US citizen instead of the non-US citizen.

Everyone get medical care here not just people with cash, althought if you are very selfish type of guy I can understand why it bother you.
We just have a different mindset here. It's the sense of capitalism we're ingrained with, not selfishness.

I don't have insurance right now, and it doesn't bother me at all that it's not given to me. I think if you want something, you should have to earn it, not have it handed to you through the sweat and effort of strangers. If I need to see a doctor, I pay out of pocket. I find that I save quite a bit of money that way anyway, versus paying for insurance.

One last time tho, the hours of work and pay check have nothing to do with the socialized system and all to do with the fact that they weren't enough students in medecine for the last generation.
I have a very hard time believing this.

The paycheck is a lot of what drives people to go through (and pay for) Med school here. Out of the doctors and med students I know personally, I can only think of one that would still be a doctor even if they only made $50k/year.

It's simple supply and demand. Human nature. You're not going to find very many people to go through the extra effort if the rewards aren't on par.

If you'd like to have some fun, run the numbers.

Kivorn mentioned that he payed 1/3 of his income in taxes. Now, not all of this goes to healthcare, but it's the number he mentioned.

I've seen a doctor maybe 3 times in the last 5 years. I usually walk in, talk to him about 10 minutes, and walk out, either with a prescription or without.

Obviously, I'll see the doctor a LOT more as I get older. And if my wife has a baby, there's a lot of expense there.

But take 1/3 of what you were making at 25, and multiply it by 40 years of work. Or, in my case, take 1/3 of what I'm making now and multiply it by 30 more years of work.

Wow.

Geez, I wish I only payed a third of my income in taxes...

I find that I save quite a bit of money that way anyway, versus paying for insurance.
How old are you? Do you have a wife? Kids?

I think if you want something, you should have to earn it, not have it handed to you through the sweat and effort of strangers.
Well in the socialized health care, everyone is participating, nothing is free in the end. Difference is you can ask for the best, and it's probably why it should be the best system, and why it is the worst one. Abuse. When you only need one pill of the common pool of medicaments, why not take those 2 expensive pills of the specific brand?
They tried to monitor those abuses, but pressures from many (assurances, private hospitals, drug companies, etc) on doctors and patients make their budget bleeds more every year.

It's simple supply and demand. Human nature.Society nature. I never knew if it's a legend or a fact, but in old China (before communism), people of one village were paying their doctor as long as they were healthy. But if they were sick, they would stop paying. Even if it's probably an utopic view, I find it brings an interesting view of what doctors should do. Prevent or cure?

I'm 27. No wife, no kids, and pretty healthy. Sure, if I start thinking about having kids or get a little older, then it'll be a different story (hell, I need to start saving up for a liver transplant already). Until then, there's no point in my subsidizing other people's medical bills.

Society nature. I never knew if it's a legend or a fact, but in old China (before communism), people of one village were paying their doctor as long as they were healthy. But if they were sick, they would stop paying. Even if it's probably an utopic view, I find it brings an interesting view of what doctors should do. Prevent or cure?
That's an interesting idea. I don't think it would ever work fairly, since no one seems to fully abide by their doctors' advice. It's not your doctor's fault if you just can't keep from cramming down one more McMeal, even though he tells you it'll kill you.

Until then, there's no point in my subsidizing other people's medical bills
Right, because we all live in a self contained vacuum. And society has been built and existed up to this point soley as an option to be there should you ever decide you at some point need it.

It's not your doctor's fault if you just can't keep from cramming down one more McMeal, even though he tells you it'll kill you.
Or work out every day and jog and get a brain tumor like my uncle.

Anterak, your argument regarding the pills are flawed in a way :)

The doc decides what pills you get.

Not that I don't agree with you on the abuse system. That's why I'm glad Sweden is leaning more and more towards liberal (read: republican for you whackos who still don't know what a real liberal is) politics. Everyone chipping in for the benefit of society I'm all for, but we need to weed out people abusing the system.

I have a friend who votes "red". He strongly believes in leftist politics and that a strong state with a well developed safety net is the way to go.
He's 21. He's on welfare. Why? Because he commutes across the country twice a month to see his girlfriend and is thus unable to maintain a job.

Now people like him we call clueless hypocrits, and they should be fined for every cent they take out of the government in welfare.

Right, because we all live in a self contained vacuum. And society has been built and existed up to this point soley as an option to be there should you ever decide you at some point need it.
I'm not living in a socialist country, even though some keep trying to move it more and more that direction. Being a business owner, I already subsidize far too many programs that I'll never ever use and probably won't even know about.

It has nothing to do with society or taking advantage of it. Private insurance companies exist (plentifully) solely because they are extremely successful financially. My choosing to wait until I'm more in need of insurance to participate is no different than my choosing to wait until I'm hungry to buy food.

The fact is that our government can't operate with even the slightest hint of efficiency. It would be a horrible idea to take a profitable, multi-billion dollar industry and run it into the ground with red tape.

Or work out every day and jog and get a brain tumor like my uncle.
Right. That was my point about that utopian way of handling doctors. It sounds good, but wouldn't work in practice.

It has nothing to do with society or taking advantage of it. Private insurance companies exist (plentifully) solely because they are extremely successful financially. My choosing to wait until I'm more in need of insurance to participate is no different than my choosing to wait until I'm hungry to buy food.

Sanchek we share views on way too many odd things , alittle weird :p

I like our system, I see socialism and government programs as a crutch for people who simply can't take responsability for thier own lives and needs.

Insurance companies are a for profit business, and for that reason alone they are not "Nessiccary".
I'd have to have 4 major operations and 2 children over the course of my lifetime to "break even" with the insurance companies.

Saving that money I'd be paying out of my income every month and either putting it into higher interest savings or investments, is a much..much, more benefitical plan.

I can run my own life fine, I don't need the government doing it for me, and penalizing me because the majority of people are screwups.

Better finacially responsability is a better alternative then any program.

Sorry to hear about your uncle LL. I hope he recovered.

Another aspect to consider is what happens to medical research in a socialized system. I would like to see how it has been affected in countries with socialized medicine as opposed to those without. I'm not making a statement here, just curious if there is indeed a slowdown on new research where profit is tightly controlled. Anybody know or have links?

Slowdown on medical research? Definately not. Sweden's medical research is world renowned.

And recieving large governmental funds.

Dear Darus:

It's nice to know that I was a 'screwup' by choosing to be born with early-onset Rheumatoid Arthritis, and that Faervas was 'irresponsible' enough to hit a patch of black ice in a light pickup truck at age 20 and shatter his spinal column ;). The problem with private insurance (besides the fact, of course, that many people *with jobs* aren't provided the option, or can't afford it) is that private insurance companies can decide that you will cost too much and not insure you (or consider the primary condition you need insurance *for* a 'pre-existing condition' and not cover it - my current situation), or, as happened some years ago in my case, you can have two great doctors (one GP, one rheumatologist) who are willing to go to bat for you, but who are both driven out of business not by puny Medicare reimbursements, but by the overhead and huge resource drain resulting from having to deal with multiple insurance company beauracracies and their (frequently absurd and/or deliberately obstructionist) demands. In some specialties (obstetrics comes to mind), the expense of malpractice insurance is what drives them out...

Wonderful profit-driven medicine has affected my ability to obtain care in other ways as well; because a four hour wrist fusion is much less cost-effective than a 45 minute carpal tunnel surgery, when I needed the other wrist done, I learned that the doctor who did my wrist fusion no longer performed these surgeries; when I needed an radial head resection and synovectomy (elbow), I found out that both of the surgeons in Dallas who had been recommended to me for this job no longer do the operation and both are concentrating on sports medicine. Why? Volume = profits... (My elbows remain unoperated on to this day and I'm down to about 45 degrees in the left and 60 degrees in the right btw - the resulting expense to taxpayers was several years of supporting me on SSDI while I retrained - and 30k of debt to myself).

The medication issue is the most ludicrous of them all; no-one can tell me with a straight face that the major drug companies and their relentless marketing machines are in any way 'responsible', or care about whether people are actually appropriately treated for their condition; they care about profits. When the patent runs out on a drug, perfectly effective drugs are often allowed to languish, or no longer manufactured at all, in favor of the 'next big (high profit margin) thing'. Why not? They're a business, after all, but go google the term 'orphan drug' sometime :). Why do I say this? Again, personal experience. By 1993, I had rapidly progressing, uncontrolled inflammation and joint destruction as a result of my condition; I had been through all of the available DMARDS for my disease, as well as a couple of clinical drug trials; nothing had any effect whatsoever (except making me too sick to work ;) ). My kickass rheumatologist read something somewhere about another antimalarial, atabrine, that had been used successfully in some lupus patients, and we decided to give it a try, as I had little to lose at this point. This was a drug that was invented in 1936 and was used as an antimalarial in WW2; other than imparting a yellow tone to the skin, it has very few side effects. In my case, that drug was a miracle - within two months my inflammation, and accompanying blood perturbations, were in complete remission - and because it was long out of patent, it only cost 15.00 per month! Unfortunately, my joy was short lived as two years later the drug manufacturer decided not to renew its permit to manufacture the drug (no profit for them), and I've had to hunt down rapidly disappearing private compounding pharmacists ever since.

The overall point that I am trying to make in this entire diatribe is that, in my opinion, supported by 20 years of experience in dealing with the system as a consumer, the current corporate/insurance/drug manufacturing marketing based system we have for health care delivery in the US is, at this point, a completely bankrupt model and it is hard to see how nationalized health care could be much *worse*, in terms of quality, availability, or expense of care, than the bloated, fundamentally corrupt mess that we have now. (and I haven't even addressed hospitalizations and the expense to taxpayers generated by visits by the uninsured to emergency rooms when they become desparately ill yet, nor the loss in taxpayer revenue resulting from people lacking access to routine health care :) ) As I was on disability for several years in the late 1990s, and had to rely on Medicare, I can say that it was actually *easier* to get needed procedures done while on Medicare than it was via either of the HMOs I had had previously; unfortunately, nondisabled folks under age 65 do not have this option. And, my drug coverage on Blue Cross/Blue Shield now is so laughably poor that I usually don't use it all, in which case Medicare is the win there too...

Socialized medicine would, in my opinion, actually save the taxpayers a significant amount of money, as consumers wouldn't be paying for multiple (private, but bureaucracies they are nonetheless) bureaucracies, and a truly nationalized system would actually have an interest in keeping expenses down, not cutting back-room deals with drug companies to trade away their right to negotiate prices and to agree to use the most expensive drugs for given conditions. Gobs of evidence suggests that people who receive regular health *maintenance* care cost much less to the system than those who do not in a myriad of ways, from lost days at work, to emergency room visits, to more invasive/expensive procedures being required because conditions were not caught early, etc.

I'm not saying that socialized medicine would be fabulous or perfect - pay for doctors would certainly be an issue, but on the other hand, the thousands of doctors who are 'HMO slaves' now would see their overhead slashed - but it's hard to see, despite all the shrieks of the 'horrors' of socialized medicine coming from the Right, how it could be worse for the working class than what we currently have - and even under a socialized system, the wealthy *always* have access to private doctors should they want them.

Finally, don't make the absurd assumption that people who are sick and lack insurance are simply too lazy to go out and work and get it, because it just ain't so. During my time on SSDI living in senior/disabled housing, I frequently had to choose between paying for my medication or paying the bills, as did my neighbors... and I watched my upstairs neighbor (who had schizophrenia) try desparately to hold down a cashier's job so that she could pay for her meds, and my next door neighbor (who had Hepititis C as the result of a contaminated blood transfusion) furiously making crafts when she was able to try to pay for hers. That we allow people to languish, to have their lives ruined and potential wasted, when they could be, with proper (usually very inexpensive) care, contributing to society (and maybe, hint hint, paying taxes) is *shameful*, and that we allow it to continue in this incredibly affluent, 'civilized' country, is beyond my comprehension. Basic health care *should* be a right, not a priveledge for every American, and the wide-reaching, stabilizing benefits it provides to a society more than makes up for its expense.

Regards,
Nydia Ywalmoriel
Past Coercer - Autonomous Collective

there is indeed a slowdown on new research where profit is tightly controlled

Why would you think profits are controlled? Those companies are not limited to selling drugs in their country of origin. Some of the largest drug/pharma companies selling product in the US market are not based in the U.S.

Damn, Nydia. I was gonna comment on the long post, but I guess

radial head resection

says enough!

One point though.....I absolutely cannot agree with

Socialized medicine would, in my opinion, actually save the taxpayers a significant amount of money,

I doubt that any government program has ever created a cost savings (let alone made something work smoothly), and this would be the biggest government program of all.

Here's what I want. Tell me what it will cost and EXACTLY what it will do and for whom.

I can be more conservative/libertarian than anyone, but I do have a soft side. HOWEVER, as long as, say, insert_liberal_politician_here stands up and says "the first thing I'm gonna do is put through MASSIVE HEALTH CARE LEGISLATION that means EVERY ONE of our children is insured" I'll be the first person to say BULLSHIT - until he says "it's gonna cost Stephen EXACTLY $x out of every paycheck.

I'm can be a softie, but I'm not stupid. I know I make too much to ever get anything out of a program like this, so I'd better have results/costs calculated down to the penny.

Dear Mirdorr:

I agree with you completely on that issue (that there should be both transparency and accountability - something that obviously wasn't there when we gave away our right to negotiate drug prices in the Medicare benefit bill) - and given the current heavily lobbyist-influenced way that things get done in our government, I too am very wary of what we might get saddled with. The fact remains that the *current* system is bleeding both working and middle-class americans, and employers, dry, *and* leaving many out in the cold and/or providing substandard care - and that while shifting that burden to a tax-based system might not result in lower overall expenses (although both federal oversight and pressures to keep spending down should help), ensuring that everyone has access to basic health care will result in significant 'savings' in the form of increased productivity, which is in itself a worthwhile goal.

Regards,
Nydia

Mirdorr-

I am assuming that the US market is the largest consumer of drugs (dollars wise) in the world (I could be wrong).

What if the US were to socialize it's medicine and institute price controls? Would not those other countries then lose a huge chunk of their profit base for pharmaceuticals? Sure, in a country with socialized medicine you can always export to countries that do not put price controls in place, but your domestic profits are lower, meaning you have to really gouge your foreign customers to make up the difference or cut back your operating costs. Not many affluent countries who are not already socialized in their medicine are out there that can afford that kind of cost for drugs.

by the overhead and huge resource drain resulting from having to deal with multiple insurance company beauracracies and their (frequently absurd and/or deliberately obstructionist) demands. In some specialties (obstetrics comes to mind), the expense of malpractice insurance is what drives them out...



Tort reform will practically eliminate the out of control malpractice costs. Being required to lose money by seeing medicare patients (which require the most paperwork also) is a much larger burden on most practices than dealing with private insurance companies. For those reasons your supposition is flawed.


As I was on disability for several years in the late 1990s, and had to rely on Medicare, I can say that it was actually *easier* to get needed procedures done while on Medicare than it was via either of the HMOs I had had previously; unfortunately, nondisabled folks under age 65 do not have this option.

Of course it was easier, your doctors were doing charity, losing money with each of your visits. It was easier to get "needed" procedures because they were happy to do anything that they could bill for to try and get the most value per visit. If you expand it across the country to cover every citizen full time, you multiply the burden on providers.

Okey this is how "socialized medicine" works in regards to sales of pharmaceuticals and research:

Everyone can research freely. That's right. No governmental control past the regular "are you qualified for these experiments" stuff.
Drug companies can sell their drugs to any prizes they want, or at least close to.

So why is the medicine cheaper over here then?
It's simple. The government chips in. Say a bottle of pills cost $50. You pay for instance $30 instead, and the government chucks in the remaining twenty bucks for you.
That's what socialized medicine is. It's the same with healthcare. I pay 12 bucks to see a doctor in sweden. The time it takes me is in fact worth more. What happens is that the government supplements the remaining sum to make the hospital break even.

So that's what I'm doing with my 32% income tax. I'm effectively lowering the cost of many other elements in society. This is true for many other areas as well.
What would happen in Sweden if we dropped to a lower tax base and cut the market "free"?
Simple. The prices for everything would rocket, and I'd be no better off than before. "But what about competition? Won't that bring the prices down?" Eventually, yes. But hardly on crucial everyday items. Like my rent. There isn't enough living space in Sweden (we're in a living space crisis at the moment). What would happen would probably be that I, among hundreds of thousands of others, would be evicted when the government removes its economical influence from the market. The obvious solution? Projects. Fun eh?

That's the thing in Sweden. It's how it all work. We pay more tax so stuff gets cheaper and so that everyone's guaranteed the same priviliges, such as equal healthcare, affording to drink milk (yeah, the government controls the milk prices), cheaper dental, free schools (all the way from primary to university. as many times as you'd like. we probably have the highest educated average there is, or at least close).

It's socialized capitalism baby.

What is your total tax rate in Sweden?

What if the US were to socialize it's medicine and institute price controls?

Thing is, you're asking for *2* things to happen. Not just one. We could easily have socialized medicine without price controls. I might as well ask what would happen if the government takes over the cell phone industry.

Frankly, we'll never have completely socialized medicine. It just goes against the grain of everything this country is about. I'd guess that, if we have it, it willl be some sort of limited system to help only a percentage of the population.

I hate the idea. But hey, have you complained about insurance companies doing it to doctors? AFter all, that's all the "negotiated" prices of the insurance companies are. Wouldn't you like to comparison shop among doctors based on reputation and price, instead of by who is on your insurance company's list?

I'm effectively lowering the cost of many other elements in society.

Uh, no, you aren't. You're simply paying for them in a different way. You're kicking in your large wad of cash and, if you don't use up that much in services - tough cookies.

You're "helping society." I won't deny that. It's great that it helps people. But moving money around doesn't necessarily lower costs. I will not say your system is a bad system or that some costs might not be lower. It works, and you like it - fine. But I have my doubts that your government (or anyone evaulating your economy) could come up with actual numbers showing that, with price controls removed and taxes lowed, you'd be worse off than you are now. Realistically, it boils down to a religious discussion (as most topics do on the net).

In the U.S., of course, the numbers are even HARDER to come up with because our tax is not a flat percentage.

Wouldn't you like to comparison shop among doctors based on reputation and price, instead of by who is on your insurance company's list?
You can. It's still supply and demand. Pay a little extra and you can get on the PPO/POS plans that let you see just about anyone (except for the doctors that choose to be cash only).

Or just maintain hospitalization insurance, go absolutely anywhere you want, pay out of pocket for doctors visits, and typically get much better service. Doctors hate dicking with insurance vs. a cash customer. You get more face time with the doctor and he/she is a lot happier to see you, when you're paying with the green. 99/100 people will save money doing that anyway.

Or just maintain hospitalization insurance, go absolutely anywhere you want, pay out of pocket for doctors visits, and typically get much better service. Doctors hate dicking with insurance vs. a cash customer. You get more face time with the doctor and he/she is a lot happier to see you, when you're paying with the green. 99/100 people will save money doing that anyway.
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Thats exactly what I do, I even took it a step further and hospitalization only covers costs above 50,000, with a 25,000 deductable.

With thats its incredibly cheap, and well I could probly afford it anyways.. a few dollars is enough to justify the peace of mind in-case I ever get into a major medical situation.

Pay a little extra

Sure - I was just making an example showing that many people are already in a controlled system (controlled by insurer as opposed to government) and don't even know it.

Sure - I was just making an example showing that many people are already in a controlled system (controlled by insurer as opposed to government) and don't even know it.
Mira is correct.... I can give you an example. Doctor A and Doctor B but accept Blue Cross. You would think that Doctor A and Doctor B but get reimbursed the same fee for the exact same service.... WRONG.

Blue Cross (I use them for example purposes only because everyone has heard of them) has individual contracts with each doctor. The insurance companies pay more to a doctor if there is no one in the area who want to use them because their reimbursment suck. On the same token, they will find the cheapest contract they can find and use that doctor as a way to save money.

I can give you another great example. The hospital I work at accepted Oschner insurance. They submitted a contract that would have been fiscally irresponsible for the hospital to accept so they got booted from my hospital. Sooooo, all the people who loved comeing to that hosptial CHANGED INSURANCES at there place of employment so they could continue to come to the same hospital.

I bring this up to illustrate that all this revolves around money, buisness and free choice/personal responsiblity.

EDIT: oh and the Oschner insurance went belly up.

Sooooo, all the people who loved comeing to that hosptial CHANGED INSURANCES at there place of employment so they could continue to come to the same hospital.
Sorry, that actually disproves his point.

While insurance companies do have too much say sometimes, you have the option of switching to a different company if you don't like what they are doing. You don't even need to get insurance if you don't want to, as was mentioned.

They really can't do the same with government control.


oh and the Oschner insurance went belly up.

Ah yes, that's the sound of the point being driven home.

Companies who do things the wrong way(such as making people wait to see a certain doctor, or drive a distance to see the one they want you to) eventually go out of business.

While insurance companies do have too much say sometimes, you have the option of switching to a different company if you don't like what they are doing. You don't even need to get insurance if you don't want to, as was mentioned.

My point was that the care and money are managed to a certain extent. The individual has ultimate control of who they want to use/if they want to use.

If I said anything that may have lead you to believe I am for government control of medical care then I was gave very poor examples.

Nope, you didn't say that..I was just pointing out that while the insurance industry appears to have control, they do not actually have that power since we can simply change insurers or choose not to get that insurance at all.

Doctor's should be compensated for all the work and studying they do. The reason that there are so few doctor's is that they are being under payed. I have family that live in canada and it takes months to be able to see a doctor, not to mention that the facilities and doctors are worse than the ones in the US. Most top doctors flee to the US where they can make much better money, while the canadian people have to stick with the leftovers, not the mention all but the poor have to pay extra for the worse healthcare. The middle and upper class get stuck with the big tax bill at the end of the year, while the poor who sit on their ass get a free ride. A socialized healthcare system is easily abused, people stay at hospitals longer than they need, take more medicine than they need, go back more often, and stay just for the free room and food.

Capitalism is the best system atm, the strength of the US is proof of it. Socialism drags down the middle and upper class to support the people that don't feel like supporting themselves.

I was watching this special on Friday night. It was about a Hospital around where the Staten Island ferry accident happened. They were showing 3 different people and there health care..quality of it versus insurance coverage.

First person was in our country illegally (not from Mexico either) and had zero health insurance let alone any money. She had been to the hospital emergency room a total of 6 times with in the last 2 months. She complained of lower back pain and they ran a ton of tests trying to figure out what the problem was and in the end it was discovered she had Kidney stones. So after 6 visits and no insurance or no money..she was never EVER turned away and on top of it had a team of doctors trying to figure out what was wrong with her. Her medical bills go unpaid and simply get dispersed across those who have insurance.


The second person was a 60-year-old woman who was crippled in the Ferry accident. She had insurance and was covered a fair amount over all when it came to her insurance until it came to Rehab equipment which they didn’t cover. She was charged a large sum each time the doctor stopped by in the morning to say.."HI". This took like 5 minutes each morning and all he was doing was stopping by to register a visit and at that point the patient was charged close to 200 each time. When they asked the Hospital about these charges he basically said this needs to be done to cover the cost of those who cannot pay. So in a nut shell..you have insurance your being charged a large sum over joe blow so that those with out insurance are getting there bills picked up some how. This woman ended up paying the most out of pocket over even those with out insurance. The working middle class getting the shaft.

Last guy was another Ferry accident victim who lost both legs and needed tons of rehab. He to had no insurance and his medical bills were very high with all the care he needed. In the end his father didn’t have to sell his house to pay for all this and he ended up with some of the best care available in this country. Most of it was donated and bills covered from fundraisers to help him out from every day people. His 160k prosthetic legs where given to him. This was all from the people of this country.

There is no system that is perfect but that 1-hour show on Friday night was damn interesting let alone was hoping those who responded on this thread where able to see it.