Trump's Second and Third year in office
Quote: RonCI'm quite sorry if it offends you, but my experience is that people that pay nothing for something tend not to value that something nearly as much as people who pay even a small fee for it. Co-pays at least make you think about a cost involved and whether it is worth a visit or not.
Does every "group" in society have some that try to take advantage of situations? Yep. Talking about one specific subset of a much larger group does not mean that I disregard that abuse.
I'm certainly not happy with the rightwing position that says we don't want to pay for anyone else, but we won't support a candidate who will actually run on that position.
If you don't want healthcare for all, get candidate who will say he or she will throw those in the street who can't pay. Or at least get a candidate running on the platform. "Healthcare for those who pay."
At least those on the right would no longer be fooling the public on what they actually stand for. Because that's certainly what some seem to stand for.
Quote: rxwineNor has Trump consulted with many people before he started hurting their businesses with his tariffs.
I am trying to find out where I supported tariffs...nope can’t find it, but good try. Good news is the tariffs will be a temporary bad means to an end that includes better trade deals for the US...based on today’s announcement it looks like the EU has come to the table to make a deal...that didn’t take long!
Quote: ParadigmI am trying to find out where I supported tariffs...nope can’t find it, but good try. Good news is the tariffs will be a temporary bad means to an end that includes better trade deals for the US...based on today’s announcement it looks like the EU has come to the table to make a deal...that didn’t take long!
You were pointing out Obama didn't get everyone's okay before he established Obamacare.. I'm just pointing out the Trump did the same thing with tariffs. Didn't get everyone's okay.
Quote:Have you considered that the system wasn't broken for a lot of people? They didn't have a problem that needed solving by Obama...they were doing just fine paying for their own health insurance/health care services. Obamacare screwed that up for a lot of people...they didn't get to "keep their doctor and keep their existing plan"
Quote: darkozI dont know the stats but to my memory almost all the publicised cases of medicare abuse were NOT perpetrated by the poor classes receiving them but the doctors and medical billing that was fraudulently padding their services
...and I have talked about stamping out all fraud, waste, and abuse. The abuse you talk about is also a huge concern but it is not the kind of fraud that would take valuable spaces for medical appointments. The former kind of fraud is very relevant to a potential shortage of actual "slots" for care under any kind of "everyone gets some" system.
We're already showing the potential for a shortage of doctors with our current system. Any system that pays them less will result in some leaving the profession even sooner than they plan--see SOOPOO's post--because it will make financial sense to them. If you already have enough assets socked away to pay 50%-75% of your current income level, there is not as much incentive to see a lot more patients to make less than you could take home without working. The other way they could go is to provide "Cadillac Services"...
The other providers are mid-levels, nurse practitioners and physicians assistants. I have been seen by both and I know some personally. Their concern is that part of those programs is to have them supervised by doctors so that they continue to learn and also so that they have a place to send cases beyond their limited scope. The additional stress on the doctors from having to see more patients to make the same money and then also to properly supervise their mid-levels. Mid-levels make very decent salaries; some of the them may feel the same way as doctors about accepting lower salaries.
I don't want to toss people out in the street without health care. I also want to see Emergency Rooms as just that; not as the first medical choice for people who have no insurance. I just think we have to figure out how to not break the back of our country's economy while providing services.
Quote: rxwineI'm certainly not happy with the rightwing position that says we don't want to pay for anyone else, but we won't support a candidate who will actually run on that position.
Your position is fine. Being nasty is just being nasty.
The answer is not the system we have now nor is it the M4A as Bernie proposes.
I will admit that I am not sure exactly how to construct the answer. Somewhere between now and breaking our economy is where the solution should land.
Quote: TigerWuI see a lot of critics of universal healthcare, medicare for all, and Obamacare, yet I never see those people/politicians offer any other solutions to fix the broken system we have now.
That’s because there is no solution. 85% of the American public was satisfied with their medical insurance before Obamacare. There was no good reason to mess with it.
" It turns out that across the board, for all ages and family sizes, for HMO, PPO, and POS plans, premium increases averaged about 60 percent from 2013, the last year before ACA reforms took effect, to 2017. In same length of time preceding that, all groups experienced premium increases of less than 10 percent, and most age groups actually experienced premium decreases, on average."
Forbes
The best system could be the Swiss system, which is based almost totally on private insurance, with government subsidies for the poor.
Quote: RonC...and I have talked about stamping out all fraud, waste, and abuse. The abuse you talk about is also a huge concern but it is not the kind of fraud that would take valuable spaces for medical appointments. The former kind of fraud is very relevant to a potential shortage of actual "slots" for care under any kind of "everyone gets some" system.
We're already showing the potential for a shortage of doctors with our current system. Any system that pays them less will result in some leaving the profession even sooner than they plan--see SOOPOO's post--because it will make financial sense to them. If you already have enough assets socked away to pay 50%-75% of your current income level, there is not as much incentive to see a lot more patients to make less than you could take home without working. The other way they could go is to provide "Cadillac Services"...
The other providers are mid-levels, nurse practitioners and physicians assistants. I have been seen by both and I know some personally. Their concern is that part of those programs is to have them supervised by doctors so that they continue to learn and also so that they have a place to send cases beyond their limited scope. The additional stress on the doctors from having to see more patients to make the same money and then also to properly supervise their mid-levels. Mid-levels make very decent salaries; some of the them may feel the same way as doctors about accepting lower salaries.
I don't want to toss people out in the street without health care. I also want to see Emergency Rooms as just that; not as the first medical choice for people who have no insurance. I just think we have to figure out how to not break the back of our country's economy while providing services.
Im sorry but i just dont believe the MAJORITY of poor people (im sure you can find some anomalies just like in all things) want to spend their time in hospital rooms
Its quite dreaded especially in poorer neighborhoods where the hospitals are not run so well
People ARE more inclined to IGNORE serious health conditions when they cant afford hospital visits so that their conditions worsen to a point treatment may become much more expensive
And conversely people may be quicker to seek aid if they have their costs covered
But the average person wants to be stuck in a hospital like getting a hole in the head
Each individual needs to decide for themselves (not by righties) how serious their condition is
Affordable for nearly anybody. How do they even stay in business, make a profit, when the same visit to an ER would cost $500-1000? Why does anyone bother to go to an ER when these places are around?
And really, why aren't people almost forced to use one of these rather than taking up time and space at an ER?
Quote: darkozIm sorry but i just dont believe the MAJORITY of poor people (im sure you can find some anomalies just like in all things) want to spend their time in hospital rooms
It seems odd to me that you and another person keep trying to put words in my mouth.
Just so it is clear to you and the other guy--I NEVER said that it was most, all, etc. of the people served in these situations. The point is not that at all, even though you keep on trying to put words in my mouth with your replies--the point is that the kind of abuse I talked about takes up valuable slots for patients with more than the sniffles and that other patients could use and that there may be even more limited slots under a M4A system.
Why not dispute THAT part instead of trying to make something more of my statement than is there?
Quote: darkozEach individual needs to decide for themselves (not by righties) how serious their condition is
Yes, they do. I would just say to you that in a small part of the population, it is a lot easier to make the decision to "Go" if there is no cost at all at the point of service. Again, extra strains on the system will be worse when the system is covering more people and there are the same number of, or less, available providers.
It may not be true in hospitals or places with bad reputations, but what about places that provide good quality care to their clientele?
****
Does M4A address in any way the potential provider shortages?
Basically you Skype with a doctor and they will call in the prescription for you if one is needed. It costs the same amount as an office visit would, but saves a heck of a lot of time.
Quote: beachbumbabsPlace I discovered about 5 years ago. Urgent care clinic . Streetfront. No insurance required. Walk in. $30 for 1 complaint, $60 for 2. Colds, flu, sinus infection, minor injury needing cleaning or stitches, antifungal rx, etc. Vast majority of complaints needing medical attention could be addressed here, antibiotics prescribed, etc.
Affordable for nearly anybody. How do they even stay in business, make a profit, when the same visit to an ER would cost $500-1000? Why does anyone bother to go to an ER when these places are around?
And really, why aren't people almost forced to use one of these rather than taking up time and space at an ER?
Do they accept insurance of any kind?
I have found that my insurance does not allow use of urgent care clinics, even though I always ask if it seems to be a situation requiring a doctor's visit with some urgency but not to the level of an emergency....for example....
Son split head open in head to head collision with another player in a baseball game. His face, in the words of the late Gordon Solie, became a "crimson mask." in a matter of seconds. Wife a bit upset. I took him to the head, cleaned him up with towels and stuff and stopped the bleeding. Stitches/staples necessary. Took him to an urgent care place. Less time to be seen and stapled (he refused numbing medication for the site) than to fill out the paperwork.
Son has pain in side and says that it is the worst he has ever felt. Lower right quadrant involved but not really as bad as the general feeling. That was a trip to the ER. Why? the issue may have involved his appendix, and they don't do surgery at urgent care.
...but, since then, urgent care is not an option under the same insurance.
I am not familiar with any "$30 per complaint" type places, but it sounds like an idea if it is profitable.
Quote: ams288For the last year or so my insurance company has been pushing "telehealth" services for minor illnesses like colds, fevers, rashes, etc.
Basically you Skype with a doctor and they will call in the prescription for you if one is needed. It costs the same amount as an office visit would, but saves a heck of a lot of time.
Plus you at least get to be at home or wherever in case of a wait to "see" the doctor...much better than hanging out with sick people in the waiting room!
Amen to that, Babs! I would much rather go to an urgent care center than the ER. However, most of these places (at least the ones near me) are not open 24/7. Sometimes the ER is the only option.Quote: beachbumbabsPlace I discovered about 5 years ago. Urgent care clinic. Streetfront. No insurance required. Walk in. $30 for 1 complaint, $60 for 2. Colds, flu, sinus infection, minor injury needing cleaning or stitches, antifungal rx, etc. Vast majority of complaints needing medical attention could be addressed here, antibiotics prescribed, etc.
Affordable for nearly anybody. How do they even stay in business, make a profit, when the same visit to an ER would cost $500-1000? Why does anyone bother to go to an ER when these places are around?
And really, why aren't people almost forced to use one of these rather than taking up time and space at an ER?
Quick story: a few years ago, Mrs. Joeman had a laceration on her hand. It wasn't big or gushing blood, but it did need stitches. We drove to a nearby urgent care center.
It was about 6:55 in the evening. The posted hours on the entrance said they were open until 9. However, when we got inside, they said they were closed! They said that they had reduced their hours to close at 7, but haven't updated the hours on the door. I think the receptionist saw us out in the parking lot and hurried to "close out the clinic's day" on the computer before we got inside so that they wouldn't have to stay late!
We ended up having to go to the ER since it was our only option. She actually was seen and treated in a short amount of time, but we had to pay many times more than if the urgent care clinic had treated her.
As for the argument of people going to the ER for minor illnesses, I have seen that personally (mostly before ObamaCare, so today it may be different). It only makes sense; let's say you have a sinus infection and need antibiotics. You could go to the urgent care center and pay $30 for a diagnosis & prescription, or you could go to the ER for free. If $30 is a big deal to you, you would go to the ER.
Quote: ParadigmHave you considered that the system wasn't broken for a lot of people? They didn't have a problem that needed solving by Obama...they were doing just fine paying for their own health insurance/health care services. Obamacare screwed that up for a lot of people...they didn't get to "keep their doctor and keep their existing plan"
Right.... SO WE NEED TO FIX IT. That's my whole point.
Forget Obamacare, even before that people couldn't afford insurance or medical care and were going bankrupt because they couldn't afford it. Does that sound like a system that isn't broken?
Quote: SOOPOO
I could be banned for repeating this, but, here goes....... I am an anesthesiologist. Commercial insurance essentially subsidizes government payors. Hospitals that have high Medicaid/Medicare populations would have ZERO anesthesiologists if they did not subsidize them. Hospitals with good payor mixes do not need to subsidize their anesthesiologists. If everyone had Medicaid or Medicare at the current rates there would be NO ANESTHESIOLOGISTS. So the rates would need to go up, (COSTS TO THE GOVERNMENT HIGHER than they are saying now) or care would be severely restricted. The first day I am supposed to accept Medicaid or Medicare rates from more than a third of my patients is an INSTANTANEOUS retirement day, for me, and every anesthesiologist that is towards the end of his career.
I don't understand this line of reasoning... are there no anesthesiologists in countries that have universal healthcare or a system similar to medicare for all? What do anesthesiologists do in those countries? Why couldn't you and your fellow anesthesiologists do that in THIS country if we were to implement a similar plan?
If people want to quit a $300,000 JOB because they have to take a 20% pay cut, let them. I wish them luck maintaining their lifestyle.
No one person is irreplaceable, and it should be obvious that any major shift in such a large part of the economy will result in some people taking a hit.
Think of the poor insurance company executives. They might lose their private jets.
Quote: billryanI am so sick of this whole" I'm going to take my ball and go home" nonsense.
If people want to quit a $300,000 JOB because they have to take a 20% pay cut, let them. I wish them luck maintaining their lifestyle.
No one person is irreplaceable, and it should be obvious that any major shift in such a large part of the economy will result in some people taking a hit.
Think of the poor insurance company executives. They might lose their private jets.
Some people will have to take the 20% pay cut. Some people, with investments already in place that may net nearly the same amount of dollars as the net on their salary, may decide not to stay because working for less is not attractive to them. I think SOOPOO correctly points out that enough people doing the latter in critical skill areas could lead us to a shortage, using your pejorative description if they "take my ball and home", and disappear from the workforce. You can't just make them work for less.
You also talk about those "poor insurance company executives"--there are about 2.6 million people involved in the insurance industry. It is going to be a large hit for them; most of them not making anywhere near the salary of a provider or an executive.
Which is why the time has come for voter ID, like everything else,“You know, if you go out and you want to buy groceries, you need a picture on a card. You need ID.”
WTF
If it wasn't for flying, I would not need ID
Except for the airport, I cant remember the last time I needed ID
If I never flew, I could live years and years in our modern society and never have to present my ID
Quote: terapinedWhich is why the time has come for voter ID, like everything else,“You know, if you go out and you want to buy groceries, you need a picture on a card. You need ID.”
I just wish Trump could say something like, "It's time to make election day a national holiday, or have it on a Sunday. You know, everywhere else it is."
If the only elections you win is when LESS people vote, it's not something to be particularly proud of.
Same thing happened to controllers. New hires for both got put on a B scale.
A huge part of medical costs are liability insurance and tort costs. If they do reform the system, getting those costs under control by capping awards and giving better Good Samaritan protection for new procedures, implants, or drug reactions is probably going to have to be part of it. Which is another few hundred thousand jobs in that industry. But it will get caregiver costs down, too.
Quote: beachbumbabsPlace I discovered about 5 years ago. Urgent care clinic .
Quote:Walk in. $30 for 1 complaint, $60 for 2.
Quote:... when the same visit to an ER would cost $500-1000? Why does anyone bother to go to an ER when these places are around?
Reminded me of a sign that is up in the waiting area at my doctors surgery. It lists the INTERNAL costs that the government has to pay for various levels of service. It's a push to get patients to take the most cost effective route to treatment. Note how relatively cheap even the most expensive options are.
And this is UK single payer. We get invoiced nothing at the point of service delivery.
This suggests that having central government 'buying in' the services, they negotiate pretty well and cut out lots of middle men.
Though it creaks a bit sometimes, we Brits love our National Health Service.
And yes, we do get some piss takers who go to ER ( We call it A & E ) with trivial issues. They are generally made to wait many hours to get served as their 'just rewards'. What we tend not to have are folks who daren't get treatment for life threatening disorders because of the potential costs.
Quote: terapinedTrump last nite
Which is why the time has come for voter ID, like everything else,“You know, if you go out and you want to buy groceries, you need a picture on a card. You need ID.”
Eh? Did he really say that? Could he really believe it? In what possible context could he be stating fact?
My only photo ID is my passport and I use that to fly. I MIGHT be asked to produce it if i buy an air rifle or a crossbow, or join a casino.
To buy groceries, I present some pictures of the queen or wave my credit card. In the US, I was asked for my photo ID to buy a beer, when I was 52 ( that made me laugh ), but I don't recall being challenged in Walmart.
Requiring Photo Id Discourages Voting. Does Not Significantly Reduce Fraud Where There Is Already Hardly Any
But then again, when your leader/hero is the kidn of guy that mocks the disabled and brags about his c**k in a presidential debate, and says the free press is an "enemy of the people", I guess it's to be expected.
Quote: OnceDearEh? Did he really say that? Could he really believe it? In what possible context could he be stating fact?
My only photo ID is my passport and I use that to fly. I MIGHT be asked to produce it if i buy an air rifle or a crossbow, or join a casino.
To buy groceries, I present some pictures of the queen or wave my credit card. In the US, I was asked for my photo ID to buy a beer, when I was 52 ( that made me laugh ), but I don't recall being challenged in Walmart.
Chances are Trump has never bought groceries in his life. Maybe he stopped in for some booze out carousing one night or something.
They're making a big deal out of this stupidity for 2 related reasons.
George HW Bush made a gaffe while President, in a grocery store, about the product scanners, and the price of milk. It was seen as a strong metaphor for how out of touch he was with the people, and that perception was credited as part of why he lost re-election.
There's been cognitive dissidence like we've never before seen, with Trump claiming he represents and understands working class people, (and them believing him) when he's nothing of the kind, and in fact has been sued thousands of times for stiffing workmen, hiring issues, all kinds of stuff. The news media is hoping this illustrates better than any previous example out of his mouth just how ignorant he is of most people's daily lives, and helps break the spell.
Quote: billryanI am so sick of this whole" I'm going to take my ball and go home" nonsense.
If people want to quit a $300,000 JOB because they have to take a 20% pay cut, let them. I wish them luck maintaining their lifestyle.
No one person is irreplaceable, and it should be obvious that any major shift in such a large part of the economy will result in some people taking a hit.
Think of the poor insurance company executives. They might lose their private jets.
Coming from the guy who quit and took his ball home in the Cooperation Game.
You just can't make this stuff up.....lol
Not sure why such a successful guy as yourself, that chose to give it all up for Henderson, would be so bitter about another rejecting opportunity.
Quote: SteverinosThat's not even the scariest thing that happened at that rally. The people yelling at the media with t-shirts and middle fingers are the absolute worst kind of people. Embracing and accepting that behavior is disgusting.
But then again, when your leader/hero is the kidn of guy that mocks the disabled and brags about his c**k in a presidential debate, and says the free press is an "enemy of the people", I guess it's to be expected.
Deplorable.
Quote: RonCI think SOOPOO correctly points out that enough people doing the latter in critical skill areas could lead us to a shortage, using your pejorative description if they "take my ball and home", and disappear from the workforce. You can't just make them work for less.
They may not work for less than $300k, but there will be plenty of people coming out of anesthesiologist school who will.
Quote:You also talk about those "poor insurance company executives"--there are about 2.6 million people involved in the insurance industry. It is going to be a large hit for them; most of them not making anywhere near the salary of a provider or an executive.
The automobile industry was a large hit for people building carriages and breeding horses. Just because something has been around for decades, or even centuries, is no justification to guarantee people a job for the rest of their lives. The industry my wife has worked in her entire adult life has all but collapsed; she is having to transition into a new career. It's tough darts, but society and technology moves on. Either adapt, or curl up into a ball feeling sorry for yourself and slowly wither away.
We're seeing it now with the coal industry. Oh, you don't want to get a non-coal industry job because that's the industry you grew up in? Even if someone provides training for you in a new career and job placement? Then I have no sympathy for you when the coal runs out or is supplanted with something else. Crawl into your whiskey bottle and drink yourself to death for all I care.
Quote: SteverinosI just wish Trump could say something like, "It's time to make election day a national holiday, or have it on a Sunday. You know, everywhere else it is."
I'm all for that, but I've honestly never had a problem voting during a work day. Polls are usually open really early and stay open fairly late.
He quit and left his ball ($1.40) on the field for us to enjoyQuote: MaxPenComing from the guy who quit and took his ball home in the Cooperation Game.
You just can't make this stuff up.....lol
The stable genius thinks comparing his campaign manager to Al Capone is a good idea.
Also, is he under the impression that Al Capone got a raw deal....?
Quote: beachbumbabs
George HW Bush made a gaffe while President, in a grocery store, about the product scanners, and the price of milk. It was seen as a strong metaphor for how out of touch he was with the people, and that perception was credited as part of why he lost re-election.
I saw something really stupid a few weeks ago.
Bill Gates was on Ellen, and they were doing a little game where they were quizzing him on the price of groceries. Of course, because he's an "out of touch billionaire elitist," he got like every single one of them wrong. The audience was hootin' and hollerin', and honestly Gates seemed like he was having a good time, but the thing is, I was playing along while watching, and even I got them all wrong.
I barely make $40k a year and I'm in the grocery store twice a week, so I am definitely in touch with the cost of food. The stuff they were quizzing him on was really stupid and specific crap, like a five pound bag of Totino's pizza rolls. I would have no idea how much that costs, either... $5? $20? How about you ask about REAL food, like a gallon of milk, or a pound of cheese, or a dozen eggs? I guess that wouldn't make their "point," though.....
Quote: ams288
Deplorable.
Is that those "compassionate Conservatives" I keep hearing about? Maybe they can go hang out with the "tolerant left."
Quote: ams288
The stable genius thinks comparing his campaign manager to Al Capone is a good idea.
Also, is he under the impression that Al Capone got a raw deal....?
I don't understand his logic.... (then again, I rarely do)....
It's my understanding Manafort is being held in solitary a)because he's been accused of very serious crimes and is a flight risk, and b)for his own protection because he's a high-profile prisoner.
Furthermore, of course he hasn't been convicted of anything... THE TRIAL JUST STARTED. Then again, leave it up to Trump to think people should be in prison before they've even been convicted of a crime.
Third of all, Manafort is not on trial for "Russian Collusion" right now.... he's on trial for bank fraud.
And finally, why even mention Russian Collusion about Manafort's trial if collusion is "not a crime?"
My god, Trump is shatteringly stupid....
Quote: MaxPenComing from the guy who quit and took his ball home in the Cooperation Game.
You just can't make this stuff up.....lol
Not sure why such a successful guy as yourself, that chose to give it all up for Henderson, would be so bitter about another rejecting opportunity.
Yep, I quit it because it was a waste of my time. People arguing incessantly about the best way to make 15 cents or some minute amount. It wasn't my bat and ball though. I wouldn't expect you to understand the difference.
Come on now Bill, isn't that exactly what you are doing in this thread - the 15 cents, of course.Quote: billryanYep, I quit it because it was a waste of my time. People arguing incessantly about the best way to make 15 cents or some minute amount. It wasn't my bat and ball though. I wouldn't expect you to understand the difference.
Quote: AxelWolfCome on now Bill, isn't that exactly what you are doing in this thread - the 15 cents, of course.
I don't follow you.
Quote: TigerWuThey may not work for less than $300k, but there will be plenty of people coming out of anesthesiologist school who will.
Do you actually have some numbers to support that or are you just guessing that is what will happen?
If we need 10% to 20% more in the next decade, are the schools putting out enough for that? What if 5%-10% leave the job because of lower pay?
It sounds good to say we will just get them from new graduates, but the path to becoming one is not short or easy.
BBB also mentioned something that is critical--tort reform and lower malpractice costs....will the M4A have that?
That's why I support a gradual transformation, starting by lowering the age to 55 from 65. It may take a decade or more to fully integrate the system.
I think there should be some deductibles, but they should max out early on.
Quote: OnceDearReminded me of a sign that is up in the waiting area at my doctors surgery. It lists the INTERNAL costs that the government has to pay for various levels of service. It's a push to get patients to take the most cost effective route to treatment. Note how relatively cheap even the most expensive options are.
And this is UK single payer. We get invoiced nothing at the point of service delivery.
This suggests that having central government 'buying in' the services, they negotiate pretty well and cut out lots of middle men.
Though it creaks a bit sometimes, we Brits love our National Health Service.
And yes, we do get some piss takers who go to ER ( We call it A & E ) with trivial issues. They are generally made to wait many hours to get served as their 'just rewards'. What we tend not to have are folks who daren't get treatment for life threatening disorders because of the potential costs.
We've had this argument ad nauseum. Insured Americans who uses services think it's great. Uninsured Americans rely on substandard services and risk financial ruin for using healthcare. Libertarians don't believe health care is a right. People who don't have adequate coverage and have a catastrophy generally are screwed. And all countries with government health care are doing it inefficiently, are substandard and are screwing their constituents.
Whatevs. If you have money and are employed by a company who pays a portion of your insurance or you've got the age where Medicare kicks in it's awesome. And everyone else is a lesser citizen because their lack of coverage is because they're some lefty commie welfare stealing democrat votin' sicko. Am I right?
Quote: RonCDo you actually have some numbers to support that or are you just guessing that is what will happen?
Just guessing, based on what happens in other industries. The industry I work in, for example, has a shortage of people right now so it's easy to get a job right out of school.
Quote:If we need 10% to 20% more in the next decade, are the schools putting out enough for that? What if 5%-10% leave the job because of lower pay?
I don't know if anesthesiologist schools are putting out enough people to account for a potential drop in the workforce.
Quote:It sounds good to say we will just get them from new graduates, but the path to becoming one is not short or easy.
I do not disagree with this, and I'm not saying the problem would be solved overnight. There would likely be a number of years for things to normalize. All I'm really arguing is that a drop in the anesthesiologist work force would not be permanent, and the labor market and educational system would adjust to account for the change, like it does in almost every other industry.
Quote:BBB also mentioned something that is critical--tort reform and lower malpractice costs....will the M4A have that?
No idea. I would hope so.
Quote: billryanI'd imagine any system wide reform would have to address that and many other things. I'd have to read up on how England, Canada and the rest of the world transformed into the current platforms.
That's why I support a gradual transformation, starting by lowering the age to 55 from 65. It may take a decade or more to fully integrate the system.
I think there should be some deductibles, but they should max out early on.
It was easy to convert to public when costs were low to begin with. Because medicine and surgery have advanced visits have increases exponentially. Countries would have a very difficult time today converting from private to public.
I agree. You (as a nation ) are where you are. From the outside, your nation looks like it's broken for a lot of the population and as a whole, has costs dictated by the insurance, legal and medical industries, rather the the medical industry alone. Obama had a mountain to climb to even try to get a transition started. It's the sort of transition that would need to be multi-generational and bipartisan. Never really much hope, I guess.Quote: boymimboIt was easy to convert to public when costs were low to begin with. Because medicine and surgery have advanced visits have increases exponentially. Countries would have a very difficult time today converting from private to public.
Good luck with trump-care, if it ever gets defined.
Quote: OnceDearGood luck with trump-care, if it ever gets defined.
You know, if Democrats put Trump's name on bills they're trying to pass, I suspect that would increase their chances of passing.
Or just make Trump angry.
So, no downside, I guess.
Just call it a "tariff" and Republicans will pass it by the end of the week!
But while everyone sits around thinking of solutions. Take a few hundred billion per year out of the largest "defense" budget the world has ever dreamed of, and provide ALL insurance needed by doctors at zero cost. Bring some reality to tort reform. Last I read, the reason reform didn't pass is because they wanted a ceiling of 300k for medical boo boo's. That ain't enough.
But no one should have to give a surviving family 300 million dollars because their relative smoked like a lab rat until they died from copd.
It doesn't seem extraordinarily unimaginable to structure health care like we do public school. Everything up to grade 12 is gratis. You want to go to college [hospital], you need skin in the game. Get it, skin in the game?
The nation also needs to look at morbid obesity in children as child abuse. You got a kid that is 30% overweight, you need a doctors release as to why that is so. Teachers can demand kids get on ssri's to improve behavior, they ought to be able to notice a kid 40 pounds overweight in grade school.
Nobody really wants it fixed anyway, to much invested in the status quo.
Quote: petroglyphNobody really wants it fixed anyway, to much invested in the status quo.
Nobody wants it fixed because they're selfish.
Quote: TigerWuRight.... SO WE NEED TO FIX IT. That's my whole point.
Forget Obamacare, even before that people couldn't afford insurance or medical care and were going bankrupt because they couldn't afford it. Does that sound like a system that isn't broken?
I don't understand this line of reasoning... are there no anesthesiologists in countries that have universal healthcare or a system similar to medicare for all? What do anesthesiologists do in those countries? Why couldn't you and your fellow anesthesiologists do that in THIS country if we were to implement a similar plan?
In those countries the government will pay a reasonable salary to their anesthesiologists. I only make such here because private insurance pays me 7X per case and medicaid pays me X, and medicare pays me 2X. So the government thinks anesthesia costs 1-2 X. It really costs 5X, with private insurers subsidizing the government. If there are no more private insurers subsidizing the government, where do you think that money comes from?
The people who say that we pay anesthesiologists 1 billion a year for the 100 million government patients, so M4A at 350 million will cost 3.5 billion are just dead wrong. That figure will be closer to 10 billion, but that only gets found out later. Or there will be a massive shortage of us. Now multiply that by all specialties (admittedly less than my specialty) and the cost for M4A is WAY HIGHER than we are being told.
Quote: OnceDearI agree. You (as a nation ) are where you are. From the outside, your nation looks like it's broken for a lot of the population and as a whole, has costs dictated by the insurance, legal and medical industries, rather the the medical industry alone. Obama had a mountain to climb to even try to get a transition started. It's the sort of transition that would need to be multi-generational and bipartisan. Never really much hope, I guess.
Good luck with trump-care, if it ever gets defined.
I'm Canadian. I've had US health care which was fabulous, only because I was well insured.
Quote: SOOPOO...and the cost for M4A is WAY HIGHER than we are being told.
This is my biggest fear with this program. Everyone can put away their knives; I certainly would like us to find a better way to "do" healthcare. I don't pretend to have the answer but I am pretty sure that any time a projected "cost" comes out for any government program, it is more likely to be way low than correct or way high. We need some honest numbers here and I think we will find that the government cannot provide the quality of healthcare people used to having good insurance already pay for or timely service for anyone.
Doctors are high earners. They spend a lot of time and money going to school. If the earnings potential is reduced, some of them are going to choose to head in other directions before even becoming doctors. Yes, some are truly "called" and will do it anyway. The ones deciding on other careers will help cause a shortage and also allow others into the program, potentially with reduced standards for enrollment or maybe reduced incentive to go into the harder fields. Ones near the end of the career might see yet a different variant of a huge bureaucracy and cash in their chips.
I don't know if our economy can take the strain of the taxes necessary to support M4A. Yes, we can cut things. At what point does cutting our military become dangerous? How about other programs? Can we find enough trillions to provide coverage for everyone? Will the United States continue to be an innovator? Innovation costs more...
Please accept my sincere apologies for implying you were American. My bad! $:o)Quote: boymimboI'm Canadian. I've had US health care which was fabulous, only because I was well insured.
Quote: OnceDearPlease accept my sincere apologies for implying you were American. My bad! $:o)
Three days for personal insults.
This thread is full of people arguing incessantly. Of course, there will be no reward for time wasting here(perhaps a few rewarding suspensions). That's why I said minus the 15 cents.Quote: billryanI don't follow you.
There was no reason to read all the posts in the thread you just needed to read the rules for the week and put your pick in. I understand, fewer the threads you have to deal with MaxPen is +EV (-;
I could suspend myself, but BBB would throw away the key :o)Quote: billryanThree days for personal insults.
