Nationalized Healthcare.

[creatureofthenyte]

Pork is all the little pet earmarks that these legislatures add to important bills to make themselves look good to their constituents. Both sides do it and it definitely needs to stop.

Precisely. Either we can fund the pet earmarks, OR we can fund health care adequately; but we Can't do Both, that's the thing.

[TitsMcGee]

I would just like to point out that for the people mentioning dental stuff, I don't believe that would be covered under the national health care bill. It's not even covered under government health care as it is, I should know I'm on Medicaid. And as for government run health care, they don't do that great of a job as it is. Charlie has applied for Medicaid on a few different occasions, been denied each time and he's a diabetic. If a diabetic doesn't qualify for government insurance, what about anyone else with a chronic disease?

[creatureofthenyte]

I would just like to point out that for the people mentioning dental stuff, I don't believe that would be covered under the national health care bill. It's not even covered under government health care as it is, I should know I'm on Medicaid. And as for government run health care, they don't do that great of a job as it is. Charlie has applied for Medicaid on a few different occasions, been denied each time and he's a diabetic. If a diabetic doesn't qualify for government insurance, what about anyone else with a chronic disease?

See???

The government already picks and chooses who and what gets covered, just like some of the private insurance companies do, somewhat akin to what Phee was posting about previously. Why would we want to give them more power to do that on a larger scale ?

Edited September 26, 2009 by creatureofthenyte

[phee]

See???

The government already picks and chooses who and what gets covered, just like some of the private insurance companies do, somewhat akin to what Phee was posting about previously. Why would we want to give them more power to do that on a larger scale ?

I think thats what the reform is about right? because that kind of thing does not work NOW

[Guest Megalicious]

I would just like to point out that for the people mentioning dental stuff, I don't believe that would be covered under the national health care bill. It's not even covered under government health care as it is, I should know I'm on Medicaid.

Actually it is, but you have to find a dentist that accepts it such as UoM school of Density or a hand full of other Dentist that offer care under medicaid. Hard to find, but out there.

You see, I am kind of baffled. I have been extremely poor. I know what it is like to not have any kind of coverage - even when growing up I did not have the benefit of going to the doctor or dentist, even if we were extremely poor my mom was never around enough to get us on something state ran - and yet I can't help but feel Nationalized Healthcare is not the answer.

I look at the failure of Tenncare and other things like it and just cringe.

I believe we have the right to be healthy and receive preventative and quality healthcare. I mean isn't that what LIFE, liberty and the pursuit of happiness, that the DOI states is EVERYONES natural and legal right, is all about? What is life without a good QUALITY OF LIFE? I understand the need, I understand the importance, but I don't think the answer lies in what is trying to be shoved into legislature at the moment. No do I believe that need will be met by our government any time soon.

I try to rationalize Managed care, but then I think even if healthcare cost went down I know what its like to be poor, a $30.00 co-pay might as well be a fucking million dollars, when you don't have it, YOU DON"T HAVE IT.

Then there is my Florence Nightingale side that knows SOMETHING has to be done, people just can't keep living like this.

Then there is my rational side that says Nationalize Healthcare will never work and " Yeah, I want my Brain surgeon to one - Know WHAT THE FUCK HE IS DOING, and two - get paid a shit load of money. Why you may ask? BECAUSE HE IS FUCKING CUTTING MY BRAIN OPEN!".

I just don't think IF there was a NH system in play, that it it would function very well.

Think of how much time you get with your doctor now, pissed off that he is only there for two seconds of the fucking hour you are waiting at the doctor? What kind of stress is this going to put on the healthcare system? Where will not only the resources for the payment of this new NH plan come from, but the salary of nurses, doctors and the building of new facilities need for the increase in care?

I know something has got to give. People need preventive healthcare -period. I am just not sure which way will be successful for our country. OBVIOUSLY what is now in play IS NOT WORKING.

I just don't know .....

[phee]

Forced National healthcare to me is as bad as forced privatized healthcare....

That is why I am so big on the OPTION side of this.... not one side only or the other.

[TitsMcGee]

Actually it is, but you have to find a dentist that accepts it such as UoM school of Density or a hand full of other Dentist that offer care under medicaid. Hard to find, but out there.

You see, I am kind of baffled. I have been extremely poor. I know what it is like to not have any kind of coverage - even when growing up I did not have the benefit of going to the doctor or dentist, even if we were extremely poor my mom was never around enough to get us on something state ran - and yet I can't help but feel Nationalized Healthcare is not the answer.

I look at the failure of Tenncare and other things like it and just cringe.

I believe we have the right to be healthy and receive preventative and quality healthcare. I mean isn't that what LIFE, liberty and the pursuit of happiness, that the DOI states is EVERYONES natural and legal right, is all about? What is life without a good QUALITY OF LIFE? I understand the need, I understand the importance, but I don't think the answer lies in what is trying to be shoved into legislature at the moment. No do I believe that need will be met by our government any time soon.

I try to rationalize Managed care, but then I think even if healthcare cost went down I know what its like to be poor, a $30.00 co-pay might as well be a fucking million dollars, when you don't have it, YOU DON"T HAVE IT.

Then there is my Florence Nightingale side that knows SOMETHING has to be done, people just can't keep living like this.

Then there is my rational side that says Nationalize Healthcare will never work and " Yeah, I want my Brain surgeon to one - Know WHAT THE FUCK HE IS DOING, and two - get paid a shit load of money. Why you may ask? BECAUSE HE IS FUCKING CUTTING MY BRAIN OPEN!".

I just don't think IF there was a NH system in play, that it it would function very well.

Think of how much time you get with your doctor now, pissed off that he is only there for two seconds of the fucking hour you are waiting at the doctor? What kind of stress is this going to put on the healthcare system? Where will not only the resources for the payment of this new NH plan come from, but the salary of nurses, doctors and the building of new facilities need for the increase in care?

I know something has got to give. People need preventive healthcare -period. I am just not sure which way will be successful for our country. OBVIOUSLY what is now in play IS NOT WORKING.

I just don't know .....

Where I live up in the arctic circle no one accepts Medicaid for dental, so I have to shell out 100 bucks every 6 months to see the dentist.

[Guest Megalicious]

Forced National healthcare to me is as bad as forced privatized healthcare....

Well duh, Phee. I mean how Big Brother would that be ....... *shivers*.

[Guest Megalicious]

Where I live up in the arctic circle....

This made me bust up laugh. thehehe.

[phee]

Well duh, Phee. I mean how Big Brother would that be ....... *shivers*.

Right... indeed

But we are seeing right now the results of NOT having a public nationalized option.... isn't it great ??? (sarcasm)

[Guest Megalicious]

Right... indeed

But we are seeing right now the results of NOT having a public nationalized option.... isn't it great ??? (sarcasm)

Well yeah, the grass is alway green on the other side. Is it not? (no sarcasm included).

[phee]

Poor people might have a way to get healthy, just like the wealthy???

[TitsMcGee]

Poor people might have a way to get healthy, just like the wealthy???

You realize we're the only country in the world where you are considered "poor" if you are overweight. Maybe the poor wouldn't be so unhealthy if they actually had access to fresh fruits and veggies instead of fast food all the time. Maybe the government should be putting grocery stores in the poverty stricken areas...

[Guest Megalicious]

Poor people might have a way to get healthy, just like the wealthy???

No, my point is, people NEED help, something has to happen, but the governments answer for this seems to be not only to have our country TRILLION of dollars in debt, but have a system that doesn't work. Tenncare is about to go bankrupt for fuck sakes, what happens when that happens on a NATIONAL level?

Or let me ask you this, would you feel comfortable having a chunk of your check taken every week to know that someone else is getting crappy healthcare? So not only are you taking home less money, but the person you are trying to help is not getting the care they really deserve?

It doesn't make sense. It's illogical in every sense of the word.

I am not debating on the FACT something needs to happen - it DOES. National healthcare? I am not so sure.

[phee]

You realize we're the only country in the world where you are considered "poor" if you are overweight. Maybe the poor wouldn't be so unhealthy if they actually had access to fresh fruits and veggies instead of fast food all the time. Maybe the government should be putting grocery stores in the poverty stricken areas...

That is actually a really good idea

[TitsMcGee]

That is actually a really good idea

I have those sometimes

[StormKnight (1)]

my $0.02

Malpractice cases and suits are only 2% of what is currently spent on healthcare. The effects of tort reform are discussed in this article, too.

What makes it such a talking point is the dramatic press and the high payouts of the few high cost cases, the doctor's name being dragged through the mud by media, and the malpractice insurance companies take that as a chance to stratify certain specialties risk rates. It is also the easiest to understand for most lay people, as it is most publicized, and most seen. It also does hit doctors hard, as the insurance can take up to 70% of the salary of a doctor. 2% of $2.5 TRILLION in cost annually ($50 BILLION by my math,) paid by the 700,000 practicing doctors in the country currently is a hell of a lot of money per physician ($71,428.57.)

*on soapbox for malpractice*

Personally, I would be happy to keep ahead of malpractice (up to 50% of what is billed in my specialty,) and modest living. Most primary care doctors (internal medicine doctors, family practice, OB-GYN, and pediatrics,) the malpractice is a large portion of what they take in, (up to 70%.) Also, unlike a hospital type (surgeons, anesthesiologists, etc,) they have overhead to pay for as well.

Example, say a primary care doctor bills $100.00 USD per patient visit:

$50.00 can be malpractice (OB-GYN have it bad, it can be as high as 70%, see below.)

$25-30.00 is overhead and office staff salary (receptionist, nurse, coder, equipment, etc.)

$10-15.00 is those student loans (up to $200,000 and higher if you are typical and don't have parents that are affluent paying your way (maybe 1-2% of my graduating class at most.) This is basically a house loan with higher interest rates.)

$2.00 for continuing medical education (CME.) Every doctor graduated since 1998 have to re-certify every ten years in their specialty, requiring them to keep latest knowledge up to date.

The remaining $3-8.00 of the visit is theirs. Subject to taxes.

Time wise, for every 15 minute appointment, there is at least that much in paperwork/insurance negotiating. When considering it as an hourly wage, can be as low as minimum wage for doctors in some areas. When the mentality that 80 hours a week (maximum allowable for residents to work,) is being a wuss (as some old schoolers call the residents,) most practicing primary care doctors work well beyond that.

Remember, this is average breakdown. Usually the doctor takes a pay cut to maintain malpractice. Insurance doesn't pay the full 100; usually it is 50 or 60, and takes months to get from the companies. So cuts have to be made somewhere.

OB-GYN doctors have it really bad. Not only do they have the highest percentage of malpractice lawsuits, but they are liable the longest. If they are an obstetrician, (actually delivering babies and working with pregnant women,) they have to keep records of every one of those kids they deliver for a period not less than 21 years, in case of something during delivery caused physical problems down the road. And a suit can happen anytime. These reasons are the cause of obstetric doctors closing up shop, and most are concentrating only on gynecologic (i.e. cancers, dysmenorrhea,) issues. They are considered primary care providers, and as such their compensation is less from insurance companies. So you women out there wondering why you can't find obstetric care, these are the reasons.

I will say that I am looking within no less than 4 years after entering practice that my malpractice rates will be up to 50% of the average salary, and that is regardless of whether or not I even *have* a lawsuit against me. If I do get sued, even if it is thrown out, that percentage will go up instantly, and possibly beyond 50%.

And as for nurse practicioners and physician assistants: The reason they are cheaper to use is because they don't have to worry about high rate malpractice insurance. The reason they don't have to carry as much malpractice is that, in the end, a physician has to review and sign off on their assessment and treatment of patients. In the end, the physician is the final target of the lawsuits. So, more providers working under a doctor, the more chance for liability a doctor has. And while both NP's and PA's are sued, it is to a much lesser extent than the doctor they work under. If released from the sign off of a doctor on their charts as is sometimes discussed, their malpractice will also rise to the same level as doctors, as they will take on the full liability, and become less cost effective.

While I do believe in tort reform, and should be part of reform in general since it attacks the providers, it is not the alpha-omega of it all.

*steps off pedestal*

About insurance companies/companies:

We are also talking about insurance companies, entities that exist to make money and a profit for the stock holders. WellPoint (NYSE: WLP) is the parent company of Blue Cross Blue Shield in several states, and is openly traded. As we have seen in the meltdown in banks and Wall Street issues, without enforcing ethics by a set of laws, the company is akin to a primal animal, which the brain (employees/CEOs) is worried about one thing: its own survival, by eliminating competition (i.e. pack mentality (forming monopolies/mergers,) or consuming (buying) them,) and nourishing themselves ("feeding" off of money they take in, as it were.) As a biologist, I have seen animals who have access to food unlimited keep eating until full, and keep the rest away from their cage mates. It could be inferred that greed is a basal survival instinct. For those into Sagan and "Dragons of Eden," this is of the limic (reptilian) system in the brain.

Now, if we apply the idea that of people regressing in large organizations/large groups to the lowest thought/instinct, it could be construed it could only be inferred that the entity/animal that is a large company will regress to a survival instinct; greed. Without a higher level (like the cerebrum in the brain model,) to control it (e.g. laws,) that greed goes out of control.

To summarize my thoughts:

• Insurance companies are out to make money by any way they see fit, and they act on the reptilian brain.
  
• Without something in place, whether law or government competition to give it reasoning skills (i.e. a cerebrum to hold the reptilian brain in check,) to control it, it will run out of control and be greedy.
  
• If allowed to cross state lines to provide insurance, smaller, local companies will be absorbed by larger companies, leading to fewer options for insurance fewer and fewer companies are out to offer insurance, forming a cartel of a few large companies that will set prices (OPEC, anyone?)
  

For solutions? I am not sure. However, I don't believe it lies in a private entity that has the greed/mentality of a primitive animal.

Edited September 26, 2009 by StormKnight

[Enishi]

I'm still not entirely certain either way. I don't believe that people have an inherent 'right' to health care (or anything else for that matter) which exists outside of a specific social and karmic context, and in my eyes being able to receive the fruit of one's own labor is more basic and important than any right to services. However, given the way things are right now, I think an argument can be made that nationalized health care does give more people access to the fruit of their labor, as the article below discusses:

http://www.americanthinker.com/2007/12/a_conservative_case_for_univer.html

December 12, 2007

A Conservative Case for Universal Health Coverage

By Randall Hoven

I am a small-government conservative/libertarian and have hated the concept of socialized medicine almost all my life. But now, I could live with universal health coverage in the U.S.. Here's why.

We now have the worst of both worlds: we are paying for universal health coverage, but not getting it. In fact, we pay more for health care in taxes than countries that provide universal coverage. Then we pay more than that amount again in private coverage. Additionally, what we have now in the U.S. is nowhere near a free market in health care. Defending the status quo is not defending a free market. And if socialized medicine is your fear, we already have it.

I've heard no one, on either side of the political spectrum, play up the fact that the government in the U.S. already spends more on health care than almost every other country on earth. I'm talking government spending, not private spending. According to the U.S. Statistical Abstract, government spending on health care in the U.S was $2,168 per person in 2001 (the last year for which comparison data are available). Here were the top 10 government spenders on health care in 2001.

* Norway: $2,550

* U.S.: $2,168

* Denmark: $2,098

* Iceland: $2,025

* Sweden: $1,832

* Germany: $1,803

* France: $1,599

* Canada: $1,531

* UK: $1,518

* Belgium: $1,417.

If we add in private spending as well, it's not even close.

* U.S.: $4,887

* Switzerland: $3,690

* Norway: $2,982

* Denmark: $2,545

* Iceland: $2,441

* Germany: $2,407

* Canada: $2,161

* Sweden: $2,149

* Netherlands: $2,134

* France: $2,104.

Note that the countries frequently cited as models of universal health care, Canada and the U.K., spent less on public health than the U.S. did. Sweden, the notorious welfare state, spent 15% less than the U.S.. The only country to spend more, Norway, has about the size and population of Colorado, with oil exports over 3 million barrels per day.

Even as a fraction of GDP, government in the U.S. spent a comparable amount to other nations (6.6% in 2002). Canada spent just slightly more (6.7%), and Japan and the U.K. spent less (6.4%). Only seven countries of the 28 countries listed spent a greater fraction of GDP on public health funding than the U.S..

What about the private side, the "free market" side? There, government regulates the health industry and mandates what health insurance must cover.

While the U.S. does not have universal health coverage, it has had universal health care since 1986. Any person who goes to an emergency room in virtually any hospital in the country must be examined and then either treated or transferred to another hospital for treatment if the condition requires immediate care.

According to the Council for Affordable Health Insurance (CAHI), "By the late 1960s, state legislatures had passed only a handful of mandated benefits; today, CAHI has identified more than 1,900 mandated benefits and providers. And more are on their way." According to CAHI, such mandates include:

* Providers such as chiropractors and podiatrists, but also social workers and massage therapists;

* Benefits such as mammograms, well-child care and even drug and alcohol abuse treatment, but also acupuncture and hair prostheses (wigs); and,

* Populations such as adopted and non-custodial children.

Then there are federal mandates such as minimum hospital stays for baby deliveries, equal coverage caps for both mental and physical health benefits and reconstructive surgery after mastectomies.

According to the CATO Institute, the net cost of health regulation in the U.S. is over $169 billion, or an average of $1,500 per household.

So let's review. The government provides Medicare for the old, Medicaid for the poor, veterans' hospitals for veterans, medical research funding and whatever else adds up to 6.6% of GDP. The federal government forces hospitals to provide emergency treatment to all comers. State governments mandate over 1,900 types of coverage on health insurance. Health care regulations cost the average household over $1,500.

We already have socialized medicine and we are already paying for it -- twice: once in taxes and once privately. What we are not getting is universal coverage.

But if universal care (via emergency rooms) is already mandated, what's the problem? First, it is not the best way to get treatment. For one thing, the condition has to be regarded as a medical emergency. Also, the law does not relieve you of having to pay for that treatment. In fact, medical bills are the leading cause of bankruptcies in the U.S., accounting for half of them.

So while you might not die, the U.S. health care system does give you the age-old offer of "your money or your life".

As small-government conservatives or libertarians, we could say, "That is the individual's choice: get the insurance or suffer the consequences." But if that is our policy, then why is our government paying over $2,100 per person per year and regulating health care at a cost of $1,500 per household? What are we getting for that money?

If we are to be consistent libertarians, then the government should stop meddling in health care and health insurance altogether. End Medicare. End Medicaid. Close down veterans' hospitals. Stop funding medical research. Stop funding pharmaceutical research. Stop mandating vaccines. Stop mandating emergency room treatment. Stop mandating health insurance policies. Stop doing those things that cost us 6.6% of our GDP when we have to kick in another 7% or more of our own.

If our government stopped all those things, then I would a happy libertarian. But the government will not stop them. If politics is the art of the possible, it is not possible to end all the programs and policies cited above. So ... if we are going to be forced to pay for something, then we ought to get it. Either provide us the coverage, or give us our money back.

Full disclosure: My daughter needed a heart transplant at age 15. We had full coverage from my employer, so cost was never a personal issue to us. I'm not sure what these things cost (neither did her cardiologist), but I believe the surgery and resulting hospital stay would be a few hundred thousand dollars. Testing and diagnostics beforehand could exceed $100,000. Anti-rejection drugs and follow-up testing could run to six figures yet again. I believe a total cost of $500,000 is not out of the question, with annual post-surgery costs in the five figures.

This was not a matter of elective treatment. There was nothing that could have prevented it. In my daughter's case it was a rare condition, with cause unknown, unforeseen and unforeseeable. The choice was do or die. And there was no decision on our part that could have reduced the cost in any significant way. There are no low-cost heart transplants. There or no alternative treatments. A bake-sale here or poker-run there would not come near the required amount.

If you are struck with such a catastrophic health crisis, you simply must have a very good health insurance policy or a net worth into the millions to avoid both death and bankruptcy.

And health insurance is not a trivial cost. Family coverage goes for about $13,000 per year or more. The median family income in 2001 was $51,407. The choice for some families is to pay over a fourth of their after-tax income on health insurance, or risk relying on emergency room care only and then going bankrupt should a catastrophic health issue come up. Many chose no or inadequate coverage, and many went bankrupt.

The cost problem is not one just for poorer families. At $13,000 and up per year per family, and growing faster than inflation, health insurance affects everyone. We now spend 15% of our GDP on health. Any Chief Executive Officer would love to have health insurance taken off his worry list. Any state governor would love to have Medicare removed from his federal mandates. It is impacting our productivity and competitiveness.

Let me make something else clear: universal health care coverage is not the same as single-payer health care. Canada and the U.K. have nothing to brag about regarding either the quality of health care or the cost of it. But those are not the only models of universal coverage. Germany, Japan and others have universal, or near-universal, health coverage without a single-payer system.

It would be naïve of me to propose a specific plan. But a true conservative ought to be able to work within the following guidelines.

* Public health spending in the U.S. not to exceed current costs as a fraction of GDP (currently 6.6% of GDP).

* Coverage of all U.S. citizens. The definition of "coverage" could be debated, but should include catastrophic type coverage as a minimum.

* Consolidation and integration of all aspects of public health programs should be on the table, including Medicare, Medicaid, veterans' hospitals, research and all federal health programs and policies. That is, Medicare reform should be part of the deal.

* Preservation of private choices in health care.

* Medical tort reform.

* Reduced mandates on individuals, insurers, health providers and states regarding health care policies and practices.

I don't see why a small-government conservative or libertarian would think the above is worse than what we have now. I also don't see why the above should be impossible, even politically.

Someday, some sort of universal coverage is going to happen in the U.S. What plan would you prefer -- one consistent with the above, or one dictated by Hillary Clinton, Barack Obama or John Edwards? When Iraq becomes yesterday's news, Republicans need to be ready with this issue.

[candyman]

* Public health spending in the U.S. not to exceed current costs as a fraction of GDP (currently 6.6% of GDP).

* Coverage of all U.S. citizens. The definition of "coverage" could be debated, but should include catastrophic type coverage as a minimum.

* Consolidation and integration of all aspects of public health programs should be on the table, including Medicare, Medicaid, veterans' hospitals, research and all federal health programs and policies. That is, Medicare reform should be part of the deal.

* Preservation of private choices in health care.

* Medical tort reform.

* Reduced mandates on individuals, insurers, health providers and states regarding health care policies and practices.

I don't see why a small-government conservative or libertarian would think the above is worse than what we have now. I also don't see why the above should be impossible, even politically.

Someday, some sort of universal coverage is going to happen in the U.S. What plan would you prefer -- one consistent with the above, or one dictated by Hillary Clinton, Barack Obama or John Edwards? When Iraq becomes yesterday's news, Republicans need to be ready with this issue.

You know very well that although a plan like that is awesome it will never happen. What our system has right now is a bunch of cancer spots and we have to take care of those spots no matter what system we have. They are problems that are going to stick around and cause hell for ANY system unless they are taken care of. People have spoken of greed and greed doesn't give a shit about which system we are using. Reforms have been made in so many different systems yet these systems keep finding ways to keep on the same path that they were before...they just put on a different costume so we won't what is really going on until it is too late.

I don't care who makes the plan...once it gets through D.C. it is going to be FUBAR...if it was ever good to begin with. And who cares what the Republicans are doing now...if it is about wars then they are on an even playing field with the Democrats who have just as much poo in their diapers and seem to be doing a GREAT job taking care of the war they think is wrong. But this isn't about a war and it really isn't about a political party either...they both pull the same shit, just with different names for their actions.

I still say that I don't care what the bill has in it...because if we can't handle or fix what we have now then there is no hope for ANY system lasting at all...and we can't seem to handle anything right now and we sure as hell are not up to fixing anything...that goes for the government, common people, everyone! Change and reform don't help anything if they don't address all the issues.

[Tacohitts]

Its all about corporate greed,and it seems America is the only country in the industrialized nations that has this problem,I have always hated corporate greed and always will.IMO corporations need to stay the f--- out of politics all together.f-- fortune 500 corrupt corporations!!

[KatRN05]

I keep seeing the comment that "You have to be filthy rich to get anything done"...that's not necessarily true. I work at Henry Ford, we get patients who have zero insurance and we've done everything necessary to keep them alive. And I mean everything. We don't say, "Oh that antibiotic is too expensive because they have no insurance"...or "That 30,000 dollar clotting factor is too expensive for that patient so they will have to bleed". Now, when I worked at Beaumont, you have no insurance, sorry, go downtown. I can't tell you how many patients I've gotten from Beaumont because of "insurance issues" and the issue is they have no insurance. But we've (HFH) NEVER not treated anyone because they lacked it.

Anywho, I'm for national healthcare as long as I'm not going to be taxed to death for it.

Edited September 26, 2009 by KatRN05

[Reaper]

Ok, lets address the opinion that, "the number of new patients that are uninsured will flood the system with the lack of doctors needed to help them." I keep hearing that doctors will go into specific fields instead of general practice because of the liability and the lowered wages due to competition. There is also supposedly not enough doctors ideally right now to cover such a flood of new patients. Will this not lead to waiting lists as described? I believe that is why they are saying that the OPTION will create waiting lists. What say you? (haha, I know. I sound like Bill O'Reilly.)

[Slogo]

(haha, I know. I sound like Bill O'Reilly.)

Don't say that, you're a good guy.

I really don't see anything wrong with an option. I just don't understand why there are some in this country who believe that the only way anyone should get something they need is by someone charging and arm and a leg.

I for one believe we should devote all of our time to getting a good Republican in the White House. And by that I mean reanimating Theodore Roosevelt and allowing him to run again.

He was the first president to call for nationalized healthcare, income tax, (though only on the very rich), estate tax, environmental laws, etc...

edited to include the last part

Edited September 26, 2009 by Slogo

[StormKnight (1)]

I keep hearing that doctors will go into specific fields instead of general practice because of the liability and the lowered wages due to competition.

It is that, and personality and desire of the student, as I discuss below.

The specialties that are considered primary care providers are:

-Internal Medicine

-Family Medicine

-Pediatrics

-Obstetrics-Gynecology

Now to look at Match statistics. "The Match" is the lottery/application process all medical students have to go through to get a residency in the US. The medical student designates specialty and program in the places they want to be based on the program quality and personal requirements. (e.g. wanting to do Family Medicine in Cooperstown, NY, because family lives close; Anesthesiology in Florida, because the program is the best, etc.) The programs are ranked (e.g. program A is number 1 choice, program B is number 2, etc.,) which becomes the student's lottery ticket, as it were. One Tuesday in March, after concentrating on traveling to interviews, networking, etc for most of the fourth year, they see what program picked them on their list. If no program they selected took them, they have the rest of the week to find a position to do something. This is a lot of phone calls, faxing, e-mails, etc. in something called "The Scramble." Some get the specialty the want, others just get the intern year and try again the Match during their intern year. It is stressful, competitive, and occasionally heart-wrenching.

I bring this up to accent how much the above specialties are almost a give-me to get into, not because of the number of programs or positions, but competition isn't there for them. A bit is because of the student's experience in those rotations. My experiences as a third year student (where we get exposed to the speicalties,) have consistently been that the residents and the attending physicians are absolutely miserable because of the malpractice, longer hours (well beyond the 80-hour work week limit residents have to adhere to,) and fighting insurance companies.

Also, the personality of the student draws them to certain specialties. I was attracted to surgery because of the intense work, the manual skill, and still practicing medicine (i.e., I dig bright lights and cold steel, and I am not phased by blood, guts and messy trauma.) Anesthesiology had the same level of attraction because it was still bright lights and cold steel (needles,) but there was an academic side in the fact they have to handle patient medical conditions if they manifest under anesthesia, and a geek side because of all the gadgets we have to use, like monitors, anesthesia machines, etc. If things had went the way I planned, I would have been in the service as one of those two specialties, in the mud and muck of a remote hospital, away from the civilian salaries that go with these specialties, for most of my working career (I was planning to be a lifer in the service.) What I would earn wouldn't have mattered. If anyone could see me working in the two specialties, I almost glow with both personal enjoyment and spiritual contentment, as if the job nourishes the soul. As I told one vascular surgeon I worked with being that amped, "There are some of us who, well, enjoy their job just a bit more than the rest of us." To which, he replied, "Some of us need our medications adjusted." Everyone notices it: nursing, attendings, even the patients.

The primary care positions attract a certain personality that is now becoming more and more rare in the student makeup. And those that thought about it, think twice after seeing how miserable most are in those rotations. I could walk into most of the primary care specialties, but it is a major personality clash. My nature is much more of a hands-on approach, and I would do poorly as a resident and an attending in primary care (as I did as a student.)

Below are the numbers of programs, positions offered by all the programs, amount of US med school graduates that chose it/got a position, and the percentage that was filled by US students in the Match from this year. Link to the PDF of the statistics here.:

-Internal Medcine: 376 programs, 4922 positions, 2632 students chose it, for fill percentage of 53.5%

-Family Practice: 453 programs, 2535 positions, 1071 students chose it, for a fill percentage of 42.2%

-Pediatrics: 208 programs, 2392 positions, 1682 students chose it, for a fill percentage of 70.3%

-Obstetrics/Gynecology: 245 programs, 1185 positions, 879 students chose it, for a fill percentage of 74.2%

Just to show my favorite speicalties:

-General Surgery: 239 programs, 1065 positions, 824 students chose it, for a fill percentage of 77.4% And it is going back up after a lull, as general surgeons do more and more work

-Anesthesiology: 93 programs, 733 positions, 612 students chose it, for a fill percentage of 83.5% Gone up in recent years due to lifestyle.

So, it is a combination of both what Reaper has stated about liability, and low wages (average for the primary care specialties is just at $100,000 or so, minus what they have for overhead, etc.) and the fact that the students are not getting a good impression of the specialties, and are not attracted to the specialties.

[creatureofthenyte]

On a side note, I am genuinely curious, Phee have you read through the health care bills that Henry Waxman and Max Baucus have put forth ? I know they're both probably over 1000 pages, but still..

Read these bills, seriously. From what I've read of them so far, what they are proposing, is Worse then what we have now.

Oh and in reply to my comment about the govenrment running our lives with this plan....

Out in San Fransisco, they are attempting to implement a "sin" tax on soda. Trying to make it so they can tax people into making healthier food & choices.

If they start with that, they will move on to everything else, and then before we know it, we will be living in "Brave New World".