How to control healthcare costs in the United States

[kallend 2,108]

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How many doctors would we have if they knew that they had to invest the time and money required, out of their own pocket, and then be told by the govt. that they were only allowed to make $70,000 a year.
Maybe we could get the govt. to insist that those teaching in the universities only get to make $30,000 a year. After all, we have to cut costs.
How about the industries that build all of the different equipment? Should they only make a 1% profit?
Do you see where this is going? The next thing you know, we've got unqualified illegal aliens installing oxygen systems in the hospitals. But, hey, we are keeping down the price of health care.

Bogus argument. There is no desperate shortage of medical practitioners in countries where government provides healthcare. Illegal aliens are not installing O2 equipment in Canada, Sweden and France.

I know a bunch of skydiving MDs in the US, and more than half of them are salaried (working for hospitals or medical schools) rather than running their own practices, because they do NOT like the hassle involved in the current system.

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The only sure way to survive a canopy collision is not to have one.

[NCclimber 0]

It does seem that a lot of people who favor Universal Healthcare aren't that concerned about the financial implications to both those who will be paying for most of it and the people in the industry.

[NCclimber 0]

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Bogus argument. There is no desperate shortage of medical practitioners in countries where government provides healthcare.

Really?

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Surveys report that more than 4 million Canadians can't find a family physician to care for them. In 2002, it was estimated that Canada was short 3000 family physicians, and that the situation was getting worse. In 2004, it was estimated that another 1400 family physicians would retire in the following two years.

http://chealth.canoe.ca/channel_section_details.asp?text_id=2994&channel_id=7&relation_id=3621

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I know a bunch of skydiving MDs in the US, and more than half of them are salaried (working for hospitals or medical schools) rather than running their own practices, because they do NOT like the hassle involved in the current system.

Anecdotal proof. How compelling.

[kallend 2,108]

The Los Angeles Times on Sunday examined how "[a] looming doctor shortage threatens to create a national health care crisis by further limiting access to physicians, jeopardizing quality and accelerating cost increases." According to the Times, 12 states -- including California, Texas and Florida -- have reported physician shortages or expect them within a few years. The reported shortages are among 12 specialties -- including cardiology, radiology, and several pediatric and surgical subspecialties. One in five U.S. residents who lives in a rural or urban area is considered medically underserved by the federal government because of the low availability of physicians, according to the Times. Wait times to see a dermatologist for a routine skin cancer examination in 15 large cities averaged 24 days, according to a 2004 survey by physician staffing firm Merritt, Hawkins & Associates. Women in the 15 cities waited an average of 23 days for a routine gynecological checkup, the survey shows. The average wait for a visit with a cardiologist was 19 days, and the average wait to see an orthopedic surgeon for a knee injury was 17 days, according to the survey. Within the next 15 years, aging baby boomers are expected to increase the demand for urologists and geriatricians, the Times reports. One study finds that the aging population will increase the demand for cataract surgery alone by 47%. By 2020, physicians are expected to retire at a rate of 22,000 a year, up from 9,000 in 2000, according to the Times. To address the shortages, areas with the greatest physician and hospital shortages have been increasing physician salaries, and lawmakers are being urged to lift a cap on funding for physician training and to ease limits on the immigration of foreign physicians. This month, the executive council of the Association of American Medical Colleges will consider a 30% increase in enrollment, double the increase it called for last year. In addition, some states, such as Florida, New Jersey and California, are proposing building new medical schools or expanding existing schools (Girion, Los Angeles Times, 6/4).

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Anecdotal proof. How compelling.

Who said anything about "proof"?

Since it's true, it's more compelling than Royd's hypothetical musing.

...

The only sure way to survive a canopy collision is not to have one.

[NCclimber 0]

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Does this somehow prove your claim about a no "shortage of medical practitioners in countries where government provides healthcare"?

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Anecdotal proof. How compelling.

Who said anything about "proof"?

How pedantic of you.

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Since it's true, it's more compelling than Royd's hypothetical musing.

Perhaps to you. Is this like saying the current US heatwave proves AGW?

Compelling indeed.

[kallend 2,108]

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Does this somehow prove your claim about a no "shortage of medical practitioners in countries where government provides healthcare"?

It shows that shortages have nothing to do with the method of funding.

...

The only sure way to survive a canopy collision is not to have one.

[NCclimber 0]

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Does this somehow prove your claim about a no "shortage of medical practitioners in countries where government provides healthcare"?

It shows that shortages have nothing to do with the method of funding.

A bolded excerpt from the article you quoted:

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One in five U.S. residents who lives in a rural or urban area is considered medically underserved by the federal government because of the low availability of physicians,

So we're talking about people getting healthcare on the taxpayer dime, right? I wonder how that situation might change with a national healthcare program.

[kallend 2,108]

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Does this somehow prove your claim about a no "shortage of medical practitioners in countries where government provides healthcare"?

It shows that shortages have nothing to do with the method of funding.

A bolded excerpt from the article you quoted:

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One in five U.S. residents who lives in a rural or urban area is considered medically underserved by the federal government because of the low availability of physicians,

So we're talking about people getting healthcare on the taxpayer dime, right? I wonder how that situation might change with a national healthcare program.

That is NOT my interpretation of the wording of that sentence.


The AMA (American Medical Association) becomes the latest of many expressing concern that there might not be enough physicians to go around, now or in the future.

Honolulu (USA) -- The American Medical Association acknowledged a physician shortage in some areas of the country and some specialties, according to policy adopted at its Interim Meeting last month.
v 'We don't know what the correct mix is, and what we need is data to determine what the best policy is,' said AMA president-elect John C. Nelson, MD, MPH. 'The bottom line is we want to make sure that patients have access to physicians that they need.'

The AMA is the latest organization to shift official policy from recognizing a surplus of physicians to realizing that numerous factors may be contributing to an imminent physician shortfall.

Several specialty societies are considering the issue, and the government-appointed Council on Graduate Medical Education reversed its position in November 2003 and called for an expansion of medical school spaces and residency slots.

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The only sure way to survive a canopy collision is not to have one.

[rehmwa 2]

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Maybe we could get the govt. to insist that those teaching in the universities only get to make $30,000 a year. After all, we have to cut costs.
How about the industries that build all of the different equipment? Should they only make a 1% profit?

Makes sense, now, since they aren't very profitable, their employees will have to take a big pay cut, but that's ok, they have health care. And we can legislate that they get to live in smaller more efficient houses, give them free public transportation to works, and put mandatory prices reductions on basics like food and clothing.

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Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[billvon 3,078]

>Who has the most chance of surviving it, the rich guy who can spend all
>the money in the world or the poor guy who can't afford insurance?

The rich guy.

Who has a chance to get a better house? The rich guy.

Who has a better opportunity to send his kids to a private school of his choice? The rich guy.

Who has a better opportunity to buy really healthy food instead of Big Macs, and therefore live longer? The rich guy.

Who can move to a city with clean air and an excellent police force - and therefore live longer? The rich guy.

That's the way things work in a capitalist society. Want those benefits? Become a rich guy. Go to school, go to college, work hard etc etc. Then you get all the excellent housing, medical care, food etc.

If you don't want to do that, then that's fine too. Take it easy and don't work too hard. Then you get a minimum level of medical care. If that's not enough, well, at least you had a good time while you were here.

Your choice.

[brierebecca 0]

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Oh, I agree. Recall I used to defend doctors for a living. My issue is what kind of tort reform. It's difficult to handle things like that to get tort reform without chilling legitimate grievances.

I think it's a difficult problem, too. Not one I'd like to be responsible for correcting. But requiring a positive medical review before filing suit should be a minimum requirement.

Brie

"Ive seen you hump air, hump the floor of the plane, and hump legs. You now have a new nickname: "Black Humper of Death"--yardhippie

[kallend 2,108]

From: www.google.com/search?sourceid=navclient&ie=UTF-8&rls=DBUS,DBUS:2006-10,DBUS:en&q=physician+shortage+usa

The marketplace doesn't determine how many doctors the nation has, as it does for engineers, pilots and other professions. The number of doctors is a political decision, heavily influenced by doctors themselves.

Congress controls the supply of physicians by how much federal funding it provides for medical residencies — the graduate training required of all doctors.


Funny how those "blue" states have more physicians per capita than the "red" states:

DOCTORS PER 1,000 RESIDENTS (2002)

State Rate
Mass. 4.3
N.Y. 3.9
Md. 3.8
Conn. 3.6
Vt. 3.5
R.I. 3.4
N.J. 3.1
Pa. 2.9
Hawaii 2.8
Ill. 2.6
Minn. 2.6
La. 2.6
United States 2.6
Wis. 2.6
Va. 2.5
Calif. 2.5
N.H. 2.5
Maine 2.5
Wash. 2.5
Tenn. 2.5
Ohio 2.5
Ore. 2.4
Del. 2.4
N.C. 2.4
Fla. 2.4
Colo. 2.4
Mo. 2.3
Neb. 2.3
Mich. 2.3
N.D. 2.3
N.M. 2.2
W.Va. 2.2
S.C. 2.2
Ky. 2.2
Mont. 2.2
Kan. 2.1
Ga. 2.1
Ind. 2.1
Texas 2.0
Ala. 2.0
S.D. 2.0
Utah 2.0
Ariz. 2.0
Ark. 1.9
Alaska 1.9
Iowa 1.8
Wyo. 1.8
Nev. 1.7
Miss. 1.7
Okla. 1.6
Idaho 1.6

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The only sure way to survive a canopy collision is not to have one.

[mnealtx 0]

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Funny how those "blue" states have more physicians per capita than the "red" states:

Yeah, for some odd reason doctors tend to be in higher concentration where the big hospitals are. Exercise for the student - determine whether a city of 500k or a town of 50k is more likely to have a large, regional hospital.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[NCclimber 0]

Here are some disturbing facts I found:

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Despite the relatively high level of health expenditure in the United States, there are fewer physicians percapita than in most other OECD countries. In 2004, the United States had 2.4 practising physicians per 1000 population, below the OECD average of 3.0. There were 7.9 nurses per 1 000 population in the United States in 2002, which is slightly lower than theaverage of 8.3 across OECD countries. The number of acute care hospital beds in the United States in 2004 was 2.8 per 1 000 population, also lower than the OECD average of 4.1 beds per 1 000 population.

[billvon 3,078]

>Exercise for the student - determine whether a city of 500k or a town
>of 50k is more likely to have a large, regional hospital.

Second exercise - determine which city is more likely to have more people in it!

[kallend 2,108]

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>Exercise for the student - determine whether a city of 500k or a town
>of 50k is more likely to have a large, regional hospital.

Second exercise - determine which city is more likely to have more people in it!

beat me to it!

...

The only sure way to survive a canopy collision is not to have one.

[lawrocket 3]

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Funny how those "blue" states have more physicians per capita than the "red" states

I'm not surprised at all. Those in Red states to live in more sparsely populated areas - and in places where agriculture, etc., is prevalent. You'll probably find that gyms are less prevalent in those locations, as well.

Doctors are needed where the areas are less healthy and where there is a dense population. Diseases tend to spread more quickly in dense population centers. Hence, the need for more doctors.

Doctors - particularly specilaists - also tend to congregate in population centers. You won't find many board certified trauma surgeons in Kit Carson County, Colorado because there is not enough level 1 trauma for the doctor to keep employed.

So the blue states - where people live in cities, packed closely together and the air sucks and more traffic accidents occur each day in the city that occur in a month in Idaho will find more doctors.

My wife is hotter than your wife.

[rehmwa 2]

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Funny how those "blue" states have more physicians per capita than the "red" states

I'm not surprised at all....

too late, mneal and billvon both mocked kallend already for being obtuse

...
Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[kallend 2,108]

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Funny how those "blue" states have more physicians per capita than the "red" states

I'm not surprised at all. Those in Red states to live in more sparsely populated areas - and in places where agriculture, etc., is prevalent. You'll probably find that gyms are less prevalent in those locations, as well.

Doctors are needed where the areas are less healthy and where there is a dense population. Diseases tend to spread more quickly in dense population centers. Hence, the need for more doctors.

Doctors - particularly specilaists - also tend to congregate in population centers. You won't find many board certified trauma surgeons in Kit Carson County, Colorado because there is not enough level 1 trauma for the doctor to keep employed.

So the blue states - where people live in cities, packed closely together and the air sucks and more traffic accidents occur each day in the city that occur in a month in Idaho will find more doctors.

Right, no big cities in Texas or Georgia, and in Nevada the population certainly isn't concentrated in cities like Vegas.

NH, Vermont, Minnesota and Maine, of course, are just asphalt jungles.

...

The only sure way to survive a canopy collision is not to have one.

[lawrocket 3]

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Right, no big cities in Texas or Georgia, and in Nevada the population certainly isn't concentrated in cities like Vegas.

Oh, I'm not saying that. I am speaking in general temrs. Texas has population centers like Dallas and Houston and Austin. What do you think are the odds that Dallas and Houston and Austin have a greater concentration of doctors than 2.0 per 1,000? I'll bet you money on it.

What do you think are the odds that Atlanta has a greater concentration of Doctors than 2.1 per 1,000? I'd say there's a pretty good chance.

Now Las Vegas is a different beast, isn't it? Odds are there are more emergency physicians there than in similar cities because it's so touristy - probably more than half the people in Vegas at any one time don't live there.

Here's a population density map of the US that kinda shows my point. http://earthobservatory.nasa.gov/Newsroom/NewImages/Images/us_population_2005_lrg.jpg

Sure, there are population centers in those places, and I'll bet they've got more doctors than the rest of the state. But your exceptions tend to prove my rule.

My wife is hotter than your wife.

[NCclimber 0]

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Right, no big cities in Texas or Georgia, and in Nevada the population certainly isn't concentrated in cities like Vegas.

NH, Vermont, Minnesota and Maine, of course, are just asphalt jungles.

It has to do with average population densisty for the entire state.

Could you really not infer that from what people were posting?

[sv3n 0]

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Reply To
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Regulate the prices, bring healthcare down to a reasonable level, and make sure that everyone is covered.

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I have already asked you - when you are trying to regulate "prices", you are regulating salaries. Do you want YOUR salary to be regulated as well if someone (like a homeless or a McDonalds employee) thinks you earn too much?

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I don't disagree with you there......that's a hard road to follow. But if the reason our healthcare prices are so high is as plain as the prices are overinflated..........then how do you suggest we bring them down to a reasonable level?

So, you think that the medical field should do it just because they are feeling altruistic? I dare say that there are very few people in the medical field who are truly 'called' to the profession.
How many doctors would we have if they knew that they had to invest the time and money required, out of their own pocket, and then be told by the govt. that they were only allowed to make $70,000 a year.
Maybe we could get the govt. to insist that those teaching in the universities only get to make $30,000 a year. After all, we have to cut costs.
How about the industries that build all of the different equipment? Should they only make a 1% profit?
Do you see where this is going? The next thing you know, we've got unqualified illegal aliens installing oxygen systems in the hospitals. But, hey, we are keeping down the price of health care.

I'd leave that up to better men than myself. Obviously it's possible if it's happening elsewhere. One would have to take an indepth look at what prices were higher and why.......then work out a systematic way of getting our prices down.

...and you're in violation of your face!

[sv3n 0]

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>Who has the most chance of surviving it, the rich guy who can spend all
>the money in the world or the poor guy who can't afford insurance?

The rich guy.

Who has a chance to get a better house? The rich guy.

Who has a better opportunity to send his kids to a private school of his choice? The rich guy.

Who has a better opportunity to buy really healthy food instead of Big Macs, and therefore live longer? The rich guy.

Who can move to a city with clean air and an excellent police force - and therefore live longer? The rich guy.

That's the way things work in a capitalist society. Want those benefits? Become a rich guy. Go to school, go to college, work hard etc etc. Then you get all the excellent housing, medical care, food etc.

If you don't want to do that, then that's fine too. Take it easy and don't work too hard. Then you get a minimum level of medical care. If that's not enough, well, at least you had a good time while you were here.

Your choice.

Correct........except that when you're talking about large houses and private jets, you're talking about luxuries. When you're talking about healthcare, then you're talking about someone's life. If a government is supposed to take care of it's people then it needs to do something about that.

...and you're in violation of your face!

[billvon 3,078]

>When you're talking about healthcare, then you're talking about
>someone's life.

When you're talking about where someone lives, you're talking about someone's life.

When you're talking about what someone eats, you're talking about someone's life.

Doesn't mean we have any obligation to guarantee people houses in the mountains where the air is clean, or to guarantee fresh broccoli so they don't eat at McDonald's all the time.

>If a government is supposed to take care of it's people then it needs to
>do something about that.

No, it really doesn't. The role of government (at least in the US) is not to "take care of its people." That's the role parents play for their children; we should leave it to them. They're better at it.

[nathaniel 0]

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then work out a systematic way of getting our prices down.

Easy. Reduce demand. Take away subsidies and "rights" to health care. Watch prices fall as doctors and hospitals have to compete for patients, and patients become unwilling to overspend because it costs their own money to consume health care instead of coming out of some invisible gov't ledger.

If you kept the difference you'd see to it yourself that you got the $4000 knee surgery instead of the $100,000 one. Likewise if you got to keep the difference between the $1600 / mo insurance plan that gets you the $100k treatment and the $200 / mo plan that gets you the $4k job.

Seeing as $100,000 surgeries would go out of style quick, the health care industry would reorient itself towards the affordable and the effective. Like ordinary markets throughout the economy.

Have you ever seen a price chart when you discussed treatment with your doctor or at a hospital? Hospitals will often refuse to reveal their price structures in advance of treatment. Nobody asks anyway. If you were spending the same amount on a house or a car or a computer you'd walk out if you couldn't see the price. They know that patients don't care because patients have practically no incentives to care.

My advice is to do what your parents did; get a job, sir. The bums will always lose. Do you hear me, Lebowski?