Seeing some of the shit I'm reading here just makes my head want to explode, holy fuck.
now that the schools produce rocks don't expect critical thinking skills from this side of the pond.
As a doctor, I actually support the idea of universal health care, but that is because I am an emergency medicine physician and already provide universal health care. The system will require a broad range of changes in medicine, law and pharmaceutical science.
The system must:
1. Maintain physician salaries. Cut salaries and smart students will go to other fields. I certainly would. And I dont want my urologist to be the guy that couldn't get into business school.
2. Severe changes in the right to sue. The goverment is not going to fund the current system of jackpot payouts. The cost of taking a case to trial is about $200,000 and thats if you win. The cost of my malpractice is about $90,000 per year, and that is without any judgements.
3. The goverment will need to subsidize the pharmaceutical industry. Much like industries such as defense. We will need to pay for costly research. And it will likely lead to less research being done.
4. The goverment will have to purchase all the property of the private physicians/hospitals/ labs and xray facilities. This alone could bankrupt the goverment.
5. Our current tax system could not in any fair way figure out how to distribute the increase in taxes.
As was stated before, decouple health insurance from employment. Make group rates illegal. Encourage the development of plans that allow for high deductables with HSA's (ones that dont expire at the end of the year). These things could allow for a more efficent private healthcare system. My employer pays me a stipend for being a full time employee, I use it to buy a PPO plan with a $5000 deductable. I save $7000/year for the same plan with a $1000 deductable. I put $5000 into an HSA and use it to pay for medical expenses. This allows me to properly deduct these expenses from my taxes without having to pay the 7% of my income first.
Any UHC system would have to be rolled out in phases.
As a doctor, I actually support the idea of universal health care, but that is because I am an emergency medicine physician and already provide universal health care. The system will require a broad range of changes in medicine, law and pharmaceutical science.
The system must:
1. Maintain physician salaries. Cut salaries and smart students will go to other fields. I certainly would. And I dont want my urologist to be the guy that couldn't get into business school.
2. Severe changes in the right to sue. The goverment is not going to fund the current system of jackpot payouts. The cost of taking a case to trial is about $200,000 and thats if you win. The cost of my malpractice is about $90,000 per year, and that is without any judgements.
3. The goverment will need to subsidize the pharmaceutical industry. Much like industries such as defense. We will need to pay for costly research. And it will likely lead to less research being done.
4. The goverment will have to purchase all the property of the private physicians/hospitals/ labs and xray facilities. This alone could bankrupt the goverment.
5. Our current tax system could not in any fair way figure out how to distribute the increase in taxes.
As was stated before, decouple health insurance from employment. Make group rates illegal. Encourage the development of plans that allow for high deductables with HSA's (ones that dont expire at the end of the year). These things could allow for a more efficent private healthcare system. My employer pays me a stipend for being a full time employee, I use it to buy a PPO plan with a $5000 deductable. I save $7000/year for the same plan with a $1000 deductable. I put $5000 into an HSA and use it to pay for medical expenses. This allows me to properly deduct these expenses from my taxes without having to pay the 7% of my income first.
Any UHC system would have to be rolled out in phases.
Have you looked at other countries who pay doctors less (pretty much all of them is my impression)? Do you have studies showing the effect on quality of service?
Maybe having doctors who want to help people instead of ones who wouldn't be there except for big bucks will IMPROVE care.
I find it interesting that money is your #1 item...
That tells me only about the insurance companies. Are they gouging? It doesn't prove lawsuits are excessive - or that 'reform' wouldn't be an injustice..
I like that - democracy-driven research. There's no reason it has to be less...
That's why we create a plan. And the government is already paying for a lot of that equipment, through Medicare/Medicaid, just much less efficiently.
I am not talking about just money. I am talking about the psychologic dynamics of education and manpower. I have personnally met many physician from other countries. On average they are less impressive than those who are trained in the US. This is a simple calculation of competition. They also have no production incentives so they generally see half as many people per hour as I do.
If you federally fund medical schools 100% you may see this dynamic change but not much. I am considered in the top 1% of academic acheivement and I certainly want to leverage that into the best income for myself and my family, who wouldn't.
Would you choose the lesser paying, harder working job? As it is I work in one of the hardest working specialties primarily because it pays better. Sure, I love my patients, I love the application of scientific knowledge to relieve human suffering, but I would sure like better pay and less work, who wouldnt.
You want studies, but I will tell you from my experience with evidence based medicine, studies on these subjects are useless because of population bias. The truth will be seen only after we impliment a system.
Yes insurance companies gouge by thier very nature. They are generally unregulated, but the cost of a trial is not a statement of insurance company charges but money paid to attorneys. My statement was not a judgement about the validity of medical malpractice suits, only that if you think the government is going to fund the current system you are mistaken.
You really have no clue what drives research do you. Basic science research is mostly academically driven but applicable pharmaceutical research just like automotive research is driven by marketability. The amount of money spent by pharmaceutical companies is almost double that of the NIH. http://www.cbo.gov/ftpdocs/76xx/doc7615/10-02-DrugR-D.pdf
Currently medicare pays about 50% of the cost of a visit, and Medicaid about 10%. So guess who pays the rest. You do, your cost is higher to make up for the inadequacy of the federal funding. Why do you think it costs 5x as much for the same physician time in an ER than in an Urgent care, and thats just the physician billing. We utilize board certified ER physicians in our Urgent care and ER and pay is almost the same but the cost to the patient in the Urgent care is 1/5 that in the ER when you compare equal services, equal physician time and equal accuity.
Remember I am pro-UHC, I just want the government to come up with a plan that funds the entire system not just the financing of the system at the expense of providing good health care. The last thing I want is to be told that I cant do the test I need or use the best drug because of cost.
The implimentation of any UHC will have broad reaching implications and can only be achieved successfully if all aspects are included. If the lawyers don't want to do there share then its a no win, if the insurance industry is out it will fail. But most of all it cost a certain amount to render care, sure we spend more to administrate it, but the care itself has a cost. If you chose to keep the administration costs the same and cut the direct care funding there will be a decrease in access and quality. You get a better burger if you pay more at a steak house than at burger king, there is just no way around that.
I see a lot of people fretting and worrying about the idea of a universal healthcare system, such as what they have up in Canada.
I ask to you - why is this so bad?
I agree - though I don't consider generics less than 'the best drug'.
A lot of doctors seem obsessed by lawyers. IIRC, that's no more than 2% of healthcare costs - it's not the answer, and 'reform' risks injustice for victims.
What do you mean about the insurance industry? They need to go.
An ill society is less productive and more of a financial burden to that state.Do like your grandparents did and earn it ya dam.... I'm getting sick of all this give me thinking go out and do it! If you need help that is what church and comunitys are for not the dam federal goverment! If you have a problem why the hell should we all pay for it work it out on your own.... rub some dirt on it and grow a dam pair!
State officials are responding sharply to a study that suggests doctors are victims of price-gouging by insurance companies who continue to raise malpractice insurance premiums even as claims decline.
The data in the Annual Statements filed under oath with state insurance departments, which this Report discloses, call into question much of what the medical malpractice insurance industry has been saying publicly during the past several years, said Missouri Attorney General Jay Nixon.
There is no excuse for malpractice insurers doubling their rates while their claims payments decrease.
According to the study, released by the Consumer Federation of America, Public Citizens Congress Watch and U.S. PIRG, medical malpractice insurance rates for doctors have skyrocketed in recent years even though claim payments are down.
The numbers underscore the need for much tougher, more aggressive oversight to prevent and punish profiteering, Connecticut Attorney General Richard Blumenthal said. Federal and state regulators should thoroughly scrutinize recent rate increases and take appropriate corrective action.
Affordable medical malpractice insurance is critical to public health. Expensive insurance rates become a matter of life and death when they drive doctors out of business - as is happening in Connecticut and nationwide. Insurance company greed can be hazardous to our health.
Michigan Office of Financial and Insurance Services Commissioner Linda A. Watters said she was "definitely disturbed" by the numbers in the report, which offers "evidence that doctors may be paying excessive premiums."
"In the market competition study that we recently issued, we considered loss ratios below 50 percent as patently excessive. If these carriers truly have loss ratios that that are this low and yet they are still increasing rates, one has to wonder if they're gouging, Watters said.
Upon a triage level, how many of those walk-ins require care from a hospital?I just want to give you some news from the front line. I am here at one of our urgent cares it is Sunday and I just saw the 20 th patient since 9 am. These are all walk-ins and we are the only physicians open other than our Er and one other Er for a 50 mile radius.
That's some impressive data you've got there, champ.I have personnally met many physician from other countries. On average they are less impressive than those who are trained in the US
I believe they dont want it because it gives the govt TOO MUCH CONTROL and they have enough already!tydas said:Apparently, many people think that some lazy dude is getting something for free and they are jealous...
Upon a triage level, how many of those walk-ins require care from a hospital?
I just did a quick Google Earth check, and all within a 3km radius from my home in a suburb of a ~350,000 city, I have 5 different business hours drop-in medical clinics to treat qualifying MSP patients (BC residents and generally other provincial or territorial residents who are temporarily not out of their home region for generally more than 24 consecutive months). Such clinics are private entities by partnered GPs who have their indivual regular patient schedule along with rotatational staffing availability for consistent drop in patient visits.
I believe they dont want it because it gives the govt TOO MUCH CONTROL and they have enough already!
I don't think anyone should have to pay taxes on money used for healthcare.
Uhhh....... I think medical stuff is already tax deductible.
The Internal Revenue Service lets you deduct medical costs as long as they are more than 7.5 percent of your adjusted gross income
....
Often-overlooked medical deductions:
Travel expenses to and from medical treatments. The IRS evaluates the standard cents-per-mile allowance each year. For 2010, you can deduct eligible medical travel at 16.5 cents per mile. In 2011, the mileage rate deduction is 19 cents.
Insurance payments from already-taxed income. This includes the cost of long-term care insurance, up to certain limits based on your age.
Uninsured medical treatments, such as an extra pair of eyeglasses or set of contact lenses, false teeth, hearing aids and artificial limbs.
Costs of alcohol- or drug-abuse treatments can be counted on your Schedule A.
Laser vision corrective surgery is a tax-allowable procedure.
Medically necessary costs prescribed by a physician. That means if your doctor told you to add a humidifier to your home's heating and air-condition system to relieve your chronic breathing problems, the device -- and additional electricity costs to operate it -- could be at least partially deductible.
Some medical conference costs. You can count admission and transportation expenses to the conference if it concerns a chronic illness suffered by you, your spouse or a dependent. Meals and lodging costs while at the seminar, however, are not deductible.
Are u sure? I buy private insurance and I was under the impression I couldn't write this off. I would be happy to be wrong about this. Anyone?
I know if you are self employed (scedule C) or have an LLC you can deduct it. I'm not sure if your employer doesnt offer insurance, you may not be able to deduct it.