But more government jobs in county morgues... paradox...
But more government jobs in county morgues... paradox...And it creates jobs for street cleaners as well.
I take no side, trying to ask a honest question. I read an article a while back about healthcare cost per head around the world, I remember US is head and shoulder above everyone else like $9k ish per head. All other are in the $4-6k range. Why is it so expensive in US? If US can get it down to average range isn't it solve all the issues?
Doctors and procedures charges are through the roof as are prescription drug prices. You couldn't get an American doctor to accept the wages paid in other countries. The AMA keeping the numbers of doctors low to keep prices up, Cost of college, Hospital administration, there's just so many before you even get to the insurance companies.I take no side, trying to ask a honest question. I read an article a while back about healthcare cost per head around the world, I remember US is head and shoulder above everyone else like $9k ish per head. All other are in the $4-6k range. Why is it so expensive in US? If US can get it down to average range isn't it solve all the issues?
It will be interesting to see how the states react, especially the blue states that will be getting the most tax cuts from AHCA. They could just raise their state taxes on capital gains on high earners to capture that tax cut, but their taxpayers will get an additional federal income tax deduction for state taxes paid, and since the ACA tax targeted the highest earners, effectively they would be multiplying the overall state benefit benefit vs the federal government by a factor of 1.3+.
I personally would rather my tax money go to CA to cover Californians, and get a big deduction from the Feds, than having it go to cover Trump supporters who keep insulting us San Francisco area folks. Effectively, after federal deduction, I would be paying 2.5% instead of 3.8%, but my state would be getting the full 3.8% in revenue.
Doctors and procedures charges are through the roof as are prescription drug prices. You couldn't get an American doctor to accept the wages paid in other countries. The AMA keeping the numbers of doctors low to keep prices up, Cost of college, Hospital administration, there's just so many before you even get to the insurance companies.
By a 3-to-1 margin, the American public holds a negative view of the American Health Care Act, legislation that House Republicans passed last month and that President Donald Trump supports.
Just 16 percent of adults believe that House health care bill is a good idea, versus 48 percent who say it’s a bad idea.
There's not one state that has a 50% favorable opinionOooh and it's soooo popular:
http://www.nbcnews.com/politics/fir...lmingly-disapproves-house-health-care-n775491
Even only 34% of REPUBLICANS like it.
Silly primary care doctors, if they were smarter, they could have been subspecialists.I wouldn't say the AMA is playing a part in the issue at all. The AMA is a dying organization, 50 years ago it was the closest thing to being a guild. Today, their membership numbers have dwindled, representing probably around 15% of all practicing physicians. Many of the membership numbers reported by the AMA is buoyed by free/discounted membership they provide to medical students and medical trainees. Most physicians are flocking to the organizations that represent their specialty (like the American Academy of Pediatrics), and those organizations are also better advocates for patients/physicians than the AMA ever was.
Further, I would say the physician shortage is more related to inherent issues with the medical system rather than a bottleneck of entrance of physicians into the system. Around 17 new medical schools have been opened within the past decade, and many schools are expanding class sizes. In addition, the US openly recruits medical graduates from around the world to fill spots not taken by US trainees. Why does this happen? Reimbursement. Physicians in primary care receive substantially less than their peers. It is rather draconian, but when the medical system was maturing, the physicians decided that 30 minutes operating on someone is worth substantially more than spending 30 minutes in preventive care to avert a heart surgery. This doesn't mean that 30 minutes should be the same reimbursement for all specialties, but the payments given to preventive care is depressing. This is why you'll hear about the shortage of primary care doctors, but never orthopedic surgeons. Many medical school graduates avoid certain specialties specifically because of the reimbursement issues.
Oooh and it's soooo popular:
http://www.nbcnews.com/politics/fir...lmingly-disapproves-house-health-care-n775491
Even only 34% of REPUBLICANS like it.
That is true to a degree. There is a preference to not do primary care because the reimbursement/salary is terrible compared to other fields and the work structure (clinic all day with non-stop patients and non-stop notes) is brutal. Most people think your doctor sees just them and like 2 other patients in one day. The reality is your doctor in clinic in almost any field sees probably 25-35 people per clinic day day and generates at minimum a 2-3 page document for every patient seen. Non-stop back to back to back with a 1 hour break for lunch. That's not even accounting for how primary care/general internal medicine often deals with problems that are essentially incurable and in good portion require the person to take control of the situation which often they do not (smoking, obesity, substance abuse, depression to a degree, etc) or the sheer amount of coordinating or other administrative things they have to do.I wouldn't say the AMA is playing a part in the issue at all. The AMA is a dying organization, 50 years ago it was the closest thing to being a guild. Today, their membership numbers have dwindled, representing probably around 15% of all practicing physicians. Many of the membership numbers reported by the AMA is buoyed by free/discounted membership they provide to medical students and medical trainees. Most physicians are flocking to the organizations that represent their specialty (like the American Academy of Pediatrics), and those organizations are also better advocates for patients/physicians than the AMA ever was.
Further, I would say the physician shortage is more related to inherent issues with the medical system rather than a bottleneck of entrance of physicians into the system. Around 17 new medical schools have been opened within the past decade, and many schools are expanding class sizes. In addition, the US openly recruits medical graduates from around the world to fill spots not taken by US trainees. Why does this happen? Reimbursement. Physicians in primary care receive substantially less than their peers. It is rather draconian, but when the medical system was maturing, the physicians decided that 30 minutes operating on someone is worth substantially more than spending 30 minutes in preventive care to avert a heart surgery. This doesn't mean that 30 minutes should be the same reimbursement for all specialties, but the payments given to preventive care is depressing. This is why you'll hear about the shortage of primary care doctors, but never orthopedic surgeons. Many medical school graduates avoid certain specialties specifically because of the reimbursement issues.
The Annals published an article last year that concluded that for every one hour of face to face clinical care, ambulatory physicians (they observed FM/IM/Cardio/Ortho) spent two hours doing EHR/paperwork. Think about just how insane that is.That is true to a degree. There is a preference to not do primary care because the reimbursement/salary is terrible compared to other fields and the work structure (clinic all day with non-stop patients and non-stop notes) is brutal. Most people think your doctor sees just them and like 2 other patients in one day. The reality is your doctor in clinic in almost any field sees probably 25-35 people per clinic day day and generates at minimum a 2-3 page document for every patient seen. Non-stop back to back to back with a 1 hour break for lunch. That's not even accounting for how primary care/general internal medicine often deals with problems that are essentially incurable and in good portion require the person to take control of the situation which often they do not (smoking, obesity, substance abuse, depression to a degree, etc) or the sheer amount of coordinating or other administrative things they have to do.
However the flip side is that popular subspecialties have very hard training caps in terms of numbers. An internal medicine training program can have 40 to 60 new doctors per year with generally about 1/2 doing primary care or general internal medicine, and family medicine can have 12-20 depending on the program as well with all doing primary care. Orthopedics training programs on the flip side are more in range of 2-5 depending on the place and even then some get siphoned off to do very advanced orthopedics rather than just general stuff.
Overall certainly we could use more primary care, but I think the NP/PA market for primary care is perfectly acceptable as well for low risk patients and if there was a significant reduction in the sheer amount of paperwork and administrative duties that physicians have to do in clinic you'd probably see less burnout and more recruitment into the field The paperwork is absolutely insane.
What you do is repeal ACA outright and force some democrats to the table. Obstruction is support for ACA.
What I want and what is likely to happen aren't likely to happen. If the GOP want to get this done with Democratic support this seems to be the only way to get them to the negotiating table. Right now it is stonewall all the way. When there is nothing in place they may be more willing to negotiate.To the table. To do what? You've never said what follows. What an actual replacement or health care plan / policy would look like.
So you're a healthy man in his thirties without insurance and you get into a car accident, or get diagnosed with a devastating illness, charity does not step up. What next? You can't pay. Do you get care or not?What I want and what is likely to happen aren't likely to happen. If the GOP want to get this done with Democratic support this seems to be the only way to get them to the negotiating table. Right now it is stonewall all the way. When there is nothing in place they may be more willing to negotiate.
The stupid thing is that everybody is mad at them.
What I want is as close to a free market system as possible. If you're a man in his thirties with good health, why would you buy insurance if you can buy it when and if you get sick? No forced coverage for pre-existing conditions at normal rates but more protections so you can't get dropped when you change jobs or other things happen. If you're paying into insurance for years you shouldn't have to reapply. If you get sick and you don't have health insurance and haven't had it for years then its going to hurt. Bad decisions should carry bad results or more bad decisions are going to be made. This is where charity could come in, when there are needs people do step up to the plate to help.
I want government, as much as possible, out of health care. If you're poor and can't afford health services then we can figure something out. Incentivize free clinics for poor people, promote private giving to these clinics via ad campaigns paid for by the government.
Healthcare cost is the real problem, not who gets "coverage" or not.
Believe that is a could be out today. Don't think it's set in stone that today will be the day. Think it's more hopefulness.PSA: just heard the CBO score should be out today
What I want and what is likely to happen aren't likely to happen. If the GOP want to get this done with Democratic support this seems to be the only way to get them to the negotiating table. Right now it is stonewall all the way. When there is nothing in place they may be more willing to negotiate.
The stupid thing is that everybody is mad at them.
What I want is as close to a free market system as possible. If you're a man in his thirties with good health, why would you buy insurance if you can buy it when and if you get sick? No forced coverage for pre-existing conditions at normal rates but more protections so you can't get dropped when you change jobs or other things happen. If you're paying into insurance for years you shouldn't have to reapply. If you get sick and you don't have health insurance and haven't had it for years then its going to hurt. Bad decisions should carry bad results or more bad decisions are going to be made. This is where charity could come in, when there are needs people do step up to the plate to help.
I want government, as much as possible, out of health care. If you're poor and can't afford health services then we can figure something out. Incentivize free clinics for poor people, promote private giving to these clinics via ad campaigns paid for by the government.
Healthcare cost is the real problem, not who gets "coverage" or not.
Repubs have no intention of compromise with Dems because they have the power to do what they want anyway. The rest of what you offer is just pablum & misdirection.