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      08-16-2011, 03:33 PM   #23
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I make this one point. The way the our system is set up with student loans, etc. Most docs tend to have school related debt well into their 30's.
Wouldn't it be easier to fix this root problem with the spiraling cost of medical education, than to have to endure ever-ballooning, spiraling healthcare costs in an attempt to handle the problem much later?

Having healthcare costs cover the problem of spiraling med school costs is like coming up with an expensive advanced solution to save millions of children from the brink of death due to late stages of Scurvy, instead of just making sure kids got enough vitamin C, so they never got Scurvy in the first place.
Higher education like universities and colleges shouldn't be socialized. I don't think people should have a right to college nor do I think health care should be a right. When those things become rights so will things like cars and houses. Obamacare actually does have a rule in it that takes your ability to get a student loan from a private bank. So now you have to go through the government if you want to get a loan to pay for college.
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      08-16-2011, 03:40 PM   #24
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Wouldn't it be easier to fix this root problem with the spiraling cost of medical education, than to have to endure ever-ballooning, spiraling healthcare costs in an attempt to handle the problem much later?

Having healthcare costs cover the problem of spiraling med school costs is like coming up with an expensive advanced solution to save millions of children from the brink of death due to late stages of Scurvy, instead of just making sure kids got enough vitamin C, so they never got Scurvy in the first place.
Couldn't agree with you more. It isn't just med school costs, it is the cost of higher education in general.

The example of Vitamin C and Scurvy can also be applied to how we currently handle our medical problems in this country. We are throwing good money away by not focusing more on preventative medicine instead of simply trying to cover everyone in the country. It is hard to argue against the idea that everyone should have coverage. But the cost of our healthcare is in direct relation to how people abuse their bodies and don't take care of small problems before they become big ones.
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      08-16-2011, 03:43 PM   #25
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Originally Posted by AngelinIsRich08 View Post
Higher education like universities and colleges shouldn't be socialized. I don't think people should have a right to college nor do I think health care should be a right. When those things become rights so will things like cars and houses. Obamacare actually does have a rule in it that takes your ability to get a student loan from a private bank. So now you have to go through the government if you want to get a loan to pay for college.
Private Banks never lent their own money as part of the program that was ended. The Banks were given GOVERNMENT money to loan out to students, and then they skimmed profits off of the top for themselves. It was another example of Private Banks who were Privatizing Profits, while Socializing Losses back to us taxpayers.

It cracks me up when you guys rail on about "Socialism", and in the same breath defend private businesses being handed gov't money to fund their private profits.

And it didn't end Private banks lending their OWN money. It just ended private banks from taking GOVERNMENT money and lending it to students. If you want a private student loan backed by private bank money, nothing is stopping you. Here is just a tiny sample of pages and pages of private student loan programs you can get:

http://www.usbank.com/student-lendin...VendorID=r4334
http://www.chasestudentloans.com/
https://www.wellsfargo.com/student/

I can see this is going to be yet another one of these threads where you post one factually incorrect post after another, with a dozen people having to correct your errors. Don't you ever get tired of being proven factually incorrect enough to take two seconds to fact check ANYTHING you blather?

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      08-16-2011, 03:47 PM   #26
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Couldn't agree with you more. It isn't just med school costs, it is the cost of higher education in general.

The example of Vitamin C and Scurvy can also be applied to how we currently handle our medical problems in this country. We are throwing good money away by not focusing more on preventative medicine instead of simply trying to cover everyone in the country. It is hard to argue against the idea that everyone should have coverage. But the cost of our healthcare is in direct relation to how people abuse their bodies and don't take care of small problems before they become big ones.


Historically, I think every rational politician on both sides have all tried to address that exact issue. Even if they disagree with how to get there.

I'm afraid that has now been completely lost in the conversation in the shadow of Obamacare being passed. Now all the talk about healthcare is blind to that goal, and is all wrapped up in crys of "Socialism" and the like.
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      08-16-2011, 04:34 PM   #27
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Historically, I think every rational politician on both sides have all tried to address that exact issue. Even if they disagree with how to get there.

I'm afraid that has now been completely lost in the conversation in the shadow of Obamacare being passed. Now all the talk about healthcare is blind to that goal, and is all wrapped up in crys of "Socialism" and the like.
I always think about the example of AIDS/HIV. It is much more profitable for drug companies to treat these patients than it is to cure them. It is such a horrible thing to even think about.

There was a short period of time when both sides talked about preventative medicine. But it is such a complex problem to tackle. It is infinitely simpler to just say, "We will just pay for your medical coverage."

The number of companies incorporating "Wellness Plans" is growing day by day. It has been shown to decrease the amount of money that they have to spend on their employees health benefits. It comes with an initial investment. But it pays dividends in the long run. I am not directly saying we should run this country like a business. But, we could certainly learn from what many of these companies are doing. As long as it is optional, it appeases everyone. No one should be forced to eat a certain way or go to the gym. But when people are given a no cost option, studies have shown they take advantage of the opportunity. Certainly a step in the right direction.
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      08-16-2011, 05:14 PM   #28
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I always think about the example of AIDS/HIV. It is much more profitable for drug companies to treat these patients than it is to cure them. It is such a horrible thing to even think about.

There was a short period of time when both sides talked about preventative medicine. But it is such a complex problem to tackle. It is infinitely simpler to just say, "We will just pay for your medical coverage."

The number of companies incorporating "Wellness Plans" is growing day by day. It has been shown to decrease the amount of money that they have to spend on their employees health benefits. It comes with an initial investment. But it pays dividends in the long run. I am not directly saying we should run this country like a business. But, we could certainly learn from what many of these companies are doing. As long as it is optional, it appeases everyone. No one should be forced to eat a certain way or go to the gym. But when people are given a no cost option, studies have shown they take advantage of the opportunity. Certainly a step in the right direction.
It doesn't even need to be a "no cost option".

Even a "low cost option" where people pay as much as they can afford towards their total health care premiums would be good. Many people who have no healthcare right now (and get all their healthcare for free in hospitals as emergencies thanks to Richard Nixon) would be happy to PAY to get preventative healthcare if they could afford it.

Tell people they can get something valuable at a 50% discount, and people will line up to pay for it. In the end we will pay less for their emergency care, and they will contribute more towards their own healthcare expenses. We all win.
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      08-16-2011, 06:53 PM   #29
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So you're saying Doctors don't really care to provide good health care unless they are paid top dollar?
Yes. Altruism is valued, but let's face it: doctors are not in medicine to be paid peanuts. The reason that our medical institutions (hospitals, research centers, etc.) are so highly valued and ranked in the world is due to the talent that we attract. That talent is due to a combination of government funding, strong patent laws (you can profit off your innovations), and relatively high pay for medical professionals.

Medicine cannot be practiced according to a script or a set of explicit guidelines, contrary to public opinion. It is an art form that requires a combination of investigative skills, large pool of scientific/medical knowledge, and experience.

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Originally Posted by 11Series View Post
Wouldn't it be easier to fix this root problem with the spiraling cost of medical education, than to have to endure ever-ballooning, spiraling healthcare costs in an attempt to handle the problem much later?

Having healthcare costs cover the problem of spiraling med school costs is like coming up with an expensive advanced solution to save millions of children from the brink of death due to late stages of Scurvy, instead of just making sure kids got enough vitamin C, so they never got Scurvy in the first place.
You're right, except that the spiraling cost of medical education is NOT a root cause of healthcare costs. A simple analysis of healthcare costs indicates that physician pay accounts for ~20% or less of the total increase in healthcare costs per year. If you cut physician pay 10-20% (and I realize you didn't advocate this, but it's a common argument out there in the public today), guess what happens? You hardly make a dent in healthcare expenditures (2-4% of the total cost).

And in doing so, you decrease physician reimbursements on average by $15-30k per year. This has very significant implications on hiring physicians in the future, and continuing to attract the best and brightest to the field of medicine.

Medical education costs do need to be controlled, but not at the expense of physician reimbursement. And we need to tailor it accordingly. We need to subsidize fields like family practice and OB-GYN, which fewer and fewer American medical graduates choose today. Tort reform needs to take place as well, as it is contributing to the decline of Obstetricians/Gynecologists and their practices.


PS - I still owe you a reply in the other thread on the debt ceiling. I've been rather busy lately, but I'll jump in when I get a chance.
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      08-16-2011, 06:57 PM   #30
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It will have to be amended to add back the public option. Fixed.
I am strongly against this, and I will tell you why. A public option will INEVITABLY lead to a completely socialized medical system.

As long as you have a public option that is available to all citizens, you put private insurers out of business. No private corporation can compete with the United States government, for obvious reasons; they cannot be bailed out, but the government fund can.

I really think people need to take a closer look at health savings accounts. Take a look at the Singapore healthcare system, and how effective it has been at providing national healthcare; everyone has healthcare, but it is privatized, and costs are controlled by empowering the customer (patient) as the payer.

And just so it's clear, I don't think we can completely privatize our healthcare system, either. There absolutely HAS to be a social healthcare net, to ensure that the disadvantaged/needy/poor have access to affordable healthcare. I just disagree with how monstrously large our current government healthcare schemes have become, to encompass such a large proportion of our population.
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      08-16-2011, 07:03 PM   #31
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I always think about the example of AIDS/HIV. It is much more profitable for drug companies to treat these patients than it is to cure them. It is such a horrible thing to even think about.

There was a short period of time when both sides talked about preventative medicine. But it is such a complex problem to tackle. It is infinitely simpler to just say, "We will just pay for your medical coverage."

The number of companies incorporating "Wellness Plans" is growing day by day. It has been shown to decrease the amount of money that they have to spend on their employees health benefits. It comes with an initial investment. But it pays dividends in the long run. I am not directly saying we should run this country like a business. But, we could certainly learn from what many of these companies are doing. As long as it is optional, it appeases everyone. No one should be forced to eat a certain way or go to the gym. But when people are given a no cost option, studies have shown they take advantage of the opportunity. Certainly a step in the right direction.
Call me crazy, but I agree with the bolded. Why not incentivize being healthy??

Subsidize people who participate in marathons. Subsidize gym memberships. Government bonus checks for people who can maintain their BMI or body fat % below a certain level. But before that, do economic feasibility studies to determine which studies have positive externalities exceeding their costs.
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      08-16-2011, 11:45 PM   #32
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As long as you have a public option that is available to all citizens, you put private insurers out of business. No private corporation can compete with the United States government, for obvious reasons; they cannot be bailed out, but the government fund can.
Why would people with perfectly good private insurance provided through their company (and paid in part by their employers) go out of their way to drop their insurance, and pay more (100% of their own premiums) into a gov't plan?

Do you think companies will be able to attract top talent if they stop offering competetive benefits packages, and tell people to take gov't insurance?

Do you think companies will give up their big tax deductions they get to take for offering health insurance plans to their employees?

If private insurance companies can't compete, even with these massive systemic advantages already provided to them, then perhaps private insurance isn't as good as it's been portrayed by health insurance lobbyists.


I think there is a massive problem with people confusing the US health CARE providers (docters, nurses, hospitals, etc) with US health INSURANCE companies. The two are not the same thing at all. The public option would use all the same doctors and nurses and hospitals, it is just the payment system that would change.

To be honest, I'd love to see our entire health INSURANCE system (who have never diagnosed a single patient, or provided a single ounce of health care directly to anyone) be replaced by a German-style private non-profit insurance system. We can have the world's best health CARE results without our current lousy health INSURANCE companies dragging us down like an anchor.
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      08-17-2011, 12:02 AM   #33
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Why would people with perfectly good private insurance provided through their company (and paid in part by their employers) go out of their way to drop their insurance, and pay more (100% of their own premiums) into a gov't plan?

Do you think companies will be able to attract top talent if they stop offering competetive benefits packages, and tell people to take gov't insurance?

Do you think companies will give up their big tax deductions they get to take for offering health insurance plans to their employees?

If private insurance companies can't compete, even with these massive systemic advantages already provided to them, then perhaps private insurance isn't as good as it's been portrayed by health insurance lobbyists.


I think there is a massive problem with people confusing the US health CARE providers (docters, nurses, hospitals, etc) with US health INSURANCE companies. The two are not the same thing at all. The public option would use all the same doctors and nurses and hospitals, it is just the payment system that would change.

To be honest, I'd love to see our entire health INSURANCE system (who have never diagnosed a single patient, or provided a single ounce of health care directly to anyone) be replaced by a German-style private non-profit insurance system. We can have the world's best health CARE results without our current lousy health INSURANCE companies dragging us down like an anchor.
1.) Private companies are ALREADY dropping health insurance coverage. You would have to mandate that private corporations be required to provide all employees with healthcare. In which case, they would likely choose the government insurance program, which is cheaper.

2.) Private insurance companies can't compete because they don't have the same leverage as the United States government. Think of it this way: who has more leverage, an insurer with 5 million subcribers, or the government insurance system with 60, 80, or 100 million subscribers? Government insurance programs have more leverage over hospitals, physicians, and pharmaceutical corporations, and thus are able to negotiate better rates and deals. Eventually, this would drive private insurers out of the market.

I am no lover of our current hodge-podge HMO/private insurance market, but a single payer system is even worse. When you have a single payer, all competition is eliminated; the government has the leverage to set prices, and you end up with an inherently inefficient system with overcrowding and misallocation of resources. Many western countries are realizing this; look at the physician shortages, unavailability of care, and expenses of the National Health Service (UK) as an example.

I also like the idea of non-profit insurance schemes. As long as they are 100% private, and there are enough to foster competition, AND each insurance scheme provides access to as many physicians as possible, I am fine with this. Germany's system, if implemented correctly, could be successful here.

But I wish someone would just grasp and run with the health savings accounts scheme. It's such a brilliant solution that plays to both liberals and conservatives: universal coverage and a largely private system.

From wikipedia:

"Singapore has a universal healthcare system where government ensures affordability, largely through compulsory savings ...while the private sector provides most care. Overall spending on healthcare amounts to only 3% of annual GDP. Of that, 66% comes from private sources.[2] Singapore currently has the lowest infant mortality rate in the world (equaled only by Iceland) and among the highest life expectancies from birth, according to the World Health Organization.[3] Singapore has "one of the most successful healthcare systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes," according to an analysis by global consulting firm Watson Wyatt.[4] Singapore's system uses a combination of compulsory savings from payroll deductions (funded by both employers and workers) a nationalized catastrophic health insurance plan, and government subsidies, as well as "actively regulating the supply and prices of healthcare services in the country" to keep costs in check; the specific features have been described as potentially a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programs.[4]"

Bolded are the concerns with such a system, however.

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      08-17-2011, 12:03 AM   #34
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A simple analysis of healthcare costs indicates that physician pay accounts for ~20% or less of the total increase in healthcare costs per year.
Labor costs are pretty common to be somewhere between 20-35% of any business's expenses. It would be crazy to imply that any company could ignore labor costs and be successful.


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And in doing so, you decrease physician reimbursements on average by $15-30k per year. This has very significant implications on hiring physicians in the future, and continuing to attract the best and brightest to the field of medicine.
We are NOT attracting the "best and brightest" into the field of medicine to become doctors. We are attracting the wealthy and the priviledged who can shoulder massive education bills to become doctors, to the exclusion of many of the "best and brightest" who simply cannot afford to become a doctor.

If we can take a big chunk out of medical school debt, so that becoming a Doctor isn't such a financial roll of the dice, then we can REALLY attract the "best and brightest".
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      08-17-2011, 12:21 AM   #35
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Labor costs are pretty common to be somewhere between 20-35% of any business's expenses. It would be crazy to imply that any company could ignore labor costs and be successful.


True, I'll concede this. But just like any human capital-intensive business, labor is a critical factor in the medical field. Thus, changing labor prices will have a significant effect on productivity.


We are NOT attracting the "best and brightest" into the field of medicine to become doctors. We are attracting the wealthy and the priviledged who can shoulder massive education bills to become doctors, to the exclusion of many of the "best and brightest" who simply cannot afford to become a doctor.

If we can take a big chunk out of medical school debt, so that becoming a Doctor isn't such a financial roll of the dice, then we can REALLY attract the "best and brightest".

Seriously? There are a million reasons to illustrate why we ARE attracting the best and the brightest. Average standardized scores, accomplishments prior to medical school entry, GPA, etc. All students who want to go to medical school can, as long as they are willing to live modestly until they pay off their debt burden. Until now, government loan programs were relatively generous, usually covering most if not all the needs of a student. The rest of the expenses can be covered via private loans and scholarships. The military also offers a loan forgiveness program in exchange for X years of service.

Suggesting that all medical students are elitist and wealthy is frankly insulting; I can personally say that the vast majority of my classmates were NOT wealthy, and paid for their education through scholarships and loans.

The issue, that you stated at the end, is the immense debt burden doctors face following graduation, coupled with initially meager training salaries, at such a late stage of their lives. Rising educational costs also add to this. Did you know that we pay thousands of dollars for the PRIVILEGE of taking licensing exams? And all of this before we earn a penny.
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      08-17-2011, 09:40 AM   #36
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Medicare/Medicaid refuses and drops more patients than any other insurance group in America.
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      08-17-2011, 09:46 AM   #37
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I agree completely with pman. Now 11 series, the individual option will inevitably lead to socialized and government run hc because insurance groups will have to take people that are way too expensive. So then costs will skyrocket for the insured and they'll drop out, making the government once again bring back Obama's original plan which has a governmental insurance. That insurance that the government will provide will kill off insurance companies because they'll be unable to compete.
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      08-17-2011, 12:24 PM   #38
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I agree completely with pman. Now 11 series, the individual option will inevitably lead to socialized and government run hc because insurance groups will have to take people that are way too expensive. So then costs will skyrocket for the insured and they'll drop out, making the government once again bring back Obama's original plan which has a governmental insurance. That insurance that the government will provide will kill off insurance companies because they'll be unable to compete.
Fortunately, I don't see a revised plan with the public option coming through the legislature anytime soon.

If Obama loses in '12, though, I hope Republicans take the issue seriously. We can't go back to status quo; reform is DEFINITELY needed, as our system is broken. But we can't nationalize our system, either.

Then again, after seeing the debt debacle, I really have no hope for any solution
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      08-17-2011, 12:47 PM   #39
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I completely agree there needed to be reform, however Obama's hc reform isn't the right thing. 11 series, medical school should be expensive and not subsidized or paid for by the government. You'd get a bunch of people not seriously taking medical school and becoming shitty doctors which can be fatal. Going into medical school is risky and those who go into should know what they're getting into and having costs high will keep out the idiot wanna-be doctors.
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      08-17-2011, 01:30 PM   #40
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Originally Posted by AngelinIsRich08 View Post
I completely agree there needed to be reform, however Obama's hc reform isn't the right thing. 11 series, medical school should be expensive and not subsidized or paid for by the government. You'd get a bunch of people not seriously taking medical school and becoming shitty doctors which can be fatal. Going into medical school is risky and those who go into should know what they're getting into and having costs high will keep out the idiot wanna-be doctors.
i just stumbled on to this thread and just read the 2 pages of "debating". i just had to say...

i wonder if going to medical school was easy as going to junior college or mandatory as going to high school, people would actually go...? and if you cannot graduate, wonder if there will be something like GED just like for those who couldnt get a high school diploma.

but anyhow, people who are for "obamacare" should really consider one fact that bothers me. if all tax payers are presented with equal healthcare, then who is to say who needs more urgent care than the other? who is to say who needs longer or better treatment than the other?

will you the fatal cancer patient take a number and wait in line behind a cyclist with a scrap on his knees just to see a doc?

although healthcare "seems" pretty darn messed up currently but just like everyone says on this forum... "gotta pay to play"

i work for my self and i do not have healthcare. and just like everyone not being able to afford (including my self) HRE and BBS... healthcare is and should be the same way. NOT everyone can afford them, nor should they because thats how things are in the world.

people should know that government issued or hand out is like a slow killing poison, it only belittles the recipients and their abilities. you never hear welfare recipient decreasing... nor hear about unemployment recipients decreasing. may be what people should realize is what if the government runs out of money again? they cant even handle the load now... but to add more? yeah right.

ok well there was my vent.
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      08-17-2011, 02:14 PM   #41
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No, go on Krnboy. Your point that if the government can't even pay their bills right now how can they afford to add to the list 99% of Americans healthcare? See then everyone would be screwed if the government pull a default card again.
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      08-17-2011, 02:21 PM   #42
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i just stumbled on to this thread and just read the 2 pages of "debating". i just had to say...

i wonder if going to medical school was easy as going to junior college or mandatory as going to high school, people would actually go...? and if you cannot graduate, wonder if there will be something like GED just like for those who couldnt get a high school diploma.

There is a reason that there are strict standards for admission and completion of medical degrees. Physicians are empowered with a great deal of responsibility, which requires certain abilities, skills, and knowledge. Without these standards, you risk doing more harm than good in healthcare. Look back at the early 1900's and late 1800's, when any hackjob could become a surgeon. Those are not times I would like to return to.

but anyhow, people who are for "obamacare" should really consider one fact that bothers me. if all tax payers are presented with equal healthcare, then who is to say who needs more urgent care than the other? who is to say who needs longer or better treatment than the other?

will you the fatal cancer patient take a number and wait in line behind a cyclist with a scrap on his knees just to see a doc?

That's not how "obamacare" would work. As you can tell, I am quite strongly against Obama's healthcare bill. Nonetheless, this is just fearmongering. Triaging patients would not disappear simply because the government pays for care. Patients are always treated in order of need; that is rule #1 out of the book. You would likely see more of that, not less, with a government system, as there would be no discrepancy between private and government care. Instead, 'elective care' would be put on the backburner.

although healthcare "seems" pretty darn messed up currently but just like everyone says on this forum... "gotta pay to play"

i work for my self and i do not have healthcare. and just like everyone not being able to afford (including my self) HRE and BBS... healthcare is and should be the same way. NOT everyone can afford them, nor should they because thats how things are in the world.

Totally, 100% agree. Health care is not a right, it's your responsibility. If people are not empowered with taking care of their bodies, they will abuse them and the system. Look at the current obesity and diabetes epidemic in the U.S.; the vast majority of these people are where they are, and will become ill, due to their lifestyle choices. And yet, we are responsible for paying for their past indiscretions.

Until people take responsibility of their own health, we will continue to have an abused system. That's why an incentive system for being healthy is crucial.


nt.
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      08-17-2011, 02:30 PM   #43
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Wow, out of all the comments I have disagreed with you about(which has been many), this one is the most glaring.

You really think we are not attracting the best and brightest in the medical field?...now that is funny...wouldnt the elites and wealthy not be affected by the cost of the education as daddy would pay for it(which does happen in a small % of medical students)???...3/4 of medical students are poor to middle class and work their butt off to get in...their GPA, MCAT scores are better than 90-95% of others...for certain residency prog's(after completing med school) there are 200 applicants for 1 residency spot...you dont think these are the cream of the crop???...even if your father was a well known physician, you are not getting in unless your GPA and MCAT warrants admission...now if you are in a gray area, having connections will prob get you in.

BTW, the so called "poor" make up the majority of med students right now...when the cost of tuition is 30-40K, 90% of applicants are too poor to afford this hence they need many types of loans to make it through med school...and when you finally get your MD degree and you are doing residency, they will pay you a whopping 40-45K now, real good money for somebody with a doctorate degree...



Quote:
Originally Posted by 11Series View Post
Labor costs are pretty common to be somewhere between 20-35% of any business's expenses. It would be crazy to imply that any company could ignore labor costs and be successful.




We are NOT attracting the "best and brightest" into the field of medicine to become doctors. We are attracting the wealthy and the priviledged who can shoulder massive education bills to become doctors, to the exclusion of many of the "best and brightest" who simply cannot afford to become a doctor.

If we can take a big chunk out of medical school debt, so that becoming a Doctor isn't such a financial roll of the dice, then we can REALLY attract the "best and brightest".
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      08-17-2011, 02:37 PM   #44
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Quote:
Originally Posted by AngelinIsRich08 View Post
I completely agree there needed to be reform, however Obama's hc reform isn't the right thing. 11 series, medical school should be expensive and not subsidized or paid for by the government. You'd get a bunch of people not seriously taking medical school and becoming shitty doctors which can be fatal. Going into medical school is risky and those who go into should know what they're getting into and having costs high will keep out the idiot wanna-be doctors.

Wow that was a inane statement...if med school wasnt subsidized chances are your own parents wouldnt have been able to go and you wouldnt be driving a X5M but rather a Honda CRV...if only the wealthy couldnt get into med school based on their ability to pay for school you would get all the lazy dumb people with 3.0-3.5 GPA's taking care of you and you loved ones...are you crazy???

You want that rich guy with a 3.0 GPA and low MCAT score from UC Santa Cruz doing your heart bypass surgery????

BTW, if anyone thinks this goes against what I have been saying about smaller govt it is slightly true but not really...the govt is making an investment into every doctor trained and the doc's pay the govt back trust me...not only the loans but all the Medicaid and Medicare pts they have to see at half of what Blue Cross is paying...trust me, it gets payed back many times over.
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