Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 I'll also add the illegals and the poor go to emergency rooms because that is the only facility actually required to treat them. They can't set appointments to see doctors by office visit. Moreover, there has been an increase in the rendering of traditional MD services through nurse-practitioners. This is wise. Much of the time, people go to ER's for coughs and colds and fevers and flus. No doc. is needed. A nurse-practitioner can see them, check them and presribe an antibiotic. Much of the burden is the failure to deliver efficiently. If people could go to places with less overhead for routine fevers and flus and tummy aches, we might find the cost of rendering (which we so fervently clamor is sky-rocketing) would actually substantially reduce. This is not just about doctors, and there is nothing set in stone that says if people don't get prescribed antibiotics from a person who was schooled for 8 years, the country's health crisis will become worse. Quote Link to comment Share on other sites More sharing options...
LarryC Posted June 9, 2008 Share Posted June 9, 2008 John, TennCare is state Medicaid, which often underpays. And I have heard of satisfaction problems with Medicare (federal) in some Part B regions. Quote Link to comment Share on other sites More sharing options...
Me Loves Khorns Posted June 9, 2008 Share Posted June 9, 2008 In every country where socialized medicine exists, there is not a huge malpractice attorney problem. If we socialize medicine, we should also socialize attorneys. Put them on a salary. Look at the merit of cases, not the monetary value they may bring... Of course, politicians are lawyers, so it will never happen. BTW, I am married to a lawyer, so no, I am not bashing all things that lawyers do. But, you cannot have it both ways... Free health care and willy nilly lawsuits gone wild... Paul Quote Link to comment Share on other sites More sharing options...
Me Loves Khorns Posted June 9, 2008 Share Posted June 9, 2008 And, in my practice, I have the policy that goes like this. If someone comes in and is going to pay cash, I will charge them the amount I would normally get from an average insurance company. But, it helps if the patient asks, would never be offended if someone did... But, we have to charge the insurance companies $2000 to end up gettting $200.00. And, yes the system is screwed up, but doctors, although we do well, are not the ones rolling in the millions... Would be cool if we did, could line me up some Palladiums for the bedroom, hall, kitchen, den, etc... Paul Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 MLK (hmmm, interesting initials): Anyway, I know you are aware there is a big difference between a person's "need" for legal services and the person's "need" for health care. Actually, if you look at the comment you made about doctors "rolling in the millions" and studied the wealth and income distribution in America, you'd find that hardly anybody is "rolling in the millions." My point is that doctors are way, way up on the totem pole. An income of $174,000 a year puts you in the top 5% of Americans. I don't know where $300,000-$350,000 a year would put you, but I bet it would be within the top 2%. Not making millions means very little when you look at where you fit in. Nonetheless, the point I am making is not so I can show how doctors make so much money and we need to bring them down. I am for making money. My point is that doctors are nowhere clsoe to struggling compared to the rest of America. The only struggle they have is to live a "doctor's lifestyle." http://www.census.gov/hhes/www/income/histinc/h01ar.html Quote Link to comment Share on other sites More sharing options...
Me Loves Khorns Posted June 9, 2008 Share Posted June 9, 2008 Sure, I don't complain about my income, I do quite well and all. But, I work my a$$ off to do so. Late nights, weekends, etc. Personally, if I had it to do over again, would probably do something different. Would very likely have gone to law school, as attorneys too make quite a comftorable living. I certainly don't feel like the system is perfect. And, truthfully, if a universal system were in place, it would bring more patients in who at least have some type of funding. Could make up for it in numbers of people seen. But, would have to add some malpractice protection into the equation. I know this is a very touchy subject, easy to get upset with it. And, to play devil's advocate. If healthcare is a right, or should be free, should water and food also be free. Need those 2 things much more than healthcare... I don't know the answer to all of this, don't think the politicians in Washington know what the heck they are doing either... Neither candidate has to worry about such things, they just like to hear themselves pontificate on this and that. Get in office, mess things up a bit, run again on some grandiose platform. And, that goes for both parties. Paul Quote Link to comment Share on other sites More sharing options...
Duke Spinner Posted June 9, 2008 Share Posted June 9, 2008 hmmmnnnn .. just researching Ferndale census data .. and .. I see we share the same Latitude, MD ..[] too bad the climate aint near the same ...[] Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 That's funny. If I had a "do-over," I'd probably have gone to med-school. Actually, a veterinarian possibly. Anyway, the grass is always greener, ain't it? My take is that you (the rhetorical "you" as in everyone who can) will be happier not feeling they "have" to work their a$$es off to sustain a living. Minimizing debt and living well within one's means makes for a much easier lifestyle. No mortgage, no credit card debt, no car debt. These make for much less stress. It was challenging getting there, though. You know, we had to forego 60" plasma TV's, regular vacations, replacing beaten-down furniture, hiring contractors to do remodeling that I could do myself, and the like. It was a tough life. I even smoked generic cigarettes, for God's sake! Quote Link to comment Share on other sites More sharing options...
oscarsear Posted June 9, 2008 Share Posted June 9, 2008 National systems in other countries have been in place for quite some time. They were set-up and are designed to meet the needs of their entire populations. And some of them have enormous costs associated with them. France, in particular, has a birth to grave system that uses a sizable portion of their GNP. Canada has an interesting aspect to its system. They make little use of nurse practitioners or P.A.s requiring M.D.s to see most patients. That contributes greatly to their delays. As I mentioned we can examine these other existing systems and work to develop ours in ways that do meet the needs of people, avoids lengthy service delays and keeps the cost somewhat in line. I would also mention that our own population could help itself a lot by living healthier lifestyles. If we adopt a national system I would hope that preventative measures are incorporated into it. For example we currently place sin taxes on high health risk items like tobacco and alcohol. But that money is sparingly applied to the healthcare costs it is based upon. All such taxes need to be used pay for the care they were supposedly collected for. Another component not usually considered is how will we sustain advancing medicine. Some of our current research is funded by federal grants, etc. But a lot is also funded by the medical industry and fielding any new product requires a significant investment. This is done now in hopes of reaping profits from the work but if the profits become limited that incentive is diminished. All of this industry in in-place and is also part of this countries investment scheme. How do we convert from what we currently have to something else without upsetting the financial markets? Do we nationalize Pfizer and buy out its investors? Healthcare is a huge entity and it is intermingled in our lives in ways that are not always obvious. Tug on one side of it and something will shift elsewhere. My favorite suggestion is to make working in healthcare a tax free career. It is dirty, dangerous and very stressful work and that would be one big incentive to keep an adequate workforce in place without having to actually boost wages. Consider changing a dirty diaper on a child and translate that into an incontinent adult. Most people won't even care for their own aging parents but expect that someone else will. Healthcare is not a pretty career. Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 Agreed in some respects. However, on the issue of pharma, I would hope that if the national gov't bothered getting into it, they'd scrap all the BS. That industry rolls out so much crap into the marketplace, it is almost sickening. There are basics, and then, there's Cialis and all sorts of new drugs that do the same old thing but are just pawned off as the "new thing" because of patent protection issues. New anti-anxiety drugs, new sleeping drugs, drugs for ADHD, and on and on and on..... Just how many different types of drugs are needed in the marketplace to make a person sleep or feel less pain? Vicodin works against pain, and so does Morphine. Yet, I'd bet there must be 50 different kinds. Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 It is a very interesting thing to note that a person whose household income is $250k is in the top 2%. These are not the big bucks CEO types one would imagine. Quote Link to comment Share on other sites More sharing options...
tigerwoodKhorns Posted June 9, 2008 Share Posted June 9, 2008 That's funny. If I had a "do-over," I'd probably have gone to med-school. Actually, a veterinarian possibly. Anyway, the grass is always greener, ain't it? My take is that you (the rhetorical "you" as in everyone who can) will be happier not feeling they "have" to work their a$$es off to sustain a living. Minimizing debt and living well within one's means makes for a much easier lifestyle. No mortgage, no credit card debt, no car debt. These make for much less stress. It was challenging getting there, though. You know, we had to forego 60" plasma TV's, regular vacations, replacing beaten-down furniture, hiring contractors to do remodeling that I could do myself, and the like. It was a tough life. I even smoked generic cigarettes, for God's sake! Yea but "no medical insurance" apparently makes for much more stress. Sorry, I couldn't resist. [6] Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 That's funny. If I had a "do-over," I'd probably have gone to med-school. Actually, a veterinarian possibly. Anyway, the grass is always greener, ain't it? My take is that you (the rhetorical "you" as in everyone who can) will be happier not feeling they "have" to work their a$$es off to sustain a living. Minimizing debt and living well within one's means makes for a much easier lifestyle. No mortgage, no credit card debt, no car debt. These make for much less stress. It was challenging getting there, though. You know, we had to forego 60" plasma TV's, regular vacations, replacing beaten-down furniture, hiring contractors to do remodeling that I could do myself, and the like. It was a tough life. I even smoked generic cigarettes, for God's sake! Yea but "no medical insurance" apparently makes for much more stress. Sorry, I couldn't resist. Chris, that was beautiful! [] You dog, you! I do need to sign up before I have the big one. Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 Yes, I am aware of that statistic, too. Interestingly enough, a person could traverse faster through the wealth strata than the income strata. As to the "voo-dooism" of socialism, I think much has to do with the "cold war" era most of us are old enough to remember living through. Anything relating to a step closer to Russia's way of life was a threat. Quote Link to comment Share on other sites More sharing options...
Me Loves Khorns Posted June 9, 2008 Share Posted June 9, 2008 At least it was free...[] Paul Quote Link to comment Share on other sites More sharing options...
sputnik Posted June 9, 2008 Share Posted June 9, 2008 That's funny. If I had a "do-over," I'd probably have gone to med-school. Actually, a veterinarian possibly. Anyway, the grass is always greener, ain't it? My take is that you (the rhetorical "you" as in everyone who can) will be happier not feeling they "have" to work their a$$es off to sustain a living. Minimizing debt and living well within one's means makes for a much easier lifestyle. No mortgage, no credit card debt, no car debt. These make for much less stress. It was challenging getting there, though. You know, we had to forego 60" plasma TV's, regular vacations, replacing beaten-down furniture, hiring contractors to do remodeling that I could do myself, and the like. It was a tough life. I even smoked generic cigarettes, for God's sake! Yea but "no medical insurance" apparently makes for much more stress. Sorry, I couldn't resist. Chris, that was beautiful! You dog, you! I do need to sign up before I have the big one. This is a topic that has been near and dear to my heart over the past 8 months. Within a matter of a few seconds last fall, I sustained injuries in a motorcycle wreck that resulted in medical bills having a "face value" of over $300,000 (the actual pay out has been less than half of that) and I'm still a long way from a full recovery. Jeff, I don't know what your finanacial situation but, either way, that's a lot of money to some people. <begin preaching> Get yourself insured, the "big one" can happen any time. I never realized how hard it would be to take care of everything including myself while I was recovering . For several months, I was so doped up that I was in no condition to work or scutinize any medical bills or take care of myself. Luckily, I had good insurance and I own my own company so I didn't take a huge financial hit. <end preaching> Looking at the EOBs, I had the same concerns about how much I would've paid had I not been insured. My condition, at first, was touch and go and the surgeons saved my life in the initial operation so I'm not going to quibble at all about their billing (it would've been worth any price.) But, at some point during my hospital stay I got a MRSA infection that required three more surgeries and some pretty expensive antibiotic treatment. Again, all of this was covered by insurance and I'm very grateful to the docs that got me through this phase but I can't help thinking that maybe the hospital shouldn't have charged for this since the infection was contracted while I was under their care. I know complications happen and one can get MRSA just about anywhere but in a case like this, should the hospital charge for services that have resulted from an exposure in their own facility? If a mechanic fixed my car but then dented it during a test drive, they would repair it free of charge. Doctors and lawyers, what do you think? Quote Link to comment Share on other sites More sharing options...
oscarsear Posted June 9, 2008 Share Posted June 9, 2008 sputnik.... Nosocomial infections can occur when everyone is doing their utmost to prevent them or they can occur if the proper procedures are not followed. That hospital has an epidemiologist that is responsible for the protocols covering infection control. They teach and they test. They conduct sample testing of various parts of the hospital and the staff looking for these organisms and they have to keep records by law (they are inspected by JCHO). If there is proof that they had a MRSA outbreak that was out of control when you were infected you might be able to claim some sort of negligence. It is a stretch. Hospitals are where sick people are and sick people (meaning you too) are more susceptible to getting opportunistic infections. Sorry to hear about your accident. Ratty business that. Makes you appreciate life a whole lot more doesn't it? Quote Link to comment Share on other sites More sharing options...
merkin Posted June 9, 2008 Share Posted June 9, 2008 How about socialized attorneys, housing, food, media and all education also. (Not to mention sports) Wait that would be Russia! Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 Sputnik, your example makes me glad to hear you preach to me about buying insurance. I think I will. I've won the odds so far, but there comes a time.... For some good news, radiology's bill for the x-rays was only $38.00. Now, that's what I'm talkin' about! [] Waiting for a response from the doc's people on my offer to pay $111.97 to match the pay for medicare on the one where I was gouged..... Quote Link to comment Share on other sites More sharing options...
Jeff Matthews Posted June 9, 2008 Author Share Posted June 9, 2008 How about socialized attorneys, housing, food, media and all education also. (Not to mention sports) Wait that would be Russia! Don't forget socialized pet food, veterinarian services, stereo equipment and vacations. [:S] I hate it when people can afford things I can't. [N] [:'(] Quote Link to comment Share on other sites More sharing options...
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