Thread: A Health Care Scenario

No, I haven't been to Spain. But I have been to the US (for a couple of years now) And I have lived in Norway.
And getting sick is a lot more scary over here.
The reason I went off like this is some stupid idiot radiohost that I heard last week who claimed that in Scandinavia (wich Norway is a part of) they use eutanasi on patients that the government feel is too costly to treat.
I get mad when people say that kind of things about my country!

Originally Posted by flyboy

Here is the WHO (world health organization) ranking of the health care in different countries:
1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba
40 Brunei

For some reason it seems like the countries that have the "four year" education (it is six-six and a half in Norway) scores all over higher than the "six years plus a bunch of stuff before and after" system.
Is there really any need for a MD to make 500.000 a year? So what if they just made 150.000? It is not like thay would have to take the bus to work anyway.. And would it really hurt them to step down from driving a Porche to a Lexus?
Health care is three times as expensive in the US as in other countries with similar income. The ironic part is that the countries with similar income most likely scores higher on quality of health care.
Don't get me wrong, I love the US, but this entire health care debate has ****ed me off a bit lately: of course it is ok to debate wether or not ot is good for the US to get universal health care, but why is it such a big thing to talk so much about how bad it is in Europe, when it really works a lot better?

You should travel to Dominica and you would realize how stupid this listing is. The european nations ahead of us, sure. Cuba? Colombia? Chile? Are you joking? Besides I think we should all move there since it seem the WHO says that these are the best places to be. I vote that all Americans who are able should move to Europe and all the other said countries. Let me know when everyone is going because for all of its faults, I have lived elsewhere and traveled and I would rather live here than anywhere else. The airports have planes leaving everyday. it will be lonely, but there is a lot of land here and I'll go to farming since there wont be any creditors to pay or bills for that matter.I mean I like the jungle and and cocaine fields and Dominica is as modern as it gets (I have been there, its awful unless you are a tourist). If you think docs should make less than bankers then perhaps they should quit and let the bankers die. $500K may seem like lot, but compared to what others have made with far less sacrifice and accrued with greed, I think they deserve it. If you disagree great, the US is a democracy and your vote and opinion is equal to mine.
However, its all opinion. I prefer to keep this friendly. I hope responses are geared to only the scenario.
Best Regards,

it is not my list, it is WHO's

Originally Posted by treydampier

You should travel to Dominica and you would realize how stupid this listing is. The european nations ahead of us, sure. Cuba? Colombia? Chile? Are you joking? Besides I think we should all move there since it seem the WHO says that these are the best places to be. I vote that all Americans who are able should move to Europe and all the other said countries. Let me know when everyone is going because for all of its faults, I have lived elsewhere and traveled and I would rather live here than anywhere else. The airports have planes leaving everyday. it will be lonely, but there is a lot of land here and I'll go to farming since there wont be any creditors to pay or bills for that matter.I mean I like the jungle and and cocaine fields and Dominica is as modern as it gets (I have been there, its awful unless you are a tourist). If you think docs should make less than bankers then perhaps they should quit and let the bankers die. $500K may seem like lot, but compared to what others have made with far less sacrifice and accrued with greed, I think they deserve it. If you disagree great, the US is a democracy and your vote and opinion is equal to mine.
However, its all opinion. I prefer to keep this friendly. I hope responses are geared to only the scenario.
Best Regards,

I'm not trying to say that health care system here in EU would be better than you have there in the USA, but i've understood that people with no money have no much changes to get medical aid except in the urgent cases.

My late great uncle lived in Florida from 1946 to 2004. At least from the late sixties i remeber as he flew back here almost every year to get his medical and dental checks because it was so much cheaper here, as he said. I didn't understand it back then and still doesn't get the sense.

I think if that if the WHO made the same list with the exception that it would cover only people with money then USA would be nr 1. If it would cover those without health insurance or money then, well, i can't say.

Regards,
Tomi

Originally Posted by honedright

You are contradicting yourself.

Really? Your assertion is false. If you disagree the burden of proof is on you, since you were the one to make it (hint: logic operations come in handy).

Here's a good reference:

Originally Posted by merriam-webster

Main Entry: con·tra·dic·tion
Pronunciation: \ˌkän-trə-ˈdik-shən\
Function: noun
Date: 14th century
1 : act or an instance of contradicting
2 a : a proposition, statement, or phrase that asserts or implies both the truth and falsity of something b : a statement or phrase whose parts contradict each other
3 a : logical incongruity b : a situation in which inherent factors, actions, or propositions are inconsistent or contrary to one another

Originally Posted by gugi

Really? Your assertion is false. If you disagree the burden of proof is on you, since you were the one to make it (hint: logic operations come in handy).

"people are irresponsbile" (an absolute)

"people like responsibility only when it refers to others"

Irresponsible people like responsibility? When it refers to other's (people) who are irresponsible?

Either contradicting, confusing, or both.

Originally Posted by honedright

Irresponsible people like responsibility?

Uhm that's not what I wrote. Would you find the same construction but with different quality equally contradictory?

"people are stingy"
"people like others to be generous, just not themselves"

I didn't think my second statement was that confusing, rephrasing it would be 'many people like only others to be responsible, while they remain irresponsible themselves'.

To prove the alleged contradiction you will have to establish a relation between the two statements, for example that 'irresponsible people don't like anybody to be responsible, perhaps they are irresponsible just because they don't believe in responsibility as a principle'.
Otherwise these are two independent statements because they describe completely different things,
(1) one's preference how they act themselves (2) one's preference how others act.
And yes, my observations are that people are inconsistent, so (1) and (2) don't need to be correlated, or in other words 'do to others as you want them to do to you' is a matter of conscious choice and not a universal law, like gravity for example.

Originally Posted by treydampier

Suppose Tom leaves high school and decides to go play baseball at a private university because he has an academic and athletic partial scholarship. Four years later he graduates with honors and has acquired roughly $20K in debt for a 100K education (I'd say thats a good deal). Then he decides to go to medical school and works up $250K in debt. Lets even go so far and say he wants to be a surgeon with 5 years of training where the interest on his loan of which only $100K is in low interest (<3%) and he ends up finishing his training with roughly $310K in debt.

So he decides to be a true doctor (Interesting concept. A true doctor? Not a false one?) and work in a rural setting where docs are needed. In his first year he bills $150K in unpaid medicaid and medicare fees and private insurance. He then does over $300K in indigent (immigrant, uninsured or otherwise) work for which he receives nothing.
Now, he works hard and has billed over $1,000,000 in revenue in his first year. By the time he pays his taxes for his business, his personnel, his malpractice, his rent, office costs, and everything else he makes a grand $150K form which he has to pay a mortgage, taxes, and school loans.(There is no guarantee that just because someone chooses a career as a medical doctor, financial success will follow.)


Why is it fair that the doctor goes to school and training for 13 years after high school and has to work for the government (Don't work for the government. Run a cash only practice and be happy that you are helping people. Accept what you are given and live accordingly. Or, choose a different profession.)

Why is it wrong for the doctor to expect payment just like the plumber gets paid when he is called, or the electrician, or better yet your mortgage company? (It's not wrong. Only those who are trying to get something for nothing would think so.)

I want to know why a student feels like its ok not to have health coverage when schools provide options for it (they have too legally at all ages) and then complains about the bills when they get sick? (Some people, especially the young, have been conditioned to complain and whine. Not surprising in an age of "victimization.")

When did the US people start thinking everything should be free, (Probably about the time of the Roosevelt admin in the 30's) and if healthcare everywhere else is better, why don't the people who don't want to work or pay their bills or healthcare leave to other countries with free healthcare? (That should be a big clue. Health care is not better elsewhere - just the statistics.)

I think docs everywhere, especially the pediatricians who get screwed, should make at least $500K/year.(Why? You earn what you earn.)

I think the hospitals should be able to deny care to illegal aliens unless they agree to pay something (even if its a quarter). Why not demand responsibility. (Exactly. It's certainly demanded of responsible citizens.)

Why not let docs set a fee schedule and require insurance to pay for it, or else be unable to cover health? (If you choose to be a subscriber, or panel doctor, you accept what the insurer is contracting for reimbursement. You don't like their schedule, go elsewhere. Or, cash practice. Ask why you went into the healing profession - to heal, or make money?)

Why can a doctor not tell a CEO of an insurer that he demands everything he has in order to treat his disease since the insurance companies have been making billions and yet their pay scales have continued to decrease the past 10 years? (For the same reason you don't want someone from another profession coming into your office telling you how to run your business regardless of your financial successes.)

I got angry after seeing a 23 year old recent college grad say he shouldn't have to buy health insurance and yet he shouldn't have to pay for healthcare either. (They're really both the same. There are some with very childish minds waiting for the adults to pay the bills.) Is this really the road the US is headed? (Currently it is. But I believe common sense will prevail and the nonsense will stop.) The scenario above is an example of a friend of mine who just finished a surgical residency and now works in rural Mississippi.
I want responses both for and against because although I am not and Obama fan (Good, that means you have the ability to think for yourself.) he at least told the companies owing TARP money that they couldn't pay out obscene bonuses. (By what authority???)

Cheers!

Ok I'll make an attempt to bring that back on topic.

Originally Posted by treydampier

In his first year he bills $150K in unpaid medicaid and medicare fees and private insurance. He then does over $300K in indigent (immigrant, uninsured or otherwise) work for which he receives nothing.
Now, he works hard and has billed over $1,000,000 in revenue in his first year. By the time he pays his taxes for his business, his personnel, his malpractice, his rent, office costs, and everything else he makes a grand $150K form which he has to pay a mortgage, taxes, and school loans.

So, you are saying these are the correct numbers and you think at the end of the day your friend made too little money.
From what I can see the biggest problem is the unpaid services. I don't have much to say why he didn't get his $150000 from the government. From what others have posted the government is a lot more prompt than the private insurers. I guess his option would be to not accept medicare and medicaid in the future. I do not think doctors are obliged to accept any insurance plan.
On the other $300000 I am a bit confused from your wording, but it seems to me that that's treating uninsured patients. It would seem to me that there are two ways to address that (1) don't treat them (that may be illegal), or provide the bare minimum and least expensive treatment, or (2) support the attempts to reduce or even eliminate the number of uninsured (but even if that happens if their insurer won't pay for the services it doesn't really solve the problem).

I most certainly agree with honedright that financial success is not guaranteed for anybody and I don't understand how you come up with the random numbers of who needs to make what.

Originally Posted by treydampier

I think the hospitals should be able to deny care to illegal aliens unless they agree to pay something (even if its a quarter). Why not demand responsibility.

My question to you is why do you limit your demands to illegal aliens only? If you want to solve the problem of your friend you should demand everybody who gets served pay, no matter where they were born or what their legal status is. Separating people based on whether they are legal or illegal residents has absolutely nothing to do with the issue at hand. Being robbed by an american citizen may make you feel better than being robbed by a foreigner, but it won't make you richer.

Finally I think that your proposition that doctors be allowed to perform whatever they think is necessary and bill whatever they want is completely insane.

The reality is that the available resources are limited and the problem is optimization. The mechanism of competition by opposing interests is one way to work towards an optimal solution but that doesn't guarantee finding a very good solution either. Obviously it's all even more complicated by the fact that everybody has their own measure of what is 'better' based on their own priorities. You seem to think that the huge medical expenses in US are worth the advances in cutting edge medicine, even though these advances benefit a miniscule fraction of people. Others feel that countries like Cuba are better who do not have this advances, but do much better job at providing more standard care to more people.

Avoid hazards of medical treatment abroad - CNN.com

"Western Europe and some of the other countries like Australia, New Zealand, Canada, Japan, for example, all provide services that are reasonably comparable to U.S. standards," said Dr. Gary Brunette, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention's Travelers' Health Team

Reasonably comparable to U.S. standards. Reasonably comparable?? - that's good to know. But aren't those other industrialized countries supposed to be better??? Reasonably comparable - ha!