Those without it need help, obviously. The most important considerations are:

1) What are the drawbacks to the single-payer system (aside from "KEEP THE GUBMENT FROM OWNIN THE HOSPITALS")?

2) What are the drawbacks to the systems proposed in Cali and Mass requiring everyone to purchase insurance?

2) What has brought about the crisis in the first place? What is unique to this nation about it (ie: what in our system of laws or gov. caused it)?

For me, I think a large step would be lowering property taxes and allowing these small businesses to be able to provide more, but what then is done about the massive cos. who don't have to worry as much about this?

Inquiring minds are pondering this...

1/10/2007 6:22:32 AM

Okay ill respond to each in kind

1) The healthcare system currently is designed to that people purchase the level of insurance they want and can afford. That system leads to corrupt billings, less innovation because medical practices won't do certain things because insurance doesn't pay back enough, and the simple fact that people will begin to use the hospital as a normal doctor. Look at Canada. Sure, everyone has healthcare but have you SEEN their hospitals? Have you see the doc offices? They suck ass compared to the US.

Overall why the fuck would I want to pay for other peoples insurance. I pay for the level I want and the features I want. One system means I don't have that level of choice I want.

2) dunno about this but honestly most people cannot afford insurance. And why should you HAVE to pay for something you don't use. There's lots of people without medical insurance that survive just fine and pay cash when the time comes.

3) There are several steps that need to happen

First, regulate the hell out of the pharmaceudical business. There's no reason that Clariton, a allergy medicine, should cost $10 a box when it costs 58 cents a box to make. (CNN.com last year). The 58 cents includes the FDA charges etc.

Second, set limits on what a typical doctor visit can cost. The reason insurance premiums are so high is because a standard doctor visit costs $200. Most people don't realize this because they have insurance. OH but did you know insurance carriers only pay 50% to 75% of that? Why the hell do we as the public have to pay the full amount then? (this is not in all cases, just standard doctor visits).

Third, there needs to be stronger punishments against doctors offices, insurance companies and individuals that scam the system. Until you make it not worth their while you'll have problems

Fourth, and this is gonna piss off people. I think Welfare should only cover the first 2 kids. You want to have more kids? Fine, get a job. "But I can't afford to feed these kids" Then you shouldn't have had them. "That's not fair!". You're damn straight it's not fair I have to pay for your fat ass to sit at home, it's not fair I have to pay for your 5+ kids, it's not fair that I have to pay because you made bad decisions and fucked up your life.

I don't mean abandon the children but right now it's ridculus. You can live on welfare better than you can on a job that pays $10 an hour because of the insurance you get from the 'gub-ment' and the free stuff you get. Sure you aren't going on any vacations but that's part of the reason we are getting in such of a hole. It's a no win subject and it's either the kids who get hurt or my wallet and there's no real decision here. We need to make it not worth it.

Don't give them money to pay their rent. Have the agency direct deposit to their landlord. The same for their electricity and water. You get food stamps for food. That's it. Make it bare necessities. People will bust their ass to find a job or a better means to survive all the while food is on the table and the bills are paid.

This wouldn't affect the people who TRULY need the welfare system. In truth, and this is the part that'll piss off people. I think women who can't keep their legs shut on welfare should ahve to choose between having their tubes tied or no more welfare. I would not mind paying for that through taxes.

1/10/2007 7:45:35 AM

^ How are wage and price controls going to fix the system? All that is going to do is cause shortages. You need to fix the underlying problems causing prices to rise, not just make it illegal for the price to do so.

We have an incentive problem. The decisions are being made by doctors and patients neither of which is paying for it and both prosper because of it. If you want to make insurance affordable then just legalize HMOs as well as any other insurance structure people want to invent. This will at least put someone in the hospital that is thinking of the cost-benefit analysis. If people still want "pay regardless" insurance then they can pay for it.

Award caps will alleviate much of the insurance costs and help alleviate some of the labor shortage.

And making it easier for people to become doctors would also help alleviate some of the labor shortage.

But it doesn't end there, even the most restrictive HMO still suffers from selection problems. Specifically, people prone to illness are more likely to seek insurance which drives up rates which drives away healthy people until health insurance is so expensive only really unhealthy people will want it, everyone else is self insuring.

1/10/2007 8:50:39 AM

Quote :

"I think Welfare should only cover the first 2 kids. You want to have more kids? Fine, get a job."

While I can agree with the welfare for only 2 kids since I don't want to pay for them to stay home either, the part I'm going to comment on is the part about getting a job if you want more kids. Daycare (while I realize you can get a nanny for a little cheaper) is extremely expensive. I have two kids and my wife has to stay home because she would have to make between $14-$15/hr just to pay for the daycare and not bring home any money. So in order to make it worth our while for her to work, she would have to make close to $25/hr. Now don't get me wrong, both my wife and I want her home to raise the kids, but some people don't want to stay home but yet can't afford basic childcare. However, if these folks happen to have the grandparents nearby that can watch the kids (or someone else to do it for free/really cheap) then yeah, they def need to be out getting some jobs.

1/10/2007 8:51:29 AM

Quote :

"Look at Canada. Sure, everyone has healthcare but have you SEEN their hospitals? Have you see the doc offices? They suck ass compared to the US. "

Not that I'm saying it's the way to go, but this anecdotal evidence can be refuted by my own anecdotal evidence, which says that hospitals I've been to in the British Isles were nice and promp and whatnot. My dad works in Canada a lot and has no problem with them, and he's no fan of the single-payer system. There are plenty of inferior med facilities here as well. My family lived in Johnston Co. and came all the way up to Raleigh for any doctor visits since the facilities were so second rate.

I'm sure the inverse is true in some cases, as well. The major drawbacks I see are possible gov. restrictions on expansion of the system, or loss of important health care jobs.

Requiring anyone to purchase healthcare should only be a possibility if and only if this comes with some sort of tax cut in kind, specifically ones related to income and wages.

[Edited on January 10, 2007 at 2:44 PM. Reason : .]

1/10/2007 2:41:17 PM

Quote :

"What has brought about the crisis in the first place? What is unique to this nation about it "

frivolous lawsuits have a big part in it. We are the most litigious society in the world.

1/10/2007 4:52:04 PM

I think a variety of issues have brought us to where we are today with our medical system. High administrative costs (ie. figuring out who pays for what) consume an insane amount of our spending. The percentage is double compared to other western nations. We've also got other issues as well: frivilous lawsuits, poor preventive care, spiraling drug costs, and a constant push to extend lifespan of sick and terminally ill patients which leads to increased consumption of health care. There's no one magic bullet that will solve all these problems; instead, the system needs a comprehensive shakeup.

1/10/2007 5:28:23 PM

It's an important employer, that's for sure.

Probably the most important in the nation.

1/10/2007 5:36:05 PM

RedGuard, a lot of people talk about frivolous lawsuits, but I have yet to see any evidence that they are a big problem. "But Alex", you say, "what about all those stories on the news about people sewing McDonalds for being fat or because their coffee was too hot or whatever?" Those cases are isolated insidents blown completely out of proportion as far as I can tell. I certainly haven't seen any evidence of this "epidemic" of frivolous law suits that people talk about, and I've seen no proof that they are a drain on our legal system or our healthcare system. Besides, when was the last time you've heard of someone actually winning one of these lawsuits?

Now as far as my opinion on the topic at hand goes, I agree with Raige that we need to regulate pharmaceutical business as well as doctors' offices and hospitals more. I also think socialized medicine like in Canada may be a good idea, but there are pros and cons, so I'm not sure if I'm for or against it.

Pros:
1) Everyone has access to healthcare, and no one has to pay out the ass for copays, premiums, etc.
2) Medical professionals can focus on treating patients instead of making money
Cons:
1) I don't want to go to a doctor's office, much less a hospital or an emergency room that's run like a DMV office
2) Medical facilities may become underfunded like public schools
3) Socialized medicine could create a shortage of doctors, much like our public school system experiences a chronic shortage of teachers

Obviously, it's a complicated issue, so I don't know if I'm for or against it.

1/10/2007 6:35:15 PM

Canada's health care system is really not very good. Go and read up on it. People have to wait months for things like CAT scans. Even though they are technically outlawed, private health care facilities have sprung up recently because of the shortcomings of the State system.

1/10/2007 9:28:35 PM

Of the people who are uninsured, I wonder how many actually can't afford it. It's reported as if every single person who doesn't have it can't afford it. I bet half the people just would rather have digital cable or a nicer car and take the risk of not having health insurance than going without luxury items.

1/10/2007 9:34:57 PM

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_compared#Quality_of_health_care

Life expectancy is longer by 2 years in Canada, fwiw (check the Census Bureau link).

[Edited on January 10, 2007 at 9:37 PM. Reason : .]

1/10/2007 9:36:29 PM

Quote :

"Canada's health care system is really not very good. Go and read up on it. People have to wait months for things like CAT scans. Even though they are technically outlawed, private health care facilities have sprung up recently because of the shortcomings of the State system."

I have read up on it. They have the same wait times as American hospitals for procedures that are necessary. For elective surgeries they have a long wait time, but I am not upset if someone has to wait an extra year for plastic surgery.

They also pay a lot less than we do for their system. Thanks for trying though.

1/10/2007 9:47:20 PM

^^

I wonder how smoking rates between the two countries compare. I'm sure American's mass consumption of fast food doesn't help health rates for the USA either...

[Edited on January 10, 2007 at 9:48 PM. Reason : ^]

1/10/2007 9:47:41 PM

Euthanize people older than 55. That would have the added bonus of taking care of hooksaw.

1/10/2007 9:55:10 PM

^do you really think Canada is that different from the NE United States? Have you been to Canada?

1/10/2007 9:55:26 PM

The simple fact of the matter is that single-payer health care countries, almost without exception, pay less and get more. Canada and Western Europe have a lower expenditure on health care per capita than we do, and they have higher life expectancies, lower infant mortality, and overall better statistics in most categories. Prices of almost everything you buy are inflated by our fucked up system -- or lack thereof.

I'm looking at some Public Policy notes from last spring, and I have "$3,000 of the cost of every new GM car goes to health benefits"

Quote :

"f you want to make insurance affordable then just legalize HMOs"

Brilliant, so you've done what the single-payer plan does in eliminating choice while not noticeably limiting costs! Let's have the worst of both worlds!

Quote :

"And making it easier for people to become doctors would also help alleviate some of the labor shortage."

Uh-huh. I think you'll find yourself in the extreme minority when it comes to being willing to forsake doctor competence.

In response to the thread:

1) People don't like the idea of paying for other people's healthcare, even though that's exactly what they do now. Hospital trips are so expensive, in part, because they need to charge the haves more for when they get stuck treating a have-not. There is also a factor of limiting choice, and, as always, Americans at least act like they hate beauracracy.

2) I'm not intimately familiar with either plan, but unless you're offering some super-cheap version, you still have the problem of people not being able to afford it. Besides that, you still retain all of the problems of private insurance -- the fucked up incentives system, for example.

3) A few things, not least pertaining to a sort of fucked-up national mentality about medicine. We put an enormous emphasis on care for the elderly (once you get to be older than 80 or something, you'll probably live longer than someone the same age in another country, but before that, you probably won't...if that makes sense). We seem largely more focused on treatment than prevention, which leads to people going to emergency rooms and costing a shit ton for what they probably could have avoided by actually seeing and talking frankly with their GP.

We also got good at developing fancy new shit, and Americans eat it up. If they get a choice between a relatively simple, cheap test and an MRI, they'll tend towards the MRI. Partly that's techno-worship, and partly it's the, "Hey, I'm not paying for it, insurance is!" mentality.

We also allow prescription drugs to get substantially more expensive in this country than others do.

Ultimately, though, the roots of the crisis are not distinct from the inherent flaws in private insurance.

1/10/2007 10:55:51 PM

Quote :

"Life expectancy is longer by 2 years in Canada, fwiw (check the Census Bureau link)."

Life expectancy (and fatalities per birth) doesn't take into account demographic differences between the 2 countries.

1/10/2007 11:12:45 PM

Such as what, pretell?

Ultimately, these discrepancies are a bit large to be explained away by, "Oh, well, we eat at McDonalds."

1/10/2007 11:19:52 PM

The air is cleaner for one thing.

1/10/2007 11:57:07 PM

Typically, I'm not a fan of state capitalism/monopolies, but this isn't just any widget, this is people's lives.

If not a national system, i wouldn't mind actually seeing subsidies to companies that provide discount clinic in grocery stores or wal-marts or what have you (we dont have many here that ive seen, but other states have them in most towns), and i dont like subsidies usually. this is just an important issue. i guess i should say that this all came about from my own personal experience last week. a friend w/ no insurance had to seek help, and we almost ended up at a homeless shelter before we discovered the neighborhood clinic at the nearby publix (this was in florida). it was brand new. not so cheap, but still efficient and accessible. i wouldnt mind helping fund those or giving them breaks to hopefully fund the creation of more (and hopefully a drop in prices, of course).

^well, that's another complaint for another day

[Edited on January 11, 2007 at 12:09 AM. Reason : .]

1/11/2007 12:09:03 AM

GrumpyGOP and others, what we have here is what Frederick Hayek predicted way back in the day. When you try to operate a mixed economy the two parts, private and public, will conflict for resources and gradually the whole system will confound each other's correction mechanisms until the system collapses.

So, what is the solution? Well, we need one or the other. Either the system must be private or it must be public, it cannot be both.

Personally, my favorite system involves reforming the system into the style of a public utility. Hospitals, Clinics, ambulance service, everything will be owned by the state (I presume it will be organized along federalist lines) and administered by private contractors.

For example, Wake County will open bids to find a company to administer it's various hospitals along the contracted lines stipulated by the Commissioner of Health. Companies will be free to bid against each other to manage a given hospital, the company with the best compromise between reputation and price wins the right to manage the hospital for 5 years, lets say. This contract between the county and the company will involve everything from fines for incompetence to protection from liability.

In this way we can eliminate many problems while maintaining the resemblance of competition. Private healthcare will, of course, still be legal and should be completely de-regulated, which should be acceptable now that we have state provided healthcare available.

State healthcare will only provide generic medications free of charge, otherwise you must buy your patented medications and treatments from the private healthcare system with your own money (or buy insurance, but very few will). This caveat is to maintain America's incentive structure to develop new drugs and treatments without bankrupting the state aparatus.

1/11/2007 1:08:42 AM

Quote :

"Such as what, pretell? Ultimately, these discrepancies are a bit large to be explained away by, "Oh, well, we eat at McDonalds." "

Such as the fact that there are a lot more blacks in America than in Canada. Blacks have a significantly lower life expectancy than whites.

1/11/2007 1:33:11 AM

^That's because there is a higher rate of poverty in the african american community

1/11/2007 2:02:53 AM

Quote :

"RedGuard, a lot of people talk about frivolous lawsuits, but I have yet to see any evidence that they are a big problem. "But Alex", you say, "what about all those stories on the news about people sewing McDonalds for being fat or because their coffee was too hot or whatever?" Those cases are isolated insidents blown completely out of proportion as far as I can tell. I certainly haven't seen any evidence of this "epidemic" of frivolous law suits that people talk about, and I've seen no proof that they are a drain on our legal system or our healthcare system. Besides, when was the last time you've heard of someone actually winning one of these lawsuits? "

Now, now. I probably shouldn't have used the word frivolous, but the speed at which patients are calling their lawyers over every little thing is a serious issue for the medical system. I disagree with those who say that simple tort reform will solve all our medical woes; from what I see, it's only one of many different issues that create problems for our system.

Yet the lawsuit is a very real issue. The threat of lawsuits are creating real distortions and shortages in the medical field. The cost of malpractice insurance is skyrocketing in part because of the increase in the number of suits filed against doctors; the typical ob-gyn can expect to pay six-figure insurance premiums and be sued at least three times during their career. Certainly there are bad Ob-Gyns that are being rightfully punished, but many times, they've simply become the most convenient target by a frustrated and emotional parents simply because Mother Nature decided to be cruel. There are existing obstetricians who just give up delivering babies all together, creating acute shortages in several states.

Think about it, even if the lawsuit threat is overblown, it is now an engrained terror for nearly every medical student in the system at this time. Why pick an already difficult field like obstetrics, with its lousy hours and difficult work, when you get the added bonus of being the most popular target by every malpractice lawyer in the country?

The threat of lawsuits also pushes doctors into defaulting to more expensive surgeries and techniques just to protect themselves. Since we're talking about obstetricians, there's been a spike in the number of caesarean sections, with one of the largest driving factors being the fear of a lawsuit. The caesarean is a more expensive process with much greater long term risks, yet its becoming more popular by doctors who want to "play it safe" in the immediate future.

Again, I don't see lawsuits as the largest driver by any means: I lean more toward inefficiencies in the medical bureaucracy. Yet to dismiss this issue as merely propaganda by greedy doctors and big business is to ignore a very real issue facing the entire system.

1/11/2007 3:24:19 AM

lets just kill all the elderly

1/11/2007 8:17:30 AM

Quote :

"The air is cleaner for one thing."

The Czech Republic has some of the worst environmental problems on the planet, and its health statistics are better than ours.

1/11/2007 12:54:55 PM

AHAHAHAHAHAHA

DID PRAWNSTAR TRY TO BLAME THE US'S COMPARATIVELY LOWER LIFE EXPECTANCY ON BLACK PEOPLE?

OMG, THAT GUY OUT AND OUT SUCKS AT LIFE.

[Edited on January 11, 2007 at 12:57 PM. Reason : REALLY SUCKS]

1/11/2007 12:56:41 PM

GrumpyGOP:

Quote :

"Uh-huh. I think you'll find yourself in the extreme minority when it comes to being willing to forsake doctor competence"

I know what I am presenting is anecdotal evidence, but still, I know a guy who is a resident in anastheseology (however you spell that) and he says that between college, medical school, and residency, it is nearly impossible in the U.S. to become a doctor before you turn 30. Surely, there's got to be <i>a little</i> wiggle room here.

Oh, and RedGuard, thanks for the info.

[Edited on January 11, 2007 at 1:09 PM. Reason : .]

1/11/2007 1:08:22 PM

Actually Red Guard, medical malpractice lawsuits are not the problem. Studies have been conducted on this and this myth of the frivolous lawsuit has been put to bed time and time again. In reality, there is an under reporting of medical malpractice in this country. I know it is easy to scape goat the trial lawyers, but facts are facts. Here is the Harvard Medical School study on medical malpractice.

http://www.oshmanlaw.com/Harvard-Medical-Practice-Study.pdf

1/11/2007 3:16:26 PM

Hmm, all that study claims to show is that malpractice was rarely reported in 1984. So what? That has nothing to do with lawsuits, not all of which stem from malpractice.

And if you seriously want to think lawsuits are not a major factor in healthcare then try to remember the late 90s when a single lawsuit bankrupted 1/4th of the insurers in North Carolina.

1/11/2007 3:52:39 PM

no, the lawsuits are not bankrupting the insurance companies. The insurance companies playing the stock market and over reporting the amount of money they have is bankrupting the insurance companies. Emperical studies have been showing that medical malpractice lawsuits are accounting for 1% of malpractice insurance costs.

People have been deluded into thinking that lawsuits are the problem and not shoddy hospital care and the insurance companies being irresponsible with the money paid into the system.

1/11/2007 3:56:32 PM

1) Constantly looking to Canada as the shining example of nationalized healthcare is more of a straw-man than an accurate comparison... Theirs is among the least successful attempts at nationalized healthcare, so let's give ourselves a little more credit. Still, they are overall healthier..just less satisfied about it. Instead, read up on France. they pay about half per capita what we do, still have consumer freedom to choose their provider, they can go straight to a specialist (no gatekeepers), same-day appointments aren't hard, doctor's are free to run private practice ...

2) we waste a lot of money on administrative costs. admin. overhead eats up ~17% of the money going into private insurers. Medicare only spends ~2% in this fashion .... a single payor plan would remove a lot of the cost that is generated by the insurance system itself.

3) As GrumpyGOP points out, there are huge expenses in our emphasis on elderly care (1/3 to 1/2 of medicare spending is on treatment in the last 6 months of a person's life) and our greater access and utilization of high-tech diagnostics.

I personally favor nationalized healthcare. that doesn't mean socialized care, where doctors are gov't employees and patients are given limited options. We can still have the freedoms for patients and doctors that we have now (we can also question how free both sides are currently, with the insurance companies and their 'networks' putting different reimbursement/copay rules on who seeks what treatment where).

It makes sense for at least basic healthcare to be national. Health insurance by nature is a way of averaging out risk among many people. it only works because some people pay more in premiums than they take out in care, and that allows others to get more care than they pay for in premiums. This is the sort of the thing the government does very well. We all pay our taxes so it can provide services we all need, like national defense. Insurance isn't some magical money-saver for us to buy when we need healthcare. Try buying insurance when you're already diagnosed with some serious condition - it'll either be excluded, or your premium will be signifantly higher to cover your cost to the system.

We don't need the gov't to cover everything. Preventive care and access to a GP are cost-effective means of maintaining good health for the overall population. more elective stuff can be left in the hands of the free market and private insurance so that you can get that hip replacement quickly if you're willing to pay for it.

as a final comment, the healthcare system already pays for uninsured people in many ways, which is passed on to all of us. one big expense is a reliance on emergency rooms for either primary care that could be provided more economically by a GP, or for real emergency situations that could have been avoided by regular access to care. I haven't provided any sources to back myself up (i apologize - i really tried to look for the links, and i dislike posting stuff undocumented more than you dislike reading it), but i did have this link to an NYT article reporting how some hospitals took it upon themselves to provide free basic care to uninsured people - and the hospitals saved money because these uninsured stopped appearing in the emergency room requiring massive hospital resources. http://www.nytimes.com/2006/10/25/health/25insure.html?ex=1168664400&en=ce1f04692aa4e4be&ei=5070

some will note that a not insignificant number of our nation's ~ 50 million uninsured people are young and healthy ..folks like us, in their twenties, just starting their careers. with illness not even remotely forseeable, it's an unnecessary cost. however, like we pay our social security now when we don't need it so we're covered later, so we should cover our basic healthcare needs.

btw, a good summary of the healthcare system as it stands (along with great citations for further info) : Clemmitt, Marcia. "Rising Health Costs". The CQ Researcher. April 7 2006, vol 16, number 13. ii'd link you, but it's subscription, so use your login to the ncsu library to hunt it down.

1/11/2007 4:03:17 PM

just saw nutcancr's post, which is right on. physician malpractice insurance has been going up because this is the arena insurance companies use to recover their losses from bad investments.

and another note (b/c i just can't help myself) is to remind you that currently about 15% of GDP - that's 1 in 6 dollars produced in the US economy - is spent on healthcare. our current system isn't working. Canada spends 9.6%, France spends 9.7%, UK spends 7.7%.. and given the scale of our economy, for 15% we should be getting more. .. that's all in the CQ article i cited.

1/11/2007 4:09:31 PM

Quote :

"Actually Red Guard, medical malpractice lawsuits are not the problem. Studies have been conducted on this and this myth of the frivolous lawsuit has been put to bed time and time again. In reality, there is an under reporting of medical malpractice in this country. I know it is easy to scape goat the trial lawyers, but facts are facts. Here is the Harvard Medical School study on medical malpractice."

As Loneshark pointed out, this data is nearly twenty years old and only discusses the malpractice rates of doctors. As I mentioned before, I used the word frivolous carelessly, but I still believe that the increasing litigous nature of our society is creating a very real fear among doctors of lawsuits and is allowing insurance companies to drive up their malpractice insurance rates. Even if the actual increase of lawsuits is small and the payments a small fraction of total medical expenses, the perception of their increase among doctors is causing a very real fear among both practicing doctors and medical students and thus creating significant shortages in key areas (and by extension, driving up the cost of care for certain services). Something needs to be done to correct this problem before we have more serious problems down the road.

Also, I again point out that lawsuits are only one small piece of a larger problem. I'm not saying that tort reform is going to magically save our medical system; it's simply one piece in a much larger puzzle. Efforts to reform the medical system need to focus on the way we handle distribution of medical services.

1/11/2007 4:52:15 PM

12 october, 2006

Quote :

"Even if the actual increase of lawsuits is small and the payments a small fraction of total medical expenses, the perception of their increase among doctors is causing a very real fear among both practicing doctors and medical students and thus creating significant shortages in key areas (and by extension, driving up the cost of care for certain services). Something needs to be done to correct this problem before we have more serious problems down the road."

Blame the insurance companies for this, not the trial lawyers or the victims of neglegence.

[Edited on January 11, 2007 at 4:58 PM. Reason : .]

1/11/2007 4:57:42 PM

Quote :

"I know a guy who is a resident in anastheseology (however you spell that) and he says that between college, medical school, and residency, it is nearly impossible in the U.S. to become a doctor before you turn 30. Surely, there's got to be a little wiggle room here."

I'm not so sure. Society is getting the benefit of having these guys while they're in residency, which means the only ones who aren't benefitting are the residents themselves -- they make peanuts at that and can't start raking in the big bucks until they're done with it. So the problem you're describing is really, "It's nearly impossible in the U.S. to make money as a doctor before you turn 30."

Some adjustment could probably be made there. College and med school are obviously necessary, and I think residency is, too -- for one thing, it forces people to work in hospitals and clinics which might otherwise be understaffed, and for another, medicine is one of those things where I would kind of like you to have a lot of practice under watchful supervision before you deal with me on your own.

So: Don't make the process of becoming a doctor shorter or more lenient, just make it more affordable. This is one of those areas where government expenditure would be for the greater benefit of all, I think.

1/11/2007 6:26:07 PM

I'm not going to trust someone who is about the same age as me (20s) to administer my healthcare.

1/11/2007 7:01:32 PM

Quote :

"Personally, my favorite system involves reforming the system into the style of a public utility. Hospitals, Clinics, ambulance service, everything will be owned by the state (I presume it will be organized along federalist lines) and administered by private contractors. For example, Wake County will open bids to find a company to administer it's various hospitals along the contracted lines stipulated by the Commissioner of Health. Companies will be free to bid against each other to manage a given hospital, the company with the best compromise between reputation and price wins the right to manage the hospital for 5 years, lets say. This contract between the county and the company will involve everything from fines for incompetence to protection from liability. In this way we can eliminate many problems while maintaining the resemblance of competition. Private healthcare will, of course, still be legal and should be completely de-regulated, which should be acceptable now that we have state provided healthcare available. State healthcare will only provide generic medications free of charge, otherwise you must buy your patented medications and treatments from the private healthcare system with your own money (or buy insurance, but very few will). This caveat is to maintain America's incentive structure to develop new drugs and treatments without bankrupting the state aparatus."

I actually wouldn't mind any of that. Not a bad plan, actually. I've always thought that this should be a more local issue if anything.

1/12/2007 12:40:12 AM

call me a bastard, but I still don't see how healthcare is a right for people. Clearly, we all want healthcare, and we want to be healthy. But I just don't see why people think that healthcare is a God-given right. As such, I don't see why the government should concern itself with worrying about the "uninsured." I don't like the idea of the government making an industry necessary, such as the car insurance industry. I just don't like it.

At the same time, I do see problems w/ the healthcare industry, namely grossly inflated prices, and I do think the gubment should step in, but only because of the inflated prices. Kind of like it supposedly steps in to fix price fixing and the like. Of course, I don't know what should be done, either

1/13/2007 2:53:25 AM

Yeah I don't want to pay the medical bills that you fatasses accrue by being lazy and stupid.

1/13/2007 3:01:02 AM

Sorry, practicality dictates that you agree to pay for it and then get your elected officials to appoint a commission to determine what will be covered and get that commission to determine that fat-ass related illnesses are not cost effective to cure, in effect, a death-sentence. But if a single-payer system is the price we must pay to have someone make this decision then so be it; the cost of not having it made is too great.

1/13/2007 4:32:48 AM

Quote :

"I'm not so sure. Society is getting the benefit of having these guys while they're in residency, which means the only ones who aren't benefitting are the residents themselves -- they make peanuts at that and can't start raking in the big bucks until they're done with it. So the problem you're describing is really, "It's nearly impossible in the U.S. to make money as a doctor before you turn 30.""

That's not true. Residence and Interns make upwards of 100,000 a year. sure they aren't making the bigger bucks, but in the end they are. coming from a family of physicians, I can asure you that no doctor is starving (you are a doctor once you pass the boards and graduate from med school).

1/13/2007 5:11:03 AM