US "broken" healthcare

Discussion in 'Budget & Taxes' started by Ivan_sintikov, Aug 17, 2017.

  1. Ivan_sintikov

    Ivan_sintikov Newly Registered

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    I am really impressed by the US political system that made so creative, Laissez-faire oriented economy as a whole. A lot of industries were developed faster and better then in Europe en masse, and as the result - the productivity of the US economy is enormous.

    However, I wonder why, while there is ongoing angry and disappointment within large political groups and population about US healthcare system, there seems to be no "effective" solution for that?

    Instead of that, complicated and defunct laws (eg "Obamacare", medicaid, etc) increasing burden on productivity with taxes are enacted.

    Why very efficient, productive and creative market economy does not fix the issues for the large population groups?

    If the prices of healthcare services are too high so a lot of people can not afford them, then there must be people earning a lot on the other side - mostly doctors I believe, but also insurers, medical administrators, etc. That mean, that there is enormous shortage of these people in economy. If that is the case (and I definitely see this is the case, physicians and surgeons are making healthy 6-figures), a lot of people see that, and pursue doctor's (or administrator's) careers to earn that much money, and market correct itself.

    However, let us stop here: we do not see doctors buying mansions and ferrari's with first paychek, at least en masse. Why? There are two main reasons IMO.

    1) Healthcare education is very expensive. People take huge study loans for protracted study and then repay them with their huge paycheck.

    However, if that education is unreasonably expensive (and I believe it is) - why there are no huge amount of new universities, taping in this very lucrative business?

    May be (and I believe it is!) - the main reason here is that it is too difficult to obtain all sort of government permissions for healthcare education business, and all sort of "associations" of healthcare education are too restrictive and abusing their oligopoly for charging high prices for healthcare degrees?

    That's the number 1 problem IMO.

    2) If US doctor's salaries are too high in comparison to other countries' (and they really are, 2-4 times higher than in prosperous Canada/Western Europe with universal healthcare systems, 10+ times higher than in Eastern Europe/Developing Asia/India) - absent large barriers for migration, market should correct itself and doctors from these countries should relocate to US to earn for a mansion and ferrari.

    It happend economy-wide with engineers, mathematicans, investment bankers, quantitative trading, asset-managers and a lot of other professionals in the past. Eastern europeans, indians and chineese flooded into these industries taping surging demand for these professions, and salaries, initialy unreasonably high - 7- and even 8-th figures salaries for traders are significantly decreased after all the universities started to offer finance-related programms.

    It did not happend for healthcare, however. That may be true, that responsibility of a trader is incomparable to a surgeon (one may only lose billions, while the other one - lives), however, the barriers for acceptance of foreign doctors (from both emerging markets and developed nations) to work in US are incredibly high. It is almost impossible to foreigner doctor from other country to be accepted for US practice.

    That may also be due to some unnecessary restrictive rules damaging the market forces.

    That is the problem 2 IMO.

    3) There are unreasonably huge liability claims in minor chance of doctor's mistake - that can make a doctor/hospital bankrupt, if uninsured. And therefore insurance premium would also be high, for insurer to stay in business.

    However, that situation - a small group of people damaged from doctor's mistake (and paid enormous sums, mostly went for lawyers, however) - is effectively barring affordable healthcare for lots of other people.

    Would not it be much more effective and convinient if people were able to simply "withdraw" their right for liability claim in a low probability case of a mistake (or put a reasonable "cap" on sum), for a significant reduction in healthcare price?
    To say it other way, prospective healthcare client is now effectively enforced to pay for an insurance for an unlikely doctor's mistake case. Would not it benefit everyone if these servies were clearly offered separately and cleints to be free to deciede to purchase them or not?

    And those, that need to feel free to claim any uncapped amount in case of doctor's mistake - pay the full price, including doctor's insurance?

    That's the problem number 3 IMO.

    To sum up:
    Problem 1: Barriers to entry in healthcare education business
    Problem 2: Barriers to entry for foreign healthcare specialists in US
    Problem 3: Separation of healthcare services and liability insurance protection for customer

    What do you think on these three issues?
     
  2. tkolter

    tkolter Well-Known Member

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    Well salaries are high due to education being expensive, malpractice insurance and they want to make a good income being highly educated.

    As for the second one I'm all for opening the health care profession if education and experience match doctors in the USA, that would limit them to largely peer nations, but would open up the profession to foreign doctors.

    And what about cost controls of medical drugs and devices and procedures in the USA to some Federal standard adjusted for inflation.
     
  3. Old Man Fred

    Old Man Fred Well-Known Member

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    My plumbing license is reciprocated in all 50 states, Canada, Australia, and Ireland. Obviously they have to have a dire need abroad for my work permit to be approved, but for the past 10 years I've had an open invitation to move to Australia or Canada. Why the **** can't they figure that out for doctors?
     
  4. CourtJester

    CourtJester Well-Known Member

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    Here in Florida we have doctors from all over the world so that is clearly an imaginary issue.
     
  5. Diuretic

    Diuretic Well-Known Member

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    In the US healthcare is a commodity. In much of the rest of the modernised world, it is a service.
     
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  6. Old Man Fred

    Old Man Fred Well-Known Member

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    Most STEM graduates in the United States are foreign students, and just because most doctors are immigrants in your area doesn't mean they were doctors when they came here.
     
  7. Jimmy79

    Jimmy79 Banned

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    My understanding is that foreign trained doctors need to start residency and board testing all over again here.
     
  8. Old Man Fred

    Old Man Fred Well-Known Member

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    Standards are always regionalized-the plumbing code in California is drastically different than Arizona or Michigan, and I would assume that the health conditions prevalent in the US are vastly different from those in India, Africa, or Europe. America's problem is that a burdensome artificial barrier has been put in place for doctors, to the point that many "doctors" you interact with are no actual doctors.
     
  9. Jimmy79

    Jimmy79 Banned

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    Nurse practitioner does basicly all of the primary scheduled care in the US. The practice I use only has 2 doctors, but more than a dozen NPs. You only see the doctor for some thing out of the ordinary.
     
  10. Lil Mike

    Lil Mike Well-Known Member

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    You made quiet a few high quality observations and comments about the US healthcare system, so I first want to thank you for that, because they are not common on this forum.

    There is a barrier issue to the number of physicians licensed to practice each year. Physicians can't be licensed until they complete a residency. So even if you graduate from Medical school, until you complete your residency you can't be licensed to practice, so this causes a backlog of doctors waiting for residencies to open up. Most residencies are funded by the federal government (I think capped at about 100,000 a year?) and the AMA has a lot of political pull, and have no interest in increasing the number of residencies. So the solution to that issue is for the federal government to either fund more residencies per year, or for states to fund more.

    The liability issue is a major one as well but that actually seems to solving itself. More and more states have passed some form of limited liability, particularly for non monetary damages. But it will take at least a generation for that to make any difference in malpractice insurance rates and expensive "defensive medicine" practices.
     
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  11. Old Man Fred

    Old Man Fred Well-Known Member

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    My father in law is the last of Canada's "Frontier Doctors", and I call him for everything because he's one of a handful of individuals in the world who is a medical expert in, well everything. He's a surgeon, a pediatrician, an anesthesiologist, a gynecologist, and a general practitioner, and has spent the last decade of his career fighting for the right to set a broken bone and deliver a baby in the wilderness of British Columbia.

    The only problem that America has is that when I was in high school I got laughed at because I was the only one out of 800 students who actually knew what the **** they wanted to do with their lives, and everyone else was preoccupied with "whatever makes a lot of money".
     
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  12. Deckel

    Deckel Well-Known Member Past Donor

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    I think it was in the mid 80's (or was it 90's?) when they decided the US would have too many doctors so they made it harder to become one--specifically the government restricted the number of residencies it would fund through medicare.
     
  13. CourtJester

    CourtJester Well-Known Member

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    Your understanding is incorrect.
     
  14. Jimmy79

    Jimmy79 Banned

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    How so?
     
  15. CourtJester

    CourtJester Well-Known Member

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    Look up your states requirements. I can't do all the work for you.
     
  16. Ndividual

    Ndividual Well-Known Member

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    Costly yes, broken no.
     
  17. Ned Lud

    Ned Lud Banned

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    Rich countries tend to hire doctors trained at vast (comparative) expense by very poor ones - who cares if the poor die? Humans are so made that they either do a job because they care for others or because they want lots of money to show off what shits they are, I suppose. The life of current GPs in the UK is so drear that they deserve to be well paid, and surgeons sploshing around amongst the smelly old blood and guts deserve respect as well as money. The situation in the 'States, however, is ludicrous - to pay twice as much as anyone else for a crappy service that doesn't even cover everyone really is grotesque, and results from its sick notion of what human life is about. When I was young a communist friend of my father's wanted me to become a doctor. 'It would take me a lot longer', said I. 'since I've not studied science'. 'So what', replied he, ' - we need doctors who can read and write!' He'd been a theology student himslef till he ceased to believe in it, and he had a huge, very poor, practice amongst Rhondda miners. When the NHS started and he would have been rich, he immediately made off to a small practice in the Swansea Valley. When I read about American doctors I try very hard to remember him, and all the decent people in Africa, Cuba and so on. I don't think we can really discuss medicine divorced from standards of decency, can we? Or are Americans different?
     
    Last edited: Sep 1, 2017
  18. Old Man Fred

    Old Man Fred Well-Known Member

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    Did you shoot that commie?
     
  19. Ned Lud

    Ned Lud Banned

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    We live in a democracy over here, and seldom shoot the most admirable people in our communities or anyone else, though we'd chuck a racist Nazi in the river. It was thick black with coal dust and would suit your heart.
     
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  20. Old Man Fred

    Old Man Fred Well-Known Member

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    So you live in a democracy that admires those who support mass murder, genocide, and above all serfdom, and doesn't have any environmental regulations?
     
  21. Ned Lud

    Ned Lud Banned

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    No kid - you do. What that person supported was the rights of the miners to the results of their own labours and the end of the Hitler-loving scumbags who ran the UK's control of the mines. You know nothing whatever about the past - you are just a stupid , brainwashed crud. I was arguing with communists, child, when you were lynching 'black' boys in your merry American way. Think on!
     
  22. CourtJester

    CourtJester Well-Known Member

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    Except that they were. When I had my surgeries in India my doctor was trained in India and was very, very dedicated to his profession. A really decent good human being. He had eight doctors that worked under him all of whom were caring good people. Three were going to leave India to practice in America. I can only hope that their genuine caring for their patients wasn't crushed by the American system of medicine.
     
    Last edited: Sep 7, 2017

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