For those who think Bush is the problem...read.

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Originally Posted by Dylan H

Bob, why exactly do you think that villages with populations of only 100 or so don't have doctors any more? Because it isn't profitable enough for those doctors to only treat populations so small perhaps?

Running healthcare with profit as the only motive results in exactly the situation you describe.

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It is for THAT reason I believe Canada went to universal care...because large parts of the sparsely populated west didn't have doctors..or enough of them. I get the point of a partial move towards public care. I am not 100% sure public healthcare to some point in the US isn't bad idea. I have swung quite a bit on that...BUT..and this is the KEY point. Nothing they passed this year will really do much to help that. The US gov't makes Canada's government look efficient on how it funds healthcare.

I wouldn't trust the Feds or the US States to not muck it up to be honest...

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Originally Posted by Bob Riebe

If you see it from that aspect then the problem runs far deeper than profit medical care. The only thing that has inflated near the same rate as doctor costs is education; therefore the Feds. must step in an reduce the wages in the educational institutes so the people running the colleges do not make millions whilst the teachers make tens of thousands; ESPECIALLY in medical schools.

With reduced educational costs the doctors will not have to charge so much to pay for their education, and of course the government, the same one that sat around scratching is ass and picking its nose as ITS rules destroyed Fannie and Freddie, will use its error free pixie dust to bring their smooth running train to education.
NO more private or state colleges everyone can go to the wonderful Fed. institutions.
Of course, the same Feds. who forced this state run law on its citizens are exempt by law from having to use said same system; whereas they are also the same people who voted THEMSELVES a pay raise during an economy THEY said was near as bad as the Great Depression.

BRILLIANT!

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As I said in my above post, Maybe some form of public healthcare for the USA isnt a bad idea..but Bob's post here really explains why no one trust's the current part of power in the US AT ALL on healthcare. The people in Congress exempt themselves from the programs they are ramming down the public's throat. Whenever a politician does that...you have to know it is bad news.

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Originally Posted by Eki

Why's that? I don't think so. The taxes are just to cover the costs, not to make the shareholders and doctors rich. Salaries for example are lower in the public healthcare, as far as I know.

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They are? The Doctors salaries are less, but in Canada, nurses and practical nurses make 20 to 35 % more working for the public system, rather than in doctor's offices, or nursing homes run by private corporations.

What is more, the public sector unions that are staff in the hospitals usually have the workers there also making above the private sector average for the same job. I worked in the hospital kitchen here for two summers as a porter. Unskilled labour just taking meals up to the floors. I was paid per hour about 30% more than I made for the next 3 years in my real job when I got out of school.

For Profit healthcare providers and health insurance companies do some things very well.

A good system would have elements of both..but not sure how I would make it all work....

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Originally Posted by Eki

Because for example cancer treatments can cost much more than an ordinary person can afford. There are also other expensive treatments not affordable to most people.

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So no one has ever payed for cancer treatment without government "help"? Interesting.

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Originally Posted by Eki

Do you think they'd decide to become for example teachers when they still make at least twice as much as teachers? If there aren't high paying jobs for doctors, they'll take what they can get as long as the deal is good enough to stay working as a doctor.

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Many will retire early. Then we'll have a worse doctor shortage than we do now. How will that effect quality of care?

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Originally Posted by Dylan H

Chuck, salaries have very little to do with the quality of doctors in any system. In just about any country in the world the number of doctors is limited by one factor only, the ability of the country to train sufficient numbers.

If anything if you cut the salaries of doctors in the US you may get rid of a substantial number of the unpleasant types who forget that they are treating people and only pursue financial renumeration. As Fousto has inadvertently pointed out you'll still get enough doctors, just ones who are motivated by factors other than money.

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We already have a doctor shortage. If you take away the incentive for many of them (money), do you really think that they'll continue to devote years of schooling just to come out of school with massive debt they can never pay off? It's not the salary that effects the quality of care. It's the shortage that we have and may be worsened by this that will cause the drop in quality of care.

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Originally Posted by Dylan H

Bob, why exactly do you think that villages with populations of only 100 or so don't have doctors any more? Because it isn't profitable enough for those doctors to only treat populations so small perhaps?

Running healthcare with profit as the only motive results in exactly the situation you describe.

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So how do you think this will change the profit motive? Sure the government isn't concerned with profit, but they do still have to worry about costs. It still may not be cost effective to have a doctor in a town of 100, especially with less docs.

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Originally Posted by fousto

Chuck would take Tie dye because he is beyond help.

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I think perhaps you have me confused with someone else?

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Originally Posted by chuck34

So no one has ever payed for cancer treatment without government "help"? Interesting.

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I guess it depends on the cancer and the treatment. For example here is a limit of how many hospital nights one has to pay and those that go over the limit are free. Also prescription drugs that you buy are partly compensated and tax deductible.

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Originally Posted by anthonyvop

Really?

Hypothetical: You need some delicate, advanced medical treatment.
Would you prefer having;

A. A doctor who earns top dollar at John Hopkins or the Mayo Clinic

or

B. Dr. Tie-dye from the "People's Clinic Co-op" in East L.A.

Don't bother answering....we both know the truth.

Salaries have a great deal to do with quality of work. There are exceptions but they are very, very rare.

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Firstly I was talking about salaries not affecting recruitment INTO the field, not recruitment WITHIN, but you raise a good point that often is not clear to laymen.

I've worked in both kinds of institution long enough to know that working in a big-name institution is no guarantee of staff quality.

I would want to be treated by the doctor with the best clinical acumen in my field or the surgeon with the best skills and least complication rates. I suspect that is what you would be looking for too.

Going to John Hopkins or its equivalent is all well and good but who do they recruit? The best clinicians or the guys with the most impressive paper CV? People are too easily impressed by the title 'Prof' while forgetting that clinical skills are often far removed from academic prowess, just as in most other practical fields. I have through my career come across 'Profs' who command immense respect from non-doctors who are truly appalling in their clinical care. You also forget that big name institutions often specifically attract academics rather than hands-on clinicians because of the volume of research they do. Some of the best doctors I have ever had the pleasure of working with are at 'no-name' institutions where they get to do hands on straight forwards clinical work