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

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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.

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I know what American medical students pay for their training and it IS expensive but it is not extortionate. American medical students also do get their moneys worth in general, whilst I'm sure there are exceptions the general level of training is excellent.

I don't think you will see a substantial cost-saving by reforming the costs of medical training, even by removing the profit component completely costs won't be reduced substantially. Training doctors is simply an expensive business.

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Originally Posted by chuck34

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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You raised two points in your posts (I only quoted this one of yours). You suggested that there'd be worse recruitment and worse retention of doctors. On the latter I'd agree but on the former there won't be any effect. In Italy for example the average doctor earns 1/3 their US equivalent but the government doesn't have a cap on training numbers, end result is that they produce too many doctors and have to export them.

Ultimately if there's a shortfall in doctor numbers you can always deregulate the market a little and allow more overseas doctors to come in to plug holes. Given how well paid American doctors are now there'd be plenty of foreign ones willing to work for a relatively lower salary. Problem then is that you're up against some very powerful medical colleges and lobbies.

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Originally Posted by chuck34

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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You're probably right in that catering for every town with a population of 100 people will never be cost effective even for a state-run healthcare system. However there's even less incentive for a healthcare service looking for profit to serve rural communities that Bob described because the population density simply doesn't make it worthwhile, and private healthcare doesn't need to provide a service for any other reason.

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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.

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Here medical studies are free, just like all other university studies. So, I think the doctors owe the taxpayers for paying their education.

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Originally Posted by chuck34

Many will retire early.

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Why, if their pension is lower than the cut salary?

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Originally Posted by Eki

Why, if their pension is lower than the cut salary?

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They're near retirement anyway. Plus they may not want to deal with all the extra regulations, and beurocratic BS that is comming up. Many other reasons as well.

http://www.investors.com/newsandanal...aspx?id=506199

http://www.cnsnews.com/news/article/62812

Doctor shortage in the US? Wow...I have news for you. WE have it here with Gov't healthcare. I think the doctor shortage is perception at times in the US...but in Canada it is real. We have communites of 2 and 3 thousand citizens begging for doctors, and taking doctors from foreign nations and giving them perks to set up shop for 5 years....

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Originally Posted by Dylan H

Firstly I was talking about salaries not affecting recruitment INTO the field,

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Not true at all. Salary is a big recruitment tool for occupations. In fact the number of students considering a career in the medical field has dropped considerably since the passage of Obamacare.

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Originally Posted by Dylan H

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.

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Anecdotal evidence but if you really believe that staff at a institution like Johns Hopkins isn't superior than your local free clinic I wish you good health.

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Originally Posted by Mark in Oshawa

Doctor shortage in the US? Wow...I have news for you. WE have it here with Gov't healthcare. I think the doctor shortage is perception at times in the US...but in Canada it is real. We have communites of 2 and 3 thousand citizens begging for doctors, and taking doctors from foreign nations and giving them perks to set up shop for 5 years....

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We have doctor shortage in some places too. Most doctors want to live and work in big cities and towns in the south instead of small villages in the north. Increasing the number of educated doctors might help so that not everybody has the chance to pick the place where they work and some would have to accept jobs in undesirable locations or be unemployed, but that could lead to decreased quality of doctors.

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Originally Posted by anthonyvop

Not true at all. Salary is a big recruitment tool for occupations. In fact the number of students considering a career in the medical field has dropped considerably since the passage of Obamacare.

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So? There'll be a new group of people who will find medicine more attractive as the emphasis shifts. Medicine has plenty of other things to offer people apart from money including simply being a bloody interesting job. Medical salaries in the UK have seen a drop year on year for the last three or four decades yet again filling medical school places has not been a problem.

Countries like Cuba pay their doctors peanuts, as do places like Italy. A shortage of doctors is not a problem they have to cope with, quite the opposite in fact. Both countries I believe have more doctors per capita than the US.

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Originally Posted by anthonyvop

Anecdotal evidence but if you really believe that staff at a institution like Johns Hopkins isn't superior than your local free clinic I wish you good health.

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I'm aware that English is not your primary language so I can't be too harsh but you clearly didn't understand what I wrote. If you think academics with a great grip on theory but who don't spend much time practicing clinical medicine are who you want treating you fair enough. There are plenty of extremely skilled people who choose not to work in institutions like John Hopkins simply because they do not like the academic research orientated culture.

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Originally Posted by Eki

We have doctor shortage in some places too. Most doctors want to live and work in big cities and towns in the south instead of small villages in the north. Increasing the number of educated doctors might help so that not everybody has the chance to pick the place where they work and some would have to accept jobs in undesirable locations or be unemployed, but that could lead to decreased quality of doctors.

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Many countries offer financial incentives to work in rural areas or specifically recruit doctors overseas purely for those rural areas (Australia and Canada come to mind). Others like Iran or South Africa with state funded medical education make it mandatory for junior doctors to spend time in rural areas for a period in return for free training. There are plenty of ways to try to tackle the problem.