Did I just experience "socialized" medicine?

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Re: Did I just experience "socialized" medicine?

Postby Thelonlieste » 17 Dec 2009, 23:37

This is simply food for thought: Nationalized healthcare systems are part of the problem.

The Wall Street Journal wrote:Dr. Shetty, who entered the limelight in the early 1990s as Mother Teresa's cardiac surgeon, offers cutting-edge medical care in India at a fraction of what it costs elsewhere in the world. His flagship heart hospital charges $2,000, on average, for open-heart surgery, compared with hospitals in the U.S. that are paid between $20,000 and $100,000, depending on the complexity of the surgery.

The approach has transformed health care in India through a simple premise that works in other industries: economies of scale. By driving huge volumes, even of procedures as sophisticated, delicate and dangerous as heart surgery, Dr. Shetty has managed to drive down the cost of health care in his nation of one billion.


http://online.wsj.com/article/SB125875892887958111.html?mod=WSJ_hpp_sections_world

So why not have global economies of scale?
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Re: Did I just experience "socialized" medicine?

Postby catfish13 » 18 Dec 2009, 01:42

They are talking about raising premiums next year and some green supporters are screaming their heads off and complaining about providing care to PRC citizens who are legally residing in Taiwan (apparently subjecting them to the same treatment non-PRC foreigners get is still too much for them green vest guys). If enough rowdiness is generated they'll probably do something about it.

Although personally I think NHI needs to change some of its things around, like requiring an annual out-of-pocket deductible. Or else the healthcare system is just getting severely abused. It's reasonable that a teaching or municipal hospital charges more for regular doctor's visits than small private practice clinics, but a lot of people are still rushing into clinics for small and relatively minor issues that can be taken care of easily with a nice night of rest and maybe some aspirin or cough syrup.

In the US, some of the fiercest defenders of privatized healthcare are also users of "socialized medicine" and insurance companies and lobbyists have a lot of oppositions deep in their pockets. The public option died even when it shouldn't have.
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Re: Did I just experience "socialized" medicine?

Postby Mr He » 18 Dec 2009, 09:09

While dissing the NHI, there are a few things people forget - and that is its cost as a percentage of GDP.

I saw a poster at my dentist, which claimed that the NHI here in Taiwan uses a mere 2% of GDP - compare that with the US where 15% are used, France which runs the world's best health care system on 9% of GDP, or Denmark which does a less stellar job on a mere 8%.

On doctor's salaries - admittedly the US is different as people have to pay their own way when in med school. Where I come from the universities are state financed, and they get their education for free. Also, already after a year or 2, they can get study jobs at hospitals paying well enough for most of them to end their studies debt free.

In other words, they start off no worse than anyone else taking a masters, and their average salaries are higher.

I am not saying that a good doctor in private practice should not earn US$200k a year, after all they work for the money. However US$300k-US$400k?!?!?! Get outta here.

Despite being relatively worse paid in DK than it is in say the US, we do not have a shortage of people entering Med School - actually it's one of the hardest to get into in Denmark, if not the hardest.
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Re: Did I just experience "socialized" medicine?

Postby djlowballer » 18 Dec 2009, 09:22

headhonchoII wrote:You didn't read what I said. He won't suffer by having his wages controlled and still be a rich man while allowing a good health service to be provided to more patients. If speed of surgery is the answer then you don't need the best of the best, just access to a neurosurgeon. These guys work all the time, what do they need so much money for? If the government pays the tab they shouldn't get paid too much either, that is public money. The same type of dedication, long term skill building and lack of social life is required of many top scientists and engineers yet their wage level is a factor lower... the fact is most of them would do it anyway. There are many doctors who would like to step up to surgeon level ASAIK from somebody in the family. There are no lack of interested candidates. It is extremely competitive to get what are called consultancy positions and yes pay is an attraction.


You mention that becoming a doctor is similar to being a top level engineer or scientist. This is partially true. All work hard in highschool to get into a good college. Then during college take grueling classes to prepare them for the next level, but afterward is where the work diverges.

Top engineering student will get outstanding placements and either start at or within a year or two start pulling in a 6 figure income. They will work for a few years until their company provides money for a masters, get their MSc and climb higher.

Pure Scientists have a different but similar path. Excellent students in Chemistry, Biology, Physics, etc can find very well paying jobs right off the bat. My friend graduated near top of UDell's Chemisty/Chemical Engineering and now makes bank running a chemistry lab for a nuclear power plant. However for research jobs a PhD is almost a requisite. This usually poses little to no problem. Little known secret: Most graduate students in the sciences are paid to attend. Why? Because you are basically working for the University as a researcher / TA. After graduation a top scientist in the private sector can soon command over 100$ US /h.

Medical Students have the same scientific criteria as the latter, but they are under so much more scrutiny. Where LHC physicist is dealing with finding a higgs boson on a wipeoff board, there is a good chance a Dr is going to be dealing with a dying child split open on a medical table. LHC guys messes up, no big they can try a new experiment, Dr messes up and he just lost a human life. The training to become a Doctor is demanding on a whole different scale.

So therin lies the problem with controlling wages: You can lower the pay of doctors and still have them be "rich" like good scientists and engineers but where is the incentive to waste nearly double the time and experience so much more stress when one can just use their talents to become a medical researcher and make the same amount of money and enjoy a comfortable life?

Sure there will always be those truly great human beings who will take one for the team, the pages of history filled with them, but you are naive if you think those few are enough to keep the system running. The majority of people are self centered. Want proof? Listen to the millions screaming "healthcare is too expensive, I deserve the same amount of care as those richers" without any concern for how it will be done and what greater effect on the system it could have so long that they get what they need.
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Re: Did I just experience "socialized" medicine?

Postby CraigTPE » 18 Dec 2009, 09:26

I don't begrudge those who actually provide the service from being paid for their expertise, effort and experience.

I do have a problem with the insurance industry making bazillions while providing no value to the process.
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Re: Did I just experience "socialized" medicine?

Postby djlowballer » 18 Dec 2009, 10:09

CraigTPE wrote:I don't begrudge those who actually provide the service from being paid for their expertise, effort and experience.

I do have a problem with the insurance industry making bazillions while providing no value to the process.


Oh no I agree with you there. I am actually for heathcare reform. I am against both the status quo and drastic changes. There is a way to keep the same level of medical expertise AND have the system run effectively/fairly. It just requires careful and thought out gradual change.
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Re: Did I just experience "socialized" medicine?

Postby CraigTPE » 18 Dec 2009, 10:26

djlowballer wrote:Oh no I agree with you there. I am actually for heathcare reform. I am against both the status quo and drastic changes. There is a way to keep the same level of medical expertise AND have the system run effectively/fairly. It just requires careful and thought out gradual change.

Keep the delivery system and scrap the insurance system by making a few minor tweeks to Medicare to provide for buy-in from under-65's.
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Re: Did I just experience "socialized" medicine?

Postby djlowballer » 18 Dec 2009, 14:23

CraigTPE wrote:
djlowballer wrote:Oh no I agree with you there. I am actually for heathcare reform. I am against both the status quo and drastic changes. There is a way to keep the same level of medical expertise AND have the system run effectively/fairly. It just requires careful and thought out gradual change.

Keep the delivery system and scrap the insurance system by making a few minor tweeks to Medicare to provide for buy-in from under-65's.



Yeah but "scrap the insurance system" could put a shitload of people out of work and further burden the system. I actually thought the german system made sense. If you make under X amount of money you had to buy into one of the public healthcare systems. If you were on public healthcare and made x+1 you could get a cheaper more comprehensive private plan with a copay but only after paying into the public system after like 2 years. The public plan was actually a bunch of companies that competed with each other. If the company runs itself well it sends money back.

My main gripe with the debate isn't the care itself, rather people seem to use the issue as a veil for what amounts to class jealousy. People are quick to complain about the pay of bankers, CEOs, doctors, engineers, programmers, and anything that requires serious training or commitment. To me that is ignorant. Especially when you never hear arguments like "oh its bullshit adam sandler made 20 million on Funny People" or "Fuck Alex Ovechkin, he gets payed 9 mil a year to push a puck around the ice". I don't understand how people can conceptualize an actor making 20 million on a film that grosses 200 million but can't accept a CEO making 20 million for leading a company to a gross of 1 billion. Especially considering being a CEO is a harder job.
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Re: Did I just experience "socialized" medicine?

Postby GuyInTaiwan » 18 Dec 2009, 14:43

djlowballer: Adam Sandler is a retard, and his movies blow. He shouldn't get paid 20 million, except perhaps as a one-off payment never to make another movie in his life. That really would be something worth paying out of the public purse.
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Re: Did I just experience "socialized" medicine?

Postby djlowballer » 18 Dec 2009, 15:14

Hey funny people was a good movie...for like the first 20 minutes before the writers forgot what the movie was about and started a new story mid movie... yeah 20 mil to stop him once and for all.
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