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curious2
2012 Nov 9, 5:21am
So doctors aren't "flocking", to use your word from a previous post, to the most expensive healthcare areas to make more money.
When did I ever use the word "flocking"? Sometimes I think the reason you dislike me so much is because your memory drifts so badly, you're shadowboxing a phantom that exists only in your own mind.
Nevertheless, it is true that people (including doctors) do tend to move to areas where they can make more money, rather than less. For example, highly qualified doctors from India want to immigrate to America, because they can make more money here, but very few American doctors want to emigrate to India, largely because they would make less. Supply goes to where the demand is.
As a doctor you cannot just move from one state to another at your will. there are different "regulations" for different areas to practice medicine.
Of course you can move state to state at your will, who told you that you couldn't? Getting state licensing after the first time isn't difficult. I've done it for my wife 4 times. It takes a few hours of filling out forms is all. Practice isn't really different from state to state.
now can somebody give me a no -nonsense big picture answer to why the following is happening?
I find it hard to believe this is actually a serious question. Can you think of anything being done today in medicine today that wasn't being done in 1947?
curious2
2012 Nov 9, 6:21am
Can you think of anything being done today in medicine today that wasn't being done in 1947?
For one thing, healthy people weren't being sold "preventive" C-T scans in 1947:
Meanwhile, in nearly all private sector fields, advancing technology has led to higher productivity and lower costs. Computers today can do all sorts of things they couldn't in 1947, yet in real terms they cost less.
When did I ever use the word "flocking"? Sometimes I think the reason you dislike me so much is because your memory drifts so badly, you're shadowboxing a phantom that exists only in your own mind.
I don't dislike you, I just dislike your tendency to make grand paranoid rhetorical statements that you can't back up. I agree with you the system sucks, one of the biggest reasons I'm an expat. I just find your perceptions of why the system sucks, where the costs really lie, and who is driving them is so out in left field that I can't believe it. I do notice that your holy trinity of evil (government/medicare, doctors/ama, pharma) is almost never joined by insurance companies and is absolutely never joined by lawyers. I suspect I know what you do and for who.
Nevertheless, it is true that people (including doctors) do tend to move to areas where they can make more money, rather than less. For example, highly qualified doctors from India want to immigrate to America, because they can make more money here, but very few American doctors want to emigrate to India, largely because they would make less. Supply goes to where the demand is.
I can't believe you have the nerve to say I never admit to being wrong, (which I actually do pretty frequently) then post this. That is so lame I can't believe it. You can't be serious. So you are saying that for all your posts about supply and demand you were actually talking about foreign docs coming to America not American docs working in America? That's the causation I'm getting backwards? I'm the one "fishing for ad hominem targets"? I don't think so.
Give it up. I've given you charts, links, tables, everything you hold dear. Most doctors prefer to live in desirable areas even if they make less. Where there are more doctors than needed they drive up the cost of health care. There's lots of scratch my back, I'll scratch yours. It's especially bad in area's where docs are allowed to refer to facilities they own. A practice that is such a conflict of interest I can't believe any state allows it. Go back and read the Atlantic article again, that's just what it says. Supply and demand doesn't overcome human nature. My mind hasn't drifted, I've said this from the beginning.
I'm fine with phasing down average Doctor's salaries... BUT, then you also have to lower the bar for entry to Med School, lower the cost of med school, lower the length of Med School.
Maybe have a Jr. Doctor... Sr. Doctor.. maybe a Jr. Doctor only needs an additional 2 years.. like a masters degree. And they can work as General Family doctors for lower pay.
The on the job training.. .REsidency for Doctor's is the most important part of training. If you want an average doctor.. you pay less... If you want a GREAT Doctor... you pay more.
Can you think of anything being done today in medicine today that wasn't being done in 1947?
For one thing, healthy people weren't being sold "preventive" C-T scans in 1947:
I've agreed with you time and again that medical care shouldn't be marketed. People don't need preventive c-t scans for anything. People that are sick or very sick need medical care. If it exists today but didn't exist in 1947 then it's more expensive. What's your point?
Meanwhile, in nearly all private sector fields, advancing technology has led to higher productivity and lower costs. Computers today can do all sorts of things they couldn't in 1947, yet in real terms they cost less.
No businesses were using computers in 1947 so no matter what the cost of a computer is today it's higher than 1947. What did a pc cost in 1947? laser printer, fax machine, cell phone, digital phone system, pda, server for the office network? They didn't exist, no one bought them. Now they are de rigour in very large numbers for all offices. Are they more expensive today than when they didn't exist or not?
Be interesting to see what an average office spent on equipment in 1947 vs today. Some typewriters, analog phones, and adding machines vs a full on office of today. You might find the chart above isn't so far off.
Robber Baron Elite Scum
2012 Nov 9, 7:02am
Doctors ARE overpaid including the hospital, medical centers & pharmacuetical companies they work for.
You dumb degenerate cockroach peasants need to stop denying the truth.
My grandfather John D. Rockefeller got together with his very close business pal and later his in-law... Andrew Carnegie to shutdown natural cures and remedies while only pushing expensive pharmacuetical treatments.
To produce pharmacuetical drugs, you need oil.
My grandfather did this by hiring the best lobbyists money could buy at the time. They established the AMA and required medical licenses to practice medicine which can only be obtained through unneccesary long schooling with brainwashing misinformation and propganda that will teach a doctor to only know how to prescribe pharmacuetical drugs... Not cure.
There is no profit in cure. There is also not much profit in direct mass murder.
But there is MUCH MUCH profit in indirect gradual mass murder in the form of "medical treatment".
You sap idiots slaves need to stop thinking of the mass majority of doctors (pretty much 99.99%) as so highly, as if they deserve so much god damn respect because they care so dearly to cure your illnesses and they know so much.
They know nothing except how to make us white collar old money financial scumfuck crooks more fucking insanely WEALTHY!
Anyone that denies US doctors make a undeserved inflated salary is just a dumb degenerate cockroach peasant and a donkey-fucking bastard serf...
They many not make as much as their masters but they sure as hell aren't mother-teresa. We bribe these dirty new money yuppies with expensive dinners and fancy vacations.
They know full well that they are just as miserable like you peons and they only reason they got in this profession is so the wall street criminal scumfucks will flip them a few more nickels than the rest of the worthless pieces of shit.
Once doctors and other medical professionals mass murder the population through poisions veneering as "medicine"...
We will also dispose of these self-deluded worthless piece of shit pawns...
Doctors are just new money pawns to be equally tortured to death once they prove to no longer be of any use...
It makes me chuckle when people respect the majority of them (only a few should be worthy of your respect)... Many doctors also believe themselves to be in the good old boys club with us white collar financial scumfuck robber barons... hahahaha
ALL OF YOU FUCKING DIE ALREADY INCLUDING DOCTORS ALONG WITH THEIR WORSHIPPING FANBOY COCK-SUCKERS!
curious2
2012 Nov 11, 6:37am
your holy trinity of evil (government/medicare, doctors/ama, pharma) is almost never joined by insurance companies and is absolutely never joined by lawyers.
Bob, your comment illustrates yet again that your distorting memory does a sad disservice to you and the discussion. I say it's sad because with links you ought to be able to overcome your defect, just as glasses and contact lenses enable nearsighted people to see clearly. You sound like someone who needs glasses (links) but refuses for reasons of vanity or pride or whatever to admit it. In this thread and elsewhere, I have repeatedly cited insurance (including especially mandatory insurance) as part of "the problem," and likened insurance companies to organized crime syndicates. And, I have yet again rebutted your false Republican talking point about lawyers and "tort reform". Nevertheless, you and Homeboy seem to view PatNet as an opportunity to vent your "warrior gene" fighting instincts, apparently too weak to step into a ring at your local gym so you fish for ad hominem fallacies as a way to attack rather than discuss. It is a real pity that the illuminating points of light in your comments are hidden under a bushel of strawman arguments and misplaced ad hominem attacks.
P.S. Two more links on what I've actually written about insurance, in addition to the links I fit into the text above:
Most medical care in the U.S. is paid by government: Medicare, Medicaid, and other programs. Your monthly premium, though large and growing, is largely wasted, and in any event pays only a fraction of total spending.
A lot gets lost in the mandatory insurance system and the administrative levels....
You are right that Obamacare reduces choice, but you are mistaken in saying there was a free market before Obamacare.
I never said there was a free market before Obamacare. The market pre-Obama care however was MUCH more free than post-Obamacare however.
you can only reduce the price by increasing the number of doctors. there is no other solution.
I find it funny how people still focus on the cost of the physicians when considering cost of health care. Physicians make up about 8% of healthcare costs. Reducing this cost by 50% will not make much of a dent in costs...
hank you for pointing out the importance of Medicare in setting prices. To be sure that we have our facts, can you please elucidate, exactly who sets Medicare prices, and who owns the insurance billing codes that will be used in ObamaCare? To guide your research, I'll offer you a hint: they are an Association that endorsed ObamaCare, and their members tend to share a specific degree, though admittedly they do not represent the majority of doctors (only around 10%).
Yes Curious. THere is a conspiracy by the AMA and the doctors to set high payment plans. This must be the reason why physician payment schedules have been being reduced year after year after year. Perhaps you can find solid evidence to support your conspiracy theories instead of following the rest of the sheeps in thinking that doctors are the sole reason health care costs are high...
curious2
2012 Nov 15, 3:04pm
Physicians make up about 8% of healthcare costs.
Do you have a source for that? I keep finding numbers around 20% for "physician services:"
http://www.kevinmd.com/blog/2012/04/wasted-health-dollars.html
An issue is how much goes directly to doctors, and how much goes to other services that the doctors refer to (sometimes in exchange for kickbacks) or own. The biggest waste is in the insurance system though, including both actual insurance overhead and the billing coordinators that medical practices need to hire.
Issues with this thread include (1) there are bigger problems driving overspending and (2) it's probably more accurate to say physicians are inefficiently paid, with perverse incentives and little or no correlation between price and value.
now can somebody give me a no -nonsense big picture answer to why the following is happening?
this thing is impossible to happen in free market.
THe graph you showed was an increase in medical care vs the price of goods. How does that relate to doctor salaries, unless you are assuming that the increase in cost of medical care is based solely on the increase in doctor salaries. Have you considered that the increased health care costs are a result of other increased cost structures?
but very few American doctors want to emigrate to India, largely because they would make less.
no one wants to move to India... did you think that people just dont want to live in India? would you want to live there?
curious2
2012 Nov 15, 3:08pm
did you think that people just dont want to live in India? would you want to live there?
I love the food :) Also medical care seems inexpensive, partly because they don't seem to require an Rx to buy drugs.
I have repeatedly cited insurance (including especially mandatory insurance) as part of "the problem," and likened insurance companies to organized crime syndicates. And, I have yet again rebutted your false Republican talking point about lawyers and "tort reform".
Obamacare is "mandatory insurance"....
insurance companies are not doctors...
so whats your point again?
http://www.medicalnewstoday.com/releases/226768.php
http://www.healthcarefinancenews.com/news/physician-compensation-among-lowest-western-nations
Here are two links i posted earlier
http://www.medicalnewstoday.com/releases/226768.php
http://www.healthcarefinancenews.com/news/physician-compensation-among-lowest-western-nations
the article you quote says 20% goes to doctors and other clinicians. Im guessing the other clinicians take up a lot of this as there are typically a lot more mid-level (non-doctor) providers than actual doctors themselves.
In addition, you should also take note of amount of money spent in overtreatment. This is classic defensive medicine, which many doctors are forced into due to the numerous frivolous lawsuits. I only mention this because you dismissed tort reform in earlier posts.
did you think that people just dont want to live in India? would you want to live there?
I love the food :) Also medical care seems inexpensive, partly because they don't seem to require an Rx to buy drugs.
I agree food is great... but really? You really think people dont move there cuz the lower salaries? I doubt that is hardly in anyones mind when deciding NOT to move there...
curious2
2012 Nov 15, 3:29pm
but really? You really think people dont move there cuz the lower salaries?
Around the world people in every line of work tend to move to places where they can earn higher salaries. Why would doctors be somehow different from all other people in all lines of work?
I only mention this because you dismissed tort reform in earlier posts.
Not only dismissed, disproved. Bob and I have had this debate.
Around the world people in every line of work tend to move to places where they can earn higher salaries. Why would doctors be somehow different from all other people in all lines of work?
Unfortunately your argument was not that doctors would move somewhere for higher salaries. Of course people would move to another country if they got paid more. Instead, your argument was that doctors dont move to India cuz salaries are lower there, which is an entirely different argument. My argument was that there are PLENTY of other reasons why ANYONE would not move to India.
Not only dismissed, disproved. Bob and I have had this debate.
Funny how you take the quote of a couple people and think that it is disproved. The fact of the matter is that, there are tons and tons of frivolous lawsuits. Just look on daytime TV and you will see lawyers paying millions for TV ads to recruit clients. This is a cost to healthcare since eventually the cost of lawsuits are eventually passed to patients.
curious2
2012 Nov 16, 1:22pm
Meccos, if you are going to spout a myth from Faux News, you should at least give equal time to opposing views and some factual numbers. Decades of studies have shown that American hospitals injure 20% patients, but most malpractice does not result in litigation, and the share that does result in litigation amounts to only 2% of total spending:
http://www.justice.org/cps/rde/justice/hs.xsl/8686.htm
How American Healthcare Killed My Father
http://www.medscape.com/viewarticle/503853
Malpractice Lawsuits Are ‘Red Herring’
Your myth is slightly irritating because certain people keep repeating it even though it's a red herring.
Meccos, if you are going to spout a myth from Faux News, you should at least give equal time to opposing views and some factual numbers. Decades of studies have shown that American hospitals injure 20% patients, but most malpractice does not result in litigation, and the share that does result in litigation amounts to only 2% of total spending:
I find it amusing that a liberals first instinct is to accuse someone of watching Fox news if they have an opposing view.
I also find it funny how you can make such a strong argument about doctor salaries being too high when it makes up 8% of health care costs, but dismiss cost of malpractice suits at 2-3% of health care costs. The fact is frivolous lawsuits add cost to healthcare. Even based on the articles you linked, if it comes to 2-3% of healthcare costs, that would equate to 40-80 billions dollars depending on what figures you read. Can you tell me 40-80 billion dollars is nothing?
BTW most malpractice suits do not go to litigation because they are either thrown out because they are outrageous or because it is more cost effective to settle. These costs are unknown and not calculated. In addition, most would argue that the true cost of defensive medicine is unknown and other costs such as the cost of malpractice insurance carried by all medical professionals, administrative costs, lawyer costs, lost work time are also additional costs not calculated into these figures. Regardless even at 2-3%, based on your figures, the cost are into the billions and billions of dollars.
btw, do you think your articles written by trial lawyers or quoting trial lawyers are really credible in making an argument on this subject matter??? linking articles do not really mean much, especially if they were produced by people with a clear bias
Your myth is slightly irritating because certain people keep repeating it even though it's a red herring.
So what exactly is "my myth" that you accuse me of? All i said are the quotes belowMeccos says
Funny how you take the quote of a couple people and think that it is disproved. The fact of the matter is that, there are tons and tons of frivolous lawsuits. Just look on daytime TV and you will see lawyers paying millions for TV ads to recruit clients. This is a cost to healthcare since eventually the cost of lawsuits are eventually passed to patients.
In addition, you should also take note of amount of money spent in overtreatment. This is classic defensive medicine, which many doctors are forced into due to the numerous frivolous lawsuits. I only mention this because you dismissed tort reform in earlier posts.
So these things Ive said got your panties in a bunch?
Wow....this is old. Am an MD/PhD, worked in foreign countries and respect non-MD jobs: people work hard and compensation does not scale with "hard work" - this is nonsense. YES, we are handsomely paid as MDs in the USA, which is not true in Germany and other countries with better healthcare systems. It's the way the system is set up, it has NOTHING (I repeat, NOTHING) to do with how hard MDs work, how smart and dedicated they are, and the cost of education. The supply of MDs is low, the market is carefully controlled and the honoraries are extraordinarily high compared to other developed countries, except Netherlands and Australia that also pay high MD honoraries. Most of the world does FINE paying MDs normal wages, equivalent to that of professionals such as lawyers and engineers: that's the upper middle class in most of the world.
It's pure economics. If hard work and sacrifice paid well, Bangladeshi sweatshops would be full of 6-figure pay checks.
As for why the technology sector pays comparatively worse: US-based tech companies employ and reward handsomely engineers and scientists abroad. They can also easily bring foreign labor into the US, which can explain part of the decay in the salaries of most technology and manufacture sectors. So, the oddity in America is that engineers and other professions that are "equivalent to medicine" are severely undervalued. Plus, an MD is never out of a job, other careers are hit harder by unemployment. For the MD crusaders out there, who brag about their 1 billion hours per week and so on, try 6+ months of unemployment and see what it does to your mental health.
But keep in mind: MDs are not the crème of american society, just a niche of high-paid professionals that generated a "super upper middle class". Those salaries do not place MDs in positions of power and influence...
edit. To the MDs who give the "we deal with people's lives" argument, have you thought of becoming kidnappers? That argument violates basic ethical standard to be a physician: you cannot monetise a human life, that's what criminals do.
can earn over $200K, as a doctor, in places like Des Moines Iowa, nevermind the big coastal cities.
More like 500-700k even for primary care
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I think it's time that we stop the lies and admit the truth, doctors are simply overpaid. GPs are at ~$150K while specialists and surgical specialists are from $200K to $500K. Most engineers and scientists simply do not have sustainable salaries of that amount and then, for those blowhards out there (you know who you are), stop bragging about your $200K salaries in Silicon Valley. You can earn over $200K, as a doctor, in places like Des Moines Iowa, nevermind the big coastal cities.
There are postdocs in both the physical and biomedical sciences earning $42K/yr and then, soon, another 4K+ NASA scientists will be unemployed and most likely, overspecialized for a future position outside of the Natl labs. FYI, many of those jobs are accounted for. Instead of re-training a/o re-assigning these talented individuals into becoming doctors, PAs, pharmacists, nurses, etc ... they have to compete against 20-somethings for limited freshman spots in some heath care program, if they want to find a career in a field with a lot of legislated protection. Yes, there's NO (typo, now fixed) free market, in terms of supply, in the field of medicine. Here's my solution, if one can score a 30 or higher on the MCAT, he/she should be able to transfer into the clinical years of an MD program, typically into year number 3. Yes, it should be a low cost program as those first two year subjects: biochemistry, physiology, anatomy, histology, etc, are in the public domain of knowledge. While one's working in industry, let's say a NASA subcontractor, one can study those subjects on his own and then, take the AMA exam which shows that one's qualified to become a doctor.