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Sun Wukong
17th June 09, 12:37 PM
... maybe i misspoke to get your attention.

This isn't an all encompassing solution, but it just really seems like a good idea to me. Before you say anything, yeah, it definitely won't fix anything all by itself.


I realize that this is no new idea, but it just seems to me that this has been over-looked far too much. At any pace, here it is:


Train more Physicians. A lot more, not just a couple screwball scholarships either. I mean make a training program with extremely aggressive recruitment like unto the US military recruiting on college campuses and gifted high school seniors around the country. Make it patriotic to be a Physician or to work within the medical field.

My reasoning behind this is that one of the large reasons for medical expenses being so high is the extremely large salaries which physicians draw and the relatively limited number of venues for which to find medical treatment.

When our medical system is overwhelmed by a fresh crop of well trained physicians and other medical support personnel, the prices on medical care will have to come down as the demanding wages for physicians will naturally come down as a result of having a higher labor pool to draw from and an increase in private practices competing for patients.

Now, how do we finance the training of all these physicians? Simple, income tax paid by those very same trainees and treasury bonds. Those physicians will pay income taxes for the rest of their lives on their earnings. We don't have to raise taxes at all, but in the mean time we apply all the income tax paid by those physicians at standard rates directly in to the pool where we drew the funds. The initial funds will have to come from the treasury, but the treasury can back those bonds with promise that the trained physicians themselves will pay off the debts in the long term (say 30 years).

So what do you think?

Ka-Bar
17th June 09, 12:46 PM
Interesting idea, but the high salaries of physicians are comensurate with the length, difficulty and expense of the education that being a physician requires.

There are already more medical school applicants than available medical school seats, so demand is not the issue.

I think a better solution would be training, employing and utilizing more medical professionals like Physician's Assitants and Nurse Practicioners, care providers with extensive training who can diagnose disease and prescribe treatments and medications under the supervision of a physician. Imagine a clinic staffed by 3 Nurse Practicioners and 2 Physician's Assistants, all overseen by one physician. Imagine the cost savings as oppossed to a clinic staffed by 5 or 6 physicians.

EuropIan
17th June 09, 12:49 PM
but you'll be taking all the wealth and status out of being a doctor...

I mean, they'll just be another public servant...Oh noes!

Sun Wukong
17th June 09, 01:07 PM
Interesting idea, but the high salaries of physicians are comensurate with the length, difficulty and expense of the education that being a physician requires.

There are already more medical school applicants than available medical school seats, so demand is not the issue.

I think a better solution would be training, employing and utilizing more medical professionals like Physician's Assitants and Nurse Practicioners, care providers with extensive training who can diagnose disease and prescribe treatments and medications under the supervision of a physician. Imagine a clinic staffed by 3 Nurse Practicioners and 2 Physician's Assistants, all overseen by one physician. Imagine the cost savings as oppossed to a clinic staffed by 5 or 6 physicians.

Yes, this is why we would have to have more medical schools for my suggestion to be prudent. A substantially higher number of schools. Yes, it would be expensive, but I believe the programs would pay for themselves in the long term; say, a 30 year period.

Cullion
17th June 09, 01:07 PM
A cheaper thing which might help would be to improve the American public's health by not using their taxes to subsidise corn production which seems to just generate fructose syrup to be used as a cheap filler in so many of your processed foods.

Sun Wukong
17th June 09, 01:08 PM
but you'll be taking all the wealth and status out of being a doctor...

I mean, they'll just be another public servant...Oh noes!

No, they would still be independent and free to work in whatever capacity they want, private or public. No string attached except income tax.

jvjim
17th June 09, 01:09 PM
A cheaper thing which might help would be to improve the American public's health by not using their taxes to subsidise corn production which seems to just generate fructose syrup to be used as a cheap filler in so many of your processed foods.
I beleive that if we stopped subsidizing corn, everyone's dreams would come true. Never happen though, corn industry would tank for about 30 years.

Sun Wukong
17th June 09, 01:12 PM
A cheaper thing which might help would be to improve the American public's health by not using their taxes to subsidise corn production which seems to just generate fructose syrup to be used as a cheap filler in so many of your processed foods.

You are side stepping.

Cullion
17th June 09, 01:14 PM
You are side stepping.

Not really, it just seems dumb to plough money into something before making an improvement which immediately saves you money.

Lebell
17th June 09, 01:15 PM
healthcare is for n00bs.
real man dont need that pussy stuff.

elipson
17th June 09, 01:21 PM
A cheaper thing which might help would be to improve the American public's health by not using their taxes to subsidise corn production which seems to just generate fructose syrup to be used as a cheap filler in so many of your processed foods.
America Hater.


I've actually been thinking about this very solution for a while now. I think medical staff training should be subsidized as a public good, as well as instructors and institutions that provide such training.

But I've got some pretty radical ideas for health Care reform. These reforms would be too right wing in Canada, and yet considered too left wing in the US.

Sun Wukong
17th June 09, 01:22 PM
Not really, it just seems dumb to plough money into something before making an improvement which immediately saves you money.

Let's look at the mental math for this. You are saying that it is a bad idea to make an investment that does not immediately make you money...

you are a very bad capitalist.

Kein Haar
17th June 09, 01:23 PM
As long as doctors know they can perform teh an4l r4p3 on insurance companies, costs will remain high.

Oh, same with people treating their insurance companies in such a way that if we used our car insurance similarly, it would go towards oil changes.

When critical mass is reached of people having to simply write a personal check to doctors....people won't fucking be going.

Then doctors will be like "Um bailout plz thnx"

I believe I had a relative die during the depression in such a way.

"Ow. My stomach."
"Appendix."
"Wot."
"Needs to come out."
"K?"
"$400.00"
"I kan haz finaning mebbe?"
"No"
"K thnx c u in heaven." ::Plonk::

Cullion
17th June 09, 01:28 PM
Let's look at the mental math for this. You are saying that it is a bad idea to make an investment that does not immediately make you money...

you are a very bad capitalist.

No, I'm not saying this. I'm saying that there's a low-hanging cost saving with health benefits available. Prevention is always better than cure.

Oh, and you'll likely have to import your extra doctors. The bell-curve IQ distribution and the fact that you plan to make doctors less scarce will mean that you probably won't get the number of doctors you want domestically.

Sun Wukong
17th June 09, 01:40 PM
No, I'm not saying this. I'm saying that there's a low-hanging cost saving with health benefits available. Prevention is always better than cure.

I never said this was a one shot fix, in fact, I said that this alone would not be enough.



Oh, and you'll likely have to import your extra doctors. The bell-curve IQ distribution and the fact that you plan to make doctors less scarce will mean that you probably won't get the number of doctors you want domestically.
I disagree about not having enough intelligent people to be physicians.

It is already widely acknowledged that seats in medical schools are more scarce than qualified applicants. If we increase available seats and make training far more affordable "Free, sort of", I think we'll fill the numbers quite adequately in the long run. You know the old adage, Rome wasn't built in a day.

In the short run we would definitely need to recruit foreign doctors aggressively, but we are already doing that.

Ajamil
17th June 09, 02:02 PM
Oh, same with people treating their insurance companies in such a way that if we used our car insurance similarly, it would go towards oil changes.

They have this. In fact, in a rare moment I was actually watching a real TV at my mother's home, and there was an add for basically car maintenance insurance. I thought it was cool and unique, and then next program they had a separate company make basically the same claims in a slightly different commercial format. Here's one. (http://www.used-car-advisor.com/car-repair-insurance.htm)

On topic, what results have we seen in professions where this has kind of happened? What about lawyers or computer engineers (not certain on the explosion of the last one)? What do we do about all the people we pay to train, who then flunk out?

Sun Wukong
17th June 09, 02:30 PM
So far, the only argument I've heard against this is that it would not pay off fast enough.

Do we have any other contributaries?

Sun Wukong
17th June 09, 02:33 PM
There is some argument against this in based on gouging insurance as pressure to drive price up, but that isn't practical criticism in that insurance companies will never go away unless medical care becomes state funded.

In which case, the medical insurance companies either begin billing the national government or just go out of business. I have no comment either way on this, because I don't see how this contradicts any postulation on my part that increasing the supply of doctors will drive down cost of medical care.

Sun Wukong
17th June 09, 02:36 PM
I do find it weird that NoB voted against this, as I am effectively suggesting the largest tax incentive for being an MD for all time.

You are being blinded by the "free" part of the argument, and not seeing the part where their taxes will be diverted out of the general tax fund and into paying for their own training. Basically keeping them from paying income tax completely.

Do I have to call it "student loan repayment" instead to make it appealing to the financial right wing?

elipson
17th June 09, 03:40 PM
Oh, and you'll likely have to import your extra doctors. The bell-curve IQ distribution and the fact that you plan to make doctors less scarce will mean that you probably won't get the number of doctors you want domestically.

you're assuming that the talent pool of potential good physicians is already maxed. I don't believe this, as I believe there are a large number of people who could be good doctors, but are driven away from this by the cost of schooling.

Cullion
17th June 09, 03:47 PM
I never said this was a one shot fix, in fact, I said that this alone would not be enough.


I disagree about not having enough intelligent people to be physicians.

It is already widely acknowledged that seats in medical schools are more scarce than qualified applicants. If we increase available seats and make training far more affordable "Free, sort of", I think we'll fill the numbers quite adequately in the long run. You know the old adage, Rome wasn't built in a day.

In the short run we would definitely need to recruit foreign doctors aggressively, but we are already doing that.

So your plan is to reduce doctors salaries by spending more tax money, whilst your public treasury is already looking threadbare. Alright.

HappyOldGuy
17th June 09, 04:39 PM
I think we should try some strict medical malpractice limits to reduce the cost of insurance and see how that effects health care prices first.

40 states have tried it. It doesn't work.

The shortage isn't of people who want to be doctors. The shortage is of med school slots. Which are intentionally kept tight to keep doctor salaries up. But doctor salaries are not a major part of our health care costs.

Cullion, Australia has passed us on the fat train, and you guys are catching up fast, so corn syrup is clearly not the big problem (although it might contribute).

Cullion
17th June 09, 04:45 PM
In the UK our problem is beer consumption and lack of exercise. Americans don't drink as much beer and more of you go to the gym.

bob
17th June 09, 04:51 PM
The AMA, if it is anything like our local equivalent, is a union. Probably the most powerful, politically effective union there is. There is no way they are going to stand for their labour market being flooded.

Cullion
17th June 09, 05:00 PM
Medical associations are professional associations. They act for their members interests like unions do, but they also try to guarantee standards of competence in return. That's why their influence is so great. If doctors decide to argue against increasing the supply of doctors by questioning medical educational standards, it's very hard for a non-doctor to argue against them confidently.

HappyOldGuy
17th June 09, 05:10 PM
In the UK our problem is beer consumption and lack of exercise. Americans don't drink as much beer and more of you go to the gym.

The first, sure, but I've heard the reverse on exercise?

Cullion
17th June 09, 05:19 PM
The first, sure, but I've heard the reverse on exercise?

I don't have a link to an authorative source on the exercise thing, it was mentioned in some documentary I saw years ago. Consider it hearsay.

Annecdotally an American who sits next to me at work tells me that mild exercise like walking or cycling to work instead of driving is more common here, although you tend to take highly competitive sports much more seriously at school.

Quikfeet509
17th June 09, 05:21 PM
This thread is full of wonderful points and illustrious fail.



[end statement]

elipson
17th June 09, 05:27 PM
Medical associations are professional associations. They act for their members interests like unions do, but they also try to guarantee standards of competence in return. That's why their influence is so great. If doctors decide to argue against increasing the supply of doctors by questioning medical educational standards, it's very hard for a non-doctor to argue against them confidently.

Who said anything about dropping standards?

Unless you consider Tuition costs to represent "Standards". I can't even see you pushing that perspective.


Why don't we take the money from corn subsidies and fund a) med schools and b) the tuition for those schools, awarded based on academic merit.



So your plan is to reduce doctors salaries by spending more tax money, whilst your public treasury is already looking threadbare. Alright. The public treasury problems are a completely seperate issue. Obviously spending money on ANYTHING in such a situation will put stress on the system, but that doesn't mean such spending should be avoided, especially if its in the public good.

Sun Wukong
17th June 09, 05:34 PM
So your plan is to reduce doctors salaries by spending more tax money, whilst your public treasury is already looking threadbare. Alright.
My plan is to increase the number of MD's which has the side effect of putting downward pressure on salaries and the benefit of making health care easier to find and to finance it by issuing treasury bonds backed by the future income of the MD's who made it through the programs at a repayment rate equal to income tax; effectively alleviating their income tax burden 100% until their portion of the debt comensurate to what their tuition and schooling fee's would have been otherwise is paid off.

... As for our public treasury looking threadbare... you do know exactly what the alternatives to this plan are right? I'm suggesting an alternate program to social medicine... and it's bad because it costs money NOW that would be repaid by the very same immediate beneficiaries of the program? rather than costing everything and being passed on to every US citizen indefinitely in the form of higher income taxes for everyone.

My suggestion doesn't raise anyone's taxes at all, in fact it would be an enormous tax CUT for every graduate of the program for YEARS.

I still fail to see exactly what the dilemma is from a strictly conservative economic standard.

This isn't spending money, it's more like a complicated student loan program where the top lender is the US government. It lends money to students, while providing new training facilities for the physicians. We could take international students to bring in extra money for the programs. If they decide to stay in the US and practice medicine, give them a 100% tax cut until they've exceeded the amount of money they spent on tuition.

This is not charity. This is not GIVING away money. This doesn't even fall under the category as WASTING money.

I'm not suggesting LOWERING the salaries. I'm suggesting paying salaries commensurate to their demand. The side effect of having an increase in health care providers is that the health care is easier to get because their are more providers. The principle of supply and demand suggest their salaries would fall because the supply went up.

How is this NOT a win/win for everyone?

Cullion
17th June 09, 05:36 PM
Who said anything about dropping standards?

You've missed the point. If the aim is to lower the cost of employing doctors by increasing their supply, this is a likely argument from a professional association intent on protecting their members. It will be very hard for non doctors to know whether they doing just that, or telling the truth.



Unless you consider Tuition costs to represent "Standards". I can't even see you pushing that perspective.

No, not at all. I'm just pointing out that if the aim is to make doctors cheaper, then it's reasonable to expect resistance.



Why don't we take the money from corn subsidies and fund a) med schools and b) the tuition for those schools, awarded based on academic merit.

By all means.

elipson
17th June 09, 05:41 PM
I totally expect resistance. The same way that if you tried to take away the over-priced wages of certain government workers there would be an instant strike.

Sometimes you just have to break some eggs.

I think its very much in the interest of a) the highest paid medical professionals and b) the institutions and teachers who train these professionals, to keep the barriers to entry high and the numbers low. It's a professional cartel and I don't have much sympathy for it.

HappyOldGuy
17th June 09, 05:44 PM
I wouldn't call that much of a try. Lawsuits are rampant and often frivolous... there needs to be more penalties, America is way too litigious. The family practice doctors I have known have all complained about malpractice insurance costs and how large a portion of their expenses goes to those costs.

Doctors complain about malpractice, and always will. Outside of a few specialties, it has fuck all to do withour medical costs.

If you knew you were going to get sued every time you made a mistake, you would bitch too, no matter if you were paying a nickel a year or a thousand bucks a minute.

Quikfeet509
17th June 09, 05:48 PM
You are completely forgetting about defensive medicine and the amount of money and time that is wasted performing it.


Please don't.

bob
17th June 09, 05:49 PM
The first, sure, but I've heard the reverse on exercise?


OBJECTIVE: Obesity results from protracted energy imbalance. Whether this comprises excessive energy intake, lowered physical activity or both, remains disputed. DESIGN: Physical activity energy expenditure, evaluated in three different ways from daily energy expenditure (DEE) measured using doubly labelled water, was examined for trends over time. Data included subjects in Europe (Maastricht, the Netherlands) and North America extending back to the 1980s. These data were compared with measures from the third world, and measures made on wild terrestrial mammals. RESULTS: Physical activity expenditure in Europe (residual of the regression of DEE on basal energy expenditure (BEE)) has slightly but significantly increased since the 1980s. There was no trend over time in physical activity level (PAL=DEE/BEE), or in the residual variance in DEE once mass, sex and age were accounted for. This latter index of physical activity expenditure also significantly increased over time in North America. DEE of individuals in Europe and North America was not significantly different from individuals measured in the third world. In wild terrestrial mammals, DEE mostly depended on body mass and ambient temperature. Predicted DEE for a 78 kg mammal living at 20 degrees C was 9.2 MJ per day (95% CI: 7.9-12.9 MJ per day), not significantly different from the measured DEE of modern humans (around 10.2-12.6 MJ per day). CONCLUSION: As physical activity expenditure has not declined over the same period that obesity rates have increased dramatically, and daily energy expenditure of modern man is in line with energy expenditure in wild mammals, it is unlikely that decreased expenditure has fuelled the obesity epidemic.

HappyOldGuy
17th June 09, 05:59 PM
You are completely forgetting about defensive medicine and the amount of money and time that is wasted performing it.


Please don't.

Relevant to the broad question of costs for sure, but not directly on malpractice.

Cullion
17th June 09, 06:11 PM
I totally expect resistance. The same way that if you tried to take away the over-priced wages of certain government workers there would be an instant strike.

Sometimes you just have to break some eggs.

The difference is, doctors perform a much more skilled and critical function in society than many of the government workers you refer to.

In the UK, the types of unionised government worker who don't perform these critical functions where their skill levels would be hard to replace maintain their hold by the Labour party being reliant on campaign funding from union dues.


It's a professional cartel and I don't have much sympathy for it.

For sure.

Cullion
17th June 09, 06:28 PM
My plan is to increase the number of MD's which has the side effect of putting downward pressure on salaries and the benefit of making health care easier to find and to finance it by issuing treasury bonds backed by the future income of the MD's who made it through the programs at a repayment rate equal to income tax; effectively alleviating their income tax burden 100% until their portion of the debt comensurate to what their tuition and schooling fee's would have been otherwise is paid off.



... As for our public treasury looking threadbare... you do know exactly what the alternatives to this plan are right?

Yes. One or more of:-

i) Status Quo

ii) Cut tax-funded medical assistance to the poor and elderly

iii) Generic drugs and crackdown on defensive medicine

iv) Stop doctors being incentivised to recommend uneccessary procedures.

etc..



I'm suggesting an alternate program to social medicine... and it's bad because it costs money NOW that would be repaid by the very same immediate beneficiaries of the program?

When you talk about beneficiaries, remember that your aim here is to drive their salaries down.



rather than costing everything and being passed on to every US citizen indefinitely in the form of higher income taxes for everyone.

Well, if you've made up your mind that state activism is the only solution, this is one of the less evil options.



My suggestion doesn't raise anyone's taxes at all, in fact it would be an enormous tax CUT for every graduate of the program for YEARS.

You plan to fund it by issuing more debt.



I still fail to see exactly what the dilemma is from a strictly conservative economic standard.

See above.



This isn't spending money, it's more like a complicated student loan program where the top lender is the US government. It lends money to students, while providing new training facilities for the physicians. We could take international students to bring in extra money for the programs. If they decide to stay in the US and practice medicine, give them a 100% tax cut until they've exceeded the amount of money they spent on tuition.

This is not charity. This is not GIVING away money. This doesn't even fall under the category as WASTING money.

I'm not suggesting LOWERING the salaries. I'm suggesting paying salaries commensurate to their demand.

Yes you are and you know enough economics to know you are. If it increased the supply of doctors without lowering their cost, then it wouldn't save anybody any money. But you already know this (my bold) :-



The side effect of having an increase in health care providers is that the health care is easier to get because their are more providers. The principle of supply and demand suggest their salaries would fall because the supply went up.


How is this NOT a win/win for everyone?

Because you've proposed a method of further stressing your federal government's credit rating in order to lower doctor's salaries. There's two losers right there.

Spade: The Real Snake
17th June 09, 06:34 PM
Doesn't the Government doing something of this nature already, with the exception being the Doctors being trained on the Government Dime contract their services to the VA and IHS hospitals?

Quikfeet509
17th June 09, 07:02 PM
Here's a fun question - who determines if the procedure that the doctor wants to do is necessary or not?


Usually the idiot on the phone barely makes above minimum wage, has no healthcare background, and is reading from a pre-generated algorithm without the ability to interpret when deviations are necessary.

But it makes the laypeople feel good that someone is reigning in the evil doctors from ordering tons of unnecessary tests at the expense of the taxpayers...even if that person is a monumental idiot with a 5th grade education.

Neildo
17th June 09, 07:06 PM
this is a very long term strategy, but it could work. i also recommend making an MRI machine as common as a phone booth. or perfect the tricorder. at that point a doctor mostly takes on the role of technician that knows how to read the equipment.

Ajamil
17th June 09, 11:15 PM
CONCLUSION: As physical activity expenditure has not declined over the same period that obesity rates have increased dramatically, and daily energy expenditure of modern man is in line with energy expenditure in wild mammals, it is unlikely that decreased expenditure has fuelled the obesity epidemic.

That's incredible. Who did this study? So can I use this to smack my mother's idea that screens (TV, CPU, etc.) are the death of us?

Sun Wukong
18th June 09, 01:56 PM
Yes. One or more of:-

i) Status Quo

The status quo in the US is unacceptable.



ii) Cut tax-funded medical assistance to the poor and elderly

You cannot be serious. We already have a serious health care deficit in this country. You are suggesting inflaming things into a full on epidemic.



iii) Generic drugs and crackdown on defensive medicine
Generic drugs... surely you realize a person cannot simply sell generic drugs for everything; there is this thing called intellectual property rights. Plus, most people do buy generic drugs when available.


iv) Stop doctors being incentivised to recommend uneccessary procedures.

Providing medical care is a matter of business in this country. You are talking about interfering in the rules of daily commerce. We could take steps to stop the practice of "unnecessary" testing but then again, you'd be interfering in medical pathology at some point. I suppose you mean to prevent fraud openly practiced in medical communities? You realize that some of these procedures are so expensive simply for the fact that medical care is prohibitively hard to obtain right?



When you talk about beneficiaries, remember that your aim here is to drive their salaries down.
No, my aim here is to make medical care more widely available with the added benefit of higher levels of competition to get patients... and not just the ones with insurance.



Well, if you've made up your mind that state activism is the only solution, this is one of the less evil options.
In this case, we have a medical monopoly on health care ruled by financial gate keepers. To address this, we need anti-trust activities that go a bit beyond what we currently have designed. Call it state activism if you want, but I recall a similar form of state activism in which Germany commissioned auto-makers to create an affordable car for any average citizen that seems to have worked out quite nicely.



You plan to fund it by issuing more debt.

You realize of course that the federal government already pays tuition for doctors in government backed loan programs, right? All I'm suggesting is expanding that to build more medical schools, a lot more and offer massive income tax incentives to becoming an MD.

Consider for a moment the cost involved for paying almost all medical bills for all patients at the current cost levels assuming they stay the same in real dollars. A woman I recently read about paid $220,000 in a single year for cancer treatment.

The average cost for one year of medical school is $35,000 in state and $50,000 for out of state expenses at a state medical school.

Private institutions cost considerably more. The average years of study for medical school are about 4 years. So on average, medical school costs about $140,000 to $200,000 USD per student who successfully graduates.

Assuming that the woman whose cancer was successfully removed total cost was about average, then medical school for 4 years costs less than having cancer for just one year.

Now, cancer is extremely common. MD's are extremely uncommon by comparison. Do the math. How much does it cost to pay the entire medical bill for a single patient who does NOT have a way of paying for their life saving medical treatment. WHo is paying that bill right now? Everybody, that's who.

We are already paying the cost of the medical care shortage, the cost is just hidden better.



Yes you are and you know enough economics to know you are. If it increased the supply of doctors without lowering their cost, then it wouldn't save anybody any money. But you already know this (my bold) :-
What exactly would cause the cost of medical attention to stay current given a higher supply of medical practitioners? I'm curious to know how the usual rules of competition in supply and demand of services would be suspended in this industry.



Because you've proposed a method of further stressing your federal government's credit rating in order to lower doctor's salaries. There's two losers right there.
There is a medical care shortage in this country. I'm suggesting making a medical care surplus. The federal government is already paying through the nose at artificially high medical care costs. They are artificially high because there is a medical care monopoly that shouldn't exist here.

The surest way that I can think of to eliminate the monopoly without interfering with the free market extensively is to increase the number of physicians in this country by a staggering amount. These numbers, in the short term, would be self sustaining IMO and would not require further expenditures on the part of the federal government to support beyond the initial establishment of a much larger medical care force.

It is important to note, that this initial debt would be paid off by the physicians themselves in the form of what their normal income taxes would have been. Personally, I think this is a stroke of genius. And being a genius, I like the feel of this stroke; I like it a lot.

elipson
18th June 09, 02:31 PM
Generic drugs... surely you realize a person cannot simply sell generic drugs for everything; there is this thing called intellectual property rights. Plus, most people do buy generic drugs when available.

Your intellectual property rights extend for 20 years while many other countries only respect patents for 5 years. That gives your system 15 years of monopoly prices for new drugs. That's a pretty big reason many of your drugs are rediculously expensive, and why a lot of Americans try to buy drugs from Canada (which are approved by the Canadian medical authority, so don't give me any "quality" arguments).

The only reason this is allowed to continue is that stakeholders throw heaps of money at politicians to keep it this way, saying decreasing the number of years for a patent would decrease the incentive for research. Bullshit. 5 years is plenty of time to profit off something.

Lebell
18th June 09, 02:52 PM
hey, did anyone of you guys volounteer for drug tests in the hospital, they pay you for it.

ive done some.
also psychological tests with ecg scans and stuff.
you get like 25 euros an hour or something.

elipson
18th June 09, 03:37 PM
They don't do that for most people. They just wanted to double check that there wasn't something horribly wrong with you. They didn't have the heart to actually tell the real reason for your tests.

HappyOldGuy
18th June 09, 03:51 PM
Your intellectual property rights extend for 20 years while many other countries only respect patents for 5 years. That gives your system 15 years of monopoly prices for new drugs. That's a pretty big reason many of your drugs are rediculously expensive, and why a lot of Americans try to buy drugs from Canada (which are approved by the Canadian medical authority, so don't give me any "quality" arguments).

The only reason this is allowed to continue is that stakeholders throw heaps of money at politicians to keep it this way, saying decreasing the number of years for a patent would decrease the incentive for research. Bullshit. 5 years is plenty of time to profit off something.

20 years is the international standard.

Lebell
18th June 09, 03:51 PM
shut it.

a friend of mine is a clinical psychologist ad spends lots of time researching crap.
whenever he needs labmonkeys he calls me.

ive done all kinds of crap, wired up doing simple hand eye co-ordination tests and stuff.
boring, but easy money.

Cullion
18th June 09, 03:55 PM
The status quo in the US is unacceptable.

One down.



You cannot be serious.

No, I'm not.



Generic drugs... surely you realize a person cannot simply sell generic drugs for everything; there is this thing called intellectual property rights.

This is a tricky one.

When a drug is being sold at a cheaper price in another country, I don't think the state should enforce market segmentation at the behest of a private concern.

On the other hand, I don't want to disincentivise people from doing research, nor make them feel they can't disclose any research because they need to maintain a trade secret.





Plus, most people do buy generic drugs when available.

Will insurance pay for generic drugs?



Providing medical care is a matter of business in this country. You are talking about interfering in the rules of daily commerce.

Not necessarily. Consumer's associations are part of a functioning free market. These things often don't have to be handled by the force of law (and in my view rarely should be). If they started publicising doctors financial incentives to recommend unnecessary procedures, you could see some change.



We could take steps to stop the practice of "unnecessary" testing but then again, you'd be interfering in medical pathology at some point. I suppose you mean to prevent fraud openly practiced in medical communities? You realize that some of these procedures are so expensive simply for the fact that medical care is prohibitively hard to obtain right?

Yes, but please see above.



No, my aim here is to make medical care more widely available with the added benefit of higher levels of competition to get patients... and not just the ones with insurance.

Yes, I know that's your aim. I'm just pointing out the unintended consequences of this type of intervention in the market.



In this case, we have a medical monopoly on health care ruled by financial gate keepers. To address this, we need anti-trust activities that go a bit beyond what we currently have designed. Call it state activism if you want, but I recall a similar form of state activism in which Germany commissioned auto-makers to create an affordable car for any average citizen that seems to have worked out quite nicely.

Germany systemically has one of the highest unemployment rates of any modern industrial nation and would be bankrupt if it had to pay for it's own defence. I'm sure they're greatful though.



You realize of course that the federal government already pays tuition for doctors in government backed loan programs, right?

Yes. That's what's made the cost of medical tuition soar.



All I'm suggesting is expanding that to build more medical schools, a lot more and offer massive income tax incentives to becoming an MD.

The tax incentives by definition need to be less than the salary cut you would generate in order for this to have a net downward effect on salary-related healthcare costs to the federal government.



Consider for a moment the cost involved for paying almost all medical bills for all patients at the current cost levels assuming they stay the same in real dollars. A woman I recently read about paid $220,000 in a single year for cancer treatment.

I'm very sad to hear it. Maybe we could make it cost as little as $100,000 and more importantly, reduce cancer rates by stop incentivising your processed food industry to fuck up the American public's health. The cost reduction doesn't have to come from this particular kind of intervention though.



The average cost for one year of medical school is $35,000 in state and $50,000 for out of state expenses at a state medical school.

Once credit become available to purchase a good, it tends to soar in price. The cheaper the credit, the higher it goes.



Private institutions cost considerably more. The average years of study for medical school are about 4 years. So on average, medical school costs about $140,000 to $200,000 USD per student who successfully graduates.

Assuming that the woman whose cancer was successfully removed total cost was about average, then medical school for 4 years costs less than having cancer for just one year.

Now, cancer is extremely common. MD's are extremely uncommon by comparison. Do the math. How much does it cost to pay the entire medical bill for a single patient who does NOT have a way of paying for their life saving medical treatment. WHo is paying that bill right now? Everybody, that's who.

Yeah. See above for other methods of reducing the costs.



What exactly would cause the cost of medical attention to stay current given a higher supply of medical practitioners?

It wouldn't. I pointed out that you contradicted yourself on this point. You said the doctors wouldn't lose out and said that their salaries would go down in the same post.



There is a medical care shortage in this country.

Not compared to the UK. We already have all the interventions you suggest and more.



It is important to note, that this initial debt would be paid off by the physicians themselves in the form of what their normal income taxes would have been. Personally, I think this is a stroke of genius. And being a genius, I like the feel of this stroke; I like it a lot.

You've just diverted income tax currently paid from physicians away from all other areas of federal spending and declared it free. That's not genius it's economic incompetence and knowing how smart you normally are I think you were drunk when you wrote it.

Zendetta
18th June 09, 04:03 PM
... and more importantly, reduce cancer rates by stop incentivising your processed food industry to fuck up the American public's health.

I can't decide if this statement is a great idea or a Quixote-worthy stab at a very wealthy, entrenched, politically connected windmill. Either way, you are correct.

The fucking gawdawful things americans put in their bodies has pretty much killed any interest I once had in "universal" health care. I seriously DO NOT want to subsidize the consequences of a bunch of bloated yanks' carb addictions.

elipson
18th June 09, 04:27 PM
20 years is the US standard, which they have tried to push on the rest of the world.

Quikfeet509
18th June 09, 04:31 PM
The fucking gawdawful things americans put in their bodies has pretty much killed any interest I once had in "universal" health care. I seriously DO NOT want to subsidize the consequences of a bunch of bloated yanks carb addictions.



Ab-so-fucking-lutely.



People should have the right to destroy their health anyway they see fit [sort of] but the rest of us should have the right to not pay for their health consequences.



As for generics, there is an interesting trend when people have HSA's (pre-tax fund that they can pay for their health expenditures anyway they see fit) - when they perceive it as their dollar, they buy generics.


I say make universal health care so that everyone has an HSA (with a minimum amount of coverage paid for by taxpayers) combined with high-deductible catastrophic coverage (also with a minimum amount of coverage paid for by the taxpayers) with the caveat that failure to adhere to treatment protocols and lifestyle modifications results in a reduction of catastrophic care.

You want to continue to smoke, eat crap, and sit on your ass? You still get monies to see your PCP and do routine care but eventually when you crash you get to pay your own dime.


Combine that with malpractice caps and we would have a winner.

fes_fsa
18th June 09, 04:39 PM
wouldn't work.

you can get grants and loans and shit to pay for med school. then when you're done with school, yeah, it's a slow process, getting money to pay off all your debts, but in the mean time, you can consolidate your college and med school shit or even refinance to make less of a burden for yourself. and if you still can't afford to pay it, pay what you can and just let them collect it out of your taxes. education isn't why medical care costs are so high.

even if you trained someone for free, after college, you still have to do your residency (or a doctor that doesn't get to act without supervision of another doctor). how much do you think a resident physician makes? they get less than $20/hr. they don't get paid shit.

if you really wanna know why medical care costs are so expensive, just look at all of the clinics and ERs that accept medicaid, medicare, or some other form of government assistance. they HAVE to, by LAW, see patients, whether these patients can afford it or not. free healthcare means that you not only deal with very minor injuries, that could've been treated at home, but also the hypochondriacs. most hospitals and doctor's offices are simply not equipped to handle so many people, despite the allotment the government gives them. sure... alot of these patients could just be evaluated and sent home, but the penalty for being wrong is so high that the medical community isn't willing to risk it.

the result is forfeiting the quality or raising the costs of your care. alot of clinics have done both.

stupid Reagan and his EMTALA.

HappyOldGuy
18th June 09, 04:50 PM
20 years is the US standard, which they have tried to push on the rest of the world.
Wrong. The US law prior to the WTO was 17 years.

But keep on Raging against the machine and don't be killing in the name of.

Lebell
18th June 09, 05:24 PM
But keep on Raging against the machine and don't be killing in the name of.

are you referring to that loud beatmusical group?
they should get a haircut.

Zendetta
18th June 09, 05:26 PM
You still get monies to see your PCP and do routine care but eventually when you crash you get to pay your own dime.

Free PCP from the Gub'ment?!??!

That's my kind of socialized medicine!!!




Good/Bad/Ugly/Unrelated: Po' Folks be taking they kids to the ER for shit that plainly ain't no 'mergency, gawdamn!

Quikfeet509
18th June 09, 08:18 PM
Free PCP from the Gub'ment?!??!

That's my kind of socialized medicine!!!




Good/Bad/Ugly/Unrelated: Po' Folks be taking they kids to the ER for shit that plainly ain't no 'mergency, gawdamn!


That's the kicker. ER visits would be classified as "catastrophic care" and they would have to use up some of their own money.


Bet when faced with that fact, people that use their local ER as a PCP would end up going to their PCP instead since it is significantly cheaper.

Sun Wukong
19th June 09, 11:53 AM
The only reason this is allowed to continue is that stakeholders throw heaps of money at politicians to keep it this way, saying decreasing the number of years for a patent would decrease the incentive for research. Bullshit. 5 years is plenty of time to profit off something.

This is a legal matter for courts as well as a political matter. The United States is built on ideals of free enterprise. Arguing against free enterprise, regardless of my own feelings, is very difficult and indeed, often a dead end in the US political arena. Sorry to say, but that's just something for congress and the Supreme Court to decide and I doubt it will go in favor of relaxing intellectual property concerns.

elipson
19th June 09, 04:24 PM
I don't see how preventing competition for 20 years complies with the ideals of free enterprise.

Cullion
19th June 09, 04:30 PM
The time allowed on a patent is arguable, but without patents then there is little or no incentive to share research information and thereby medical research is slowed.

It would be better to reduce the need for the drugs in the first place.

elipson
19th June 09, 04:31 PM
I agree with the need for patents, just not 20 years. That's excessive.


It would be better to reduce the need for the drugs in the first place.
False dichotomy. It's not either/or.

HappyOldGuy
19th June 09, 04:40 PM
If you decrease the patent time, you increase the premium that the companies have to charge in order to recoup their costs in the short term. That is the only effect. It's a valid debate, but it's a red herring on this topic.

And again, it has nothing whatsoever to do with the difference in drug costs between the US and Canada, since both have substantially the same patent laws.

Zendetta
19th June 09, 04:42 PM
Cullion spoke of the evil american food industry.

HOG, you are kind of a Berkeley Foodie type - were you at the Michael Pollan/Novella Carpenter talk last night?

HappyOldGuy
19th June 09, 05:26 PM
Cullion spoke of the evil american food industry.

HOG, you are kind of a Berkeley Foodie type - were you at the Michael Pollan/Novella Carpenter talk last night?

No I've seen Pollan before. but I didn't know about that one. Unfortunately I'm not very mobile right now. I jacked up my knee on Monday.

Zendetta
19th June 09, 06:02 PM
I jacked up my knee on Monday.

Judo wins again!