I can comment on this. I was in practice in Harlingen from '90-'93 in a group of 3 anesthesiologists mainly performing cardiac anesthesia. There is corruption in the Valley, no doubt, but IMO 95% of the doctors are honest, hard-working people. Hell, we were all over-worked. I got to the hospital at 6:30 and was lucky to get home by 6 pm. That did not count call every 3rd night where I would spend most of the evening in the hospital. There just wasn't time for even thinking about overcharging patients. We all just wanted to do a good job and get home. Also, the malpractice cap wasn't changed until 2003, so I don't get the quote by the surgeon saying things changed in the mid-nineties. Like every profession, we all have our bad apples, and there was one group of doctors I had a big issue with. I am usually pretty reserved about other people's "turf", but I called these guys out for being overly aggressive with the elderly patients who were high risk. However, my overall experience with the doctors was good. A lot of the same ones had offices in McAllen.
We need more doctors who are physicians first rather than businessmen first. Unfortunately the businessman trend has been more and more the norm of late. (not denegrating all doctors, but money seems to be the driving force for a greater and greater percentage). The worst doctors of course are rearely if ever policied by their peers.
I know several general surgeons from McAllen. There is a certain (relatively) new hospital there which I would guess forms the basis for most of the allegations of overutilization (which I am inclined to believe).
Didn't Obama promise to decrease healthcare costs? Now they are floating the VAT around to pay for healthcare. Paying Drs. a fixed rate equal terrible idea. Some Drs. are better than others, and deserve more pay. Teachers get the same pay and look at our public schools. Man are you guys total socialist now. What the hell is happening to our courntry.
I'm not sure about the flat salary idea, but I am open to thinking about it. I suppose I hadn't really considered it. The only problem I could forsee with that is that compensation for good doctors and for ****** doctors would be the same. In addition, what motivation would doctors have to pursue specialties that require more study, or that expose them to increased legal risk? OBGYN for instance would likely benefit from a pay increase via a flat salary, however it is a more legally risky specialty to take up, and I don't think one could dispute that due to the current legal risk vs monetary reward it is difficult to find a good and reliable OBGYN's. The thing is that I am willing to examine any number of solutions so long as the people who are pursuing that solution are willing to treat doctors as hard-working people who chose their profession for a reason (there are less risky professions you could pursue if all you want is a big paycheck), rather than as money-grubbing predators who are responsible for everything that is wrong with modern medicine. I think it is important for all critics of the current healthcare system to recognize that doctors, for the most part, are just as frustrated as they are with the costs and the red tape that prevent them from treating patients more quickly and efficiently. It is also important to take into consideration WHY some doctors are compensated more than others. Cardiologists and Neurologists, particulary surgeons, are exposed to a great deal of stress and risk; and even an appropriate diagnosis will not always save a patient's life. Imagine how much it sucks telling the family, "I am very sorry, we did everything we could" when on top of that you have to worry about the reactions you might receive. It is a natural part of the grieving process to feel the need to assign blame for your loss (there is no shame in this, it is simply something you go through while coping with losing someone) and sometimes that leads to hasty lawsuits. I feel that it is a disturbing trend that some people now consider it "wrong" for someone to make a lot of money, even without examining the services that they are providing. As I lean Libertarian and tend to encourage a free market, I personally believe that to dislike or even hate someone for their success indicates little more than one's own self-loathing for one's own lack of success. Hate someone for being an *******, or a selfish *******. You can even dislike them for being a miser, but all of these reasons are to do with a person's personal moral fiber, and not really with the magnitude of their salary. After all, one can be an *******, or ungenerous with one's money, no matter how much one makes. (Ever been to a border town in Mexico and decided not to give a dollar to that poor lady with the kid?) But I suppose some people, for some reason, tend to think of the money another person is making as the money that they are NOT making--almost as though it could be theirs if the other guy wasn't paid so much, which is, sadly, nothing like how economics actually works. But class warfare in a way has become something of a religion in this country.
No one said "flat salary". It would make sense for a 6-year GP in the heart of NYC to make more than a 6-year GP in El Paso, due to cost-of-living if nothing else. It would also make sense for specialists who went to extra years of education would be on a different tier from your standard GP.
This is cool. I think law should be the same way. Lawyers who work with the poor shouldn't get paid less than corporate lawyers. If all lawyers made similar salaries, then there wouldn't be so many ambulance chasers and there would be more civil rights and defense attorneys.
"Ambulance chasers" are not funded (either partially or fully) via programs paid for by the American taxpayers like doctors are. Terrible analogy.
I am very much against unethical practice patterns, overbilling, etc. Again, I think physicians are more than career HC providers: they have professed a calling to heal. Having said that, my opinion is that what doctors sell is no more necessary for survival than what grocery stores or homebuilders pedal. Shall we make provision of food nonentrepreneurial? The provision of housing? Clothing? Should the only for-profit businesses be ones selling things no one could be reasonably said to need? With first-party payors and transparent pricing, much of the problems with bilking payors could be greatly reduced. Orthopaedics is increasingly policing itself in regards to practice patterns, primarily via board certification and recertification procedures (case collection periods, nonoperative treatments tried before surgery, etc). I am less well informed of what other specialties are doing.
Don't people need some level of legal service? I have an odd jobs man who was divorced and his ex-wife gets most of his paycheck. His new wife gets very upset with him because he has to do odd jobs in addition to his full time job, yet they still can't always make rent and end up moving with their 2 children quite frequently. Meanwhile, his ex lives with a guy but won't get married because she will lose her paycheck if she does. Boy, he could sure use some inexpensive legal help that is better than his ex's legal help to get him out of the jam. It would have been even better if that legal help was around at the time of his divorce as well. Doctor's just screwed up in that they relied on the AMA. Lawyer's have done a great job cozying up to the Democrat party which in turn has helped them stay strong and independent. In fact a few attorneys that I know have been given ambassadorships for their fundraising efforts for the DNC.
"Ambulance chasers" are not funded (either partially or fully) via programs paid for by the American taxpayers like doctors are. __________________________________________________ no, but they should be. They are responsible for an additional 10% across the board adjusted cost to products and services, which in turn increases the tax rate and from which government receives additional funds from sales receipts....bravo...
You've stooped to "well if you love it so much why don't you marry it." You should be proud of your stance on this issue if that's where your logic takes you. Of course, you offer nothing useful as far as reform or insight into the problem. More reflexive bickering. We pay more per capita than anyone else and receive worse service... what do we do?
You like arguing. I understand your point that is what is good for the goose isn't good for the gander. I disagree. Let's leave it at that. By fixing some parts, you are breaking others. No system offers everything for everybody. The system being bandied fails at some major points. They are being glossed over. It ruins what are our strengths (quality of care and innovation) and fixes one weakness (universal coverage) and exacerbates another (cost). It also causes the demise of yet another industry to where we will soon become solely a service industry country. I do have a better system. However, it wouldn't be a perfect system.
