Feel free to go to school for 11+ years to help out with the problem if you feel the situation is so dire Groverat.
I guess my definition of access is quite unorthodox. For example, do you think people have access to food and water in this country? I figured we all do, as long as we are willing to pay for it. So by my bizarre definition of access, I meant one can look up the phone book, call an Internist, Family Physician, or Pediatrician for an appointment. Then you bring some form of payment with you for receiving the treatment. An office visit to one these physicians is usually $50 to $100. Believe it or not, the part of paying for the services/products also happens to me whenever I buy necessities such as food and water from the grocery store. Now if you mean access as in having every procedure, doctor, and test available to you, that's not going to happen in the reform bill from the President and Congress either. Remember, part of the plan is to have a panel of so-called experts deciding what is appropriate for all of us. Going by that definition, I am not sure there is a country where 90%+ of procedures, tests, medications, and physicians are available to all. Do you know such a country?
The government should be obligated to pay for a physicians debt if they would have us become servants of the universal healthcare machine. Did anyone force me to pursue this career? No. Am I providing a valuable service? Yes. Should physicians be compensated for years of debt incurred and years of potential income lost while studying or during residency? Yes.
But yet you are somehow owed healthcare? Also your lack of knowledge about the PGY process is quite evident. During residency PGY's provide valuable medical service at a fraction of the cost. Maybe we should cut their paychecks as well?
No one forced the "unfortunate" or the "uninsured", to be unfortunate or uninsured. Why the hell should I give a rat's tail about somebody who's either of these two things?? By your definition nobody owes anybody anything. I would think the reason that a surgeon is "owed" a large salary is because they provide a valuable service that not many other people can do (safely). What's wrong with a surgeon making money for something that they're good at????
And no one actually tries to argue the point, which is telling. "My group is owed something, your group isn't." That is, perhaps, the key difference between so-called liberals and so-called conservatives in this country. Both think they are entitled, but liberals at least thing others are entitled as well.
We pay more because we are fat (We are Fat.). Further, we have decided to chase people out of primary care (note that the situation that caused the exodus from primary care- more work for less money- is the same situation that you want to apply to all specialties) (Link). I have proposed an idea for increasing access to primary care a number of times, but nobody has replied yet and I'm not hopeful that anyone will take interest. However, access to primary care does not mean that people will utilize it.
The original point of the thread regarded Obama's comment re unindicated tonsillectomies-- opposed with literature and supported by a lay article about one market, the article itself pointing out that the market is an outlier. No one owes surgeons a good living. What surgeons have the right to do is to pursue happiness unfettered by the federal government except in the specific cases the Constitution authorizes Congress to intervene.
kgp, You are one crazy dude. Don't you know we are getting closer and closer to guaranteeing happiness in this country? Where did you get the idea that we need to pursue happiness?
As do I. And it's a good thing Congress has the Constitutional authority to levy and collect taxes from people of all income levels.
This is not a thread about whether taxation is unconstitutional. It is about the POTUS' Ill-supported intimation that physicians are allowing themselves to be pushed into unindicated tonsillectomies to a meaningful degree, a statement on his part made in support of something I do not find in the original document or its ratified amendments. Calling the local and state-licensed practice of medicine interstate commerce is a politically expedient lie. The Constitution grants Congress no power over medical practice, and it expressly forbids Congress' assumption of powers except by amendment.
Roll tape. Obama says, "Right now, a lot of times, doctors are forced to make decisions based on the fee payment schedule that's out there. So if they're looking, and you come in, and you've got a bad sore throat or your child has a bad sore throat or has repeated sore throats. The doctor may look at the reimbursement system and say to himself, 'You know, I make a lot more money if I take this kids tonsils out.' Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change ... maybe they have allergies, maybe they have something else that would make a difference." Unsurprisingly, the troll that started the thread didn't bother posting Obama's actual words. So let's look at the question again with Obama's perfectly reasonable statements in mind: Are Docs performing tonsillectomies a problem? Obama never asserted that it is tonsillectomies that are the problem or even a problem to any significant extent. He used that one procedure as an example for how the profit motivation can pervert a doctor's treatment process. This makes it even more absurd that you cheer on those who duck the obvious question about flat salaries and patient outcomes, which is what Obama was actually talking about. It seems like most of the people in this thread want to do anything but discuss what the president actually said and the subject matter the president was actually discussing.
I fail to see how you can justify flat salaries for medical professionals. If you are going to regulate the income of one profession, why not regulate the income of lawyers or investment bankers? Where is the line drawn for government intervention? Free enterprise is free enterprise even if it provides medical treatment.
Flat salaries work better in some environments than others. I have previously introduced arguments and literature support for their problems pertaining to anesthesiology. Another major issue is emergency specialty call coverage. As a more widely dispersed populace, Americans face different geographical medical staffing issues than, say, the Dutch. There are no neurosurgeons in Sweetwater. If you sustain a bilateral jumped facet with cord compression in an MVA Friday night, you depend on a doctor from another town to agree to go to work in the middle of the night, probably all night, to give you care. Without paid transfer and trauma call panels elsewhere, those accepting doctors will be even harder to find. Treatment delays and failures will lead to greater loss of life and limb. German physicians went on strike not too long ago over the prospect of government-mandated work-week extension from 38.5 to 43 hours. Salaried doctors are going to be somewhat like other salaried employees-- they won't as often volunteer to work 70 or 110 hours per week, nor on weekends and holidays. The massive drop in available physician man-hours were we to go to 43 hours/doc/wk here in the US would be staggering. Germany has made its physician population more like many other trades and is reaping what it sewed: fewer than 60% of those entering medical school go into practice in Germany. Extrapolating what works or appears to work in one environment to widespread application is hazardous. There are many drawbacks to flat-salaried physicians, often impacting patient care. Shorter hours, for example, lead to increased hand-offs, a source of medical error. Discussing flat salaries is fine, but one should not make the mistake of believing them a panacea or even necessarily a net positive. Oh, and they are unconstitutional if federally set. Liberty was rather firmly codified into our founding documents, and government-set salaries are not remotely an example of liberty in action.
