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Old 02-25-2013, 03:50 PM   #101
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Bread is too expensive. Clearly we should cut the pay of bakers.
Meaningless.
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Old 02-25-2013, 03:52 PM   #102
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Let's not also discount wait times for elective surgeries. The United States is among the lowest and I don't think it's a stretch to say that those with private insurance will wait less and pay more. By increasing wait times to that of Canada's, we could significantly reduce costs due to staffing and facility expense.
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Old 02-25-2013, 03:53 PM   #103
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As a Canadian i'll never understand why America tolerates such an outrageous health care system..
Fortunately you don't need to be concerned. I do understand why you would find it amusing to watch at arms length as we work all this out.
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Old 02-25-2013, 03:54 PM   #104
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Meaningless.
What's meaningless is holding out doctors as being paid too much. They are getting paid exactly what the market will bear, just like everyone else. Next you decide some other "Big Fish" need to be skewered. Look to treat the cause, not the symptom, grasshopper.
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Old 02-25-2013, 03:54 PM   #105
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Let's not also discount wait times for elective surgeries. The United States is among the lowest and I don't think it's a stretch to say that those with private insurance will wait less and pay more. By increasing wait times to that of Canada's, we could significantly reduce costs due to staffing and facility expense.
Nah, the US is in the middle. Canada is worst but socialist France and Germany have shorter wait times.

Edit: study here http://content.healthaffairs.org/con.../2323.abstract
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Old 02-25-2013, 03:56 PM   #106
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What's meaningless is holding out doctors as being paid too much. They are getting paid exactly what the market will bear, just like everyone else. Look for the cause not the symptom, grasshopper.
The free market doesn't apply to health care. You've written that yourself, right? So how can doctors be "getting paid exactly what the market will bear"?!?

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Old 02-25-2013, 03:59 PM   #107
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The free market doesn't apply to health care. You've written that yourself, right?
Uh, no.

What I believe is that we don't presently have an efficient free market in health care services in the US.

The free market could apply just fine to health care--modified as we see fit to accomodate social goals.
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Old 02-25-2013, 04:03 PM   #108
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Uh, no.
Sorry, maybe I'm misunderstanding your position.

Do you believe that the free market is working as intended for health care in the US at the current time? In which case, the article and the health care "crisis" and this thread are much ado about nothing because, well, that's how the market works?

I realize that you want free market solutions tried.

Edit: We're cross-posting. I don't necessarily disagree with an efficient free market approach but I wonder if more transparency, etc., will accomplish those goals.
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Old 02-25-2013, 04:06 PM   #109
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Do you believe that the free market is working as intended for health care in the US at the current time?
No, surely not. But I do think doctors are getting paid according to the distorted market principles now in effect. Addressing those distortions is (IMO) a more productive approach than calling doctors out as overpaid.

Payments to doctors, hospital adminstrators, the phalanx of code-enterers and bill-sorters, etc are all reflections of the "system" we've set up.
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Old 02-25-2013, 04:08 PM   #110
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Could you please spell out how you see that working out? What specific changes to which specific programs and policies are you suggesting?
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Old 02-25-2013, 04:12 PM   #111
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No, surely not. But I do think doctors are getting paid according to the distorted market principles now in effect. Addressing those distortions is (IMO) a more productive approach than calling doctors out as overpaid.
Fair enough. Most people would support more efficient market approaches. The devil is in the details, of course.
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Old 02-25-2013, 04:32 PM   #112
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http://benbrownmd.wordpress.com/

This pretty much explains salaries by profession. It doesn't explain additional costs like leasehold improvements, Impact fees ( 50 to 100 thousand in my county), or the need to sock away a million dollars just in case one of your kids is dumb enough to want to go to med school. It also shows why dentistry is better financially.
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Old 02-25-2013, 04:59 PM   #113
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Let's not also discount wait times for elective surgeries. The United States is among the lowest and I don't think it's a stretch to say that those with private insurance will wait less and pay more. By increasing wait times to that of Canada's, we could significantly reduce costs due to staffing and facility expense.
Really? It's pretty easy to find evidence to the contrary online, though you chose the worst case Canada instead of looking at all 30 OECD countries with lower cost and better outcomes.

This shows otherwise (wait times are often misused by opponents of universal health care in the US, mostly an out of date argument). For example the UK used to have long wait times from what I've read, but they've improved dramatically it seems...
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Old 02-25-2013, 05:08 PM   #114
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Total healthcare expenditures are 4.6 trillion. Total physician salaries are about 300 billion. So that means somebody else is raking in 4.3 trillion or 94% of the pie.
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Old 02-25-2013, 05:11 PM   #115
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Gatordoc50 was talking about wait times for elective surgery as opposed to the percentage of people waiting 6 days or longer to see the doc when sick. Although it's an interesting graph. That data is different. Tlhis graph shows weeks wait for elective surgery in varous countries at different points in time.
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Old 02-25-2013, 05:22 PM   #116
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Gatordoc50 was talking about wait times for elective surgery as opposed to the percentage of people waiting 6 days or longer to see the doc when sick. Although it's an interesting graph. That data might be different.
It's similar. Some universal health care countries still beat out the US in price and have similar (short) waiting times for elective surgeries. It's more a factor of hospital beds rather than costs (though, obviously, one dictates the other). Pages 106-7 have some graphs.

Explaining Waiting-time Variations for Elective Surgery Across OECD Countries
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Old 02-25-2013, 05:24 PM   #117
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Really? It's pretty easy to find evidence to the contrary online, though you chose the worst case Canada instead of looking at all 30 OECD countries with lower cost and better outcomes.

This shows otherwise (wait times are often misused by opponents of universal health care in the US, mostly an out of date argument). For example the UK used to have long wait times from what I've read, but they've improved dramatically it seems...
Let's be fair. Those who would like to convince themselves that their docs are ripping them off have been cherry picking data thru out this thread. Pick a country. We are fatter than them all.
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Old 02-25-2013, 05:31 PM   #118
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It's similar.
Doesn't look similar to me. That's not to say that if we move to a single payer or total gov't managed system we can't emphasize the service levels we wish to emphasize. But, at the moment, our elective surgery waiting times look pretty good. Improving elective surgery wait times would NOT be a reason for us to change. I'm not saying there aren't other reasons, just that wait time for elective surgery isn't one of them.

And these times are very different than the "percentage of people waiting 6 days or more to see a doc" times that midpack showed.
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Old 02-25-2013, 05:44 PM   #119
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Improving elective surgery wait times would NOT be a reason for change. I'm not saying there aren't other reasons, just that wait time for elective surgery isn't one of them.
Right but no one claimed that going to universal care would shorten waiting periods. It's obvious from your graph, though, that doing so doesn't have to mean longer waiting times.
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Old 02-25-2013, 05:58 PM   #120
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Right but no one claimed that going to universal care would shorten waiting periods. It's obvious from your graph, though, that doing so doesn't have to mean longer waiting times.
No, it wouldn't have to mean longer waiting times. They could stay the same or improve. Actually, there's no medical system metric that could not be improved if we went to universal care. Likewise there is no medical metric that could not be improved if we stayed with our current system. It's all trade-offs and allocation of resources. You have to decide what you want and apply the will and resources to make it happen.

Look again at the graph Midpack posted. "Percentages of people waiting six days or more to see their doc" is not the same as "weeks of time wating for elective surgery."

That's all I'm sayin'
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