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  1. #1721  
    Quote Originally Posted by davidra View Post
    Easy, simple, and relatively cheap. Do away with fraud and unnecessary procedures, and you'll do just fine financially.
    So how do your enforce "unnecessary procedures"? It seems like when insurance companies try to deny procedures (because they are seen as unnecessary), people get all up in arms because they say this should be a decision between the doctor and the patient. So, are you saying that people will be more comfortable with a government employee or panel saying what procedures are allowed? Or, are doctors suddenly going to stop sending their patients for unnecessary procedures? And how will fraud in Medicare suddenly end? Seems like some pretty big "what ifs" you're shooting for. Of course, I would assume you are for Tort Reform as well? Seems like you've posted in the past that you don't see much savings in that, but shouldn't any savings, regardless of how little (based on your thoughts on that, I've heard otherwise and that it could be significant) be used to keep costs down?
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  2. #1722  
    Quote Originally Posted by davidra View Post
    Lke I said, sometimes your observations don't corellate with reality. Anecdotes are not data. Admittedly, it's possible doctors in Charleston make more money that doctors in NY or California...but I doubt it.


    Median salaries for physicians

    Median salary by discipline
    Well....I guess statistics say one thing, but the homes that these doctors are buying are another. A dooctor client of mine just bought a $2.5 million home looking out over the harbor, and I know what his income is. About every other home in this area is either owned by people who have lived their their entire life, attorneys, or physicians. Again, not sure how they can afford these homes with the incomes you say they make. Like I said, statistics say one thing, but the proof is in the way they live....and trust me....they aren't living like people making $150k.
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  3. #1723  
    Quote Originally Posted by davidra View Post
    Oh...and if you want doctors to work for $75-100K per year, you could start that by not having them be in debt for over $100,000 when they finally start making a good (non-trainee) income at age 31 or 32.
    No one forces them to take this route....everyone must make sacrifices to make this work. You seem intent on making just the insurance industry sacrifice. In an economy where we already have almost 10% unemployment, it will be interesting when even more unemployed folks hit the streets from massive layoffs from the insurance companies. And I'm not talking about the CEO and top execs....talking about the service folks. But hey, they had it coming to them, right? So....let's have everyone make sacrifices....even doctors....maybe it takes 10 years to pay off those loans rather than 5? It's for the children man....it's for the children! You need to get past how much money your fellow doctors "need" to make.
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  4. #1724  
    Quote Originally Posted by davidra View Post
    Lke I said, sometimes your observations don't corellate with reality. Anecdotes are not data. Admittedly, it's possible doctors in Charleston make more money that doctors in NY or California...but I doubt it.


    Median salaries for physicians

    Median salary by discipline
    I would imagine that doesn't include contributions to their retirement plans and other perks. Probably $20k to $30k in most instances. Doctors get pretty sweet retirement plan contributions....especially those with private practices.
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  5. #1725  
    Quote Originally Posted by clemgrad85 View Post
    Well....I guess statistics say one thing, but the homes that these doctors are buying are another. A dooctor client of mine just bought a $2.5 million home looking out over the harbor, and I know what his income is. About every other home in this area is either owned by people who have lived their their entire life, attorneys, or physicians. Again, not sure how they can afford these homes with the incomes you say they make. Like I said, statistics say one thing, but the proof is in the way they live....and trust me....they aren't living like people making $150k.
    Are you listening? It's not the income I say they make. The numbers are right in front of you. You can deny data if you want, but those are the fact, ma'am. You know a small number of doctors who do well. There are many more who don't, who live in modest homes and make much less. If you want to limit the income of subspecialists, you wouldn't find an argument from me....but HMO's didn't have a lot of luck with that in the early 90s.

    And as far as determining what works and what doesn't, I will simply refer you to the Agency for Healthcare Research and Quality. They are the arbiter of what works and what doesn't, they use clear criteria and involve many varied physicians in their determinations. They have been determining evidence-based interventions for many years, and anyone who knows anything about quality and safety would gladly allow them to assist in this determination. But of course they are a federal agency. They just happen to know what they are doing. You can be suspicious if you want, but they are not susceptible to lobbying, or bias, or external pressure. They base their decisions on evidence, nothing more.

    AHRQ

    As an example, if you want to see how they analyzed treatment decisions for prostate cancer, look through this page to see how they reach their conclusions. This happens to be an example for which adequate data is lacking to make a firm conclusion, but there are many other topics in which clear guidelines are suggested.

    Prostate Cancer
    Last edited by davidra; 09/09/2009 at 09:03 AM.
  6. KAM1138
    KAM1138's Avatar
    #1726  
    Quote Originally Posted by davidra View Post
    Sorry. I've been very consistent. Insurance companies price themselves out of the equation, and are unnecessary for routine care.
    Don't be sorry--be honest. If you were consistent then why didn't you agree with me when I said:
    4) Eliminate common care health insurance. No insurance system will work, when payouts are extremely likely on a continuing basis (which health costs are). It's like trying to buy food insurance. It is also why costs are skyrocketing--because we are pretending we can insure against expected costs, rather than relatively unlikely catastrophic events (Stroke, heart attack, major injury, cancer). Use the savings between a policy that covers everything and this to put into an HSA or something similar--providing a pool off money to pay for everyday medical costs (this pool has an excellent chance of growing quite large while a young adult is healthy, say from 18-35 years of age. So, even a significant health-care need at age 30 or so would be paid for from an account that's been growing for 10-12 years.
    Posted August 20, 2009


    Quote Originally Posted by davidra View Post
    Limiting insurance companies to catastrophic policies would save a lot of money, but how will you provide care to the millions of people who can't afford it? Or are they of any concern at all?
    Oh right, the uninsured. That's why I suggested this:
    3) 47 Million supposedly uninsured. Use the current 300 billion we currently pay for Medicaid to provide health insurance the poor supposedly without (that's approximately $6400 per year available for that--per person--a quick estimate for insurance that's better than mine costs approximately $4400 per year--assuming a 40 year old as an average age--keeping in mind medicare is a separate system for the elderly). That's clearly a quick estimate, but an example of what could be done.
    Same Date

    Quote Originally Posted by davidra View Post
    There are multiple parts to the equation: no exclusions for pre-existing conditions; no loss of insurance when you get sick; provision of care for those that truly can't afford it; and cost control.
    I don't believe I mentioned in that post, but I had an idea about pre-existing conditions as well. Not sure how well it would work out without an economic analysis, but I was thinking a good starting point would be that an additional (reasonable) co-payment would be added to things directly related to that pre-existing condition. The concept is to not throw the baby out with the bathwater. Don't disqualify someone because of a condition that may or may not ever be an issue. But in all insurance, there are always different costs for risk and a pre-existing condition is a risk. However, instead of hammering the patient for something that hasn't happened, create a 'what-if' type of situation, where they share cost (via higher co-payment). It reduces the outlay for the patient, and the risk for the insurer. Of course this is just an idea--a starting point.

    As far as those who cannot afford it--I already pointed out that we spend 300 billion a year on medicaid--which is more than enough to provide 47 million people medical insurance better than I have. With lower costs, and considering that that 47 million number include those who already can afford it but choose not to take it, I think we can cover those people by Reforming GOVERNMENT inefficiency as well. We can probably lower that expenditure greatly and still cover the poor--that is if we really want to reform things.

    As far as cost control--that's what a free market does, proven time and time again. A open, free market where consumers can choose services leads to the best price per service ratio. If you refuse to believe that literal price controls are superior, I suggest you look to history to realize that is untrue.

    Quote Originally Posted by davidra View Post
    You tell me how you will solve those problems without any government involvement, and avoiding for-profit wasteful insurance companies, and I'll be a believer. It's perfectly rational for people to choose a direct care model if that's what they want; and for those who can't afford it, they should be able to have health care, and the best mechanism is by simply expanding Medicare. Easy, simple, and relatively cheap. Do away with fraud and unnecessary procedures, and you'll do just fine financially.
    First, I didn't say there should be no government INVOLVEMENT. There should be PROPER government involvement. That is--being the watchdog for business, not the overlord. They are where you turn if companies engage in unethical practices--essentially fraud. Then the government's job is to come down on them.

    Expanding medicare? I'm not sure why that model which already requires many more payers than beneficiaries, and which is on its way to insolvency is a good solution. Simply, when the beneficiary to payer ratio increases so do costs, and I highly doubt that would work economically. Seniors often also end up buying supplemental insurance because medicare isn't sufficient--at least that's what I hear. No, I don't see that system as working particularly well, although if reformed it might be able to function for this relatively small segment of the populations, because it is subsidized by a larger workforce (the taxpayers).

    So, essentially, my ideas--from a humble non-medical expert already address (at least as concepts) all the things that you say need to be done. Its funny how you just missed all of this weeks ago, when you declared that I just didn't understand. Seems like I addressed these issues in a reasonable manner with reasonable suggestions (as a starting point), but you certainly didn't even attempt to discuss the merits or shortfalls.

    Of course I tried to appeal to you to end your trollish behavior then, when I said: Perhaps if you made an honest attempt to understand other people's views instead of declaring they are idiots you'd have some chance at engaging in a fruitful discussion. Instead you've chosen to be hostile and in my case attribute things to me that I didn't say (in regard to that nazi nonsense). So, what I don't get is someone like you who doesn't seem interested in having an sincere discussion.
    Posted to you on August 21st.

    If you've been consistent in your views, then I guess there must be some other reason for your behavior, but I guess that's your issue to resolve, because my views have been on the table (which apparently you've agreed with to some degree at least all along). I guess I really DID understand things after all.

    KAM
    Last edited by KAM1138; 09/09/2009 at 09:14 AM. Reason: Additional point. Emphasis added
  7. #1727  
    Quote Originally Posted by clemgrad85 View Post
    No one forces them to take this route....everyone must make sacrifices to make this work. You seem intent on making just the insurance industry sacrifice. In an economy where we already have almost 10% unemployment, it will be interesting when even more unemployed folks hit the streets from massive layoffs from the insurance companies. And I'm not talking about the CEO and top execs....talking about the service folks. But hey, they had it coming to them, right? So....let's have everyone make sacrifices....even doctors....maybe it takes 10 years to pay off those loans rather than 5? It's for the children man....it's for the children! You need to get past how much money your fellow doctors "need" to make.
    Laughable. Maybe insurance companies should concentrate on something other than health care, for a start.

    And how old were you when you started making money? And how much debt did you have? And how many kids did you have before you were in your early 30's? I can just imagine you would be willing to live in a low-income situation with a family, working 100 hours a week, in hopes that you will make $75,000 at age 32, and then you can start paying off your loans. Your arguments are ludicrous. You want to have a doctor available to take care of you and your family, or not?
  8. #1728  
    Quote Originally Posted by davidra View Post
    Are you listening? It's not the income I say they make. The numbers are right in front of you. You can deny data if you want, but those are the fact, ma'am. You know a small number of doctors who do well. There are many more who don't, who live in modest homes and make much less. If you want to limit the income of subspecialists, you wouldn't find an argument from me....but HMO's didn't have a lot of luck with that in the early 90s.

    And as far as determining what works and what doesn't, I will simply refer you to the Agency for Healthcare Research and Quality. They are the arbiter of what works and what doesn't, they use clear criteria and involve many varied physicians in their determinations. They have been determining evidence-based interventions for many years, and anyone who knows anything about quality and safety would gladly allow them to assist in this determination. But of course they are a federal agency. They just happen to know what they are doing. You can be suspicious if you want, but they are not susceptible to lobbying, or bias, or external pressure. They base their decisions on evidence, nothing more.

    AHRQ

    As an example, if you want to see how they analyzed treatment decisions for prostate cancer, look through this page to see how they reach their conclusions. This happens to be an example for which adequate data is lacking to make a firm conclusion, but there are many other topics in which clear guidelines are suggested.

    Prostate Cancer
    All I did was give you the facts "ma'am" on who I see buying rather large and expensive homes in our area. I would agree that not all doctors make $400,000, but I still say that everyone....including doctors.....need to make sacrifices. Where is it written that doctors need to be making a median income of $140,000? Does that not make physicians one of the higher income professions?What would be wrong with a median income of $100,000 if it would help make health care available for the $47 million uninsured in our country?
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  9. KAM1138
    KAM1138's Avatar
    #1729  
    Quote Originally Posted by davidra View Post
    Oh...and if you want doctors to work for $75-100K per year, you could start that by not having them be in debt for over $100,000 when they finally start making a good (non-trainee) income at age 31 or 32.
    I agree with this--the costs for University are ridiculously high (let's reform that massive drain on the wealth of this nation). Doctors lose MANY years of earning on top of this debt as well.

    I should note--I don't want to fix doctor salaries, I want the market to decide what is reasonable, and it will naturally find the balance point.

    KAM
  10. KAM1138
    KAM1138's Avatar
    #1730  
    Hello Everyone,

    I'll make an additional note here. Insurance companies being involved in the medical industry isn't the problem. The problem is that what they are selling isn't insurance--it is simply an indirect payer system. You cannot rightfully insure something that WILL happen, you insure against things that MAY happen with the price being dependent on the odds. You insure against RISK, not against known costs.

    Medical "insurance" I read really came into prominence due to wage controls in the depression/WWII era. In order to give something to workers, they gave them medical coverage, because they couldn't raise their wages. In other words--this socialistic experiment in wage controls helped CREATE this problem we have today. Important to find the cause of problems when looking for solutions.

    Anyway, I'll reiterate again. Transforming insurance companies into Catastrophic care insurers (which is a risk, not a given) CAN work. Eliminating the massive number of transactions of common health care will also help to streamline their organizations, and increase efficiency. I'd love to not need this, but the costs of surgery (for example) are so high that it is out of bounds currently for almost everybody. Some reform of those costs are required to, but that's another issue.

    Key point: Eliminate the middle man (ALL middle men--not replacing insurance companies with government--costly and wasteful in their own ways), and return the Patient/Doctor interaction to a free market arrangement. Indirect payment schemes are a major problem, and need to be eliminated as much as possible.

    KAM
  11. #1731  
    Quote Originally Posted by KAM1138 View Post
    Oh right, the uninsured. That's why I suggested this:
    3) 47 Million supposedly uninsured. Use the current 300 billion we currently pay for Medicaid to provide health insurance the poor supposedly without (that's approximately $6400 per year available for that--per person--a quick estimate for insurance that's better than mine costs approximately $4400 per year--assuming a 40 year old as an average age--keeping in mind medicare is a separate system for the elderly). That's clearly a quick estimate, but an example of what could be done.
    Same Date



    I don't believe I mentioned in that post, but I had an idea about pre-existing conditions as well. Not sure how well it would work out without an economic analysis, but I was thinking a good starting point would be that an additional (reasonable) co-payment would be added to things directly related to that pre-existing condition. The concept is to not throw the baby out with the bathwater. Don't disqualify someone because of a condition that may or may not ever be an issue. But in all insurance, there are always different costs for risk and a pre-existing condition is a risk. However, instead of hammering the patient for something that hasn't happened, create a 'what-if' type of situation, where they share cost (via higher co-payment). It reduces the outlay for the patient, and the risk for the insurer. Of course this is just an idea--a starting point.

    As far as those who cannot afford it--I already pointed out that we spend 300 billion a year on medicaid--which is more than enough to provide 47 million people medical insurance better than I have. With lower costs, and considering that that 47 million number include those who already can afford it but choose not to take it, I think we can cover those people by Reforming GOVERNMENT inefficiency as well. We can probably lower that expenditure greatly and still cover the poor--that is if we really want to reform things.

    As far as cost control--that's what a free market does, proven time and time again. A open, free market where consumers can choose services leads to the best price per service ratio. If you refuse to believe that literal price controls are superior, I suggest you look to history to realize that is untrue.



    Expanding medicare? I'm not sure why that model which already requires many more payers than beneficiaries, and which is on its way to insolvency is a good solution. Simply, when the beneficiary to payer ratio increases so do costs, and I highly doubt that would work economically. Seniors often also end up buying supplemental insurance because medicare isn't sufficient--at least that's what I hear. No, I don't see that system as working particularly well, although if reformed it might be able to function for this relatively small segment of the populations, because it is subsidized by a larger workforce (the taxpayers).

    So, essentially, my ideas--from a humble non-medical expert already address (at least as concepts) all the things that you say need to be done. Its funny how you just missed all of this weeks ago, when you declared that I just didn't understand. Seems like I addressed these issues in a reasonable manner with reasonable suggestions (as a starting point), but you certainly didn't even attempt to discuss the merits or shortfalls.

    Posted to you on August 21st.

    KAM
    Not really interested in your opinion of my behavior, at all in any way.

    1. Expanding Medicaid as a solution to the uninsured: not likely. Without additional incentives, and increasing reimbursements, this won't work as many physicians won't accept Medicaid. Medicaid is also much less restrictive than Medicare and in my opinion, more expensive than it should be. It also puts a tremendous resource drain on state governments, and is causing significant state shortfalls in many areas....and taking the total Medicaid expenditures and comparing it to your health insurance isn't rational, either, unless you actually have used your insurance to pay for treatment. The Medicaid budget includes the cost of care provided, not just the cost of insurance. You can use all that money to pay for insurance....but all the care that needs to be provided will cost as well, right?
    2. Why struggle with trying to come up with scenarios that will unnecessarily convolute the ability of persons to get insurance for pre-existing conditions? Why just not say everyone is covered, and be done with it? You insist on making things much more complicated (and therefore expensive) than need be. Yes, you will have to figure out co-pays, but why "hammer" the patient at all? Everyone should be covered. Start with that baseline and work from there.
    3. Cost control has worked real well in controlling health care costs, hasn't it? Patients have no idea what they are paying, or what their insurance company is paying. As long as charges and reimbursements are hidden behind a veil of secrecy that benefits the insurance companies and the providers, there is no "open market". And I would question whether there should be one, which I suppose makes me a socialist as far as health care goes. So be it. I don't like the term "market" being applied to people's health. But that's just me.
  12. #1732  
    Quote Originally Posted by davidra View Post
    Laughable. Maybe insurance companies should concentrate on something other than health care, for a start.

    And how old were you when you started making money? And how much debt did you have? And how many kids did you have before you were in your early 30's? I can just imagine you would be willing to live in a low-income situation with a family, working 100 hours a week, in hopes that you will make $75,000 at age 32, and then you can start paying off your loans. Your arguments are ludicrous. You want to have a doctor available to take care of you and your family, or not?
    People make decisions on what job route they want to take. Are you saying we have people being forced into going into medecine? This needs to be reported ASAP!Many people think they want to be a doctor or an attorney but after 4 years of college decide it just isn't worth it (to them) to go the additional time, and yes, cost, to get into the real world. I know I didn't want to go that route and so I took a different road.

    As for my road....it was not easy. I was not forunate enough to be a Kennedy and my family was not wealthy. I basically lived week to week for 5 or 6 years trying to build my business. It was helpful having a wife who had a steady paycheck that was deposited each month and that helped through the tough times. Having been in the same business now for 24 years, I have managed to get it built up fairly well, but I have certainly been hit by the economy....but very few people haven't been hit, right? I can tell you this, I am part of the segment of income earners that is hoping Obama sticks to his pledge of not raising taxes (not one single dime!) on those making less than $250k. I am going to hold his feet to the fire on that pledge.....after all....he promised this on many, many occasions.
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  13. #1733  
    Quote Originally Posted by clemgrad85 View Post
    All I did was give you the facts "ma'am" on who I see buying rather large and expensive homes in our area. I would agree that not all doctors make $400,000, but I still say that everyone....including doctors.....need to make sacrifices. Where is it written that doctors need to be making a median income of $140,000? Does that not make physicians one of the higher income professions?What would be wrong with a median income of $100,000 if it would help make health care available for the $47 million uninsured in our country?
    No, that's not what you did. You gave me your observations. Those are not facts. Find out what percentage of those homes are bought by doctors in comparison to others. Or look up the definition of "anecdotal".

    Yep, it makes them one of the higher income professions. You certainly could choose to go to a poorly trained MD who didn't have a large debt at age 35. You conveniently ignore that part of the equation. And so it took you five to six years to make a good income, right? Did you start right out of Clemson? How about instead of having any income during that time period, you instead paid tuition to medical school? And then you spend another 3-6 years making a minimal income? Would you be pleased about that?
  14. KAM1138
    KAM1138's Avatar
    #1734  
    Quote Originally Posted by davidra View Post
    Not really interested in your opinion of my behavior, at all in any way.
    Oh that wasn't for your benefit--it was to demonstrate the type of person you are to others, and how you've chosen to engage in trollish behavior in many instances instead of fruitful discussion. Hopefully you are done with that now.

    Quote Originally Posted by davidra View Post
    1. Expanding Medicaid as a solution to the uninsured: not likely. Without additional incentives, and increasing reimbursements, this won't work as many physicians won't accept Medicaid.
    Ah, you aren't really reading are you. I didn't say expand Medicaid. I said use the money currently being spent to provide insurance (and an HSA--not stated directly so I'll just add that elaboration) so these poor people have the exact same system that anyone else does.
    Will Doctors accept direct transfer from a bank (HSA) account? I'm guessing they will.

    Quote Originally Posted by davidra View Post
    The Medicaid budget includes the cost of care provided, not just the cost of insurance. You can use all that money to pay for insurance....but all the care that needs to be provided will cost as well, right?
    Well, to be fair--I mentioned (as an example) that the cost of the insurance I sampled was about $4400. As I stated above--the idea was to put that other $2000 a year into an HSA under that person's name. If they ever became gainfully employed, they could then continue that insurance on their own.

    Considering that 47 Million "uninsured" include many who CAN afford insurance, but choose not to, the amount we can spend per poor person is actually greater than $6400. Even keeping that flat, with actual reform, and lower costs that will result, this should be plenty of money to cover the poor.

    While this was a conceptual construct the same idea could work with the elimination of common insurance. In that case a larger portion would be put into the HSA and less spent on Catastrophic insurance.

    Quote Originally Posted by davidra View Post
    2. Why struggle with trying to come up with scenarios that will unnecessarily convolute the ability of persons to get insurance for pre-existing conditions? Why just not say everyone is covered, and be done with it? You insist on making things much more complicated (and therefore expensive) than need be. Yes, you will have to figure out co-pays, but why "hammer" the patient at all? Everyone should be covered. Start with that baseline and work from there.
    Why not just say everyone is covered? You'd have to understand basic economics to understand any answer I would give. I'm not sure you do. I'll try. Essentially--medical care isn't free, and there is no endless well of money somewhere to pay for everything. Of course, this was just ONE idea on how to deal with that. I'm sure there are others. Also--it isn't HAMMERING anyone--its relating payment to care--in a way that mitigates hammering, and keeps continuing costs lower.

    Quote Originally Posted by davidra View Post
    3. Cost control has worked real well in controlling health care costs, hasn't it? Patients have no idea what they are paying, or what their insurance company is paying. As long as charges and reimbursements are hidden behind a veil of secrecy that benefits the insurance companies and the providers, there is no "open market". And I would question whether there should be one, which I suppose makes me a socialist as far as health care goes. So be it. I don't like the term "market" being applied to people's health. But that's just me.
    No, if cost controls worked we wouldn't have skyrocketing prices. That's what you fail to understand--the cost control system has failed--miserably. If it wasn't failing then why would there be a need for reform?

    That disconnect between patient and payment is a root problem in all of this. You are right--there is currently no open market--and where has that led us? To SKYROCKETING costs.

    You question whether there should be a "market" for health...well, there isn't--there is a market for SERVICES. That's how an economic system works--or at least how ones that work well work. Socialistic systems which the government and insurance companies mimic in many ways do not work well--as is demonstrated by the skyrocketing costs. If you want to pretend that medical care isn't part of an economic system go ahead, but doing so won't lead you to any viable solutions.

    If we want to provide for the poor--let's just provide for the poor, but let's do it by raising them up to our level. Let's avoid dropping everyone else down to the mediocre level of care they get.

    Here is the bottom line issue as I see it. You want to delve deeper into a system that has led to skyrocketing costs. I want to go away from a system that has led to skyrocketing costs. I don't want to repeat the same mistakes that led us to the healthcare "Crisis" we are in. Repeating and expanding flawed systems isn't a solution.

    KAM
  15. #1735  
    Quote Originally Posted by davidra View Post
    And so it took you five to six years to make a good income, right? Did you start right out of Clemson? How about instead of having any income during that time period, you instead paid tuition to medical school? And then you spend another 3-6 years making a minimal income? Would you be pleased about that?
    That's why I made the decision not to go that route. Don't you see it's a decision people make? I had some college debt, but very reasonable and it helped my parents out to take on this debt.

    Yes.....I graduated from Clemson in July of '85, and started working August 1 of '85. And no, it took far longer than 5 or 6 years to be making a "good income". I wouldn't want to put my early year income on display here, not exactly something I would be bragging about. But, like I said, it helped to have a wife with at least a set salary (I have never had a salary, only commission income, makes life more interesting for sure!). So, sometimes we just must struggle in order to achieve something better down the road.
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  16. #1736  
    Interesting coverage on American healthcare on the BBC: BBC - Mark Mardell's America
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  17. #1737  
    Quote Originally Posted by E.LesterBrown View Post
    Michael, if the insurance industry is signing your pay checks, do you think it's unfair for folks to wonder whether you might have a conflict of interst here when you say stuff like your last post?
    I realize it's fashionable this time around to make the insurance carriers the demons (last time was the pharmaceutical industry, but apparently they get a pass this time), but why exactly is it any less a conflict of interest for a doctor to be advocating a pro or con position?
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  18. groovy's Avatar
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    #1738  
    Quote Originally Posted by Toby View Post
    I realize it's fashionable this time around to make the insurance carriers the demons (last time was the pharmaceutical industry, but apparently they get a pass this time), but why exactly is it any less a conflict of interest for a doctor to be advocating a pro or con position?
    And if it is a conflict of interest, how can any politician have an opinion at all? Especially, since most or all of them receive donations from individuals and political action committees associated with drug companies and the insurance industry?
  19. #1739  
    Quote Originally Posted by Toby View Post
    I realize it's fashionable this time around to make the insurance carriers the demons (last time was the pharmaceutical industry, but apparently they get a pass this time), but why exactly is it any less a conflict of interest for a doctor to be advocating a pro or con position?
    By no means do pharmaceutical companies get a pass. They are worse abusers of the system than anyone....but at least they provide a service....drugs. Insurance companies provide nothing. If I were lobbying to increase doctor's reimbursements at the expense of the money going to insurance companies, you should ignore what I say. I am not saying that at all. If anything, I would suggest that the reimbursements be more equalized between subspecialists and primary care docs so that students have a realistic choice for repaying their loans if they choose to go into primary care. It is ridiculous for an ophthalmologist to be paid $10K for a 30 minute cataract procedure when a primary care doc can spend an hour and a half with a patient and get reimbursed $50 or less. If we need primary care docs, and everyone seems to think we do, then make that career more appealing. That is simply changing reimbursement criteria; it's not lobbying for more money to go to physicians. I think enough already goes to physicians, and I think too much goes to some. Does that make me seem biased toward physicians? You can like it or not, but my bias is toward cost-effective care for every person in the US. I don't much care about what doctors say, or what people who work for insurance companies say, or what pharmaceutical companies say. I am sick of seeing patients with unexpected diseases pushed to bankruptcy, even when they have insurance. I'll just say it again....not one of you who are opposed to universal coverage have ever been rendered pennyless by a simple surgical procedure, otherwise I guarantee you'd feel differently. And I see that every day. They're just not on this board. That's my bias. And all this claptrap about how much doctors make (less than everyone thinks), and how badly the government does at managing health care (ask how many want to give up their Medicare) is nothing but roadblocks and distractions to the true problem....sick people with no way to get care.
  20. #1740  
    Quote Originally Posted by groovy View Post
    And if it is a conflict of interest, how can any politician have an opinion at all? Especially, since most or all of them receive donations from individuals and political action committees associated with drug companies and the insurance industry?
    Could not agree more. That's why they should leave their death panel and socialized medicine crap at the door and let people work on this who know what they're talking about. And that let's almost all politicians out.

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