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stinkcat_14
Guest
Here is a little more explanation for you.Actually I know what you are saying, I am confused about
you believing what you wrote…
books.cat-v.org/economics/capitalism-and-freedom/chapter_09
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books.cat-v.org/economics/capitalism-and-freedom/chapter_09
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LisaA
Guest
That’s a really grand assumption. Doctors are just people like anyone else. Their taste in cars bears little resemblance either to their talent or financial results. It’s more a matter of priorities. One of our docs drives a 20 year old Volvo station wagon. Another has a BMW. They both make the same money. Doctor A puts money into his family with a focus on education, sports and developing their talents. Doctor B likes having a nice car and his kids are grown up. They make the same money, and are equally talented.
IOW to project massive impact because of car ownership is getting WAY over your skis. As to claiming some individual doctor has created barriers to entry to make more money…REALLY? What doctors earn these days has a lot more to do with what someone will pay them than being able to influence the payers. It doesn’t matter a bit how rare a heart surgeon is, what he gets paid is based on a formula over which he has ZERO control.
Lots of amazingly erroneous information out there
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stinkcat_14
Guest
Actually, I do not care what kind of car the doctor drives. The point was, if the doctor earned the money from being smarter than average or giving better care and therefore attracting more patients that is one thing. On the other hand, if the doctor earns more money because of the anti-competitive practices of the AMA in regards to lobbying for medical licensing restrictions and other barriers to entry, then there is nothing praiseworthy about that.That’s a really grand assumption. Doctors are just people like anyone else. Their taste in cars bears little resemblance either to their talent or financial results. It’s more a matter of priorities. One of our docs drives a 20 year old Volvo station wagon. Another has a BMW. They both make the same money. Doctor A puts money into his family with a focus on education, sports and developing their talents. Doctor B likes having a nice car and his kids are grown up. They make the same money, and are equally talented.
IOW to project massive impact because of car ownership is getting WAY over your skis. As to claiming some individual doctor has created barriers to entry to make more money…REALLY? What doctors earn these days has a lot more to do with what someone will pay them than being able to influence the payers. It doesn’t matter a bit how rare a heart surgeon is, what he gets paid is based on a formula over which he has ZERO control.
Lots of amazingly erroneous information out there
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LisaA
Guest
On that we agree. We’ve dealt with the medical board and the restrictions are sometimes ridiculous and vary greatly from state to state. We used to have amazing foreign doctors come for additional training but in this state they couldn’t get a license because they hadn’t had a _year APPROVED residency. We had a few doctors that would go through another three years’ training in America to get a license. Other states would allow the foreign training.
That being said, it sounded as if you were blaming doctors for what the medical bureaucracy inflicts on them. The AMA is NOT a doctors’ advocate. They make millions from medical billing codes and have ZERO to offer the average doc in practice. I don’t think though that they have much influence on state boards.
Lisa
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RACJ
Guest
There actually WAS one musician who gave HALF of everything he earned to charity, but he met an untimely death. His name was Harry Chapin, one of the few outspoken liberals for whom I actually had tremendous respect. To the pont here, one can’t eat dollars, and even in one’s avaricious lifestyle, many people are either employed or benefit in some way no matter how one spends or invests his money.What struck me is that in OUR culture the contempt for the weakest, the useless is manifested in the Democrat pro abortion platform. What is weaker than an unborn child? Even the poorest in our country CAN sustain life, get food, shelter, and medical care. They are ALIVE unlike the millions of “useless” unborn babies discarded because of the cruel and heartless attitudes of those in power.
Further we do no service to the poor by being dishonest and patronizing. In America the vast majority of the poor are there because of poor decision making by themselves, their parents, or sadly generations before. We have generational poverty borne of government programs intended to FIGHT poverty that have simply not addressed the underlying causes of these problems. Flinging money at chaotic and dysfunctional cultural “norms” does not help either those mired within them or prevent the next generation from following suit.
As to mega salaries for CEO’s, while I do not personally think they deserve them in many cases, we have to be equitable in our attitude. What about sports figures? Celebrities? Actors? Musicians? Do THEY deserve millions more than us great unwashed who pay to see them? Why don’t they say STOP!!! Why don’t they give their money to the poor? Our clinic office receives a number of pop culture magazines that show what mega million dollar home or mega thousand dollar handbag was purchased by some drug addled pop tart. It disgusts me to no end. I suspect the Holy Father also referred to that type of rampant greed and consumerism but somehow since the Hollywood elites are “in” with the Beltway elites, the media never points this out
Lisa
I’d rather see an individual decide how best to acquire and spend his wealth than have some exhorbitantly paid political hack redistribute it for him.
Rob
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LisaA
Guest
Wow didn’t know that about Chapin. One of my favorite singers of all time. I think we all have great admiration for those who were blessed through talent or ambition or brains who take what they’ve been given and give back. I don’t know too much about the details but it does seem that Bono does a lot for charity. And Gary Sinese has done AMAZING things to support our troops.There actually WAS one musician who gave HALF of everything he earned to charity, but he met an untimely death. His name was Harry Chapin, one of the few outspoken liberals for whom I actually had tremendous respect. To the pont here, one can’t eat dollars, and even in one’s avaricious lifestyle, many people are either employed or benefit in some way no matter how one spends or invests his money.
I’d rather see an individual decide how best to acquire and spend his wealth than have some exhorbitantly paid political hack redistribute it for him.
For the most part though I think wealthy celebrities and entertainers have been seduced by the glittering images of fast cars, big homes, and sparkly jewelry. Not exactly storing up treasures in heaven if you live a consumer lifestyle.
Lisa
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pnewton
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Except this too makes the same failure as Obamacare, namely, refusing to address the cost of healthcare and only focusing on healthcare insurance. Without addressing the factors that raise health costs(malpractice suits, FDA approval, etc.) , we are just shuffling money.
I have been meaning to tell you, as one of the minority that has agree with you on this issue, that in all deliberations, we must remember that wealth is not a zero sum issue. Taking from the rich does not give to the poor.
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mikekle
Guest
Oh, I agree with you on the insurance industry as a whole, namely car insurance. I have been paying car insurance since I was a teenager and had my first car, and I have NOTHING to show for all these years of paying that! I never had an accident that MY insurance had to pay out for, so all that money went to God knows what?!! LOL Plus, Im just one person, cant imagine all the other people in my same situation and the billions raked in by these insurance companies. But when it is literally a law, someone MUST buy your product (car insurance), you cant loose!
I guess thats why the industry as a whole can afford to put 1000s of tv commericals advertising for more customers constantly!! LOL
Something needs to be done about the car insurance industry, Hopefully Obama will target them next, I am getting really sick of seeing hundreds of dollars I work for, end up with me having nothing to show for that money!
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epan
Guest
Finally, we agree. It is tiring. However, it will only get worse, unless something is done. So, we will be hearing it much more into the future.
Once US healthcare costs exceed 20% of GDP (probably within 12-15 years), it will simply be unsustainable.
So much of US politics and business is driven by what is called a “greedy algorithm”. By that, I mean to look for the cheapest short term solution, or the most profitable short term solution, without considering the long term consequences.
A different, yet related, topic is that of military retirement and healthcare benefits, which now eat of 50% of the defense budget, and which will grow dramatically in coming years. The reason is the expediency for politicians to have an all volunteer service, which will not balk at going to war. In this way, public debate is reduced, and politicians may engage in military action quickly and quietly. As long as the economically challenged kids go to war, and we leave the senator’s and CEO’s kids in private colleges, then all is good, and who cares if a future generation will pay the bill for the career military truck drivers and cooks.
An alternative to this would be the Euro model of requiring every citizen to serve. In fact, most military and government jobs do not require a high level of skill. These jobs may easily be done by someone serving 2-3 years. Such a model solves much of the long term retirement costs problem. But the problem for the politicians is that if everyone serves, then a public debate is required when we go to war. That is a terrible thing to face, in a democracy.
I visited an IRS office once. I wanted to work on some tax matters. It took 6.5 hours of waiting to get a printout. The people in that office were probably all career IRS employees who will retire from one federal job, and then take another one, remaining on the government employee dole. I suggest that requiring mandatory government service of 24-36 months of all citizens would not solve the bureaucracy problem, but it would reduce the huge burden of retirement pay to government employee freeloaders.
The healthcare problem is similar. If you look at the care delivered on a per patient basis, it is ridiculously expensive, but of high quality. You mention the problem of “who is going to pay?” That is another area where we agree on the problem. The costs are spiraling beyond sustainability. Therefore, we need to find another model.
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Ridgerunner
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At the time, he drove a Corvette. I’m not sure what he drives now. He was a rare creature; a super-specialist who theoretically worked for a big hospital group and ran the department, but was actually independent. His fee structure was whatever he said it was, and he could do what he wanted about charging this person more or that person less.
I also knew a very well thought of neurosurgeon who wouldn’t take any kind of insurance at all. He set his fees, had only one administrative person, and worked out whatever he wanted with his patients. His fees were actually pretty reasonable, probably a good part of it due to the fact that his overhead was minimal. He told people how it worked up front and that he wouldn’t take insurance. His secretary would give the patient all the information they needed to bill their own insurer, and that was how it worked.
Actually, that’s not terribly different from the French system in a way. About 2/3 of the people are in the “public system”, but they have to pay for care themselves and bill the government for reimbursement. The other 1/3 is entirely private. In the U.S., I believe we’ll end up with, not a two tier system, but likely a four-tier system.
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Ridgerunner
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Unfortunately, no one in government has any interest in actually dealing with healthcare costs as such, and certainly the current government doesn’t.
I know a guy who served as a state prosecutor and got credits toward a state pension from that. Then he worked as a private lawyer and got social security credits for that. Then he worked for another state as a bureaucrat and served enough time for a pension for that. Then he worked for yet another state and did the same. Then he ran for a judgeship and won and he’ll get yet another pension for that. And none of it is funded.
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LisaA
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Having patients in control and monitering healthcare costs makes a huge difference. If you look at medical procedures that are elective and out of pocket, you see costs go DOWN not up. Our current model of having healthcare delivery almost completely divorced from payment gives patients no incentive to ask questions or shop around.
Removing all of the MANDATES makes a huge difference in the funding of healthcare through third party payers. The insurance model works fine if it’s insurance. Dr Monica Wehby a pediatric neurosurgeon who is running for Senate in our state pointed out that Obamacare is NOT insurance, it’s a benefit package because of all the mandates. Insurance is spreading risk of something catestrophic. If car insurance were like health insurance is these days, we’d expect insurance to pay for oil changes. When the state mandates a package of benefits, particularly foisting this ridiculous one size fits all model, then the people will pay a LOT more for a LOT less.
Giving doctors incentives to volunteer or allowing them to see patients free without jeopardizing their status as Medicare/Medicaid providers would reduce costs to patients. Ditto with the restrictions on free medications. Many pharmaceutical companies will provide free medications for doctors to pass out but again if the patient is Medicaid, he is prevented from giving him free meds or free services.
This isn’t brain surgery…there are proven methods of ratcheting down medical costs that would be acceptable to Americans (rationing, lower level providers, two tiered medicine are not). But unfortunately the strength of various lobbies keeps efficiency from this market.
Lisa
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LisaA
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My BIL was a high ranking officer for our city police. He was told that if he retired (at age 50!!!) he would maximize his retirement benefit. So he “retired” and then went right back to work for the police force although with a different status. He’s also getting retirement from the new gig.
It’s the city and state pensions that bankrupted cities, counties, and states. I think this is a far bigger issue because it’s so far beyond our sight much less our control than costs like healthcare or Social Security. We have NO idea what our cities, states, and counties are racking up. Just ask the people of Detroit.
Lisa
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