Current Events > Medicare for all won't work; hospitals will go out of business.

(+) Yeah! (+)

nexigrams posted...

I wonder what would happen if we got rid of them all?

Were we to somehow ban 3rd-party payers, apart from maybe charity and catastrophic coverage, prices would implode immediately.

Gwynevere posted...

We should put this dude in charge and see where it gets us

And if I was in charge of fixing healthcare, I would cut wages in medical fields by half to align with other countries, disallow any medical malpractice lawsuits, dismantle the bullshit chargemaster, and increase taxes to enact universal healthcare.

nexigrams posted...

It works every other civizilzed country, no reason why it wouldn't work in the most prosperous country in human history. It's almost like the insurance companies exist solely to raise prices 4000%. I wonder what would happen if we got rid of them all?

Our salaries would go down and I would quit and find a new job doing consulting.

I need to be paid at least 250K+ salary to put my license at risk to deal with stupid people who come to the hospital for shoving a rod up their rectum.

If it's up to TC everyone would pay 70-80% of their salary in taxes.

Dan_Haren- posted...

If it's up to TC everyone would pay 70-80% of their salary in taxes.

Yup lol. That would actually get people to do what they want to do vs what they have to do, and I do believe in that most people are good people and will do things that better society.

megamanfreakXD posted...

I need to be paid at least 250K+ salary to put my license at risk to deal with stupid people who come to the hospital for shoving a rod up their rectum.

As an employee of a hospital, you're personally at risk for things you do? I'm an engineer, and as an employee, any fuckups I do, my employer is responsible, unless it's gross negligence on my part... I mean sure, if I fuck up in a big way, I'll get fired, but I won't get my PE license pulled or get sued.

IdiotMachine posted...

As an employee of a hospital, you're personally at risk for things you do? I'm an engineer, and as an employee, any fuckups I do, my employer is responsible, unless it's gross negligence on my part... I mean sure, if I fuck up in a big way, I'll get fired, but I won't get my PE license pulled or get sued.

Hows that work? You, as the engineer, sign off on the blueprints on a building. That building then collapses even though it was built to the spec you signed off on. How are you not at fault?

IdiotMachine posted...

As an employee of a hospital, you're personally at risk for things you do? I'm an engineer, and as an employee, any fuckups I do, my employer is responsible, unless it's gross negligence on my part... I mean sure, if I fuck up in a big way, I'll get fired, but I won't get my PE license pulled or get sued.

As a doctor or nurse your license is on the line every day.

IdiotMachine posted...

As an employee of a hospital, you're personally at risk for things you do? I'm an engineer, and as an employee, any fuckups I do, my employer is responsible, unless it's gross negligence on my part... I mean sure, if I fuck up in a big way, I'll get fired, but I won't get my PE license pulled or get sued.

I mean you have malpractice insurance but you have to report any ongoing lawsuits to your new employers which can make applying or changing jobs very difficult. And that record sticks with you forever.

It only takes one lawsuit, even though you are not at fault or of the patient is being an asshole. Hospitalists see up to 30+ patients a day. Can you imagine EM physicians?

Kloe_Rinz posted...

Hows that work? You, as the engineer, sign off on the blueprints on a building. That building then collapses even though it was built to the spec you signed off on. How are you not at fault?

I don't sign on my behalf, I sign on my company's behalf. All our sign-offs are from the company and not the individual engineers.

Kloe_Rinz posted...

Hows that work? You, as the engineer, sign off on the blueprints on a building. That building then collapses even though it was built to the spec you signed off on. How are you not at fault?

the employer is, like every other job(unless it's a criminal act)

Dan_Haren- posted...

As a doctor or nurse your license is on the line every day.

megamanfreakXD posted...

I mean you have malpractice insurance but you have to report any ongoing lawsuits to your new employers which can make applying or changing jobs very difficult. And that record sticks with you forever.

It only takes one lawsuit, even though you are not at fault or of the patient is being an asshole.

That sucks... Medical malpractice insurance is also something you pay out of pocket, and not the hospital covering you? Do patients sue the doctor or the hospital usually? Or that doesn't matter?

IdiotMachine posted...

Yup lol. That would actually get people to do what they want to do vs what they have to do, and I do believe in that most people are good people and will do things that better society.

Most people in society are fucking stupid and the vast majority only care about themselves.

I'm gonna leave this topic soon but I think you just have a really poor fundamental understanding of everything. At the end of the day money drives innovation and there's a reason why the US leads the world in innovation in almost every sector and that includes healthcare.

IdiotMachine posted...

That sucks... Medical malpractice insurance is also something you pay out of pocket, and not the hospital covering you? Do patients sue the doctor or the hospital usually? Or that doesn't matter?

If you are in private practice, you pay for your own. If you work in a good hospital they usually have good malpractice insurance.

megamanfreakXD posted...

If you are in private practice, you pay for your own. If you work in a good hospital they usually have good malpractice insurance.

Gotcha. Thanks for the peek in the medical world.

s0nicfan posted...

As a doctor, how much of a pay cut would you realistically accept in exchange for a shift to a more EU-centered style of medicine?

I used to do medical billing payroll software and this isn't the question you think it is. Many doctors get paid for the work they do and only the work they do. Some get a combination salary + work. Different hospitals have different policies.

You're thinking like it's a regular white collar job where you go to work and get paid and that's it.

A more appropriate comparison is like, you're a waiter and you no longer get any kind of salary, literally 0 per hour, but now every customer is guaranteed to tip the exact same %, and no one will ever dine-n-dash ever again. Do you accept and what's the lowest % tip you'll accept?

s0nicfan posted...

Coffee, there's something I'm curious about, but my question is a bit personal so I'm going to try to keep this as details-ambiguous as possible, and I ask this with the utmost respect for you and your profession, and ALSO as someone who believes the US healthcare system is a fucked up mess: As a doctor, how much of a pay cut would you realistically accept in exchange for a shift to a more EU-centered style of medicine?

From what I can tell, outside of the US the second most highly paid doctors are German doctors, and they make roughly half of what US doctors of the exact same profession pay. In the UK, they make roughly a third of what a US physician makes (again, on average). As I understand it, US doctors are largely on the hook for paying for their own malpractice insurance, which is crazy expensive, so in terms of net difference I'm sure it's less than half, but let's be practical and say it's 40%. Would you cut your pay by 60% tomorrow if it meant a different, more globally available system?

Feel free to be as vague as possible because I understand that letting CE know (even roughly) what you make is a terrible idea, but I'm very curious what your perspective is as someone who would be directly impacted by a large shift in the industry and whether you feel like your peers would stand with you on the issue.

EDIT: and if you'd rather not answer, that's fine too, although I'd appreciate it if you'd at least say you chose not to answer rather than just ignoring the question, but really whatever you're comfortable saying.

A bit tangential to your tangential question - are your figures accounting for not having to pay for medical school? German doctors making half of US might be closer if you take out the medical school loan costs...

Ruvan22 posted...

A bit tangential to your tangential question - are your figures accounting for not having to pay for medical school? German doctors making half of US might be closer if you take out the medical school loan costs...

They're not factoring in student loans, but only because healthcare reform is rarely explicitly bundled with education reform. So unless we're proposing a "drastically change everything all at once" policy, it's just the unfortunate reality that healthcare reform by itself would require people like coffee to take a 60% pay cut on top of a large tax increase, at no change to cost of living, to make things more like the EU.

USUALLY these discussions are purely hypothetical so I was curious to hear from the doctor's mouth directly whether that's acceptable or not.

s0nicfan posted...

They're not factoring in student loans, but only because healthcare reform is rarely explicitly bundled with education reform. So unless we're proposing a "drastically change everything all at once" policy, it's just the unfortunate reality that healthcare reform by itself would require people like coffee to take a 60% pay cut on top of a large tax increase, at no change to cost of living, to make things more like the EU.

USUALLY these discussions are purely hypothetical so I was curious to hear from the doctor's mouth directly whether that's acceptable or not.

Ahh - I *believe* she said somewhat recently that she had paid off all of her school debt (was understandably excited), which I'm sure would affect her/a person's answer. Your description of doctor's wages in other countries doesn't seem quite as accurate? Again IF she wanted to answer, it's definitely not something she has to speak to...

Everything sucks so much...

IdiotMachine posted...

Perhaps you should actually find out how it works. Germans making less than ~60k pay a ~15% tax that funds the program; those who make more can opt out and purchase private insurance. Those who are under the German government healthcare are not entitled to any of the "standard" stuff that we are accustomed to here in the US, like private rooms in hospitals, consultations with private doctors, alternative or complimentary treatments.

Turbam posted...

@Choco

Is any of this true?

uhhh
idk how accurate the 15% is
with enough money you can purchase private insurance, yeah
my dad shared his hospital room with a few other ppl when he broke his foot a few years ago so that's accurate i guess
idk what exactly "consultations with private doctors" is supposed to mean, but if it's about private-only doctors who don't take public healthcare patients then yeah that is true by definition
"alternative or complimentary treatments" you can barely avoid aLtErNaTiVe treatments with how much germans love homeopathy so that point doesn't sound true but idk what exactly they meant

Ruvan22 posted...

Ahh - I *believe* she said somewhat recently that she had paid off all of her school debt (was understandably excited), which I'm sure would affect her/a person's answer. Your description of doctor's wages in other countries doesn't seem quite as accurate? Again IF she wanted to answer, it's definitely not something she has to speak to...

Pay ranges pretty wildly depending on the type of doctor and it's difficult to get a perfect picture, so I went googling for the average pay for a surgeon and also for a general practitioner, and in both cases the EU pay was somewhere between half and a third. For example:

https://www.physiciansweekly.com/how-do-us-physician-salaries-compare-with-those-abroad/

1. United States $316,000
2. Germany $183,000
3. United Kingdom $138,000
4. France $98,000

It's possible the sources being referenced are biased, but it's generally tough to find salary comparisons so I went with the number ranges that seemed to appear in the most number of results. Any site I found I ran through media bias fact check to at least make sure they have a history of factual reporting, but that isn't a guarantee of accuracy, either. In general, though, I don't think it'd be particularly controversial to suggest that an EU style healthcare in the US would require doctors across the board to take a pay cut roughly in the range of 40-60%

I have friends in Canada who make more than what's listed under Germany

We could turn the US healthcare system in a monospony tomorrow, and save a couple trillion dollars.
The current private+public system is a disaster, and most of that is back-office staff trying to figure out who actually pays for anything.

Source: I did IT consulting for a "small town" doctor, and I got to see the shit. HIPAA doesn't let me say more.

s0nicfan posted...

Pay ranges pretty wildly depending on the type of doctor and it's difficult to get a perfect picture, so I went googling for the average pay for a surgeon and also for a general practitioner, and in both cases the EU pay was somewhere between half and a third. For example:

https://www.physiciansweekly.com/how-do-us-physician-salaries-compare-with-those-abroad/
1. United States $316,000
2. Germany $183,000
3. United Kingdom $138,000
4. France $98,000

It's possible the sources being referenced are biased, but it's generally tough to find salary comparisons so I went with the number ranges that seemed to appear in the most number of results. Any site I found I ran through media bias fact check to at least make sure they have a history of factual reporting, but that isn't a guarantee of accuracy, either. In general, though, I don't think it'd be particularly controversial to suggest that an EU style healthcare in the US would require doctors across the board to take a pay cut roughly in the range of 40-60%

s0nicfan posted...

Pay ranges pretty wildly depending on the type of doctor and it's difficult to get a perfect picture, so I went googling for the average pay for a surgeon and also for a general practitioner, and in both cases the EU pay was somewhere between half and a third. For example:

https://www.physiciansweekly.com/how-do-us-physician-salaries-compare-with-those-abroad/
1. United States $316,000
2. Germany $183,000
3. United Kingdom $138,000
4. France $98,000

It's possible the sources being referenced are biased, but it's generally tough to find salary comparisons so I went with the number ranges that seemed to appear in the most number of results. Any site I found I ran through media bias fact check to at least make sure they have a history of factual reporting, but that isn't a guarantee of accuracy, either. In general, though, I don't think it'd be particularly controversial to suggest that an EU style healthcare in the US would require doctors across the board to take a pay cut roughly in the range of 40-60%

Sorry I don't think I was very clear in my last post. I wasn't disagreeing with the final number approximating non US physician outcome, I was asking how that number could reflect starting without debt. Something like "Would you be willing to give up a third of your salary if it meant universal healthcare and starting with zero personal educational debts"?

Can you imagine what it'll be like if the health industry was nationalized and no longer a for-profit venture?

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