Re: Krugman on health care costs.

Post #203,451 by Yendor 4/15/05 8:34:42 AM Reply	Re: Krugman on health care costs. [...]but I doubt that average doctors salaries will fall to average, say, EE salaries anytime soon. Your average doctor goes through four years of college to obtain a BS in some biology-related field (generally.) Then they go to medical school for 4-6 years (sometimes more, depending on specialty.) Then they do a number of years of residency, during which they're actually getting paid, but low salaries, because others in their field consider them to be "still learning." Put all that together, and your average doctor earns little to nothing until they're past 30. Your average EE goes to school for four years to obtain a BS in some electrical-engineering-related field. ;-) Optionally, if they really like school, they might decide to get a Masters...But it's not a requirement. And it only takes 2-3 years to get one. Your average EE can start earning decent money starting at around 22 (maybe 25 or so if they went to grad school right after college.) -YendorMike "They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety." - Benjamin Franklin, 1759 Historical Review of Pennsylvania
Post #203,453 by Another Scott 4/15/05 9:05:16 AM Reply	But compare US physicians to other countries. I went to graduate school with a fellow from Iran. His father was an architect. He was studying post-graduate EE. Both fields were paid more, and had more status, in Iran than physicians. I think it's similar in many other countries (and the OpEd mentions France). Many other fields in the sciences have delayed "real" salaries too - research physicists, chemists, political scientists, etc. Just about anything in academics is the same or worse (college, PhD, research associateship or non-tenure-track assistant professor at low salary, maybe tenure-track in a few years if you're lucky, off to another assistant professorship if you're not, etc.). Physician-level salaries are rare in these fields but require as much or more training. Physician training levels differ between countries and that is likely part of the salary difference. But part of it is also the traditional medical pricing stucture in the US. Cheers, Scott.
Post #203,457 by boxley 4/15/05 9:48:07 AM Reply	try finding a doc that studied in a country you recognise or did residency in a city you recognise and graduated in the last 20 years, slim pickins out there. Now try to find one that has some practice in your needs (internal medicine for me) now narrow that down by whether they accept the insurance (if you are lucky enough to have any) and now hope they are accepting patients. Its not the cost of Docs that is the problem, its the lack of them. thanx, bill All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #203,540 by broomberg 4/15/05 8:54:35 PM 4/15/05 8:55:12 PM Reply	Who cares WHERE, IF they are competant Ben sprained his ankle. Again. Wednesday. Primary Dr. said to go to the hospital for xrays, workup, etc. Hospital put a light-weight air "cast" on it, and told him to keep his weight off it. Pull out the crutches. Very minor swelling, hurt like hell when he woke up, did not seem to be getting better. But Ben can't use crutches, his shoulders dislocate. So today he went to an orthopedic surgeon who is a partner in the practice with his regular Dr, who is on vacation. Note: This is all paraphrasing my wife since I was not there. It was actually WORSE. 10 seconds: Minor sprain, minor pain, he should be walking on it, stop whining. Huh? Last time an asshole orthopedic Dr took that attitude, we pushed back for an MRI of his shoulder to find out he needed major reconstructive surgery. He can't put any weight on it. Dr: Sure he can. It's a minor sprain. How can you be so sure? Dr immediately reacts harshly that anyone would question him, demeanor changes, etc. Dr: Low swelling. Last time his broke his ankle there was no swelling for a week, it just hurt like hell and then something snapped and THEN he started swelling. Dr: (with a MAJOR asshole attitude): What do you want me to do about it? Are there any tests that you can use to be sure, or is there anything you can do to better support him? He can't use the crutches and he can't walk on it. Which his Ehler Danloss, we can't take chances. Dr: Ehler Danloss - Huh? Hmmm. (obviously he did not read the chart, and is clueless in this area) That just means he's loose anyway and there is nothing we can do. So don't use crutches, he can walk on it. Now if I was there, it would be the moment to demand my copay back and walk out. Or deck the bastard. Barb on the other hand was unable to to get any further with him, and the Dr ended up walking out in a huff. Called me at work. I told her to call the Primary for another referral to a different Dr. The Primary's response (secretary?) was that they did not know of any who would be any better. I told her we'd go through the phone book looking for an orthopod who knew what Ehler-Danloss was. At that moment we remembered one of our friends was foot doctor. She is also a surgeon. She should be able to recommened someone. A bit of phone tag, and I was talking to her. Her: WHAT? He told him to walk on it!?!?!? He has Ehler-Danloss, he needs a hard cast to make sure he has enough support. He'll just get worse without it. Meet me at my office tomorrow morning and I'll fix him up. Note: She missed his original broken ankle about 6 years ago, so she is VERY sensitive to his condition. Health care in the USA is purely random. It is a matter of connections and the ability to talk back to bad doctors, and that it WHEN you have insurance. Then add to the fact the bad advice this guy gives probably triggers a few lawsuits, which then drives up the costs for everone. Edited by broomberg April 15, 2005, 08:55:12 PM EDT Expand All History
Post #203,541 by Another Scott 4/15/05 9:04:05 PM Reply	Whew. :-( Hang in there. Luck to Ben too.
Post #203,553 by ben_tilly 4/15/05 11:44:57 PM Reply	I sense a profit opportunity Or with less work, a phone call to point out how badly he screwed up, and a kind suggestion that you'd like your co-pay back. Cheers, Ben I have come to believe that idealism without discipline is a quick road to disaster, while discipline without idealism is pointless. -- Aaron Ward (my brother)
Post #203,588 by bionerd 4/16/05 4:35:26 PM Reply	You should file a complaint with your health plan. You're in a HMO, right? The HMO credentialed him to participate in your plan and is required to recredential him every few years. Any complaints in his file make it more difficult for him to get recredentialed. If he doesnt get reapproved, he cant participate in your HMO and he takes a major hit to the pocketbook. Address the letter to your health plan's Quality Assurance Director and copy the Chief Medical Officer. I would also copy your state's Insurance Commissioner and the American Board of Orthopaedic Surgery. I spent many years working as an administator for a Michigan HMO/PPO. Complaints like this don't go unnoticed. It'd be worth your time to do this, if you're so inclined. This doc needs a kick in the pants.
Post #203,696 by CRConrad 4/18/05 2:29:46 AM Reply	Hmm... One wonders, again, just HOW backwards... ...the U.S.A. is, in some respects. BRoomy writes: Pull out the crutches. [...] But Ben can't use crutches, his shoulders dislocate. Do you still use those mediaeval torture instruments, "crutches" that go up into your armpits? Haven't seen those here in the Nordic countries for, hmm... About thirty years, I guess. For good reason, I think. (Side note: Quit with the stupid hard returns within paragraphs, BrooM. WTF are they supposed to be good for?!? My browser knows to size the lines to its window; if I want it to show everything narrow, I just resize its window narrow.) [link\|mailto:MyUserId@MyISP.CountryCode\|Christian R. Conrad] (I live in Finland, and my e-mail in-box is at the Saunalahti company.) Your lies are of Microsoftian Scale and boring to boot. Your 'depression' may be the closest you ever come to recognizing truth: you have no 'inferiority complex', you are inferior - and something inside you recognizes this. - [link\|http://z.iwethey.org/forums/render/content/show?contentid=71575\|Ashton Brown]
Post #203,846 by broomberg 4/18/05 6:45:12 PM Reply	Interesting Other than wheel chair (which is what we just rented for the week), what options do you suggest? And no, until the Admin bans me from embedding CRLFs, I will continue to do it. My brain can't handle lines wider than what I hit enter on, and squishing the browser skinny makes everything else yucky. Also, sometimes unlimited width boxes create a window slightly large that the width of the screen. No matter how much wider I resize the browser, the windows grows a bit more, always forcing left/right scrolling. So I'll attempt to never trigger that. Peter yelled at me a while back for the same reason. Something about it pissed you people (over the pond) off. Sorry.
Post #203,863 by ubernostrum 4/19/05 4:53:14 AM Reply	So... My brain can't handle lines wider than what I hit enter on \r\n\r\n So how exactly do you manage to read other people's posts? --\r\nYou cooin' with my bird? \r\n[link\|http://www.shtuff.us/\|shtuff]
Post #203,866 by broomberg 4/19/05 6:33:33 AM Reply	Painfully With left and right scrolling or head movement. Sometime by squishing the browser, but I'd prefer not to have to reach for the trackball if possible.
Post #203,876 by Another Scott 4/19/05 7:52:20 AM Reply	I'll keep that in mind. What's your preferrred width?
Post #203,877 by admin 4/19/05 8:42:47 AM Reply	You should set a local CSS file You can control the max width of the content panes pretty easily that way, and you should be able to do the text entry pane as well. Better that than everyone hitting 'enter'. Regards, -scott anderson "Welcome to Rivendell, Mr. Anderson..."
Post #203,964 by broomberg 4/19/05 6:50:59 PM Reply	Show me how and I'm happy to do it.
Post #204,199 by ubernostrum 4/21/05 12:23:48 AM Reply	What browser do you use? --\r\nYou cooin' with my bird? \r\n[link\|http://www.shtuff.us/\|shtuff]
Post #204,219 by broomberg 4/21/05 6:37:01 AM Reply	Firefox
Post #204,594 by ubernostrum 4/24/05 7:46:07 PM 4/24/05 7:46:47 PM Reply	Find your profile directory and in it, there's a subdirectory called 'chrome'. In it, create a file called 'userContent.css' (there's an example file included by default in most distributed versions of Firefox). Any CSS rules you want to apply, put in that file and restart Firefox. For example, to enforce a maximum width of 200px for all text, you could use this: \r\n\r\n `p, blockquote, pre, ol, ul, dl, dd, dt, li, h1, h2, h3, h4, h5, h6, input, textarea, legend, select, q { max-width: 200px!important; }` \r\n\r\n I think that'll cover all the commonly-used text elements. It may cause some problems with certain sites' layouts, but not as many problems as if the rule were broader. --\r\nYou cooin' with my bird? \r\n[link\|http://www.shtuff.us/\|shtuff] Edited by ubernostrum April 24, 2005, 07:46:47 PM EDT Expand All History
Post #203,869 by Meerkat 4/19/05 6:51:42 AM Reply	How about a 'if broomberg then clobber crlf' filter :) Two out of three people wonder where the other one is.
Post #204,002 by CRConrad 4/20/05 9:20:07 AM Reply	Have you tried all the options? Barry (doesn't answer, but) asks: Other than wheel chair (which is what we just rented for the week), what options do you suggest? You didn't answer my question, so I don't know if this is superfluous, but here goes: In case you ARE still using the idiotic armpit-crusher crutches, I suggest getting a pair that don't go up into the user's armpits. I can't say for sure, of course, but it feels to me that the normal (in civilised countries) kind, the ones that go halfway up one's forearm, should be much less likely to dislocate one's shoulders. [link\|mailto:MyUserId@MyISP.CountryCode\|Christian R. Conrad] (I live in Finland, and my e-mail in-box is at the Saunalahti company.) Your lies are of Microsoftian Scale and boring to boot. Your 'depression' may be the closest you ever come to recognizing truth: you have no 'inferiority complex', you are inferior - and something inside you recognizes this. - [link\|http://z.iwethey.org/forums/render/content/show?contentid=71575\|Ashton Brown]
Post #204,011 by boxley 4/20/05 9:32:19 AM Reply	its the excess downward pressure on the arms that dislocate the shoulders, not the numbing armpit busters. thanx, bill All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #204,137 by broomberg 4/20/05 7:28:29 PM Reply	Sorry, thought the question was rhetorical Yes, we still use them. And I don't know if the short ones would be better. We could try. MRI is tomorrow, hard cast goes on after that. And while we may be in the barbarical USA, one thing I notice is we tend to have MRI availability for non-life threatening issues far faster than what I've heard about in Canae. Any north of the border care to chime in to tell me if this is BS?
Post #204,160 by jake123 4/20/05 9:01:01 PM Reply	Yep, it's true 'course, we don't have any families going bankrupt over medical costs, so I guess it's a wash. --\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca \n [link\|http://consultron.ca\|http://consultron.ca] [link\|irc://irc.ecomstation.ca\|irc://irc.ecomstation.ca] \n Kingston Ontario Canada [link\|news://news.consultron.ca\|news://news.consultron.ca] *\n-------------------------------------------------------------------
Post #204,164 by boxley 4/20/05 9:04:09 PM Reply	cant go bankrupt here anymore either All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #204,165 by jake123 4/20/05 9:04:51 PM Reply	That's dry. --\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca \n [link\|http://consultron.ca\|http://consultron.ca] [link\|irc://irc.ecomstation.ca\|irc://irc.ecomstation.ca] \n Kingston Ontario Canada [link\|news://news.consultron.ca\|news://news.consultron.ca] *\n-------------------------------------------------------------------
Post #204,172 by broomberg 4/20/05 9:18:07 PM Reply	Today was a good wheel chair day He had a race at school Other kid had knee surgery. Ben won.
Post #204,179 by Another Scott 4/20/05 9:57:53 PM Reply	Woo and Yay!
Post #204,305 by broomberg 4/21/05 3:43:45 PM Reply	MRI verbal came back Ankle surgeon was very sad. Listed about 1/2 dozen things, mostly bad, things like tendons seperated from bones. Bruised bones. Variety of tears. Put in a hard cast for now, set at an angle that makes it 100% impossible to walk, even by accident. Give it a couple of weeks to see if it starts to resolve. If not, the surgery means pullin the tendons down, drilling holes though various bones, pulling them through and affixing them in place. I think I'm going to forward the MRI study to the original Dr. and put a simple cover letter on it. How about: Yo, Fuckwad!
Post #204,308 by boxley 4/21/05 3:52:46 PM Reply	I would personally hand it to him with card to the firm of Howie Fukem and Hard thanx, bill All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #204,319 by mmoffitt 4/21/05 4:17:12 PM Reply	30? Neurosurgeons yes, but not the majority. I'll give you a year. 19-23 undergraduate school. 23-25 medical school (the last two years of med school are internships - a fancy name for OJT). Then its residency (read: yet more OJT) at typically R.N. pay (~$16-$20/hour). And there are a LOT of residency programs that are only two or three years. Then take a test - at age 27 or 28. Pass it and you've made your 5 million. So, basically, we make millionaires out of non-thesis, non-dissertation graduate students who are virtually guaranteed to earn their so-called "doctorates" in medicine once they are admitted to grad school (which, I'll grant, in this country is not exactly easy, but some 16,000+/year manage it). Notwithstanding the fact that they only go to graduate school for 2 years and never have to come up with an original thought. Feh. A pox upon all of the little prima donnas. And their average salary of $200,000/year IS a problem. bcnu, Mikem Eine Leute. Eine Welt. Ein F\ufffdhrer. God Bless America.
Post #204,332 by broomberg 4/21/05 4:36:32 PM Reply	OH, BS A good Dr is worth far more than that $200K. A bad one should be killed. No middle ground.
Post #204,371 by boxley 4/21/05 7:45:23 PM Reply	lawyers and mechanics, same thing All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #204,519 by mmoffitt 4/22/05 5:26:36 PM Reply	Right. A real doctor is. Unfortunately, real doctors don't typically get paid that much. Just remember that Real Doctors write Dissertations. bcnu, Mikem Eine Leute. Eine Welt. Ein F\ufffdhrer. God Bless America.
Post #204,527 by broomberg 4/22/05 6:50:38 PM Reply	Hmm You mean that long winded blather that may or may not advance human knowledge. Sorry, let me rephrase that: Medical doctors which are capable on aiding the sick, operating and possibly curing the wounded are worth way more. Those that don't bother to read the charts and ignore historical information before practicing factory medicine should be shot.
Post #204,536 by jake123 4/24/05 1:12:40 PM Reply	I disagree They're not worth way more than 200K per annum. They're worth a relatively large salary in the society they work in. In my society, 200K is not relatively large, it's astronomical, and puts you firmly into the 5 percenter category. I suspect that the same is true in your society as well, as much as many people may want to ignore the half on the bottom. --\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca \n [link\|http://consultron.ca\|http://consultron.ca] [link\|irc://irc.ecomstation.ca\|irc://irc.ecomstation.ca] \n Kingston Ontario Canada [link\|news://news.consultron.ca\|news://news.consultron.ca] *\n-------------------------------------------------------------------
Post #204,546 by broomberg 4/24/05 2:18:24 PM Reply	5%er? What exactly does this mean? Does this # mean that are earning more than 94% of the population? So you consider this a BAD thing? An arbitrary number, a peak, that is the ceiling? So 5.00001% is OK, but 5% is not? If so, it also means that if they were making $200K, 94% of the of the population was making $199K, then it is still bad? Seems silly, doesn't it? Or are you referring to some multiple of average salary? Again, though, I disagree. A very small percentage of people have the combination of intelligence, connections, financial support (to go to the right schools), time, and ambition, to learn something far LESS than 1% of the population does, and at the same time apply it in the real world, interacting with diseased people, being exposed to a variety of communicable illnesses as part of their job, make life changing and possibly threatening decisions multiple times a day, under enormous pressure to get it right. Many of these same people, with this level of intelligence, connections, and ambition could become high flying business assholes, MBAs, leveraged buyout specialists, etc. People who make far more money than doctors, yet contribute almost nothing to your personal well being when you need one. They perform an exceptional service. You begrudge them an exceptional salary? You want them all a member of a union, a union that represents bakers, truckers, autoworkers, and whatever other "regular" job is out there, and have the union rep decide through collective bargaining what is a "fair" salary, taking into account the full spectrum of people they are supposed to represent? If so, have fun asking the trucker to remove you appendix when it is about to burst. Or maybe you think those "professions" are to "lowly" to lump together in the way I did. OK. Engineers building a bridge. Architects designing a building. In each case, the ones making the REAL decisions, the final life threating ones, the final designs, those people make more than doctors. The teams of people working at the next level down, implementing those decisions, they are more like operating room nurses. A hell of a lot of responsibility, and decent pay, but not finally accountable for the success or failure. Again, have fun getting that Architect to remove your appendix. There is a personal, timing critical element associated with the medical profession that does not seems to be associated with any other, except police and fire. But police and fire require far less training, far less effort, which mean far more people can go into those careers. And they are pretty much interchangeable. You see dozen cops on the street, you don't interview them to determine which is the best one to break up a fight. You grab the closest one. They are cogs in the machine. Sure, some are better than others, but almost all of them can satisfy the immediate need. Do I really want a heart surgeon operating on my son's ankle? No. They both might be the best in their field, but they are really different fields. So, tell me what a reasonable salary is, and the level of responsibility / productivity deserves it? And whether you feel any factor would allow individuals to exceed that by a wide margin.
Post #204,560 by a6l6e6x 4/24/05 4:22:28 PM Reply	And the mother would be proud. There is a union, though not by name, called the AMA. They make sure there is not an over-supply of doctors. Ask Arkadiy how doctors pay compared to engineers and programmer in the old Soviet Union. Alex The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. -- Bertrand Russell
Post #204,565 by broomberg 4/24/05 4:35:46 PM Reply	Ahh, the old Soviet Union We pretend to pay you, you pretend to work.
Post #204,571 by jake123 4/24/05 4:59:21 PM Reply	Wow, how spurious Look, the spread between the five percenters and the 95 percenters (ie, top and bottom 5 percentile) is what right now? What has it been historically? What has been the effects historically of huge spreads like the one that holds currently? For life and death decisions, there's not enough room in the top five percentile to put everyone that has to make them. As for your comments about "what's OK", with the 5 vs 5.0001, well, that just make you look like you're trying to split serious hairs because you know the basic position is untenable in the long run. Your point about the "95% of the pop making 199K" is just as dumb; that's not what that means and you know it. Doctors can't make that kind of money because it's not possible for the society that supports them to pay it in the long run. Doctor's up here are very well paid compared to most people, as they should be. However, putting them into the ranks of the extremely wealthy (which is what an average annual income of that magnitude does) only means that most people will never be able to access their services. In the long run, that's untenable for the society, and even for the small group of people that can afford to pay it directly; things like disease don't pay attention to the niceties like the class of the person they infect. Here's another rebuttal: those guys that pick up the garbage and fix the sewers have the lives of far more people in their hands than the average airline pilot, let alone doctor; without those services thousands of people's lives and health are at risk - basically, anyone who lives in a city owes a lot to garbage men and sanitation workers. According to your logic, they should get 200K/ann too. In one paragraph you talk about bakers, autoworkers, and truck drivers, and then immediately flip to engineers and architects. You need to check out your examples better. The fact that you don't might indicate that you've not thought this through properly. You feel very grateful to doctors because your son has medical problems, and they're helping. Fair enough. You might feel differently about them if you made 20K per year, and the doctors were saying "sorry, we can't help you, because you can't pay." There are more than one in ten of your countrymen in that position right now, today, where they will have to listen to that if they or one of their family members has a problem. If you want doctors to be five percenters, that is the INEVEVITABLE result. --\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca \n [link\|http://consultron.ca\|http://consultron.ca] [link\|irc://irc.ecomstation.ca\|irc://irc.ecomstation.ca] \n Kingston Ontario Canada [link\|news://news.consultron.ca\|news://news.consultron.ca] *\n-------------------------------------------------------------------
Post #204,587 by broomberg 4/24/05 6:55:02 PM Reply	Convenient misdirections For life and death decisions, there's not enough room in the top five percentile to put everyone that has to make them. Why not? Here's another rebuttal: those guys that pick up the garbage and fix the sewers have the lives of far more people in their hands than the average airline pilot, let alone doctor; without those services thousands of people's lives and health are at risk - basically, anyone who lives in a city owes a lot to garbage men and sanitation workers. According to your logic, they should get 200K/ann too. Nope. You missed years of training and dedication. I can take any random homeless person off the street, give him $10 a day, and have him throw garbage cans at a truck. The driver will get paid more, of course, but again, given a few weeks of training driving a big truck, I've filled the job. So, go back to the SHORT list of people who qualify based on my premise. That is ability, dedication, many years of education combined with an immediate impact on people's lives. Doctors. Airline pilots. Feel free to add the remaining few, and be sure to note their income level. Ok, back to what you would consider reasonable. Give me a $ amount. And note, I call major BS on $200K per year equaling "extreme wealth". In this country, $40K is barely enough to scrape by, raising 2 kids. Some may claim the to be middle class, but only on the flyover areas of the county. Certainly not in the NE US where I live. Here is an article that claims middle class spans $31K-$76K. Of the people in this middle class, 20% have a college degree and 1.5% have a PHD. [link\|http://www.hiringnetwork.com/common/article88.html\|http://www.hiringnet...on/article88.html] Note: These were 2001 dollars so I'd adjust it up a bit for inflation. So at $80K or so we have entry-level well off. Which leaves a large range up to rich people who own profitable companies, to very rich people who live off of trust funds. Again, all based where you live. In NYC, middle class is up to $250K per year. [link\|http://tenant.net/Alerts/Guide/press/nyt/sr051897.html\|http://tenant.net/Al...nyt/sr051897.html] $200K is NOT extremely wealthy. So, back to: What is reasonable? Is $150K reasonable? So the difference is $50K per Doctor. According to this: [link\|http://dbapps.ama-assn.org/aps/amahg.htm\|http://dbapps.ama-assn.org/aps/amahg.htm] there are about 690,000 in the US. 690,000 x 50,000 = 34.5 billion dollars. This is about 1/3 the error rate of Medicare and Medicaid mis-billings. [link\|http://www.health-itworld.com/enews/03-15-2005_545.html\|http://www.health-it...-15-2005_545.html] It obvious does not scratch the surface of the total health care industry cost. Oh, I know, knock off another $50K. That'll fix the problem for sure! You have found a scape goat and you simply won't let go.
Post #204,627 by boxley 4/24/05 10:33:55 PM Reply	you wouldnt trust me to take out your appendix? why not? I have carved out a number of mammals intentionally and dont want to reminisce about humans. Am I the person you want to diagnose your broke appendix? prolly not, thanx, bill All tribal myths are true, for a given value of "true" Terry Pratchett [link\|http://boxleys.blogspot.com/\|http://boxleys.blogspot.com/] Any opinions expressed by me are mine alone, posted from my home computer, on my own time as a free american and do not reflect the opinions of any person or company that I have had professional relations with in the past 48 years. meep questions, help? [link\|mailto:pappas@catholic.org\|email pappas at catholic.org]
Post #204,631 by jake123 4/24/05 11:14:35 PM Reply	Because more than five percent of the population gets to make those kinds of decisions every day. Air traffic controllers face pressures far in excess of doctors, as do harbourmasters, police, fire, and that's in less than thirty seconds of thought. The amount of training required is irrelevant to the amount of pressure. Try another one. Of course, you yourself probably have no problem affording doctors for your kids. As I said, you probably don't appreciate the position of someone in your society that's not in your shoes. Here's another question. Do you think CEOs deserve tens of thousands of times the income of their average worker? After all, they have tons of training, face a lot of pressure... MBAs are graduate degrees. Surely they deserve it. Personally, I don't give a rat's ass about how badly fucked your healthcare system is, since I don't have to live under it. However, the idea that all doctors (or even necessarily all good doctors) deserve to live in the ranks of the extremely wealthy is simply dumb. --\n-------------------------------------------------------------------\n* Jack Troughton jake at consultron.ca \n [link\|http://consultron.ca\|http://consultron.ca] [link\|irc://irc.ecomstation.ca\|irc://irc.ecomstation.ca] \n Kingston Ontario Canada [link\|news://news.consultron.ca\|news://news.consultron.ca] *\n-------------------------------------------------------------------
Post #204,648 by broomberg 4/25/05 12:39:37 AM Reply	I thought of the same people barring harbor masters. And they all failed the education test. Which you conveniently discounted. The amount of training DOES count. It is a matter of how fast you can replace the bad ones. It is a matter of personal investment. It is a matter of personal sacrifice. It is a matter of proving capability. As I pointed out before, no, I don't think the the MBAs "deserve" it, but they've managed to manipulate the system so they get it, such is life. And again, you claim "extremely wealthy" when that number (as I've supported) doesn't begin to scratch the surface. You have an axe to grind.
Post #204,649 by broomberg 4/25/05 12:39:46 AM Reply	I thought of the same people barring harbor masters. And they all failed the education test. Which you conveniently discounted. The amount of training DOES count. It is a matter of how fast you can replace the bad ones. It is a matter of personal investment. It is a matter of personal sacrifice. It is a matter of proving capability. As I pointed out before, no, I don't think the the MBAs "deserve" it, but they've managed to manipulate the system so they get it, such is life. And again, you claim "extremely wealthy" when that number (as I've supported) doesn't begin to scratch the surface. You have an axe to grind.
Post #204,651 by ben_tilly 4/25/05 1:34:59 AM Reply	You've confused medicine and public health Medicine is about taking care of you if you're sick. Public health is about making sure that most people aren't at immediate risk of getting some horrible disease. These two professions are not only different, they are often opposed because they are to some extent economic substitutes for each other. Saying that the poor need to be treated so that they don't infect the rest of us is a public health decision, not a medical one. That said, I personally wish that public health was a better-respected field. Because they do save a lot more lives than doctors. And when confronted with a new disease, public health people are able to mount a successful response long before medicine has any hope of doing so. (Take SARS for instance, that was stopped by public health, not medicine. If we had to wait for a medical response, then right now we'd each know people who died from SARS.) Cheers, Ben I have come to believe that idealism without discipline is a quick road to disaster, while discipline without idealism is pointless. -- Aaron Ward (my brother)
Post #204,611 by tuberculosis 4/24/05 9:32:20 PM Reply	Disagree somewhat Physicians are definitely high value people. No argument. However, the big money, as usual, attracts people who ought not to be physicians. They have the smarts, and the drive, but not the proper motivation. There are quite a number of physicians that suck out there right now. They don't care about patients, they're more concerned with collecting money and playing golf. Many of them work for large HMO networks. I definitely think they are overpaid. So what to do? Drop the salaries and we'll have practitioners who do it because they love it. Those are the people we want in practice. But we may lose a few who seek greener pastures elsewhere. I say let em go. They would have made rotten doctors anyhow. As for your other point - I don't buy that physician is some kind of godlike profession. So my mechanic can't take out my appendix. I don't guess my surgeon is going to do too well with my brakes either. Everybody has specific value. I note that in Europe, where physicians are paid much less, the quality of the care is much higher. Physicians actually come to you and there is competition. They don't make huge money but they do care about what they do. "Whenever you find you are on the side of the majority, it is time to pause and reflect" --Mark Twain "The significant problems we face cannot be solved at the same level of thinking we were at when we created them." --Albert Einstein "This is still a dangerous world. It's a world of madmen and uncertainty and potential mental losses." --George W. Bush
Post #204,630 by drewk 4/24/05 11:09:46 PM Reply	Gotta call a big steaming BS on that one So what to do? Drop the salaries and we'll have practitioners who do it because they love it. Those are the people we want in practice. But we may lose a few who seek greener pastures elsewhere. I say let em go. They would have made rotten doctors anyhow. So what to do? Drop the salaries and we'll have programmers who do it because they love it. Those are the people we want in IT. But we may lose a few who seek greener pastures elsewhere. I say let em go. They would have made rotten developers anyhow. So, Todd, how's that salary doing? Sorry if that comes off as harsh, but are you seriously suggesting that paying less is the way to improve a profession? === Purveyor of Doc Hope's [link\|http://DocHope.com\|fresh-baked dog biscuits and pet treats]. [link\|http://DocHope.com\|http://DocHope.com]
Post #204,636 by tuberculosis 4/25/05 12:00:21 AM Reply	You make my point I'm saying paying more doesn't help and paying too much has hurt. Like paying VB hackers $150k to do ASP didn't do a lot for programming. It just flooded the profession with people who were just in it for the money. You've seen what has happened there. People who ought not to be programmers glutted the field because of the money. People who were good at being programmers have dropped out (pointing at myself here) because there is no satisfaction in the profession. Overall, I'd guess that US software development capability has taken a net drop thanks to the introduction of dumbed down tools (Java) to enable the idiots at the expense of the pros. Beyond this, the few passionate remaining now spend all of their time riding herd on the idiots trying to compensate for their net negative contributions. So can we draw a parallel to what happens when MD is though to mean Mega-Dollars? Same deal. Ranks expand with people motivated by dollars rather than love of profession. The good guys get harder to find. I mean, look, my mom has a couple of medical conditions that requires regular visits to a Gastroenterologist. Kaiser has assigned her to their specialist - a Dr who is semi retired (though in his mid 40's) and only has offices hours one day a week - with a six week waiting list. In a period of 8 months, mom was hospitalized twice - the second time it happened she was still waiting to see Dr TeeTime. When she did get in to see him he hadn't bothered to read up on her other conditions that complicate her treatment and was largely useless at working on coming up with lifestyle changes to reduce likelihood of recurrence. I did better for her with Google. I don't think you can just lower salaries across the board. Top people should still make top money. But somehow, we need to thin the herd and eliminate the "easy money" motivator. No I don't know how to do this. "Whenever you find you are on the side of the majority, it is time to pause and reflect" --Mark Twain "The significant problems we face cannot be solved at the same level of thinking we were at when we created them." --Albert Einstein "This is still a dangerous world. It's a world of madmen and uncertainty and potential mental losses." --George W. Bush
Post #204,639 by drewk 4/25/05 12:15:54 AM Reply	And you make mine I don't think you can just lower salaries across the board. Top people should still make top money. But somehow, we need to thin the herd and eliminate the "easy money" motivator. No I don't know how to do this. Figure that one out and lots of people are going to love you for it. Being selfish, I'd prefer you figure it out for IT first. === Purveyor of Doc Hope's [link\|http://DocHope.com\|fresh-baked dog biscuits and pet treats]. [link\|http://DocHope.com\|http://DocHope.com]
Post #204,661 by tuberculosis 4/25/05 3:32:20 AM Reply	Heh, me too "Whenever you find you are on the side of the majority, it is time to pause and reflect" --Mark Twain "The significant problems we face cannot be solved at the same level of thinking we were at when we created them." --Albert Einstein "This is still a dangerous world. It's a world of madmen and uncertainty and potential mental losses." --George W. Bush
Post #204,531 by Another Scott 4/22/05 7:33:07 PM Reply	Familiarity breeds contempt. There are an awful lot of PhDs out there who are at least as incompetent as some of the physicians you've come across. Don't use such a broad brush. I know, I know, "It's fun." :-) E.g. A student taking their final oral exam before being awarded a PhD in physics: Q: Is the wavelength of light bigger than a breadbox? A: ? True story. :-( It was a theorist, of course. Cheers, Scott.
Post #204,671 by pwhysall 4/25/05 7:32:11 AM Reply	OT: Branch this sort of thing, please. We've got a squillion forums here. Let's use them. The second this particular discussion got onto the financials, it turned into a political or financial question. This isn't the first thread I've seen that's gone seriously OT for the forum it's in, and it's not like the software makes it hard for us to put things into an appropriate forum even halfway through a thread. Just a friendly request, folks. Peter [link\|http://www.ubuntulinux.org\|Ubuntu Linux] [link\|http://www.kuro5hin.org\|There is no K5 Cabal] [link\|http://guildenstern.dyndns.org\|Home] Use P2P for legitimate purposes!
Post #204,740 by mmoffitt 4/25/05 12:02:09 PM Reply	One might argue Krugman belongs in financials to begin with. bcnu, Mikem Eine Leute. Eine Welt. Ein F\ufffdhrer. God Bless America.

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