Magox Posted September 19, 2009 Share Posted September 19, 2009 If I weren't so gored out my mind out in the middle of Yosemite i would have to just followed with then a little then come full circle Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 19, 2009 Share Posted September 19, 2009 If I weren't so gored out my mind out in the middle of Yosemite i would have to just followed with then a little then come full circle I am envious, I wouldn't mind going in a circle in Yosemite anyday! Hope you have a camera and are taking lots of photos... enjoy! Link to comment Share on other sites More sharing options...
Magox Posted September 19, 2009 Share Posted September 19, 2009 I am envious, I wouldn't mind going in a circle in Yosemite anyday! Hope you have a camera and are taking lots of photos... enjoy! Amazing! I've lost myself a few times all ready and honestly I really don't feel like finding myself any time soon. Link to comment Share on other sites More sharing options...
Doc Posted September 19, 2009 Share Posted September 19, 2009 Whether you know it or not, you made his point... have you ever studied econ? In this case, one could argue that the AMA limits the amount of Doctors in the field, promotes specialists, raising demand for their services and works with the education establishment to keep ed costs high. One of those, supply demand deals without any anti-trust enforcement. There is still a group out there that believe this is all to keep us in demand for these high priced services, paid both out of pocket and from the public trough, especially through research grants and does little to actually cure us. That is an extreme view IMO, but I do think that the way our system is set up a certain amount of that de facto happens, planned or not. The U.S. has 1 doctor for every 390 patients. New Zealand has 1 doctor for every 420 patients. England has 1 doctor for every 440 patients. Canada has 1 doctor for every 470 patients. So the AMA is not "limiting the number of doctors," or at least not compared to other socialized systems touted by Barry and co. As for "promoting specialists," that's just flat-out wrong. When I went to medical school some 17 years ago, they had just started a big push for primary care, which continues to this day. I initially went to a 3-year internal medicine residency, thinking that I'd be an internist or specialize in GI, but disliked it so much that I transferred out after 1 year and went into anesthesia (thankfully I didn't waste any time, since you need a preliminary year in either IM or surgery anyway). Medical students are simply drawn to the specialties for obvious reasons (and I really wish I had decided on anesthesia before going into residency), but the specialties do their best to limit their enrollment. As for anti-trust, you can call any doctor and ask what he/she charges. But you'll probably get a "we don't know" since the insurance companies control the reimbursements and have their own schedules, and most doctors are happy to get something close to what they expected. Moreover, insurance companies are free to talk amongst themselves and compare rates, whereas it's truly "anti-trust" for doctors to do the same. And the AMA has been complicit with the insurance companies all along, while charging multi-millions for their proprietary CPT codes which the insurance companies use to reimburse, again at whatever level they choose to do so. Again, if you want to criticize doctors because you have to pay for their education, take a look around you at things you pay for and ask what education they had, or what right they have in charging you whatever it is that they charge. I'll bet most don't a) go through 8 years of post-graduate schooling, b) spend 3, 4, sometimes 5 or more years in low-paid apprenticeship (aka residency) and thus delay real earning until their 30's, c) have to worry about lawsuits bankrupting/ruining them, and d) have to deal with insurance companies. But as is usually the case, you pay for quality, so if you want to go to a good doctor, it only stands to reason that you should pay more, no? Again the sense of entitlement that "I deserve cheap healthcare" is what is the problem, in the face of a population that treats their bodies like crap and expect everything possible done and nothing missed, otherwise it's a lawsuit. And if you want to look at a profession that doesn't regulate their members, look no further than lawyers. They have been pumping them out so fast that they had to find ways to make a living, and that's how malpractice and other frivolous lawsuits began multiplying, and adding to health care expenditures. But tort/malpractice reform is only being paid lip-service. Why? Because lawyers run the country. Link to comment Share on other sites More sharing options...
Wacka Posted September 19, 2009 Share Posted September 19, 2009 Shakespeare had it right. Link to comment Share on other sites More sharing options...
Doc Posted September 20, 2009 Share Posted September 20, 2009 Shakespeare had it right. "Nothing can come of nothing?" Link to comment Share on other sites More sharing options...
Wacka Posted September 20, 2009 Share Posted September 20, 2009 "The first thing we do, let's kill all the lawyers" Henry VI Part II. Link to comment Share on other sites More sharing options...
DC Tom Posted September 20, 2009 Share Posted September 20, 2009 "Nothing can come of nothing?" "O what a rouge and peasant slave am I." Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 20, 2009 Share Posted September 20, 2009 "All The World is a stage, but they forget to mention that I am the chief critic?" Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 20, 2009 Share Posted September 20, 2009 The U.S. has 1 doctor for every 390 patients. New Zealand has 1 doctor for every 420 patients. England has 1 doctor for every 440 patients. Canada has 1 doctor for every 470 patients. So the AMA is not "limiting the number of doctors," or at least not compared to other socialized systems touted by Barry and co. As for "promoting specialists," that's just flat-out wrong. When I went to medical school some 17 years ago, they had just started a big push for primary care, which continues to this day. I initially went to a 3-year internal medicine residency, thinking that I'd be an internist or specialize in GI, but disliked it so much that I transferred out after 1 year and went into anesthesia (thankfully I didn't waste any time, since you need a preliminary year in either IM or surgery anyway). Medical students are simply drawn to the specialties for obvious reasons (and I really wish I had decided on anesthesia before going into residency), but the specialties do their best to limit their enrollment. As for anti-trust, you can call any doctor and ask what he/she charges. But you'll probably get a "we don't know" since the insurance companies control the reimbursements and have their own schedules, and most doctors are happy to get something close to what they expected. Moreover, insurance companies are free to talk amongst themselves and compare rates, whereas it's truly "anti-trust" for doctors to do the same. And the AMA has been complicit with the insurance companies all along, while charging multi-millions for their proprietary CPT codes which the insurance companies use to reimburse, again at whatever level they choose to do so. Again, if you want to criticize doctors because you have to pay for their education, take a look around you at things you pay for and ask what education they had, or what right they have in charging you whatever it is that they charge. I'll bet most don't a) go through 8 years of post-graduate schooling, b) spend 3, 4, sometimes 5 or more years in low-paid apprenticeship (aka residency) and thus delay real earning until their 30's, c) have to worry about lawsuits bankrupting/ruining them, and d) have to deal with insurance companies. But as is usually the case, you pay for quality, so if you want to go to a good doctor, it only stands to reason that you should pay more, no? Again the sense of entitlement that "I deserve cheap healthcare" is what is the problem, in the face of a population that treats their bodies like crap and expect everything possible done and nothing missed, otherwise it's a lawsuit. And if you want to look at a profession that doesn't regulate their members, look no further than lawyers. They have been pumping them out so fast that they had to find ways to make a living, and that's how malpractice and other frivolous lawsuits began multiplying, and adding to health care expenditures. But tort/malpractice reform is only being paid lip-service. Why? Because lawyers run the country. I love this lack of responsibility, it is the insurance cos fault and the AMA's fault and the educational system itself. Like Doctor's have nothing to do with this. That is disingenuous at best and at worst a downright abdication of one's responsibility towards your profession. You wouldn't let welfare cheats or for that matter not complain about the reimbursement rates of Medicare, but you let the insurance cos and the AMA... run by Doctors perpetuate this crap. P.S. While I think the image of unfettered lawsuits are a pr problem from what I understand it is only a small portion of the overall premiums doctors pay into the system including settlements. I still think torts need reform from a moral standpoint with great criminal penalties to doctors who mess up. But to be honest, I would need to see some updated stats on this. Also IMO tort reform while nice for insurance cos is not likely to reduce Doctors Liability insurance cos premiums because it is too much of a cash cow for insurance cos yet Doctors do little about it except complain. I would love to see a risk assessment analysis of current torts and the over risk to insurance cos. Link to comment Share on other sites More sharing options...
VABills Posted September 20, 2009 Share Posted September 20, 2009 I love this lack of responsibility, it is the insurance cos fault and the AMA's fault and the educational system itself. Like Doctor's have nothing to do with this. That is disingenuous at best and at worst a downright abdication of one's responsibility towards your profession. You wouldn't let welfare cheats or for that matter not complain about the reimbursement rates of Medicare, but you let the insurance cos and the AMA... run by Doctors perpetuate this crap. P.S. While I think the image of unfettered lawsuits are a pr problem from what I understand it is only a small portion of the overall premiums doctors pay into the system including settlements. I still think torts need reform from a moral standpoint with great criminal penalties to doctors who mess up. But to be honest, I would need to see some updated stats on this. Also IMO tort reform while nice for insurance cos is not likely to reduce Doctors Liability insurance cos premiums because it is too much of a cash cow for insurance cos yet Doctors do little about it except complain. I would love to see a risk assessment analysis of current torts and the over risk to insurance cos. Then why in every state that has enacted some form of tort reform did the average premium go down over 30%? Insurance companies know that it limits the liability and therefore factored into the cost. That means 1/3 or more of your insurance cost goes to protecting against these frivolous lawsuits or over reaching awards. Malpractice insurance also went down by quite a bit more, which allowed more doctors to make more money or move into those states knowing they could actually make money and repay for the costs of education, offices , and staff. Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 20, 2009 Share Posted September 20, 2009 Then why in every state that has enacted some form of tort reform did the average premium go down over 30%? Insurance companies know that it limits the liability and therefore factored into the cost. That means 1/3 or more of your insurance cost goes to protecting against these frivolous lawsuits or over reaching awards. Malpractice insurance also went down by quite a bit more, which allowed more doctors to make more money or move into those states knowing they could actually make money and repay for the costs of education, offices , and staff. Show me a link to some ligit stats... I am not against Tort Reform, because I think without it it abdicates responsibility of the doctor to perform better and because though frivolous lawsuits I remembering being only a small portion of claims still are morally bankrupt. I just don't think they are a cure all, still it is a great political issue for those for tort reform and it makes sense to do something.... still I would like to see actual stats. Interesting this is a national issue when insurance is regulated by the states, how do you deal with that jurisdictional conflict in the bill? Link to comment Share on other sites More sharing options...
Doc Posted September 20, 2009 Share Posted September 20, 2009 I love this lack of responsibility, it is the insurance cos fault and the AMA's fault and the educational system itself. Like Doctor's have nothing to do with this. That is disingenuous at best and at worst a downright abdication of one's responsibility towards your profession. You wouldn't let welfare cheats or for that matter not complain about the reimbursement rates of Medicare, but you let the insurance cos and the AMA... run by Doctors perpetuate this crap. The insurance companies, and their execs (who again don't have near the level of education Doctors do, FYI) are raking in billions every year. They have large, powerful, well-funded lobbies. The AMA is a toothless dinosaur that most Doctors have abandoned. I haven't been a member since I left medical school, and med students are a large percentage of their membership, along with Doctors close to retirement age. We as a group have been loathe to fight the undermining of our profession, but it appears that time is close to being over. Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 21, 2009 Share Posted September 21, 2009 The insurance companies, and their execs (who again don't have near the level of education Doctors do, FYI) are raking in billions every year. They have large, powerful, well-funded lobbies. The AMA is a toothless dinosaur that most Doctors have abandoned. I haven't been a member since I left medical school, and med students are a large percentage of their membership, along with Doctors close to retirement age. We as a group have been loathe to fight the undermining of our profession, but it appears that time is close to being over. Good... and I agree with the insurance execs comment which is part of the reason everyone including doctors are getting a raw deal every time there is a political discussion on Capitol Hill. If you are not at the table effectively and as coordinated group or coordinated groups, you will be at least partially dismissed and much less effective. Do it. Link to comment Share on other sites More sharing options...
Doc Posted September 21, 2009 Share Posted September 21, 2009 Good... and I agree with the insurance execs comment which is part of the reason everyone including doctors are getting a raw deal every time there is a political discussion on Capitol Hill. If you are not at the table effectively and as coordinated group or coordinated groups, you will be at least partially dismissed and much less effective. Do it. The word is that AMA president J. James Rohack was "at the table" with Barry and co., but told in the beginning that he would have to agree with what was discussed or "he could leave right now." Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 21, 2009 Share Posted September 21, 2009 The word is that AMA president J. James Rohack was "at the table" with Barry and co., but told in the beginning that he would have to agree with what was discussed or "he could leave right now." Not sure who Barry was, but the AMA needs to be at a separate table with his own group of Doctors and any other independent Doc groups with him, not with the insurance Cos, which is whom I am assuming your are referring to as Barry. Link to comment Share on other sites More sharing options...
Wacka Posted September 21, 2009 Share Posted September 21, 2009 Don't act stupid. Barry Soetoro was the name the Messiah went under when he was a kid living in Indonesiaas a kid. His screwy mother married Lolo Soetoro and the Messiah took his name.He used it until college. Link to comment Share on other sites More sharing options...
YellowLinesandArmadillos Posted September 21, 2009 Share Posted September 21, 2009 Don't act stupid. Barry Soetoro was the name the Messiah went under when he was a kid living in Indonesiaas a kid. His screwy mother married Lolo Soetoro and the Messiah took his name.He used it until college. Ooooh thaaat Barry Seriously, thinking more about it, coming out with a agreed upon statement about what was discussed is typical for these discussions and not that big a deal. It is way that everyone can feel free to talk frankly without having their words used against them later or for the discussions being a set up for a press hit... that doesn't mean that what was discussed has to result in an agreement or that there can't be disagreement, just what was discussed is agreed to before hand and anything ancillary or off the record stays off the record. Still can't acknowledge the insult. Link to comment Share on other sites More sharing options...
Doc Posted September 21, 2009 Share Posted September 21, 2009 Not sure who Barry was, but the AMA needs to be at a separate table with his own group of Doctors and any other independent Doc groups with him, not with the insurance Cos, which is whom I am assuming your are referring to as Barry. Nope, I'm talking about Barry Obama. Which is how he was known in prep school. Link to comment Share on other sites More sharing options...
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