Raymond Harris is only 54, but he already has gone through three kidneys.
Like most people, Harris was born with two working kidneys. He lost one at age 8 because of a fall. He lost the second to high blood pressure at 42. He lost the third ”” donated by his wife ”” at age 48, because of a rare reaction to a dye that doctors used to view the blockages in his arteries.
And while Harris gets a lot of health care, he isn’t exactly healthy.
Sarcasm on “By all means we should stop treating this guy. The money spent on him would cover the basic care needed for several uninsured people.” sarcasm off.
This scenario is what we would have in the long term with rationed care. This scares me, since my wife has a serious chronic illness, and no, it is NOT related to lifestyle choices, so we can’t play the guilt card of “she smoked, or she overate, so it’s her fault”. Some of her treatments are very expensive, but they give her a better quality of life and allow her to be a wife and mother, not just a patient. The alternative is inexpensive pain meds, but then she would be spending 2/3 of her life in bed, drugged up.
In Texas, I’m with you. I have two chronic illnesses, both manifested in my youth (type I diabetes and rheumatoid arthritis). They are auto-immune disorders; not related to lifestyle choices – I’m not overweight, I don’t drink or smoke, I exercise and eat healthy foods. And it terrifies me that folks like me and your wife are often lumped into the same category of people about whom the pundits say, “All of these diseases are accumulations of what’s happened before in a person’s life” and “We have to think about keeping people as healthy as possible so they don’t get these diseases.”
Cheaper drugs would be helpful (the patents ran out on many types of insulin years ago but the FDA has yet to approve generics), as would better coordination among specialists. But I’m lucky in that regard – all my specialists are at a nearby university hospital, and they coordinate all patient records on an in-house computer system. Thus one doctor gets all the data from my other doctor. I do believe there are solutions to some of the issues this article mentions – just don’t continue to accuse all of us with chronic illnesses of not taking care of ourselves.
The bottom line is, folks like Harris would not be alive in England, France, Switzerland and the other socialist paradises. If you keep folks with chronic conditions going, obviously they are going to “be less healthy” (Duh) and cost more.
So, there are no people with chronic health conditions in other countries? Stephen Hawking?
#1 – so you don’t have any government help?
Currently, the government already helps people with chronic health care through its socialist programs of medicare, medicaid and the VA.
It’s true that the primary care system could use some overhaul, and it’s also true that a lot of chronic conditions are the result of people’s bad habits.
As a health care professional, what disgusts me is the people that have access(and money or insurance, or both) and don’t put the system to good use. I used to work in a department that assessed patients prior to surgery. They would come in for surgery on their “broken” organ or system, but with out-of-control hypertension, diabetes, other cardiac problems, you name it. You should have seen all the blank stares, looking at the floor, or shuffling about I’d get when I asked, “when was the last time you saw your primary care provider?” or “does your PCP know you’re having surgery”? I may as well have been talking about rocket science–those who had not taken their blood pressure meds in six months, weren’t having it monitored; those not taking their oral hypoglycemics and then wondering why their blood sugars were sky-high. Many had had both cardiac and/or diabetic diet counseling and would not follow the diet. One woman tried to sneak a rotator-cuff repair(shoulder, which ALWAYS requires general anesthesia) without telling her cardiologist–come to find out, when I called him, that she also actually needed a BYPASS, which she refused to have, so she was currently maxed out on cardiac medication to prevent the next heart attack. The anesthesiologist refused to do the case(rightfully) without cardiac clearance and the woman ended up in another ER the night before the scheduled shoulder repair, with chest pain. Had she had that surgery, she probably would have died on the table or shortly after. I feel for the shoulder pain but the heart is more important. The cardiologist was ready to kill her himself when he found out she tried to pull a fast one like that on him.
I’ve digressed but the point here is that patients also need to be responsible for their own health care and actually utilize the system that is in place. What’s the point of having some of the finest health care in the world if we’re not going to use it judiciously?
I divide the health care debate into three sections
1. Catastrophic care. This is care that will wipe out a family and cannot be forseen or planned for. Things like a cancer diagnosis or accident where hospitalization and recovery can run hundreds of thousands and into millions of dollars. Everyone should have some form of Catastrophic coverage. This type of loss is exactly what insurance was designed to cover.
2. Primary care – this is “normal” care – checkups, normal sick visits (flu, cold, ear infections, immunizations, etc.) This type of care is rather inexpensive (compared to the first type). Having insurance for this type of care drastically increases the cost of delivering it and, thus, the cost of care. Insurance was never designed to cover “normal wear and tear” on what was insured. Imagine the cost of your automobile insurance if you expected it to cover regularly scheduled maintenance with a $10 copay when you went to the mechanic!
3. Chronic care – this a long term expense that we should also have coverage for. One cannot plan on developing Asthma or Diabetes or some mental or psychaitric issues that require long term drug and doctor support. This is where our system really breaks down because the cost of treatment (without insurance) can be very great and it can be lessened by getting regular care when you discover you have a chronic condition.
It is not the regular doctors visits that break a person. It is the treatment for the catastrophic and chronic care that breaks a person if he does not have insurance.
YBIC,
Phil Snyder
Steven hawking simply has progressive paralysis due to motor neuron disease. He does not have multiorgan failure. One defective system (motor neuron disease, dementia, congestive heart failure, renal failure) is not too difficult to maintain. Two systems (congestive failure and renal failure) is much much more challenging. Three systems (add in liver failure) and repeated hospitalizations become the norm.
As for making people responsible for their own health care, this is not possible given the fact that prescriptions are restricted to physicians, and physicians are in a global shortage. It would be best to make all noncontrolled substances non prescription, and make patients responsible for managing common illnessses like hypertension, asthma, congestive failure, and the like.
[blockquote]So, there are no people with chronic health conditions in other countries? Stephen Hawking?[/blockquote]
So there you go, folks, all you need to get top-notch government healthcare is to be a famous, world-class astrophysicist in the Royal Society. The political system will see to your every need.
If you’re a reupholsterer in Leeds, however, or just a pregnant mum about to give birth, well, the NHS has a comfy elevator waiting for you.
I have watched with increasing amusement the attempts to make “socialist” health care look bad. There seems to be a strange world where every mistake made particularly in the NHS – which must treat hundreds of thousands of patients a day – is solely the result of the evil system, and the many, many avoidable premature deaths in the USA don’t even exist! (If you want an example of this thinking then look at Matthew’s posts at Standfirm).
The strange thing is the people in countries with “socialist” health care aren’t screaming for change – even though they have the power of the ballot box to introduce it, and the ability to get all the benefits of private health care if they wanted to pay the premiums (which, by and large, they don’t). These people enjoy the lower costs and extra years of life (and the better health outcomes on every conceivable measur), and would rather have the “evil socialist system” than the appalling health outcomes from your very expensive system.
Thank goodness I live in a country with a nationalised health service!!
[blockquote]Thank goodness I live in a country with a nationalised health service!! [/blockquote]
See? Everyone gets what (s)he wants. Maybe we should send our uninsured northward and let the canucks treat them on their dime. They seem like the generous sort.
#9 – That’s pretty cynical, Jefferson. Of course, all you need here is to have a lot of money. Or to be a government official. Who goes to the Navy Hospital to get treatment. The government treats its own quite well. Still, I don’t see your point. Here, the upholsterer or the pregnant mum might not even get health care. Unless its an emergency. Unless they have lots of money.
Add that more people seem to be happy with medicare than they are under their private insurers. We all have anecdotes, but by and large, people in Britain and Canada, and Holland and Switzerland are happy.
#10 – chances are if we paid to send them northward, they would treat them more cheaply. Ethically, we would still have to foot the bill. Jefferson, you don’t quite address her plain fact – that more people leave this country to get health care than people come to ours.
Of course, there are plenty of people flying all over the globe to get health care treatment. Which seems to give lie to the idea we’re the only thing going.
RE: “Of course, there are plenty of people flying all over the globe to get health care treatment.”
Yep — we should definitely cut the involvement of the State in healthcare delivery so that we can recapture those people — rather than the expansive collectivist vision that John Wilkins typically advocates.
I’m thrilled that people in Holland, Britain, Canada, etc. are happy. Like I said, our uninsured should go there for treatment. After all, when someone here brings up an objection to treating non-Americans on the public nickle, he’s called a “racist,” and I’m sure our friends to the North aren’t racist and therefore would be tickled pink to see Americans flooding their wards looking for care.
Jeffersonian – I don’t live in Holland, Britain or Canada — but rather I am in New Zealand. Could you please explain to me why I should pay for your countries appalling treatment of its poorest and most vulnerable?
It sounds like another example of American arrogance – ie lets just dump our problems in someone else’s backyard – though I am sure you did not intend it to be!!
Sarah – “expansive collectivist vision?” Look, I’m just glad that people who don’t believe in government aren’t running things anymore. That’s a good way to make sure nothing happens for the benefit of the people. They did a good job of making sure government worked pretty poorly.
Jefferson – you offer anecdotes and hyperbole, but remain wary of facts. That’s OK. Look, if I thought Obama was a Kenyan communist who is getting ready to confiscate evenyone’s machine guns and before driving white people into concentration camps, I’d probably feel the same way. What will happen to the poor bankers or insurance companies when he gets all that power?
I’m not worried. There will be a health care plan with a public option. You’ll find your bills decrease a bit, but it will be harder to get an immediate appointment because there will be more people. The health care market will boom. Fewer will become insurance industry bureaucrats, and there will be a market for more doctors. Companies will be able to spend more money on investment than on health care plans. Smaller businesses will have greater options. While some froth at the mouth hunting for Stalin under the bed, we’ll become just a little more like that feared socialistic America hating country Switzerland or even worse, Canada or Holland. Perhaps Americans will lose their identity and stop eating apple pie and play more soccer.
Capitalism won, Jefferson. That’s the problem. Now its a matter of what kind of capitalism we live in. A Utopian one with injustice and servitude? Or one that is fair and offers opportunity to all?
“The strange thing is the people in countries with “socialist†health care aren’t screaming for change – even though they have the power of the ballot box to introduce it, and the ability to get all the benefits of private health care if they wanted to pay the premiums (which, by and large, they don’t). These people enjoy the lower costs and extra years of life (and the better health outcomes on every conceivable measur), and would rather have the “evil socialist system†than the appalling health outcomes from your very expensive system.”
In England, the patient featured would not only get an extra kidney, he would not even get dialysis. Dialysis is restricted in England to those who are likely to come off of it. Not only would he not get dialysis he would not even know that it is pretty standard, and offered to the uninsured here in the US. I guess if you don’t know that dialysis is “standard” you don’t miss what you don’t have. So I guess you will be “happy” what ever that means. And certainly costs would be cheaper which means that your fellow taxpayers will be “happy”. And the surviving population will be healthier which means that your ruling bureacrats will be “happy”.
However I fully anticipate that “health reform” will come in. And yes, people will be happy with it, the same way that folks whose kids have medicaid will be “happy” with that. They think it is normal to wait three months for an appointment with a neurologist, and that it is “normal” to not be offered fast forword (intensive auditory exercises) for treatment of central auditory processing disorder. After all there are almost no pediatric specialists who understand learning disorders (other than to prescribe Ritalin), and even fewer who accept medicaid. Their parents will tell you how “happy” they are, and will count their shekels in joy.
Me, I’m just glad that I was able to get my child (adopted at age 3 from El Salvador) appropriate therapy. When she was six, I was told that she was mentally retarded, and had ADHD, and that nothing could be done for her but to make sure her self esteem was high. Her IQ was 68 at age 6 but is now 110 after appropriate and expensive therapy, none of which any insurance company paid for. She is a sophomore in college, now. I’m a neurologist. I worked three jobs for three years to make sure my kid didn’t get run over by the health system. I must have paid over 50 grand all told, but I think I got a bargain.
Folks with alternate priorities are welcome to vote for them. It’s a free country.
For the record #16 I was equating happy with “live longer lives with better health and more enjoyment because less of our income goes to get that life and health”.
That is what the statistics say we have.
If you define happiness as shorter life and poorer health via more expensive care — then I suppose that is your choice, but it doesn’t seem like a market based, economically rational decision.
About the number of kidney transplants and dialysis …. Our dreadful “socialist” system provided a young man in our housegroup with his second transplant — having been provided with all the dialysis he needed while he waited for a match was found. He has a condition that means that he will “burn through” the new kidneys and will need other transplants in his life (that is as much as I know of his condition). There has been no suggestion that he will be limited by anything other than the need for a match … so will have some dialysis while this is found each time ie he hasn’t been told “three is the limit” or any such thing.
He doesn’t have any idea how long this current kidney will last (ie when the next transplant will be needed) but so far it is holding out better than his last.
Would he still be able to get insurance in the USA – he must be about 20 and is at university? What would it cost him compared to the salary of someone with a degree? I would genuinely be interested to know.
RE: “You’ll find your bills decrease a bit, but it will be harder to get an immediate appointment because there will be more people. ”
No they won’t — they’ll increase, as they did for the payers when the government instituted medicare and medicaid. And it’ll be quite a bit longer wait for an appointment . . . because there will be fewer services and slots available due to the rationing.
RE: “The health care market will boom.”
Yup — just like the “utility market” will boom. Just like the “auto market” “boomed” with the latest ClunkerBailout.
RE: “and there will be a market for more doctors.”
Oh yeh that’s for sure . . . and fewer doctors to fill the “market.”
RE: “While some froth at the mouth hunting for Stalin under the bed . . . ”
Naw — no need to hunt for collectivism.
RE: “Capitalism won . . . ”
Heh — like John Wilkins would know — he doesn’t know what “socialism” and “collectivism” is either.
So I assert the opposite of Wilkins . . . as with the Gospel, we simply don’t share the same foundational worldviews. Wilkins wants collectivism and ardently pursues it, all the while claiming that it’s “capitalism.” Just as he claims “orthodoxy” while believing flaming heresies.
Typical deconstructing of language, as he’s done for five years now . . . earning . . . the “respect” of all.
[blockquote]Jeffersonian – I don’t live in Holland, Britain or Canada—but rather I am in New Zealand. Could you please explain to me why I should pay for your countries appalling treatment of its poorest and most vulnerable?[/blockquote]
I was wondering that very same thing, to be honest, but me being an arrogant, uncaring Yank, you’d expect that. OTOH, we hear that Kiwis are generous to a fault, so I’m sure you won’t mind if we buy them tickets to Aukland, Christchurch, etc. so they can get the benefits of socialized health care. And remember: It’s racist to refuse.
[Comment deleted by Elf – we have asked you before to please moderate the language used in comments and to direct comments to the thread and not to other commenters]
“That is what the statistics say we have.”
Unfortunately, your statistics are warped by the way you define “life”. In the US life is defined by the clamping of the umbilical cord. If your child lacks breath we will intubate and breath for her) if she lacks a beating heart we will attempt to restart it for her. In Switzerland one has to actually breath on one’s own before one gets care, otherwise one is “dead”. Similarly in places like France if your 32 week preemie infant lives but then dies at 35 weeks, well that was a “still birth”. In the US, that was a death at 3 weeks, and yes it does alter our statistics, to have life expectancy drop from 78 to 3 weeks, instead of being dropped quietly from the “N”.
If you control for our homicide rate, and if you control for premies (which few countries try as hard as we do to save) then our sick and old live longer, much longer than do yours. Unfortunately, the fact that our breast cancer patients live 5 years longer is dwarfed by the fact that you fudge your statistics about your preemies dying before 40 weeks.
Furthermore, sick, frail, old people (like the chap in the article) are “less healthy”. No kidding. Dead people are cheap, and if you don’t have to accurately report your premie deaths, well your statistics will look very healthy also.
Our 28 week preemies are likely to grow up to have slightly damaged lungs, and may well have learning disorders. That can be treated, but it is expensive. Your dead preemies will not have that problem. Neither will your dead cancer patients be “unhealthy”. By contrast, even though our cancer survival rates are second to none, fragile, old people who need frequent monitoring for cancer, and the effects of chemotherapy cannot be considered “healthy”.
As to your 20 year old man with renal failure, he would get medicaid and would get his kidney transplant like everybody else. Just about everybody on dialysis ends up on medicaid. However unlike Australia he would not receive priority over the 48 year old man in the article because in the US, we don’t discriminate by age.
And that is the problem. If we did, our survival rates would improve. A 65 year old who gets a new kidney may live another 10 years. A 20 year old who gets another kidney may live another 55 years. Other countries ration expensive care (such as dialysis) by age. The US has not.
Up to now.
Wow !!!
It would be helpful to provide a little evidence please … for instance
[blockquote] by the fact that you fudge your statistics about your preemies dying before 40 weeks.[/blockquote]
I don’t know the details of how our statistics are collected but what I do know is that when I had a still born child at 18 weeks gestation I was told that had the child survived to 20 weeks that he would have been considered alive and then to have died and so be counted in both our births and deaths. As it was I was offered the chance to have him registered as a birth and death voluntarily but it was (very gently – I was fragile at the time) explained to me that even if I did he would not be counted in the births and deaths statistics because of the 20 week gestation cut-off. Is that the statistical fudging you are talking about- ie that he should have been included?
I am not aware that there is any rationing by age in New Zealand and am really surprised at the accusation that Australia has. In New Zealand our system works on points that are given on the basis of clinical criteria established by groups of the best specialists. They look at the best research on what factors should be taken into account to ensure the best outcomes. A little example – one of my children needed grommets when young for persistent ear infections. He was assessed against the criteria (I was shown both the criteria and the assessment so I was fully informed and could also question it) of
1. How frequently did he get ear infections?
2. How serious were they when he got them?
3. How much hearing loss did he have because of the resulting glue ear?
4. Any other clinical factors – in his case he got extra points because he was unable to tolerate two of the major antibiotics so we were relying on a smaller group that meant that the risk of developing resistance was higher.
5. Is he at a critical stage of development? He got extra points both times he had grommets put in — the first time because it was when he was developing speech, and when they fell out almost 4 years later because he was in the first year of school so learning to read etc.
On the basis of this assessment and this assessment alone (ie not our ability to pay etc) he was placed in the operating list in order of his severity. We had the operation (both times) within 2 weeks — and the second time was told that the waiting time at the local private (determined by parental means only) hospital was 3 weeks.
The same process was done when my 82 year old mother needed a hip replacement. There were clinical criteria about how well she would withstand the operation — which could be regarded as associated with age I suppose — but certainly no age criteria as such. Again, I was her support person so both of us were shown the criteria and her rating and given an opportunity to both discuss it and query it. She had her op.
Sometimes we do get newspaper articles with the allegation that the system is discriminating — and lets face it no system will always be perfect. For instance a few years ago a man in his 60s (I think – this is from memory) who was refused a transplant (can’t remember the organ). When the full facts came out in public (a difficulty as our privacy laws means often people make claims and won’t give permission for the health providers to comment) it turned out that he had terminal cancer — and yes he might have had a better few months with the transplant — but it was going to be a few months regardless. That information kind of ended his campaign, particularly since we have a shortage of organ donors and it was explained that the organ would not be able to be “reused” when he died because of the risk of transmitting the cancer.
I have been trying to think on and off today about what would be a good Christian criteria that could be used to evaluate different health systems. It seems to me that there is no bible verse that says “thou shalt do your health system through individual insurance” and also none that says “thou shalt have a collective health system”. People might like to correct me if I am wrong on that.
It also seems to me that the Bible is not negative about Government – Paul says we should obey authorities and it could not be claimed that this was because of the high moral status. Similarly Jesus has render unto caesar … The Bible seems to see the Government as having some legitimate role in God’s work – even the Roman Government. So I don’t think a decision by a country to use the Government to achieve what the people want is unbiblical.
So what might the criteria be? I have been thinking along these lines:
1. Jesus was always healing. He didn’t do a just select few. This suggests to me that there is something about doing as much as we can to alleviate suffering with whatever we have.
2. Similarly his healings were of all types of people – rich and poor, men and women – so there is something about need being the basis of intervention.
3. In the same way, he healed out of his generosity – he did not demand payment of any kind, even becoming a follower. There is something about giving being the basis rather than paying.
4. Finally there is the whole strand of teaching in the Bible about us being our brothers keeper and of ensuring the poor and the widow are treated well. There is something about the equality of people before God their maker.
So I conclude that if I was having to vote on the health issue (and obviously I am not) I would be looking at:
1. Which proposal will give the most health in the community for the resources?
2. Which would most closely align health provision to health need?
3. Which would enable me to give to my community as well as receive?
4. Which would be most colour and status blind when making decisions?
So now I have put my thoughts down, I would be interested to know if these would be the criteria that you would use, and if not what they would be. (I also think this might be a more interesting and productive discussion !!)
“Is that the statistical fudging you are talking about- ie that he should have been included? ”
In the US, such an infant would have been considered alive regardless of age. New Zealand appears to be fudging less than most European nations if they accept 20 weeks. In some nations if the preemie dies before 40 weeks its considered a still birth.
Well, there is that part, Old Testament to be sure, that instructs us not to covet or steal. I don’t see any footnotes allowing us to use the power of the State to get around such injunctions, either.
“Jesus was always healing. He didn’t do a just select few. This suggests to me that there is something about doing as much as we can to alleviate suffering with whatever we have.”
Actually Jesus was not. In Nazareth he could do no miracles because of their unbelief.
While there was certainly a long line of folks at the Bethesda pool, he spoke to one unfortunate, not all.
“2. Similarly his healings were of all types of people – rich and poor, men and women – so there is something about need being the basis of intervention.”
Actually faith appears to be the key ingredient, not need. As he said “the poor will always be with you”.
“3. In the same way, he healed out of his generosity – he did not demand payment of any kind, even becoming a follower. There is something about giving being the basis rather than paying.”
But he also instructed his followers that the workman is worthy of his hire.
“4. Finally there is the whole strand of teaching in the Bible about us being our brothers keeper and of ensuring the poor and the widow are treated well. There is something about the equality of people before God their maker. ”
True. That was done by permitting the poor to glean the fields after the harvest, and by encouraging works of charity. It was not achieved by insisting that the owner of the vinyard, allow the tenants to seize the fruits of the vinyard without paying the owner the proper rent.
Thanks Clueless – I will think about your comments.
On the issue of my 18 week gestation child, I also miscarried at about 8 weeks gestation. How would the USA have handled that? Still a live birth?
Hi Clueless
I have given your feedback some thought.
I don’t agree that faith was the key ingredient — it was the key ingredient in success agreed, but it was not in the offer of healing, and what we are talking about here is “can you access” not “will it succeed”. There is always failure in medicine. I am not also sure how “Having faith” could be used in evaluating between the different options. Can you suggest a question based on it that starts “Which proposal ….” (The same goes for lack of faith which was of course what was behind Nazareth.)
I think I would phrase it “we are told of one fortunate at Bethsaida” John tells us that what we are not told would fill volumes.
I don’t understand your comment about workmen … Do you think the other countries don’t pay their doctors? They get paid and in our country are amongst the highest paid professionals. I am sure they also get paid in Britain, Australia, Canada and other countries too.
Your last comment about the vineyards doesn’t make any sense to me either. Perhaps I misunderstand but it sounds like you think people here steal medical attention. It doesn’t work like that. We all pay through our taxes over our lives, but we get to collect when we need it. There is no stealing involved, and I am definitely not worse off if my neighbour gets medical attention than if he doesn’t. In fact, to the extent that I love my neighbour, I am very pleased, happy and relieved that he is always able to get as good treatment as anywhere in the world without regard to his current financial circumstances.
“There is always failure in medicine.”
Obviously. It was never appropriate to compare it to messianic healing.
“I don’t understand your comment about workmen … Do you think the other countries don’t pay their doctors? They get paid and in our country are amongst the highest paid professionals.”
In Australia and England, physicians aren’t required to take on 150,000 in debt before beginning. US physicians are. This debt is not because medical school is intrinsically expensive, I am involved in one, and neither I nor any physician teacher gets paid. We volunteer our time. The hospitals volunteer their space. All of the students tuition money (40,000/year) and all of the money the medical school raises through charity, fundraising go to pay the 40 million dollar cost that is created by federal regulation and taxes. Medical schools are a profit center for government. It is one of the things that helps pay for medicare.
So physicians are indentured prior to beginning practice to the tune of 150,000, (while being guilt tripped that “student tuition doesn’t cover the cost of schooling).
After that physicians work at subminimum wage (when the 80 hour + workweek is factored in) for some 4-8 years so as to pay for the uninsured in university hospitals. Residency slots are issued to public hospitals to compensate for the uninsured/medicaid burden, since medicaid and (to a lesser extent medicare) do not cover cost of basic supplies like IV fluids, surgical devices, etc.
After that, physicians set up business and attempt to attract patients who can pay for their services, while being forced to hold hospital priviledges as a condition of getting insurance. They are required to spend approximately 120,00 -150,000/year up front in order to comply with all regulation, and (if you are a specialist) are expected to see all people in the ER who need you, whether or not they can pay (and most of them cant pay). The ER call alone is an uncompensated tax of about 30% of time. If you see folks in the ER (and there is a 50,000/per patient fine if you refuse) you pretty much have to accept medicaid/medicare as medicaid/medicare/uninsured is 80-90% of ER call.
As I have said before, when I was in private practice if I worked less tha 60 hours a week, I didn’t make a dime and I owed my hospital money. I had to work 80 hours a week to make minimum wage, but I could become “rich” by working 100 hours a week.
Now, they wish to “tax” us “rich” doctors, because after all (as you pointed out) we “get paid and … are amongst the highest paid professionals:
This is theft, deception, and forced slavery, using the power of government as a club. By taxing the “profits” without altering the debts taken on, the government (and US citizens) are preventing physicians from paying off debts that they incurred in good faith, thus forcing continued indentured servitude.
This is no different from the “company stores” of the old railroad towns, where each year workers found they owed more money to the railroad, no matter how hard they worked.
Me, I have already left private practice. Every physician I know is doing likewise, or is considering means to leave medicine entirely. A couple of years ago, a favorite resident decided to be an airline steward and says that he gets paid more. The other residents (whose debt chains them to their galley seats) envy him. They won’t be exploring any alternate careers until they pay off their student loans.
No child of mine will ever enter medicine if I can help it. I hope to buy subsistance farms for both my kids, pay for their college education, and help them get good jobs as government bureacrats. That is where the money is.
I am sure they also get paid in Britain, Australia, Canada and other countries too.
Your last comment about the vineyards doesn’t make any sense to me either. Perhaps I misunderstand but it sounds like you think people here steal medical attention. It doesn’t work like that. We all pay through our taxes over our lives, but we get to collect when we need it. There is no stealing involved, and I am definitely not worse off if my neighbour gets medical attention than if he doesn’t. In fact, to the extent that I love my neighbour, I am very pleased, happy and relieved that he is always able to get as good treatment as anywhere in the world without regard to his current financial circumstances
scratch the last two paragraphs, I failed to remove them.
“Your last comment about the vineyards doesn’t make any sense to me either. ”
The owner of the vinyard paid for the land. He planted the vines. He tended them for years. It takes a minimum of 7 years to get useful fruit from a vine. (About the time it takes to make a doctor). The vinyard owner built the watchtower and the press. The tenants stole the fruit of the vine after all the work was done.
But you might say that the poor old tenants are hungry and deserve to have the grapes. And the “rich” vinyard owner is just a greedy capitalist who doesn’t deserve to keep the land that is needed so badly by the poor unfortunate tenants who after all are “God’s children” too, and should be “loved as a neighbor” by the greedy vinyard owner who clearly isn’t a Christian since he doesn’t want to share.
Maybe. And if the vinyard owner was truly “rich” it would be unpleasant watching the tenants being turned out of the vinyard to starve or be sold off as galley slaves. Surely Jesus wouldn’t want that, right? “Sharing the wealth” would be best, right?
Suppose the vinyard owner took on debt to build the vinyard. Since he cannot pay the debt (because the tenants have stolen the fruit of his labors) the vinyard owner gets sold as a galley slave.
Now what is the “justice” of it?
I think it is always best to focus on the 10 commandments.
Don’t tell lies. Don’t steal. Don’t be envious.
And don’t do it by proxy using the government as your mafia goon and call it “Christianity”. It’s not. It is an insult to God’s glory to call socialism Christianity.
[Comment deleted by Elf – please address the thread topic and avoid ad hominem or personal comments]
Hi Clueless
I don’t know if you will come back now that the post has slid down the rankings, but the way you describe conditions in your country for health professionals really does sound bad. I am so sorry for you. I wish you had the kind of working conditions that our medical professionals face. They may not be perfect — very little ever is — but they sure do sound palatial compared to yours.
I had not thought of it when evaluating the two systems but perhaps the health profession will be another beneficiary of a change in your system. I hope so because I would not like to see this level of exploitation continue.