Discussion in 'General Chat' started by Longwalker, Jul 27, 2018.
Interesting times. We'll see if anything comes from this. From my POV, this has HRC's cloven hooves all over it.
Bad things happen when you don't pay your child support.
Someone once said Hell hath no fury as a woman scorned. So just what will the total costs of that few minutes cost him and his dad?
Many years in jail.
Two of a kind. I think the south end of the northbound horse looks better.
If HRC is involved, which is always on the table, as many years in jail as Jeff Epstein.
Ok so when I meant a social safety net, I meant that people should not be allowed to not get medical care because they can't pay ridiculous medical fees a
So I read some articles concerning healthcare specifically and I like that not only do they explain it in a manner of brevity, but they realize that despite good outcomes compared to our peers (other core nations), the system is far from perfect.
If I had to nitpick, I'd have liked a bit more openness with the sources. Look in the description of this video for instance. Here, they put in a link where you can read every source they used in coming to their conclusion because as much as I like to consider myself a trusting person, the new #1 rule on the internet is "Don't trust anything unless you can verify it".
There is only 1 reason for the explosion in hospital administrative jobs, and thus the massive increase in health care delivery costs - government regulation, driven almost exclusively by Medicare/Medicaid. The best social safety net ever yet discovered is liberty.
Health care delivery is light years more efficient today than it was when I was a kid, driven largely by advances in diagnostics, which were themselves driven by advances in math, physics, and engineering. Prior to computerized tomography (CT scan) and MRI (magnetic resonance imaging) in the 70s and 80s, if a doctor couldn't discover the issue with x-rays and lab tests (which themselves have advanced greatly in that time), they would do exploratory surgery. If you think a few thousand USD for a CT or MRI is expensive, try renting a surgical suite for a few hours for the surgeon to try and dig around to find something. And then there's the recuperation period from that surgery. And the anesthesiologist, and the nurses, and post-op care within the hospital for several days.
And yet with all those efficiency gains, costs spiral out of control. Again, I will refer you to the chart above as a refresher as to why.
We both want the same thing. But government-sponsored "safety nets" of any sort, for any thing, always increase the cost to the final consumer. And the folks who can least afford those cost increases are the folks you're trying to help.
I'm not trying to be snarky, but the pernicious myth that governments can "help" people must be buried, and the earth above the casket needs to be salted.
One of the changes that your graph doesn't show is the distribution of time by the physicians. While the number of administrators have skyrocketed and the number of physicians has only increased by a percentage, the duties of the physicians have expanded. The daughter of a friend of mine completed medical school a few years ago and went into a residency. An approximation was that for every 15 minutes she spent with a patient, diagnosing, discussing & prescribing she had to spend the other 45 minutes of the hour filling out forms and providing justification for every decision, conclusion and action that she took. In an 8 hour day, if she wasted no time and took no breaks she could see 8 patients. Lat I knew she was disappointed to the medical services industry to the point that she was considering moving to one of the third world countries just to get away from all the wasted effort.
Dont worry fam, you're not being snarky at all.
As Friedman (and von Mises, and Hayek) would say, that too is a result of regulation. It has the real world effect of making the provision of medical care scarce. Scarcity of any desired good/service, as I'm sure you're aware, increases the price. Before I met my wife, I dated a gal that was a nurse practitioner for an internist. The amount of paperwork she brought home at night was just staggering.
To recover costs and still make a profit, your doctor friend needs to increase the cost per visit since she can see so few patients; whereas if she could see 20-30 patients a day, she could volume discount. She would have more happy patients 9and she'd make more money).
FWIW, my older sister is a pediatrician. She graduated med school in 1989. She's been ready to quit practicing since maybe 2003 or so. She's utterly fed up with it.
At least "without make-up" the south end of the north-bound horse can produce something of value, even if it is fertilizer for plants; what comes out after make-up is so vile it has no use at all.
There is a reason for that, and it date back to 1910 and the Flexner Report which closed down medical schools from 155 to 31. By 1935 yer number of Medical schools was 66. A current cost estimate to start a medical school is not cheap, 67 Million over 6 years. http://www.thecb.state.tx.us/DocID/PDF\1515.PDF
Currently, 141 grant an MD and 35 a DO. Whereas there are 201 law schools.
This may not be 100% true but I also think that being a doctor is seen as one of those jobs that you do for the money. Thus, new medical professionals are very money motivated. Medicine needs to be a more philanthropic profession.
Hmmm...why shouldn't they be able to make a lot of money?
Do you know what it takes to be a doctor? First, if you don't graduate college magna cum laude or summa cum laude, your odds of getting into medical school are slim. That's 4 years of hard work as an undergrad, which all by itself ain't cheap. Even for English majors, prerequisites for med school are the same: 8 hrs of freshman chemistry and lab, another 8 hrs of organic chemistry and lab, 6 or 8 hours of physics (which requires proficiency in college level algebra as well as the calculus), and a lot of biology/microbiology. And then do well on MCAT. Then study your guts out for 4 years of med school. Then there's residency, a minimum of another 3 years of even more studying than they did in med school. Some residencies are 5 years (orthopedics, for one, is 5 years). And some docs who finish residency go on to do fellowships (another 2 years) in specialties like cardiology, pulmonology, infectious diseases, endocrinology, nephrology, and quite a number more.
And you actually expect that, with an extra 10-15 years of very intensive post-secondary study, they shouldn't be interested in making a lot of money when they're finally allowed to practice medicine unsupervised???
Tell ya what. Become a doctor and do your own philanthropic work. It is the height of hubris to suggest other people ought to follow your model.
My brother-in-law is a pulmonologist. He works about 80-90 hrs a week. He only collects about half of what he bills. My sister is a pediatrician. Because of state medicaid requirements, their practice actually loses money on medicaid patients. But they cannot turn them away. So they had to hire a nurse practitioner to take care of the medicaid patients. At the NP's salary, she's a break-even, instead of a loss to the practice.
I used to be a nurse. Most doctors I know want to quit, in spite of the good money. They're tired of the bullshit. My sister has been ready to quit her medical practice since the early 2000s.
What sort of work does your sister do nowadays?
she is still practicing medicine. she'll be 60 in 4 years. I expect she retires early, especially if I can encourage her to partner with me on some real estate deals I'm working on.
Separate names with a comma.