Systemic problems of the Medical System

[nadinbrzezinski]

Well so far we have all concentrated on the insured who don't have enough, and the uninsured. We have another problem. And that is the overspecialization of doctors, and pay for doctors, which some believe is too high.

Well here is why it is high, as well as solutions to it, that should also lead to more Family Practice Physicians, which we don't have enough off.

1.- Twelve years of school average, four for premed, four for medical school and four for any basic specialty. If a doctor wants a little more add another two. Now the problem is not the years of school, but how we finance this. If the US adopted a European training system, we would be able to cut it back by two, (that assumes HS students are mature enough to go directly to med school... and in places like oh Mexico they are, so that would cut it down to six years of med school and four of specialty) But still there is another problem. Why do doctors go for lucrative specialties? Even if a young doctor wants to go for GP, his or her income over a career will be lower, and the interst rate of the loan will not go down just because he\she decided to go for a family practice, ok. So one thing we, at a policy level, need to do to change the dynamic is to quite frankly pay for kid's school in exchange for service. Yes, having young doctors serve in under served areas would make sense at multiple levels. Oh and not having to pay exorbitant loans would also encourage more young doctors to go for less lucrative practices, and for lower pay. Yes some people will be greedy no matter what.

2.- Insurance. Never mind doctors are not sued as often as the Republicans claim, doctors STILL have to have the insurance. Some hospitals pay for it, but not all. And doctors in private practice pay for it. No doctor will be stupid and do this without it. Chances are they will not face a lawsuit, but they still pay for it. So yes, we need some level of reform, just not the kind our republicans assholes want.

Now the other great misconception is when people look at median incomes they are high, as in very high. Some specialties worst than others. Realize half make less, and half make more... ok, or even less, since usually we are talking median, not average.

Now this bill doesn't deal with this. I mean we the people making university training free for health care workers reeks of socialism and communism, run fer them hills! But reality is that this is part of the systemic problems we are having.

[HuckleB]

1. This is a huge problem.

And that doesn't include nursing or any other health care profession. The shortage of docs and nurses is an issue now, when many people have no coverage. It needs to be addressed, or any HCR will be in trouble.

That said, no plan put forth has deigned to address this issue as far as I know, and I don't think it's a good enough reason to stop HCR.

[nadinbrzezinski]

2. I am just mentioning this as an issue

and I specifically mentioned doctors since a lot of people are horrified at how much some specialists make. That said, nursing is in worst straits, but we also need to deal with things like the treatment of labor in hospitals, ranging from the clean up crew, to the lab techs and all nursing personnel. This is disgraceful, and if we are to fix the system we should start looking at this in a systemic way. HCR deals with only one end of it, really, and not well either.

[bertman]

3. K & R.

[travelingtypist]

4. More of that.

You know, addressing the symptom while ignoring the disease, for instance, real finance reform, reinstating Glass-Steagall to prevent the speculation bubbles, that kind of thing. Talk about a frame for the debate for this mess.

[nadinbrzezinski]

5. Glass Steegal has zero to do with financing of

college education.

Now it is part of a systemic problem for the ECONOMY and a slew of other aspects, but if you want to talk of what is part of the problem... speak of the privatization of the lending system for college students. This affects medical students, nursing students and history students alike.

[travelingtypist]

6. Never said it did.

My point -- badly stated I guess -- was that we should be fixing diseases instead of just symptoms. Corporate personhood is a disease, media ownership consolidation is a disease, repeal of Glass-Steagall is a disease, our trade policy that destroyed our manufacturing base is a disease. Obama isn't touching any of those.

[nadinbrzezinski]

7. He is a member of the political class

and people need to stop thinking that political elites will change the system with nothing coming from us.

[travelingtypist]

8. Obama political class?

No, I don't buy that for a second. Maybe now, but not always. Less than six years ago he was a state senator, hardly elite by any stretch.

There was a bunch that came from us in the election in 2008 to give the Democrats these overwhelming majorities. People need to stop whining and start working to get the Blue Dogs and other conservaDems out, out, out. If we need bigger majorities, then by damn let's go and get them.

[nadinbrzezinski]

10. You think somebody who IS NOT a member of the political class

will be able to run for President? Okie dokie.

And what do you think a State Senator is?

[travelingtypist]

11. A state senator is one of thousands.

Kind of a nobody. Can anybody on this "politically astute, aware" forum name their state senator? Suggest you commission a poll to prove my point.

Barack Obama is one in several billion -- at the right place at the right time with the right skills and Howard Dean's 50-state strategy foundation to build on. Without those things, his "membership" in the "political class" and $4.50 would buy me a Starbucks.

Get a clue.

[nadinbrzezinski]

13. Two points

State Senators ARE part of the political elite, just at a lower level. Parties STILL approve them.

And if you ask most Americans who their FEDERAL Senators and their representatives are, forget it. they can't either.

By the way my State Rep is Saldana and my State Senator is Kehoe... any other questions?

I even know who my city rep is... in front of the city council.

Now you go buy a clue and realize how the political system works okie dokie.

[travelingtypist]

14. You are a valued and needed and educated citizen.

The rest of the bunch? Couldn't tell you Stabenow from Schumer. You know this. You know this.

Your entire post tries to pretend the average non-informational voter lives up to my lowest expectations.
What are you smoking?

[nadinbrzezinski]

15. No I am telling you that those who RUNS FOR PRESIDENT

are members of the political class. If they are not, they will be destroyed by the party and the media system. It is time people realize how the system works. That's the first step to get change.

[AngryAmish]

9. I think the barriers of entry are too high

Doctors have pushed to restrict the number of medical schools and number of medical students for years. I am a big proponent of the nurse practitioner system. In fact, I think the most efficient way to run a GP is to have ten nurse practitioners and 2 MDs.

As for docs without insurance - it happens. Mostly in the "tort reform" states or with the lousy docs. If a doc has no insurance then financing a suit against them is a hill too far for most lawyers.

[Odin2005]

12. Don't forget how the AMA creates artificial scarcity by limiting medical licenses.