Cougy_Monster wrote:

Hengst wrote:

Let me first say, I absolutely respect your opinion and all of your years of training. But I really only get 3 things from your post

#1 - you disagree with me

Which is completely fine, and welcomed. I think it's important to discuss differing perspectives, that's how good solutions that work are actually found.

#2 - you point out some major problems in the system that I didn't

anyone working 30 hour shifts doing anything is probably a bad idea, particularly when trying to save peoples lives. Seems to me like the money in the health care system is mostly going to the wrong people, and not to the doctors that deserve it.

#3 - You're awfully defensive

And i'm not really sure why. I never said anywhere that we didn't have good doctors in our system, I'm mostly just pointing out that the current system is not set up to allow everyone to get the best care that they need, not that there are not great doctors that can give it to them.

And as far as the english professor thing goes, sorry that you took offense to that but I mostly just threw a graduate profession out there. Whether or not its english, physics, chemistry, engineering or another graduate profession I guarantee that there are other professions out there that have worked just as hard and sacrificed just as much blood sweet and tears to do what they do. Whether it's "english" specifically I don't know, but that wasn't really the point. It wasn't intended as a personal shot against medical doctors. I didn't really see so much of a rebuttal in your post as much as you just seemed angered by my blog, which is fine, I really didn't expect very many people to agree with me on this site (actually I'm pretty surprised so many people seem to have read it).

I'd be perfectly happy to have a conversation with you some time, and I'm sure I could learn a lot from your perspective. I doubt you'd change my mind, but you could certainly help me improve the way I'm approaching things.

And no, I'm not a medical doctor, I just know a lot of people who have been screwed over by their insurance companies, or are denied coverage because of "pre-existing" conditions. . . As well as a lot of people who can't receive the care they need because of the way their policies are set up (be it care for physical therapy, mental health, or just other normal stuff).

It does seem that there are some professionals in your field that do agree with me though.

http://www.pnhp.org/

There are definitely a lot of docs (in fact pretty much all that I've met) that would like a system that provides healthcare for everyone...but I truly don't know very many that want a true socialized system. Socialized medicine works on 1 basic principle: allocation of restricted resources. A government decides it will employ X number of cardiologists and provide X dollars for procedures, even though it is obvious that 2 or 3 times more cardiologists are needed to handle problems in a timely manner. End result is 1/3 the cost and those who get timely care are extremely satisfied and the others are just glad they won't have to pay when it's their turn. The perfect example of this even in the U.S. is the VA hospital system. I've worked there, and it is like getting your healthcare at the post-office. It's horrible.

A few weeks ago I was in the OR with a young woman who had sustained a major trauma. She required many, many units of blood to save her life. After 12 units (that's a good amount for those not familiar with blood products) the british doc with me said, "In the UK this is when the blood bank would call the OR and say she's had enough blood and she would die." The UK system has decided 12 units of blood is all 1 life is worth. That may save them money that can then be used to vaccinated kids for free (not a bad system necessarily), but that kind of system will NEVER fly in the U.S. because Americans have a strong sense of entitlemenet for everything, including an unlimited supply to life-saving measures. By the way, she lived. We cared for her without knowledge of her insurance status. All the garbage people read about hospitals letting people die because they don't have insurance is a rare event. We treat everybody.

As far as research is concerned, the U.S. produces the vast majority of medical innovation because we have financial incentive. Canada hasn't come up with a new drug since WW-II. The world criticizes Phizer, Eli-Lilly, Merck....but there work saves lives. I'd take their "corrupt" business practices over 99% of lawyers world-wide anyday.

Your opinion on the 30hour shift is legitimate. I hate them. All docs hate them. The alternative in a socialized system is that at 3pm the ORs shut down. Period. End of story. People die. That is the TRUTH. There is no incentive to work late when you are salaried at below your market value.

I apologize for responding defensively, but one thing you have to understand is that doctors are constantly under attack from lawyers (at least 1/2 of what we do is CYA...which is exceptionally expensive by the way), the public (somehow reader's digest has made everybody an expert on their health) and the democratic party (billary suggested that physicians should have a salary of $80,000). I had faith in our government's ability to help manage healthcare until I went to DC and spoke in person with supposedly powerful people. Trust me, you don't want a lawyer managing healthcare any more than you want a doctor representing you in court.

One last tidbit, most European countries with socialized medicine are opening up private hospitals. It's actually a booming industry. The public is tired of government work.

Allow me to say amen to that
Hey, let me just set the record straight. Me beef is definitely not with you or doctors it's more with the system and some of the money grubbing business people at the top of the system. I think MOST doctors are in the biz because they want to help people. Again, I respect everything you do, and I do respect your experience. I do think it would be interesting to sit down and talk some time. Too bad you live somewhere close to canada, but if you're ever in Utah and want to have a lengthy discussion let me know .

Hengst wrote:

Allow me to say amen to that ;)
Hey, let me just set the record straight. Me beef is definitely not with you or doctors it's more with the system and some of the money grubbing business people at the top of the system. I think MOST doctors are in the biz because they want to help people. Again, I respect everything you do, and I do respect your experience. I do think it would be interesting to sit down and talk some time. Too bad you live somewhere close to canada, but if you're ever in Utah and want to have a lengthy discussion let me know ;).

Amen back atcha.

Most docs also hate the business folks that steal money from us and patients, but the alternative (the government stealing from us and patients) is much worse--in most docs' opinions.

The U.S. economy is a free market. Conservatives would like the free market to rule everything, but that is not possible. For example, the airline industry in a completely free market would cycle through bankrupt business plans to enormous prices. Furthermore, healthcare is not truly a free market because when your spouse or child is facing death, you are not free to choose to do nothing. So, there has to be some regulation. Who regulates is the question. Since docs haven't historically regulated themselves, lawyers want to do it. That's a bad idea. I try to get docs to contribute to politcal action committees so we can control our own future....

There is alot of waste in healthcare (most Americans have more money spent on them in the last 6 months of their life than the rest of their life combined). We need to just let people die when it's time and not 6 months after the Big Man wants them home. 6 months on a ventilator is a bad way to go.

By the way, only 8% of healthcare dollars go to physicians.

Cougy_Monster wrote:

Hengst, I read your blog regarding socialized healthcare and I have to say (respectfully of course) I disagree with just about all of it. One simple post here could not debunk all you claimed in your writings, but I'll at least make a few comments.

To start off, other than having been a patient in the U.S. and a foreign country I'd like to know where you get your expertise. You're claiming in your posts that people who disagree with you have been blinding by "PR". I'm a physician trained in the U.S. and practicing in the U.S. I also actively participate in research, some of which has been funding by the National Institute of Health. I work daily with physicians from the UK who freely offer their opinion of socialized medicine (in case you're wondering, they come to the U.S. to enhance their training because of the procedures we can afford to do here that they don't do in their socialized system). I practice within 45 miles of the Candadian border and I have personally cared for patients who have come across the border to get life-saving care in a more timely fashion (i.e. before they die--this is especially true for MRIs or CTs to diagnose various cancers). I also actively participate in medical legislative bodies and I have been to Capitol Hill and met with a few congress-people as well as the powers that run the Centers for Medicare and Medicaid Services.

The first point I will make is that there is not a non-physician on this planet that will ever be able to fix medicine. On my first visit to DC I was blown away by how totally ignorant politicians are regarding the simplest of medical issues. It's as if they get their information from blogs (no offense).

Second, the World Health Organization uses many numbers (self-reported by each country by the way) to rank world-wide healthcare. Having the U.S. ranked #37 is akin to the media leaving BYU out of the top ten 2 years in a row. The U.S. is exceptionally honest with itself in healthcare reporting, which hurts in the rankings. Furthermore, the U.S. life expectancy is lower than many other countries because we have faster cars, more money for fast food and GUNS. When 30 college students get shot and die it makes our healthcare #s look bad....for no good reason. On the other hand, countries like Cuba claim to have the lowest HIV rate in the world simply because their corrupt government makes up the #s.

Alright, for the sake of sanity I'll save other comments for another post...except for the following. You compared the training of an English PhD to a medical doctor. I'm sorry, and again, no offense to any professors out there, but you just don't understand the training required to be a physician. I'll skip by the details of the sacrifices necessary to get pretty-much all A's in exceptionally difficult classes as an undergrad and skip to medical school itself, where many people give up everything important to them to learn an insane amount of information. And it's not just book learning. I spent months working 100 hours a week, including 30 hour shifts straight with no sleep and often barely any time to eat. During these years many people lose their good-nature and their families. I'm lucky to have kept both ;) . Then after 4 years of undergrad and 4 years of medical school (really the equivalent of 8 years if you consider 40/hrs a week to be full-time) you start your residency training. The powers that be tried to LIMIT work hours for resident physicians to 80-88/hrs a week and 30 continuous hours. In reality the only limit is on what is reported. Residency training is a minimum of 3 years (again the equivalent of 6 when factoring in the 80/hrs a week). Most physicians train longer--my specialty requires 5 years after medical school. All this time you are getting "paid" less than $10/hr even though you have gone to 8-12 years of post high school training--and remember, this is $10/hr for a fully licensed MD. That is not enought to pay rent, food and pay off the $250,000 debt you owe in student loans.

I'd love to reply to all of your points, some of which are valid concerns but in my opinion not entirely accurate. Maybe later. For now I've got to finish the last 14 hours of my 30 hours shift....

CougyMonster, seeing people coming over the border for care is emblematic of rationing and scarce resources, to be sure. Something no one wants. But would you not agree that 35 million uninsured Americans, or whatever the actual number is, is just a different way that the resources are being allocated here? To me that reality is a troubling as the people coming over the border for medical attention.

I have never understood why it is either our system or "socialized medicine." Once that term comes out, end of debate, because who wants socialized medicine? I thought "socialized medicine" was where the doctor is employed by the governement. Am I wrong? That said, do you consider Medicaid or Medicare "socialized" medicine? If you do, why? If not, then what is wrong with this model as a means for covering all Americans? I am not advocating this, just wondering. The fact is that about 1/3 of all Americans today are on one or the other programs already.

OLB wrote:

Airwolf84 wrote:

People making minimum wage can't get by at all... their monthly income would be $960 (even less than that after taxes)... not even enough to make a rent payment in a lot of places. The minimum wage of $5.75 is an atrocity!!! The name of the game in today's society is shortchanging employees and cutting costs no matter the expense in order to improve the bottom line. It's no accident that today's CEO makes an obscene $575 to every $1 one of their employees makes. 50 years ago, this ratio was about 50 to 1 and the average family could survive on one income just fine, but not anymore.

Before you spout off your crap about minimum wage, why don't you check out the Bureau of Labor Statistics. http://www.bls.gov/cps/minwage2004.htm

Do you even have a freaking clue who the minimum wage earners are in our society? More than half of all minimum wage earners are under the age of 25. A quarter of all minimum wage earners are teenagers. In other words, at least half of all minimum wage earners are either teenagers in high school or young adults who are probably working while they go to school or learn a trade. This is backed up by the fact that more than 50 percent of minimum wage earners work less than 35 hours a week. So these minimum wage earners are living at home or are sharing apartments with other people (kind of like what one does when they are young, single, and going to school).

You make it sound like people are trying to have families while working a minimum wage job. The fact is that 60 percent of all minimum wage earners have never been married. These are people that live with roommates so they can share living and utility costs.

While I am sympathetic about your rant on CEO salaries, the fact is that the average American has more material wealth today than 10, 20, or 50 years ago. I won't argue that the average American is better off today, because much of "better off" has to do with the way one lives his/her life. But nobody can dispute that American's live better.

Today most Americans have air conditioned homes, air conditioned cars, cable television, multiple TVs, computers, DVDs and DVD players, I-Pods, cell phones, digitial cameras, high speed internet, etc. How many people had these things even 15 years ago?

Beat me to it! Wolfie, if you really want to fix it then GET RID of minimum wage. It actually keeps wages down! As for CEO's, they get paid their fair share. Like it or not that's the way it is. They don't make up their own salaries, they are compensated by a board for the job they do. Look at the guys who headed GE. Here is a great example. You tell me this guy wasn't worth every penny. He retired in 2001 and his replacement two years ago made a salary a little over 3 mil with a little over 1 mil in bonuses.

In 1980, the year before Welch became CEO, GE recorded revenues of roughly $26.8 billion. In 2000, the year before he left, the revenues increased to nearly $130 billion. When Jack Welch left GE, the company had gone from a market value of $14 billion to one of more than $410 billion at the end of 2004, making it the most valuable and largest company in the world.

At the time of his retirement, Welch received a salary of $4 million a year.

You telling me the mail clerk added the same value?

As for the gap between the rich and the poor growning, of course it will grow. There will always be very poor people, but the beauty of our capitalist system is that if you apply yourself and work very hard you have a good chance of becoming rich. There will always be those poor that are satisfied with handouts and therefore don't improve, but the rich continue to work hard and improve their own wealth so the gap continues to grow. The only thing unfair about this is that the media and liberal dems continue to defame those who are actually working hard and succeeding!

Cougy_Monster wrote:

Hengst wrote:

Allow me to say amen to that ;)
Hey, let me just set the record straight. Me beef is definitely not with you or doctors it's more with the system and some of the money grubbing business people at the top of the system. I think MOST doctors are in the biz because they want to help people. Again, I respect everything you do, and I do respect your experience. I do think it would be interesting to sit down and talk some time. Too bad you live somewhere close to canada, but if you're ever in Utah and want to have a lengthy discussion let me know ;).

Amen back atcha.

Most docs also hate the business folks that steal money from us and patients, but the alternative (the government stealing from us and patients) is much worse--in most docs' opinions.

The U.S. economy is a free market. Conservatives would like the free market to rule everything, but that is not possible. For example, the airline industry in a completely free market would cycle through bankrupt business plans to enormous prices. Furthermore, healthcare is not truly a free market because when your spouse or child is facing death, you are not free to choose to do nothing. So, there has to be some regulation. Who regulates is the question. Since docs haven't historically regulated themselves, lawyers want to do it. That's a bad idea. I try to get docs to contribute to politcal action committees so we can control our own future....

There is alot of waste in healthcare (most Americans have more money spent on them in the last 6 months of their life than the rest of their life combined). We need to just let people die when it's time and not 6 months after the Big Man wants them home. 6 months on a ventilator is a bad way to go.

By the way, only 8% of healthcare dollars go to physicians.

Yuck, if I'd have known that stat I'd have put it in my blog.

BoiseBYU wrote:

CougyMonster, seeing people coming over the border for care is emblematic of rationing and scarce resources, to be sure. Something no one wants. But would you not agree that 35 million uninsured Americans, or whatever the actual number is, is just a different way that the resources are being allocated here? To me that reality is a troubling as the people coming over the border for medical attention.

I have never understood why it is either our system or "socialized medicine." Once that term comes out, end of debate, because who wants socialized medicine? I thought "socialized medicine" was where the doctor is employed by the governement. Am I wrong? That said, do you consider Medicaid or Medicare "socialized" medicine? If you do, why? If not, then what is wrong with this model as a means for covering all Americans? I am not advocating this, just wondering. The fact is that about 1/3 of all Americans today are on one or the other programs already.

That is the beauty and deception of this argument. Those millions of uninsured still recieve great healthcare. All they have to do is go to the local General Hospital and they will receive treatment regardless of whether they are insured or not. People always refer to them as uninsured as if they cannot get treated but that is a fallacy. They do get treated to the tune of billions a year.
Here's an option why not just get rid of health insurance altogether? Make people pay for it and I guarantee you that prices will drop. The problem is that you have to first limit the damages from lawsuites. How about it doctors? How much of your practice's fees pay for legal insurance. I know our OBGYN had to leave her practice because her partners decided the insurance for delivering babies was just too high. So now there are many fewer groups delivering babies in our area, which means demand for their services is much greater as well as the potential for lawsuits and both in turn leading to skyrocketing fees for their services.