Tuesday, August 25, 2009
A doctor tells the truth
In this short but amazing article, a doctor in California explains his front line view of how he feels about health care in America. As you can read, we already have a shortage of primary care physicians. This guy is making half of what he did 20 years ago. Is that any way to make primary care physicians out of med students? I think not. This should be a wake-up call to the knuckleheads in Congress.
Subscribe to:
Post Comments (Atom)
17 comments:
His reasons for why there will be no PCPs in the future are that he's only making $75 per patient per visit? My apologies to the impecunious Dr. Vance, but his complaints are indicative of the problem. Medical care should not be a money grab. I know you have a contending point of view, but our health care system should not be modeled after a true free market system because it's not selling a commodity (like TVs). Kenneth Arrow explained it much better than I can in his essay "Uncertainty and the Welfare Economics of Medical Care", but basically, due to the nature of health care, we:
A) can't evaluate the products before we buy them;
B) don't know when we will need them, and;
C) therefore, cannot budget (or even pay) for the extremely expensive costs that Dr. Vance would like to see go even further up.
We have an intrinsic trust-relationship with our doctors (which is why they have a code of ethics), for these reasons. Your Best Buy lackey that's selling you a new plasma doesn't have to take a pledge before he goes out on the sales floor, and with good reason. We know (or could know) what we're getting when we purchase that new TV. We don't know what we're getting when we agree to that surgery that may or may not save our life. When you put in a for-profit system and make the incentive money, this ethical trust-relationship goes out the window.
That said, I have a hard time garnering sympathy for him, but as far as his concern that there will be no more PCPs in the future, if there's a need for them (and every bill I've seen proposed is very PCP-centric), they will exist.
Wanting a good salary doesn't constitute a "money grab." Doctors have to undergo a grueling educational process - their resumes, therefore, are more impressive than the average Joe. In a free market, excellent doctors are rewarded for their pleasing of the consumer; not-so- excellent doctors, who don't please as many people, are not as rewarded. This doctor wants the consumer to dictate how much he will be paid, not the bureaucrats in some agency. Ethics does not go out the window becuase a doctor is well paid.
In a free market, excellent doctors won't be the best paid. That title will go to the doctors who are the worst: those that order expensive tests, needless treatments, and prescribe drugs of companies that cater to them. You're right--ethics don't go out the window because a doctor is well-paid (as they are now). The ethical trust-relationship that you have with your doctor goes out the window when he becomes akin to a used car salesman, trying to squeeze every last dime out of you.
I hear you Will, but you've got to bone up on your American History. If what you're saying is the case, why didn't those conditions exist prior to 1965, before the govt screwed up the system with a nice healthy dose of socialism? Prior to Medicare and Medicaid, there were few complaints, if any, about needless tests. And there's scant evidence of complaints about the "evil" insurance companies.
I hope to bone up on it more this semester, but in the meantime, I would argue that these conditions did exist prior to 1965. Please correct me if I'm wrong, but wasn't that the reason for Medicare and Medicaid in the first place? Medical costs had skyrocketed during the 1950s, and those without insurance couldn't afford to get medical care. What were the reasons that medical care began to cost so much (that it necessitated these programs) if "socialism" hadn't been introduced to the system yet?
No, medical costs were not skyrocketing. Look at the chart under health care on this blog. I thinks it's my post on the root cause of the crisis. The demolibs pushed for socialized medicine for 30 years and finally got it in the 60's. They wanted it because they love government and government control. They don't like the market. A professor named Charlotte Twight wrote a great article on this in The Independent Review a few years back.
In the years leading up to 1965... Begining in the 1900 there was really no such thing as health insurance and hospitals were limited in there care and usually on available to the elitists. Pasteur didn't even create the field of Microbiology till the 1900 and during its creation many still sought the comfort of being treated in the old ways saying in bed home.
From the article “The Cost of Sickness” in 1925: “Expenditures for the services of physicians and nurses and for hospitals and medicines were estimated for 1921 by Mr. Moore of the Public Health Service as $1,400,000,000 or a per capita of $12.33, and by Dr. Charles H. Herty, of the Chemical Manufacturers Association, for 1925 as $1,015,000,000
According to the Western Journal of Medicine's Article regarding the Chain Reaction regarding Healthcare from 1965 -1970. The reasons for Medicare and Medicaid were to remove the financial barries of the poor and old however the legislation behind changing these were poorly concieved and executing to help move us along to the continued High Costs and Availability to healthcare for all that we are finding as each year goes by.
I do agree with Will that many doctors are to blame for allowing pharmacutical agencies to pad there wallets for pushing there products on the public for issues. This I have expierenced first hand and in true free market form I fired the guy. But how many people educated and uneducated alike fall victim to the doctors scientific diagnosis and solution for there ills.
Your right these Doctors did spend imense amounts of time and effort in educating themselves. What they failed and continue to fail at is the "bedside manner" and explination of there diagnosis and solution. Bring it down to earth and allow the patient to decide with many options if there are. Not just the one that gives you a bonus like a used car(e) salesman.
I don't know, maybe Im not grasping the truth of any of this but it seems like we are doomed if reform healthcare and we are doomed if we dont'.
Always more to evaluate....
Still my favorite saying... " why do we study history? To learn from it. Then we must be poor students because we always make the same choices and never try anything different"
Yes,we are "dooomed" if we don't reform it. But isn't the only reform a true free market in medicine? Doesn't competition give people an incentive to please us so they stay in business? I fired Pot Belly Sandwich shop yesterday? Why? Took too long to get my sandwich, and the Jason's Deli sandwich is better and not as expensive! That's how the free market works.
There's no such thing as a true free market--in food, health care, or otherwise. Potbelly and Jason's are regulated under public safety and sanitation measures, and I appreciate that when the sandwich I buy hasn't been made with rotting meat and moldy bread by a guy with hepatitis hands. So when you say "true free market in medicine", what do you mean? What changes do you want to the system? What's being done (or not being done) right now that you'd like to see "reformed"?
"Regulated under public safety and sanitation measures." True, but not true. The regulations are in writing, but how often does the govt show up to inspect? Once a year - maybe? So doesn't each place, in order to get the customer back, attract new customers, and maintain its reputation, provide fresh, tasty food? Yes. And guess what, there was no one checking for the first 300 years in America.
Just checked the health care reforms in the four states that have tried it so far: Maine, Oregon, Massachusetts, and Tennessee. As the Austrians have predicted: all these plans have failed.
Sure, health and sanitation standards may not always be adhered to and the government may not check them out but "once a year"; however, the mere existence of those standards creates an agreement between establishments serving food and their customers, with the government being the arbiter in cases where that agreement is violated. It keeps them from trying to sell expired, unsafe food and forces them to use sanitary methods of serving that food. Otherwise, they get complaints and the government, rightly, investigates and then prevents them from doing business.
Also, you keep using this logically fallacious argument that we existed for X number of years without health care, work place safety, food sanitation, etc., but you conveniently ignore the fact that people's standard of living was extremely poor and they were dying because of these things. My life is vastly improved because I don't have to play Russian Roulette every time I buy ketchup. There are things that the government regulates that are justified, necessary, and actually make people's lives better.
Sorry Will, your knowledge of American history is lacking once again. "People died because of these things." Who taught you that? What statist, leftist in academia? In fact, for three centuries we had a free market society, and it grew and grew and grew. What did it go from - 107 people in Jamestown to over 100 million before they even brought out the political and unnecessary Pure Food and Drug Act in 1906? People served clean and good food for three centuries because it was in their best interest to do so. The ones who tried to serve stale food went out of business.
Seriously, you think that just because there was an aggregate population increase that no one died from these things? If we're just going to go that route and throw logic out the window, then I guess since the population has exploded since 1907, the Pure Food and Drug Act was a good thing.
Not enough is being done! There's 87 million cases of food poisoning in the U.S. every year, including 371,000 hospitalizations and 5,700 deaths. We need at least one FDA, one USDA, and one OSHA inspector per restaurant and food establishment in America! We need EVERY SINGLE SANDWICH, CRACKER, BURGER, SHAKE, FRY, SODA, PRETZEL, CHIP, AND PIECE OF FRUIT CHECKED INDIVIDUALLY! Then, and only then, comrades, will you be safe! Workers unite!
viagra suppliers viagra shelf life how viagra works viagra soft tabs viagra sample natural herbs used as viagra viagra shelf life does viagra work viagra prescription uk lowest price viagra free sample pack of viagra viagra uk cheap purchase buy viagra benefits generic viagra india
Post a Comment