TH: Both those words are adverbs. Just saying. Edwin, I find your intimacy describing your daily trials and tribulations eye opening and insightful but I fervidly disagree with your beliefs on the new healthcare legislation. As a future physician I find it hard to comprehend how a country as strong, rich, and powerful as ours can turn our back on the poor, the old, and even our children and then have the audacity to claim that protecting them will cause the fall of our union. I look forward to the day I begin my 2nd year of residency in 2014… Read more »
StudentDOc, I appreciate your kind words, and I’m delighted to see students have a passion for helping the poor. In point of fact, so you won’t think us all too harsh, many of us care for the poor every, single day that we go to our jobs. We don’t, for the most part, pursue collections on them. And every emergency physician in America has about $150,000 or more in bad debt each year from uncompensated care. Now, it may seem that the problem will be fixed by the legislation. But about half of my practice is Medicare and Medicaid, which… Read more »
Curious Doc
13 years ago
I have been reading your fabulous writing and articles for years now. I have disseminated your website and articles to my residents, students, nurses, family and anyone else that appears to be able to read. I DO NOT disperse reading material lightly. I choose carefully and do it rarely. In other words, thank you for writing! Another ED doc had an idea for healthcare refrom. Curious to hear what you and others might think about it. Ban health insurance. The government picks up the tab for hospitalizations, oncological treatments, major medical type stuff etc. Anything below a certain number, say… Read more »
CuriousDoc, I think that’s a brilliant idea! You know, the whole healthcare insurance idea began after WWII, largely as incentive to attract needed employees in growing businesses. (If I understand my history correctly). Insurance has absolutely driven up cost, and demand, because people often fail to feel the cost of a thing because that cost is diffused through the collective. The problem of course is that not everyone can have everything, and someone has to pay for it! Right now, everyone seems to want vastly more benefit than they contribute, believing a) the rich government will pay for it through… Read more »
Student DOc
13 years ago
Curius Doc, What you are talking about it a single payer system with some modifications. That is a similar model of health care that has been implemented in every industrialized nation except ours. The problem is we have health insurance companies who goal is to increase profits. The reason that the health care bill we just passed is so weak is because insurance companies spent millions and millions of dollars on lobbyists to sway politicians thinking. I would whole heartedly support a plan like that with the understanding that those who couldn’t afford primary care were helped because if they… Read more »
Charles
13 years ago
Student DOc: “We spend more per capita on health care almost double than any other country in the world with no better outcomes and we let almost 40,000 people die each year because of lack of health insurance.”
Please stop.
On a related note, our admissions committee has noticeably changed over the last 15+ years. Evidently it’s not only here. Yet another reason to end those silly white coat ceremonies. “Student doctors” aka students. Two ears, two eyes, one mouth. Learn.
Student DOc
13 years ago
Charles: No need to get upset because we disagree. According to OECD 2007 study United States spent 7,290$ per capita with the runner up spending 4,763. According to the WHO 2006 study United States Spent 6,719 still in first place with the runner up spending 5,585. -https://www.oecd.org/dataoecd/5/34/43800977.pdf -https://www.who.int/whosis/whostat/EN_WHS09_Table7.pdf Harvard Study -Objectives. A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data. Methods. We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey. We analyzed participants… Read more »
StudentDOC, Still, I’m confident we could have provided more expanded coverage without the sweeping takeover of healthcare that this reform legislation involves. We really have no idea what the ultimate implications will be, because it’s written in legislative/legal language (probably the least comprehensible or enjoyable verbage in history), and because even the legislators don’t understand. What you don’t yet understand is the way government insinuates itself in your practice. It’s a wonderful idea, to hope that the government will pay for care but not tell physicians how to practice. But that, unlike the free market, is truly mythic. Government, when… Read more »
FatTriplet3
13 years ago
Ed, My wife heard you speak last night at Holy Trinity and sent me a link to this blog. It’s in my RSS feed. And here I am leaving a comment when I really should be doing other things. I thought it might be helpful to fill in a little detail on the history of our current health system and why its broken in so many way. Almost all economists agree (across the political spectrum) that the most fundamental problem with our current system is related to the tax exclusion of employer provided health care benefits. Ed, you touched on… Read more »
FatTriplet3
13 years ago
StudentDoc, I appreciate your passion for helping patients. I’ll make a prediction, in 10 years after being in private practice for some time, you will utterly detest Obamacare unless its enormous problems can be overcome before the meat of the benefits take shape in 2014. Let me say up front that I agree that our health care system needed reform. Badly. The overwhelming problem with Obamacare is that it does very little to control costs. I am aware that CBO scoring says otherwise, but even Elmsendorf, the head of the CBO has expressed serious concerns that the legislation will end… Read more »
FatTriplet3
13 years ago
CuriousDoc, The single best piece I have ever read on health care in America is “How American Health Care Killed My Father?” Its 10,000 words but well worth the effort. He brilliantly dissects the problems with the current system and, in the end suggests: * Universal Catastrophic Health Insurance provided by financed by tax dollars. My opinion is that the deductible needs to be very high, in the $50K range. Another good option would be to have the deductible scale based on age: say $25K for to age 35, $50K to age 65 and $75K after age 65. * Mandatory… Read more »
Linda
13 years ago
Dr Leap, I am of a similar mind of student doc, altho I’ve got 30+ years in the healthcare business. So, I am not so easily dismissed by your excuse of years of practice. When I began as a young, passionate hospital pharmacist, we had lots of time to implement new protocols & procedures (this was before commercial IV nitroglycerin, so we developed a manufacturing process so it could be used by our anesthesiologists on CABG patients – a very new procedure at the time!). Time went by, new drugs came along, new protocols had to be written, less “cowboy”… Read more »
FatTriplet3
13 years ago
Linda, I agree with the goals you lay out. But I do not see why a top-down approach will work. If you let patients spend their own money (via HSA’s) they will become much more cost-conscious. I have experienced this first-hand. When I had an HSA with a high deductible, I would ask my doctors about every test they requested. I would ask whether their is a generic, etc. The disadvantage of your approach is that so often the “one size fits all” approach cannot take into account the local knowledge of the patient and their condition and the physician.… Read more »
I don’t know why bing sent me to your site but I must say I have been quite entertained by the posts you have pulled together. How much time did it take to begin to get this many users coming to your blog pages? I am pretty new to this WWW thing.
Awesome site you have here but I was curious if you knew of any message boards that cover the same topics discussed in this article? I’d really love to be a part of community where I can get opinions from other knowledgeable people that share the same interest. If you have any suggestions, please let me know. Bless you!
I found your weblog web site on google and examine a few of your early posts. Proceed to maintain up the excellent operate. I simply extra up your RSS feed to my MSN Information Reader. Looking for forward to reading more from you later on!…
Operating from home is certainly a worthwhile plus delivering endeavor. Though every one’s the drive to want to help you dwelling using some kind or another, the majority of don’t have the determination, homework knowledge, as well as follow-through expertise essential to generate their own wishes become reality. The idea of home working might be interesting, nevertheless terrifying simultaneously. Many feel you will need a lot of getting the type of time and/or money in buy as a profitable home-based skilled. That simply is untrue. Almost all do business from home tasks are conveniently achievable along with demand almost no… Read more »
Hello, you used to write magnificent, but the last several posts have been kinda boring¡K I miss your tremendous writings. Past few posts are just a little bit out of track! come on!
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Verily and forsooth!
TH: Both those words are adverbs. Just saying. Edwin, I find your intimacy describing your daily trials and tribulations eye opening and insightful but I fervidly disagree with your beliefs on the new healthcare legislation. As a future physician I find it hard to comprehend how a country as strong, rich, and powerful as ours can turn our back on the poor, the old, and even our children and then have the audacity to claim that protecting them will cause the fall of our union. I look forward to the day I begin my 2nd year of residency in 2014… Read more »
StudentDOc, I appreciate your kind words, and I’m delighted to see students have a passion for helping the poor. In point of fact, so you won’t think us all too harsh, many of us care for the poor every, single day that we go to our jobs. We don’t, for the most part, pursue collections on them. And every emergency physician in America has about $150,000 or more in bad debt each year from uncompensated care. Now, it may seem that the problem will be fixed by the legislation. But about half of my practice is Medicare and Medicaid, which… Read more »
I have been reading your fabulous writing and articles for years now. I have disseminated your website and articles to my residents, students, nurses, family and anyone else that appears to be able to read. I DO NOT disperse reading material lightly. I choose carefully and do it rarely. In other words, thank you for writing! Another ED doc had an idea for healthcare refrom. Curious to hear what you and others might think about it. Ban health insurance. The government picks up the tab for hospitalizations, oncological treatments, major medical type stuff etc. Anything below a certain number, say… Read more »
CuriousDoc, I think that’s a brilliant idea! You know, the whole healthcare insurance idea began after WWII, largely as incentive to attract needed employees in growing businesses. (If I understand my history correctly). Insurance has absolutely driven up cost, and demand, because people often fail to feel the cost of a thing because that cost is diffused through the collective. The problem of course is that not everyone can have everything, and someone has to pay for it! Right now, everyone seems to want vastly more benefit than they contribute, believing a) the rich government will pay for it through… Read more »
Curius Doc, What you are talking about it a single payer system with some modifications. That is a similar model of health care that has been implemented in every industrialized nation except ours. The problem is we have health insurance companies who goal is to increase profits. The reason that the health care bill we just passed is so weak is because insurance companies spent millions and millions of dollars on lobbyists to sway politicians thinking. I would whole heartedly support a plan like that with the understanding that those who couldn’t afford primary care were helped because if they… Read more »
Student DOc: “We spend more per capita on health care almost double than any other country in the world with no better outcomes and we let almost 40,000 people die each year because of lack of health insurance.”
Please stop.
On a related note, our admissions committee has noticeably changed over the last 15+ years. Evidently it’s not only here. Yet another reason to end those silly white coat ceremonies. “Student doctors” aka students. Two ears, two eyes, one mouth. Learn.
Charles: No need to get upset because we disagree. According to OECD 2007 study United States spent 7,290$ per capita with the runner up spending 4,763. According to the WHO 2006 study United States Spent 6,719 still in first place with the runner up spending 5,585. -https://www.oecd.org/dataoecd/5/34/43800977.pdf -https://www.who.int/whosis/whostat/EN_WHS09_Table7.pdf Harvard Study -Objectives. A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data. Methods. We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey. We analyzed participants… Read more »
StudentDOC, Still, I’m confident we could have provided more expanded coverage without the sweeping takeover of healthcare that this reform legislation involves. We really have no idea what the ultimate implications will be, because it’s written in legislative/legal language (probably the least comprehensible or enjoyable verbage in history), and because even the legislators don’t understand. What you don’t yet understand is the way government insinuates itself in your practice. It’s a wonderful idea, to hope that the government will pay for care but not tell physicians how to practice. But that, unlike the free market, is truly mythic. Government, when… Read more »
Ed, My wife heard you speak last night at Holy Trinity and sent me a link to this blog. It’s in my RSS feed. And here I am leaving a comment when I really should be doing other things. I thought it might be helpful to fill in a little detail on the history of our current health system and why its broken in so many way. Almost all economists agree (across the political spectrum) that the most fundamental problem with our current system is related to the tax exclusion of employer provided health care benefits. Ed, you touched on… Read more »
StudentDoc, I appreciate your passion for helping patients. I’ll make a prediction, in 10 years after being in private practice for some time, you will utterly detest Obamacare unless its enormous problems can be overcome before the meat of the benefits take shape in 2014. Let me say up front that I agree that our health care system needed reform. Badly. The overwhelming problem with Obamacare is that it does very little to control costs. I am aware that CBO scoring says otherwise, but even Elmsendorf, the head of the CBO has expressed serious concerns that the legislation will end… Read more »
CuriousDoc, The single best piece I have ever read on health care in America is “How American Health Care Killed My Father?” Its 10,000 words but well worth the effort. He brilliantly dissects the problems with the current system and, in the end suggests: * Universal Catastrophic Health Insurance provided by financed by tax dollars. My opinion is that the deductible needs to be very high, in the $50K range. Another good option would be to have the deductible scale based on age: say $25K for to age 35, $50K to age 65 and $75K after age 65. * Mandatory… Read more »
Dr Leap, I am of a similar mind of student doc, altho I’ve got 30+ years in the healthcare business. So, I am not so easily dismissed by your excuse of years of practice. When I began as a young, passionate hospital pharmacist, we had lots of time to implement new protocols & procedures (this was before commercial IV nitroglycerin, so we developed a manufacturing process so it could be used by our anesthesiologists on CABG patients – a very new procedure at the time!). Time went by, new drugs came along, new protocols had to be written, less “cowboy”… Read more »
Linda, I agree with the goals you lay out. But I do not see why a top-down approach will work. If you let patients spend their own money (via HSA’s) they will become much more cost-conscious. I have experienced this first-hand. When I had an HSA with a high deductible, I would ask my doctors about every test they requested. I would ask whether their is a generic, etc. The disadvantage of your approach is that so often the “one size fits all” approach cannot take into account the local knowledge of the patient and their condition and the physician.… Read more »
I don’t know why bing sent me to your site but I must say I have been quite entertained by the posts you have pulled together. How much time did it take to begin to get this many users coming to your blog pages? I am pretty new to this WWW thing.
קידום דפי גלישה מקוונת עושים רק בחברת קידום אתרים מקצועית כמו חברת נט-סטייל . צרו עמנו קשר על מנת לרכוש שרות של קידום אתרים בגוגל בדרך הטובה ביותר.
Awesome site you have here but I was curious if you knew of any message boards that cover the same topics discussed in this article? I’d really love to be a part of community where I can get opinions from other knowledgeable people that share the same interest. If you have any suggestions, please let me know. Bless you!
I found your weblog web site on google and examine a few of your early posts. Proceed to maintain up the excellent operate. I simply extra up your RSS feed to my MSN Information Reader. Looking for forward to reading more from you later on!…
Operating from home is certainly a worthwhile plus delivering endeavor. Though every one’s the drive to want to help you dwelling using some kind or another, the majority of don’t have the determination, homework knowledge, as well as follow-through expertise essential to generate their own wishes become reality. The idea of home working might be interesting, nevertheless terrifying simultaneously. Many feel you will need a lot of getting the type of time and/or money in buy as a profitable home-based skilled. That simply is untrue. Almost all do business from home tasks are conveniently achievable along with demand almost no… Read more »
Hello, you used to write magnificent, but the last several posts have been kinda boring¡K I miss your tremendous writings. Past few posts are just a little bit out of track! come on!