A recipe to cut health care costs immediately

[SOCALS]

I think one of ways to cut health care costs is to cut doctors' salaries. In Canada and Europe doctors do not make these exorbitant amounts like here in the US. A great way to create competition would be inviting doctors from Canada and Europe and giving them citizenship. It would make doctors think twice before charging $1000 for extracting 2 teeth, which happened to me a month ago. And I believe that doctors in Canada and Europe are at least as competent as American doctors.

I believe that one of the goals of this health care reform is to reduce payments to doctors by expanding government health care programs since we all know that the government tries to pay doctors as little as it can get away with. Doctors will have to accept lower pay as it will be harder for them to negotiate with the government

PLease share your thoughts.

[leftstreet]

1. Doctors are members of the working class. why turn on them?

Insurance companies are not

[SOCALS]

2. The problem is that

there is not much competition among doctors. Curently, they are free to charge any ridiculous amount they want. In Russia, I paid $50 at most for any dental procedure/surgery.

Do doctors have to live in million dollar houses? Do they have to drive a 40 000 car? Why are they so obsessed with material things? I don't own an expensive house or car and I am fine.

[Chan790]

4. No, but...

it's the privilege they earn for going to school/interning for 12 friggin years. Sorry, I'm more inclined to think you're an idiot for this suggestion than I ever will be to side with you on this one. You're just wrong. Sorry, you deserve one of these though.

:dunce:

Thanks for playing.

[SOCALS]

6. Then how do Canadian or UK doctors

manage to live on salaries 2-3 times lower than those in the US? They have to go to school for 12 years too, don't they? That's why I suggest giving citizenship to qualified doctors from Canada and Europe.

[Name removed]

13. Deleted message

Message removed by moderator. Click here to review the message board rules.

[JVS]

22. No they aren't. They're professionals, like lawyers. They don't need a boss in order to practice.

[leftstreet]

27. They still have to sell their labor n/t

[JVS]

28. Professionals are part of the petite bourgeoisie

http://en.wikipedia.org/wiki/Petite_bourgeoisie

Their relationship to the means of production is different from the working class.

[leftstreet]

30. Right, which is mostly a psychological state. Still have to sell their labor

:shrug:

[JVS]

37. Selling your labor directly to customers is a lot different than selling to a boss.

Doctors are for the most part independent contractors. In fact, since they usually hire support staff, viewing them as the working class is false. They're business people, but small scale.

[Hannah Bell]

31. not these days. fewer docs run independent practices. they work for others.

http://www.nejmjobs.org/rpt/independent-physician.aspx

http://www.nejmjobs.org/rpt/percentage-independent-physicians.aspx

[clear eye]

3. That's one of the provisions that was removed from the Public Option

in the Senate before they took it out altogether.

[SOCALS]

50. What provision was it? What did it say?

[clu]

5. michael moore touched on this in sicko

everyone's being forced to give up a little. as important as doctors are, they might have to give up a little as well.

[SOCALS]

7. I think eventually doctors will have to make certain sacrifices.

Otherwise, the country will go bankrupt like President said!

[clu]

23. it's there, but it's minor

let's focus more of the cost savings by cutting out shareholders and administrative middle-men. i saw a frontline documentary recently which stated that health insurance companies in some parts of europe are run non-profit.

[Luminous Animal]

8. Doctors there don't have to pay back exhorbitant student loans.

They don't have to have support an expensive billing staff to negotiate with the myriad of insurance company regulations, and restrictions.

[SOCALS]

9. In this case

medical schools will have to lower their tuition. They can figure out a way to motivate schools to lower it

[jmowreader]

10. I wouldn't do what they do for less than they make

Between the fact they make life-and-death decisions on a frequent basis, there's a whole industry devoted to suing the living shit out of them and the difficulty of getting that job in the first place, I think they're entitled to whatever they can earn.

Something to consider: In the US, according to Wikipedia (I know, I know) defending against malpractice consumes 9 percent of the US health dollar, whereas in Canada it consumes 0.27 percent. There are 3.5 times the number of malpractice suits in the US than there are in Canada.

And would you like to tell us how much a doctor is entitled to?

[SOCALS]

11. Let's examine the Canadian malpractice

laws and adjust the US laws accordingly. Lawyers will have to sacrifice too.

As for salary, if they cut their income by 10%, it won't be a disaster. We all had to accept paycuts in one form or another. And health care in the US is far worse than in Europe or Canada to warrant the generous compensation our doctors enjoy

[surrealAmerican]

16. It's not really the malpractice laws that make this difference.

In the US patients are far more likely to sue because they otherwise will not be able to afford the medical costs associated with an adverse outcome. In Canada, their medical expenses at least will be covered.

[pitohui]

42. surrealamerican has it right

most victims of malpractice don't sue, when they do, it's out of desperation to get back some control over their life

i know a woman who was a victim of malpractice, and a $20K procedure turned into a $200K disaster, now why the hell shouldn't she sue after she was injured AND infected with staph and (eventually killed anyway before the lawsuit was settled)

in the usa if your care is fucked up, and you're in hospital more or injured for life, you MUST sue, otherwise you have the double whammy of your health is destroyed AND you will never be able to pay your bills and meet your obligations, because the cost of the extra care is at least six figures

if you want to discourage people from suing, don't fuck up their care and then charge them hundreds of thousands EXTRA because of your fuck-up

[SOCALS]

49. If you imply that

American doctors are superior to Canadian or European doctors, you are wrong. Until American doctors cure cancer or AIDS, they are just as good as any other foreign doctor and deserve as much compensation as their foreign counterparts. I know right wingers like to say we have the BEST health care in the world , but it is just propaganda

[jmowreader]

51. I don't believe I said that

I know Canadian and European doctors have less bullshit in their practices--the insurance situation is much different and there's less of a chance to be sued for malpractice.

[Cleita]

12. Doctors are already limited in what they make because the insurers,

HMO's, Medicare and Medicaid only approve of certain fees for each OV and procedures so they have no control over their fees except for those uninsured that have to pay cash. Not only that they have to have larger office staffs than the Canadian and European doctors in order to manuever through the intricacies of billing those entities. In Canada fees are pre-arranged every year or so between the doctors and the provincial government to reflect changes in procedures and inflation. All the doctor's staff has to do is keep track of the patients seen and procedures performed. Then they send it in to the provincial business office once a month for payment. There was a study showing that Canadian doctors have to see about half the patients per hour than their American counterparts to make the same amount of money.

Insurance increases the overhead of the health care provider. Single payer universal health care does not. So not only are those doctors making a comfortable living but they are working less hard for it, yet those systems can deliver the same comprehensive, quality health care to all their citizens for half the cost. The documentation is out there if you are really interested in learning about it.

[SOCALS]

14. No matter how big their expenses are,

doctors still manage to earn $150,000 to 500,000, and surgeons even more. I would agree with that if they cured every desease known to man, but they didn't and are only as good as European doctors. I know many doctors in Europe who would love to come to the US and deal with all these issues while making high six figures

[Cleita]

18. Really, all over Europe?

Exactly where, Eastern Europe? Otherwise, doctors are well compensated in countries with effective government health plans and oversight. They don't have to worry about being stiffed by non-payment and they don't have to turn away truly sick people for lack of ability to pay. They have nice homes and drive nice cars, like Mercedes. That's the facts and like I said the information is out there if you really want to study the issue. I myself am tired of providing links to studies and articles. If you are going to post here, you had better know what you are saying and be able to back it up.

[dysfunctional press]

15. and who exactly do you think sets doctor's 'salaries'...?

especially those in private practice?

[SOCALS]

17. If there are much more doctors in the country,

their rates will go down. I hope many would agree that the more doctors we have the better. By inviting foreign doctors, we will use the benefit of cheaper medical education in their home countries.

[Cleita]

19. That cheaper medical education in other countries comes from another

commie program in those countries, free education through university and medical school. Not only that they aren't bogged down with having to pay back student loans, like our doctors do.

[FarLeftFist]

21. The way to get more doctors is to entice them with a high salary....

You think someone will want to do brain surgery for $50/hr? They would most likely become an electrician for the same pay rate and a lot less risk.

[SOCALS]

29. How many electricians do you know that make

$100,000 a year? Are you for real?

[iceman66]

32. Lots.

A union electrician who works a fair amount of overtime, or one that owns his own business, can make that much or more.

[SOCALS]

34. Is it typical or is it

right wing propaganda that blames unions for high cost of cars? Like those painters at Ford making $75 per hour?

[iceman66]

38. It's not that unusual.

You have to keep in mind than electrician is considered a skilled trade, so union scale is a bit higher than an assembly line worker.

A non-union, non-business owner electrician would make considerably less than that.

Also, the $75/hour represents the total cost to the employer (much of which is legacy health care costs that would be ELIMINATED if we had true universal health care) and not the worker's hourly wage.

[dysfunctional press]

45. are you for real?

there are plenty of skilled construction trades where you can make $100K in a year.
my father raised our family on his salary as a heavy equipment operator(operating engineer).
eventually, he only did tower cranes, and was very good at it. he's retired now, but he cleared over 100K several times at the end of his career as wages increased.

although- wages might not be as high in the anti-union 'right-to-workget-fucked-over' states.

[dysfunctional press]

24. and how would that be accomplished 'immediately', as your op suggests..?

keep diggin...

[JVS]

20. We should totally h1b them

[RB TexLa]

25. Unlimited Visas for them and unlimited medical school slots. They can advertise on television for

customers like everyone else.

[SOCALS]

26. That's exactly what should happen.

I am tired of hearing that doctors have to go through 12 years of school and have to pay loans and that's why they have to charge $20,000 to reattach a finger. Doctors have to pay for education in Russia, but they don't charge $20,000 for a finger. And no, health care in Russia is not free. But the finger reattachment will cost you maybe $500 tops.

We all have to pay school loans but still have to incur paycuts when times are tough.

Doctors are not entitled to astronomical rates. And there are plenty of doctors in other countries who would love to work here for a reasonable salary

[iceman66]

33. That is only a tiny part of the problem.

Although doctors in the US are somewhat overpaid compared to their counterparts elsewhere, even a very successful surgeon earns a pittance compared to a pharmaceutical or insurance industry executive.

[SOCALS]

35. We have to start somewhere. The less money is spent

on health care in general and doctors in particular, the less money will be left for executives

[Lance_Boyle]

36. why not start with THE PROBLEM instead of the doctors?

Insurance execs are not necessary - they add zero value to health care. How about THEY take a pay cut (or a long walk off a short pier while wearing concrete shoes)?

[iceman66]

39. It is our private insurance system

that drives up the costs of health care which, in turn, allows the doctors to charge/earn more than they otherwise might be able to.

If you just limited doctors' salaries, without adressing the underlying problem, that would only mean even more money for the insurance execs.

[SOCALS]

41. I am saying we can START

by increasing choice and competition in the market of doctors' services. You can be sure that once you announce 50,000 work visas for qualified doctors, you will IMMEDIATELY see an additional supply of 50,000 medical experts in the US.

It will also imrpove the image of America in the world since these doctors will be able to help their families in their home countries.

[iceman66]

44. There is some merit to your suggestion,

but it wouldn't be the best place to start if the goal is comprehensive health care reform.

We would still have a broken system. There'd just be more doctors competing over those insurance industry dollars.

[pitohui]

40. my thought? you're angry because you were robbed on a simple tooth extraction

$1K is just theft for extracting teeth, and if you really live in socal, you could have had it done for a fraction of the price by getting off the couch and heading across the border into mexico, where there are any number of excellent dentists willing to do the work for a reasonable price -- hell, for $1K they might have been able to save the teeth

i know someone whose mouth was rebuilt in mexico and his teeth saved, if he'd had the work done in the usa, he would have prob. ended up w. dentures simply because the cost, this has been quite a few years now and the work has held up beautifully

i understand your anger, and many dentists in the usa are pure and simple criminals, who steal, just making up any old price for "cosmetic dentistry," but for dental work, you can usu. travel and you do have options

i would say that my mexican dentist is much better than my usa dentist, because he keeps costs reasonable so he actually gets lots of work and lots of experience, my usa dentist seems to work only part time and spends most of her efforts working on her golf game...

so yah i understand the anger

cost controls DO need to be a part of reform, and lazy docs/dentists who want to be millionaires without working more than 20 hrs a week need to face genuine competition...but i really think it is DENTISTS who are most guilty of this, i do know a couple of part time doctors who are just putting in minimum hours but i think (hope) they are a minority..part time dentists seem to be plague in louisiana, i'm thinking people become dentists here precisely because they don't wanna work, they wanna rip people off, every time i call for a simple cleaning i have to shake my head -- my local dentist literally only has her office open 3 days a week, and for very short hours, this is not a woman w. a good work ethic

[SOCALS]

43. I am a fairly healthy person

and so far just dentists were the major expense for me. I am sure I would be as angry when I have to deal with other doctors. I lived in Russia for several years and I can tell you that their dentists/doctors are as good as American ones , and they have to pay for education, and they have to go to school for 12 years, but they do not charge dozens of thousands of dollars for simple surgeries. And again, Russian health care is not free, you have to pay for services.

[laughingliberal]

46. Would rather see the hospital corporations' prices addressed first. nt

[WeCanWorkItOut]

47. Overpriced doctors are a real part of our problem

Doctors in Germany are making less than $80,000.
In Italy and Greece I believe it's even less than that.
Why? Partly because they have more doctors.

And why is the cost of medical education so high
in some parts of the US? Because the schools can get away with it,
precisely because doctors make such excessive salaries.

One reason we tolerate this is, I suggest, because of ignorance:
a tendency to think if MDs make so much, they must be really smart.
But that's partly due to lack of people to compare them to.
For instance, if the inexperienced MD says you have cancer,
and the nurse practitioner says you have something else,
and the nurse practitioner is right--you might stop having
so much automatic respect for doctors.
But if you don't have access to NPs, it might be harder to figure out.
Of course if you're a scientist, you're also apt to realize
that the average MD is not extraordinary.

So one solution to the overpriced doctor problem is to give people
more access to NPs, who are restricted by law in many states.

[SOCALS]

48. I remember in Moore's Sicko

they showed a doctor in UK who made less than $100,000 and was perfectly happy with it. I do believe that American doctors got infected with greed some time ago