Would that include cases where the mother's life is endangered?Originally Posted by The Rani
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Would that include cases where the mother's life is endangered?
And I'd add that the pharmaceutical industry obviously has a much greater interest in developing drugs that "manage" symptoms for life (a monthly income stream for the rest of the patients life) rather than developing a one-and-done cure for the actual ailment. If you think about it, very few significant conditions have been *cured* in the last, say, 50 years compared to the time before it. But there's one drug after another to manage symptoms if taken for life. So ask your doctor....
But doesn't that get into the whole question of when does life begin? I don't know too many docs who want to go there. But I really don't want to open that can of worms any further.
Or more correctly, IMO, at which point does the life which begins at conception receive the full set of human rights that we grant to the woman carrying that life. That is really where I think most of the (well-meaning) arguments come from in this debate, and since I don't have a uterus I tend to stay out of it.
By the time she had the surgeries she was dying, it was too late. The treatment she didn't get would have been delivered much earlier and would involved meds with regular testing. I would think the whole idea is not to let it get to an emergency situation. in the first place, that would seem to be lousy disease management. But then nobody was doing management because she didn't have a job and so no insurance.
She did get effective management for several yeats when tshe qualified for a specific state program designed to deal with people like her, but then the program was eliminated in budget cuts. Disease management ended, and the disease eventually grew out of control and she got sick enough to threaten her life, at which time she again became eligible for treatment. Of course this treatment, coming too late was ineffective and she died anyways. So you see its not a question of money, the state ended up spending more on her that they would have if they had paid for her disease managment and kep her out of the hospital.
But that would save money and her life; we don't do things that way in America.
Last edited by Mikebert; 04-04-2011 at 08:06 AM.
I was referring to a period in the 1980's when the number of admissions to medical school were allowed to increase, and for a while it became much easier to get into med school. What I recall from reading an article more than a decade ago was that the policy was tried in an attempt to hold down fees, but when they looked at what actually happened they did not see this happen. It wasn't a large-scale effort that perhaps you are thinking about, but one of those small-scale programs used to test ideas. And I am sure there were flaws.
But as there is no reason to believe that increasing the number of suppliers would drive down costs in a market with the very peculiar characteristics of American medical care, one would like some evidence that supports this idea before whole-heartedly embracing it.
Last edited by Mikebert; 04-04-2011 at 08:22 AM.
CT-scans routinely cost $1500-$3000. I suspect they are big money makers for somebody. But again, when I had my skiing accident in February, even though my head didn't hurt, the American doctor who was with me would have ordered one up at the drop of a hat. The French doctors at the clinic just checked that my eyes were working, etc., and tht was that.
David Kaiser '47
My blog: History Unfolding
My book: The Road to Dallas: The Assassination of John F. Kennedy
When this site opened up we had a Boomer doctor who posted for a while and I asked him about generational differences in medicine. He said that Boomers couldn't hold a candle to GIs or even Silents in terms of their contributions to treatment but that they had concentrated on "humanizing" medicine. Let's face it, figuring out how to save money isn't one of the things Boomers are good at.
I do think that fact that new doctors commonly owe six-figure debts is a huge problem because it makes it very unlikely they will do anything to rock the boat.
David Kaiser '47
My blog: History Unfolding
My book: The Road to Dallas: The Assassination of John F. Kennedy
Lawyers come out with six figure debts and no one cares about that. Universities just produce more law schools and lawyers.
I think doctors these days go into medicine for the status and money.
For example, if you are a dermatologist (or many other well-paid specialties), you get $300,000 per year in private practice in your early 30s.
That's BigLaw. You get those jobs by going to HYS, one of the other T14, or graduating in the top 10% of your class. Also, you get sleep deprivation, all nighters, and ultimately get thrown out if you can't bring in $2,000,000 in billables.
Lawers have a trimodal salaray distribution when starting out. $180,000, $40,000, and Starbucks barista.
If I had known what I know now when attending school, I would have gone to med school rather than law school. Seriously. Something like radiation oncology. Maybe neurosurgery.
They also have to pay for practice insurance as well op top of the college tuition costs.
I had a friend who had the equivalent back in the 80s. She quit her Big Law job after a year. It wasn't just the hours. She didn't want to become what it might turn her into. She did ok, though. She's now a judge.
The details were in the book, which I read, the article doesn't have much detail.
The study is irrelevant to the issue, which is a moral one, not practical. As I mentioned, no insurance can mean that some people who don't get treatment die because of this, while at the same time other people who don't get treatment don't die from the treatment.
For example, suppose over the period of the study X% of the study population gets sick with something that is fatal if left untreated. Suppose further that the entire population faces a Y% risk of dying from medical treatment over the period of the study. If X% and Y% are roughly the same magnitude no excess deaths will be seen in the population. This does not mean that nobody is dying from lack of treatment (X is zero), just that people avoiding treatment-related deaths balance out the deaths (Y and X are about the same size).
Finding no effect implies that people in the population WERE dying from lack of treatment because treatment-related deaths are known to occur (i.e. Y is > 0), and if some extra deaths were not offsetting this (X=0), the result (Y - X) would be > 0 meaning LOWER mortality in the population that did not have insurance. Unless the study was too insensitive to pick up any effects.
Her body might tell her that, too. One of the involuntary BigLaw refugees I know around here had severe GI issues until she got a Legal Aid job. Of course, her salary was cut from $200,000 to $40,000.
I prefer to deal with people coming into my office and telling me than want to kill themseves rather that have to keep track of my daily life in 0.1 hour slivers of time. I have learned, however, that I really don't get along people with strange personality disorders. I didn't realize that people had psychiatric and psychological disorders until I started practicing disability law. I thought it was basically something people made up.
I'm been debating med school for about two years now.
How about collecting milllions for doing less than nothing? Many CEOs fall into this category. Since most mergers/aquistions fail, doing nothing is better than doing the merger, on average. To the extent the average CEO doings reflects M&A, they get paid for doing less than nothing.
If CEOs were paid much less, they possibly would not feel as impelled to "do something" to justify their enormous compensation and our companies would be run better.
Medicaid and charity care cover a lot of this.
And Medicare kicks in 29 months after disability begins if you actually worked $4,000 worth of work enough years of your life.
However, that being said, Medicaid, Medicare, and the Pentagon are eventually going to cause the federal debt to surge past the soverign debt event horizon. That will be fun.
If I could get on "The CEO List" I would. Multimillion Rent Seeking is where it's at!
I say negative to this one, even though CEO's and others at the top collection millions while many are starving are not among my favorite people. But I don't believe that they actually don't do anything. Yet so many complained about union laborers who many felt got paid huge sums for not doing enough. As far as mergers/buyouts are concerned, I believe most ARE successful and that is why there are now so many near-monopolies in nearly every industry. Again, not among my favories. Very few such proposals have been blocked in the past few decades.
Yeh, that's what I thought. America is so very fundamentally exceptionally different from everywhere else in the world, and medicine is so fundamentally exceptionally different from every other possible service, that all the accumulated weight of experience in every other place in medicine, and in every other service in America simply... does not apply in this case.
That's flat-out retarded. A statement of religious faith, nothing more.
"Qu'est-ce que c'est que cela, la loi ? On peut donc être dehors. Je ne comprends pas. Quant à moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce être dans la loi ?" -- Tellmarch
"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy
"[it] is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky
No, I'm pretty sure that in the bizarro U.S. Healthcare System, increasing the supply of specialist doctors would increase the cash flow to the specialist doctors as a whole.
I know it's counter-intuitive.
My husband is the director of a behavioral health and addictions unit at a non-for-profit hospital. He tells me of horror stories about how mental health issues are some of the most ignored in our country. The insurance industry does not want to provide help in many cases, so these people end up on the street. They can't afford their meds and it is a downward spiral.
It appears in way too many cases, we would rather pay for them to go to prison than to seek understanding of their mental issues that could be managed with treatment and medicine.
Last edited by Deb C; 04-04-2011 at 03:16 PM.
"The only Good America is a Just America." .... pbrower2a
In the UK, the GP's make the highest income, mainly because they manage all the care. At least this was according to an article sent to me by an MD, that I have since deleted.
As I mentioned in an earlier post, just because you are living in poverty does not mean you are on Medicaid. There is a very low income requirment to qualify.
Charity care is mostly only available in non-for-profit hospitals. This is one reason why your non-profits are having a hard time. There are two hospitals in the town where my husband works. One is non-profit the other is for-profit. Some doctors who only have privilages at the for-profit hospital will send patients without insurance or who can't afford to pay, to what they consider as free care hospitals. While there is some money set aside at the hospitals for charity care, the patients far exceed that allocated budget.
The non-profits are catching on that they, no matter how charitable they want to be, will not stay in business if they are continually being sent the no insurance patients. The system is unfair. Single Payer would put hospitals on a level playing field.
"The only Good America is a Just America." .... pbrower2a
Then they end up in my office.
I send them to the free/low income clinics where they can get their meds.
Mental health is a fiasco, but you can generally get your meds around here through the privitized state agencies through the rent-a-psychiatrist program.
Now, sometimes the bipolars and paranoid schizophrenics won't take their meds...or really enjoy the cocaine...
Nothing I can do about that.
Yes, sometimes they don't take their meds. The side affects of some of these drugs are what some consider worse than the illness. Med adjustment is another real concern. When you don't have access to an ongoing treatment, it doesn't take much at times for the meds to get out of balance. It is truly a complex issue which it appears that you already understand.
Our state programs are busting at the seams, as you have probably experienced in your area too.
"The only Good America is a Just America." .... pbrower2a
