Real reform has to include ways for doctors and clinics to make money. Increasing the supply of health care would lower costs via competition.

Real reform also has to include the formation of a market between health care providers and health care consumers. Right now there's a market where insurance companies sell to employers and health care providers sell to insurance companies; I don't have a meaningful role to play in reducing my own health care expenses.

If they aren't already, premiums will soon be so high that most of us would be better off paying out of pocket.

Great points, Pseudonym. And from what I understand, the situation that Pardez describes already exists in Great Britian, where primary care physician is a low-pay job by professional standards.

All this seems so darn obvious. Why can't Congress see it?

TORT REFORM, TORT REFORM, TORT REFORM. I'm gonna go rip shit if this health care bill passes but absolutely ballistic if there is not healthy tort reform included in it.

We already have government controlled health care. That is why prices for ordinary care are going up. Our laws require that hospitals and doctors treat most of the sick at no charge in emergency rooms, and at artificially low charges under Medicare and Medicaid. Hospitals and doctors cover their unpaid costs by charging other sick people more, those that have insurance. The insurance companies respond to these increasing charges by increasing premiums. These increases are not funding skyrocketing profits.

So, insurance rates go up as the insured pay for the uninsured, or pay for those willing to skip out on their routine medical bills. Then, politicians blame the insurance companies for raising premiums! It is merely a hidden tax system, to keep from disclosing the true cost of government policy. Hidden tax systems reduce the market for the taxed services, producing shortages.

Real reform would get the government out of the health business. Do you want to be charitable? Then contribute yourself. At the worst, provide vouchers, and make the real costs visible, without taxing some sick people to pay for other sick people.

Odd how the Veteran's Administration keeps doctors on payroll without problems. The R-Party says VA treatment is fine.
This is just more bleating from the right-wing.

We also need to consider the flip side of the coin - reducing the costs of medical school. Since the cost of getting a medical degree is so prohibitive, lower that barrier.

RE "more sleepless years doing your medical residency"

It's a stupid system.

Patients shouldn't be treated by doctors who didn't get enough sleep.

Doctors shouldn't go through a no-sleep hazing which expands their egos.

Medical residents should work a maximum of 40 hours/week.

Saying you oppose government-run health care but support the VA is like saying you oppose abortion except in cases of rape and incest.

Personally, I support our men and women in uniform, and that's why I oppose the VA. We should not be inflicting substandard care on them.

"Odd how the Veteran's Administration keeps doctors on payroll without problems. The R-Party says VA treatment is fine. "

You haven't been paying much attention, have you?

Feebie says:

"TORT REFORM, TORT REFORM, TORT REFORM. I'm gonna go rip shit if this health care bill passes but absolutely ballistic if there is not healthy tort reform included in it."

Sure, focus on the mouse in the corner, not the herd of elephants in the middle of the room.

Tort claims are a TINY piece of the problem -- dwarfed, even, by the magnitude of the self-enriching "defensive medicine" costs over which doctors shed crocodile tears.

And, to boot, the VAST majority of medical malpractice is never the subject of any claim.

You might want to look this stuff up before you get on your high horse with a bullhorn.

BTW, a study has shown that a significant amount of the medical training given to doctors is eventually wasted -- by female physicians who decide to drop out or work part-time once those distracting little kiddies come along.

It's not PC, but a preference for male doctors would help ease the doctor shortage.

Feebie-
I agree with you, but already Kaiser Permanante compels all patients into binding arbitration. I don't understand why all insurers do not do the same. You don't want insurance, then do not agree to binding arbitration and a $250k cap on any payouts. Tudd turdlets past that.

I assume state governments and insurance companies are dropping the ball on this, as insurance is regulated at state level.

a study has shown that a significant amount of the medical training given to doctors is eventually wasted -- by female physicians who decide to drop out or work part-time once those distracting little kiddies come along

What study has shown? In addition, if a person takes out the loans and pays for the education required in medical school, he or she should be able to do whatever they want with the education they received...including changing diapers.

Besides the PCP doctor shortage is associated with doctors not wanting to do the underpaid grunt work when they can become millionaires as a specialist. It isn't a matter of too few doctors going into or staying in practice.

-Julie

A quote from one of the characters in Ayn Rand's Atlas Shrugged seems appropriate here:

"Let them discover the kind of doctors their system will now produce. Let them discover, in their operating rooms and their hospital wards, that it is not safe to place their life in the hands of a man whose life they have throttled. It is not safe if he is the sort of man who resents it – and still less safe if he is the sort who doesn't."

"Medical residents should work a maximum of 40 hours/week."

My son is an intern now, the system wouldn't run if the grunts worked 40-hour weeks. He's typically at work from 7:30 until 11:00 pm, the last few hours spent on chart updates/closures(for discharged patients) and other reams of paperwork. The sh*t's really going to hit the fan when he goes into the ER for three months starting in January and starts a cycle of two-on one-off and still has all the paperwork to do. Staff docs dump what they don't want to do onto the interns and residents. It's a wonder any of them make it through it.

To Jay R,

(In support of JulieW)

You present a superior attitude and many capital letters. I suggest you inform us inferiors with links to your information. I would like to be more informed. What are your references?

You seem to think that defensive medicine is unrelated to tort reform. To my knowledge, doctors do not benefit when they order tests in the hospital. And they clearly don't benefit when the patient is on Medicare/caid or doesn't pay at all.

We're seeing a trend in Japan for doctors to go into dermatology, opthamology and other fields where they can actually have a life despite the doctor shortage. We're severely short on trauma surgeons, pediatricians and obstetricians. The government put a cap on the number of medical licenses issued yearly about 10 or 15 years ago supposedly to improve the quality of medical education. This resulted in shortages all across the board, with physicians in fields that require them being on call getting burned out and quitting, which of course exacerbated the shortages, and kids in med school now see the lives these people lead and say 'No thanks'. We've reached a critical point now, where an ambulance with a trauma patient may be turned away from 10+ facilities before they find one that can treat them.

The Labor Ministry is now (oi....)working with the Medical Association to see what steps can be taken to try and fix the problem, but it's going to take a long time. They shouldn't have screwed with the system in the first place.

Jay R. is a bit right. Woman doctors are going to be on major problem of the future doctor shortages.

Julie you are half right about if a person wants to do the work and work hard at that they get the rewards and if they want to squander that. BUT what happens is that the choice to become a doctor is more than one sided. Hey I want to become a doctor so tomorrow I will enroll and ..... The other half of the equation is who will teach me.

What happens is that more medical schools take more women they try to be PC so they try to go half men / half woman. I may want to be a doctor but some schools will say sorry buddy enough male students we need more woman. So lost to the future one doctor. Not because i was stupid but because i had a dick.

But lets go on, say that in ten years after graduation that a portion of the woman quit to start a family. They plan to come back but give any person of six years or more downtime and their skill set is shot. Being a doctor requires constant study and learning new methods. The woman who went to go tend after the kids will loose their marketable skill. Who will you hire a person who is up to date or one who is behind in the current knowledge. Some will come back, others will likely throw up their hands and just quit.

I am not saying men will be better. Some men will quit, and/or change careers. But in the end I would suspect that the retention of the men would be higher than women. Also the men will be a better deal in the end as they will work more often harder. Who would you rather have in a hospital a woman that will work 35 hours a week versus a man that will do 70 hours and week.

http://www.dailymail.co.uk/health/article-556310/Too-women-doctors-bad-patients.html

Another slightly interesting articles that goes in to real life examples of the problems with woman doctors.

http://www.thecanadianencyclopedia.com/index.cfm?PgNm=TCE&Params=M1ARTM0013191

Sorry Canadian but gives an glimpse

A 2005 survey found that just 23 per cent of Canadians were able to see a physician the same day they needed one - placing this country last among the six studied, including the U.S., Britain and Australia. Canada's doctor-patient ratio is among the worst of any industrialized nation: with just 2.2 physicians per thousand people, it ranks 24th out of 28 OECD countries (well below the average of three). And among the G8 countries, Canada ranks dead last when it comes to physician supply.

This is what the US is in store for.

A common mistake that people make when analyzing 'socialized medicine' schemes is to assume that they are designed to expand the provision of healthcare. But they are not. They are designed to ration the extent of healthcare services, both in the variety of treatment modalities and the duration of care. In actuality they are lifespan management schemes. They are an institutionalization of the principles of eugenics. The subject population is kept healthy through their productive years, after which their senescence is allowed to accelerated, so they die 'of natural causes', which comes to mean that they die from causes that the state does not choose to treat.

i see your point john paulson but your conclusion - not so good.....who would i rather have for my doctor, the woman working 35 hours/week of the man working 70? the woman. she's not tired.
what about, though, the women doctors who don't quit, and how do you know going into medical school which ones they are? my doctor is a woman who has two toddlers, she didn't quit. she's awesome, by the way, probably the most thorough and knowledgeable doctor i've ever met. and i work in healthcare.
a better solution would be to get rid of quotas altogether. but i don't see that happening just yet.

In the end it is still a numbers game. In the future the demand for doctors high. So either you hire / create more doctors or you use the doctors your have as much as you can (or try a to do both). If I was a hospital I would hire the man as he can do more than the woman with a family.

Whatever (lower case w) which do you want at midnight when your kid is sick and you go to the clinic. Whoops sorry the clinic is closed as they could not find a doctor to stay in the clinic after six. They had one before but she complained about the hours.

Yes your doctor does sound nice but she is still one out of a legion. You lucked out! She sounds like a real strong woman. The thing is if the odds are that female doctors will generally be less reliable and have a shorter usability that a male doctor. Not saying that women can not be great doctors.

You ask how do medical schools know who will stick with medicine the answer is they really don't know. Your right they should get rid of quotas. Those who are smart and capable should be allowed in. You have tits - good for you do you have the brains. Sorry no sex based affirmative action.

What happens is that more medical schools take more women they try to be PC so they try to go half men / half woman. I may want to be a doctor but some schools will say sorry buddy enough male students we need more woman. So lost to the future one doctor. Not because i was stupid but because i had a dick.

And I disagree with affermative action in all of it's forms. If I am good enough I should get in...no matter where I came from or whether I sit or stand to take a piss.

Also the men will be a better deal in the end as they will work more often harder. Who would you rather have in a hospital a woman that will work 35 hours a week versus a man that will do 70 hours and week.

I want a good doctor that is there, no matter how many hours he/she works per week or how they got there. Why are you looking at the sex of these doctors rather than attempting to address the behavior? Perhaps if we increased the number of slots in medical schools, took away affirmative action, and increased the slots available up the line (intern/resident/etc) we would have more doctors working to complete the same pool of work. They would be paid less, but they would also have a life (and get sleep). Wouldn't that have a shot at working to increase retention? My issue isn't with looking at retention problems, my issue is assuming that the retention problems are associated with sex.

-Julie

JulieW writes: "And I disagree with affermative action in all of it's forms. If I am good enough I should get in...no matter where I came from or whether I sit or stand to take a piss."

The ironic thing is, some colleges are finding their student bodies have become so overbalanced with women that they are engaging in under-the-table admissions preferences for men. And no, I don't like it any better than admissions preferences for women. But touching on that...

John Paulson writes: "What happens is that more medical schools take more women they try to be PC so they try to go half men / half woman. I may want to be a doctor but some schools will say sorry buddy enough male students we need more woman."

I don't know for sure that what I wrote above, about the schools who are giving de facto preference to men, applies to any med schools yet. But part of the triple-dog-irony of this whole thing is that, anecdotally, part of the problem is that men are no longer bothering to apply because they think that their gender will cause them to be excluded, even though in some cases it's working the other way around.

anecdotally, part of the problem is that men are no longer bothering to apply because they think that their gender will cause them to be excluded, even though in some cases it's working the other way around.

And this is a bigger issue. Why would I want a doctor, male or female, that would give up under the perception of a difficult task? Let's be honest, getting into medical school, let alone passing and moving forward, isn't easy for anyone. It isn't like women with IQs of 50 are getting in while men are being turned away. All doctors are intelligent. So, if someone isn't up for the competition, I don't want them cutting me open or prescribing me medication or any of the other tasks that doctors do.

We all have adversity in our lives. If someone is truly the victim of bigotry you have to be willing to fight harder to accomplish your goals. "I don't think they will let me so I'm not going to try" doesn't elicit empathy in me, nor in most people.

I will stand beside anyone and fight with them against injustice, but if the person who will benefit is unwilling to fight, the issue is suddenly not worth much of my time.

-Julie

"I will stand beside anyone and fight with them against injustice, but if the person who will benefit is unwilling to fight, the issue is suddenly not worth much of my time."

Point taken. But note the issue I mentioned is just part of a larger problem. And as I said in another thread, I don't expect the feminists to fight on behalf of men... but if they insist on continuing to fight against the rights of Western men, while at the same time being supportive of the anti-women practices of radical Islam, they risk creating a severe backlash. Given that every civil rights movement of the 20th century has now gone bad, I think it would be wise for women to assist in ensuring that yet another one won't be necessary.

wow, john paulson, you have clinics that are open at 6 pm? we don't, for the male or female docs. we have outpatient centers for that.
your line of thinking though, could be applied to any job - any job that employs women is subject to maternity leave/mothers who want to stay home, so why not just have them all hire men only? pretty soon i'm in the kitchen barefoot and pregnant again.....which is bad for all of us, because i can't cook.
and if having women work jobs, period, is risky because they have children, why is it that hospitals etc. can find nurses at all, for example? not too many male nurses out there.....
i'm all for eliminating affirmative action. but discouraging a specific gender from working at any job? not so much. anyone hired for a job needs to fulfill the requirements of the job. period.
by the way, currently, most of the doctors i work with are from somewhere other than the US. including my personal doctor, actually, the woman, she's from guatemala. what problem with our med schools is that reflecting?