Paul Krugman "death panels"

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Define "a lot."

How many have come back after discovering that the professional compromises that are required are not worth the higher pay packets that are promised. I work with a number of colleagues who did precisely that. Attracted by promises of higher compensation in the United States they took up positions, but quickly discovered that their higher compensation came with too many strings attached:

1) Higher costs of living that were not offset by income tax savings
2) Higher overhead costs of maintaining a practice
3) Significantly higher administrative costs (in both time and money) to maintain a practice
4) Significantly higher insurance costs

and that does not even get to the quality of life issues implicit in making the move from Canada to the United States.

That is not to say that all Canadian physicians who move to the US come back disgruntled. But some do. And some US physicians come to Canada to practice. (Not to mention a wide range of foreign trained physicians, the barriers erected by my profession notwithstanding).

If you want to talk about the realities of practicing medicine in North America, I strongly suggest that you walk a mile in our shoes before pretending to know what you are talking about.

Fair enough, however this is sure a shining example of Canadian Health Care:
http://www.canada.com/ottawacitizen/new ... =15068&p=1

Also:


As the U.S. Congress wrestles with government-sponsored health care bills that have often been compared to Canadian, British, and French models, Canada's new medical chief admits that the Canadian model is 'imploding.'
The incoming president of the Canadian Medical Association sees a public health care system on the brink of collapse, and the outgoing CMA president is publicly suggesting that more of a private system be implemented.
http://www.digitaljournal.com/article/277758

That is sure a ringing endorsement of your health care system.

To be fair to Canada, it appears your healthcare system is nowhere near as bad as the UK's.


As the United States debates the merits of government-sponsored health care, stories emerge from the UK of dramatic bed shortages in maternity wards and the consequences those shortages have on patients in labor.
While the American public discuss the merits of government-sponsored health care, dramatic stories emerge from the United Kingdom - where health care is entirely government-controlled - of bed shortages in maternity wards that are forcing women to deliver babies in elevators and in other environments that lack proper hygiene.
http://www.digitaljournal.com/article/278301

Oh how would you like your baby born in a toilet?

Again attempting to damn the system with the anecdote. No country can create a perfect system, and I would be the last person to pretend that our system is without fault.

But I don't even take your example to be a condemnation of our system. You can't create a surgeon out of thin air--and there will be times in any system that no surgeon is available, even for an emergency procedure such as this one. The story does not tell us what all of the on-call surgeons in the Outaouais and Ottawa regions were doing at the time the call went out for a surgical admission. It's not that there were no surgeons, it's that there were no available surgeons.

No system can function effectively with too much excess capacity--and with with elastic demand and fixed capacity there will always be times when demand exceeds capacity. What matters is not that demand was excessive, but what was done to respond to that excessive demand. Note that this patient was not left hanging out to dry, but the attending physician continued to pursue options until one presented itself--which happened within six hours of the patients initial arrival at the ER.

The ambulance drivers clearly made an error--but human beings make errors, and what followed was a result of that error. It is unfortunate, but it does not demonstrate a systemic failure from my point of view.

As for the CMA, let's remember that this is our professional association--it's there to speak on behalf of and in the interests of physicians. We are only one piece of the overall health care system. While many of us (though not all) would like to see a parallel, private-pay system, that is not the only answer to the systemic challenges that we are seeing.

An operation for an appendix bursting isn't exactly an extremely rare operation. If something like that happened in the United States, most hospitals would be able to deal with it. Heck they could even call a surgeon at home to come to the hospital due to an emergency situation. If a Doctor is handling a patient in a nonemergency situation that doctor could still end up being called in.

Ah and I should take your opinion instead of patients opinion. That is not democratic. Who gave you the right to talk for other people? I still believe in the satisfaction surveys.

A lot of us on the spectrum whose parents did get help for us, know what our lives could have been like if our parents didn't know our rights. Is the US health system perfect, no it isn't but I probably get a lot better medical care in the United States than I ever would in Canada.

A lot of people on medicare are thankful to get treatment at all because fewer and fewer places will accept it, because when they treat medicare patients they are doing it at a loss. This raises prices for people whom have insurance because doctors have to make up the expense elsewhere.

Subjective "satisfaction" is a lot different from quality of health care. For example, my mother is "satisfied" with her current doctors because they prescribe pills for her diabetes. However, she still has diabetes and many of its problematic side effects. Back when she had a doctor who made her go on a diet that worked, she was less "satisfied" because the solution wasn't as easy as popping pills, but her diabetes was gone.

I suspect the biggest reason medicare has higher "satisfaction" ratings is because the person insured doesn't have to pay for it. Meanwhile the younger people are less "satisfied" with private insurance because they do have to pay for their own insurance, and also have to pay for medicare insurance to boot.

It's like arguing that private insurance is better because people on private insurance are demonstrably more healthy - lower incidence of diabetes, heart disease, etc. But just as "satisfaction" is affected by medicare being "free", actual health is affected by age and not just by the fact of private insurance.

Oh, is that what we should have done! Why didn't we think of that. [facepalm]

First, a hospital with no surgery department (such as the community hospital in Wakefield) wouldn't be able to deal with it. And neither would such a hospital in the USA.

Second, even a hospital with a surgery department needs available surgeons and an available operating room. If all of the active and on-call surgeons are using all of the operating rooms, then just who do you propose does the surgery and where?

Non-emergency surgeries will get bumped for emergencies when the emergencies demand more surgeons and space than is allocated for them. But once all the resources are committed, that simple solution no longer exists, and you start to look farther afield for available resources.

Remember, this was a rare set of circumstances. Appendectomies get performed routinely and quickly in surgical hospitals nationwide on a daily basis. Just because one day the system got full does not mean that the system is broken. And just because this happened to occur in this country does not mean that the exact same set of circumstances could not occur in any other country and any other medical system.

i think you'll have to make a youtube video where you explain this using a chalk-board if you want to get anywhere with him.

No they don't have to pay, in employer-sponsored health insurance the employer pays most of the coverage. It is an employee benefit.



That is one of the things that the author discussed. In Medicare you get access to services without a heavy financial burden. I think that if your needed treatment is not covered by your insurance that affects your "satisfaction".

The employee is still paying for it cause the money is taken out of what they would be earning to give them that insurance.



And more and more doctors refuse to accept medicare patients so you can still be denied coverage in the fact the best doctors may simply refuse to take you as a patient.