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PostPosted: Thu Jul 15, 2010 3:54 pm 
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I read this thread too. Why you continue to accuse me of not reading the thread is beyond me.

Look, this one doctor closing his doors is being treated as if the whole medical profession is collapsing.

But there's no actual evidence of that.

As for people upset that I want to raise taxes on the wealthiest Americans (and mind you, we don't know if this man would qualify. Not every doctor is rolling in millions), the wealthiest Americans saw their personal incomes increase nearly 20% during this depression. So yes. I think they can afford to compensate the country for the profiteering they did on our suffering.

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PostPosted: Thu Jul 15, 2010 3:57 pm 
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Because if you had read the thread, you would have read the article I posted, and then you might have some understanding of what is going on in Massachusetts at the moment.

Do you know why Massachusetts is relevant to the topic at hand?

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PostPosted: Thu Jul 15, 2010 4:01 pm 
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I read the article. I appreciate why Massachusetts is relevant. No, I'm not going to step and fetch to a pop quiz because you won't take my word for it. Also, your article is an opinion piece written by a doctor. I take his argument with a grain of salt.

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Last edited by Monte on Thu Jul 15, 2010 4:02 pm, edited 1 time in total.

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PostPosted: Thu Jul 15, 2010 4:02 pm 
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Monte wrote:
I read the article. I appreciate why Massachusetts is relevant. No, I'm not going to step and fetch to a pop quiz because you won't take my word for it.


Racist.

Was this on anyone else's Monte Buzzword Bingo this week?

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PostPosted: Thu Jul 15, 2010 4:03 pm 
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Monte wrote:
I read the article. I appreciate why Massachusetts is relevant. No, I'm not going to step and fetch to a pop quiz because you won't take my word for it. Also, your article is an opinion piece written by a doctor. I take his argument with a grain of salt.


Then why don't you have a basic understanding of what has caused their problems?

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19 Yet she became more and more promiscuous as she recalled the days of her youth, when she was a prostitute in Egypt. 20 There she lusted after her lovers, whose genitals were like those of donkeys and whose emission was like that of horses.

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PostPosted: Thu Jul 15, 2010 4:03 pm 
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Wow. I'm surprised you actually dared to recognize a statement as having some sort of racial charge or history.

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PostPosted: Thu Jul 15, 2010 4:05 pm 
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FarSky wrote:
Out of curiosity: can the doctor refuse to see Medicare patients?


Currently, a physician can opt-out of the Medicare program. They will then forever be ineligible for the Medicare or Medicaid program, and indeed may get dumped by some private payers who require you to accept Medicare in order to contract with you.

Then, if we assume his claims to be accurate, he will lose the 80% of his business that is made up of Medicare patients. What is most likely is that the remaining 20% are inadequate to do one or more of the following, in order of likelihood from least to greatest:
1) Cover fixed costs.
2) Pay staff (variable cost)
3) Create net income sufficient to warrant his efforts

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Rynar wrote:

Then why don't you have a basic understanding of what has caused their problems?


You mean - why don't I agree with the point the doctor was making in his opinion piece? For a variety of reasons. First and foremost, if a person with a financial interest is projecting doom and gloom these days, I generally don't put too much weight on their opinions. For example, when the oil lobby pays science whores to dissent from the overwhelming body of evidence on global warming, I rightfully don't give them much in the way of credibility.

I also think we should simply offer medicare for all, or simply nationalize the health care industry entirely. If policies cobbled together in this congress (or at the state level) fail, it's just more support for the kind of health care system I think we should have.

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How do you keep the doctors? How do you get new ones?

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19 Yet she became more and more promiscuous as she recalled the days of her youth, when she was a prostitute in Egypt. 20 There she lusted after her lovers, whose genitals were like those of donkeys and whose emission was like that of horses.

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Monte wrote:
Wow. I'm surprised you actually dared to recognize a statement as having some sort of racial charge or history.


Really? Why?

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

I'm surprised you continue to use it. Since you're the first among us to play the Race Card.

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PostPosted: Thu Jul 15, 2010 4:08 pm 
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If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?


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FarSky wrote:
If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?


Duh!

That 72% marginal tax rate on the rich!

Come on now 'Skee, keep up.

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Rynar wrote:
How do you keep the doctors? How do you get new ones?


Are there any doctors in Canada? Does every doctor leave Canada? Are there any doctors in Great Britain? Does every doctor leave Great Britain? Are we the only country that has doctors? There are lots of brilliant, highly qualified people that take jobs in public service because they feel a duty to do so. Teachers, cops, detectives, criminologists, prosecutors and public defenders, soldiers, intelligence agents - the list goes on and on.

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Last edited by Monte on Thu Jul 15, 2010 4:10 pm, edited 1 time in total.

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PostPosted: Thu Jul 15, 2010 4:09 pm 
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Do Canada and Great Britain pay their doctors on time? I think that's probably a question of great relevance.


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Monte wrote:
You mean - why don't I agree with the point the doctor was making in his opinion piece? For a variety of reasons. First and foremost, if a person with a financial interest is projecting doom and gloom these days, I generally don't put too much weight on their opinions.

See, now I know you're lying. You believe the environmental lobby all the **** time. You know, the one with a financial interest in more government funding to study the problems, or to create green jobs via Federal regulation and/or consumer panic/feel-goodness...

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PostPosted: Thu Jul 15, 2010 4:11 pm 
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FarSky wrote:
If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?


Actually the contention he's making is correct, insofar as economics go.

The idea is that spreading the risk to a larger pool brings cost down. The problem is that in all nations with socialized/nationalized care, the costs continue to rise, quality continues to waver, and timely access/rationing continues to be a true problem.

The true question about whether or not to nationalize a health system is not an economic one, really, it is an ethical, moral, and political one.

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PostPosted: Thu Jul 15, 2010 4:11 pm 
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Monte wrote:
If he was a better business person, he could have made up his losses in other ways, right? If he had better business sense, he would have cut costs or expanded in order to deal with the new realities. But he didn't.

But he's a victim, and the unemployed guy is not.


Ok, so since he does 80% of his business through medicare, he should have to make up those loses in other ways? You're suggesting he should do more private insurance to cover the losses on medicare?

That's basically stating that Medicare is a losing proposition is it not?


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I assume they do. We could learn a lot from them.

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PostPosted: Thu Jul 15, 2010 4:12 pm 
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FarSky wrote:
If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?
Mainstream heterodox economic theory actually covers this ...

The short answer is that by geometrically increasing demand for a good in short supplies creates an asymmetric shift in the demand/supply curve. This externality consequently creates a short term supply failure which pushes more providers into production. The increase in providers over compensates for actual demand metrics and creates a situation very similar to the work force explosion of the 1970s and the degree explosion of the late 80s and early 90s. Basically, the market overshoots the equilibrium point for real demand and drives the value of the commodity (in this case health care) through the floor.

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Last edited by Khross on Thu Jul 15, 2010 4:14 pm, edited 1 time in total.

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PostPosted: Thu Jul 15, 2010 4:12 pm 
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Arathain Kelvar wrote:

Ok, so since he does 80% of his business through medicare, he should have to make up those loses in other ways? You're suggesting he should do more private insurance to cover the losses on medicare?

That's basically stating that Medicare is a losing proposition is it not?


Perhaps he should have chosen a better field of medicine. Plastic surgery, or something more profitable?

(I ask the above question in a continuance of my comparison to the unemployed guy that so many people come down so hard on, not because I actually think this guy deserves what's happening).

edit - mainstream heterodox....

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PostPosted: Thu Jul 15, 2010 4:13 pm 
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FarSky wrote:
Do Canada and Great Britain pay their doctors on time? I think that's probably a question of great relevance.


GB doesn't correlate, as physicians there are all essentially employed physicians, and while that model does exist here it is not the majority.

Furthermore, those physicians (in GB) are not compensated at the level ours are, there is as a result a shortage more dramatic than ours. This shortage exists even with substantial subsidization of medical education.

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PostPosted: Thu Jul 15, 2010 4:14 pm 
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Monte wrote:
Arathain Kelvar wrote:

Ok, so since he does 80% of his business through medicare, he should have to make up those loses in other ways? You're suggesting he should do more private insurance to cover the losses on medicare?

That's basically stating that Medicare is a losing proposition is it not?



Perhaps he should have chosen a better field of medicine. Plastic surgery, or something more profitable?



Fun Fact:
Pulmonology is one of the most profitable areas of healthcare, given that the 4th leading cause of death is COPD, directly treated by pulmonologists, and that the supply of pulmonologists is relatively low due to licensure limitations, and that pulmonologists have unique opportunities to partner with private businesses to provide durable medical equipment and testing services to patients.

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PostPosted: Thu Jul 15, 2010 4:15 pm 
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DFK! wrote:
FarSky wrote:
If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?


Actually the contention he's making is correct, insofar as economics go.

The idea is that spreading the risk to a larger pool brings cost down. The problem is that in all nations with socialized/nationalized care, the costs continue to rise, quality continues to waver, and timely access/rationing continues to be a true problem.

The true question about whether or not to nationalize a health system is not an economic one, really, it is an ethical, moral, and political one.

Your third sentence says to me that the question is, in fact, an economic one.

Now, if all things are not equal, and quality or availability of care is called into question (i.e. an economic issue), then I believe it's a matter of discussion. But if all things are equal, I cannot fathom the intrusion of ethical, moral, or political questions when faced the ability or opportunity to provide sick people care, particularly due to political ideology.


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PostPosted: Thu Jul 15, 2010 4:15 pm 
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Monte wrote:
Rynar wrote:
How do you keep the doctors? How do you get new ones?


Are there any doctors in Canada? Does every doctor leave Canada? Are there any doctors in Great Britain? Does every doctor leave Great Britain? Are we the only country that has doctors? There are lots of brilliant, highly qualified people that take jobs in public service because they feel a duty to do so. Teachers, cops, detectives, criminologists, prosecutors and public defenders, soldiers, intelligence agents - the list goes on and on.


Do any of those jobs require hundreds of thousands of dollars in education to get an entry level position? As well as reuiring the hundreds of thousands of dollars a year in Malpractice Insurance?

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PostPosted: Thu Jul 15, 2010 4:22 pm 
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FarSky wrote:
DFK! wrote:
FarSky wrote:
If we can't manage to pay the Medicare payments now, why would we be able to do so on a grander scale?


Actually the contention he's making is correct, insofar as economics go.

The idea is that spreading the risk to a larger pool brings cost down. The problem is that in all nations with socialized/nationalized care, the costs continue to rise, quality continues to waver, and timely access/rationing continues to be a true problem.

The true question about whether or not to nationalize a health system is not an economic one, really, it is an ethical, moral, and political one.

Your third sentence says to me that the question is, in fact, an economic one.

Now, if all things are not equal, and quality or availability of care is called into question (i.e. an economic issue), then I believe it's a matter of discussion. But if all things are equal, I cannot fathom the intrusion of ethical, moral, or political questions when faced the ability or opportunity to provide sick people care, particularly due to political ideology.


Not sure I follow you here.

Quality and availability aren't economic factors in the healthcare context, because "access to care" doesn't truly mean "access to care." For instance, any person in the US has equal "access" to emergency care in the context of health policy as a result of various laws, most important of which is EMTALA. However, I'm willing to bet you had less "access" to care in rural Alabama (or was it Arkansas) than in Nashville.

Anyway, perhaps I should merely clarify my point:
Using solely economic factors it would only make sense to nationalize health services. This is the same idea that a benevolent dictatorship is the most efficient method of governance.

The question becomes whether you want a dictator, no? To continue the analogy, then, do you want the nationalized system to dictate what care individuals do or do not receive?

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