tag:blogger.com,1999:blog-6568749253826790814.post2773042958551896062..comments2024-01-05T10:11:27.498+00:00Comments on Soot and Ashes: The World AFTER the Crash: Do you have health insurance? Would you like to be able to buy cheaper insurance?bloggerhttp://www.blogger.com/profile/06585266242070350399noreply@blogger.comBlogger60125tag:blogger.com,1999:blog-6568749253826790814.post-41980338392159946652009-09-17T14:58:26.138+01:002009-09-17T14:58:26.138+01:00evildoc....I really don't mind that you make a...evildoc....I really don't mind that you make a good salary ,especially when you consider what you do and how much education it took. Why do the investment bankers of Wall Street make so much more just churning money and creating ponzi-schemes . You Doc are a social positive and the bankers are a social neg. <br /><br /><br />Recently I was a victim of the health care industry . I had great insurance coverage ,but the greedy <br />health care Insurance Company decided they were going to ration my wife . I screamed bloody murder and they tried to undo their bad faith ,but it was to late . My take was that she would of lived 5 to 7 years more ,absent the bad faith and the germs she picked up at the hospital that killed her while the insurance company was dicking around .<br /><br />I spent weeks at 3 hospitals watching the system for hours and hours . I got a good take on what is wrong and I talked to many a family and nurses and insurance shills and you name it . <br /><br />One would have to have a medical degree to know when they are being rationed . The power that I saw that the private Insurance Companies had regarding the health care was clear . The influence on the doctors and system is far-reaching . <br />If we keep going in the same direction a good health care policy will cost a family of 4 30 k a year by 2027 to get coverage .<br /><br />The system in part is broken because of the 30% profit that insurance companies want to make ,and than there is another 10 to 15 % in waste and paper work . Add to that the high cost of medical mal-practice insurance and this explains about 40% of excessive cost in the system .<br />Nurses have confessed to me these problems ,while I was spending my life at the hospital for weeks.<br />So, go ahead and think that your getting your money worth from private insurance until they decide to screw you or cancel you <br />or refuse to pay for a needed procedure .<br />I propose single pay system with three plans from A to C . The costs should be set yearly and the three plans would offer standard to higher level care like private room and elective stuff covered ,<br /><br />The elephant in the room is chronic care ,and that is a major problem . Currently ,those costs end up wiping out a older person usually and represent the final years of life usually . I Don't know how to solve that problem .Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-80215775335594066502009-09-15T18:57:01.210+01:002009-09-15T18:57:01.210+01:00keith, I lived in England for a decade and can cat...keith, I lived in England for a decade and can categorically say that I would take their healthcare system (NHS) over the US 'sickcare' system any day. The healthcare that I and my family received was excellent and prompt. People in England don't have to file for bankruptcy because their kid got sick. 67% of bankruptcies in the US are a result of healthcare costs families can't pay.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-18667443717245731962009-09-10T02:18:27.100+01:002009-09-10T02:18:27.100+01:00Here's an email making the rounds:
The AMA We...Here's an email making the rounds:<br /><br />The AMA Weighs In <br /><br />The American Medical Association has weighed in on National Health Insurance. The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves. The Gastroenterologists had sort of a gut feeling about it, but the Neurologists thought the Administration had a lot of nerve. The Obstetricians felt they were all laboring under a misconception. Ophthalmologists considered the idea shortsighted. Pathologists yelled, "Over my dead body!" while the Pediatricians said, 'Oh, Grow up!' The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it. Surgeons decided to wash their hands of the whole thing. The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter." The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea. The Anesthesiologists thought the whole idea was a gas, and the Cardiologists didn't have the heart to say no. In the end, the Proctologists won out, leaving the entire decision up to the assholes in Washington.Wind Farmernoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-74382463334997085512009-09-10T00:43:50.741+01:002009-09-10T00:43:50.741+01:00Sorry Preston,
Still not convinced that I need th...Sorry Preston,<br /><br />Still not convinced that I need the governemt to tax me more to pay for the healthcare of someone because someone bought wheels instead of saving money for thier own daman car crash.Angry Leprechaunnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-63466626374969788192009-09-09T23:52:31.819+01:002009-09-09T23:52:31.819+01:00Part IV. Physican vs. Box-Packer salary. Final not...<b> Part IV. Physican vs. Box-Packer salary. Final notes </b><br /><br />I am grateful for the opportunity life has given me, but this was not simply a passive "happening". I've taken huge steps to do things the right way. Meanwhile unedu"ma"cated mortgage brokers were making $400k/year destroying buyers' futures while banking big bucks and living big expecting it never to end. While, despite my "great" salary I live in a reasonable apartment upstate, happily enjoy my loaded to bear paid off honda 2004 accord couple.<br /><br /><br />So... you wanna sit there and sneer at docs? Knock yerself out.<br /><br />You wanna be populist tool yelping "why should Doctor/Lawyer/Scientist/CEO get more money than box filler or custodian" despite my essentially 12 years in school, my loans, my outrageous responsibility with outrageous (indeed, disproportional) risk taken when bad outcome happens, my skill and my commitment? You wanna snark behind your computer about "Lazy Asses".<br /><br />Knock yerself out.<br /><br />I am deeply aware that I am fortunate. Life has dealt me a decent hand in letting me have the skills, interest, and perhaps foresight to choose the career I did.<br /><br />I am, I guess, OK with your disapproval<br /><br />regards<br /><br />evildoc.evildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-33408185813607249712009-09-09T23:51:19.540+01:002009-09-09T23:51:19.540+01:00Part III. Physican vs. Box-Packer salary
Fourth,...<b> Part III. Physican vs. Box-Packer salary </b><br /><br />Fourth, let's consider "obligation" and "risk" and "responsibility" in more detail<br /><br />Here is one example of what I do every day. Am I arrogant for considering this a bit more... challenging at least... than packing boxes? Perhaps I am arrogant. But, I am profoundly grateful that life lets me have this responsibility and I try every day to live up to that responsibility, so maybe I am not arrogant.<br /><br />Last night I took care of a "healthy" military 30 year old who has not been healthy for a year since contracting a weird bug in Iraq, developing a profound life threatening neurological disorder and spending 9 months in military hospitals, released 3 months ago only to have a medical crash yesterday leading to a local hospital admsision that transferred him to me at my tertiary care hospital. This 30 year old man, who has put life on line for our country, had refractory seizures, 105 fever, respiratory failure, possible meningitis. <br /><br /> I made all the medical decisions in attempt to keep him alive. I spent nearly three hours at the bedside with family and patient for the $180 "admission bill" this generates regarding my professional services (no worries, his stay overall likely will be $40k or more). I directed/co-directed spinal tap, intubation, antibiotic choice, anti-seizure-med choice, ventilator management, sedation. I counseled terrified family about outcome. Had the charm to explain I could not promise survival and did so in tactful and caring manner. Laid out options and expected course for subsequent evaluation. Did everything right, but no doubt the patient still might have bad outcome which in the wonderful USA means that I might be sued for $10 million, even though nothing was done "wrong". Bad outcome in a young man can be enough for a jury. But my professional billing was $60/hour for the three hours spent keeping him alive. As I could not do multiple quick admissions during that time (I stayed late at work, unpaid to wrap up) that were pending, my hospital presumably took a loss paying me $150/hour during those three hours, relative to my "billing". So it goes. <br /><br />That is but one story of what I do in general for mulitple patients each day.<br /><br />Let's look at the obligations in more general sense.<br /><br />1) My decisions affect lives.<br /><br />2) I sign the line making medical decisions. I can be sued for outcome (and outcome often will be bad no matter which branch of a decision tree one takes) even if i do the right thing. Give heparin (blood thinner) for an arterial leg clot and patient bleeds into brain and dies? Lawsuite. Don't use heparin cause worried about brain and leg hasta be cut off? Lawsuit. D*mned if you do or don't.<br /><br />3) I have exquisitely good training and I am very very good at what I do.<br /><br />4) I have high level obligations to my "customers".<br /><br />5) I give devastating news to terrified families I've never before met.<br /><br />And with all this, my work is in huge demand, with four spots needed nationally for each one of me out there.<br /><br />I realize none of this rises to the level of packing boxes. ;)<br /><br /><b> final info in next post... </b>evildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-25081292022814583082009-09-09T23:48:01.413+01:002009-09-09T23:48:01.413+01:00PART II Evildoc on Physician salary vs box-packer ...<b> PART II Evildoc on Physician salary vs box-packer salary </b><br /><br />Second, I note as a bit of an aside, that most physicians do not earn $200/hr and furthermore that of the evil unfunded healthcare bubble system, physician salaries are not the dominant cause of cost, though it is not a trivial part. <br /><br />Here is a link to average physician salaries of late, noting that most physicians are in lower ranked fields (Medicine, Peds, Family Medicine, Pscyhiatry, NOT in subspecialtis at the upper end). Most are in the 150-300k/yr range $75-150/hr.<br /><br />http://www.allied-physicians.com/salary_surveys/physician-salaries.htm<br /><br />Third, now embracing the "merit", "responsibility", "risk", "intellect", "work ethic", "paid dues", "hey I'm elitist" column...<br /><br />Well, I worked hard in high school. Was one in six applicants who got into Princeton. Worked hard and majored in molecular biology with a (non-official) concentration in European history. Ran a campus charity in spare time. Traveled. Had fun. Networked with good people. Scored sky high on standardized tests and for "fun" at time when minimum wage was $3.50 or so, I was one in ten who pulled a job teaching at an SAT course pulling $19/hour, while graduating with like 150 credits (120 the norm) from P-ton. Lazy ass indeed. <br /><br />Was one-in-three applicants to get into med school and got into a top twenty school. Took a fortune in loans (though far far less than do most folks today) to complete my training at age 26, in debt. Spent next 3-4 years working 90+ hours per week for average $29k salary during residency in job where- no joke- a screw up could kill a fellow human, my patient. For income I moonlighted overnight shifts alone in a rural ER once a week, during my "off" day from the 90-hour week. Kept my lazy ass pretty trim I assure you.<br /><br />Oh yeah... Internal Medicine Boards, what we take to be Board Certified. Medicine has about the toughest test (highest fail rate... either grandly tough test or boy we are badly trained) with about 55% pass rate. I scored 90th percentile.<br /><br />Became an Internist eschewing the bigger bucks of subsequent subspecializing. I like seeing variety of illness. Started in 1995 in the ER as an ER Doc (these days ER's mostly do not employ Internists as the model has shifted) coming from medical family and with good sense of medical pay. The $120k pay was grand at the time. Yes. I know that most people have not seen salaries rise the last 15 years, but today working AS an internist (not the more highly paid ER Docs even of today) my salary bubbled up to $300k or so, in part due to supply-demand issues, in part due to the "health bubble", in part as I have a niche position with some unusual perks, in part as I am not "fresh out" where the hospitalist physicians still get $175-200k.<br /><br />My hospital pays my salary. An admission workup of patient (whether 40 minutes minimum or 90 minutes "usual" maximum effort) bills for the hospital just $180. Plumber at my house gets that or more for 90 minutes work, and I don't begrudge him that. He too is skilled and responsible. Indeed, I often model Doctor on trades like Plumber and Electrician as the processing is similar.<br /><br /><b> to be continued... </b>evildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-79744369182227050582009-09-09T23:45:17.066+01:002009-09-09T23:45:17.066+01:00Part 1. evildoc on "$200/hour Doctor vs $7/ho...<b> Part 1. evildoc on "$200/hour Doctor vs $7/hour box packer" </b><br /><br /><i>---anonymous said<br /><br />Why does a Doctor charge $200 or more an hour and the person working at the warehouse loading the trucks with boxes of medicine to be shipped to all, only charge $7 an hour?----<br /><br />---thumb twerler said<br />Evildoc, yeah, please educate us why a lazy ass who partied for 8 years thru college and achieved a Doctors certificate deserves more money then a person who actually works for a living.----</i><br /><br />Ahhh, where to start.<br /><br />OK. Before I provide actual content to my answer, let's anticipate and embrace the inevitable populist-ish, hate-the-elite responses this will provoke.<br /><br />This is just anticipating responses...<br /><br />First. Yes, I know many here hate "big" anything. Big Oil. Big Finance. Big Pharma. Lawyer monopoly. Doctor monopoly. Military Industrial Complex. Real Estate Industrial Complex. All "Big" and thus no doubt eeeevil. Response: OK. I get it. The world is a challenging place in which to get ahead. Time to move on.<br /><br />Second. Yes, I know Medicine (let's say, for now, Physicians at least) represents a monopoly with barriers to entry. Only one in three applicants are granted leave to go to medical school, even though (i assert) many of the other two-thirds pool still might have been competent physicians if given the chance to go and even though there is a Doctor shortage. Response: Tough noogies. Most good jobs that require (or even that don't require) advanced skills have barriers to entry. Not everyone gets to be a junior investment banker on Wall Street at age 22. Not everyone gets to be Doctor, Lawyer, Professor. Heck, try to be- what is it- a longshorman where there are unions, if your daddy wasn't one. Suck it up.<br /><br />Third. Yes, I know while simple supply-demand should rule capitalist free market economic transactions (yeah, where in America is "simple" supply/demand running anything), I know also that the supply-demand equation for physician work is bollixed by the supply limitation of Physicians and by the "bubble" effect of insurance-paid work, rather than physician need to get direct payment (eg. bushels of corn from the local farmer who en masse would not have $2000 angioplasties if they had to pay for it instead of insurance paying). Bubbles bubbles everywhere, I know. So it goes.<br /><br />Fourth. Yes, I know we are an envious society. Anyone who does well gets, "what's so special about him" from those who don't do so well. <br /><br />OK. There can be more but that gets a good bit of the venting angry populist rejoinders out of the way.<br /><br /><b> So... now... why do Docs get "$200/hr" while the warehouse packer gets $7 per hour? </b><br /><br />Well...<br /><br />First, let us start not with "merit" or "responsibility" or "risk" or "intellect" or "work ethic" or "paid academic and social dues"<br /><br />Let's try the supply-demand market.<br /><br /> If the shipping warehouse puts up an ad for the $7 position, he gets 100 qualified applicants within a few days, hours or seconds.<br /><br />Meanwhile, my work as Hospitalist (hospital based medicine) which pays most of the guys $175/yr for about 2000 hours work ($90-ish per hour, not $200, though I get a big bonus as I have special responsibilities and am probably in the $140/hour zone), is work in which right now in the USA, there are four open positions for every qualified candidate. If i quit my job tomorrow- what with my good qualifications- I likely could have new work within the week at $200-250k (100-125/hr). Supply and Demand. The good ol' American way.<br /><br /><b> to be continued... </b>evildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-4231369427563062272009-09-09T23:06:12.503+01:002009-09-09T23:06:12.503+01:00Oops sorry. Blogger default used other handle.
re...Oops sorry. Blogger default used other handle.<br /><br />regards<br /><br />evildocevildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-87507013997562395762009-09-09T22:32:46.172+01:002009-09-09T22:32:46.172+01:00Another follow up to...
------thumb twerler said
...Another follow up to...<br /><br />------thumb twerler said<br />Evildoc, yeah, please educate us why a lazy ass who partied for 8 years thru college and achieved a Doctors certificate deserves more money then a person who actually works for a living.-------<br /><br />I admit I rather liked my "walking tushy" line, but I could post a serious response, I suppose. Would Keith take a twenty paragraph post and publish it?<br /><br />evildocVac Quackhttps://www.blogger.com/profile/00270264448787969908noreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-82935043383042773272009-09-09T21:42:21.690+01:002009-09-09T21:42:21.690+01:00---thumb twerler said
Evildoc, yeah, please educat...---thumb twerler said<br />Evildoc, yeah, please educate us why a lazy ass who partied for 8 years thru college and achieved a Doctors certificate deserves more money then a person who actually works for a living.----<br /><br />A lazy ass who partied?<br /><br />Weird, I work with couple hundred fellow evildocs each day, and I have yet to see a walking tushy taking care of anyone. Better yet... I don't see any lazy tushies wandering around taking care of anyone.<br /><br />I've never seen a tushy paid $7/hr or $200/hr for anything (though we get into dangerous terrain there I s'pose).<br /><br />Can you explain what tushies with poor work ethics have to do with Physician salary structure?<br /><br />I mean... I hear your envy, but your question perhaps would best be rephrased.<br /><br />regards<br /><br />evildocVac Quackhttps://www.blogger.com/profile/00270264448787969908noreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-17823154592401545492009-09-09T19:25:47.464+01:002009-09-09T19:25:47.464+01:00they may charge 200 An hour but they have to submi...they may charge 200 An hour but they have to submit bills to the insurer for 1000 an hour?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-19460894847940014102009-09-09T18:55:45.657+01:002009-09-09T18:55:45.657+01:00Angry Leprechaun said...
" Everyone deserves...Angry Leprechaun said...<br /> " Everyone deserves health care? I am not sure that I am buying that one and sorry if I sound like a cold heart d!ck." <br /><br />Chill out dude, what are you going to do when one of those guys with the 22" wheels smashes the thing against a tree? Just leave him by the side of the road to bleed to death?? It would teach the others a lesson, maybe they would buy some insurance instead of hot wheels but we can't do that. <br /><br />Chances are the Hospital just has to eat the bill - that raises the costs for everyone.<br /><br />It's best to just admit that any of us might need care, that no one should really be just left by the side of the road to die even if they are poor and stupid.prestonnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-13849921704780885572009-09-09T18:00:51.782+01:002009-09-09T18:00:51.782+01:00I'll be honest, I have health insurance throug...I'll be honest, I have health insurance through my employer - if I did not and/or they gave me the money instead, I would probably just take the money and save/spend it. I am a pretty health dude so I certainly would not pay 8K a year for it like my employer probably does. Albeit, I would probably purchase a catastrophic/high deductible plan with an HSA for emergencies and to save for my future - as it should be.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-91736721894129096792009-09-09T17:33:28.727+01:002009-09-09T17:33:28.727+01:00evildoc said...
----Why does a Doctor charge $200...evildoc said... <br />----Why does a Doctor charge $200 or more an hour and the person working at the warehouse loading the trucks with boxes of medicine to be shipped to all, only charge $7 an hour?----<br />“Uhhh... why not?<br />Do we really wanna weigh what goes into each job description?”<br /><br />Evildoc, yeah, please educate us why a lazy ass who partied for 8 years thru college and achieved a Doctors certificate deserves more money then a person who actually works for a living.thumb twerlernoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-88144672394191504152009-09-09T16:24:12.194+01:002009-09-09T16:24:12.194+01:00Not posting my comments again, can't handle it...Not posting my comments again, can't handle it? Go back into hiding!Angry Leprechaunnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-31336361687834610912009-09-09T14:48:15.984+01:002009-09-09T14:48:15.984+01:00"Hey schmuck anon at 4:12 am
"does aus..."Hey schmuck anon at 4:12 am<br /><br /><br />"does australia have a gargantuan defense budget that protects the world too?"<br /><br />Protect the world? The USA is the worlds #1 arms dealer and slaughterer of innocent women and children.<br /><br />Wake upand smell the cordite!"<br /><br />hey douchebag...i was just trying to point out that we can't afford healhcare because of our oversized defense budget.<br /><br />whether our military is the most righteous in the world or worst than the Nazi's...is irrelevant to the debate...we don't have the money...idiot.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-32399037034699147732009-09-09T14:27:30.809+01:002009-09-09T14:27:30.809+01:00heya mate, i lived in the uk for four years... the...heya mate, i lived in the uk for four years... the health care system there it top-shelf...Anonymoushttps://www.blogger.com/profile/08729470111856498087noreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-76901279485970430122009-09-09T13:24:37.269+01:002009-09-09T13:24:37.269+01:00----Why does a Doctor charge $200 or more an hour ...----Why does a Doctor charge $200 or more an hour and the person working at the warehouse loading the trucks with boxes of medicine to be shipped to all, only charge $7 an hour?----<br /><br /><br />Uhhh... why not?<br /><br />Do we really wanna weigh what goes into each job description?<br /><br />-evildocevildocnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-9017554739342727652009-09-09T03:47:21.101+01:002009-09-09T03:47:21.101+01:00Insurance is a misleading term when it comes to he...Insurance is a misleading term when it comes to health and is a lie.<br /><br />Health Insurance is a cartel concept that is anti-free market and corrupt. <br /><br />We should use government funds to build hospitals, train docs and nurses, and provide angel capital matching for research. Then let the free market go at it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-9162200068056565782009-09-09T02:07:03.513+01:002009-09-09T02:07:03.513+01:00Anonymous said...
hey bukko,
does australia have...<b>Anonymous</b> said...<br /><br /><i>hey bukko,<br /><br />does australia have a gargantuan defense budget that invades other countries all over the world too?</i><br /><br />No. Isn't it great? That's why Australia can afford to protect its own citizens!Bukko Boomerangerhttps://www.blogger.com/profile/02424677168216647964noreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-49473480426746534452009-09-09T01:47:25.487+01:002009-09-09T01:47:25.487+01:00Hey schmuck anon at 4:12 am
"does australia...Hey schmuck anon at 4:12 am<br /><br /><br />"does australia have a gargantuan defense budget that protects the world too?"<br /><br />Protect the world? The USA is the worlds #1 arms dealer and slaughterer of innocent women and children.<br /><br />Wake upand smell the cordite!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-1170396237931761032009-09-09T01:07:15.287+01:002009-09-09T01:07:15.287+01:00.
YES I HAVE IT!
OF COURSE I WOULD LIKE IT CHEA....<br /><br /><br />YES I HAVE IT!<br /><br />OF COURSE I WOULD LIKE IT CHEAPER!<br /><br />BUT NOT AT THE COST OF GOVERNMENT INTRUSION!<br /><br /><br />.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-3653458747604857262009-09-09T00:40:40.584+01:002009-09-09T00:40:40.584+01:00They've socialized the financial system, why n...They've socialized the financial system, why not the health care system? And if the insurance companies complain about being shut out, (waaaa!), well tell 'em to just compete! What's the problem? Isn't that what it's all about?patratnoreply@blogger.comtag:blogger.com,1999:blog-6568749253826790814.post-13703147222698978702009-09-09T00:25:57.620+01:002009-09-09T00:25:57.620+01:00Oh and by the way, Obama can take the "what i...Oh and by the way, Obama can take the "what is your answer, what is your solution" comments and shove them up his ass. Is that the only argument he can come up with when he thinks his is the only solution and soes not listen to anyone else.Angry Leprechaunnoreply@blogger.com