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We see a lot of people trying to justify medical salaries due to the cost of education and malpractice insurance, but an integrated program could work around th

by hakfoo 7y ago

We see a lot of people trying to justify medical salaries due to the cost of education and malpractice insurance, but an integrated program could work around that. We should treat it like the infantry. If you want to drive a tank and blow up people, you don't apply to a college and get a Doctorate in Blowing People Up. You don't buy insurance to cover if you blow up the wrong people. You join the army. I'd like to see health care reform inspired by military structure. A high-schooler eager to get into medicine joins the Health Corps, and gets their education covered in exchange for n years of working in state-run facilities. There's strongly restricted legal recourse if the Health Corps hospital cuts off the wrong foot-- here's $500 and a really nice wooden peg. As a self-contained system, I could also imagine it working around some of the structure that's restricting the industry. I'm picturing programmes to advance in both through direct study and training, and where appropriate "field promotions" (think of the 20-year term nurse who knows more than most of the doctors from experience, but will never be able to escape their position without expensive and onerous formal training/certification)

lallysingh 7y ago
Would that end up also being single payer?
- radicalbyte 7y ago
  If you wanted to do it cost effectively, yes. I have experience of single player (UK) and private insurance based but properly managed by the government (NL) and can tell you that single player is much cheaper to run. When I moved to NL about 15 years ago the UK was spending the same per capita on the NHS as The Netherlands spent from the central government to cover the shortfall to the insurers. In 2019 there isn't as much difference: a significant amount of providers in the UK have been privatised which increased costs whilst at the same time the NHS budgets have been systemically strangled in real terms - something like annual 2% budget increases against annual 15% cost increases thanks to demographics and lifestyle choices. So in short: single payer is great but the second the Republicans (or whatever the "don't tax the rich" party is at the time) get to touch it they'll ruin it.
ascorbic 7y ago
So, basically the NHS? https://www.healthcareers.nhs.uk/career-planning/study-and-training/considering-or-university/financial-support-university/financial-support-medical-and-dental-students-england https://www.healthcareers.nhs.uk/career-planning/study-and-t... https://www.bma.org.uk/advice/employment/contracts/nhs-medical-indemnity https://www.bma.org.uk/advice/employment/contracts/nhs-medic...
irrational 7y ago
There would need to be other changes. Right now many doctors work insane hours. My dad is a doctor who we rarely saw growing up. Now in in his 70s he has retired to live near a native american reservation where he works at the clinic. He puts in 60+ hours a week and claims that that is retirement for a doctor. I imagine that young doctors not making the big bucks would not be willing to work themselves to death like the current ones do.

by hakfoo 7y ago

lallysingh 7y ago

Would that end up also being single payer?

radicalbyte 7y ago
If you wanted to do it cost effectively, yes. I have experience of single player (UK) and private insurance based but properly managed by the government (NL) and can tell you that single player is much cheaper to run. When I moved to NL about 15 years ago the UK was spending the same per capita on the NHS as The Netherlands spent from the central government to cover the shortfall to the insurers. In 2019 there isn't as much difference: a significant amount of providers in the UK have been privatised which increased costs whilst at the same time the NHS budgets have been systemically strangled in real terms - something like annual 2% budget increases against annual 15% cost increases thanks to demographics and lifestyle choices. So in short: single payer is great but the second the Republicans (or whatever the "don't tax the rich" party is at the time) get to touch it they'll ruin it.

ascorbic 7y ago

So, basically the NHS? https://www.healthcareers.nhs.uk/career-planning/study-and-training/considering-or-university/financial-support-university/financial-support-medical-and-dental-students-england https://www.healthcareers.nhs.uk/career-planning/study-and-t... https://www.bma.org.uk/advice/employment/contracts/nhs-medical-indemnity https://www.bma.org.uk/advice/employment/contracts/nhs-medic...

irrational 7y ago

There would need to be other changes. Right now many doctors work insane hours. My dad is a doctor who we rarely saw growing up. Now in in his 70s he has retired to live near a native american reservation where he works at the clinic. He puts in 60+ hours a week and claims that that is retirement for a doctor. I imagine that young doctors not making the big bucks would not be willing to work themselves to death like the current ones do.