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"medicine for medicine's sake." Point 1: What do you think doctors are? Saints? They are human like the rest of us and would rather work for cash. They would p

"medicine for medicine's sake." Point 1: What do you think doctors are? Saints? They are human like the rest of us and would rather work for cash. They would probably also do better work if they were doing so for their own good. Case in point: Who had more food during the 1950-1980s. The US or the USSR? Point 2: What makes you think that national health care will make doctors magnanimous? Just switching the payer from individuals to the govt. (which gets its cash from individuals anyway) doesn't magically change people. If we get national health care, doctors will probably start doing exactly what government unions have done: invest in lobbyists. PS. The patient is in Ukraine. How will changing the US health care system help him?

giardini 18y ago
Let's talk about the US only for argument's sake. Point 1: Today's doctors are for the most part motivated by $. This was not so even as early as 50 years ago. We need more doctors and need to pay them less. Part of the solution: increased specialization, reduced time in medical school and a different form of health care system. This is a complex problem. The best short summary I have found is available at http://www.strategy-business.com/press/article/07110?gko=56480&tid=230&pg=all http://www.strategy-business.com/press/article/07110?gko=564... Scroll down and read especially "Redefining Competition" about Porter and Teisberg's ideas. Point 2: By reducing the income of doctors, we'll rid the system of the greedheads currently running the HMOs, the medical centers and the cancer institutes. People who enter medicine will be people more interested in medicine and less in accumulating a fortune. The financial motivation to get into medical school is simply too tempting currently in the US. Pre-med students are the only group in whom I have seen intentional sabotage of other (pre-med) students' work. Even worse, most pre-meds expect such behavior as normal. And consider Senator Bill Frist, M.D. repeatedly strangling kittens he obtained from the local Adopt-A-Pet in the bathroom sink to get an edge in medical school. Is this normal behavior? For today's pre-med or medical student it apparently is. Once MDs are knocked down a notch (both in pay scale and consequently in social status), PhDs will once again be able to dominate laboratory research, where they are far, far better than are MDs (who unfortunately currently dominate). We may finally get decent medical research for our government dollars. Doctors are bad researchers: their training is as scholars (i.e., they read and memorize books, books and more books) and they are good at spitting back what they've read. Training as a doctor usually destroys the ability to think independently and do good research. PS: The original article says treatment could be in the US. I took the opportunity to make a statement about the US health care system and how expensive it is. But FWIW certain changes to the US health care system would make it cheaper for anyone who could use that system.
- anamax 18y ago
  > Today's doctors are for the most part motivated by $. Not any more so than any other field. Me - I want a doctor who is smart enough to have done something else and smart enough to say "pay me what I'm worth". > We need more doctors and need to pay them less. Unless you're going to break the monopoly on services that can only be performed by doctors or the medical school monopoly, you're not going to reduce income without introducing more scarcity (they'll do something else and won't be replaced). The "universal health care" advocates never mention that the federal, state, and local govts directly control about half of the US healthcare spending and cover about half of the covered people. If you're going to argue that govt healthcare can be better/cheaper, that can be done today with those resources. As it is, they're arguing that they'll be able to cover more than twice as many people for about 50% more money. How about demonstrating that and opening up the govt system to outsiders for cost? If you're right, the private system will either become as good or die.
  - giardini 18y ago
    I cannot address complaints about your imagined concept of universal health care. Perhaps next time you'll respond to my post, rather than your imagination. Such methods as training doctors less and allowing specialization earlier, eliminating situations where doctors are currently required, tracking and publishing doctors' success rates, allowing pharmacists to write prescriptions, etc. all would reduce doctors' income and weaken the medical school monopoly. Many more students would enter medicine since, while it wouldn't pay as much, it would pay well, and the requirements and time needed to enter the field would be significantly reduced. And please read http://www.strategy-business.com/press/article/07110?gko=56480&tid=230&pg=all http://www.strategy-business.com/press/article/07110?gko=564... Scroll down and read especially "Redefining Competition" about Porter and Teisberg's ideas.

giardini 18y ago

Let's talk about the US only for argument's sake. Point 1: Today's doctors are for the most part motivated by $. This was not so even as early as 50 years ago. We need more doctors and need to pay them less. Part of the solution: increased specialization, reduced time in medical school and a different form of health care system. This is a complex problem. The best short summary I have found is available at http://www.strategy-business.com/press/article/07110?gko=56480&tid=230&pg=all http://www.strategy-business.com/press/article/07110?gko=564... Scroll down and read especially "Redefining Competition" about Porter and Teisberg's ideas. Point 2: By reducing the income of doctors, we'll rid the system of the greedheads currently running the HMOs, the medical centers and the cancer institutes. People who enter medicine will be people more interested in medicine and less in accumulating a fortune. The financial motivation to get into medical school is simply too tempting currently in the US. Pre-med students are the only group in whom I have seen intentional sabotage of other (pre-med) students' work. Even worse, most pre-meds expect such behavior as normal. And consider Senator Bill Frist, M.D. repeatedly strangling kittens he obtained from the local Adopt-A-Pet in the bathroom sink to get an edge in medical school. Is this normal behavior? For today's pre-med or medical student it apparently is. Once MDs are knocked down a notch (both in pay scale and consequently in social status), PhDs will once again be able to dominate laboratory research, where they are far, far better than are MDs (who unfortunately currently dominate). We may finally get decent medical research for our government dollars. Doctors are bad researchers: their training is as scholars (i.e., they read and memorize books, books and more books) and they are good at spitting back what they've read. Training as a doctor usually destroys the ability to think independently and do good research. PS: The original article says treatment could be in the US. I took the opportunity to make a statement about the US health care system and how expensive it is. But FWIW certain changes to the US health care system would make it cheaper for anyone who could use that system.

anamax 18y ago
> Today's doctors are for the most part motivated by $. Not any more so than any other field. Me - I want a doctor who is smart enough to have done something else and smart enough to say "pay me what I'm worth". > We need more doctors and need to pay them less. Unless you're going to break the monopoly on services that can only be performed by doctors or the medical school monopoly, you're not going to reduce income without introducing more scarcity (they'll do something else and won't be replaced). The "universal health care" advocates never mention that the federal, state, and local govts directly control about half of the US healthcare spending and cover about half of the covered people. If you're going to argue that govt healthcare can be better/cheaper, that can be done today with those resources. As it is, they're arguing that they'll be able to cover more than twice as many people for about 50% more money. How about demonstrating that and opening up the govt system to outsiders for cost? If you're right, the private system will either become as good or die.
- giardini 18y ago
  I cannot address complaints about your imagined concept of universal health care. Perhaps next time you'll respond to my post, rather than your imagination. Such methods as training doctors less and allowing specialization earlier, eliminating situations where doctors are currently required, tracking and publishing doctors' success rates, allowing pharmacists to write prescriptions, etc. all would reduce doctors' income and weaken the medical school monopoly. Many more students would enter medicine since, while it wouldn't pay as much, it would pay well, and the requirements and time needed to enter the field would be significantly reduced. And please read http://www.strategy-business.com/press/article/07110?gko=56480&tid=230&pg=all http://www.strategy-business.com/press/article/07110?gko=564... Scroll down and read especially "Redefining Competition" about Porter and Teisberg's ideas.