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View Poll Results: Which Democratic Presidential candidate are you voting for?
U.S. Sen. Joseph R. "Joe" Biden, Jr. (D-DE) 6 5.77%
U.S. Sen. Hillary R. Clinton (D-NY) 27 25.96%
U.S. Sen. Christopher J. "Chris" Dodd (D-CT) 0 0%
'VP 04 nominee / ex-U.S. Sen. John R. Edwards (D-NC) 9 8.65%
ex-U.S. Sen. Maurice "Mike" Gravel (D-AK) 0 0%
'04 candidate / U.S. Rep. Dennis J. Kucinich (D-OH) 22 21.15%
U.S. Sen. Barack H. Obama (D-IL) 33 31.73%
Gov. William B. "Bill" Richardson (D-NM) 2 1.92%
Other - Write In 5 4.81%
Voters: 104. You may not vote on this poll

 
 
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Old 12-05-2007, 11:44 PM   #136
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Originally posted by melon


The only true "free market" solution would be to ban health insurance altogether, as health insurance, naturally, artificially inflate the demand curve. That, in turn, should effectively decimate our health care industry as we know it, since nobody can afford anything at all related to health care without insurance (unless you're U.S. Senators raking in five to six figure sums for speaking engagement fees, of course, then it's just pocket change).

Of course, if you're going to substantially reduce the medical industry's income one way or another, you might as well go the path of least resistance and start regulating health care costs like the rest of the industrialized world.
You have a good grasp of the economics. Three points I'd bring up.
1) Ending the employee/employer role in paying for health care should result in employers paying out that same monetary total in wages or other compensation. So you would have more to pay for health care and insurance. Of coarse your tax burden would also increase, so that would have to be addressed.
2) As more health care is paid directly from the consumer to the provider, the layers of bureaucracy would lessen (HMO's, paperwork, etc), lowering costs.
3) As more people have direct responsibly for their health care spending you would see market forces put downward pressure on prices.

As I said, there is a role for government in health care. Providing for the poor, the retired, those in prison or in the armed forces. Regulating drugs, procedures and equipment. Accrediting schools and hospitals. Licensing doctors, nurses and other providers. Stipulating basic levels of coverage, rules for treating pre-existing conditions or extremely expensive drugs, therapy or operations. And some others we could come up.

But keeping down costs artificially with price controls and rationing should not be that role.
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Old 12-06-2007, 12:33 AM   #137
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Originally posted by INDY500


2) As more health care is paid directly from the consumer to the provider, the layers of bureaucracy would lessen (HMO's, paperwork, etc), lowering costs.
3) As more people have direct responsibly for their health care spending you would see market forces put downward pressure on prices.

But keeping down costs artificially with price controls and rationing should not be that role.
Tell me, how much do you really think a bypass surgery will go down? What about a major surgery at an ER, how much do you really think your logic will bring it down?

I guarantee you it won't bring it down to a price that's affordable by most. Then you have unpaid hospital costs that start jacking up the prices again. It's a cycle that WILL NOT be cured by "free market".
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Old 12-06-2007, 03:30 PM   #138
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Nevermind the economic issues of universal healthcare, I want to hear how the candidates plan on dealing with 47 million new people suddenly flooding the system. It's been well established that there is a primary care physician shortage in this country. The problem is only expected to get worse as the population ages (shortage of somewhere between 85,000 and 200,000 physicians by 2020). The AAMC (governing body of medical education in the US) has decided to increase the size of new medical school classes by 3000 a year, but any benefits are likely 10 years down the road at the early earliest. Those numbers and adjustments were calculated without throwing an extra 47 million people into the equation.

If people have a difficult time finding a PCP now, just imagine what it would be like with 47 million people trying to find a PCP. The fact of the matter is that right now Primary Care as a field sucks to go into. The hours are grueling and the pay sucks (relative to the field). The average physician graduates medical school with a debt of over $130,000 and primary care is not a field that will allow you to pay that back quickly.

So these candidates will have to do something drastic to change the field of primary care to get quality people to fill the needed slots. Total loan forgiveness programs, caps on the amount of patients seen in a day, etc. Any implemented system that doesn't put the focus on primary care is one that will likely not have much of a positive impact.

These politicians love to spout off about how they're going to get coverage for everybody, but have any of them actually thought about what will happen if or when that happens? I'm skeptical at best that any of the candidates will solve this problem correctly.
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Old 12-06-2007, 04:14 PM   #139
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Quote:
Originally posted by randhail
Nevermind the economic issues of universal healthcare, I want to hear how the candidates plan on dealing with 47 million new people suddenly flooding the system. It's been well established that there is a primary care physician shortage in this country. The problem is only expected to get worse as the population ages (shortage of somewhere between 85,000 and 200,000 physicians by 2020). The AAMC (governing body of medical education in the US) has decided to increase the size of new medical school classes by 3000 a year, but any benefits are likely 10 years down the road at the early earliest.
How difficult is it to become licensed in the US having been educated abroad? It certainly seems to me that Canadian MDs face essentially no challenge in doing so (whereas getting an MD in a US school essentially leaves you SOL in Canada as a number of my friends have found). If this is the case with other Commowealth nations (primarily UK, Australia), or any other nation, then you could much more easily address the shortage through implemented immigration policies targeting foreign MDs. This is generally met with hostility in Canada (due to rather silly protectionist views), so I'm not sure how much easier it would be down south. But it's certainly a fix that you could have in less than 10 years and given US MD salaries, it would hardly be difficult to attract good foreign talent.
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Old 12-06-2007, 04:49 PM   #140
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I'm not totally sure of this but my understanding is that getting an MD from a school such as McGill is basically the same as graduating from a US school. I think that Canadian schools even use the same application service.

Coming in from other countries is a more difficult route because regardless of how many years experience you have, you are required to complete a US residency in order to practice in a given speciality. I believe that you also have to complete all of the basic licensing exams that US students take (USLME Step I, Step II Clincal Knowledge and Clinical Skills,
and eventually Step III) Getting the residency slots tends to a little bit more difficult because US med school grads get most of them (~2/3). Coming in from a foreign med school, you really have to prove yourself. It may not be fair, but it's the way things are right now and I think it does have some benefits - it acts as a quality control measure.

I know that there has been talk about outsourcing certain things like diagnostic radiology to India since most of the images now are all digital, but the people in India must be licensed in the US so it defeats the purpose of outsourcing anyways.

The salary would certainly make it appealing for many people, but the number of hoops you have to jump through doesn't make it an attractive choice for everyone. Attracting good talent will likely never be the problem, it will be trying to ensure that only good talent makes it through and the not so great talent doesn't get a license to practice here.
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Old 12-06-2007, 05:26 PM   #141
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2/3 is not that bad. I think in Canada CARMS leaves something like a dozen spots each year for foreign trained doctors and those end up someplace like northern Saskatchewan.

Yes, the MDs in Canada and the US are equivalent, and they do use the same application service. It is similar for law degrees - I can go write the NY bar next summer, if I wish.

Re: outsourcing - that is relatively easy to get over. Law firms have started outsourcing some due diligence to India as well on a test basis (I don't think this is going to pass muster longterm, but anyway). All you really need is adequate supervision and the person who signs the report to be licensed - so what you do is ship over a few US-trained radiologists there on contract for a year or two to supervise the process. It's what other industries where licensing is required are doing (like say, accounting).
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Old 12-10-2007, 09:56 PM   #142
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Here is how the Dems stack up in the latest races nationaly and the early states between Clinton, Obama, and Edwards:


National:

CNN:

Clinton 40%
Obama 30%
Edwards 14%


IOWA

Newsweek:

Obama 35%
Clinton 29%
Edwards 18%


NEW HAMPSHIRE:

Mason-Dixon:

Clinton 30%
Obama 27%
Edwards 10%


MICHIGAN:

Detroit News:

Clinton 49%
Obama 18%
Edwards 15%


NEVADA:

American Res. Group:

Clinton 45%
Obama 18%
Edwards 14%


SOUTH CAROLINA:

Insider Advantage:

Obama 28%
Clinton 22%
Edwards 14%
Biden 10%
Richardson 2%


FLORIDA:

SurveyUSA:

Clinton 54%
Obama 24%
Edwards 13%


CALIFORNIA:

SurveyUSA:

Clinton 50%
Obama 24%
Edwards 16%



PENNSYLVANIA:

Quinnipiac:

Clinton 43%
Obama 15%
Edwards 9%


NEW JERSEY:

Rutgers-Eagleton:

Clinton 52%
Obama 21%
Edwards 8%
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Old 12-19-2007, 03:52 PM   #143
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I'm going with Biden, but then again I live in Washington so he might not be around by the time it's my turn to caucus. If it's down to Obama vs. Hillary I will probably go for Obama. Hillary, although I think she would do a good job as President, is too typical of a politician. She speaks out of both sides of her mouth to try to please whoever she is talking to at the moment. I respect her but I don't entirely trust her. She's great at sounding like she's saying something but really saying nothing at all.
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