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JOHN GALT, M.D

A forum for discussion of regional topics including oil depletion but also government, society, and the future.

Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Fri 18 Sep 2009, 17:08:41

$this->bbcode_second_pass_quote('Sixstrings', 'T')he only way to get medicaid is to have somebody else pay your bills, or live on the street.
Feeling a little dramatic? I take care of medicaid patients every day. Most of them have jobs and housing.$this->bbcode_second_pass_quote('', 'S')PG, private insurance costs a fortune!!!
I have private insurance. I bought it off ehealthinsurance.com. No special rates or anything. It costs me $90 per month.$this->bbcode_second_pass_quote('', 'P')eople can barely pay their rent, they're losing their homes
You know what? If you own a house, you've got a heck of a lot more money than I do, so quit bitching and pay your bills.$this->bbcode_second_pass_quote('', 't')hey simply don't have the $500 a month for insurance (which they can't even get anyhow with a pre-existing condition.. and who doesn't have one of those by the time they hit 30 or 40?).
I didn't have any at age 35 when I got my health insurance. Most people aren't having problems getting insurance. They're having trouble getting insurance to cover the problem they already have. They are stuck because they played games trying to cut corners and they lost. Spare me the lecture, because I've played the same game. I happened to get away with it. It's a bit safer game when you're in your 20s than when you're in your 50's. Ultimately life's a gamble and medicaid is certainly not the end of the world. There are a lot of things that people gamble on every day. Becoming disabled is every bit as scary as becoming ill. You want the government forcing disability insurance on everyone? Getting sued is pretty scary too. Better load everyone up with liability insurance. Before long we'll be spending more than our GNP on all the freaking insurances. Then again, we could just accept that life is a risky adventure and being "poor" in the US is pretty darned cushy in the grand scheme of things.
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Fri 18 Sep 2009, 17:19:02

$this->bbcode_second_pass_quote('Sixstrings', 'M')ost families do choose to withdraw food and water at that point. And that's their right, but I believe it should always be up to the family -- government should never make that decision.


That's all well and good, but nobody is talking about whether the government should kill your vegetative kin. We're talking about whether the government should be taking money from me and everyone else and forcing us to pay for it. Not that most things the government spends equally stupid, but still. You wanna pay half a million a year for a house plant, I say go for it. I just don't want to subsidize your horticulture fetish.
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Re: JOHN GALT, M.D

Unread postby vision-master » Fri 18 Sep 2009, 17:47:45

$this->bbcode_second_pass_quote('', 'I') have private insurance. I bought it off ehealthinsurance.com. No special rates or anything. It costs me $90 per month.


The brothers girl friend had cancer 15 years ago. She pay's $700 Month for insurance. :)
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Re: JOHN GALT, M.D

Unread postby Sixstrings » Fri 18 Sep 2009, 17:54:06

$this->bbcode_second_pass_quote('vision-master', '')$this->bbcode_second_pass_quote('', 'I') have private insurance. I bought it off ehealthinsurance.com. No special rates or anything. It costs me $90 per month.
The brothers girl friend had cancer 15 years ago. She pay's $700 Month for insurance. :)
So according to SPG..

Your brother's girlfriend didn't have trouble getting insurance, she had trouble getting insurance for the cancer she had. She's stuck because she played games trying to cut corners and lost. So she should spare us any lectures.

And yeah, she doesn't need to pay $700 a month, I'm sure she can get good healthcare from ehealthinsurance.com for just $90 a month. :roll:

I swear, the Brits, Canadians, Aussies, Europeans on the forum must think we're stark raving mad, that we think this is normal and acceptable.
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Re: JOHN GALT, M.D

Unread postby vision-master » Fri 18 Sep 2009, 18:01:11

In 1987/88 I was self employed and paid over $125 Month as a single young male. Any yahoo that pay's $90 Month for insurance today has got to have a fricken joke policy. :lol:
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Re: JOHN GALT, M.D

Unread postby AgentR » Fri 18 Sep 2009, 19:00:27

$this->bbcode_second_pass_quote('jedrider', 'T')hat's interesting. What would they do? Could they become bankers or maybe welfare workers? Would they move to third-world countries to help people truly in need? Yes, the third option is the only true moral one!


Most practicing physicians have extensive business experience; I've often remarked that an MD could leave his practice and walk into a middle management job in some random corporate environment and do a perfectly good job.

Sad thing, is that looking at take home, put in the bank kind of pay, that middle management job is starting to look much more profitable than the medical practice.

I think a lot of MD's remain onboard for now simply because the transition away from their existing business would be moderately annoying; if the decision becomes, leave practice or lose your nice house and kids tuition money, it won't even be a difficult choice.
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Fri 18 Sep 2009, 19:20:51

$this->bbcode_second_pass_quote('vision-master', 'I')n 1987/88 I was self employed and paid over $125 Month as a single young male. Any yahoo that pay's $90 Month for insurance today has got to have a fricken joke policy. :lol:


Your problem is that you're not shopping for insurance. You're shopping for a health care payment plan. If you want someone else to pay for every sniffly nose that you get, it's going to cost you a lot more. If you're willing to pay for your own sniffly nose, but want protection if you break your neck or get cancer, that's easily affordable for $90/mo. I like my insurance very well. My insurer is even a cooperative. :razz:
"We were standing on the edges
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Now is nothing more than a memory
The way things were before
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Fri 18 Sep 2009, 19:30:06

$this->bbcode_second_pass_quote('vision-master', 'T')he brothers girl friend had cancer 15 years ago. She pay's $700 Month for insurance. :)


Which is a pittance compared to what her healthcare costs have been and probably still are. Sounds pretty fair to me. Obviously she has the money or the premium would be a moot point. I'm sorry no one clued you in back in elementary school, life's not fair. It's not supposed to be. Sometimes you get cancer. Sometimes your dirt bag husband runs off and leaves you with hundreds of thousands of dollars in debts like happened to my sister. Sometimes a hurricane comes and floods your entire city and you and everyone you know lose everything. Some days you eat the bear. Some days the bear eats you. That's just how it goes.
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Re: JOHN GALT, M.D

Unread postby vision-master » Fri 18 Sep 2009, 19:31:08

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('vision-master', 'I')n 1987/88 I was self employed and paid over $125 Month as a single young male. Any yahoo that pay's $90 Month for insurance today has got to have a fricken joke policy. :lol:


Your problem is that you're not shopping for insurance. You're shopping for a health care payment plan. If you want someone else to pay for every sniffly nose that you get, it's going to cost you a lot more. If you're willing to pay for your own sniffly nose, but want protection if you break your neck or get cancer, that's easily affordable for $90/mo. I like my insurance very well. My insurer is even a cooperative. :razz:


Come on SPG, guy's hate going to the Doctor. You should know taht. :lol:

How come one of my other brothers paids like $150 Month thru employer insurance with the first $5,000 out of his pocket, eh. Answer that one!
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Re: JOHN GALT, M.D

Unread postby vision-master » Fri 18 Sep 2009, 19:32:26

$this->bbcode_second_pass_quote('', 'W')hich is a pittance compared to what her healthcare costs have been and probably still are. Sounds pretty fair to me. Obviously she has the money or the premium would be a moot point. I'm sorry no one clued you in back in elementary school, life's not fair. It's not supposed to be. Sometimes you get cancer. Sometimes your dirt bag husband runs off and leaves you with hundreds of thousands of dollars in debts like happened to my sister. Sometimes a hurricane comes and floods your entire city and you and everyone you know lose everything. Some days you eat the bear. Some days the bear eats you. That's just how it goes.



Your really not a nice person. Goodbye. :)
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Fri 18 Sep 2009, 20:06:43

$this->bbcode_second_pass_quote('vision-master', 'Y')our really not a nice person. Goodbye. :)


LOL. No. Not really. I'm harshly realistic. You want nice, you should probably limit yourself to reading Obama's address to the school kids repeatedly or something. Maybe you could volunteer at Le Leche league. I bet they're nice. :razz:

$this->bbcode_second_pass_quote('', 'H')ow come one of my other brothers paids like $150 Month thru employer insurance with the first $5,000 out of his pocket, eh. Answer that one!


I dunno. $150 sounds pretty decent to me. There are a few potential areas of difference. His plan might cover out-patient meds. Mine doesn't. Could also have to do with age or health level.
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Re: JOHN GALT, M.D

Unread postby rangerone314 » Fri 18 Sep 2009, 22:41:53

Why doesn't the government put effort into finding a way to reduce medical school costs so doctors don't have to go into debt, and find ways to have MORE doctors in the workforce. Seems if you increase the supply the labor cost will go down. But the bungholes at the AMA would probably have to say something about that.

From wikipedia: $this->bbcode_second_pass_quote('', 'C')ritics of the American Medical Association, including economist Milton Friedman, have asserted that the organization acts as a guild and has attempted to increase physicians' wages and fees limit by influencing limitations on the supply of physicians and non-physician competition. In Free to Choose, Friedman said "The AMA has engaged in extensive litigation charging chiropractors and osteopaths with the unlicensed practice of medicine, in an attempt to restrict them to as narrow an area as possible."

Profession and monopoly, a book published in 1975 is critical of the AMA for limiting the supply of physicians and inflating the cost of medical care in the United States. The book claims that physician supply is kept low by the AMA to ensure high pay for practicing physicians. It states that in the United States the number, curriculum, and size of medical schools are restricted by state licensing boards controlled by representatives of state medical societies associated with the AMA. The book is also critical of the ethical rules adopted by the AMA which restrict advertisement and other types of competition between professionals. It points out that advertising and bargaining can result in expulsion from the AMA and legal revocation of licenses. The book also states that before 1912 the AMA included uniform fees for specific medical procedures in its official code of ethics. The AMA's influence on hospital regulation was also criticized in the book.[19]

The AMA and other industry groups predicted an over-supply of doctors, and worked to limit the number of new doctors. But recently, the AMA has changed its position, predicting a doctor shortage instead.
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Re: JOHN GALT, M.D

Unread postby Pops » Sat 19 Sep 2009, 00:33:51

Yea, you pay your money or you take your chances.

When we moved to MO I wasn't making a whole lot I and was only 47 (most in my family waited till 70-ish to get cancer and die) so I didn't get a new policy.

So let's see how not having insurance worked for me: lets just take that last 5 years at say $2k/year would have been $10k in premiums plus the $5k deductible plus probably 20% co-pay is another $4k, so I would be out $19k on my $20k hospital visit. Insulin and misc wouldn't be payed on a cheap plan so add in another $3k for the first year.

Without insurance and with a small income the hospital reduced the bill by more than half to $8k and Big Pharma takes pity on me and gives me insulin so it cost me $10k the first year to get type I diabetes instead of the $21k it would have if I had insurance.

I really don't know what an insurance carrier would do the next year with someone in my case but I assume they would either drop me or raise my rate big time - it's business after all.

Now, let me say I don't mind the $8k for the hospital ($20k for that matter) because I was about one foot over the line. My blood must have been pretty interesting cuz half my bill was lab work – I'm glad to know they were actually doing something with all that blood!


So I don't know, the people who saved my life did a perfect job as far as I can tell, it's probably a good thing I came in through the ER though.
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Sat 19 Sep 2009, 08:34:08

$this->bbcode_second_pass_quote('rangerone314', 'W')hy doesn't the government put effort into finding a way to reduce medical school costs so doctors don't have to go into debt, and find ways to have MORE doctors in the workforce. Seems if you increase the supply the labor cost will go down.


The Rockefeller Medicine Men is an interesting history of that whole issue. Back in the early 1800s one of the things that the Jacksonian populists did was to repeal all of the medical licensure laws in the US. There was about a 50 year period where all sorts of alternative medicine practices really flourished. The University of Michigan had a school of homeopathy that ran right along side their school of allopathic medicine. The AMA formed as an organization with the purpose of restricting the number of doctors to drive up medical fees. They found a partner in the robber barons. The robber barons had accumulated so much money that they couldn't possibly spend it all, and they were facing a lot of militant trade unionism. They were starting to spend money on a lot of "philanthropic" activities that were basically aimed at stabilizing their social status and crafting the world in their image. They saw an opportunity in that doctors were socially influential and if they could be elevated to share upper class values, it would stabilize the position of the aristocracy. Together with the AMA, they started a process of passing medical licensure laws, making the licensing exams progressively more difficult, making medical education progressively more difficult, and making the entrance requirements for medical school more difficult. It culminated in the Flexner Report by the Carnegie Foundation in 1910 which resulted in the closure of over half of the medical schools in the US, including all of the women's medical schools and all but two of the black medical schools. Today there are cartels in every step of medical education. The AMA determines how many people can go through medical school. Each specialty then limits the number of residency slots in that specialty. That's why it takes 2 months to get in to see a dermatologist. Their board won't let the dermatology residency programs open more slots.

It was a really eye opening thing to me to realize that medical school is so hard, because they wanted to limit the number of doctors, not because the material needs to be hard. The logic ran something more along the lines of "Well, we need to make the education at least eight years or too many people will do it. What can we teach in 8 years?" Another problem that has come out of the whole AMA robber baron campaign was that a lot of their sales pitch was immortality through science rhetoric. It's become, really, a religious belief in the US. Millions of people turn out to Walk for the Cure and similar silliness. Patrick Swayze was trying to hold out for a cure for pancreatic cancer. I mean seriously. The mean survival after a diagnosis of pancreatic cancer is something like 2 months. Lets get real here. I think that's a big piece of why medical care in the US is so expensive is that deep down everyone really believes that if they go to the doctor whatever health problem they have will be magically cured. Consequently they aren't willing to set a cap on what they'll spend for medical care. Like any profession, you walk in with a hand full of cash, and we'll figure out something to spend it on. It's also a big piece of why we have such a big problem with malpractice. Any time anything doesn't go well for someone medically, they figure it must be that their doctor screwed up. Nobody wants to own the notion that we're gonna get old and die and nobody can really change that. IMHO that is the key to fixing our medical system in the US. We've got to start conceptualizing medicine as a service industry that can help with things somewhat, but ultimately can't change the reality that you're going to die. We must stop talking about "saving lives". No doctor ever "saved a life". Sometimes we can extend a life, but every patient any doctor has ever had anywhere ultimately dies. We really need to take a hard look at what is a reasonable amount of money to spend on medicine and what are the most cost effective services to spend that money on. All the money at this point goes to flashy services that ultimately don't really change much. Dying of pancreatic cancer under the care of a family practice doc is a whole lot less expensive than dying of pancreatic cancer under the care of an oncologist and a radiation oncologist and a gastroenterologist and a hepatobiliary surgeon, etc, etc.
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Re: JOHN GALT, M.D

Unread postby rangerone314 » Mon 21 Sep 2009, 07:46:42

$this->bbcode_second_pass_quote('smallpoxgirl', 'I')t was a really eye opening thing to me to realize that medical school is so hard, because they wanted to limit the number of doctors, not because the material needs to be hard. The logic ran something more along the lines of "Well, we need to make the education at least eight years or too many people will do it. What can we teach in 8 years?"

We've got to start conceptualizing medicine as a service industry that can help with things somewhat, but ultimately can't change the reality that you're going to die. We must stop talking about "saving lives". No doctor ever "saved a life". Sometimes we can extend a life, but every patient any doctor has ever had anywhere ultimately dies.


I DO wonder if State health insurance boards are so effective at keeping insurance companies from illegalling denying claims or treatment in hopes of saving money by letting patients die, why not just have THEM run a public insurance plan if they are so effective, and the rest of government is not?

Good point about the AMA... I had SOME awareness of them as a limiting factor but had no idea the rot ran as deep or as wide as it does. Most of our serious problems as a society seem to result from a deep rot that most people aren't fully aware of.

Also good point about mindset... you are very right about doctors not SAVING livings. Everything just delays death.

One time Star Trek the Next Generation hit the nail on the head with that episode "Neutral Zone" at the end of the 1st Season, when they discover 3 people cryogenically frozen that had died centuries ago and were frozen in hopes their disease would be cured in the future. Dr. Crusher mentioned that in our time, people were absolutely terrified of death.
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Re: JOHN GALT, M.D

Unread postby smallpoxgirl » Mon 21 Sep 2009, 08:26:05

$this->bbcode_second_pass_quote('rangerone314', 'I') DO wonder if State health insurance boards are so effective at keeping insurance companies from illegalling denying claims or treatment in hopes of saving money by letting patients die, why not just have THEM run a public insurance plan if they are so effective, and the rest of government is not?


State Insurance boards have a fairly easy job in that regard. It's fairly obvious when that happens, and it's politically much easier to sock it to the insurance company than to endure the crap storm of bad publicity that would otherwise follow. Actually administering a health plan is a lot like running the IRS. Lots of paper work and small amounts of money flying everywhere. Lots of goofy regulations from state and federal legislatures and a dozen different government agencies that you have to ensure compliance with.
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Re: JOHN GALT, M.D

Unread postby rangerone314 » Mon 21 Sep 2009, 08:39:38

An ideology is by definition not a search for TRUTH-but a search for PROOF that its point of view is right

Equals barter and negotiate-people with power just take

You cant defend freedom by eliminating it-unknown

Our elected reps should wear sponsor patches on their suits so we know who they represent-like Nascar-Roy
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Re: JOHN GALT, M.D

Unread postby RedStateGreen » Mon 21 Sep 2009, 14:37:13

$this->bbcode_second_pass_quote('smallpoxgirl', ' ')First off I want us to have a serious heart to heart national dialogue about reconceptualizing medicine. We have been selling medicine as a path to immortality. Everybody wants to walk for a cure, stamp out heart disease, etc. We need to come to grips with the idea that miracle cures don't exist. If it's not curable already, it's unlikely to become so. We're all going to die some day. In some cases medicine can forestall that, but by no means can it change that reality.



This right here. Until patients finally get it that death due to old age is not a treatable illness, our health care dollars will continue to go down the ICU toilet. :x

http://washington.bizjournals.com/washi ... rial3.html

(eta link)
Last edited by RedStateGreen on Mon 21 Sep 2009, 14:55:31, edited 2 times in total.
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Re: JOHN GALT, M.D

Unread postby Quinny » Mon 21 Sep 2009, 14:53:23

Its probably been covered elsewhere, but why is healthcare so expensive in the US despite the fact that it's not a universal system. You'd expect it to cost more to look after everyone rather than just a small percentag, but it doesn't seem to work like that.
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Re: JOHN GALT, M.D

Unread postby Sixstrings » Mon 21 Sep 2009, 16:17:21

$this->bbcode_second_pass_quote('Quinny', 'I')ts probably been covered elsewhere, but why is healthcare so expensive in the US despite the fact that it's not a universal system. You'd expect it to cost more to look after everyone rather than just a small percentag, but it doesn't seem to work like that.


I'll take a layman's shot at that question..

I'd guess that we have a whole lot of specialists in America. Over here, docs all want to be specialists, rather than GP's, so that they can bill more. So what ends up happening is a lot folks rarely even see their family doctor.. if they get a weird mole, they just book a dermatologist who's on their plan. If they have migraines, they bypass the family doc and go straight to the neurologist. A bit of blood in the stool? Off to the gastroenterologist they go.

So the difference here is that whereas in the UK people have a family doc, over here a lot of people really have a team of doctors. This drives up costs, since obviously there are a lot of things a competent family practitioner really should be able to handle. Family practice (called GP in Britain) is now so underrated, that if you go to see one odds are you'll be seeing a nurse practitioner.

Now another area of cost would be just the innately higher cost of a private system. A lot of little things, like sharing a hospital room. I imagine you usually have to share a room in the UK? In my area of the US, the rooms are all private. I think competition has something to do with this.. locally, there are three separate corporations running hospitals. I heard an ad on the radio the other day, where one of the hospitals is now offering luxury birth packages.. nicer hotel-style rooms with blue ray players for the HD tv, etc. This kind of thing is competition at work, where the hospital is adding benefits to attract customers. I assume that kind of competition doesn't exist in a socialized system.

So far, we have (a) higher paid specialist docs, and (b) generally nicer medical digs. And that's all I can write at the moment, since I have a terrible flu right now and can barely think. (i assume it's swine flu.. no point in going to a doctor tho, I imagine I'm past the tamiflu point.. no fever yet, but I feel so incredibaly weak.. sore throat is gone today, so at present I have flu acheyness, congestion, weakness, and feel like a have fever even tho i dont)
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