Early Retirement

[kim carnes]

Facts

[CNS]

I’m not clicking on that bc no one can say how much it will cost bc there is no way to know.

lol

Mich I’ve seen the projections many times and they’re all based on cutting reimbursements and administrative costs.  Good luck telling healthcare providers they’re now getting half as much for their services.

Cut them.  Some of the charges are ridic.  For instance, I saw an article the other day comparing cost of covid tests for cash patients vs insured.  The specific test they had info on cost cash patients $110.  Same provider and same test from same location was being billed to insurance for $720.  This is a pretty common story you hear across the industry.  So, uh, yeah, reduce and regulate. 

The argument that we have the best care providers in the world and that we have that because of what they can make here is a bullshit argument too.  Sure, we have the best docs, however, most ppl on this blog or that you know can't afford them.  If you do get to see them, you will be in debt for a long time.  If we go M4A, they aren't leaving either.  They will offer their services to the same people they do now as a concierge service above and beyond M4A coverage.  Anywhere else you think they would move to already has universal healthcare.

There is not reasonable argument for the current system unless you are a specialist, in the pharmaceuticals industry, or insurance. Everyone else is being hurt by it.

[Pete]

How can we be the only western country who can't figure out how to do this? 

[sys]

How can we be the only western country who can't figure out how to do this?

well, mostly we pay our doctors twice as much.

[Pete]

Med schools turn away a bajillion well qualified applicants every year.  We have plenty of supply of brains and the requisite "hearts" to do the job.

[kim carnes]

The reason they have that many applicants is bc those people want to get paid.

[Pete]

The reason they have that many applicants is bc those people want to get paid.

How are you able to know the precise motivation of such a huge group of people?

[wetwillie]

Med schools turn away a bajillion well qualified applicants every year.  We have plenty of supply of brains and the requisite "hearts" to do the job.

I’ve always had a major problem with this but it’s usually met with we will have lower quality doctors. 

[Pete]

And that's horse crap and they know it.

[kim carnes]

Med schools turn away a bajillion well qualified applicants every year.  We have plenty of supply of brains and the requisite "hearts" to do the job.

I’ve always had a major problem with this but it’s usually met with we will have lower quality doctors.

I mean, you would.  Obviously, the more selective you can be the better quality of individual you can find. Is there a difference in quality between a Harvard mba and a UMKC mba?  Goodness.

[Pete]

Med schools turn away a bajillion well qualified applicants every year.  We have plenty of supply of brains and the requisite "hearts" to do the job.

I’ve always had a major problem with this but it’s usually met with we will have lower quality doctors.

I mean, you would.  Obviously, the more selective you can be the better quality of individual you can find. Is there a difference in quality between a Harvard mba and a UMKC mba?  Goodness.

Don't you mean "is there a difference between a Harvard MD and a UMKC MD?"  The answer is that you don't know because you've never been treated by a Harvard MD.

[Pete]

Academic test proficiency as a predictor for MD effectiveness is hardly a proven fact.

[chum1]

Don't they all basically follow the same standards of care?

[wetwillie]

It’s an artificial barrier to entry to keep wages high.

[cfbandyman]

How can we be the only western country who can't figure out how to do this?

well, mostly we pay our doctors twice as much.

We pay over inflated costs for things that don't cost that much, it's profiteering and racketing that is going on, not docs being paid out the wazzu

[cfbandyman]

I’m not clicking on that bc no one can say how much it will cost bc there is no way to know.

lol

Mich I’ve seen the projections many times and they’re all based on cutting reimbursements and administrative costs.  Good luck telling healthcare providers they’re now getting half as much for their services.

Cut them.  Some of the charges are ridic.  For instance, I saw an article the other day comparing cost of covid tests for cash patients vs insured.  The specific test they had info on cost cash patients $110.  Same provider and same test from same location was being billed to insurance for $720.  This is a pretty common story you hear across the industry.  So, uh, yeah, reduce and regulate. 

The argument that we have the best care providers in the world and that we have that because of what they can make here is a bullshit argument too.  Sure, we have the best docs, however, most ppl on this blog or that you know can't afford them.  If you do get to see them, you will be in debt for a long time.  If we go M4A, they aren't leaving either.  They will offer their services to the same people they do now as a concierge service above and beyond M4A coverage.  Anywhere else you think they would move to already has universal healthcare.

There is not reasonable argument for the current system unless you are a specialist, in the pharmaceuticals industry, or insurance. Everyone else is being hurt by it.

Yes, agreed to all of that, there is a ton of money tied up into it.

Overall, and once again I state this, we pay more, for less per capita and we're sold it's the best in the world, when it is isn't. It's ridic.

Also, it's crazy to thing that the money you pay, is only half the story, the company matches that on the other side, bit no one ever thinks about that too...

[kim carnes]

The per capita cost for healthcare went up 250% from 1998 to 2018.  Gonna wager a guess that physician salary hasn’t gone up even 100% since then so you might want to start searching for some other cuts.

[sys]

We pay over inflated costs for things that don't cost that much, it's profiteering and racketing that is going on, not docs being paid out the wazzu

it's certainly not the only factor (drug pricing was mentioned earlier), but the main reason we pay outrageous prices for things that don't have outrageous input costs is so that the health care providers can pay their employees much more than health care workers make in other countries.

[catastrophe]

Don't they all basically follow the same standards of care?

Yeah I think ole Kim wasn’t even comfortable using actual MDs in the analogy because the difference between a top and bottom educated MBA or JD is clearly different than with an MD.

There are definitely some doctors more on the cutting edge of research when it comes to specialties like allergies, genetics, or specialized surgery, but the curriculum has so little to do with that compared to residency and getting licensed.

[kim carnes]

Don't they all basically follow the same standards of care?

Yeah I think ole Kim wasn’t even comfortable using actual MDs in the analogy because the difference between a top and bottom educated MBA or JD is clearly different than with an MD.

There are definitely some doctors more on the cutting edge of research when it comes to specialties like allergies, genetics, or specialized surgery, but the curriculum has so little to do with that compared to residency and getting licensed.

My point was about selectivity of educational institutions.  All MD schools are selective to my knowledge.

[michigancat]

Harvard MBA's just have better networks

[wetwillie]

I think there is some nuance being lost on this discussion around how much money we spend on on health care at end of life.

[Rage Against the McKee]

Yeah, adding death panels to M4A would save a tremendous amount of money.

[Stupid Fitz]

I think there is some nuance being lost on this discussion around how much money we spend on on health care at end of life.

True, there is probably a better solution than the current one where in our last years on the planet we will all most likely give everything we have left from a lifetime of work to hospitals or insurance companies as opposed to our families, but 

[8manpick]

Sounds like Kim Carnes works for Big Insurance