Those of you who do.
I don't understand this.
Please post a quick note, whatever you care to express. I don't mind if you're sarcastic or derisive, its just that I'd just like to hear some thoughts and this seems like a good place to ask, people on this list are articulate and seem to have a lot of personal experience.
I actually kind of don't expect much of a response, its a touchy subject to come right out and ask about, but I hope so.
Its healthy to be skeptical and all, but I see so much hate of "gov" here in the US, so much unfocused rage. What exactly is the issue/s?
I appreciate anything anyone cares to offer.
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SF ace says
As someone who used to do medical office management software and medical office management consulting work I can tell you your expense numbers are way, way off to the low side. If you can hire medical coders for 2500 a month then you have found the key to great personal wealth. Open a coding business today, don't hesitate. On the revenue side, as several people have pointed out, the insurance billed amount is a meaningless number. It's just part of the game of negotiating with carriers. What is paid is always a lot less.
Doctors make damn good money, but they more than earn it. It's more than fair compensation for 12-17 years of training, including 4-8 years of residency at 100+ per hours per week, racking up student loans for 8 years, giving up 8-12 years of retirement contributions while going to medical school and residency, being on call constantly, being called into the hospital at 2 am for 4 hours then going to the office all day, making life or death decisions frequently with poor or incomplete information knowing an error or even bad luck will land them in court with a gaggle of lawyers second guessing them.
Sure there are doc's out there making 500-600k. They are the guys who went to the brutal 6-7 year residencies, followed by 2-3 years of fellowship, followed by years of developing their skills and reputations. The vast majority of doctors, the bread and butter GP's and Ped's and OB people, are making in the 100's to low 200's. Like the man said ass, gas, or grass no one rides free. You want to give up another 4-6 years of your career you can earn a lot more.
I do think the docs who own medical related business and refer to their own business are in a very serious conflict of interest situation that is probably unethical. The highest cost of medical care is in area's where a lot of these arrangements proliferate. South Texas comes to mind. The lowest cost of care is were the doc's are employed by the hospital and the hospital manages costs carefully. Read up on the Mayo or Cleveland clinic sometime. The obvious question is why health care reform isn't based on these working models.
Medical school applications are way down. If it's such easy money for an easy life then apply. Otherwise don't complain. Talk is cheap.
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iwog says
talk to me when the PIIGS take out the Euro (germany with it) and Japan, are you serious? Japan awaits your immigration application. Have a nice lost decade(s). Wait I thought you were talking about Europe. Keep changing the subject much? You are running out of straws and arguing for the sake of seeing your own typing.
Your big government is too big to succeed. It will go the way of all governments that lose touch with the purpose of government and begin to cater to the corrupt wanting handouts and corporate interests demanding the same.
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I didn't see a single word devoted to my question. Not even a weak attempt!!!
HOW DO YOU EXPLAIN GERMANY?
EVERYTHING you post is extreme and absolutist. You hold views that 95% of Americans would reject instantly. You want to abolish Social Security and laws against selling drugs in vending machines. You're as radical as they come.
But you completely fail when it comes to real world examples. There's no room in your universe for a Germany or a Japan or a Canada. They can't exist. So how do you explain them? They are succeeding despite your repeated claims to the contrary.
The BEST you can do is say "They'll get theirs someday." Don't you understand how pathetic that is?
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bob2356 says
No "probably" about it - it's unethical, period. People have the right to choose providers, but this is often not mentioned.
iwog says
Does he exist in the real world?
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Why do you want to talk about Germany? Do you want to live in Germany?
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Germany is a parallel trial of government policy. We can analyze what they're doing right and wrong and synthesize policy changes for our own, differing, national socioeconomic experience.
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All things being equal this might be an interesting avenue for comparison. However all things are not equal. For example how can you compare a country who spends a massive portion of GDP on war and military occupation to one that spends only a tiny fraction on military? How can you compare the country where most medical advancements are made to anyone else who is riding on our coatails? How can you compare the country with the largest GDP to one with a GDP a quarter of the US? What gave US the largest GDP, perhaps lack of socialized medicine for one? How much higher would Germany's GDP be if it had lower taxes/socialism?
I find your comparison of apples and oranges to be a distraction at best. Arguing that Germany can afford their welfare state (at least for now) so we should expand ours too is asinine.
And lets not forget that Germany is a competing country. It has different form of government, offering an alternative to ours. Why would we want to copy them? There is already one Germany do we need another? People who like it should try living there. Is that what made America great, copying Europe?
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Once again it doesn't seem like you understand your own arguments. You give lots of reasons why Germany MUST FAIL then apply those reasons to the United States to try and ward off a more invasive governmental policy.
Now you seem to be saying "Germany would fail if it had our military and our medical advancements." (you should try and list those sometime) The GDP statement is odd. Are you saying that socialism is more successful in nations with a smaller GDP? I think most people would be satisified with the fact that our per capita GDP is almost identical.
I think the bottom line here is that your horror stories don't come true. National health care actually works. Government intervention in industry actually works. Not in 1950, but NOW!!!!
You're only left with one final argument. "It wouldn't work in the United States because (insert reason why the United States is inferior)" Instead of you asking me why I don't move to Germany, perhaps I should be asking you why you choose to stay in an inferior country? (by your own reckoning)
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AdHominem says
The coattail argument is rather bogus. Big Pharma spends 3X feeding the fat compared to R&D. Read any income statement, let's take GSK:
Topline $28B
COGS $7B
SG&A $9B
R&D $4B
Tax $2B
Shareholder profit $5.7B
Germany isn't riding on our coattails wrt drugs. We're just getting screwed sixways from Sunday.
Is that what made America great, copying Europe?
Pretty much, yes. We were burning witches and busy clearing forests while Europe had its Enlightenment. Adam Smith, Thomas Paine, and the pre-Revolutionary French milieu all had their impact on the social development of the colonies and nascent US.
It was the British Industrial Revolution we copied and accepted lock, stock, and barrel, and then built from there.
Then when things got wacky in the Gilded Age it was the Bismarckian social reforms and the British Liberal movement that inspired the Progressive era reforms of the early 20th century.
If you want to look to systems we can learn from, you've got to look at Europe state socialism, since going the otherway just results in the economic destruction of oligarchy and kleptocracy of the third world.
Middle classes can only exist where the state reigns in the predations of the upper class and provides ladders for the lower classes.
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Troy says
And which German created drugs are on the top 100? Any in the top 200? Hmmn, their socialized medicine and overly regulated economy doesn't exactly attract the top investors and bring the most innovation does it?
Troy says
Too bad it didn't take, at least not much in Europe.
Troy says
Oh, now we are talking economics/technology? Yes, socialism excels at bringing out the best in these things. It must have been socialized medicine that enabled the Industrial Revolution right? Right?
If only they had rolled out socialized medicine in Roman times we could have avoided the dark ages and still be living in the only world government that didn't fall apart.
Troy says
Are you talking about our great Federal Reserve bank and the host of welfare programs that are set to go bankrupt?
Troy says
Are you trying to tell me what to do? I thought this was a free country. Do you want to give me any other orders captain?
How about we look at USA pre 1913. Yes that is right Pre-Fed. It was a good time. Money represented a store of value that could not be debased at the whim of a central bank. Banks could not leverage so much they could never repay and expect a bailout.
Oh I know Iwog will say babies were dying in coal mines. Wants to throw the baby out with the bathwater. But what he doesn't want to admit is that HIS DREAM of reviving the new deal today in an already bankrupt country will only mean China takes over as top dog sooner rather than later. We could barely afford it then, now that we are on the brink of collapse in debt it would surely drive us over the edge.
Troy says
Pretty close to accurate, as long as government is small enough to prevent these predators from using the state to do THEIR bidding. Which sadly is what is happening now.
Troy says
Not sure what you mean by "ladders." If by ladders you mean literal ladders so they can use them to become orchard man and window washers maybe. But if by ladders you mean free medicine, housing, and all the other necessities of life, you should live in the mobile home park I grew up in full of families just living off your dime. And the only way we got out was to go into debt. I'm not sure we made the right decision. We could work a lot less, have better health care coverage and never have to worry about losing a job again. Let the system work for me as one welfare recipient so proclaim his mission in life.
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AdHominem says
Perhaps you've heard of Bayer, or Merck, if not Boehringer Ingelheim. What do you mean by top 100? Over the counter volume? Prescription volume? Quality? New drugs?
?????
Bayer is #3 ranked worldwide.
Germany is well-respected for their engineering skills as well, some people I know prefer German products over Japanese, particularly for cars.
Oh wait I forgot USA USA USA!
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AdHominem says
I guess you've never heard of Bayer, Merck KGaA, or Boehringer Ingelheim. They have some of the largest pharmaceutical companies in the world.
You really need to retool your thinking.
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Vicente beat me too it.
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AdHominem says
Nothing a few tax raises back to Clintonian if not Nixonian levels can't fix.
Yes, socialism excels at bringing out the best in these things. It must have been socialized medicine that enabled the Industrial Revolution right?
Your railing against teh socialism is rather content-free and on the order of paranoia or something. The UK and Germany both partially socialized their economies prior to WW I -- in response to even more radical big-S Socialists who really wanted to bring private enterprise under the heel of the State.
There are two kinds of socialism. The shitty kind like under Pol Pot and the kind that Eisenhower/Nixon-era Republicans would recognize and not necessarily oppose. The French, Germans, and the rest of the Eurosocialists operate towards the latter end of the spectrum.
Are you trying to tell me what to do? I thought this was a free country. Do you want to give me any other orders captain?
No, you're free to remain your special snowflake self. Don't ever change.
How about we look at USA pre 1913. Yes that is right Pre-Fed. It was a good time.
No it wasn't. The emergent industrial economy of the late 19th century was a continual series of monetary and economic boom/bust cycles.
Life sucked for tens of millions of Americans, and it was only thanks to the Homestead Act and the millions of productive land available for the taking that the economy grew and prospered as it did.
The problem was a great imbalance between labor and capital, what the railroad gaveth the railroad barons took away.
William Jennings Bryan was the teabagger of his day. He got pretty far until coopted by the Democratic establishment under Wilson.
But if by ladders you mean free medicine, housing, and all the other necessities of life, you should live in the mobile home park I grew up in full of families just living off your dime.
Not free, just government-run insurance and financial aid such that everyone has the resources to become and remain a productive member of society. We're an immensely productive people but anyone with a passing understanding of history realizes that free market fundamentalism is suboptimal compared to the mixed economy the US established and grew under ca. 1940-1980.
The economy ran off the rails somewhat in the 1970s thanks to Vietnam, going off the unsustainable foreign gold standard, necessity to weaken the dollar and the associated oil shocks, granted.
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Vincente, don't get me wrong, the Germans can make a good product. Hey, if it wasn't for us they probably would have taken over the world. Of course we are the fourth Reich dressed up in the guise of bringing democracy to the world.
And in many ways America is not just the New England it is the New Bavaria as well (english edged out german when we voted on a national language). Politics aside of course.
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Well, we agree on most things Troy, so I guess the biggest difference is that I never called you a snowflake.
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Troy says
or a freeloader
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AdHominem says
No.....they CAN'T make a good product. Socialism and taxation result in economic collapse remember?
If we're afraid of freedom, the Germans are scared shitless of freedom. Yet they seem to be doing fine. Is it possible that your economic arguments don't actually work in practice? Is it possible that the United States might actually be able to give every citizen health care WITHOUT it destroying jobs and ruining our precious multi-national corporations?
I think maybe yes. That's a far cry from what you've been preaching here.
Do you know that in France, unions are forced on Wal-mart by law? It's very strange that you'd insist raising the minimum wage would result in layoffs, yet Wal-mart keeps opening new stores in "socialist" nations anyway. Very interesting.........
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Iwog,
I NEVER said raising minimum wage causes layoffs. It does however cause unemployment by reducing the amount of employees that a business will HIRE. Lower the minimum wage and I guarantee more people will have jobs.
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iwog says
GIVE no, provide maybe. How do you propose we pay for it? And can I opt out?
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AdHominem says
Well because it's YOU.... not only no but HELL NO!
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Anyone else feel like they're changing diapers here?
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elliemae says
Yes . . . in Oil City, PA.
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Nomo, you always make me laugh.
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Vicente says
Ah yes, dictatorship! Hail Vincente! King of .....
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AdHominem says
I was making a feeble attempt at Ad Hominem. Now I'm a sad panda you didn't like it.
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Vincente, to properly use Ad Hominem you need to actually attack the credibility of the witness, usually because you do not want to acknowledge that you are standing on thin ice with your own warped views. Ellie and Nomo are good at it. It is their bread and butter. In fact it is just about all Ellie is good at and Nomo does it just for fun, though as he mentioned earlier we agree on 99% of things so he does it just for fun too. My response of Ad Hominem is therefore reserved for those who envoke it first.
But thanks for playing it makes you feel cool to be part of the gang puttin' down the guy who is different doesn't it?
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Oh, my gawd! I knew it! You think I'm COOL!
WTF is "envoke?"
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http://www.glennbeck.com/content/articles/article/198/36618/
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Bap33 says
Ol Glenn Beck is trying to throw the Republican party under the bus.
It was inevitable, but I'm surprised he did it this early.
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I don't usually like Krugman, but he had a good take on GOP bait-n-switch tactics.
So, lacking the political directness to tackle the SPENDING problem head-on, this misdirection has benefitted them NOW. They probably delude themselves they will be the recognized adults in the room after the crackup-boom. Most historical currency and deficit crisis though, just advance the whackiest elements not the ones who thought they'd be in position to profit.
The Bankruptcy Boys
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iwog says
My prediction after Obama took the white house was that the Republican voters were going to split into two major parties:
1. The Sarah Palin / Glenn Beck / Crazy ass nutjobs who rant and rave but don't know what the hell they're talking about. They're ignorant and proud of it.
2. Bob Dole / John McCain "traditional" Republicans. People in the Reagan mold. They like low taxes, but also like big spending. They're not idiots, but they're also die-hard politicians and are more concerned about winning elections than doing the right thing.
Legitimate fiscal conservatives have nowhere to go, because they're not crazy enough to win votes from group 1 and too conservative to win votes from 2 (see CPAC booing Ron Paul for evidence)
I suspect many of group 2 will wind up changing party affiliation to democrat, not because they suddenly like gay people and minorities, but because they don't want to live in a third world country either.
As we get closer and closer to the mid term elections, I'm confident that this is exactly what's going to happen.
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Adhominem says: "I NEVER said raising minimum wage causes layoffs. It does however cause unemployment by reducing the amount of employees that a business will HIRE. Lower the minimum wage and I guarantee more people will have jobs."
The minimum wage has more or less been undermined by inflation to the point where few employers would bother offering jobs for less. At least to legal workers. Which makes small businesses that engage in such practices little different than chemical companies that cut back on costs by dumping asbestos and PCB"s into the river. Hey! You're saving 10 cents a can on bug spray! Quit whining!
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In the beginning of change, like now, true patriots are ridiculed, hated and scorned. Career politicians and their supporters claim that criticism of government policies are dangerous to the country and label critics as subversives...even "terrorists".
Rebels, traitors and enemies of the state were terms used to describe American patriots by King George III.
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It's funny Honest Abe is your nickname. After all your namesake put down a secession/rebellion by people that considered themselves "patriots" and that Washington DC was no longer their legitimate government. Lincoln seemed pretty liberal/progressive, which makes it more incongruous.
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Let me repeat, in the beginning of change, TRUE PATRIOTS are ridiculed, hated and scorned. Which is what's happening now.
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Honest Abe says
Really? What poiticians have claimed that? Or labeled critics as "terrorists"?
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tatupu70 says
I do believe it's the "true patriots" who called people against the Iraq war traitors and seditionists. One of Abe's heros, Michael Savage, says that liberalism is a mental disorder and on a regular basis calls for the arrest, detention, and sometimes execution of ACLU members, liberal lawyers, liberal judges, and others.
I really don't understand how people can be this blind.
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OK, for one, how about the "leaked" document that was all over the Internet last summer from the Dept of Homeland Security (?) that warned the police to be suspicious of anyone with a Ron Paul bumper sticker. It further stated those individuals may be 'TERRIORISTS'.
By the way, which radio and TV "personalities" today are ridiculed, hated and scorned?
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Honest Abe says
No document warned police to be suspicious of anyone with a Ron Paul bumper sticker. No document said people with a Ron Paul bumper sticker were terrorists.
How do you expect to be taken seriously?