patrick.net

bob2356 says

Yes there were no residencies in the good old days when people did surgery without anaesthesia bare handed with a cigar in their mouth.

You are describing the Civil War era army surgeon on the pay of the government. In the private sector, would you spend your own money to go to a surgeon like that? So why do you think many others would?

The irony is that, monopoly-driven high cost and consequent public-pay medicine that you advocate is precisely what leads to mice/roach infested hospitals in Cuba and Venezuela as well as in VA hospitals in the US.

Quality of service is a result of consumer choice while spending their own money, not that of the bureaucratic foremen on a slave plantation (which had single-payer "free" medicine for slaves).

bob2356 says

Want ot post the statute the AMA got passed to restrict the supply of doctors? I'll wait

It's called board licensing requirement. The number of new licensees approved each year to practice medicine is pre-set via committee process, not based on how many graduating students are competent enough to practice medicine. That's the classic evidence of a monopoly restricting supply.

Reality says

bob2356 says

Yes there were no residencies in the good old days when people did surgery without anaesthesia bare handed with a cigar in their mouth.

You are describing the Civil War era army surgeon on the pay of the government. In the private sector, would you spend your own money to go to a surgeon like that? So why do you think others would?

What do you think medicine was in the pre resdency days? That was all there was. Modern anesthesia didn't start until the 1920's and IV anesthesia didn't start until the late1930's. Yes you paid for it because that's all there was. One of the first residencies was anesthesia.

Reality says

The irony is that, high cost and consequent public-pay medicine you advocate is precisely what leads to mice/roach infested hospitals in Cuba and Venezuela as well as in VA hospitals in the US.

WTF are you babbling about? What is public pay medicine? Is that like the rest of the first world that gives better medical care for half the cost? Funny you said Cuba, I actually toured a hospital and school when I visted Cuba. Very clean, no mice or roaches. Cuban kids start learning english in 2nd grade.

Reality says

Quality of service is a result of consumer choice while spending their own money, not that of the bureaucratic foremen on a slave plantation.

So 75-100k a year private medical schools provide better quality of service than 30-50k public medical schools? You are saying we would have a lot more doctors if everyone went to a 100k a year private medical school?

bob2356 says

Want ot post the statute the AMA got passed to restrict the supply of doctors?

Still waiting. and waiting, and waiting, and waiting.

Reality says

very high salaries are actually very rare in the private sector,

ROFLOL.

Reality says

If the public sector executives believe they can pull $million+ salaries in the private sector, let them go to the private sector and compete down executive pay in the private sector!

Many do, there is a constant churn between private industry and public service. You didn't get the memo? Try again.

Goran_K says

bob2356 says

Public entities are beholden to the politicians who are beholden to the voters. If voters want to stick their heads in the sand and fail to hold their politicians responsible that is their choice. Oregon has public referendum. Anyone is free to put a referendum on the ballot to reform PERS, but it hasn't happened yet.

Yes I agree. But here it seems that there is an admission that political corruption could skew what is fair or outrageous in terms of compensation.

Sure it could, that's what journalism and voting are for. Compensation committees don't skew? Usually without stockholders having a vote. Compensation committees are the ultimate incestious relationship.

bob2356 says

What do you think medicine was in the pre resdency days? That was all there was. Modern anesthesia didn't start until the 1920's and IV anesthesia didn't start until the late1930's. Yes you paid for it because that's all there was. One of the first residencies was anesthesia.

Not sure what you are trying to say . . . that US government genetically engineered/invented the opium poppy plant 4000 years ago? As anesthesia started 4000 years ago with the discovery of the medicinal use of the plant. The early 20th century "modern anesthesia" was just a packaging exercise: only allowing licensed "patent medicine" makers to use the plant extract while outlawing all other vendors using the same plant. Attributing the invention of IV to AMA is just silly. Do you think every medical invention during Obama years were due to Obamacare? and every medical invention during Trump years as result of abolishing/modifying Obamacare?

Medical students in the 19th century had post-graduate internships before practicing on their own even before there was board requirement to practice medicine. What happened at the beginning of 20th century was the AMA board licensing requirement and FDA approval requirement, both designed to raise the profit margin of licensed monopolies.


bob2356 says

WTF are you babbling about? What is public pay medicine? Is that like the rest of the first world that gives better medical care for half the cost? Funny you said Cuba, I actually toured a hospital and school when I visted Cuba. Very clean, no mice or roaches. Cuban kids start learning english in 2nd grade.

Have you not heard of the Potempkin Village? What you saw was not the average affair for typical Cuban people, not even for the typical local elite, but a "model hospital" that is specifically put together to showcase to foreign "useful idiots" like Walter Duranty and latter-day "fellow-travellers" like him.

"Better medical care for half the cost" in other first-world countries largely because they don't have administrators pulling multi-million-dollar annual salaries and pensions . . . aren't you trying to say multi-million dollar high executive pay is justifiable?


bob2356 says

So 75-100k a year private medical schools provide better quality of service than 30-50k public medical schools? You are saying we would have a lot more doctors if everyone went to a 100k a year private medical school?

Nope. You are the one trying to say higher payer/cost is a good thing. I'm advocating removing the licensing requirement altogether . . . so if people want, they can learn medical knowledge on their own, take medical exams (run like private testing services, like SAT, not like the current board exam run by AMA as a political lobby for restricting supply), then find their own internships and open their own practices, so the cost can be much much lower! If people want to pay $100k/yr of their own money to get a solid gold degree (and a solid gold toilet to go with it), let them spend their own money; there shouldn't be a board licensing requirement that limited the number of new licenses each year in such a way that the $100k/yr graduate is more likely to find match in hospitals (once again limited in supply due to licensing requirement) in high standards of living parts of the country than the $30-50k/yr medical school graudates (who are currently more likely to find opening in poorer parts of the country, therefore would make less on the new job). Removing licensing requirement would result in far more doctors and far more hospitals competing for customers.

bob2356 says

bob2356 says

Want ot post the statute the AMA got passed to restrict the supply of doctors?

Still waiting. and waiting, and waiting, and waiting.

Have you not heard of the board licensing requirement for practicing medicine? You are just pretending to be stupid.

bob2356 says

Reality says

very high salaries are actually very rare in the private sector,

ROFLOL.

Reality says

If the public sector executives believe they can pull $million+ salaries in the private sector, let them go to the private sector and compete down executive pay in the private sector!

Many do, there is a constant churn between private industry and public service. You didn't get the memo? Try again.

Not sure why you were laughing. The churning is necessary precisely because there are not nearly enough private sector positions with salaries in the $1.7mil+. The tax-payer funded monpolies have to be drafted to keep paying them those high salaries.

So the university mission is to avoid saving tax dollars by giving millions away to few individuals... how is that not wrong?


bob2356 says

Reality says

It is outrageous because these are non-profits and/or their services largely paid for by tax money (i.e. government granted monopolies). By your math, DOD having a 700B annual (public) budget, should the secretary be paid 360 million dollars a year? and a pension of $180,000,000/yr? What about the head of the social security administration or the POTUS supervising even larger annual budgets?

According to KPMG audit from last year OHSU got 33 million in tax money out of a revenue of 3.1 billion. That is 1% of revenue. What exaclty is your defintion of largley?

Ridiculous to compare large federal agencies to autonomous public corporations. The mission and job is totally different.