There is one truth that trumps all of Obama's claims-not enough supply to meet the increased demand with more insured.

Be honest--why did universal care fail in UK and Canada? Why do they need to come here? The answer is they can not get care in a timely manner because there are not enough professionals to handle the load.

Obama admits there are not enough PCP's. They not only check you out they make referrals to specialists. PCP's are saying they cannot add any more patients. If they are forced then that means you will wait a long time to get treatment just like Canada and UK.

Obama has not quick fix. It takes 8+ years after college to produce a doctor. 8 years folks!!! Not to mention they are planning on cutting the payments to docs. So what would you rather do--pay for med school, go broke for 8 years to get a job working 70 hours per week, 280 days peer year at $80,000, or work 180 days at $60,000+ with lifetime benefits when you retire as a school teacher.

Most of America opposes Obamacare. Those that favor it are buying into all the claimed outcomes and ignoring what has happened in at least 10 countries who have tried Obama care.

Why revamp the care we have? We can address the 40,000,000 with clinics using volunteers, interns, and non certified docs and nurses and ask everyone to pay according to their incomes. We can get national tort reform which has proven to lower premiums and healthcare costs, but we have to get the insurers to pass the savings on rather than keep the profits. Docs will not be ordering tests you don't need to cover their asses from the greedy lawyers.

Obama promised that he would stop the lobbist, but the fact is that trial lawyers, big pharma, are making deals with Obama and running ads to promote Obamacare without tort reform or without any negotiations on prescriptions.

Obama will gain at least 30,000,000 votes for the Dems if he gives away insurance to the underclass and uninsured----that is the reason why he wants to screw us, make us wait for services. We lose--Obama wins and special groups get to keep their care. The private sector will bail out of providing good benefits as soon as there is a public option---and you know it!

Be honest--why did universal care fail in UK and Canada? Why do they need to come here?

If universal care is such a "failure," why are the British suddenly speaking up in defense of their system?

And you act as if American health care is so wonderful that Americans would never dream of going anywhere else for treatment. I suggest you Google the term "medical tourism" and get back to us.

Right now there is indeed a shortage of doctors and nurses in America. We have dozens of counties in Texas that do not have a single doctor; residents have to drive many miles to urban centers to get treatment. This a result of our American system, mind you.

I used to live in France and it never happened to me to have to wait more than a day to see a doc. I made several visits as well in the Emergency services with quite benign stuffs such torn ankles (I can be a bit clumsy) and didn't wait more than 2 hours to get checked, X-Rayed and treated. And still they have (I had there) universal health care. And there doesn't seem to be a shortage of docs and nurses, as the college admission exams are extremely selective (only something like 10-20% of the applicants are accepted)

They are a relatively small country and have addressed the suppy/demand situation. In America we have not and we have forced experienced docs to get out. Why? Docs incomes have risen about 40% over 10 years , but their net after paying for mal practice insurance has declined since mal practice insurance has increased 300%

Please tell me about mal practice and insurance costs in France. I would like to know and so would those who point to France as a sucessful implementer of universal care.

gmajesko:

They are a relatively small country and have addressed the suppy/demand situation. In America we have not and we have forced experienced docs to get out. Why? Docs incomes have risen about 40% over 10 years , but their net after paying for mal practice insurance has declined since mal practice insurance has increased 300%

Please tell me about mal practice and insurance costs in France. I would like to know and so would those who point to France as a sucessful implementer of universal care.

Tort reform was passed in Texas back in 2002, I believe. We were told that it would cut down on health costs, and would make it possible for more doctors to work.

It hasn't happened.

As is the case with most conservative arguments, it's just not true.

Those who do get treated satisfied. If those who can't get treated didn't come here their life expectancy would be substantially lower.

So where do we go if we can't get treated here? France won't take us? Please tell me where, because you know that there is a shortage of certified docs and we must solve that problem first if we want a program as good as the French.

gmajesko:

Those who do get treated satisfied. If those who can't get treated didn't come here their life expectancy would be substantially lower.

So where do we go if we can't get treated here? France won't take us? Please tell me where, because you know that there is a shortage of certified docs and we must solve that problem first if we want a program as good as the French.

It took my mother six months to get approval from her insurance company for a surgical treatment that they originally insisted was unnecessary, despite repeated protests by her and her doctor to the contrary.

Here's what it comes down to: Americans pay a shitload of money for coverage that doesn't even cover everything. You still end up shelling out hundreds, and sometimes thousands, of dollars for procedures, even after you've paid your premiums for years.

Canadians pay $108/month for a family of four. It's not a perfect system; neither is ours. But for the money, who wouldn't take it? How much does a family of four in America pay for coverage? A hell of a lot more than $108/month, and that doesn't count copays and additional payments that your insurance doesn't cover.

I'll take some delays for elective procedures if it means I don't have to pay so much every month. I'll gladly do it.

So where do we go if we can't get treated here? France won't take us? Please tell me where, because you know that there is a shortage of certified docs and we must solve that problem first if we want a program as good as the French.

My uncle and my grandmother and aunt all go to Mexico. They've been doing it for years. My uncle even got a facelift in Mexico once; came out perfect, at a fraction of the cost.

Thailand is a popular medical tourism market, too. The technology is modern, the doctors are well-educated, and you pay very little compared to what you pay in America.

gmajesko:

Be honest--why did universal care fail in UK and Canada? Why do they need to come here? The answer is they can not get care in a timely manner because there are not enough professionals to handle the load.

The Canadian system has failed? That's news to me. I can see my doctor on the same day I make an appointment!

You probably don't realize it, but universal care would solve a big part of the malpractice problem. I large portion of malpractice suits involves continued care for medical negligence. If we had a universal coverage system, those suits would disappear. I don't know if this issue has been studied by a non-partisan group, but I would guess that it may have as large of an effect as, say, capping damages at a specified dollar amount.

National tort reform will work with the cooperation of private insurers. It is the place to start to lower costs. Also clinics (paygo), address the two problems cited by everyone-the uninsured and costs. Leave well enough alone and solve the problems. Isn't that what you do in your daily life?

gmajesko:

Your post is replete with innuendo, conjecture and speculation and completely lacking in any evidentiary support.

You say that most of American opposes Obamacare. Where is your support for this statement? What is Obamacare, given that the health care overhaul legislation was written by the United States Congress? Or is it possible that you just hate Obama so much that you believe that tacking his name onto something will make it less palatable to the masses.

You say that doctors will go broke for 8 years to get a job working 70 hours per week, 280 days per year at $80,000. Where do you get this? Is there a provision in the current statute that indentures doctors to perform services at that wage? Or, as I suspect, are you just making shit up? The 70 hours per week number -- where did it come from, other than your imagination? The $80,000 wage -- where did it come from, other than something you heard somewhere?

What is a "non certified doc and nurse" referred to in your post? I can guarantee you one thing, a "non certified doc" or a "non certified nurse" is neither a doctor nor a nurse. In order to be a doctor, one has to be able to append M.D. or Ph.D. to one's name based upon the completion of a degree program from an accredited educational source. In order to be a nurse, one has to be able append R.N., L.P.N., or something similar to one's name. These non certified individuals to which you refer aren't going to be permitted to practice medicine under any state or federal statute currently in existence, and I can guarantee you that real doctors and real nurses will object mightily to allowing those who are inadequately educated and/or inadequately trained to perform the same procedures that they perform.

Finally, please provide evidentiary, not anecdotal, support for your position that in Canada & UK, one must wait a long time to get treatment. If the US is so great, why were we most recently ranked 37th in the world by objective health care measures, vs. Canada (30th), the UK (18th), Saudia Arabia (SAUDIA ARABIA, for God's sake, 26th), Colombia, Costa Rica, Dominca, and and Chile -- 22, 33, 35 & 36). Do you know who is right below us? Slovenia and Cuba. Woohoo, we're SLIGHTLY better than Slovenia, Cuba, and Brunei, all well-known as hotbeds of medical competence.

Your lack of actual information is embarassing. I know that it is really fun to just make knee-jerk decisions based upon the most recent ramblings of whatever political source you have chosen to follow, but seriously, every once in a while it's great to do the intellectual work for yourself and make a decision based upon facts, not lies.

Good points, Emmajane.

One of the problems I think is that we're so incredibly used to the inflation of prices that we've stopped attempting to link it to anything real, we simply accept it.

It has been established that the costs for colleges do not increase half as dramatically as tuitions do. Why exactly is it that higher education costs so much? And why have we become blithely content with saddling burgeoning young graduates with more debt than anyone ever got unless they were addicted to the ponies?

The idea that there is no breaking limit for the amount education should cost, coupled with the inane idea that top-notch education is inextricably bound to exorbitant tuitions is a significant part of medical costs. This is what happens when you allow profit margin to drive EVERYTHING.

If costs don't increase, but tuitions and rates do, far outstripping inflation, then it becomes way too costly for people to become doctors or nurses without looking for cosmetic and elective disciplines.

What I don't understand is why a person has to graduate college before they go to medical school. You can get into medical school with a degree in English and less than the equivalent of two years of premed studies, most, if not all can be taught in high school. A medical degree should be an undergraduate degree just like a BS in any engineering specialty. You would save four years of tuition and after one year of internship a medical student could become a physician and would not be as loaded down with debt.

Mlang:

Do you want a 24 year old fully qualified M.D. removing your gall-bladder?

All professional schools (M.D., R.N., J.D., MBA, DVM) require an bachedlor's degree as a pre-requisite to admission. Many professional schools also require that the applicant have a grounding in certain specific subjects before they are admitted -- in the case of med school, those could include college level biology, organic chemistry, etc. Part of the requirement of a 4-year-undergraduate degree is, I'm sure, self-perpetuating on the part of the college, however, I will assert and will stand by the assertion, that no one is ready to practice medicine without intense supervision at the age of 24 (the minimum age assuming that the individual graduates HS @ 18, does 4 years of college & one year of internship).

Sure, it's expensive to become a doctor. Maybe the best way to deal with that issue is to increase the community's investment in medical education. In return for the graduate being involved in public health for a minimum period of time (say ten years) after graduation, the student receives a tuition credit. I believe, actually, that a program quite similar to this already exists, in which various states will subsidize the medical practices of physicians who choose to practice in underserved areas. An expansion of these programs, perhaps, will help to increase the supply of physicians.

I would note, and I didn't before, that the fact that we have a supply problem is indicative, in part, of the dysfunction of our current system. Primary care doctors have been forced out of practice in poor communities, not because of government health care, but because there is no government health care. I've posted this before, but I would encourage everyone to read Dr. LeBow's excellent book entitled "Healthcare Meltdown, Confronting the Myths and Fixing our Failing System." It's not as sexy as Glenn Beck's diatribes or Sarah Palin's death panels, but it actually bears a resemblance to reality and good policy.

Finally, by way of anecdote, my father, who is a retired physician, volunteers for a low-income medical clinic serving primarily migrant workers in the State of Idaho. He is a life-long Republican. He has come to believe with every fiber of his being that we need a single payer system, and a single risk pool, and that the elimination of private healt5h insurers, far from ruining the health care system, would dramatically enhance the quality of care available to all Americans and not just the privileged few who have employer sponsored health insurance.