Gas Price.....Too High?
 

In article . net,
Maxprop wrote:

"Frank Boettcher" wrote in message
...

Today the average doctor makes
approximately five times and much and many specialists make 15-20
times.

Where have you been, Frank? 15-20x? Hardly. Nearly all medical
reimbursement to physicians is now third party, and the rates of
reimbursement have been cut dramatically. Whereas a cardiologist could
reasonably presume to earn in excess of $500K per year in the mid-90s, today
they are lucky to clear $200K before taxes on average. Top-notch surgeons
used to earn well over a million per year, but work harder now, do more
surgeries and make half that or less. There are a few physicians in
private-pay only settings who still make the megabucks, but they are few and
far between.

In an industry that controls supply side by the number of
available seats in Medical schools which is way out of proportion to
the talent available.

Really? Have you chatted with emerging med school grads these days? My
recommendation to you is that you'd be well-advised to stay very healthy in
your later years. Entrusting your life to some of these new physicians
would seem riskier than skydiving. Medicine doesn't pay nearly as well as
it used to, ergo the top-notch students don't apply to the schools in the
percentage they used to. They now go into computer-related and finance
fields, where the money is. I was one of 69 optometry students chosen from
a field of nearly 1000 qualified applicants in 1980. Today the entering
class at my school is 60 students drawn from roughly 450 qualified
applicants. Med schools take about 250 students annually from a field of
roughly 1500 applicants, but of the 1250 who don't get into one school,
about 70% of them get into another school. You've implied that the supply
side of medical doctors is controlled ostensibly to keep earning high for
those in the profession. What would you propose? Would you take all of the
qualified applicants in order to spread the money around? And what would
the result of that move be? My best guess is that fewer and fewer qualified
applicants would show up each year. Money and prestige are and always have
been the primary driving force behind the interest in medicine, but are
becoming mitigated more and more each year.

Good. I don't know how much congruence there is between Australian
medicine and the USA, but having doctors who are primarily interested
in curing the sick and preventing sickness strikes me as much better
selection criteria than people who are interested in money & prestige.
I don't have any problem with them having all of the above, just the
order of importance.

Here, at least 1 med school screens candidates on a range of social
factors as well as straight exam performance. Can't see that the
results are noticeably worse.

With the exception of cutting edge research, it doesn't really take
that many brains to be a doctor, and the really bright ones get super
bored anyway if they can't do new interesting things all the time.

Do I know anything of what I'm talking about? Maybe not, but my wife is
a PhD from UNSW Medical school (ie, not a MD) and a department head at
one of Australia's biggest teaching hospitals. I have, unfortunately,
had 30+ years of moderately close social association with doctors and
fellow medical researcher types. They were/are no brighter overall,
than my colleagues in other R&D fields, but God, most *think* they are.

BTW, it's harder to get into vet school than medicine here in Oz. Less
places. Exam score (TER - equiv to your SAT most likely) is as high or
higher for vet as medicine. It's just a rationing mechanism, not a
determinant of needed ability.

PDW

Gas Price.....Too High?
 

Maxprop wrote:

"Frank Boettcher" wrote in message
...

Today the average doctor makes
approximately five times and much and many specialists make 15-20
times.

Where have you been, Frank? 15-20x? Hardly. Nearly all medical
reimbursement to physicians is now third party, and the rates of
reimbursement have been cut dramatically.

That is *one* good thing you can say for Canada's system, only one
entity to bill. In my province you submit your claim to OHIP once a
month, 21 days later they direct deposit into your account. How many
insurance companies do you have to bill each month, do they all have the
same the claim forms, same claim procedure? I'll bet this doesn't do
much to lower your administrative overhead.

Cheers
Marty

Gas Price.....Too High?
 

Martin Baxter wrote:
Maxprop wrote:
"Frank Boettcher" wrote in message
...

Today the average doctor makes
approximately five times and much and many specialists make 15-20
times.
Where have you been, Frank? 15-20x? Hardly. Nearly all medical
reimbursement to physicians is now third party, and the rates of
reimbursement have been cut dramatically.

That is *one* good thing you can say for Canada's system, only one
entity to bill. In my province you submit your claim to OHIP once a
month, 21 days later they direct deposit into your account. How many
insurance companies do you have to bill each month, do they all have the
same the claim forms, same claim procedure? I'll bet this doesn't do
much to lower your administrative overhead.

Cheers
Marty
Medical billing is standardized in the US. Claims are submitted on
a UB-92
http://www.cigna.com/health/provider...forms/UB92.pdf
and coding is done with the ICD-9 code book. The only thing that is
different between submissions is the address on the envelope.

Gas Price.....Too High?
 

On Fri, 05 May 2006 04:46:02 GMT, "Maxprop"
wrote:


"Frank Boettcher" wrote in message
.. .

Today the average doctor makes
approximately five times and much and many specialists make 15-20
times.

Where have you been, Frank? 15-20x? Hardly. Nearly all medical
reimbursement to physicians is now third party, and the rates of
reimbursement have been cut dramatically. Whereas a cardiologist could
reasonably presume to earn in excess of $500K per year in the mid-90s, today
they are lucky to clear $200K before taxes on average. Top-notch surgeons
used to earn well over a million per year, but work harder now, do more
surgeries and make half that or less. There are a few physicians in
private-pay only settings who still make the megabucks, but they are few and
far between.

In an industry that controls supply side by the number of
available seats in Medical schools which is way out of proportion to
the talent available.

Really? Have you chatted with emerging med school grads these days? My
recommendation to you is that you'd be well-advised to stay very healthy in
your later years. Entrusting your life to some of these new physicians
would seem riskier than skydiving. Medicine doesn't pay nearly as well as
it used to, ergo the top-notch students don't apply to the schools in the
percentage they used to. They now go into computer-related and finance
fields, where the money is. I was one of 69 optometry students chosen from
a field of nearly 1000 qualified applicants in 1980. Today the entering
class at my school is 60 students drawn from roughly 450 qualified
applicants. Med schools take about 250 students annually from a field of
roughly 1500 applicants, but of the 1250 who don't get into one school,
about 70% of them get into another school. You've implied that the supply
side of medical doctors is controlled ostensibly to keep earning high for
those in the profession. What would you propose? Would you take all of the
qualified applicants in order to spread the money around? And what would
the result of that move be? My best guess is that fewer and fewer qualified
applicants would show up each year. Money and prestige are and always have
been the primary driving force behind the interest in medicine, but are
becoming mitigated more and more each year. Stay healthy.

You're contradicting yourself Max. On the one hand you talk about
emerging class being substandard as an indication of the pool and
since I know a number of them (but not necessarily a relevant sample)
I can't concur; on the other you talk about 450 qualified applicants
with 60 selected. And I don't believe a high percentage of those not
selected get in at another school.

Are you concluding that doctors if paid $200K per year will become
discouraged, quit the field and become something else, or will as a
result of that "low" pay give substandard service. My position is
that fees will come down with more competition but the pay will remain
attractive to entry.

And that has been going on most of my life. As
a pre-65 forced retiree I spend five times as much for health care as
gasoline. And I'm healthy. And I don't hear very much about that.

Do you really believe physicians' fees are responsible for the high cost of
medical care?

Yes, to the extent of their poroportional impact on the total cost of
health care. Their fees also include their overhead which includes
their liability insurance among other things.

If so, you'd better do some research. Dr. fees are only a
small part of the equation. Hospital costs are a far larger percentage, and
profits to health care insurers is an equally-large percentage.

And I never indicated they were not.

And the
cost of absorbing the expense of hosptial and medical care for the
uninsured, impoverished masses may just be the largest percentage.

Come on Max. Since that slug Dickey Scruggs is suing most of the
hospitals in the country in a class action to make himself another
billion or so dollars, what they spend on the indigent is public
knowledge. Not anywhere near the largest percentage.

In any
discussion of illegal immigration, this factor must be considered, because
it's significant. My wife had an undocumented Mexican patient on her floor
at the hospital who required extensive care and treatment for a period of 6
weeks. After incurring an unpaid and unreimbursed (by the gov't.) bill in
excess of $1million, the hospital wanted to dismiss the patient to long-term
care, but no one would take her. So the hospital covered the cost of
putting the woman on a private jet and flying her to Mexico City, where she
was turned over to Mexican authorities for extended care. My guess is that
they let her die.

But let gasoline go up and the cry begins. Mostly from people driving
urban assault vehicles and throwing their plastic (oil) disposable
junk out the window. And lining up at WalMart to get that cheap
chinese stuff, which is the primary reason for the world market in
energy going through the roof.

Yup. Do you advocate paying more for inferior, more costly domestic goods?
Do you think you'll find anyone standing in line behind you in that
philosophy?

Hitting a sore spot here, Max, since I was one of those domestic
manufacturers making an "inferior" product that was "alledgedly" more
costly.

The product I used to make actually cost a little more now with a
strategy to high chinese content. The Corporate genius were shooting
for a 25% reduction in cost (with a strategy of no reduction in price
BTW). The basic cost is a push, some models higher some models lower,
The warranty element of the cost of quality is four times higher.
With warranty four times higher, relative quality comparison fairly
easy to make. Overall, everybody lost. The end user gets a crappy
product with no choice in the matter, other than the competitors
crappy product. The company is making less money,(so much less that
they sold off the division as a defensive move) and many good people
(with average seniority of 25 years) in this country lost their jobs.
And were talking about $25-35K highly productive people.

Market share for the product is down since it is now "just another
chinese import" garnering no end user loyalty.

And you might ask, why not just reverse it. Once you dismatle U. S.
manufacturing and destroy tooling, the cost of reentry is prohibitive.
If you try to go back you would have "more costly domestic goods"

Don't get me started on this one. Oh, you already have :)

Frank

Max

Gas Price.....Too High?
 

katy wrote:

Medical billing is standardized in the US. Claims are submitted on
a UB-92
http://www.cigna.com/health/provider...forms/UB92.pdf
and coding is done with the ICD-9 code book. The only thing that is
different between submissions is the address on the envelope.

Still you have to keep track of many accounts with diferent providers.

Cheers
Marty

Gas Price.....Too High?
 

Dave wrote:

On Fri, 05 May 2006 07:56:19 -0400, Martin Baxter said:

That is *one* good thing you can say for Canada's system,

Do I correctly understand you're not entirely thrilled with Canada's system?

It has it's good points and it's bad. If you are not really sick, i.e.
about to die, it can take a dogs age to get anything done. Wait times
for hip and knee replacements can typically run between 3 and 6 months.
You can easily twiddle your thumbs in a ER for 4 hours unless you're
hemorrhaging a couple of units every 10 minutes.

On the other hand bypass surgery occurs in just a few days. My brother
went to his GP with chest pain, two days later he was on the table
getting a quad bypass.

Of course, contrary to what the Government says, it is a two tier
system. If you have the bucks and want something done right now, go to
the 'states and pay for it, or try Alberta.

It is certainly not "free" as many seem to tout, we pay among the
highest taxes in the world to finance our health care system. My
province introduced a "Health Care Surtax" on top of the general tax
levy two years ago. For me that amounts to an additional $600 a year,
(the Cdn $ is now up to $0.90 US), no it's not cheap, but it is
universal and will do it's best to save your life in an emergency.

There are now many procedures and test not covered by OHIP, i.e. PSA
test, cosmetic surgeries, a good many dermatological related things,
most physiotherapy, chiropractic (thank God), podiatry and you must pay
for them yourself.

For you personally, up until two years ago one could get a thorough
ophthalmic exam at no cost every year, now one must pay,
ophthalmologists are not terribly pleased, nor am I, (I only have
presbyopia, but hey I'm not getting any younger and it's nice to get
completely checked out every couple of years.)

I think ours is a better system than yours, at least it won't bankrupt
you in the event something like a quad bypass, but it certainly leaves
something to be desired.

Cheers
Marty

P.S. for Katy, presbyopia does not mean that I'm Presbyterian.

Gas Price.....Too High?
 

Martin Baxter wrote:
Dave wrote:
On Fri, 05 May 2006 07:56:19 -0400, Martin Baxter said:

That is *one* good thing you can say for Canada's system,
Do I correctly understand you're not entirely thrilled with Canada's system?

It has it's good points and it's bad. If you are not really sick, i.e.
about to die, it can take a dogs age to get anything done. Wait times
for hip and knee replacements can typically run between 3 and 6 months.
You can easily twiddle your thumbs in a ER for 4 hours unless you're
hemorrhaging a couple of units every 10 minutes.

On the other hand bypass surgery occurs in just a few days. My brother
went to his GP with chest pain, two days later he was on the table
getting a quad bypass.

Of course, contrary to what the Government says, it is a two tier
system. If you have the bucks and want something done right now, go to
the 'states and pay for it, or try Alberta.

It is certainly not "free" as many seem to tout, we pay among the
highest taxes in the world to finance our health care system. My
province introduced a "Health Care Surtax" on top of the general tax
levy two years ago. For me that amounts to an additional $600 a year,
(the Cdn $ is now up to $0.90 US), no it's not cheap, but it is
universal and will do it's best to save your life in an emergency.

There are now many procedures and test not covered by OHIP, i.e. PSA
test, cosmetic surgeries, a good many dermatological related things,
most physiotherapy, chiropractic (thank God), podiatry and you must pay
for them yourself.

For you personally, up until two years ago one could get a thorough
ophthalmic exam at no cost every year, now one must pay,
ophthalmologists are not terribly pleased, nor am I, (I only have
presbyopia, but hey I'm not getting any younger and it's nice to get
completely checked out every couple of years.)

I think ours is a better system than yours, at least it won't bankrupt
you in the event something like a quad bypass, but it certainly leaves
something to be desired.

Cheers
Marty

P.S. for Katy, presbyopia does not mean that I'm Presbyterian.

I knew that, Martin. So how much of your tax dollar per annum do
you contribute for health care?

Gas Price.....Too High?
 

katy wrote:


P.S. for Katy, presbyopia does not mean that I'm Presbyterian.

I knew that, Martin. So how much of your tax dollar per annum do
you contribute for health care?


Guess I should have included the smiley. ;-)

The average Canadian family pays about 48% of it's income in taxes,
(federal and provincial income, federal and provincial sales, booze,
gas..etc.), 40% of that goes to health care.

Cheers
Marty

Gas Price.....Too High?
 

Martin Baxter wrote:
katy wrote:
P.S. for Katy, presbyopia does not mean that I'm Presbyterian.
I knew that, Martin. So how much of your tax dollar per annum do
you contribute for health care?


Guess I should have included the smiley. ;-)

The average Canadian family pays about 48% of it's income in taxes,
(federal and provincial income, federal and provincial sales, booze,
gas..etc.), 40% of that goes to health care.

Cheers
Marty

OK, so according to 2001 stats, a median family income in Canada was
about 68k and you are paying around 13k out of your taxes for health
care that doesn't cover some things. If we were to COBRA (pay for
total policy on own) our BCBS plan, which covers many of the things
you've listed as exclusions, would cost us 9K per annum for a family
policy. We do have some small co-pays, which usually add up to
another 1.5k/annum ... and when we need something done, it's done
quickly and efficiently. The E-room thing is the same all
over...the mortuary has to follow you in before they'll see you
immediately...My aunt, 80 years old, has her Medicare A and a
Medicaid policy on top of that. She went into the dovs 2 weeks ago
for pain in her hip...her surgery is scheduled for next Tuesday...he
wanted to do it this week but she had to make arrangements for her
cat and had some other personal things she wanted to get done. My
sister has foster kids, all on Meidcaid policies. They're seen
immediately, no co-pays. (I'm just sticking the welfare stuff
....Medicaid...in here because someone will immediately jump in
screaming about the poor and disadvantaged...who BTW, are never
turned away of there is a legitimate concern..).

Gas Price.....Too High?
 

"Martin Baxter" wrote
The Chief Excutive of Exxon Mobil, Lee Raymond will retire this year,
he's going to have a hard time making ends meet, his parachute is only
about half a billion, someone's got to pay for it.

How many such exec.s are there and if we somehow zeroed out their incomes how
much would that lower the cost of a gallon of gas??