"Martin Baxter" wrote in message
...
katy wrote:


Marty
Does your medical coverage put age limits on some procedures like in
Great Britain? It is my understanding that in GB, if you are over
50, kidney transplant and I believe, dialysis, are not
available..also some heart treatments.


Not arbitrarily, sometimes out of necessity, my uncle had an aneurysm on
the anterior descending aorta, they wouldn't try to repair it as they
they thought the procedure itself would probably kill him, he was 82 at
the time.

I won't tell you that that explanation wasn't accurate or honest, but I'm
betting his age had as much or more to do with the response than his general
health and condition. It's called rationing.

Max

"Dave" wrote in message
...
On Mon, 08 May 2006 11:50:49 -0400, Martin Baxter said:

According to reported figures that cost represents between 2 and 3% of
the
total. I think you've been reading too much AMA propaganda.

Some numbers for you guys:

http://www.kff.org/insurance/7031/ti2004-1-5.cfm

21% for physician/clinical services, 30% hospital care. (2004 data)

The drug companies are doing well:

http://www.kff.org/insurance/7031/ti2004-1-21.cfm

If you do a little reading in Tenet's 4th quarter financial statement
you will see that they spent some $545 million on "uncompensated care",
this from an operating revenue of $2,299 million (this is the hospital
side of their operation). I believe Tenet is a reasonable exemplar of
this type of business, these numbers would seem to support Max's
position.

Might or might not, depending on what goes into that "uncompensated care"
number in addition to Max's "expense of hospital and medical care for the
uninsured, impoverished masses."

It would seem the term "uncompensated care" is rather self-explanatory.

Max

In article et,
Maxprop wrote:

"Peter Wiley" wrote in message
. ..


Thing is, *nobody* I know goes into R&D in most areas with the
expectation that they'll get filthy rich. They do it because they're
interested in a particular type/class of problem. In fact, obsessed
would be a better word than interested. If they do get rich, it's a
nice side effect.

I think you've got blinders on, Pete. Motivations for doing research among
the gifted academics are as wide and varied as with any endeavor by anyone.
Seldom do researchers have the monocentric interest (obsession) that you
describe without other motives.

Yeah, I know that. But the big driver is interest/obsession IME. For
the best ones, at least.

Money is a big one these days, especially
in some fields where the payoff can be huge, such as genetic engineering.

For a lot, yes. I know a little about this field because I used to work
in a closely related area. In fact at one stage I was offered a full
scholarship to return to university and get a PhD in bioinformatics.
Decided life was too short to do this in my mid 40s & went back to sea
instead, but that's another story.

Prestige also tops the list--academics as a rule tend to be somewhat
egotistical, and peer recognition/adulation is a powerful motivator. So is
the desire to be the foremost individual in a particular field of endeavor.

Oh agreed. Moreso than money for R&D people.

It would be convenient to believe researchers have nothing but altruism
lighting their way, but that simply isn't the case, at least not very often.

I don't think I used the word 'altruism' anywhere. In fact I'm damn
certain I didn't. I've seen very senior & powerful researchers do
anything possible to preserve funding and/or get more to pursue their
pet hobbyhorses ragardless of any other factor to actually be under any
such delusion. The current global warming stuff is a lovely case in
point, actually, which I am observing from a close to ringside seat. I
am a data providor to some of this.

Most prominent research scientists won't normally discuss their motives,
apart from telling you they have " . . .always been obsessed with . . ."
their topic of choice, but the other motives are there, and they are
powerful.

Not a problem when you see them ****ed at conferences etc. Then the
truth comes out.

So - if those truly motivated in the main by money & prestige choose
some other profession than medicine, good. I don't regard a doctor
practising family medicine as all that much superior to a good auto
mechanic, to tell the truth.

Ridiculous. Next time you are seriously ill, consult your local mechanic.

About as useful and sensible as the next time I have a problem with my
interrelated software/hardware control systems, I should consult a
doctor. You'll have to do better than that, Max. I didn't say doctors
weren't skilled. Mostly, they are. The surgeon who put my arm together
did a pretty good job of it considering how badly I managed to smash
it. I'm happy with the end result. So what? A top orthopaedic surgeon
is a real good bone mechanic :-)

They get bored, in fact. Friend of mine has given up being a GP and is
doing a PhD in a health related area instead.

It's more than just boredom. It's frustration with the legal climate
surrounding health care, the governmental intervention that imposes more and
more controls over how a qualified physician can practice medicine, and the
eroding doctor-patient relationship, thanks to the first two items. A close
friend, a cardiac surgeon, threw in the towel six years ago and bought a
convenience store (grocery + gas station) in Montana. He had practiced for
24 years, been junk-sued twice (he won both), and watched his malpractice
premiums rise to the level of 25% of his annual gross income. His
professional group broke up for legal reasons, and he found himself alone,
having to be on call constantly. Since leaving medicine, he's a very happy
man. Before he was consistently frustrated and often angry.

We have been/are losing doctors in the OB/GYN specialties due to plain
stupid lawsuits so I hear you. Occasionally there's a glimmer of hope.

http://www.news.com.au/story/0,10117...9-1702,00.html

I had a suggestion for 'wrongful life' cases. We should just offer to
terminate them now, end of problem.

Don't get me started on lawyers.


The media paint a very one-sided, distorted view of medical people, Pete.
If you are forming your impressions from them, you really need to change
your information-gathering methods.

Umm, Max, I'm one of those oddball people who *read*. I don't own a TV
or a radio. I don't as a rule watch movies because I've found they're
mostly shallow and simplistic. However, I read a number of newspapers
and a wide range of scientific literature. I get to do this as part of
my job and also I do it for interest & entertainment. My opinions are
just that, but if they have congruence with the media, it's
coincidental.

As I said, I know a lot of doctors. I've designed & written software
that's running the entire NSW neonatal screening program and has
genetic data on well over a million children online. Perhaps my
familiarity has caused me to see them in a different light. I respect
the better ones' talent, skill and dedication, but I'm not in awe of
them nor do I respect them more highly than people in other demanding
professions.

PDW

In article et,
Maxprop wrote:

"Martin Baxter" wrote in message
...
katy wrote:


Marty
Does your medical coverage put age limits on some procedures like in
Great Britain? It is my understanding that in GB, if you are over
50, kidney transplant and I believe, dialysis, are not
available..also some heart treatments.


Not arbitrarily, sometimes out of necessity, my uncle had an aneurysm on
the anterior descending aorta, they wouldn't try to repair it as they
they thought the procedure itself would probably kill him, he was 82 at
the time.

I won't tell you that that explanation wasn't accurate or honest, but I'm
betting his age had as much or more to do with the response than his general
health and condition. It's called rationing.

I see. When you can't afford it, it's not rationing. Right?

This topic makes for a *great* argument.

The USA rations on money. Canada arguably rations on age. There have
been suggestions put fwd that various treatments be denied people who
smoke, are clinically obese etc etc. I suspect it's going to happen.

Oz's idol in the last Aussie Fed election proposed giving priority in
public (ie taxpayer funded) hospital care to people over 75 in an
attempt to buy votes. I had a lotta fun asking why a 75+ y/o was a
better target for a limited resource than say a 5 y/o with a long
future in front of her.

PDW

"Peter Wiley" wrote
The USA rations on money. Canada arguably rations on age. ....

There'd be no need to ration if supply wa close to demand and the reason it is
not is because supply is artificially limited - in the USA by the MD's union,
just as other trade unions like electricians and plumbers did before the
do-it-yourself trend. Imagine what electricians might charge if you had to get
a prescription for a light bulb.

Dave wrote:

On Mon, 08 May 2006 11:06:21 -0400, Martin Baxter said:

There is, of course, the added cost that doesn't show up on anybody's
balance sheet--the cost of delaying needed care because of the system's
inability to provide it when needed.

I think that applies to just about any health care delivery system.

I don't think so. In the US, generally if you're willing to pay you can get
what you need, and when you need it, without going to another country to do
so. There's a reason you see wealthy Canadians coming here for treatment,
and it's not necessarily the quality of the physicians..

No argument there. I'm more or less agreeing that medical care is a
limited quantity, it will get "rationed" (this weeks fad word) either in
a capitalistic fashion or by a socialistic method, either way there's
not enough to go around.

Cheers
Marty

In article , OzOne wrote:

On Tue, 09 May 2006 04:11:03 +0100, Peter Wiley
scribbled thusly:


Oz's idol in the last Aussie Fed election

What idol would that be?

Thought I'd get a bite :-)

Where's your new boat now in its progress across the Pacific? Been
snowing here, I'm thinking of visiting Sydney (or Qld) for a bit....

The one who was accused of not having being capable of controlling the
economy, or the accuser who is supposedly the best treasurer we've
ever had..he can balance a budget to within about 15billion, and claim
to pay off the national debt..unfortunately the current account
deficit is now getting close to 450 billion!.

WGAF, it's private money, not Govt debt. I don't have much regard for
the current clowns in power so don't expect me to defend them. They're
benefiting from circumstances largely not of their making so deserve no
credit. Just as I told the other mob before the last loss, you can get
into power if your policies are crap but your sales team is good, you
might get into power with good policies and poor sales, but you'll
*never* get into power if you have no talent and no policies. And I was
right. I'd love to see the current mob booted out. Come the day the ALP
has sensible policies....

PDW

PDW

"Peter Wiley" wrote in message
. ..
In article et,
Maxprop wrote:


I won't tell you that that explanation wasn't accurate or honest, but I'm
betting his age had as much or more to do with the response than his
general
health and condition. It's called rationing.

I see. When you can't afford it, it's not rationing. Right?

I presumed something I shouldn't have--that your uncle lived in a place with
socialized medicine. Perhaps that was not the case. In socialized
medicine, health care is always rationed. I don't know if that answers your
question, because I'm not sure I understand what you're asking.

This topic makes for a *great* argument.

The USA rations on money. Canada arguably rations on age. There have
been suggestions put fwd that various treatments be denied people who
smoke, are clinically obese etc etc. I suspect it's going to happen.

Not here. The discrimination lawsuits would clog the legal system worse
than it already is.


Oz's idol in the last Aussie Fed election proposed giving priority in
public (ie taxpayer funded) hospital care to people over 75 in an
attempt to buy votes. I had a lotta fun asking why a 75+ y/o was a
better target for a limited resource than say a 5 y/o with a long
future in front of her.

The answer: politics. But you already knew that.

Max

"Dave" wrote in message
...
On Tue, 09 May 2006 00:22:50 GMT, "Maxprop" said:

Might or might not, depending on what goes into that "uncompensated
care"
number in addition to Max's "expense of hospital and medical care for
the
uninsured, impoverished masses."

It would seem the term "uncompensated care" is rather self-explanatory.

Not at all. All it tells you is that they claim to have provided a service
and didn't get paid. It says nothing about the reasons they didn't get
paid. Reasons might include, among other things, those who refuse to pay
deductibles based on a dispute with the provider,

Possible, yes, but generally most individuals with means do not risk having
their credit trashed over such disputes. Further, such cases, if they end
up in court, are preponderantly decided in favor of the provider. Patients
sign contracts for services *prior* to receiving them, and such contracts
are considered binding, at least here in Indiana. My guess is that such
co-payment defaults involve those with little or no means to pay = the
impoverished or working poor. Uncollectable Medicaid co-payment claims at
my wife's hospital are currently in the 90th percentile.

amounts un collectible
because of poor collection practices, generally sloppy billing practices
in
dealing with third party providers, and a number of other things.

Hospitals are notorious for being astute with their billing practices, both
with patients and with third-parties. Once again this could possibly be a
percentage of "uncompensated care," but I doubt if it's larger than a single
digit percentagewise.

I stand by my initial contention that the greatest percentage of
"uncompensated care" consists of indigents who cannot pay. This is for two
reasons: 1) they generally have no means to pay, obviously, and 2) this
general classification of people have, as a rule, poor health habits and
some downright dangerous ones, such as drug use, smoking, obesity, and
neglect of minor health problems before they become major ones. These folks
end up in the hospital at a substantially greater rate than the rest of the
non-geriatric general population. And as the undocumented alien population
proliferates this group constitutes an ever-increasing part of the
uncompensated care column.

My suppositions are based upon experience and data, not darts thrown
blindfolded.

Max

"Peter Wiley" wrote in message
. ..
In article et,
Maxprop wrote:

"Peter Wiley" wrote in message
. ..


Thing is, *nobody* I know goes into R&D in most areas with the
expectation that they'll get filthy rich. They do it because they're
interested in a particular type/class of problem. In fact, obsessed
would be a better word than interested. If they do get rich, it's a
nice side effect.

I think you've got blinders on, Pete. Motivations for doing research
among
the gifted academics are as wide and varied as with any endeavor by
anyone.
Seldom do researchers have the monocentric interest (obsession) that you
describe without other motives.

Yeah, I know that. But the big driver is interest/obsession IME. For
the best ones, at least.

Try taking away their big NIH grants or corporate salaries/bonuses and see
how many of them still are obsessed.

Money is a big one these days, especially
in some fields where the payoff can be huge, such as genetic engineering.

For a lot, yes. I know a little about this field because I used to work
in a closely related area. In fact at one stage I was offered a full
scholarship to return to university and get a PhD in bioinformatics.
Decided life was too short to do this in my mid 40s & went back to sea
instead, but that's another story.

Prestige also tops the list--academics as a rule tend to be somewhat
egotistical, and peer recognition/adulation is a powerful motivator. So
is
the desire to be the foremost individual in a particular field of
endeavor.

Oh agreed. Moreso than money for R&D people.

Probably. I've always held an affection for those in academia/research who
eschew the public limelight and don't seem to require the adulation of their
peers. Rare birds, they are.

It would be convenient to believe researchers have nothing but altruism
lighting their way, but that simply isn't the case, at least not very
often.

I don't think I used the word 'altruism' anywhere. In fact I'm damn
certain I didn't. I've seen very senior & powerful researchers do
anything possible to preserve funding and/or get more to pursue their
pet hobbyhorses ragardless of any other factor to actually be under any
such delusion.

You're right. There are typically less-than-attractive underlying motives
for such obsessions, however. That's why I used the term "altruism." I
don't think it exists to any great degree in research these days.

The current global warming stuff is a lovely case in
point, actually, which I am observing from a close to ringside seat. I
am a data providor to some of this.

Most prominent research scientists won't normally discuss their motives,
apart from telling you they have " . . .always been obsessed with . . ."
their topic of choice, but the other motives are there, and they are
powerful.

Not a problem when you see them ****ed at conferences etc. Then the
truth comes out.

Occasionally, yes, but not always. Some top people are consumate liars, or
at least evaders of the truth.

So - if those truly motivated in the main by money & prestige choose
some other profession than medicine, good. I don't regard a doctor
practising family medicine as all that much superior to a good auto
mechanic, to tell the truth.

Ridiculous. Next time you are seriously ill, consult your local
mechanic.

About as useful and sensible as the next time I have a problem with my
interrelated software/hardware control systems, I should consult a
doctor. You'll have to do better than that, Max. I didn't say doctors
weren't skilled. Mostly, they are. The surgeon who put my arm together
did a pretty good job of it considering how badly I managed to smash
it. I'm happy with the end result. So what? A top orthopaedic surgeon
is a real good bone mechanic :-)

Yes, he is. But he is also a powerful physiologist, diagnostician, and
therapist. If he weren't those things, your anaesthetic-induced arythmias
might prove fatal during your total hip replacement. Or the microbial
pathogen you contracted during the surgery might undo all he did with his
"bone mechanics." If the fuel pump the auto mechanic replaced did not
solve your car's stalling-at-stoplights problem, he'll replace something
else until he gets it right. Either way your car lives to drive another
day. Bad comparison, doctor vs. mechanic.


They get bored, in fact. Friend of mine has given up being a GP and is
doing a PhD in a health related area instead.

It's more than just boredom. It's frustration with the legal climate
surrounding health care, the governmental intervention that imposes more
and
more controls over how a qualified physician can practice medicine, and
the
eroding doctor-patient relationship, thanks to the first two items. A
close
friend, a cardiac surgeon, threw in the towel six years ago and bought a
convenience store (grocery + gas station) in Montana. He had practiced
for
24 years, been junk-sued twice (he won both), and watched his malpractice
premiums rise to the level of 25% of his annual gross income. His
professional group broke up for legal reasons, and he found himself
alone,
having to be on call constantly. Since leaving medicine, he's a very
happy
man. Before he was consistently frustrated and often angry.


We have been/are losing doctors in the OB/GYN specialties due to plain
stupid lawsuits so I hear you. Occasionally there's a glimmer of hope.

http://www.news.com.au/story/0,10117...9-1702,00.html

I had a suggestion for 'wrongful life' cases. We should just offer to
terminate them now, end of problem.

LOL. What crap litigation that was. Seriously, however, the problem of
junk suits won't go away here, mostly because the trial lawyers groups in
this country are too powerful, not to mention that so many of our
congressmen, senators, and presidents are attorneys. If ever there was a
special interest group overrepresented in our government it is lawyers.

My cousin is doing primarily OB now. He has religious qualms with abortion,
so he cannot participate in the GYN end of his group practice. But he knows
his time as a physician is probably limited. Any baby born with birth
defects or with delivery complications is a potential lawsuit these days.
He's been sued five times for complaints so far beyond his control as to
stretch the imagination. All five cases were dismissed for lack of evidence
of neglect on his part, but he still had to endure the expense, the mental
turmoil, and the negative publicity such suits have wrought. OB is in a
unique position in that young women know that if they sue the doctor and
win, the damage to the profession won't affect them in the future, provided
they are through with childbearing. So such suits are plentiful. Let the
upcoming generations worry about where to find OB care---it's no longer my
problem.

Don't get me started on lawyers.

(see above) You've already gotten me started.


The media paint a very one-sided, distorted view of medical people, Pete.
If you are forming your impressions from them, you really need to change
your information-gathering methods.


Umm, Max, I'm one of those oddball people who *read*. I don't own a TV
or a radio.

Sorry, but that doesn't prevent you from getting one-sided info. Much of
the written media these days have rather anti-medical biases.

I don't as a rule watch movies because I've found they're
mostly shallow and simplistic. However, I read a number of newspapers
and a wide range of scientific literature. I get to do this as part of
my job and also I do it for interest & entertainment. My opinions are
just that, but if they have congruence with the media, it's
coincidental.

As I said, I know a lot of doctors. I've designed & written software
that's running the entire NSW neonatal screening program and has
genetic data on well over a million children online. Perhaps my
familiarity has caused me to see them in a different light. I respect
the better ones' talent, skill and dedication, but I'm not in awe of
them nor do I respect them more highly than people in other demanding
professions.

Years ago physicians were regarded in near-godlike terms. Today most people
are aware that they, like everyone else, are just humans with the same
fallibility, idiosyncrasies, and problems. I don't believe the current crop
of physicians *wants* you to be in awe of them. To the contrary, most of
them want you to know up front that they are doing their level best and do
care for your welfare, but are not free from error or misjudgment. Times
have changed in the medical world. Ego and arrogance are not absent, but
they do not define the doctor any longer.

Max