Weiser says:
=================
Too many sick people, too few underpaid doctors. The math is
inevitable.
===================

I'm going try to get a handle on the way doctors are remunerated in the
USA. If I paint with too broad a brush and make significant errors,
I'll be happy to corrected by you, Scott.

Is it fair to say that a significant number of Americans carry private
medical insurance? I'm going to assume they do.

In these private medical insurance cases, I'll further assume that the
doctor gets paid by submitting a bill to the insurance company.

Now, if these insurance companies are anything at all like other
insurance companies, they're not particularly fond of handing over
money. I'm going to assume that they scrutinize all the bills that get
submitted. Further, if they act as good agents for their shareholders,
they'll deny any costs that appear out of the ordinary. To keep life
simple, they very likely have a fee schedule: $X for setting a broken
collar bone, $Y for removing tonsils, etc etc.

And exactly how is this different than Canada?

You suggest that in Canada, there are "too few underpaid doctors".
You're trying to make some sort of economic case, I guess. Hmmmm, thus
we'd have to assume "too MANY underpaid doctors" in the USA. Clearly,
in the USA, the free market ought to find an equilibrium as more people
go into a very lucrative profession. But this is apparently not the
case. There appears to be a doctor shortage in the USA as well.

Well!!!! Isn't that peculiar!

Of course it's not if one understands power. Bargaining power! It's the
oldest trick in the trade union guidebook: keep supply artificially
low. Hey, if it works for longshoremen, why not doctors?

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Weiser says:
=================
Too many sick people, too few underpaid doctors. The math is
inevitable.
===================

I'm going try to get a handle on the way doctors are remunerated in the
USA. If I paint with too broad a brush and make significant errors,
I'll be happy to corrected by you, Scott.

Is it fair to say that a significant number of Americans carry private
medical insurance? I'm going to assume they do.

Yup. But then again many don't.


In these private medical insurance cases, I'll further assume that the
doctor gets paid by submitting a bill to the insurance company.

True, but when the amount paid by insurance does not cover the costs, the
patient is responsible for the balance


Now, if these insurance companies are anything at all like other
insurance companies, they're not particularly fond of handing over
money. I'm going to assume that they scrutinize all the bills that get
submitted. Further, if they act as good agents for their shareholders,
they'll deny any costs that appear out of the ordinary. To keep life
simple, they very likely have a fee schedule: $X for setting a broken
collar bone, $Y for removing tonsils, etc etc.

True, in many cases. However, doctors can always negotiate their fees here.
Moreover, they can charge what they like, and the difference is paid by the
patient.


And exactly how is this different than Canada?

The free market sets the prices for both insurance compensation and doctor's
services. You can buy a comprehensive HMO policy that covers everything from
soup to nuts, but you're restricted to using the medical facilities of that
HMO. In those facilities, the care you receive is mandated by your contract.
The more you pay for insurance, the better your coverage. Plus, you can
always go outside the HMO system if you need care that's not covered by your
insurance plan.

Under socialized medicine, it's like one giant HMO for the entire country,
the only upside is that you don't have to pay a premium every month. Your
care is doled out to you in accordance with government mandates, not in
accordance with a contract between you and your medical provider. Thus, you
as an individual have no control whatsoever over the care you receive under
a socialized medicine system. You take what they give you, and if you don't
like it, tough.


You suggest that in Canada, there are "too few underpaid doctors".

That¹s the nature of government-run health programs, including, down here,
the Veteran's Administration medical program for our vets. Too few doctors
willing to work for low government wages in a cash-strapped program that
often cannot provide simple things like routine daily wound care and
personal hygiene. The VA is a perfect example of the pitfalls of
government-run health care programs.

You see, when government runs health care, the taxpayers are reluctant to
fund it because individual taxpayers want their own health looked after, but
they don't want to be taxed to pay for somebody else's health care, so they
persuade their representatives to cut funding for socialized health care
because they don't believe they will ever need it. For socialized medicine
(or socialized anything else) one element of human behavior is required that
simply does not exist in the large-scale societal dynamic: Altruism.

It's the same reason Libertarianism is a social failure.

Both systems make the erroneous presumption that more than a token number of
people are truly altruistic and are thus willing to give their money for the
benefit of someone they don't know *when required to do so by government.*

On the other hand, history shows us that people are indeed altruistic and
giving to those less fortunate in this country, but they refuse to do it
through the government, they prefer to donate directly to charitable
organizations.

The reason is two-fold: Most importantly, people don't like being *required*
to pay for someone else's bad health through the forcible extraction and
redistribution of income by the tax man. Second, people have a healthy
distrust of government-run operations, which are synonymous with waste,
fraud and inefficiency. They prefer to donate voluntarily to organizations,
which gives them some degree of control over the operation of the charity.
If the charity wastes money and doesn't provide valuable services that
comport with the wishes of the donors, the donors stop donating.

When government can redistribute your income by force and allocate it to
inefficient, wasteful, poorly-run government health programs (Like the BIA
health system), people have no control over how the money is spent or
whether it is being properly used to provide care...or if it's just being
siphoned off into some bureaucrats pocket.

You're trying to make some sort of economic case, I guess. Hmmmm, thus
we'd have to assume "too MANY underpaid doctors" in the USA. Clearly,
in the USA, the free market ought to find an equilibrium as more people
go into a very lucrative profession. But this is apparently not the
case. There appears to be a doctor shortage in the USA as well.

Only in rural areas where there is not as much demand. There are plenty of
doctors in heavily populated areas.


Well!!!! Isn't that peculiar!

Not really, if you understand the dynamic.


Of course it's not if one understands power. Bargaining power! It's the
oldest trick in the trade union guidebook: keep supply artificially
low. Hey, if it works for longshoremen, why not doctors?

Which is fine so long as the government isn't artificially limiting wages,
as it does in socialized medicine.

--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Weiser says:
===================
Which is fine so long as the government isn't artificially limiting
wages,
as it does in socialized medicine.
===========================

The government, in theory, can artificially limit wages. In practice,
doctors in Canada know how clout they have. They act as anyone with
power acts (they've learned well from trade unons): they withhold
services. And they continue to withhold services until the fee schedule
looks like they want it to look.

So, it is the marketplace insifar as there is a marketplace when one
party holds monopoly power. The doctors play a significant role in
determining how much they get paid. Doctors can go on "strike" and they
have done so -- because they're doctors, they never call it anything
nearly so crass as a "strike", but the net effect is the same.

There's no need to hold any tag days for doctors up in Canada, Scott;
they're doing just fine.

Weiser says:
====================
Compared to US doctors? Please.
=======================

That begs the question: could it be that American doctors are overpaid?
Like doctors everywhere, by virtue of their licence and the influence
they wield over medical school entrance number, they hold considerable
power. In neither the USA nor Canada can the economy find a natural
equilibrium. In both countries, entrance to medical schools is severely
restricted. In large measure this is due to the influence of medical
associations. Restriction of supply guarantees higher incomes.

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Weiser says:
===================
Which is fine so long as the government isn't artificially limiting
wages,
as it does in socialized medicine.
===========================

The government, in theory, can artificially limit wages.

The government, in theory, can murder all the Jews. Strawman.

In practice,
doctors in Canada know how clout they have. They act as anyone with
power acts (they've learned well from trade unons): they withhold
services.

Ipse dixit, quod erat demonstrandum.

And they continue to withhold services until the fee schedule
looks like they want it to look.

And patients get sick and die as a result.


So, it is the marketplace insifar as there is a marketplace when one
party holds monopoly power. The doctors play a significant role in
determining how much they get paid. Doctors can go on "strike" and they
have done so -- because they're doctors, they never call it anything
nearly so crass as a "strike", but the net effect is the same.

Thanks for proving my point. Doctors in the US don't go on strike because
they are not granted a government controlled monopoly. If one doctor locks
his doors because he's unhappy with his income, patients just find another
doctor. Up there, if the doctors get testy, everybody suffers.


There's no need to hold any tag days for doctors up in Canada, Scott;
they're doing just fine.

While the patients get sick and die as a result.


Weiser says:
====================
Compared to US doctors? Please.
=======================

That begs the question: could it be that American doctors are overpaid?

Nope. They get paid exactly what the consume thinks their services are
worth.

--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Weiser says:
==============
Ipse dixit, quod erat demonstrandum.
==================

What you don't comprehend is that no doctor is required to participate
in the national insurance scheme -- all doctors are free.

Weiser says:
=================
Doctors in the US don't go on strike
================

So, you're predicting that the 50,000 to 100,000 (and growing rapidly)
unionized doctors in the USA (can you say HMO?) will never go on
strike? Good luck on that one!

Weiser, in reference to the USA, says:
===============
Nope. They get paid exactly what the consume thinks their services are
worth.
===================

And you actually believe that, eh?

I suspect it's more a case of what the consumer "must" pay, because,
while you "talk to free market talk", "walking the walk" is quite
another thing. You have yet to explain how/why the free market doesn't
respond to such lucrative incomes with a greater supply of doctors.
Scott, isn't that the way it's supposed to work?

What in hell is wrong with you guys down there, that you can't get the
capitalist system to work for you as far as the supply of doctors is
concerned? Maybe if you could get these things right, we'd be inclined
to follow your example. But, so long as the simple supply-demand thing
remains a mystery to you, perhaps we'd best stick to a system that
produces better results. When you get the kinks worked out, give us a
call.

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Weiser says:
==============
Ipse dixit, quod erat demonstrandum.
==================

What you don't comprehend is that no doctor is required to participate
in the national insurance scheme -- all doctors are free.

Who pays them? And there certainly ARE government-employee doctors...and
nurses...and administrators.


Weiser says:
=================
Doctors in the US don't go on strike
================

So, you're predicting that the 50,000 to 100,000 (and growing rapidly)
unionized doctors in the USA (can you say HMO?) will never go on
strike? Good luck on that one!

You need to learn the distinction between a union and an HMO. HMO doctors
can't strike because it's in their contract.


Weiser, in reference to the USA, says:
===============
Nope. They get paid exactly what the consume thinks their services are
worth.
===================

And you actually believe that, eh?

Of course! It's perfectly obvious. If the patient didn't think it was worth
it, they wouldn't use that doctor.


I suspect it's more a case of what the consumer "must" pay, because,
while you "talk to free market talk", "walking the walk" is quite
another thing. You have yet to explain how/why the free market doesn't
respond to such lucrative incomes with a greater supply of doctors.

It does. We have lots and lots of doctors. However, it does take many years
for the doctor population to respond to demand, which may result in
temporary shortages. But, as soon as the new crop is trained, they become
available to the market.

Scott, isn't that the way it's supposed to work?

It does.


What in hell is wrong with you guys down there, that you can't get the
capitalist system to work for you as far as the supply of doctors is
concerned?

Our doctor supply, like our lawyer supply, is just fine.

Maybe if you could get these things right, we'd be inclined
to follow your example. But, so long as the simple supply-demand thing
remains a mystery to you, perhaps we'd best stick to a system that
produces better results. When you get the kinks worked out, give us a
call.

Uh huh.


--
Regards,
Scott Weiser

"I love the Internet, I no longer have to depend on
friends, family and co-workers, I can annoy people WORLDWIDE!" TM

© 2005 Scott Weiser

Weiser, in reference to Canada says:
=================
And there certainly ARE government-employee doctors
=================

Yes there ARE. As there ARE in the USA. So what?

Weiser says:
==================
You need to learn the distinction between a union and an HMO. HMO
doctors can't strike because it's in their contract.
================

I know the distinction: the HMO is the management. Now, while I also
know that the USA is not particularly union-friendly, I also know that,
once a contract has expired, union members can withhold their services.
A strike by any other name... Which leaves the question: where is the
HMO going to find replacement doctors on short notice? Can't strike eh?
How little you understand collective power.

Weiser says:
==============
But, as soon as the new crop is trained, they become
available to the market.
===============

So, can we ever expect the supply of doctors to be such that the price
goes down? Not bloody likely, I'll venture.

frtzw906

On 20-Feb-2005, Scott Weiser wrote:

Doctors in the US don't go on strike because
they are not granted a government controlled monopoly.

Doctors in Canada have not been granted a government controlled
monopoly. Try again, only this time, deal with the facts.

Mike