A Usenet persona calling itself BCITORGB wrote:

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