A Usenet persona calling itself BCITORGB wrote:

Scott simplistically states:
==================
But in the free market model, when such shortages occur,
the market responds with more beds and services.
====================

But... http://www.usaweekend.com/03_issues/...831nurses.html ...

"More than 126,000 nursing positions in hospitals around the country
are unfilled, according to the Joint Commission on Accreditation of
Healthcare Organizations. In addition, the workforce is shrinking,
because it's aging (and retiring) at twice the rate of other
occupations."

Hmmmm.... as far as I can tell, there are shortages of medical
personnel EVERYWHERE; whether in the Canadian system or the American.

There are likely a myriad of reasons, but allow me to ride one of my
hobby horses: as far as docs are concerned, it's the doctors' unions (I
know they don't call them unions, but they're the toughest one of them
all). They very successfully play the supply management game. The
enrollment in universities is influenced by the "union". And, let's
face it, the entrance requirements to get into med school in both
Canada and the USA are nuts. If med schools pumped out more docs and
nurses, neither Canada nor the USA would have shortages.

Med schools respond to market conditions in the US. As the doctor population
shrinks, scarcity increases value and wages go up. As wages go up, more
people choose to become doctors and nurses. It's pure free market economics.
In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty beds
because there's no one to care for patients.


This is not a free market vs any other kind of system issue, because
there is no free market in the supply of labor in this industry.

Don't be silly, of course there is...in the US. But you're absolutely right
about the lack of a free market in Canada. Therein lies the problem.


--
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

Scott thinks:
================
In Canada, however, compensation for nurses and doctors outside of
private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty
beds
because there's no one to care for patients.
==============

Sorry Scotty, in Canada the compensation for doctors and nurses is
governed by a bargaining process between, for example, the nurses union
and various local/regional health boards. Here, in the Vancouver area,
for example, the doctor's union/association will bargain with, among
others, the board representing the Catholic hospitals in the region.

The doctor's association bargains for the pay schedule amounts which
determines doctors' pay.

Hmmmm.... bargaining.... what a unique concept....

As to med schools responding to market conditions.... well, I'm from
Missouri... are you telling me there's no collusion between the AMA
(that is the doc's association, right) and the med schools?

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Scott thinks:
================
In Canada, however, compensation for nurses and doctors outside of
private
practices, particularly surgeons, is government controlled, so there is
little motivation to become a surgeon or a nurse. This leads to more
shortages, which leads to inadequate staffing, which leads to empty
beds
because there's no one to care for patients.
==============

Sorry Scotty, in Canada the compensation for doctors and nurses is
governed by a bargaining process between, for example, the nurses union
and various local/regional health boards. Here, in the Vancouver area,
for example, the doctor's union/association will bargain with, among
others, the board representing the Catholic hospitals in the region.

The doctor's association bargains for the pay schedule amounts which
determines doctors' pay.

Hmmmm.... bargaining.... what a unique concept....

And the ultimate upshot is that the government (through the health boards)
controls how much doctors and nurses get paid, and the boards get their
funding through the government, which controls the aggregate amount
available for health care in any locale. Thus, if there is X amount
available, and the demands of doctors and nurses equals X+1, something gets
cut. Either they cut the number of personnel, or they take the money from
some other part of the budget to compensate. That's why hospital
administrators are constantly facing cuts and shortages of basic equipment
and supplies I would imagine. It doesn't do any good to have a full staff if
there are no supplies or equipment to serve patients.

That's the nature of socialized medicine. The total amount available for
everybody's free medical services is set by the legislature, and however
it's parceled out, whether as compensation for staff or for facilities,
equipment and supplies, there's only X available, and once it's gone,
everybody has to put up with the shortages.

Down here, a hospital can have exactly as much equipment and as many
supplies, doctors and nurses as it can afford, based on its competitive
advantage in the free market.


As to med schools responding to market conditions.... well, I'm from
Missouri... are you telling me there's no collusion between the AMA
(that is the doc's association, right) and the med schools?

What sort of collusion are you alluding to? If you mean price-fixing, no,
because that would be a violation of federal law. If you mean a conspiracy
to limit med school admissions to keep the number of doctors artificially
low, I seriously doubt it, because that would probably be illegal, but if
not, it would certainly outrage everyone if it came to light. More
importantly, med schools are in competition with each other for students, so
it's extremely unlikely that they would shoot their own feet just to pander
to the AMA.
--
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

Scott thinks:
===============
More importantly, med schools are in competition with each other for
students, so
it's extremely unlikely that they would shoot their own feet just to
pander
to the AMA.
===================

Hmmm... are you sure they're in competition with each other? If I were
a university president, the last faculty I'd want to increase enrolment
in would be medicine. Just a quick google got me tuition figures for
med school in Arizona (albeit two conflicting figures: just under
$10,000 and just under $13,000 per year). I'll assume the figures are
comparable around the USA. Surely you're not going to claim that $9,000
covers the entire cost of a med student's education. There's going to
be a huge government subsidy that accompanies this $9,000.

Med Schools have to be a royal pain in the ass to university
administrators as they are incredibly capital intensive with constant
demands for upgrading. It's so much simpler/cheaper to pump up
admission into business schools where your major expenditures are
chalk-and-talk seminars.

So, Scott, I doubt very much that there's competition between
universities to get med school students.

frtzw906

A Usenet persona calling itself BCITORGB wrote:

Scott thinks:
===============
More importantly, med schools are in competition with each other for
students, so
it's extremely unlikely that they would shoot their own feet just to
pander
to the AMA.
===================

Hmmm... are you sure they're in competition with each other?

Yup. Positive.

If I were
a university president, the last faculty I'd want to increase enrolment
in would be medicine. Just a quick google got me tuition figures for
med school in Arizona (albeit two conflicting figures: just under
$10,000 and just under $13,000 per year). I'll assume the figures are
comparable around the USA. Surely you're not going to claim that $9,000
covers the entire cost of a med student's education. There's going to
be a huge government subsidy that accompanies this $9,000.

Med Schools have to be a royal pain in the ass to university
administrators as they are incredibly capital intensive with constant
demands for upgrading. It's so much simpler/cheaper to pump up
admission into business schools where your major expenditures are
chalk-and-talk seminars.

So, Scott, I doubt very much that there's competition between
universities to get med school students.

They're just like any other business. How ever much of a pain med students
are, the university has a lot invested in the med school program, as you
yourself admit, and the only way to pay for all that infrastructure is to
have students in the programs. Any med school administrator who went to the
Regents with the argument "Med students are a pain in the butt, let's not
only not recruit them, let's deny them admission so we don't have to spend
any money educating them" would be fired.

--
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

On 28-Mar-2005, Scott Weiser wrote:

In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled,

Exactly what percentage of doctors in Canada are not in private practice?

Mike

A Usenet persona calling itself Michael Daly wrote:


On 28-Mar-2005, Scott Weiser wrote:

In Canada, however, compensation for nurses and doctors outside of private
practices, particularly surgeons, is government controlled,

Exactly what percentage of doctors in Canada are not in private practice?

Doesn't matter. What's government controlled is the compensation provided by
the national health service for in-hospital care and surgery, irrespective
of whether the doctor is a government employee or a private contractor.

--
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

On 29-Mar-2005, Scott Weiser wrote:

What's government controlled is the compensation provided by
the national health service for in-hospital care and surgery, irrespective
of whether the doctor is a government employee or a private contractor.

First of all, there are no doctors that are government employees. It
has already been pointed out that doctors in Canada are all self
employed. Furthermore, doctors work on a fee-for-service basis. If
they do the work, they submit the paperwork and get paid. The
health insurance ministries cannot avoid paying for work that has
been done.

You are, as usual, full of ****.

Mike