Maybe some 'supply side' medical care would help

[Sid]

[Disclaimer: This thread is about improving healthcare and increasing the supply of doctors, it is not about Cuba, Castro, Communism or assorted red herrings:]



Housed on a former military base in Havana, the Latin American School of Medical Sciences trains students from all over Latin America to be doctors, free of charge.

Since the revolution in 1959, Cuba has had a long tradition of sending doctors and other medical personnel to countries in Latin America, Africa and the Caribbean in need of their services.

The devastation in Central America and the Caribbean caused by Hurricanes Mitch and Georges in 1998 increased this need exponentially, and the idea of creating a medical school that would train motivated students from Central America and the Caribbean who could otherwise not afford to go to medical school was put into effect.

Students were sought who would practice in underserved, rural areas of their countries. All tuition, equipment, books, supplies, housing and food are provided free to these students for a full six years of medical study in Cuba.



Latin American School of Medical Sciences (hometown.aol.com/juliancindy/medschool2.html)


Health Care in Cuba (www.cubasolidarity.net/inhealth.html) Welcome to "Cubamigo"! (members.aol.com/merengue123/cuba.html) The Real Cuba (www.therealcuba.com/index.htm) The Drug Story (educate-yourself.org/fc/drugstory.shtml)

[Sid]

Healthcare in this country is a broken system. I am familiar with a mega $million medical school, tied with it's own hospital that turns out 15-25 doctors a year.

. . . many of them start the practice of medicine with 6 figure student loans to start paying off.

I live 30 minutes from a world-class medical complex and frequently see people coming for treatment [especially chemo and radiation, my sister just died from cancer and my bride is a cancer survivor] from a hundred miles or better . . . their medical care isn't available in their rural area.

Obviously we can do better.



Our healthcare system is faltering. It is complex and inefficient at the same time. According to Marcia Angell, former editor of the New England Journal of Medicine, "If we had set out to design the worst system we could imagine, we couldn't have imagined one as bad as we have."

Most readers of this journal have healthcare benefits and therefore are protected from the anxiety felt by almost 15% of the American population who are uninsured. But every day each of us deals with the consequences of confusing regulations, denied authorizations, and diminishing reimbursements that result in staff layoffs and higher patient-nurse ratios.

Each of us cares for patients who face an uncertain future about how they will pay for the healthcare they need. Most of us are a pink slip away from being uninsured. Even if insured, none of us are exempt from an administrative decision to increase copayments, decrease coverage, or increase employee contributions to insurance premiums in order to maintain an institutional bottom line.

What did the average American spend on healthcare? In 1997, it was $4,090 compared with the average German who spent $2,339. In Japan, Australia, and Canada, the range was between $1,741 and $2,095.

Do Americans get double the value in healthcare of these other countries? It is a question to ponder long and hard....



More. . . (www.findarticles.com/p/articles/mi_m0NUB/is_4_12/ai_105556270)

How Becoming a Doctor Works (people.howstuffworks.com/becoming-a-doctor.htm)

[CoreIssue]

So very right, Sid!

Diabetes is epidemic in this country. But how many know that insurance companies will not issue policies to diabetics?

That is just one of several conditions insurance companies will not cover you for.

Those are in need are the ones who cannot get. Something is terribly wrong with that. :(

[Sid]

That is just one of several conditions insurance companies will not cover you for.



If medical care was more affordable, there wouldn't be a need for insurance companies to dictate who gets care and who doesn't.

Maybe wellness instead of illness could be the goal of medicine.



Imagine a 6 year medical school program [probably tied into the VA], paid by our government, that would accept 5000 students a year from college graduate applicants. [a little like the military academies: a service committment of say 5 years attached]


. . . don't you believe that would change the landscape of medical care?

. . . assist with providing affordable health care?

. . . the crisis of medical services in rural areas?

. . . and the crisis that is the VA?




Of course, the insurance companies and the AMA would have fits.

[CoreIssue]

Problem is costs are forcing many doctors out of business now. Or into clinics to make ends meet.

I don't have an answer to this one. Just questions.

Adding more will not address the equipment costs.

Yes, getting rid of tons of paper work most assuredly will.

What a mess. :(

[Sid]

What a mess. :(


I've been reading a book on the crisis in public health, it confirmed something I have always believed: the last place you want to be is in a hospital because of the risk of nosocomial infections [picking up stuff in a hospital] . . .





Nosocomial infections are common with estimates at about 10% of American hospital patients, or more than 2 million cases annually in the USA. Death rates may be 20,000 annually in the USA although some estimates are as high as 88,000 deaths. Cost estimates are as much as $4.5 billion in 1995.

Hospitals generally have a high rate of nosocomial infections and the reasons are rather obvious. There are a lot of sick people around, many with depressed immune systems, and a lot of staff that deal with them every day. Nosocomial infections may arise from inhalation of droplets in the air or spread by direct hand contact from hospital staff or visitors. Most nosocomial infections afflict patients with reduced immune response either due to age, serious disease, certain medications, or recent surgery.

Like any infectious condition, nosocomial infections can be bacterial, viral, fungal, or even parasitic. The most common pathogens include staphylococci (especially staphylococcus aureus), pseudomonas, and Escherichia coli. However, various newer pathogens are becoming more important. Fungal conditions, mainly from candida, comprise approximately 9% of nosocomial infections.


Nosocomial Infections (http://www.wrongdiagnosis.com/mistakes/nosocomial.htm)

[Sid]

Chiefly, Mr Bush wants to accelerate the trend towards consumer-driven health care. One uncontroversial idea is to encourage doctors and hospitals to provide more information on the cost of treatment. The other is to cut taxes. Mr Bush's team wants to eliminate the bias in favour of employer-purchased, low-deductible health insurance in America's tax code, not by reducing the existing tax subsidies for employers, but by increasing the tax subsidies for individuals.

This philosophy is conveniently summarised in a new book, Healthy, Wealthy and Wise (http://www.amazon.com/Healthy-Wealthy-Wise-Better-Health/dp/0844771783/sr=1-1/qid=1163695198/ref=pd_bbs_sr_1/102-5579198-1212923?ie=UTF8&s=books), by three economists with close ties to the White House, Glenn Hubbard of Columbia University (formerly Mr Bush's top economic adviser), and John Cogan and Glenn Kessler of the Hoover Institution at Stanford.

They argue that since it is politically impossible to get rid of tax subsidies for employer-based health insurance, the best way to eliminate the tax bias towards high-cost insurance is to make all health spending tax-deductible and expand HSAs. Legal, insurance and tax reform together, they argue, could reduce America's health spending by $60 billion and cut the number of uninsured by between 6m and 20m. Since overall medical spending would slow, the authors reckon their suggestions would cost a modest $9 billion a year.

To an administration that believes the answer to every problem is lower taxes, the appeal of these ideas is obvious. Many health experts, however, are deeply sceptical, both about whether the shift to higher-deductible plans will actually reduce health-care inflation and, even if it does, whether the government should encourage this trend with more tax cuts.



Desperate measures (http://www.economist.com/world/displaystory.cfm?story_id=5436968)

[CoreIssue]

And what of the disparity between group policies having to take everyone but individual policies can reject people with certain health issues, such as diabetes?

Especially when the Feds passed laws killing every state bill that required insurance companies to offer insurance to such?

Millions of Americans cannot buy a policy at ANY price.

[kay-gee]

Now if this were Canada, you wouldn't even be talking about this. In the the city of Toronto a guys has a triple by-pass operation, and a tumor removered, and his leg put in a cast, all in the same day. Guess what his out of pocket expenses amounted to!

With-out a word of a lie!







Four dollars! to park his car in the hospital lot!

all the best!

[CoreIssue]

Nothing is free. What is the VAT tax?

Every product costs massively more in Canada.

Neither system is perfect.

Extensively longer waiting periods for services, including surgery, in Canada. Costs more here, but hugely faster.

More procedures available, here, than Canada.

Our biggest problem are illegals. Our idiot government forces them to be treated at our cost.

[Jessie]

costs are awful then dr's dont do their jobs right.

[kay-gee]

Heres where the American system excells. Just sue the Dr. and hopefully break even. It's very hard for us to sue a doctor.......all the best........

[kay-gee]

My American cousin is moving up to Canada from Kokomo, Indiana. (has some sort of dual citizenship). Says he pays close to $800 a month in health insurance. I almost hit the floor when he told me that. Can't imagine paying $800 monthly in income taxes at the worst of times. out of my income taxes also come roads, schools etc... also Please tell me, is that possible, or is he pulling my leg? He's about 53-55 years old, divorced, retired. all the best...

[CoreIssue]

Back up here, KG.

Why do things cost 50% more, or greater. in Canada, than the US? Because of the VAT tax, or whatever you call it.

That is on top of income and such.

I use to regularly talk with a supplier in Canada. He made it very clear how high taxes were.

Just because it doesn't get billed by the doctor doesn't mean it isn't a high cost.

It ain't free.

[kay-gee]

love to respond to question. What is VAT tax? all the best...

[CoreIssue]

love to respond to question. What is VAT tax? all the best...
Value Added Tax.

Product price X VAT % = Final Pirce

[CoreIssue]

By the way, Kokomo isn't very far from where I grew up.

[kay-gee]

Apparently a nice area. I never did get down there to see him. I believe that tax was scrapped in the 90's. That was something that manufacturers had to pay. Now we have something worse. GST (Goods & Services Tax). It's 6% Federal sales tax, the consumer pays at the cash register. That is on top of the sales tax levied by the various provinces. No doubt things can get expensive. You have to remember though, wages are much higher. Ontario, where I'm from, just voted in minimum wage at 10.25 per hour. Teachers and various civil servants are outrageously paid compared to their American counterparts.
At least no one can be denied access to health care regardless of condition or ability to pay. Not diabetes, nothing. The waits you hear about are mostly things like hip replacement etc...Don't worry. If you're having a heart attack, they get you in there! My parents are/were proof of that. Dad lived a good twenty years longer than he should have with heart problems. When I see the ship-load of pills my mom takes every day, I shudder to think what they would cost if she had to pay for them. It's not a perfect system but it sure does take a lot of the stress and worry off people......all the best....

[CoreIssue]

Different names, same tax.

Here we call it VAT.

And yep, sales tax and VAT are two different taxes. :eek:

Not sure if that is true on wages, across the board. Research I did said your medical people get about half what they do here.

But how insurance and others costs affect that, I don't know.

All I am saying is no system is perfect.

One thing you have not considered. Canada has no real military to speak of, and an understaffed national law enforcement.

So, hope you never need either, for if you do, Canada is up the creek in a big way.

And to add them would devastate the economy, with the weight of the social programs on top.

The military, in example, was down grated to pay for the social.

Always a cost, which is my point.

[kay-gee]

I suppose some one made a decision a while back to go with what is more portable to the average citizens of the country. What the hay, we won two world wars! We don't have all the expensive toys, but we get the job done when we need to. A large military is impractical for us. We are a peace loving nation and the world pretty well loves us. We got tons of dough from our natural resources, oil, ore, wood, water, electricity, gold , etc... We need to blow it on something. Might as well be universal health care.
The medical community is the exception in pay because of government caps.
Here's how the tax works: Buy a car for $20,000 lets say. add 8% Ontario sales tax. Add 6% GST. Your cost out the door is $22,800.
The only insurance we buy is home and auto.
That's it! all the best.....

[CoreIssue]

No need for a military because you are a peaceful people.

You think terrorists or other ambitious nations give a hoot?

[kay-gee]

We have a population of barely 30 million. How big of a military do you think we need?

Hey!, you guys aren't planning to invade us are you?

all the best.........

[CoreIssue]

You sound like France right before Germany invaded them.

Tanks against cavalry.

They didn't need a good military either.

[kay-gee]

Yeah but we got the ocean on two sides of us and the Arctic above. The only land invasion possible would be from the South.
Now I don't believe in the JW style paradise Earth as you know, but I think that Canada is probably as close to that ideal as man will ever get on this planet.
A multi-cultural brother-hood, where the citizens care about each other. While other countries rattle their swords, we have beaten ours into plow shares! Extremely clean. Low crime. No civil wars. High living standards. Loved and respected by all where ever we travel in the world. Nice, humble, compassionate people. Face it, in terms of general humanity, we rule. Don't get me wrong. I love America. You have a different role to play by manifest destiny! all the best...

[CoreIssue]

Yeah but we got the ocean on two sides of us and the Arctic above. The only land invasion possible would be from the South.
Think again.

You are reachable in minutes, from some places I know from my military days, with missiles. They are still there.

And even if a fleet sailed at you and took a week or two, so what? You have nothing to stop them.

Don't get cocky about it. It isn't locked a situation as you think.

And the terrorists are coming into Canada. Your border with us has become a threat and we are having to beef up patrols, big time.

Nor are they inactive in Canada. You are not Islam, thus an enemy.

Now I don't believe in the JW style paradise Earth as you know, but I think that Canada is probably as close to that ideal as man will ever get on this planet.

:eek: Yea. Right.
A multi-cultural brother-hood, where the citizens care about each other.
:roflmbo: Tell that to the French Canadians, who want to become a separate country.
While other countries rattle their swords, we have beaten ours into plow shares! Extremely clean. Low crime.
Actually, due to the terrorists, drug and sex slave trade, coming through Canada, from the Far East, they have been forced to beef up law enforcement.
No civil wars.
Just the ever present desire of the French to split.
High living standards.
As we have.
Loved and respected by all where ever we travel in the world.
:eek: I won't even begin to take that one as a serious statement.
Nice, humble, compassionate people.
:doh:
[/quote]Face it, in terms of general humanity, we rule. Don't get me wrong. I love America. You have a different role to play by manifest destiny! all the best...[/quote]
Rule what? :D

[kay-gee]

The French don't really want to separate. It's to their advantage to keep the "threat of separation" alive. They gets tons of Federal money coming at them. Bribery in any other language! They've been playing that game for 55 years. The rest of us are so nice, we just put up with them. Its really just political blah blah blah! To my knowledge only 1 human life has ever been lost over the issue. (in 1970 extremists kidnapped and murdered some guy) Not a civil war by any stretch!....all the best....

[CoreIssue]

Uh, yea. Sure.

[kay-gee]

Believe me. I've been a citizen all my life and very involved in the politics. The way things are run up there is a total comedy...........all the best...

[CoreIssue]

Politics is a joke, for sure.

[a.baker]

In the next 30 years they have a scary prediction. They say that more doctors are retiring than going to medical school. Which means we will have less doctors than we have now. We will also have a bigger population than we do now as well. And social security? For my generation...what social security?! Theres nothing secure in that! People like me that were born and raised in the U.S. and are considered extremely poor can't get medical insurance through any state funding because they have a budget. But tell that to a family of three that makes about $12,000 a year to pay for medical insurance out of there own pocket. That would be around $200-$250 every month just in case something happens. Than on top of that probably have to pay co-pays and procedures your insurance company doesn't cover or have to pay for your prescriptions. Its so true that many jobs don't even offer insurance for their employees. a.baker

[CoreIssue]

Very true.

I am 56 and no one, my age, thinks there is going to be SS for them to retire on. Or, very cut back, at best.

Medical is getting worse, every where.

I agree with what you said, about the US.

But it is also a fact the welfare/socialized countries are struggling as well. It is bankrupting them, they restrict available procedures and even bar some from getting them after certain ages.

A mess. A true mess.

[kay-gee]

Sure, it will likely bankrupt them some day, but for now why not take advantage of it? As a citizen of the country, you have a constitutional right to health care. Period!
all the best....

[CoreIssue]

Sure, it will likely bankrupt them some day, but for now why not take advantage of it? As a citizen of the country, you have a constitutional right to health care. Period!
all the best....
Actually, there is no such right in the Constitution. Meaning provided by the government.

Goverments are the worst medical providers there are.

[Jessie]

Yeah but we got the ocean on two sides of us and the Arctic above. The only land invasion possible would be from the South.
Now I don't believe in the JW style paradise Earth as you know, but I think that Canada is probably as close to that ideal as man will ever get on this planet.
A multi-cultural brother-hood, where the citizens care about each other. While other countries rattle their swords, we have beaten ours into plow shares! Extremely clean. Low crime. No civil wars. High living standards. Loved and respected by all where ever we travel in the world. Nice, humble, compassionate people. Face it, in terms of general humanity, we rule. Don't get me wrong. I love America. You have a different role to play by manifest destiny! all the best...


:eek: anyone can invade from anywhere in these days.

the US is multi cultural but there are still problems and our problems are yours.
and you've already been invaded and not by a peaceful bunch either.

war is in the heart of man. now how on earth are you going to have the kindof peace you are talking about?

[kay-gee]

Dear Jessie! LOL gotta respond to your post. Why would any one want to invade Canada? If you need all that rock and tundra and ice, then knock yourself out! Do you know that less than a tenth of Canada's land mass is even inhabited?
US is not as muli-cultural as they would have you believe. Your historical shabby treatment of native Americans and Blacks, is proof of that.
Yes, we were invaded once (by you guys of all people) in 1812! We drove you back, with a rag-tag army of British loyalists and Indians. And guess what! We're just so darned nice, we gave you back every inch of territory we had captured from you!
Sadly, it's true, war is in the heart of man. If more countries would follow Canada's lead, the chances for true world peace, would be boundless. Most of the immigrants that I had dealings with (any there were plenty) said they came to Canada because they were so sick of war and fear and general despair, in their original countries!
all the best....

[kay-gee]

Dear Core. I meant in my country. The Canada Health Act, of 1999 guarantees every citizen the right to universal and free access to health care. It is placed in our constitution, for all time, the same as your right to bear to bear arms (of which you are so proud) is enshrined in your constitution. Decide for yourself which is a more useful right. The one that allows a tiny handful of people who will ever have cause, to fire a gun at someone, or the one that attempts to keep its broader citizenry, healthy and financially solvent.
all the best...

[CoreIssue]

Who needs more of an excuse to invade than power?

[Sid]

According to the AMA, in many communities around the United States, there is a physician shortage, which presents a serious health care problem. For a host of reasons, more than twenty million people are affected by the inability to access quality medical services. While the premise of a popular television show, Northern Exposure, alluded to this very predicament some time ago, most viewers were likelier caught up in the relationships between the quirky inhabitants of Cicely, Alaska instead of pondering the very real implications for those without access to a qualified doctor.

Other reasons creating an inability to meet the demand for physician services include population growth, a larger number of people living beyond age sixty-five and needing the most services, doctors working fewer hours, some specialty areas, such as ER, are more attractive because of their less demanding schedules (primary care is more time-intensive), and our supply of physicians from U.S. medical schools is not growing.

According to a survey taken by The American Hospital Association, there are seventeen "crisis states," so defined by their legal and legislative environment. They experience difficulty with both recruiting physicians and with finances and operations. Hospitals blame increased professional liability expenses for lost physicians, reduced coverage in their emergency departments, and ability to provide obstetric services. As a result of an inability to recruit enough medical school graduates to fill their OB/GYN residency slots, hospitals in Pennsylvania are interviewing a greater proportion of residency applicants from international medical schools, whose level of education is much harder to ascertain.




Doctor Shortage, the Next Pandemic (http://www.newmediajournal.us/staff/nsalvato/10012007.htm)

[CoreIssue]

Also, hospitals don't want to pay them good salaries, there is the cost of going into practice and incredibly high insurance rates. Not to mention the paperwork created by the government and insurance companies.

[kay-gee]

What? Problems in the medical system? Can't be....
all the best...

[CoreIssue]

What? Problems in the medical system? Can't be....
all the best...
World wide reality. Only the form of the problems varies.

[a.baker]

Oh boy I think about the shortage of medical staff. With the shortage and some looking to retire soon and less and less going to school for it means even more of a shortage not to mention on top of all that our population is growing quickly.

[kay-gee]

How does one become doctor in USA now? school funding that sort of thing.
all the best...

[CoreIssue]

How does one become doctor in USA now? school funding that sort of thing.
all the best...
College. Pay for it like all other degrees.

I forget how many years exactly. 8 at least, I think.

Then Internship for another x years.

Long and costly process.