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Old 02-12-2013, 11:25 AM #43
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http://www.eurekalert.org/pub_releas...-csi052411.php
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Old 02-12-2013, 11:29 AM #44
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Originally Posted by Rapier7 View Post
The government hospitals would only look to cut costs and get through as many patients as cheaply as possible. Most of Europe has universal healthcare where the physicians are government employees and they don't make nearly as much money as their American counterparts.

Under your proposed system, the best doctors and surgeons would stay in private hospitals and make a ton of bank while everybody else (the lowly GPs, for example) would get shoved into a government hospital where their pay wouldn't be any better.

It sounds like your dad chose the wrong subspecialty in medicine to go into. Sucks for him and your family, but them's the breaks. Also, the vast majority surgeons make quite a bit of money (300k+ per year). You say your family is struggling, but do you know how much your dad makes? Or how much it costs to keep your family in the lifestyle it's accustomed to?
Yes, I understand and agree with what you are saying. But is having private companies provide a better product any different from the rest of the product markets in the U.S.? And yes I do know how much my dad makes and believe you me it is much much less than 300k a year. Closer to 120k and that's before company expenses.
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Old 02-12-2013, 01:12 PM #45
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great speech!
what a great senator to introduce him

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Old 02-12-2013, 02:27 PM #46
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So, Umami, would you say that overburdened is synonymous with poorly run? That's what I was getting at with my first post.
Well at some level yes, but a lot of the funding issues stem from congress and the DoD so I balk at blaming administrators at the VA for that.

I would say at the level of the VA administration they are run very well with what they have to work with. In my mind overburdened and inefficient are two different things. Overburdened means it takes a long time to obtain care. Poorly run means the quality of care provided sucks. There do seem to be a lot of inefficient and overburdened hospitals out there. Whether or not that's their fault is yet another issue - increasing quality of care costs money as well.

At the VA, when you get care it is good care - and in that sense it is not poorly run. In a lot of places, when you finally get care it is crap.
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Old 02-13-2013, 06:57 AM #47
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Exclamation

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Originally Posted by F1VENOM View Post
Compare apples to apples. We're talking about a surgeon here.
No I was always talking about GPs you came in to contradict me by bringing up the subset that throws off the curve. My first or 2nd post clarified that I considered the average doctor a GP and admitted that specialists make much more. How do you like those apples?

The point is that it's not a good deal for the amount of schooling and loans and its going to get worse. It will probably be much worse working for a government hospital because the "penny wise pound fool" bean counters in government will make all the decisions. Those high paid specialists will probably be replaced with cheaper alternatives.

Umami: I don't blame the administrators. They work with what they get... Which is not enough. The employee does their job, and congress has to give them the tools to do their job well. I don't think congress will handle that political football well for government hospitals either.

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Old 02-13-2013, 07:42 AM #48
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Still $177k median, not bad for 8 years of schooling and paid residencies.

http://bls.gov/oes/current/oes291062.htm
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Old 02-13-2013, 08:01 AM #49
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Debt to income ratio?
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Old 02-13-2013, 08:19 AM #50
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Debt to income ratio?
That depends on a lot but doctors seem to do decently well for themselves.
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Old 02-14-2013, 09:58 AM #51
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One type of government ran hospital being ran poorly has little to say about the ability for any government hospital to be ran well. This is essentially saying "well we tried to build an airplane and it didn't work, so therefore all airplanes don't work".

You know what they say, "If at first you don't succeed, quit."
When it comes to over-centralization, yes the best answer is to quit. As of the moment we are locked into an illogical habit of prescribing more of a particular failed policy, to fix that failed policy. Don't believe me? Look at education. Every response we have to the failings of centralized bureaucracy has been more bureaucracy. Health care, education, the commons, et all, each is best managed and maintained by grassroots. There are very little things any national board of oversight can do that a state and local could not do more effectively. After all, those are the managerial bodies which are closer to the needs of and have a vested interest in any population. What does a Washington bureaucrat from California know about the particular needs of a child a sick adult or a physician in Idaho?
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Old 02-14-2013, 11:20 AM #52
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I don't see why you quoted me, as you post had little to do with mine. I was simply pointing out the fallacy of extrapolating a universal from an existential.
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Old 02-14-2013, 11:37 AM #53
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Your attitude tipped me off.
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Old 02-14-2013, 11:52 AM #54
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There are advantages to centralization: buying in bulk, common resources as well as common knowledge, transfer-ability and common roles (allowing for ease of replacement), etc

There are advantages to independent functioning as well: no domino effect (one fall, they all fall), experimentation, specificity/specialization, etc

Obviously, a bland board regulating the smallest details of each hospital (which they could never intimately know) is a poor idea. No one is suggesting that. Obviously, a completely independent set of hospitals functioning on their own is a poor idea as well, because they lose that advantages that come from centralization. The key to this, or any case, is a proper blending of the two. You can have centralization and the benefits of common direction with specialization and local-awareness.

But this isn't even the question we are addressing here. We already have a large interconnected network of hospital at hand. We are simply talking about shifting the responsibility for some of that network from private hands to public ones. This has nothing to do with increasing or decreasing centralization. If you want to have that conversation, fine. But first recognize that is not what is going on here.

Also, you are slowly becoming a libertarian catch-phrase. I'm waiting for the Ron Paul quotes to start coming.
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Old 02-14-2013, 11:55 AM #55
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Independent organizations can do all of those things you attributed to centralization. It happens quite frequently in the business world.


It should be said that the argument has never been X vs nihilism.
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Old 02-14-2013, 11:57 AM #56
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I am regarding independent organizations functioning together for common good to be centralization (as the network of hospitals do today). We could surely imagine a world in which grassroots hospitals function on their own accord, not sharing technology, techniques, or innovations, creating vastly different qualifications and training-methods so that a doctor from one hospital would be ill equipped to help in another, etc.
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Old 02-14-2013, 12:01 PM #57
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It should be said that the argument has never been X vs nihilism.
Thank you. In fact, the national government has a vested interested in watching the watchers so to speak. What you have to do is separate the monitoring program from the program issuing commands. In this case, an elected state board watches over the locally established body to ensure that there is no gaming of the system and that they are following THEIR OWN established rules. The national board watches the state board to ensure they are doing their oversight duties.
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Old 02-14-2013, 12:03 PM #58
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Originally Posted by TheSilentAssassin View Post
I am regarding independent organizations functioning together for common good to be centralization (as the network of hospitals do today). We could surely imagine a world in which grassroots hospitals function on their own accord, not sharing technology, techniques, or innovations, creating vastly different qualifications and training-methods so that a doctor from one hospital would be ill equipped to help in another, etc.
For the record I never intended to suggest independent entities for this task, merely a reconstruction of the former american method whereby localities created their own bodies for specific functions.
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Old 02-14-2013, 12:11 PM #59
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For the record I never intended to suggest independent entities for this task, merely a reconstruction of the former american method whereby localities created their own bodies for specific functions.
Isn't that already in the nature of our hierarchical structures?
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Old 02-14-2013, 12:22 PM #60
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Isn't that already in the nature of our hierarchical structures?
Not really. The watching bodies are the bodies now issuing commands, setting policy. When it comes to the commons, this sort of thing just isn't working in any area it is being tried.
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Old 02-14-2013, 12:31 PM #61
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The watching bodies are the bodies now issuing commands, setting policy.
No. The bodies issuing universal command and setting universal policy are those that best understand the universal issues and universal demands. The bodies issuing the local commands and setting local policy are those that best understand the local issues and local demands. I cannot think of anything more logical.

I could see an argument for the need for restructuring of power towards the local levels, but not for the simple dismantlement of hierarchical structures.
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Old 02-14-2013, 12:43 PM #62
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As long as Universal command/policy stays small in quantity, there is no issue. Then again, I am anti-federalist to the bone.
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Old 02-14-2013, 12:46 PM #63
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I think the relationship between universal and local is surely situational, is it not?
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