There is a four-headed problem here: Insurance companies, lawyers, doctors and patients.

Right now, I’ve been threatened with a lawsuit if I stop treating a brain dead woman in my ICU. She’s been brain dead for almost three weeks and (by my rough estimate) has probably run up close to $100,000 in medical bills. All of this because the family is waiting for God to perform his miracle.

To the residents and students above. Save your breath. Nobody gives a damn about me or you. I gave my whole life to my patients and they took and took and took. Medicare just sent me a check for $5.67 for one hour’s work. Seems like people are very comfortable telling us what exactly a year of doctor’s work is worth. If my house floods and I need a plumber….I’m paying what he’s charging (which is more than I make an hour).

I’ve also trained foreign medical graduates for the last ten years and if the kiddie book author thinks that the answer is to let more of them practice here…oh boy, I can’t wait til they can’t figure his appendix from his pons. Medical school in most other nations is free….and it shows.

A $400,000 specialist is making as much as the President. He’s also making four times as much as GPs, despite the fact that every economic study I’ve ever seen says a GP is more valuable than almost any specialist.

They see more patients, which saves more lives. They keep people from getting sick, which saves lives and money. They actually bring in the same revenue to a hospital that a neurosurgeon does.

So the theory is that if you cut specialist pay by quite a bit, used some of the money to increase GP pay, used more to deal with idiotic Med-School costs, you’d still have cash left over.

And now what happens to the medical students today who in 10yrs will have their own practice? I guess for all their years of hard work and studying, people would rather just see doctors make $50,000 or less. So I guess today what we want is the less you were in school, the more you should make and the more you studied in school, the less you should make. That makes sense to me. Doctors no longer make the ‘BIG BUCKS’ as people may think. That era has long been gone.

Anyway, I just know how much I have put into this career and I dont think it is unreasonable to expect higher compensation.

Oh, and I will have over $200,000 in debt.

Many professions in this country start making money at yopunger ages. Doctors have to go to schools, read text books, journal for long hours. Then they have to go through long residency and internship programs anwhere from 3 to 8 years for pennies. Other professionals start making money and put that in 10% return, you are talking hundreds and thousands of dollars.

In this country Doctors have to deal with patient’s families, attorneys, insurance companies and hospital adminstrators etc.

If you bring doctors from other countries, I can guarantee you the standard of healthcare will go down. I have seen doctors in other countries practicing sub standard medicine.

You are priviliged to be in this country and enjoy the best system in the world for which you should be thanful for. You take zocor, you are lucky that you have no sideeffects, think about thousands of others who develop major problems from Zocor and ambien etc.

Good Luck

Doctors = War Criminals

My daughter has a seizure condition and the medication the doctor would like to put her on costs as much as $900 per month. Yet we called a pharmacy in Buenos Aires, Argentina (my wife is from there and travels there every year) and the exact same medication costs about US$50 there. Can someone explain why the same medication costs 1800% more here than in South America?

I’m an MD in surgery. More specifically a surgeon in training. Last week I worked 126 hours. The week before that I worked 112 and the week before that 121 hours. I am paid $41,550 per year. So based on the number hours I work I make $6.34 per hour. This is less than minimum wage in the state I live in. This also does not count the countless hours I spend studying and preparing for surgeries at home.

I haven’t seen my 1 year old son awake in 4 days. I’ve had one conversation with my wife in the last week.

In addition I have acrued over $250,000 in educational debt. I will not finish my training until I am 37 years old.

In my future I will be called at all hours of the night to help people in need – remove appendixes, gall bladders, colon’s etc – don’t get me wrong I love to operate. However, I will have no choice when I am called. If I wish to continue my profession I will have to go. Why shouldn’t I get to charge what I want? Imagine if you told a locksmith he couldn’t charge what he wants to help you when you are locked out in a thunderstorm at 3:00AM.

Mr. Reynolds, I challenge you to find a “lawyer, priest, firemen, waiter, businessmen, soldier, janitor, factory worker or clerk” who has worked these hours at this wage for 12 years.

This does not make me any better than those people. I do this because I love doing it. However, if you think I don’t deserve to make a healthy wage when I am done with my training then you need to have be examined by a psychiatrist (although maybe the pschiastrist will close up practice because you won’t make it worth it to him to practice).

Mr. Reynolds, until you take a walk in my shoes you should keep your mouth shut and not enter into a debate which only exposes your ignorance.

Finally, for everyone else. Let’s talk specific numbers….What do you all think a doctor deserves to earn? Well, the average pediatrician in washington, DC finished training with $250,000 in debt and is paid $94,000/year.

America, don’t our kids deserve pediatricians valued at higher then $94,000 a year?

I just want everyone to be clear that we are NOT talking about millions. The days of doctors making millions are over and have been over for quite some time. However, for what I have SACRAFICED, I deserve to not have to worry about how I am going to pay off my debt, afford a mortgage and put dinner on my son’s plate. At $94,000 a year with increasing malpractice insurance costs this is a very REAL concern.

I have argued that Health Savings Accounts lower healthcare costs because it makes people smarter about how they spend their money for healthcare. Your story is a PERFECT example of this. Insurance pays and who cares. But if the dollars are mine — then we get a little smarter about our decisions.

So let’s think about what kind of choices we are going to make when we get a single-payer, universal coverage healthcare system. The market requires people make value choices and I understand that a lot of people don’t like this concept when applied to healthcare, however there really is no choice unless one wants a grossly inefficient system that produces…

starving children outside the window of Alinea that I like to flick crispy calamari at while I sip on some vino.

I mean to write, “so what if we spend 16% or 18% or even 20% or more of GDP on health care?” not 6 or 8 or 10%

I’m less optimistic that this will curb costs much, if at all. The average doc does not earn a particularly princely income, although some do make millions a year (personally, if I ever need heart surgey, I want to get one of the guys who can make millions perfoming heart surgery).

Anyway, physicians and other clinical providers account for only 21% of the total health care costs, while hospital care accounts for the largest share — 30% — and is the fastest rising component of total spending. Prescription drugs are taking the rap as a fast-rising component, which is true, but they only account for about 10% of the total. And remember that many drugs are keeping people healthier so that they don’t land in emergency rooms or require even costlier care, so it may well be that the growth of prescriptions helps hold overall costs down.

Hospitalization is the biggest nut to crack. For decades, people have been saying we need better preventive care, better access to primary care providers, etc. better coordination of care in cases of people with multiple illnesses, etc.. And for decades, not much has happened to change any of that. Meanwhile, hospitals — not for profits every bit as much as for profits — are always pleading poverty, while running among the most powerful lobbies in Washington and the state capitals to keep the money flowing in. But there is a huge amount of overlap in services provided by various hospitals (in big metro areas anyway) that duplicates costs and drives up insurance reinbursements. One major way to limit the need for hospitalization is, of course, preventive care. Yet, Medicare DOES NOT PAY for “routine” annual check ups! Think about it. The over-65s are day by day more likely to get high blood pressure, high cholesterol, early diabetes, and other troubles that will land them in the hospital at some point. But they are no more likely than 55- or 45-year olds to go for an annual check up if they have no symptoms and feel good, when it will cost them $200 to $500. This is the place to start getting serious about preventive care and saving money on hospitals. Hear any Congressmen suggest that lately? Too simple for them.

All that said, my own view of this “crisis” is a bit unconventional. Pols of both parties are always decrying the “skyrocketing cost of health care.” but so what if we spend 6% or 8% or even 10% or more of GDP on health care? After food, shelter, clothing, education for my kids and public safety, I can’t think of anything I’d rather spend money on than staying healthy and living longer. When all of us collectively reach the same conclusion, we choose to buy a lot of health care, and the costs “skyrocket.”

The forces driving health care costs up are these:

– The population as a whole is aging.
– We are living longer and we want — and expect — to be healthy and active for a longer time than our parents or grandparents.
– Medical practice, technology and drugs are advancing at a faster pace, making new and better diagnoses and therapies available, almost literally by the day.
– The health care that is possible is available to roughly 250 million Americans through one or another insurance plan (the flip side of the 45 million who are uninsured). That’s a lot of people.

We can nip and tuck at the costs, but they are going up as long as these powerful factors are in play — i.e., as far into the future as we can see.

So the issue is how to extend care to people who have no coverage, period, which brings me back around to Reynolds point: there is now way we are going to be able to do that without increasing the numbers of providers and changing the way care is delivered — not the amount or quality of care, but the manner in which it is delivered. We need a system that puts primary and preventive care at the center. That’s what real reform would look like.

The insurance company paid them, not him, them 236 dollars. That doesn’t even cover the supplies used. So before you go around blaming doctors, maybe you should find out where all the money is actually going.

Dude, I’ve always been a capitalist. Picture big old bald guy smoking a fat stogie and driving a black German sedan.

I’m a Democrat because there’s a difference between capitalism and unregulated, non-transparent capitalism. And because I don’t fit in the tent with Dobson, LImbaugh and Hannity. And because I don’t want to have hungry kids staring in the window while I work my way through Grant Achatz’ tasting menu. I also accept the principle that because I’ve been lucky I can pay a bit more to carry the costs of our civilization.

Give me a rational, secular conservative alternative and I’ll re-examine my affiliation.