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Doctors Unionize to Resist the Medical Machine

nytimes.com

31–40 of 120 posts

Re: Doctors Unionize to Resist the Medical Machine

#31

I don't understand this about healthcare in the USA. Why not import a few thousand doctors from Asia through H1Bs, and drive down the cost of medical care? Remove artificial caps on licenses imposed by the AMA while at it.

The AMA is a very powerful lobbying group in the U.S. They have been able to steer regulations/laws on the state & federal level to limit competition.

Re: Doctors Unionize to Resist the Medical Machine

#32

I don't understand this about healthcare in the USA. Why not import a few thousand doctors from Asia through H1Bs, and drive down the cost of medical care? Remove artificial caps on licenses imposed by the AMA while at it.

Because you have to spend years re-training and certifying to US standards, all the time without a job and earning money to pay for said training:

http://www.npr.org/sections/money/2013/02/15/172108835/shoul...

And that's putting aside the fact H1-Bs are not exactly easy to come by right now.

Re: Doctors Unionize to Resist the Medical Machine

#33

I don't understand this about healthcare in the USA. Why not import a few thousand doctors from Asia through H1Bs, and drive down the cost of medical care? Remove artificial caps on licenses imposed by the AMA while at it.

Culturally, I suspect this would not go over well. There are a shocking number of people that would be less than impressed to be served by a doctor with a non-Anglo-Saxon last name, even if they spoke perfect English.

Especially older people, who are the largest consumers of healthcare.

Re: Doctors Unionize to Resist the Medical Machine

#34
post #7
post #6

One thing that I never understood about the US medical education is the requirement of the bachelor's degree (pre-med) before applying for most med schools. In my home country and many others, you can directly apply to med school. Now that the college costs are quite considerably expensive, four-additional year of college studies simply adds to the cost of becoming a doctor and therefore, the newly minted doctors exp…

I actually prefer the US system in that it potentially provides doctors with a more well-rounded education.

I'm torn, because on the one hand it is good for people to have a decently broad base of knowledge. On the other hand, most US colleges' idea of a "well-rounded education" is a straight-up holdover from educational programs whose only purpose was to prepare rich men's sons to make interesting conversation at parties and handle Daddy's business. When modern students actually want career prep, universities tell them they're getting career prep, and instead feed them dinner party prep at umpty-thousand dollars a year.

Re: Doctors Unionize to Resist the Medical Machine

#35
post #13

Earlier quoted context omitted.

And yet, when Texas put a cap on medical malpractice awards, the cost of medical care didn't go down at all. Surely you have a good explanation for that and you're not just repeating discredited talking points for personal gain.

You're incorrect, the cost of medical care is measurably lower as a result of tort reform in Texas. And maybe more importantly, accessibility of care has increased. You see price reflected in at least two places: 1) the variable in the formula for medicare reimbursements that reflects practice environment costs, and 2) more visibly, in Obamacare rates for the State of Texas, which would be significantly higher in the…

That second link is interesting since it claims that the perception of malpractice risk is overestimated among physicians since doctors are sued a fair amount (leading to a high perception of risk), rarely do they ever actually lose a case (leading to low actual costs). I don't see where it says that malpractice caps have any substantial reduction in the prices of medical care.

Further, your first link actually disputes your claim, not supports it.

> Theoretically, states that have enacted special laws to reduce unreasonable litigation (expert witness reform, case certification requirements, and medical review panels) and curb excessive rewards (damage caps) should have the most favorable environments, with physicians paying the lowest annual premiums. However, this is not always the case. The relationships between tort reform, malpractice costs, and medical liability environment favorability are complex and nonlinear.

Re: Doctors Unionize to Resist the Medical Machine

#36

Earlier quoted context omitted.

I believe you, but when I worked in a medical office in 1993 vendors were saying that exact same thing.

I know, I hope my Background as MD and CS plus the idea we had will make it different. We are working on something similar to an IDE :)

Break a leg :-)

And whatever you do, just don't let anyone deploy it on some overloaded Citrix server.

Re: Doctors Unionize to Resist the Medical Machine

#37
post #4
post #2

All of this rings true from what I've heard my dad, a GP, complain about for years. It's hard for him to watch other doctors game the system to increase their earnings -- not only seeing more patients with unaccountably short sessions, but also up-coding their maladies and ordering unnecessary tests. In addition to the pressure of seeing more patients per day, they have all this new administrative bullshit (ironicall…

My doctors usually spend less than 5 minutes talking to me and 10 minutes hunting and pecking at the computer. Some offices will have other staff do much of the data entry, but it doesn't seem to result in the doctor any spending more time with me.

You could try looking for Direct Primary Care, another growing movement among doctors in reaction to how messed up the system is.

I wrote a bit about it recently:

Http://micheleincalifornia.blogspot.com/2015/12/how-to-fix-americas-financial.html

Re: Doctors Unionize to Resist the Medical Machine

#38
Why do people insist on having objective criteria for performance when it's inherently subjective whether your care was any good?

I've seen this with the NHS in the UK. They have a bunch of numbers they have to make, but what do the numbers actually mean? What happens when people end up gaming the system, because the rules tell them to?

Re: Doctors Unionize to Resist the Medical Machine

#40
post #13

Earlier quoted context omitted.

And yet, when Texas put a cap on medical malpractice awards, the cost of medical care didn't go down at all. Surely you have a good explanation for that and you're not just repeating discredited talking points for personal gain.

You're incorrect, the cost of medical care is measurably lower as a result of tort reform in Texas. And maybe more importantly, accessibility of care has increased. You see price reflected in at least two places: 1) the variable in the formula for medicare reimbursements that reflects practice environment costs, and 2) more visibly, in Obamacare rates for the State of Texas, which would be significantly higher in the…

Neither link you posted corresponds to your claim about a drop in costs, and this report also contradicts what you're saying: http://www.citizen.org/documents/Texas_Liability_Limits.pdf

Do you have any other sources for your belief?

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