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The Amish health care system

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Re: The Amish health care system

#101

Post by swiley »

amiga_500 wrote: post #98
motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

“fully trained” has a different meaning in other countries. In the US the number of doctors that can be “fully trained” is artificially limited. Furthermore, many countries with cheaper healthcare have abbreviated training for doctors.

Re: The Amish health care system

#102

Post by throwawayjava »

amiga_500 wrote: post #98
motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

In other countries banks don't make five+ figures on every doctor's education, and their doctors certainly don't make enough to service six figures in education debt.

Finance capitalists keep the vicious cycle going. Doctors' unions scratch and claw for high comp because without it their new entrants are screwed.

Re: The Amish health care system

#103

Post by anon09809809 »

amiga_500 wrote: post #98
motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

The 250k+/year US salary of the fully trained doctor setting bones could be a problem. Many doctors are paid significantly less in many of those other countries.

Re: The Amish health care system

#104

Post by pmiller2 »

bmelton wrote: post #33
markdown wrote: post #13

Earlier quoted context omitted.

The same in Fiji. We have universal health care, but anyone is of course free to forego that and pay (or use their private insurance) for a private room rather than a ward, or just go to a private hospital instead. I don't understand the debate about this in the US. It's as if the rich assume that things will change for the worse for them if universal health care is enacted.

> It's as if the rich assume that things will change for the worse for them if universal health care is enacted. Well, it depends on the implementation, but Bernie Sanders has been on record numerous times as stating that his Medicare-for-All proposal would absolutely ban private insurance. Elizabeth Warren is another Democratic front-runner who indicated that she's on board with that, though her proposals didn't nec…

It's a slight misstatement to say that any of the M4A plans would have "banned private insurance." None of them prohibit supplemental coverage that would be secondary to Medicare.

Re: The Amish health care system

#105

Post by hash872 »

mannykannot wrote: post #86
_fq4v wrote: post #2

I thought the most interesting part was the commentary on non-Amish care in the past > I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, b…

The past is not a useful guide, because until recently, there was relatively little that could be done medically, and costs were commensurably low. The elephant in the room is that medical technology has advanced to the point where any person's needs can potentially greatly exceed their lifetime's ability to produce. When there are relatively few who find themselves in this state, insurance (and what is described in…

Big agree with this. Also there's no all-encompassing definition of 'healthcare' that will cover all categories, the way there is for groceries or cars or servers. As people get more disposable income to spend, they'll gravitate towards what is not so much medicine as improving their bodies (speaking as an older athlete who's spent significant money to repair shoulder, hip injuries & stay relatively young- my grandparent's generation would've said 'your shoulder's done, you're not young anymore, it's over', etc.) And then also end of life care- some amazing % of our healthcare costs go into the last 6 months of life, which is all totally optional care and we don't 'have' to have- but we want to because we have the disposable cash for it. We want the $27,000 cancer drug or the $100k for an extra two weeks of life on the backend

Re: The Amish health care system

#106

Post by flukus »

karmicthreat wrote: post #81
robocat wrote: post #64

Earlier quoted context omitted.

That is how health insurance works in New Zealand. If you want private health insurance for say $50 a month[1], then insurance gives access to procedures more quickly and the rooms are much nicer than the public health care system. It may give access to rare but expensive procedures. If you don’t want insurance, then the default is the public healthcare system, which is paid for by taxes. You will usually be in a war…

That system looks terrible for handling cancer and pre-existing conditions.

Cancer is not an elective surgery and gets treated with urgency. Across the Tasman Sea with a very similar system my father had bowel cancer removed the day after diagnosis in the public system and spent most of the recovery in no state to miss a private room.

Re: The Amish health care system

#107

Post by triceratops »

swiley wrote: post #101
amiga_500 wrote: post #98

Earlier quoted context omitted.

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

“fully trained” has a different meaning in other countries. In the US the number of doctors that can be “fully trained” is artificially limited. Furthermore, many countries with cheaper healthcare have abbreviated training for doctors.

> abbreviated training for doctors

I mean do doctors really need to spend 4 years getting a bachelor's degree in "pre-med"? If you know you're going to be a doctor why not just start off with biology, anatomy, physiology, chemistry in year one and go on to cutting up bodies in year 2? It seems utterly ridiculous to spend 4 years majoring in humanities, or calculus[1] only to seek entrance to med school.

The UK doesn't feel the need to do this.[2]

1. https://prepexpert.com/pre-med-class-recommendations/

2. https://en.wikipedia.org/wiki/Medical_school_in_the_United_K...

Re: The Amish health care system

#108

Post by new_time »

amiga_500 wrote: post #98
motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

In the 19th and early 20th centuries there was in the US a proliferation of medical schools - many unaffiliated with Universities - with very few entrance requirements, extremely uneven quality of education and little standardization in curriculum. In fact many people became doctors through apprenticeship right up through the turn of the 20th century. Many states had extremely lax or nonexistent licensing requirements. It was quite chaotic and unregulated.

In light of this, Abraham Flexner was commissioned by the Carnegie Foundation to produce a report on the state of medical education and to make recommendations.

The Flexner Report was published in book form in 1910 and set forth a programme of reform for medical education and the broader healthcare system in America. The structure envisioned by Flexner largely remains with us to this day.

The crux of the problem is that in response to a very chaotic system, order was imposed in the form of strict licensing and educational requirements which made sense given the problems of the time but have contributed to new problems in our time. Outdated regulations, standard practices and conventions have artificially restricted supply of qualified medical personnel in America and it's time we address these structural issues.

Targeted reform of the system is the best solution for American healthcare.

Re: The Amish health care system

#109

Post by gowld »

motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

The US has nurses and PAs for this stuff. A doctor is only needed as a staff supervisor, much like an engineering project only needs one licensed engineer to sign off.

It costs time to set a bone, even if you get MD service. GP doctors aren't very expensive. The costs are elsewhere.

Re: The Amish health care system

#110

Post by gowld »

anon09809809 wrote: post #103
amiga_500 wrote: post #98

Earlier quoted context omitted.

Other countries have fully trained doctors yet they don't have this problem. Therefore fully trained doctors setting bones is not the problem. It's another problem or set of problems that occurs in the USA.

The 250k+/year US salary of the fully trained doctor setting bones could be a problem. Many doctors are paid significantly less in many of those other countries.

It's not, though. It takes under an hour to set a bone, so that doctor's time is not driving the expense.
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