Honestly, why are distribution companies like McKesson and Cardinal involved in the process except to further fleece consumers? Or otherwise even exist?

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There are only two examples of infinity: The universe and human stupidity and I'm not sure about the universe.

Your idea is not outrageous. Maybe this Amazon idea today finally would break down the barriers to let groups of people and small businesses band together in cartels or something to use healthcare en masse. Getting insurance decoupled form jobs is not a bad idea.

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Elections have consequences.

Are those the management for the self insured companies?

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Elections have consequences.

The only thing I know of them is they're medical supply distribution firms, and now routinely get mentioned for funneling massive amounts of (edit)opiods to small town America.

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There are only two examples of infinity: The universe and human stupidity and I'm not sure about the universe.

Death Panels !!!

Most people are just trying to buy another two years at a time, because medical innovating makes it a potential benefit. I know that if I could have pushed my open heart surgery out three more years, I would probably been able to have a stent-like surgery and be back to normal in two weeks.

But there are many people who have higher lifetime health care costs than lifetime income. We don't want to drown them in the river like some 1880s Indian novel. But dealing with those costs compassionately is a big part if the challenge.

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"When people want their version of the truth, they go find it, no matter how baseless their beliefs." -- Ken Rosenthal

The faster we can make people die the faster we can take all their money for the treasury.

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Elections have consequences.

single payer is not the savior you think it is.

https://www.nytimes.com/2018/01/03/worl ... rvice.html

I'll take my private sector health care any day over single payer, and I say this as someone who has the experience of having lived in a country with a single payer system.

Also, re UK's failing NHS, the wait times have resulted in cancer survival rates which lag behind the rest of the developed world. Not surprising as cancer often requires quick surgery before it spreads and the staging/prognosis become worse.

https://www.thetimes.co.uk/article/thou ... -pwxxzw3sf

Another article I read on the topic showed that UK's survival rate for brain cancers is 26.3% whereas the US sees it at 36.5% (link here: https://www.dailyrecord.co.uk/news/uk-w ... g-11942705 )

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

This is a text book example of a post that is inherently inconsistent within itself.

Ogie's solution for cheaper and better health care is to:

- allow for shittier doctors to practice medicine (point #3); and
- prevent patients who are injured by these new and shittier doctors from seeking restitution (point #2).

Also I find it funny that the guy on the board who won't shut the fuck up about being a libertarian is openly advocating for government intervention into how the free market operates to make customers whole when their service provider causes them to suffer a loss due to service provider negligence.

Ogie's one of those libertarians when it's convenient for him to be one, or when it's cool to peacock around as if you are better than non-libertarians.

I guess reading comprehension isn't a strong suit here. Point 3 is nothing about allowing shittier doctors to practice, but simply about allowing more spots to be available. We have created a pipeline with artificially created choke points which result in us producing fewer doctors than are needed to serve the population of this country. That is a simple fact and I challenge you to find anything that contradicts this. The solution is to remove these choke points to allow more doctors to practice. Tell me, how will you treat 350 million Americans in any health system if there is a significant doctor shortage?

https://news.aamc.org/medical-education ... cian-shor/

As for 2, nowhere do I say that malpractice suits should be eliminated, but there certainly needs to be tort reform to prevent frivolous lawsuits. Simple measures such as plaintiffs who lose the case having to pay the doctor's legal fees would go a long way as a simple solution which does not prevent those who are actually harmed from seeking damages.

Regardless of any of the points above, the fact is we need more doctors so yes you need to open up the field to more practitioners as neither overall health care nor the costs of health care will improve if the doctor shortage is allowed to both persist and then worsen.

What is your solution? Is it to continue limiting the number of new docs so that our system collapses as NHS is right now?

Here is a nice look at how our regulations have created the shortage. Requiring licensed doctors from overseas (even those licensed in 1st world countries like the UK) to undergo a residency is particularly egregious. https://mises.org/library/how-governmen ... r-shortage

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

Artificial choke points = standards, processes, and safeguards to ensure that our medical doctors are supremely qualified. I mean would you let a "doctor" licensed in North Korea perform an open heart surgery on you? Doubtful.

What is my solution? Now listen close, and this might be hard for you to understand, but I don't have a "One Post Solution", largely because I'm not educated enough on the issue from a medical perspective, economic perspective, demographic perspective, etc.

I know that's hard for you to understand because you are an expert on every subject under the sun, and several more subjects that haven't been conceived as of yet. Well,either you're an expert, or you just play a know it all on message boards, one of those.

Do we need more doctors? Yes. Do we need cheaper access to medical care? Yes.

Do we need to lower standards for physicians to accomplish this? I hope not, and I would like to exhaust a lot of other means before we go with the ole "open the floodgates to anyone" approach to developing physicians in this country.

Also, not for nothing , but you realize there are very few frivolous lawsuits when it comes to med mal? You realize this right? Probably not.

Bringing a med mal case is an extremely expensive proposition, you've got to pay experts in many fields, medical, actuarial, quality of life, etc. It's laborious. There are depositions, reports, more depositions, etc. All of this costs money for the plaintiff, or more likely the plaintiff's attorney who up fronts all of this money and doesn't get paid unless the case is a winner. You don't have a whole lot of lawyers looking to roll the dice with a year or more of their professional time and at least 100K+ of potential expenses depending on the complexity of the claim for something that is frivolous.

Also, not for nothing , but you realize pretty much every jurisdiction has civil rules in place to address frivolous claims be they med mal, or any other civil case?

One post, quick question for only the last part. Why is malpractice insurance said to be so expensive for docs and hospitals?

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Elections have consequences.

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I'm never arguing with One Post

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There are only two examples of infinity: The universe and human stupidity and I'm not sure about the universe.

no fees unless recovery...not sure what you're talking about

Wouldn't need more doctors if people in this country took any interest in taking care of themselves. Country is full of a bunch of fat fucks sitting at computers and eating food-like meals all the while using the excuse that they would rather enjoy life than eat some vegetables and walk up the stairs.

Change the fucking attitude towards health in this country and things will get better. Not enough pills in the world going to help someone be less fat, selfish, and lazy.

Right, re-read my post.

That attorney comes out of pocket for all the expenses pre-trial. You think that attorney wants to shell out 100k on experts and give up a year of his life for a case that is frivolous?

This gets back to my post above? Who says it is so expensive?

I don't know if it it, I have no idea about insurance expenses for the medical profession. I don't have any idea about the insurance expenses for any other profession. I'm not an expert in either insurance, or more specifically in medical malpractice insurance.

So is it expensive? I have no idea if it is or not, and I'm guessing you don't either.

If it is expensive, why is it so? Again, I have no idea and I'm guessing you don't either.

More importantly, is will curbing malpractice verdicts lead to lower overall healtcare costs, and provide better care? I really don't know.

Nowhere in your post do you even start to address the fact that our current doctor training pipeline is not producing enough doctors to either replace retirees or meet the increased healthcare demands of a growing and aging population.

Clearly the only solution to such a shortage is to increase the number of doctors, and yes in order to do so you will have to find some areas to loosen the choke points in the training pipeline, which BTW is a 10 year training pipeline once they enter med school. I don’t know what utopia you are living in, but there is simply no way to address the shortage of doctors without somehow admitting more doctors into residencies.

The fact is that unless you train more doctors, healthcare costs will increase even more. This is simply supply and demand. We can already forecast our future demand for healthcare (thus the predicted 100,000 doc shortage in 2030). This in concert with an inadequate supply of doctors will of course result in healthcare costs going up for everyone as a doctor’s time will become that much more valuable of a commodity. The solution to preventing an increase in costs while also meeting the healthcare needs of the country would clearly be to find a solution on the supply curve, thus the need to increase the number of practitioners.

Something has to give and that may be lowering the standards for new docs. Is it perfect? No, but the fact is you need more doctors and there doesn’t appear to be any other valid solution short of opening more residency slots. You can partially accomplish that if you don’t require a foreign doc who can already pass boards to go through a residency. 15% of current US residency slots are occupied by such doctors. If you increase open residency slots in this country by 15% via this means alone, you go a long way towards solving the doctor shortage, which both increases the available care and reduces costs.

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

That's not exactly true. Physicians assistants and nurse practictioners are getting used in larger numbers to help offset it.

Also, like with almost all shortages about a specific industry, it's about taking away the leverage of workers more than it is about actual shortages. Outside of small areas that don't have the patient population to ever have specialists, there isn't an area in the country without access to doctors. There may be a wait to get admitted as a new patient but it's not like hospitals are shutting down with a sign that says "No doctors available".

Now, there are certainly unfilled jobs, but any industry that isn't failing has unfilled jobs.

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You do not talk to me like that! I work too hard to deal with this stuff! I work too hard! I'm an important member of the CSFMB! I drive a Dodge Stratus!

To add to my point on the red tape preventing doctors who could easily pass the boards from practicing without taking up a residency slot that would better be used by a fresh med school grad, here is a NYT piece.

http://www.nytimes.com/2013/08/12/busin ... in-us.html

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

Coincidentally, those were Chet's dad's last words as the anesthesia was taking effect.

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Power is always in the hands of the masses of men. What oppresses the masses is their own ignorance, their own short-sighted selfishness.
- Henry George

We aren't seeing the effects of the doctor shortage now, but it will start to really be felt a decade down the road. There is a large number of baby boomer doctors on the verge of retirement with not enough new docs in the pipeline. That is going to hit us at the same time we are going to see spike in demand for healthcare triggered by the rest of that generation requiring the additional healthcare demands that come with old age.

We are going to see some serious problems stemming from this shortage if it is not addressed.

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

Ogie's doctor

Job shortage projections are always tough to believe but the increase in nurse practitioners and physicians assistants is how that is already being addressed.

There should be more residency spots but I don't think foreign doctors are the answer, especially when the examples are guys like that one in the article that struggled to find a residency because of poor scores.

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You do not talk to me like that! I work too hard to deal with this stuff! I work too hard! I'm an important member of the CSFMB! I drive a Dodge Stratus!

That might be the greatest troll of all time. When did he state that fact? 20 years ago?

Time will tell, but we're really seeing a lot of the projected shortages in family practice and primary care. It seems PA's are going largely into specialty areas.

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

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I think they'd be better served paying more in the needed specialties for those. Flooding the market with foreign doctors with questionable training and low test scores on our standardized tests can put the whole system in question.

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You do not talk to me like that! I work too hard to deal with this stuff! I work too hard! I'm an important member of the CSFMB! I drive a Dodge Stratus!

I"m not saying docs who can't pass the tests should be practicing, but foreign trained docs who can pass the boards should not have to go through 4 years of residency. having them do so both wastes 4 years that they could be practicing medicine and also denies a slot to a US med school grad. If the foreign doc can't pass boards, then fine, a residency is in order.

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“When I walked in this morning, and saw the flag was at half mast, I thought 'alright another bureaucrat ate it.'" - Ron Swanson

The problem is that passing the boards alone doesn't really tell you if they are a safe doctor or not. There are countries where you become a doctor with a laughably small amount of extra work.

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You do not talk to me like that! I work too hard to deal with this stuff! I work too hard! I'm an important member of the CSFMB! I drive a Dodge Stratus!