[PRCo] Re: Gas Prices

[Richard Allman]

anyone who wants to know what I think is needed to fix our health care mess, 
contact me off this site and I'll lay it out. You might be surprised re: my 
view and if you are a Red State mentality you probably won't like it. 
Suffice it to say, that a "system" which consumes more than 15% of GNP, 
leaves 47 million people without any coverage and another almost 50 million 
underinsured has problems. Add to that the impact on American industrial 
competiveness because of health care expenditures(GM's biggest supplier is 
no long USX or it's successors, it is Blue Cross of SE Michigan.) Then look 
at the disparities in care-back operations per captia much higher in New 
Haven than Boston w/ similar populations and severity adjusted disease 
incidence. Then look at some outcomes-third world type incidence of infant 
mortality and thoroughly undrwhelming life expectacny vs. other 
industrialized nations. Other nations have found a way to cover all of their 
citizens, with better outcomes, for far less cost. Then the fragmentation of 
care-ping ponging from one specialist to another with a shortage of primary 
care physicians due to pathetic reimbursement and a system that rewards 
technical procedures, but nothing for those who follow patients and at the 
right time decide that the procedure is timely. The situation is like this-a 
woman who is the wife of a retured dentist living on the Main Line 
approached me after church a few months ago and told me she was unable to 
find a primary care physician who is accepting new patients. Similar stories 
are reported in Metropolitan Boston, home of some of the world's best 
hospitals. Medical students graduate with like $200,000 in student loan debt 
and are pushed into high paying specialties, irrespective of societal needs. 
And believe me, society is invested: the huge tuitions cover only a fraction 
of medical education and the rest is subsidized; students get to learn on 
patients doing examinations well before they are fully qualifed. Therefore, 
medical knowledge and skills are in no way the property of physicians-they 
are a public trust. It's eay to beat on the VA system, and it has had a too 
long history of problems, but by any pbjective measure, the quality of care 
there in the past decade has probably improved more than in any other 
system. It's easy to rail against Medicare, but look back to before there 
was that program, and firther, Medicare has the lowest percentage of 
expenditure for overhead of any system in the US. Sorry to rant for so long. 
You got me started, Fred!Happy New Year , all!

RICH
Richard L. Allman, MD
President, Medical Staff, Albert Einstein Medical Center
Medical Ethicist
Medical Revolutionary -in-Waiting
PTM Member

----- Original Message ----- 
From: "Schneider Fred" <fwschneider at comcast.net>
To: <pittsburgh-railways at dementia.org>
Sent: Tuesday, December 30, 2008 9:14 AM
Subject: [PRCo] Re: Gas Prices


> And, whether we wish to recognize it or not, with the welfare medical
> cards for those of insufficient means to afford medical care
> otherwise, we are somewhere in the middle.    We simply have refused
> to acknowledge it.    There are several of us on this list who have
> relatives who participate by choice.   Will someone explain to me
> what the difference is?   Yes, the difference lies in the middle
> between those who have employer paid benefits or abundant cash and
> those who have nothing or choose to have nothing ... those who
> struggle and get no where may have nothing.   However, the doctors
> can still not turn them down.
>
> It is the doctor who gets screwed.  One of the many I have collected
> as I aged told me several years ago, "I have not raised my rates in
> five years because it won't do any good.   The insurance companies
> and medicare tell me what they are going to pay me anyway."   What he
> left unsaid was that he didn't have the heart to charge those with no
> money.   Unfortunately, what happens is that the minutes the doctor
> can allocate to each patient becomes reduced each year and the
> patient is forced, in some ways, to control his own medicine and to
> make sure he asks the right questions.   There is a medical
> practitioner on this list who I personally know wrote off a
> substantial amount of money when he went from private practice to
> hospital practice some years ago.   My father-in-law wrote of
> hundreds of thousands of dollars in his life time as a surgeon.
> Sadly the image is a man driving around in a big car; they are not
> all like that.
>
> On Dec 30, 2008, at 8:54 AM, Edward H. Lybarger wrote:
>
>> If you remove the profit motive, you remove the incentive for any
>> kind of
>> quality or service.  But you also get in trouble when there is
>> unlimited
>> profit motive, because in the hubris, the recognized need for those
>> qualities gets lost.
>>
>> As with everything else, the best position is somewhere in the middle.
>>
>> Ed
>>
>> -----Original Message-----
>> From: pittsburgh-railways-bounce at lists.dementia.org
>> [mailto:pittsburgh-railways-bounce at lists.dementia.org] On Behalf Of
>> John
>> Swindler
>> Sent: Tuesday, December 30, 2008 8:37 AM
>> To: pittsburgh-railways at dementia.org
>> Subject: [PRCo] Re: Gas Prices
>>
>>
>>
>> We already have an example of socialized medicine in this country.
>> It's
>> called the Veteran's Administration.
>>
>> I've heard some good stories about the VA, particularly the one in
>> Lebanon,
>> but also too many horror stories.  Also, there were three incidents
>> over
>> past 12-15 months of patients being ignored in emergency rooms to
>> die.  All
>> three happened in government run facilities.  I'd rather be able to
>> schedule
>> an appointment at Lancaster General instead of being put on a VA
>> waiting
>> list.
>>
>> John
>>
>>
>>
>>> Date: Mon, 29 Dec 2008 14:50:18 -0800> From: pcc_sr at yahoo.com>
>>> Subject:
>> [PRCo] Re: Gas Prices> To: pittsburgh-railways at dementia.org> > > -----
>> Original Message ----> > > From: John Swindler
>> <j_swindler at hotmail.com>> > >
>>>>> My wife went on a mission trip to Novosibirsk several> > years ago,
>> and at a get-together showed a picture of our > > house. The
>> 'locals' wanted
>> to know on which floor was> > our apartment located. She felt
>> embarrassed
>> telling them> > that we lived in the entire house. And our > > square
>> footage is smaller then the average.> > When living in San
>> Francisco in the
>> 1980s I attended a> church which had a big missionary project to
>> Russia> as
>> well as Russian immigrants here. Mention a trip> to the super
>> market and
>> they begged to go along. They> were constantly astonished at the
>> variety we
>> have here.> > The battle cry of protesters coming out of the hippy
>> era> was
>> 'food for people not for profit.' Remove the profit> incentive and
>> there
>> goes our variety doesn!
>>  't it. That's why> I give pause to 'socialized' medicine. As I
>> mentioned
>> before> we seem to have much better health care in some respects> than
>> Britain. But 'if' we go socialized method I shall> probably be
>> pushing up
>> the daisies by then.> > > Phil> > > > > >
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