[PRCo] Re: Gas Prices

[John Swindler]

Thank you, Rich.  Very much enjoyed your "insiders" viewpoint.  If you care to lay out a solution for our health care mess, may I request being put on the distribution list??
 
Cheers
John
 
 
 
 
> Date: Tue, 30 Dec 2008 18:00:22 -0500> From: allmanr at verizon.net> Subject: [PRCo] Re: Gas Prices> To: pittsburgh-railways at dementia.org> > 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> > > > > >> >> _________________________________________________________________> >> Life on your PC is safer, easier, and more enjoyable with Windows> >> VistaR.> >> http://clk.atdmt.com/MRT/go/127032870/direct/01/> >>> >>> >>> >>> >> >> > > > 
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