[PRCo] Re: Gas Prices

[Richard Allman]

ok, John- I'll get it to you. What I suggest is a highly readable book on 
the subject by Arnold S. Relman, MD, former chairman of the Department of 
Medicine at the University of Pennsylvania School of Medicine and former 
editor-in-chief of the prestigious New England Journal of Medicine. I'll get 
the exact title for you. Happy New Year! RICH
----- Original Message ----- 
From: "John Swindler" <j_swindler at hotmail.com>
To: <pittsburgh-railways at dementia.org>
Sent: Wednesday, December 31, 2008 8:50 AM
Subject: [PRCo] Re: Gas Prices


>
>
> 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 med
> ical 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@!
> 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 g!
> oing 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 wit!
> h 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 does!
> n!> >> '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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