[PRCo] Re: Gas Prices

[John Swindler]

This emails a 'keeper'.  Thank you, Rich
 
John
> Date: Wed, 31 Dec 2008 17:08:02 -0500> From: allmanr at verizon.net> Subject: [PRCo] Re: Gas Prices> To: pittsburgh-railways at dementia.org> > 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> > > > > >> > > >> _________________________________________________________________> >> > > Life on your PC is safer, easier, and more enjoyable with Windows> >> > > VistaR.> >> http://clk.atdmt.com/MRT/go/127032870/direct/01/> >>> >>> >>> > > >>> >> >> > > >> > _________________________________________________________________> > It's the same Hotmail®. If by "same" you mean up to 70% faster.> > http://windowslive.com/online/hotmail?ocid=TXT_TAGLM_WL_hotmail_acq_broad1_122008> >> > > > 
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