I was talking with a doctor recently about some of this and it seems that insurance is partly to blame for lower doctor pay. He used to have his own practice but the increased requirements from insurance companies kept getting so great that he ended up closing and working for someone else's practice and cramming in so many patients per day. Insurance companies want to make a profit and they will do it from patients, from providers, or from both.

The insurance companies bring their own set of problems just as do medical product companies (including drug companies) and socialized medicine. There really are so many double edged swords here being swung around.

As opposed to gov;t run healthcare which must use taxes, premiums and national debt to pay for buildings, services, supplies, companies, etc.

No one is going to provide state-of-the-art health care unless they make money.  Whether the gov't pays or the insurers and uninsured, someone pays.

Maybe if the politicians who take big donations from big pharma and the insurance sector stopped, we'd see a drop in prices.  Until then, don't expect anything to change.  When US citizens can't buy cheaper drugs from Canada because DEMOCRATS who campaign on improved healthcare voted it down, you can't expect the costs to get any better.

But, at least ONE person in DC is trying ....  Now, if Congress could do something other than "WE HAVE TO IMPEACH TRUMP AT ANY COST!"

https://abcnews.go.com/Politics/trump-administration-announces-plan-lower-drug-prices/story?id=64679533

Trump administration announces plan to lower drug prices

Jul 31, 2019, 2:21 PM ET

On the heels of Tuesday night’s Democratic debate where presidential hopefuls pitched plans to lower health care costs,
the Trump administration moved to fulfill one of the president’s own pledges: lowering pharmaceutical drug costs.

The U.S. Department of Health and Human Services on Wednesday unveiled a new plan that could lower prescription
drug costs. The plan includes a proposal to import FDA-approved drugs from other countries like Canada.

“For the first time in HHS’s history, we are open to importation: We want to see proposals from states, distributors, and
pharmacies that can help accomplish our shared goal of safe prescription drugs at lower prices,” HHS Secretary Alex Azar
said Wednesday on a call with reporters.

According to HHS, the dual-pronged plan would establish a rule that would allow various entities, like states and pharmacists,
to create proposals for the FDA. The FDA would then look at how “they would import certain drugs from Canada that are
versions of FDA-approved drugs that are manufactured consistent with the FDA approval,” according to HHS.

The second part of the plan would have the FDA create recommendations for drug manufacturers that sell FDA-approved
drugs in foreign countries but want to import those drugs to the U.S.

“To use this pathway, the manufacturer or entity authorized by the manufacturer would establish with the FDA that the foreign
version is the same as the U.S. version and appropriately label the drug for sale in the U.S.,” HHS said.

HHS noted in its announcement that this part of the proposal could also potentially lower the price of medications for insulin
and cancer, among others.

Azar also called on Congress to continue working on ways to lower drug costs.

As opposed to gov;t run healthcare which must use taxes, premiums and national debt to pay for buildings, services, supplies, companies, etc.

No one is going to provide state-of-the-art health care unless they make money.  Whether the gov't pays or the insurers and uninsured, someone pays.

Maybe if the politicians who take big donations from big pharma and the insurance sector stopped, we'd see a drop in prices.  Until then, don't expect anything to change.  When US citizens can't buy cheaper drugs from Canada because DEMOCRATS who campaign on improved healthcare voted it down, you can't expect the costs to get any better.

But, at least ONE person in DC is trying ....  Now, if Congress could do something other than "WE HAVE TO IMPEACH TRUMP AT ANY COST!"

https://abcnews.go.com/Politics/trump-administration-announces-plan-lower-drug-prices/story?id=64679533

Trump administration announces plan to lower drug prices

I am glad Trump is working to lower drug prices. He is going to face some stiff resistance from the pharmaceutical companies, hope hit actually makes it through.

Government health insurance eliminates some or most of the problems with the profit aspect but it does bring a different set of problems to the table. I think the best solution is to find a combination of government subsidization and free market ingenuity. Having purely one or the other results in terrible outcomes.

What do you think about the VA? Do you think it should be fully or partially privatized? I see a number of inefficiencies in the system but I think it can serve as a lesson on what can be done right and done wrong by government run healthcare.

I am glad Trump is working to lower drug prices. He is going to face some stiff resistance from the pharmaceutical companies, hope hit actually makes it through.

Government health insurance eliminates some or most of the problems with the profit aspect but it does bring a different set of problems to the table. I think the best solution is to find a combination of government subsidization and free market ingenuity. Having purely one or the other results in terrible outcomes.

What do you think about the VA? Do you think it should be fully or partially privatized? I see a number of inefficiencies in the system but I think it can serve as a lesson on what can be done right and done wrong by government run healthcare.

The VA, like all massive gov't run institutions, is fraught with fraud, waste, abuse, incompetence and corruption.  It was improved to some degree when Trump signed an order allowing patients on wait lists to use outside, non-gov't providers.  It greatly reduced the backlog of people trying to be seen.

Obama ran on fixing the VA in 2008.  in 2012, the VA was letting people die while on 12 month waitlists while managers collected performance bonuses based on falsified reports of patient care.

The government is just too big.  Nobody knows what anyone is doing -- good, bad or otherwise -- unless it winds up on the news.  Then the media tries to cover it up if "their guy" is in the WH, or they blow it out of proportion and blame the guy who DID NOT CAUSE THE PROBLEM for its existence.

Obama's efforts did very little to improve problems at the VA. It took Trump, a problem solver, to actually make a dent in it.

There are many vets who commit suicide in VA parking lots because lack of treatment.

Before I understood the topic of the government providing everything, I thought that Michael Moores movie Sicko had a good point from a British PM.  He said after WWII, if they could fund a war, why can't they provide heath care to all?  Sounds good in theory.  But fast forward to today.  Their health care system sucks.  Long wait times and people missing out on treatments due to lack of staffing.

But now I understand.

The harsh reality is that medical care will never be "free". The medical professionals and industry are expensive because of the extensive training and technology.
Would you work for free after spending years and thousands of $$$ in education?
Like food and shelter, medical care is a responsibility of the individual - not the government.

The harsh reality is that medical care will never be "free". The medical professionals and industry are expensive because of the extensive training and technology.
Would you work for free after spending years and thousands of $$$ in education?
Like food and shelter, medical care is a responsibility of the individual - not the government.

That is very true. 

When I comment about the healthcare industry, it's mostly about the drug companies and the healthcare executives.  Not the nurses, doctors, etc primarily doing the work.  I mean, I'm all about people getting their due for their extensive training, but there are many who are flat out raping others. 

The harsh reality is that medical care will never be "free". The medical professionals and industry are expensive because of the extensive training and technology.
Would you work for free after spending years and thousands of $$$ in education?
Like food and shelter, medical care is a responsibility of the individual - not the government.

Try watching Sicko.  There is a young doctor in Brittan or some where around there.  He states that he and his wife have only 1 home and 2 cars.  1 is an Audi.  He said this luxury of goods is common with many doctors in Brittan.  Compared to the US where doctors have multiple homes and cars (Porsche, BMW, BNZ, etc...).  This is 1 reason why the country can partially afford to pay the doctors what they do.

Try watching Sicko.  There is a young doctor in Brittan or some where around there.  He states that he and his wife have only 1 home and 2 cars.  1 is an Audi.  He said this luxury of goods is common with many doctors in Brittan.  Compared to the US where doctors have multiple homes and cars (Porsche, BMW, BNZ, etc...).  This is 1 reason why the country can partially afford to pay the doctors what they do.

There's nothing wrong with that. They chose a profession where there is a high and constant demand for it.
We are in a capitalist society no matter what you'd want to believe. There is a level of economical Darwinism built into it.

Try watching Sicko.  There is a young doctor in Brittan or some where around there.  He states that he and his wife have only 1 home and 2 cars.  1 is an Audi.  He said this luxury of goods is common with many doctors in Brittan.  Compared to the US where doctors have multiple homes and cars (Porsche, BMW, BNZ, etc...).  This is 1 reason why the country can partially afford to pay the doctors what they do.

So, Doctors and other medical/healthcare workers should work under a "salary cap" for the good of the rest of the population, whereas every other non-gov't worker can ask for whatever compensation their particular education, experience, talent or specialization is supported by the market?

That's basically what your (Socialist) example requires.  The state/feds will dictate what is "enough" for the people they pay vs. being paid by patients and insurance outside of a gov't run system.

Doctors with a good reputation and/or specialized skillset can demand higher pay.  Most of the doctors people point to as "overpaid" are surgeons, anesthesiologists, or other specialized or skilled doctors who can do things not every HMO primary care doctor can do.  If they could, don't you think they would be?  Many doctors make more modest incomes, spend many hours seeing lots of patients a day, spend many after-office hours doing paperwork or reading up on current advancements in medicine, etc.

I think we have a tendency to look at the top tier of a profession to make a point, but ignore the majority who are already making what you'd consider "reasonable incomes".

We all know doctors have to get a 4-yr undergrad degree, another 4 yrs in graduate medical school, and 2-5 years in residency.  That's a minimum of 10 years, and as many as 13 years or more, of their lives spent preparing for their career.  Unless they have someone else pay for their education and living expenses, they are having to hold down a job outside of school and take on huge student loan debt.  If they are lucky, that debt will be paid off in another 10 years once they begin their actual practices.

Each year, over 20,000 U.S. students begin medical school.  They routinely pay $50,000 or more per year for the privilege,
and the average medical student graduates with a debt of over $170,000.  That’s a lot of money.  But for some who pursue
careers in medicine, the financial cost has been considerably greater.  Melissa Chen, 35, a final-year radiology resident at
the University of Texas San Antonio, calculates that her choice of a medical career has cost her over $2.6 million in lost wages,
benefits, and added educational costs.  And yet in her mind, the sacrifice has definitely been worth it.

“So I enrolled in a post-baccalaureate program to complete my premedical requirements and then started medical school
back in my hometown of San Antonio.  It has taken two years of additional premedical studies, four years of medical school,
and five years of residency, for a total of 11 years.”

https://www.kevinmd.com/blog/2014/11/2-6-million-cost-becoming-doctor-worth.html

Take away the opportunity to recoup that cost, pay off their education debts and afford a career in medicine while possibly starting a family, and the prospect will start to lose its attractiveness.

If the response is to let the gov't (tax payers) subsidize that educational and residency process, that opens up another bunch of problems, like people without the aptitude choosing this career path because they can't or don't want to pay for their own education.  We still have to maintain the quality of the services provided.

You get what you pay for.

A lot of people are willing to accept lower quality of care in exchange for cheaper prices and making it available to all....

....until they are stricken with a life threatening illness.  I would not want to be in any other country if I had cancer.

A lot of people are willing to accept lower quality of care in exchange for cheaper prices and making it available to all....

....until they are stricken with a life threatening illness.  I would not want to be in any other country if I had cancer.

Or ....

They go to the doctor for what they think is a minor complaint, and the treatment or misdiagnosis results in a worsened, even fatal, outcome.

Not saying malpractice and negligence are nonexistent now.  Just saying that as bad as it is now, it'll only get much worse under gov't-run healthcare.

See my reply re: the VA for reference.

Another way to think about it is you need open heart surgery needed to save your life and had 3 choices.

Hospital A:. Best doctors in the nation and newest treatments but will put you in bankruptcy.

Hospital B:. Good doctors and cheaper, but you'll be paying off the doctor bills for a long time.

Hospital C:. Interns and Doctors at the bottom of the list and old techniques.

Nothing wrong with these as long as you can choose.  The problem with Medicare for all is when you restrict prices it eliminates rewarding good doctors and researching new treatments, so all your left with is option C

Another way to think about it is you need open heart surgery needed to save your life and had 3 choices.

Hospital A:. Best doctors in the nation and newest treatments but will put you in bankruptcy.

Hospital B:. Good doctors and cheaper, but you'll be paying off the doctor bills for a long time.

Hospital C:. Interns and Doctors at the bottom of the list and old techniques.

Nothing wrong with these as long as you can choose.  The problem with Medicare for all is when you restrict prices it eliminates rewarding good doctors and researching new treatments, so all your left with is option C

Exactly.  Look at what happened in the UK.  Parents were FORBIDDEN to seek medical care for their son outside of the UK Socialized medical system, even though there were people offering to pick up the cost.

An eight month old boy being denied “potentially life-saving” treatment at Great Ormond Street would be given it at
any hospital in America, a court has heard.

The parents of terminally ill Charlie Gard broke down in tears as they listened to medical evidence relating to his
rare genetic condition and what his doctors say is a “vanishingly small” chance of his survival.

But an American doctor who has agreed to attempt a pioneering treatment for his mitochondrial disorder, said that
it was “reasonable” to attempt to save his life and if he were in a hospital in the USA his parents would have the option.

Great Ormond Street, where Charlie is currently being treated, have applied to the High Court in for permission to
withdraw life support and argue that he should not be taken abroad for treatment as it will prolong his suffering.

His parents, Connie Yates and Chris Gard, who clutched his son’s toy monkey throughout the hearing, disagree and
have raised £1.2 million in less than a month to pay for treatment.

Death panels.

https://www.telegraph.co.uk/news/2017/04/03/terminally-boy-denied-potentially-life-saving-treatment-nhs/

Another way to think about it is you need open heart surgery needed to save your life and had 3 choices.

Hospital A:. Best doctors in the nation and newest treatments but will put you in bankruptcy.

Hospital B:. Good doctors and cheaper, but you'll be paying off the doctor bills for a long time.

Hospital C:. Interns and Doctors at the bottom of the list and old techniques.

Nothing wrong with these as long as you can choose.  The problem with Medicare for all is when you restrict prices it eliminates rewarding good doctors and researching new treatments, so all your left with is option C

Or Option D: Sell all possessions, and spend on hookers and cocaine.

So, Doctors and other medical/healthcare workers should work under a "salary cap" for the good of the rest of the population, whereas every other non-gov't worker can ask for whatever compensation their particular education, experience, talent or specialization is supported by the market?

That's basically what your (Socialist) example requires.  The state/feds will dictate what is "enough" for the people they pay vs. being paid by patients and insurance outside of a gov't run system.

Doctors with a good reputation and/or specialized skillset can demand higher pay.  Most of the doctors people point to as "overpaid" are surgeons, anesthesiologists, or other specialized or skilled doctors who can do things not every HMO primary care doctor can do.  If they could, don't you think they would be?  Many doctors make more modest incomes, spend many hours seeing lots of patients a day, spend many after-office hours doing paperwork or reading up on current advancements in medicine, etc.

I think we have a tendency to look at the top tier of a profession to make a point, but ignore the majority who are already making what you'd consider "reasonable incomes".

We all know doctors have to get a 4-yr undergrad degree, another 4 yrs in graduate medical school, and 2-5 years in residency.  That's a minimum of 10 years, and as many as 13 years or more, of their lives spent preparing for their career.  Unless they have someone else pay for their education and living expenses, they are having to hold down a job outside of school and take on huge student loan debt.  If they are lucky, that debt will be paid off in another 10 years once they begin their actual practices.

https://www.kevinmd.com/blog/2014/11/2-6-million-cost-becoming-doctor-worth.html

Take away the opportunity to recoup that cost, pay off their education debts and afford a career in medicine while possibly starting a family, and the prospect will start to lose its attractiveness.

If the response is to let the gov't (tax payers) subsidize that educational and residency process, that opens up another bunch of problems, like people without the aptitude choosing this career path because they can't or don't want to pay for their own education.  We still have to maintain the quality of the services provided.

You get what you pay for.

I had a real doctor friend who still lived at home and drove a beat up car.  He was making almost $100K a year.  I asked him how come he doesn't move out or have a newer car.  He said cause he's paying off his student loans.  Then I saw him a few months later and he was driving a BMW.  So I asked if he paid off his loan.  He said no.  But he talked to his other doctor friends and they all have nice stuff.  They made him realize that if he died today, he would have not had to enjoy the nicer things in life.  So pay the min on the student loan and move out and buy what he wants.  Enjoy his hard earned career, which is what he did.

I had a real doctor friend who still lived at home and drove a beat up car.  He was making almost $100K a year.  I asked him how come he doesn't move out or have a newer car.  He said cause he's paying off his student loans.  Then I saw him a few months later and he was driving a BMW.  So I asked if he paid off his loan.  He said no.  But he talked to his other doctor friends and they all have nice stuff.  They made him realize that if he died today, he would have not had to enjoy the nicer things in life.  So pay the min on the student loan and move out and buy what he wants.  Enjoy his hard earned career, which is what he did.

That scenario isn't unique to medical doctors, especially in high cost of living areas like Hawaii.

I know a guy who had his doctorate degree in mathematics.  His undergrad degree was from Harvard.  He worked for my company, a worldwide technology contractor. 

He also lived at home with his mother and father and had huge student loan debt.  I believe he drove a car he'd recently bought new, but nothing high-priced.

Lifestyle often dictates whether you can live within your means.  Nothing says you can't "enjoy" your life while digging out from under massive debt.

When you try to keep up with the Jones, you better first make sure the Jones aren't living on credit cards and only 2 paychecks away from bankruptcy.   

I had a real doctor friend who still lived at home and drove a beat up car.  He was making almost $100K a year.  I asked him how come he doesn't move out or have a newer car.  He said cause he's paying off his student loans.  Then I saw him a few months later and he was driving a BMW.  So I asked if he paid off his loan.  He said no.  But he talked to his other doctor friends and they all have nice stuff.  They made him realize that if he died today, he would have not had to enjoy the nicer things in life.  So pay the min on the student loan and move out and buy what he wants.  Enjoy his hard earned career, which is what he did.

it happens to not real doctors too...

My brother was an OB/GYN for most of his career. He worked hard and put himself through USC and UC Davis as well as his internship where ever it was. He supported his family up to 7 kids at one point. He was the sole breadwinner. He never drove nice cars. Always bought used and drove them until they died. He even fixed them himself. However, he did buy nice homes due to his large family. He always bought high and sold low. Or in one case he over built for the neighborhood and never got his money back out of the house. He had his own practice and had 2 other doctors in his practice. Most of his time was spent in SoCal. When the Dems took over SoCal and the taxes and mostly the cost of insurance became unbearable he moved his family to Utah where he finished his time as a doctor. He had his own practice until the HMO insurance became the norm of the insurance industry. He couldn’t afford to pay his staff and accept mostly HMO patients unless he only spent a few minutes with each and ran as many as he could through his office. So basically the insurance business model of the HMO put him out of business. He didn’t get enough business without accepting HMO patients and he didn’t make enough money per HMO patient to keep his practice above water. I am sure there were other factors he didn’t tell me about.

He basically sold his practice and only the money he got and his very modest home for all his years of being a successful doctor. We worked in the IT field for about 5 years before his heart failed him. He has managed to live another 10 years with a heart that only works at about 40% on good days. He managed to pay off his house before his health problems. He has been retired living comfortably. He bought himself a 10 year old Infiniti. That is the most expensive car he has ever owned. My brother was never very good with his money when he was making a great living. I think he peaked around $250k a year back in the 80’s, maybe 90’s. If he had a few less children and was better with his money I am sure he would be much better off. His wife still works at 72 because she loves what she does. And my brother has been on her insurance all this time. But if she had retired and my brother had been on Medicare he would have had to declare bankruptcy and probably living with one of his kids.

After watching a small part of the debates tonight it sounds like Warren and Bernie are backing off a bit on the Medicare for all because I think people are realizing it is not what it sounds like in reality.

We are in a capitalist society no matter what you'd want to believe. There is a level of economical Darwinism built into it.

NO, we don't live in a capitalist society.

We live in a Ultra-Wealthy/Corporatocracy controlled SOCIALIST society, where if the ultra-wealthy/corporations make money they find tax loopholes to avoid taxes, and when they fail, they will receive a government bailout from looting the masses.

As for the middle class, well, they are slowly dying away since they are the ones who have to pick up the slack from the Ultra-Wealthy/Corporatocracy who don't pay their fair share of taxes.

NO, we don't live in a capitalist society.

We live in a Ultra-Wealthy/Corporatocracy controlled SOCIALIST society, where if the ultra-wealthy/corporations make money they find tax loopholes to avoid taxes, and when they fail, they will receive a government bailout from looting the masses.

As for the middle class, well, they are slowly dying away since they are the ones who have to pick up the slack from the Ultra-Wealthy/Corporatocracy who don't pay their fair share of taxes.

you should stop supporting and shopping at Walmart, Amazon, McDs...avoid all the malls...ditch your corporate made car..

that's why you distressed...