If we all put our troubles out by the street where we could see our own in comparison to our neighbors, most of us would drag our own pile back into the house rather than someone elses. We picked our own particular poison for a reason, and if we now see the reason to have no basis in our essential character, then we have the freedom to change.

I said with exceptions. Neurosurgeons, among others, deserve their bucks.

In terms of NPs, until there is evidence to say that increasing their prevalence to manage anything beyond basic health care needs, I cannot agree. Enough data exists to support buttressing primary care in lieu of subspecialists (better outcomes, lower cost). We need a national workforce policy and more well thought out ratios of physicians. Continuing down current path will lead, if we are not there already, to collapse of our primary care infrastructre (of which midlevels should be a part by the way).

The law grad will get $160K out of law school. The med student has been taking care of patients for two years upon graduation, after four years. The law student, has never spoken to a client, nor even written a legal demand letter in anger, after three years of empty verbiage.

The mid-career law partner makes $1.2 mil a year, as an average.

Let’s put things in perspective.

The average lawyer destroys more than $1mil of our economy each year the land pirate lives.

The average doctor restores over $10mil to our economy year after year, by keeping people working, or keeping people from getting worse.

The lawyer makes 99% of the policy decisions of the government. They have been dealing themselves the wealth and power, entirely unopposed by organized medicine. These disloyal clinician traitors have played dead in the face of the onslaught of the lawyer against clinical care from all sides.

From a more practical standpoint, with a trend towards increasing NP independence and use in primary care the idea that FP salaries are going to shoot up is ridiculous unless they go to a NP-management model. Each increase in FP salary will only make NPs more attractive and the job market worse for FPs. I think there is some interesting potential in the idea of hybrid practices with NPs handling less complicated/followup type things. There’s boutique medicine but I don’t think that will ever really grow beyond a small segment. I’m not saying this is necessarily the ideal state of affairs, but the situation does not seem to be set to improve.

1. We only require people to buy automotive liability–not collision. We are requiring them to cover the risk to which they put others by operating a car, not their own risk. They are perfectly free to self-insure for their own risk. They should be for health insurance also.

2. People have the option of not owning a car.

3. Automotive liability is not nearly as expensive.

The only moral case that can be made for mandatory health coverage is for emergency care only. By existing, you are putting the nearest ER at risk, but for non-emergency care providers are free to deny you care and so it just can’t be morally justified. It probably makes more sense to collective that limited risk through the tax system.

People have the right to not buy health insurance just as surely as they have the right to live and die without health care if that is what they want.

People should have to freedom to choose how they want to pay for their health care–prepayment via a plan or pay as expenses arise. All the political debate notwithstanding, this is a private choice and not the public’s business.

Much of the push to complete the partial collectivization is predicated on the oft proclaimed belief that the uninsured are the source of the cost problem. The data says otherwise.