Comments on: Putting a dollar amount to life http://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Exposing freemarket BShttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88527 Exposing freemarket BS Sun, 07 Dec 2008 23:11:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88527 Anonymous said: <br/><br/>'...one can argue about MD pay. English and Canadian PCP's do better than their American counterparts'<br/><br/>Fair enough. That's one reason primary care is so poor in the US. But the overall cost of healthcare is higher, and salaries of executives and medical staff do contribute. Another reason is that there is or has been a large section of Americans who earn more than Europeans and can be tapped for higher prices.<br/><br/>'...don't forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt.'<br/><br/>Yes but that makes the point for higher remuneration. A lot of European students do have considerable debt - tuition in the UK is no longer paid by the state for example and a loan system is in place - but agreed it's not at US levels. Anonymous said:

‘…one can argue about MD pay. English and Canadian PCP’s do better than their American counterparts’

Fair enough. That’s one reason primary care is so poor in the US. But the overall cost of healthcare is higher, and salaries of executives and medical staff do contribute. Another reason is that there is or has been a large section of Americans who earn more than Europeans and can be tapped for higher prices.

‘…don’t forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt.’

Yes but that makes the point for higher remuneration. A lot of European students do have considerable debt – tuition in the UK is no longer paid by the state for example and a loan system is in place – but agreed it’s not at US levels.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88509 Anonymous Sun, 07 Dec 2008 00:03:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88509 Actually freemarket BS one can argue about MD pay. English and Canadian PCP's do better than their American counterparts. Additionally, though one can argue about pay of some specialties (radiology, dermatology, etc) the fact is there has not been a significant increase in any MD pay per visit/procedure in over a decade thanks to the 1997 SGR formula. Think about the increase in costs of running a practice since 1997. MD's take less than 20% of all medicare dollars. You could cut them down to zero and it it would not solve the medicare budget issues. Also, don't forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt. Look at the big picture here. Actually freemarket BS one can argue about MD pay. English and Canadian PCP’s do better than their American counterparts. Additionally, though one can argue about pay of some specialties (radiology, dermatology, etc) the fact is there has not been a significant increase in any MD pay per visit/procedure in over a decade thanks to the 1997 SGR formula. Think about the increase in costs of running a practice since 1997. MD’s take less than 20% of all medicare dollars. You could cut them down to zero and it it would not solve the medicare budget issues. Also, don’t forget you typcial American medical school grad comes out of scholl with close to 150 K in debt. Many come out with over 200 K in debt. European med school grads usually have 0 in debt. Look at the big picture here.

]]> By: Exposing freemarket BShttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88507 Exposing freemarket BS Sat, 06 Dec 2008 22:04:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88507 Anonoymous said;<br/><br/>'The simple fact is CEO compensation is NOT a red herring when all the CEO's make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers.'<br/><br/>Quite so. The two key factors keeping US healthcare costs so high are doctor/administrator remuneration and the huge associated costs of admin, drugs and procedures that are applied to episodes of care. When many other items are cheaper in the US than Europe, healthcare stands out as an exception. Anonoymous said;

‘The simple fact is CEO compensation is NOT a red herring when all the CEO’s make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers.’

Quite so. The two key factors keeping US healthcare costs so high are doctor/administrator remuneration and the huge associated costs of admin, drugs and procedures that are applied to episodes of care. When many other items are cheaper in the US than Europe, healthcare stands out as an exception.

]]> By: Vanhttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88493 Van Fri, 05 Dec 2008 21:58:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88493 @Anonymous<br/><br/>Agreed, the markets are intertwined . I also agree that there needs to be accountability.<br/><br/>While a company may make up the losses by raising prices, we as consumers, have the ability to find a different provider. <br/><br/>That is the whole point of the free market. You have the ability to find who works best for you. If you have a problem with 30%, find someone else. Sure, there may be pains in doing so, but it is still an option.<br/><br/>Also, not all HMOs admin costs are at 30%. NIO run HMOs are historically around 5%<br/><br/>Best,<br/>V<br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> @Anonymous

Agreed, the markets are intertwined . I also agree that there needs to be accountability.

While a company may make up the losses by raising prices, we as consumers, have the ability to find a different provider.

That is the whole point of the free market. You have the ability to find who works best for you. If you have a problem with 30%, find someone else. Sure, there may be pains in doing so, but it is still an option.

Also, not all HMOs admin costs are at 30%. NIO run HMOs are historically around 5%

Best,
V
http://vansantos.com

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88489 Anonymous Fri, 05 Dec 2008 17:38:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88489 No dear Catron YOU are part of the problem if you don't acknowledge that HMO overhead costs are orders of magnitude higher than the VA (no snide comments since I trained at a VA I know better than you what is wrong with it). The simple fact is HMO's have too many middleman getting a cut (people like yourself). The simple fact is CEO compensation is NOT a red herring when all the CEO's make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers. Why is this the case? Because there is little/no oversight. If you are such an economics expert, then you know damn well the controlling interest in CEO compensation is typically the board made up of crony's and CEO's of other companies. Your statement that "There is plenty of accountability in a market-based economy" is laughable. Have you not paid any attention the last four months. This is what happens when checks on complete greed such as the Glass-Steagall act have been removed (thanks, Phil Gramm). What most people here don't realize is this whole debacle is intertwined eventually. Believe it or not Catron, I too believe in the free market, with checks to control greed that leads to unethical behavior. This behavior has been rampant and unchecked the last decade whether it be Richard Fuld, William McGuire, or your local mortgage broker who OK'd an ARM loan to someone who didn't have the credit worthiness based on an increased commission. Well, the chickens have come home to roost. Open your eyes pal. No dear Catron YOU are part of the problem if you don’t acknowledge that HMO overhead costs are orders of magnitude higher than the VA (no snide comments since I trained at a VA I know better than you what is wrong with it). The simple fact is HMO’s have too many middleman getting a cut (people like yourself). The simple fact is CEO compensation is NOT a red herring when all the CEO’s make multiple orders of magnitude more than their european counterparts and hundreds of times ordinary workers. Why is this the case? Because there is little/no oversight. If you are such an economics expert, then you know damn well the controlling interest in CEO compensation is typically the board made up of crony’s and CEO’s of other companies. Your statement that “There is plenty of accountability in a market-based economy” is laughable. Have you not paid any attention the last four months. This is what happens when checks on complete greed such as the Glass-Steagall act have been removed (thanks, Phil Gramm). What most people here don’t realize is this whole debacle is intertwined eventually. Believe it or not Catron, I too believe in the free market, with checks to control greed that leads to unethical behavior. This behavior has been rampant and unchecked the last decade whether it be Richard Fuld, William McGuire, or your local mortgage broker who OK’d an ARM loan to someone who didn’t have the credit worthiness based on an increased commission. Well, the chickens have come home to roost. Open your eyes pal.

]]> By: Catronhttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88483 Catron Fri, 05 Dec 2008 13:18:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88483 <em>The "market" has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy.</em><br/><br/>Wake up, Anon. It was <em> Congress</em> that created the current economic mess by meddling in the market. As to all of the salaries you note, they are red herrings that have been waved under your nose to distract you from the real problem.<br/> <br/><em>I am also not for Catron's laissez-faire system without any accountability.</em><br/><br/>I recommend a couple of semesters of basic economics. There is plenty of accountability in a market-based economy. The producers are accountable to the customers. This only becomes distorted when those morons in D.C. insert themselves between the two. The “market” has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy.

Wake up, Anon. It was Congress that created the current economic mess by meddling in the market. As to all of the salaries you note, they are red herrings that have been waved under your nose to distract you from the real problem.

I am also not for Catron’s laissez-faire system without any accountability.

I recommend a couple of semesters of basic economics. There is plenty of accountability in a market-based economy. The producers are accountable to the customers. This only becomes distorted when those morons in D.C. insert themselves between the two.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88482 Anonymous Fri, 05 Dec 2008 06:45:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88482 Van:<br/>I was not referring to just the "stock market" either. Markets are intertwined. If an insurance Co suffers major paper losses, they will make it up somewhere else (your premium). I am not for british style NHS. I am also not for Catron's laissez-faire system without any accountability. That is unless you think United's William McGuire was really worth 125 million in 2005 and you really think it makes sense that private HMO's admin costs are 25-30% while the VA's are 4-5%? I don't. Van:
I was not referring to just the “stock market” either. Markets are intertwined. If an insurance Co suffers major paper losses, they will make it up somewhere else (your premium). I am not for british style NHS. I am also not for Catron’s laissez-faire system without any accountability. That is unless you think United’s William McGuire was really worth 125 million in 2005 and you really think it makes sense that private HMO’s admin costs are 25-30% while the VA’s are 4-5%? I don’t.

]]> By: Vanhttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88480 Van Fri, 05 Dec 2008 02:10:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88480 @Anonymous <br/><br/>I don't believe Catron referring to the stock "market". <br/><br/>Even with the failures of major financial companies, free enterprise still continues - people still pay what they feel is the correct value for the good/service. <br/><br/>So, that "market" didn't fail... but I will let Catron talk for themselves.<br/><br/>Just an alternative view.<br/><br/>V<br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> @Anonymous

I don’t believe Catron referring to the stock “market”.

Even with the failures of major financial companies, free enterprise still continues – people still pay what they feel is the correct value for the good/service.

So, that “market” didn’t fail… but I will let Catron talk for themselves.

Just an alternative view.

V
http://vansantos.com

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88479 Anonymous Fri, 05 Dec 2008 01:45:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88479 Yes Catron, the "market" has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy. When a scumbag like Richard Fuld receives 1/2 BILLION dollars for running a company into the ground (Lehman brothers; a company that survived the US Civil War, Great Depression, and WWII, but not unchecked Greed) there is something seriously wrong with "the market". Yes Catron, the “market” has just done such a great job recently that it was just bailed out by that big bad soulless government bureaucracy. When a scumbag like Richard Fuld receives 1/2 BILLION dollars for running a company into the ground (Lehman brothers; a company that survived the US Civil War, Great Depression, and WWII, but not unchecked Greed) there is something seriously wrong with “the market”.

]]> By: Vanhttp://www.kevinmd.com/blog/2008/12/putting-dollar-amount-to-life.html#comment-88478 Van Fri, 05 Dec 2008 00:52:00 +0000 http://clients.emmense.com/kevinmd/2008/12/putting-a-dollar-amount-to-life.html#comment-88478 To follow up on what Andrew Holtz and Catron said, "rationing" is already here. Example - Flu vaccines. <br/><br/>Ignoring the "goods" perspective for a moment and look at insurance. In some regards they are making the decision to "ration" who gets what service as well.<br/><br/>Just wanted to throw that out there...<br/><br/>V<br/><a HREF="http://vansantos.com" REL="nofollow">http://vansantos.com</a> To follow up on what Andrew Holtz and Catron said, “rationing” is already here. Example – Flu vaccines.

Ignoring the “goods” perspective for a moment and look at insurance. In some regards they are making the decision to “ration” who gets what service as well.

Just wanted to throw that out there…

V
http://vansantos.com

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