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View Diary: Why can't we start our OWN Public Option? (215 comments)

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  •  Well, but don't most doctors in other countries (20+ / 0-)

    have much less if anything to pay back in student loans?

    •  Education in other countries, (21+ / 0-)

      even university, is either free or much cheaper and therefore no need for high student loans.

      Some men see things as they are and ask, "Why?" I dream things that never were and ask, "Why not?" --R.F. Kennedy

      by farbuska on Sat Dec 19, 2009 at 06:28:55 PM PST

      [ Parent ]

      •  Yes, this is why we have many Asian doctors (2+ / 0-)
        Recommended by:
        ems97007, CKendall

        in part. Many friends here are Asian doctors who studied there but then came here. I must say, they really are top notch. My last surgery was by a wonderful Indian doctor who had the best bedside manner and smarts of any doctor I'd seen over the year we were trying to figure out what was wrong.

      •  Sadly this is changing in Europe (3+ / 0-)
        Recommended by:
        Angie in WA State, ems97007, CKendall

        and very few developing nations have free universities. I don't know if it is part of the Bologna Process (this is a project to standardise higher education in Europe, allowing students to choose more freely where they will attend university, exchange credits, get credits for past work etc.--but has many negative points also) or due to the several international accords that are forcing privatisation and marketisation on education worldwide, but several European countries are in the process of ending free university education, and/or limiting the amount of time students can spend at university, removing financial support for students' living expenses, and permitting the growth of a private university sector. These policies were already imposed on most eastern European countries as part of the deal for IMF and other financial support some years ago.

        This is one of the reasons students have been protesting and on strike in Germanyand Italy recently.

        Here in the UK, negotiations are underway to lift the cap on tuition fees (currently £3000/year, all but one university here charges the full fee and that one will be from next year). I'm sorry to say that the head of the university where I work is part of the panel making this decision, and it is likely that fees will be increased to £7000=£10000/year. That is actually higher than many American state universities.

        Medical students here are currently semi-subsidised by the NHS, but it is likely that the NHS will not be able to afford to subsidise as many at these rates, so cost-sharing will come in and further restrict access to the professions to those who are already wealthy. Alternatively, the NHS could impose further restictions on the employment of the students it subsidises (i.e try to force them to remain within the NHS system) but I doubt this would stand up to legal challenges unless it was done in a very crafty way.

        Political Compass says: -8.88, -8.67
        "We never sold out cos no one would buy."--J Neo Marvin

        by expatyank on Sun Dec 20, 2009 at 12:26:43 AM PST

        [ Parent ]

    •  yeah, and I don't think they should (11+ / 0-)

      have to pay what they do here either.  but whenever anyone floats the idea of paying off their student loans in exchange for them taking lower rates, they don't like that idea.

    •  That's just one of the costs (7+ / 0-)

      There's also the insane cost of malpractice insurance, and how much they spend trying to get insurance companies to cough up the money they owe.

      Nothing brings people together more than mutual hatred.

      by Hannibal on Sat Dec 19, 2009 at 09:06:07 PM PST

      [ Parent ]

      •  i agree with this (1+ / 0-)
        Recommended by:
        koNko

        i am for taking a pretty hard line on frivolous malpractice lawsuits...and I also think that if providers really thought about how much of a headache they would save on billing with single payer, they might think about it...

        but I doubt it...

        •  Many doctors would welcome single-payer (7+ / 0-)

          most the family practice/internists. Many specialists and surgeons oppose it. Trouble is, we have too few of the former and too many of the latter.

          "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

          by Alice in Florida on Sat Dec 19, 2009 at 09:43:53 PM PST

          [ Parent ]

          •  interesting...i wonder if we could go (1+ / 0-)
            Recommended by:
            mrkvica

            single payer for all routine care, and then have some other reimbursement mechanism for the surgeons.

            probably not...

          •  OB/GYNs might surprise you (0+ / 0-)

            and welcome it, even those who do a lot of surgery.  That's the talk I hear in the doctor's lounge.  Single payer would be wonderful since our billing staffs would only have one set of rules to figure out.  We would even take a bit less money if we could count on getting paid on time according to set rules.

            Contrary to the attitude of many on this site doctors are not your enemy here.

        •  Malpractice rates aren't linked to lawsuits (2+ / 0-)
          Recommended by:
          mrkvica, CKendall

          They're linked to financial markets. I'll try to dig up the article showing the linkage -- it was quite stunning.

          Member, The Angry Left

          by nosleep4u on Sat Dec 19, 2009 at 10:23:37 PM PST

          [ Parent ]

        •  one reason for malpractice suits in the US (1+ / 0-)
          Recommended by:
          Angie in WA State

          is the lack of universal health care though--if something goes wrong, the person becomesw uninsurable and pretty much the only way to ensure they will get medical care in future is to sue for a chunk of money to pay outright.

          For example, if your child has cerebral palsy due to lack of oxygen at birth and you can show this could have been prevented, you can sue to get an amount to cover future costs of providing private health care and living costs.

          Here in the UK these lawsuits are less common as the child is entitled to healthcare, social care, housing etc. So even when people do sue, the payouts tend to be smaller because all of that is taken into account in deciding the sum that will be needed.

          The NHS itself carries insurance to cover negligence by all of its practitioners other than GPs, pharmacists and independent midwives, all of whom carry insurance through their trade unions. This is all changing however as the UK government turns local halthcare units within the UK into semi-independent Trusts, I believe part of that process is also transferring the malpractice risk.

          Political Compass says: -8.88, -8.67
          "We never sold out cos no one would buy."--J Neo Marvin

          by expatyank on Sun Dec 20, 2009 at 12:33:44 AM PST

          [ Parent ]

      •  no bookkeepers, for example (2+ / 0-)
        Recommended by:
        Creosote, mrkvica

        In France, the billing amounts to pressing one button on a keyboard.

        No bookkeeper to fight insurance companies, no dunning the patient, no forms for the doctor to sign to say that "yes, really, the test was needed", etc.

        And remember that each employee costs 2 to 3 times their salary once you add overhead...

      •  these are two separate issues (4+ / 0-)
        Recommended by:
        Odysseus, mrkvica, koNko, nosleep4u

        malpractice is, in the scheme of things, very small potatoes.  The real costs are in coverage litigation.  Not only do patients often have to litigate bad faith claims, but insurers spend enormous amounts of money fighting with each other over who has primary responsibility for payment of claims.  

        A few years ago, I broke my foot when I stepped off a curb.  I had medical insurance at the time (yeah me!), but my HMO spent two years litigating with my employer's worker's comp carrier over whether the injury was work related since I was walking to lunch with co-workers when the accident happened.  

        It wasn't even a huge bill.  A clinic visit, an xray, a cam walker, some vicodin, and a follow-up Doctor visit just to make sure it healed right.  

        "Rules must be binding. Violations must be punished. Words must mean something." President Obama in Prague on April 5

        by jlynne on Sat Dec 19, 2009 at 10:09:17 PM PST

        [ Parent ]

        •  If you mean the entire (4+ / 0-)
          Recommended by:
          mrkvica, jlynne, expatyank, scotths

          cost of the health care system, then yeah, malpractice insurance is small potatoes. But as a proportion just of doctors costs, its quite large.

          You are spot on with this:

          The real costs are in coverage litigation.  Not only do patients often have to litigate bad faith claims, but insurers spend enormous amounts of money fighting with each other over who has primary responsibility for payment of claims.  

          The MSM never discusses this.

          Member, The Angry Left

          by nosleep4u on Sat Dec 19, 2009 at 10:28:34 PM PST

          [ Parent ]

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