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OK, point blank. Somebody has to say it: Professionals, Doctors (dentists, Veterinarians, Docs...)

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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:20 PM
Original message
OK, point blank. Somebody has to say it: Professionals, Doctors (dentists, Veterinarians, Docs...)
and all of you all out there...

You are not going to be able to charge what you have been charging anymore. There.

I said it.

Sucks, right?

I know.

But you know what? My dog's shots (5 year old jack mix) aren't worth your 150.00 price anymore.

My root canal for a thousand bucks? Think again.

$500 dollars after deductible for a checkup? Go fuck yourself.

Welcome to the new economy; you all will have to adjust just like we do--- and we don't give a flying rat's ass.
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Mon Jan-05-09 08:22 PM
Response to Original message
1. Deleted message
Message removed by moderator. Click here to review the message board rules.
 
JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:23 PM
Response to Reply #1
2. oh, I see.
Care to explain?
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natrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:27 PM
Response to Reply #2
4. just kidding,but they got to make a living too and some are jusat scraping by
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:31 PM
Response to Reply #4
13. Some are. My doc's kids are in private school,
my ex-vet just cut her employees hours. Some can't face it yet.
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mr_hat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:29 PM
Response to Reply #2
7. Airwolf.
You peaked with Airwolf.
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Giant Robot Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:48 PM
Response to Reply #7
33. Is it bad that I can remember the names of the characters on that show?
:shrug:
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Joe Fields Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:37 PM
Response to Reply #7
112. They should have called the show Cokewolf...


Jan Michael loved his powder.
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jody Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:29 PM
Response to Reply #1
8. "complete idiot"! I don't agree but he's making tremendous progress toward that goal. n/t
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JFN1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:24 PM
Response to Reply #1
74. I think the OP has it exactly right.
And I thank him for saying it. He merely points out the reality of our current economy.

Retail stores do it - the whole concept of a "sale" is to charge less for the same product/service. When the tire company down the road offers free installation with tire purchases, they are discounting the fees they charge to perform a service.

So why are "professionals" any different than the rest of us, especially when many professionals are just hacks with a license? Why do they deserve special treatment? They already make a ton more money than the average citizen does for their work - isn't that special treatment enough?

And I don't know about the rest of you, but I've been screwed over far, far worse by so-called professionals, than I ever have been by a retail store...and just try to get a lawyer in trouble if he screws you over. Do you know who judges a lawyer's misdeeds? OTHER LAWYERS, of course. And the same goes for doctors, you know...so give me and the OP a break. Professionals get enough special treatment - they don't get a pass on this...the rest of us sure don't.
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keepthemhonest Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:37 PM
Response to Reply #74
97. It's the insurance companies that are making out
It is comparable to going through a store picking out everything you want and then telling the person at the register what you are wiling to pay.That is how I see it.It may look like the doctor is charging alot but when it comes down to it the insurance makes out in my opinion.They even tell the doctors what type of procedures or what type of pilla they are willing to pay for, i think they have it a litttttle backwards and I don't see MD after their name.Oh I guess you could always have your neighbor do your pap smear since docs are quaks ,right? getting down off soap box

sorry I just happen to work for some really good docs that do offer discounts to selfpaying individuals.
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JFN1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:58 PM
Response to Reply #97
108. Then they are the exceptions
to an otherwise consistent rule.
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keepthemhonest Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 08:38 AM
Response to Reply #108
141. Others should offer discounts too. NT
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rvablue Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 01:23 AM
Response to Reply #97
128. Alright, I read your argument, but how does my reality square with it:
I don't have dental insurance.

I had several problems that I had gone years without treating.

I was paying in cash. I was going to do whatever the doctor told me to do.

And I paid the $1,100 total for a root canal that took an hour.

And you know what?

I knew they weren't going to have to deal with an insurance company. Wait for payment. Do all of the paperwork.

And so I asked for a discount. Nada. Nothing. Not a single freaking cent.

Dentists and the like make shit loads of money. Do they pay a lot to go to school? Yes. So did I. But I will never make anything close to what they are making.

$1,000 for one hours work when you are in a profession meant to help people is ridiculous.
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keepthemhonest Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 08:37 AM
Response to Reply #128
140. you right
they should give deeper discounts when you are saving them all of that hassle.

I have been without all of those insurances before.When I was 34 I really finally had health insurance for the first time.When you don't have insurance you just hope nothing goes wrong with all of those things. Insurance keeps going up every year so work keeps making us pay more.This year I had to choose to raise my deductable so it would not increase.

Good luck and no being sick anymore or having dental problems,k?
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JNelson6563 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:55 AM
Response to Reply #97
150. So about 9 years ago
when the anestheseologist charged me about $800 to go under for an hour, that was just to help him scrape by? Poor soul. If I'd have known that maybe I would've bought less grocieries and paid him faster.

Sorry but for every doc/dentist/vet that is human and not just money grubbing scum, there are many more who are sickeningly so. Their mansions, yachts, high-end cars, private schools for the kids and other fabulous luxuries tend to belie the "oh they are barely getting by" argument.

Julie
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Blarch Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:21 AM
Response to Reply #74
152. Horse shit.
My wife is a dental hygienist, and their office is seeing a down turn in patients ...they know it's the people without insurance...but won't lower their prices, the people just stop coming.

If the vet doesn't lower their prices, will your dog go without meds ? ...I doubt it.
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JNelson6563 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:50 AM
Response to Reply #1
149. What a fabulous and productive contribution to the dialogue!
*sigh*
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SoCalDem Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:24 PM
Response to Original message
3. Our cats are all indoorsies, and only associate with each other
so we quit the vaccination stuff a long time ago.. If they are sick and have to go to the vet, I usually do end up getting them a vaccination because every time they GO to the vet, they seem to catch something there..even though I never take them out of their carrier..must be in the air:(

The sad thing about doctors, is that many of them have EXTRA expenses due to all the paperwork they have to fill out, and the extra people they have to hire to help them wade through it..I'm not so sure they actually keep all that much more themselves..
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:28 PM
Response to Reply #3
6. our vet built a "ponderosa" for her and her husband
two years ago, and cut her employee's hours.

We went to a new doc immediately.
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Mika Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:34 PM
Response to Reply #3
16. That's why I don't do insurance.
If the patient wants to use theirs, they can do the phone and paper work.

My rates vary according to the patient's ability to pay.

One thing taught at a prestigious dental institute on Key Biscayne is that when it comes to billing rule #1 is to check the parking lot to see what kind of car the patient is driving. I am not shitting you.


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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:36 PM
Response to Reply #16
19. Isnt' that the saddest damned thing ever.
and people don't want to believe this.

These "professionals" and I am staring straight at CPA's, Dentists, Veterinarians, Doctors--are in denial.

Look at the responses I am getting for suggesting that their lifestyles will drop.

AND THEY ARE PATIENTS.

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FloridaJudy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:22 PM
Response to Reply #16
94. Damn. I wish my dentist would do that.
There's gotta be some up side to driving a 16 year old Chrysler.

And where the heck are people getting $1000 root canals? That's what I pay for just the freakin' crown.
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tkmorris Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 05:24 AM
Response to Reply #16
136. Are you anywhere near me?
Because I need a metric ASSLOAD of dental work, and am willing to be bled for every cent I have to get it. Trouble is your typical Delray Beach dentist wants to bleed you dry before they do anything at all, I presume under the theory that you will then call upon assets they are not aware of to afford the rest. I have insurance but these people appear to be playing some kind of game with my insurance company, having rules I am not familiar with.

I am not kidding.
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Lydia Leftcoast Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:26 AM
Response to Reply #16
155. Bless you for doing that!
:-)
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Joe Fields Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:41 PM
Response to Reply #3
115. self delete...posted in wrong place.
Edited on Mon Jan-05-09 11:42 PM by Joe Fields
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SoCalNative Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:28 PM
Response to Original message
5. So don't get your animals vaccinated at the vet
there are plenty of monthly clinics offered at local pet stores and elsewhere by vets that provide shots and other medications for a fraction of the cost of a vet visit.

Sounds to me like you just need to find a job that has better insurance benefits.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:30 PM
Response to Reply #5
11. Both of our jobs have the best bennies out there
and are pretty secure. You do the detective work here.

With that said, take a leap. If you haven't figured out this economy, you are too stupid to talk to.

We ARE capable of thinking of others---are you?
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SoCalNative Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:32 PM
Response to Reply #11
14. I doubt you have the best "bennies" out there
if you have a huge deductible for medical costs.
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LostinVA Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:12 PM
Response to Reply #14
61. I know his wife has the best bennies out there
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:17 PM
Response to Reply #61
65. you rock
;)

And we do.

Happy new year!
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:43 PM
Response to Reply #11
26. If you're paying $500 after deductable for a checkup, your "bennies" suck. nt
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:56 PM
Response to Reply #26
40. oh let's see. I am actually not
quoting another DUers thread.

But it's SO WRONG OF ME TO GIVE A DAMN ABOUT PEOPLE WHO'S BENEFITS SUCK!

whatever. Read DU. Educate yourself.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:12 PM
Response to Reply #40
62. You just said your root canal cost you a thousand dollars. Your benefits suck. nt
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:15 PM
Response to Reply #62
63. Root canal of a tooth that was broken off below the gum line
and crown.

OK, it was actually about 900 bucks.

Tell me you did better.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:25 PM
Response to Reply #63
75. That's a pretty significant procedure.
Certainly more so, in my eyes, than a transmission repair on a car.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:33 PM
Response to Reply #75
83. OK, so.. ..... hmmm now my benefits don't suck???
Now, go tell someone with less money, and less bennies that they need to

SUCK IT UP> PULL THEMSELVES UP! It's a bootstrap motherfucker! Or go without a tooth, dumbass! FUCK YOU, my kid has loans to get through dental school!

Please, I beg of you...go spread your message. Please.
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Cid_B Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 05:08 AM
Response to Reply #63
135. Ummm...
How about free?
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DeltaLitProf Donating Member (459 posts) Send PM | Profile | Ignore Tue Jan-06-09 02:30 AM
Response to Reply #11
132. With the economy failing at its present rate and scale . . .
. . . no one's job is "safe."
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Threedifferentones Donating Member (820 posts) Send PM | Profile | Ignore Tue Jan-06-09 09:01 AM
Response to Reply #5
143. "Just find a better job.."
I guess, SoCalNative, you think anyone who cannot afford insurance or dental care just must not be trying hard enough? There's plenty of jobs to go around if we'll just work?

Geese, you'd think people on DU would maybe, I don't know, read the fucking news before they post. What do the words "economic recession" or "depression" mean to you?

I don't understand why you would post that people should "just" afford health care themselves on a site where the need for a social safety net is one of the most readily agreed upon issues. It seems even dumber at a time when when the economy is illustrating just how vulnerable "middle" America really is.

If you weren't kidding, I say fuck off!
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hlthe2b Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:29 PM
Response to Original message
9. hmm... I just paid $650 for brakes, $1500 for new furnace, plus
$200 for the electrician to update my circuit box. My food bill has quadrupled, though we eat as simply as is possible to eat and rarely go out. But, even a casual lunch out for me alone has increased by at least 3 fold. Which leads me to ask, JanMichael, what DO YOU do for a living? As you say, YOU (and everyone else you didn't include in your little tirade) may not be able charge or profit as much...!
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:33 PM
Response to Reply #9
15. ;)
believe me, I don't make as much as you probably--- and my raises are set.

We can't "charge" anything....wife is a librarian...and let's just say...I am watching all this, OK?
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hlthe2b Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:56 PM
Original message
Stop picking out one group of workers to villainize, JM...
Edited on Mon Jan-05-09 09:05 PM by hlthe2b
there are struggling individuals among all professions and among all workers..... What appears exorbitant at face value, just might be .....NOT. :shrug:

You aren't the only one counting every penny that won't stretch from payday to payday and staying up worrying how to pay the bills--nor what the hell would happen if you or others in your family became severely ill, nor worried about creating a pre-existing medical condition that might limit your options if you need to change jobs (and insurance carriers).

Everyone is going to be facing tough climes... That includes the highly trained professionals or the highly paid professionals (in the case of my heating/air plumber contracter and my electrician--not to mention my mechanic who keeps my 10 year old Subie going...
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:20 PM
Response to Original message
68. One group?
I picked docs, dentists and vets?

I am not "villianizing" them-- I AM SAYING...they are going to have to live on less JUST LIKE US...

And we drive an 11 year old Subie. Has your head gasket gone yet? ;) Be prepared...our mechanic charges 800 bucks-- how much does yours charge?
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hlthe2b Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:26 PM
Response to Reply #68
77. Yes... head gasket a year and a half ago....$1200
including towing 40 miles so I could avoid the dealerships....I debated about keeping it afterwards, but damn-- it is paid for (multiple times, it seems)and I'm damned scared to go into debt now even if a perfect car choice were to present itself--and it hasn't.


Hang in there... We're all in this together, JM


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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:36 PM
Response to Reply #77
84. double overhead cam, right?
you gotr screwed.

They do those all the time. ALL the damned time. Subaru knows about the problem. I FUCKING KNEW WHEN I SAW YOUR POST you had a head gasket problem.
No thanks.

I am not going to "hang in there."

I am going to go stir up shit til folks wake the fuck up.

BTW-- you may have done the right thing-- if the dudes that fixed your subie did it right, you should be trouble free for at least 75,000 more miles.
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hlthe2b Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:38 PM
Response to Reply #84
85. Go forth, stir the shit, and multiply then... I'm done...



for the night...LOL
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QueenOfCalifornia Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:38 AM
Response to Reply #15
156. We too have
"great" benefits. My husband has been with the federal government for 25 years and in one of the better paying positions. Still, living in San Diego is f-ing expensive. His raises are set and never match how much the cost of living is climbing. Our kids are the only kids in our neighborhood that attend a public school and we wonder how the other people here make the house payment go on lavish vacations every year, drive a new BMW send there 3 kids to private schools, pay all the bills and upgrade their kitchen every 5 or 6 years... :wtf: - We have a 10 year old car, my husband takes the trolley to his job downtown, we haven't been on any kind of vacation in over 5 years and before that we drove and stayed in a few nice hotels up the coast.... nothing "lavish" but it was away from home. People think that due to my husbands job, we must be getting paid a lot... Ha! what a joke... he works 60 to 70 hours a week most of the time and gets no overtime pay, none. His work load is ridiculous and bonuses went away with the Clinton administration.

There is no such thing as great dental insurance. It all sucks. I too had to have some dental work a few years back and my insurance covered part of the bill but we had to come up with $1,300 + out of pocket - I had 3 extractions and a couple of fillings. I wanted implants where two teeth our now missing but insurance will not pay for that and my option? Having some uncomfortable thing stuck in my mouth that I didn't want and still had to pay a bunch of money for... So guess what? I just have two missing teeth - granted, they are not in the front... BUT we should be able to have 2 implants paid for through the expensive insurance we pay for every month. We bought this house before the housing costs went through the roof here - That is the good news... If we had to buy a house now in the same neighborhood we couldn't begin to do so... I feel very fortunate to have gotten in here when we did.

We have a few doctors on our street - believe me, they are not suffering. They are driving brand new European sedans - they go to Italy and France for a get away - I can't afford to go out to dinner once a year where they go once a week. Are they more educated than my husband? Well it depends on if you think one advanced degree is "more" than another.

I can't believe how expensive it is to take our little dog to the vet - It is astronomical. She suffers from allergies and has to see a specialist - It cost us over $150 a visit and that is not for any of the meds she takes to control her problem. What do we do? Get rid of a family pet that all of us love? No... We do not have anyone help with the house keeping and I don't get new clothes and we go out to dinner as a family once a month opposed to going out 3 times. We give up any kind of a vacation and no HBO or Showtime. I worry constantly how we will pay the SDG&E bill - Decembers bill was just under $500. Five hundred bucks to have electricity and gas here... another :wtf:

Oh and about charging stuff? Ha! We had to use the evil cards to buy Christmas stuff for our two kids. It sucked but we draw the line on canceling christmas.

BTW, your wife rocks!
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:30 PM
Response to Original message
10. You do understand that much of that doesn't end up with the Dr., right?
Their offices are now costing them huge amounts of overhead - staffing to handle all the ridiculousness of our current insurance system, malpractice insurance...

Their expenditures have grown exponentially over the years.

So you're not really lining the Dr's pockets so much as the CEOs of the insurance companies...
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:34 PM
Response to Reply #10
17. I do know that.
Too bad. They need to take this shit up with their landlords and the insurance companies.
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:38 PM
Response to Reply #17
20. Not "their" insurance companies.
Yours. Mine. The other guy's.

It's the whole system that's sick, and we'd all benefit if it was healed.

But pointing fingers at the doctors is just ignorant in many cases. (I might be more inclined to agree with you on those guys making a fortune for injecting silly people's lips with collagen and the like).

Most docs are working very hard to help people. Dealing with piles and mountains of stupid paperwork just to work long hours helping people get and stay well. This is also after making a very expensive investment of time and money into their training.

But perhaps you'd rather people be given the OK to offer medical care with a GED?
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:41 PM
Response to Reply #20
23. Theirs. That's where the money has been.
Only recently has this become a problem for the pros. "Most docs" have their head in the sand. About 45 percent of them are waking up to the problem. The schools aren't helping.

As far as your last comment-- I don't get that-- but, whatever.
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:58 PM
Response to Reply #23
44. You don't seem to place much value on their skills
skills only obtainable with pretty thorough training. Which costs plenty of time and money.

Now, if we had a universal system, in particular a single-payer system, those with the ability could be schooled at far less expense, subsidized by the gov't. Then they'd probably work for less - though they wouldn't have to support huge staff numbers just to shuffle the paperwork of insurance companies.

Look, I'm not a doctor, or related to one, for that matter. (Wish we had one in the family, actually). But I've talked to them, and known about their situations. And I just don't think things are as simplistic as you're painting them.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:39 PM
Response to Reply #44
86. Ummmm wife... former paramedic.... Tons of masters degrees
in the family. Wife back in grad school now.

Oh, we are just so damned privileged! GOSH! We can screw people in the new Amerika! And you guys are going to LOVE it!
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NashVegas Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 09:09 AM
Response to Reply #44
144. There's a Whole Lot of That Going Around
Edited on Tue Jan-06-09 09:10 AM by Crisco
Other people who had skills they'd developed through years of training are seeing those skills completely devalued thanks to modern technology.

It's really clueless for some dentist to not make the connection between the brochure she put together using her iMac, and the photographer, layout person, and type-setter who can no longer afford her services.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:46 PM
Response to Reply #20
31. Doctors have fought single payer health care for quite a few decades now..
They are reaping the harvest of what they have sown and I frankly have little sympathy.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:48 PM
Response to Reply #31
34. What do you mean by, "they are reaping the harvest?"
Nobody but the OP is suggesting that doctors are going to be feeling a financial squeeze. In fact, as America gets older, fatter, and unhealthier--and as funding for preventative care is canceled by the states--doctors are shaping up to enjoy more job security than ever before. There's already a nurse shortage, and a doctor shortage is looming.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:56 PM
Response to Reply #34
41. I'm reading of a lot of doctors who are getting out of medicine
Due in large measure to the fact that they are no longer able to practice without faceless insurance bureaucrats looking over their shoulder.

There was an article about it over at Salon.com just a couple of weeks ago.
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:59 PM
Response to Reply #41
48. Yes.
And we're losing some really talented and dedicated people because of it.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:04 PM
Response to Reply #41
55. The plural of anecdote is not "data." nt
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:05 PM
Response to Reply #55
56. You have data?
If so then by all means post it.

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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:11 PM
Response to Reply #56
59. Sure.
Edited on Mon Jan-05-09 09:11 PM by Occam Bandage
From the NEJM:

Despite this continuing growth in the physician supply, since 2000 an increasing number of reports by the COGME, the HRSA, states, specialty societies, state medical societies, hospital associations, and a physician-researcher have reopened the question of whether the United States has an adequate number of practicing physicians now and whether it will in the future. Although many of these reports concede that on a national basis there is an adequate number of physicians, advocates of educating more doctors emphasize that shortages already exist in some locales and specialties. Moreover, because the length of time it takes to train a doctor is protracted (8 to 15 years, depending on the specialty), they point out that the United States must plan well in advance of 2020 (the year on which the COGME bases its projection of a future physician shortage) to determine how many practitioners will be needed to accommodate the growing population.

Advocates of increasing the supply of physicians also cite other factors, including the growth rate of the U.S. population (25 million persons every decade), the aging of baby boomers with concurrent increases in health care needs, the pending retirement (and increasingly early retirement) of a large cohort of physicians, an increase in the number of female physicians who work on average fewer hours than male doctors, and the increasing emphasis that doctors under the age of 50 years are placing on lifestyle issues (preferring more personal time, fewer weekend responsibilities, and less on-call duty)

There is also concern that the heavy reliance on IMGs to maintain the U.S. medical workforce substantially reduces the supply of doctors in many lower-income countries, which poses an ethical dilemma for the richest nation in the world, not to mention a foreign policy issue.9,10,11,12 In 2007, some 6600 IMGs entered U.S. graduate medical education programs, and if experience is any indicator, most of them will remain in this country after completing their training.

These factors, plus local circumstances that figure uniquely into every situation, are among the considerations that educators weigh when they decide whether to expand their particular medical school. But educators also must consider the validity of new reports projecting a shortage of physicians by 2020.13 In 2005, the COGME — about a decade after it had projected a large surplus of physicians — issued a report that estimated a shortage of 85,000 doctors by 2020, or approximately 10% of the current complement of medical practitioners.14 In 2006, the HRSA, where the COGME is housed, released a separate report that projected a shortage ranging from 55,000 to 150,000 physicians by 2020, with an acute shortage of specialists representing the largest shortfall.

http://content.nejm.org/cgi/content/full/358/16/1741


(The article provides links to the studies)

There is going to be a doctor shortage, not a doctor surplus. A steady supply, and increased demand, does not portend lower prices anywhere but in your head.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:30 PM
Response to Reply #59
81. I never mentioned lower prices..
Greater frustration and lower *income* for physicians though I think are in the cards.

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salin Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:58 PM
Response to Reply #31
46. the doc in my family changed tunes
about two years ago - when massive layoffs left the community with only one health insurer (who bargained payments to not much above medicare and medicaid rates) and the majority of the patients were uninsured. Indeed this doc became a 'conservative' over the fight over healthcare in the very early Clinton years. Not yet ready to completely disavow republicans - but has become critical - more likely to vote independently (that is - for some dems) and has dropped his strident/dismissive tone (too much listening and lapping up rightwing radio) towards other family members who are liberal. I was told to sit down when I was told of the change of perspective ... that the only entity that was now envisioned as able to keep costs down and deal with the multitude of problems in the health care industry was the federal government. I think a whole lot of folks in the health care industry have started to revolutionize their own thinking about the problems.
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:01 PM
Response to Reply #46
50. That's what I hear from my doctors.
Haven't run into any loving this system at all.
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Lisa0825 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:56 PM
Response to Reply #31
107. I have worked in medical schools for most of the past 15 years, and
Edited on Mon Jan-05-09 10:57 PM by Lisa0825
the vast majority of the doctors I know are in favor of some kind of universal health care. Maybe the top of the line specialty surgeons and such might not be, but the general practitioners, family docs, and even main line specialists that I know are convinced it is the only way to save medical care in this country.
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Fumesucker Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:33 AM
Response to Reply #107
123. The only route to true health care reform is single payer..
And the AMA is not in favor of single payer.

http://www.pnhp.org/news/2008/october/ama_position_on_sing.php

The AMA does not believe that full government control is a workable model for the United States. Single-payer systems are plagued with an undersupply of medical personnel, long waiting periods and a lack of patient choice.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 05:31 AM
Response to Reply #31
137. They are coming around
A majority of med students supports single payer

www.pnhp.org
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rvablue Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 01:25 AM
Response to Reply #10
129. But why aren't there different rates then for people like me without insurance?
I'm paying the same so that you can pay less?

Isn't that what a small cadres of DUers rail against when it comes to forgiving student loans and credit card debt and mortgage assistance?
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JVS Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 05:33 AM
Response to Reply #10
138. They'd save overhead if they went back to doing housecalls
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 03:19 PM
Response to Reply #138
163. It's not about the staff needed to turn on the lights and assist
so much as it's about the staff needed to process the reams of paperwork required by dozens at least of different insurance companies, see to the billing and other financial necessities, and otherwise deal with all of the health insurers. And it's about the huge cost of malpractice insurance - as others have pointed out, that can run upwards of 6 figures - a year.

Housecalls wouldn't help much with that at all.
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SammyWinstonJack Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:02 AM
Response to Reply #10
151. Which is why I seriously DOUBT that we will ever have anything close to
single payer health care in this Country.


So you're not really lining the Dr's pockets so much as the CEOs of the insurance companies...


Four health insurance lobbyists to every 1 congress critter, pretty much kills that deal
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 03:21 PM
Response to Reply #151
164. Oh they'll fight it tooth and nail
I agree. They're doing quite well on this set-up. Imagine the outrage from those groups when they are suddenly faced with obsolescence?
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HughBeaumont Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:31 PM
Response to Original message
12. Funny thing is, CEOs will ALWAYS "charge what they charge", no matter what.
In fact, until they start getting dragged out of their homes and through the streets, they'll give themselves raises.

Brazen?

What are the mice-people of Dumberica going to do? Revolt? Actually do something about it? HA HA HA HA HA.

Doctors here overcharge because they have lives in their hands. We should be clamoring for universal health care. Doctors aren't the enemy, insurance conglomerates with dick CEOs are. I read somewhere that executive/administrative costs comprise 10-15% of the average health care bill?
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SOS Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:35 PM
Response to Original message
18. Vets, dentists, doctors and hospitals treating the underinsured
have relied for years on the use of the patients credit card.
That will end in 2009.

The days of whipping out the credit card and paying thousands for medical care are over.
$2 trillion in lowered limits already. Millions of citizens maxed out. No more home equity to borrow from.

Cards will be declined and the patient will be asked to go home and die.
Health care, American style.
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natrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:40 PM
Response to Original message
21. my dog bit me by mistake so i go to emergency
3200 bucks for stitching it up etc
the nurse asks me if i need something for the pain and i'm like sure,thanks
the bill comes a few weeks later and it was $280 for one vicadin
seems like an awful lot of money
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:42 PM
Response to Reply #21
24. So you got stuck with that bill
and yet you called me an idiot?

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natrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:44 PM
Response to Reply #24
28. friggin deductible is ridiculous because there are 2 of us covered
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:18 PM
Response to Reply #28
66. uh huh
so are we.
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Skittles Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:38 PM
Response to Reply #21
98. how did you get bit by "mistake"
shoud I kick your dog's ass?
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QueenOfCalifornia Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:50 AM
Response to Reply #21
157. Bit by "mistake?"
What was your dog trying to bite when you got nailed instead? I am curious because I trained dogs for over 15 years and was never once bitten by "mistake" - I have been bitten but believe me there was no mistake. Also, out of all the dogs I have owned I never had one bite me, period.

I would take up the cost of that one pill with the hospital. That is insane.
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shireen Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:40 PM
Response to Original message
22. the real scammers are the insurance companies
Edited on Mon Jan-05-09 08:45 PM by shireen
Doctors deserve to be paid well, given the nature of their jobs. (So do teachers, first-responders, law enforcement, military, ... people who are vital to our survival.)

IMHO, the real villains are the blood-sucking leeches: insurance companies that charge ridiculously high malpractice premiums, patients' insurance companies that are giving less service but charging more for it, litigation-abusing patients who file frivolous lawsuits through their ambulance-chaser lawyers, and ridiculous mountains of paperwork that's wiped out thousands of acres of forest. Oh, and don't get me started from those management crooks at big pharma.

edited to clarify.
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Fearless Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:58 PM
Response to Reply #22
43. del
Edited on Mon Jan-05-09 08:59 PM by nothingtoofear
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:42 PM
Response to Original message
25. Ok, point blank. Somebody has to say it: You're an idiot.
Edited on Mon Jan-05-09 08:49 PM by Occam Bandage
Their prices are almost entirely dependent on their overhead, administrative, equipment, insurance, malpractice, and medicine costs. If you don't think their services are worth it, don't pay for them. Competition between doctors won't bring those prices down, though. They're as much slaves to the system as you are.

So tell 'em "fuck you" all you like. Then deal with your cavities and prostate cancer on your own dime on your own time. No skin off their ass.
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natrat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:45 PM
Response to Reply #25
30. my other dog needed 3600 bucks to fix her teeth,and ya know what it was worth it
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canucksawbones Donating Member (203 posts) Send PM | Profile | Ignore Mon Jan-05-09 08:51 PM
Response to Reply #25
35. This is why...
I'm happy to be a physician in a socialized system. It's good for the patient and it's good for me. I don't need a stack of staff to get hunt down insurance companies to get payed, I don't need pre-approvals to provide care. And even if someone is uninsured (like a tourist) a trip to see me in the office is $25.00 USD. Certainly isn't too painful for most people. Something more complex may take more, but I can manage to keep costs to about $50 USD for simple sutures, an additional $10 for each extra package of suture material.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:55 PM
Response to Reply #35
38. Agreed. Single-payer lowers costs for everyone, from health care providers to patients to employers.
I'm strongly in favor.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:01 PM
Response to Reply #35
49. Wonder if any liberals on this website will read your post?
If they do, they will think you are a "plant."

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orleans Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:39 PM
Response to Reply #49
99. i don't think canucksawbones is a plant. and i'm a liberal.
and i think the dr.s do need to cut back on their fees. maybe they don't all need to be driving new cars now either. go without a new car for a few years and help some patients out financially. that would be nice.

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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:58 PM
Response to Reply #25
45. It's not "me." Wake the hell up
it's "us."

"We" (my wife and I, AND the dog and cat) are fine.

WAKE UP.
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:07 PM
Response to Reply #45
58. I'm quite awake. Your post is nonsense. Again: Blaming doctors for the state of medicine is like
blaming the gate agents because your flight cost too much and then got delayed (which, sadly, many people do.)
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MajorChode Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:43 PM
Response to Original message
27. Let us know how that one works out for you...
Seeing as how nobody (but you) has raised the possibility of deflation for professional services, you can certainly try to negotiate your own price, but those providers can just as easily tell you to "go fuck yourself".

When your dog gets Parvo, your teeth rot out, and you find yourself with a serious (but preventable) health condition, perhaps you'll understand the error of your thinking.

Of course there's always alternatives. Load up the dog and take a vacation to Mexico. Everything is cheaper there.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:02 PM
Response to Reply #27
51. Let's see. The dog is up on her vaccines,
and our teeth are just fine.

Wake up. Americans are in serious shit. "Professional services" are going to suffer.
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MajorChode Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:22 PM
Response to Reply #51
71. Undoubtedly that is the case...
...and the result will inevitiably be that some of those businesses will fail. That doesn't necessarily mean that prices will fall. In fact with less competition the longer term effect may mean higher prices.
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Medusa Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:23 PM
Response to Reply #51
72. Everything is going to suffer
and everyone is going to suffer. Duh.
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NightWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:44 PM
Response to Original message
29. no, it just sounds like you may no longer be able to afford some services that you "need"
not knocking you man, I'm in the same boat. The price isnt coming down, but many of us are feeling the squeeze and are unable to afford some "needs".
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:46 PM
Response to Reply #29
32. It's an outright tragedy that necessary services are denied to many Americans.
However, blaming the doctors for medical costs isn't any wiser than blaming the gate agent at the airport because your flight was delayed.
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orleans Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:41 PM
Response to Reply #32
100. isn't this the second time you've said that? are you a doctor? n/t
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JuniperLea Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:52 PM
Response to Original message
36. I love my vet...
I pass six or seven veterinarian offices and pet hospitals to get to her office from my house. I used to live in her neighborhood, and kept going to her after two moves.

Case in point: I rescued a Chihuahua-Terrier mix from a four-lane highway during rush hour traffic three weeks ago. (Cold, wet, dehydrated, hungry, constipated, dirty, underweight and scared.) No one in the neighborhood knew her and we scanned the 'hood for blocks around looking for lost dog posters, etc. Nothing. I took her to my vet... she was checked out, given the first dose of de-wormer and a dose of flea gunk, checked for a chip. No charge. She said if we don't find the owner to bring her back for dose two of the de-wormer, and we'll talk about spaying.

It's a tiny little shop in the Snoop Dogg area of West Long Beach... I'm sure the rent is comparably low... but the love and attention she gives my dogs is tops.

Shop around! There must be more excellent vets with heart out there!

BTW, we're keeping the dog... she's put on a half pound (five lbs now) and you can barely see her ribs and spine now. She's too cute and too sweet:) So is my precious vet!!
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Name removed Donating Member (0 posts) Send PM | Profile | Ignore Mon Jan-05-09 08:53 PM
Response to Original message
37. Deleted sub-thread
Sub-thread removed by moderator. Click here to review the message board rules.
 
KakistocracyHater Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:56 PM
Response to Original message
39. It annoys me when people purposely deflect an idea
our medical industry is overpriced, this has been documented in several places, the easiest being "Sicko":$100 asthma inhaler $2.00 in Cuba (or some such price). Yes the poster IS correct, as our average wage decreases the medical industry has 2 choices-start charging your dwindling customers higher fees, or lower your outrrageous prices. The notorious circular firing squad is far too quick here, why?
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Occam Bandage Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:04 PM
Response to Reply #39
54. You lost me at "dwindling customers."
There is absolutely no evidence that doctors will be facing a shortage of patients. People will spend money when they are sick. They'll spend themselves into bankruptcy. Sure, they might skimp a bit on preventative care and checkups--but that only leads to people getting sicker, and needing to shell out even more when they end up with something serious. Every analysis suggests there is going to be a shortage--not a surplus--of medical care providers in the next ten years.

You further lost me at "outrageous prices." A doctor has enormous costs to cover, from his administrative staff to his building upkeep, from his malpractice insurance to his technical equipment, from the cost of the medication he gives you to the cost of treating underinsured patients, from the cost of his sutures to the sunk cost of years of medical school and internship.
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stray cat Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:56 PM
Response to Original message
42. Dentures overall are a cheaper alternative to dental care once you get rid of your teeth
Edited on Mon Jan-05-09 08:59 PM by dmordue
Vets bills usually aren't covered by insurance and are out of pocket but within reason I will still try to treat my pet to prevent its suffering.
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JuniperLea Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 08:59 PM
Response to Original message
47. Universal health care would help...
You must have really shitty insurance!

People are going to put off the important stuff and go to the doctor a lot less than before, no question about that. And despite the royal ass-reaming you're getting here by a bunch of uptight DUers, you are sort of right. Sort of. Chances are prices will go up for a while in an effort to make up for the lack of patient flow... people will be a lot worse for wear when they see the doctor, which will probably cost them more in the long run. If UHC comes into play, HMO's will go bye-bye right away.

It's a really bad situation. And it's going to get worse.
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tpsbmam Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:03 PM
Response to Original message
52. You know, when I was a professional and did a LITTLE private practice...
(I mostly worked in medical hospitals), I charged sliding scale. There were people with no insurance who paid as little as $5 to see me. There wasn't much I could do about hospital policies, but there was something I could do about seeing as many people as I could manage who couldn't afford to come to me in the hospital. I didn't make the huge amounts charged for my services in hospitals -- I was salaried. And the salary wasn't even close to what you might imagine. And I had fellow professionals who did all kinds of things to give back -- a number of them were part of the Red Cross emergency response disaster groups, among other things. Your contempt is noted, though.
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joeunderdog Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:11 PM
Response to Reply #52
60. three cheers for you. Many docs are not getting rich, although vets and dentists often are.
I believe they gouge the average Joe more than they should. Doctors make less on average than vets and dentists for a variety of reasons. There are articles being published everywhere about Doc's getting out of the field because they can't make a good living and the pressure is great.

I appreciate the compassionate work of people like you.
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Maru Kitteh Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:04 PM
Response to Original message
53. Your dog obviously deserve a better person than you are. Fuck up your own medical care if it suits
you, but don't insist on dragging your dog with you through the Petty Foothills to the top of Mt. Stupid.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:06 PM
Response to Reply #53
57. We are vegans too.
Scout eats Solid Gold Hund 'n Flocken...enjoys organic chewies that cost a fortune and has a fabulous doctor.

Now that you are done bitching at me, let's think about people who can't afford that shit for a mutt like we can.
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Maru Kitteh Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:17 PM
Response to Reply #57
64. Your words.
You are the one who said your dog wasn't worth the $150 for shots anymore. Clearly the dog deserves someone better.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:25 PM
Response to Reply #64
76. Well wake her up, and go drag her ass out
from under the quilt in the MIDDLE OF THE DAMNED bed.... and tell the dog that two servants apparently weren't enough to suit your ass...

And then explain to her that her pack is hateful, and go send her to a better home.

Christ.

After you do that, could you take over our donations to the Starlight terriers, and Best Friends in Utah?

Thanks.

We would also like you to cover the two hundred plus dollars on "Madison, the stray cat" that followed my wife home.....vaccines, spay, etc...while we found her a home.

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Maru Kitteh Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 01:07 AM
Response to Reply #76
127. Again, you are the one who said the dog living with you wasn't worth $150 dollars to you
Edited on Tue Jan-06-09 01:08 AM by Veganistan
Clearly, the dog deserves a better companion.
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Loki Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:20 PM
Response to Original message
67. I'm sorry you feel that way JanMichael
I've spent quite a number of years in school then in practice to have someone think that the only reason I do what I do is for the money. Every day I talk to patients who know nothing about how their disease processes could affect the outcome of the procedure they are seeing me for. Everyone who comes into our office is treated just like I would want to be treated or any member of my family. I'm sorry I have to put a price on it, but when it comes down to it, we are in the business of providing a medical service. We employ 6 people, most all of whom have some advanced degree or training who should be able to expect a living wage for their expertise, our equipment, medical supplies, the operation of our physical office (utilities and maintenance), dealing with insurance companies on a daily basis who will do everything they can to prolong sending you the payment for your services, think if you can, of doing your job and then not being paid for 2 to 3 months afterwards. Could you survive running a business like that? We do it every day. Malpractice insurance that has become prohibitive and insurance companies that expect you to become their accounting department. Those same insurance companies telling us what the diagnosis and what the expected treatment should be without ever seeing that patient. We have provided health care insurance for our full time employees and a profit sharing plan, but next year we may have to pull back and ask them to take on a bigger share of that bill. I don't live in a big fancy house, my kids go to public school and one has an after school job to help pay for her car insurance. I'm just out here trying to make a living and help take care of people.
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librechik Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:20 PM
Response to Original message
69. Why so hostile to one factor of the Epluribus? We will all be crushed at the same time
by the economic asteroid that is about to hit.
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Texasgal Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:21 PM
Response to Original message
70. If you think the docs/hospitals/surgical facilities
are making boatloads of money you are sadly mistaken.

The only folks raking in are the insurance companies.

I KNOW. I am an RN. Work for a surgical practice. Worked 12 years in triage. Seen and been through the trenches.

Oh.. and I make NOWHERE NEAR what I am worth. Thank managed care for that!

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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:27 PM
Response to Reply #70
79. My wife is an ex-paramedic
SHE KNOWS just as much as you do. 14 years in the trenches. The system SUCKS.

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Texasgal Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:50 PM
Response to Reply #79
89. So your wife knows..
Point of your thread?
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Sanctified Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:24 PM
Response to Original message
73. Vets maybe but Docs not a chance.
If it's between a lot of money and your dog dying well you may just say goodbye to your dog, however if it's between a lot of money and you dying, you will figure out how to get the money.
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Diane R Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:26 PM
Response to Original message
78. That thousand dollar root canal? My kid spent $250,000, and four years. learning how to do that.
You're a jerk.

When you've spent four years in med school, then 3 to 5 years in a residency and come out with a quarter of a million in school debt, we'll talk. When you want to get a root canal from a high school drop out who learned everything online, you can gripe about paying a thousand dollars.
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JanMichael Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:29 PM
Response to Reply #78
80. How did you kid spend that much?
my wife is in graduate school NOW. Care to let us know about those bills? Sorry dude...it's not that much. Hate your kid wracked up that debt--but s/he did not have to.

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Posteritatis Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 01:40 AM
Response to Reply #80
130. Graduate school's a joke compared to medical school
The large, large majority of graduate students I know are paid to attend; most med students I know don't get that luxury.

If you're comparing an MA with anything but the simplest MD you need the services of the latter.
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ColbertWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:32 PM
Response to Original message
82. I have no problem with doctors getting paid what they're worth, what I do have a problem with is ...
... insurance companies gouging people then denying coverage.

That's where the problem is with health care.

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OhioChick Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:42 PM
Response to Reply #82
88. Agreed. n/t
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KharmaTrain Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:39 PM
Response to Original message
87. I'm Sure If You Paid Their Malpractice Insurance
Prices would be a lot less expensive. Many doctors have given up practices or restricted them due to the high costs of insurance...THEIR insurance, not yours. Yep, those bloodsuckers get it coming and going. The more complicated procedures a doctor does, the higher their malpractice and that gets passed along...many surgeons paying six figures each year just to get "basic" coverage.

Besides malpractice, there needs to be a more standardized system for people to sue for malpractice...another cash cow...this one for lawyers. When my late father practiced, he was hauled in on several suits that were thrown at virtually any doctor who was at the hospital that day...even though he was dismissed from the suits, his premiums still went up.

Helathcare reform is desperately needed and not just on one front, but on many. Take the insurance companies out of playing god and the ambulence chasers from throwing frivoulous suits that make them a lot of money but not only hurt doctors but almost always short-change those who've been wronged.
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Texasgal Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 09:51 PM
Response to Reply #87
90. BINGO!!!
Seriously... BINGO!
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JerseygirlCT Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:11 PM
Response to Reply #87
92. The only thing I'd add on the malpractice part
is that MDs also have a responsibility to do a better job "policing" their own. Too often, they remain quiet about doctors who truly are practicing in a dangerous way - not wishing to rock the boat, or hurt one of their own, not their business.

There are bad lawyers who are eager to cash in on the situation. But there are also bad doctors, and if their own profession won't insist on them being removed from practice, then, unfortunately, another mechanism must exist to protect their patients.

As with nearly everything, nothing about this situation is black and white.
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Liberal_in_LA Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:08 PM
Response to Original message
91. They are graduating from school with a boat load of students loans these days.
Plus they have a huge insurance payment.
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emilyg Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:22 PM
Response to Reply #91
93. Not just these days
My ex graduated med. school in the 60's - boat load of loans.
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girl gone mad Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:27 PM
Response to Original message
95. This is accurate.
Doctors will not be able to charge as much, and specialists in particular will have to adapt.

Across the economy, all types of professionals are going to face pay cuts.
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Jennicut Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:35 PM
Response to Original message
96. Healthcare reform is desperately needed. The vet thing
Edited on Mon Jan-05-09 10:35 PM by Jennicut
is hard but there is pet insurance out there, don't know how expensive it is/if its worth it. I detest insurance companies in general. My 3 year old was sick, we go to the Dr. who is "in net-work" but get a nebulizer from the Dr. that comes from an "out of network" company. Like one would even ask, in network/out of network, the two coexist at the same Dr? needless to say, we payed full price for that nebulizer and had to. My daughter has bronchiolitis and needs it so what are you gonna do?
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FloridaJudy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:44 PM
Response to Original message
101. You are aware
That most docs today graduate with a mountain of debt? And some specialists don't make that much money. Locally, pediatricians make about $120,000 a year. As a nurse that sounds like a lot to me, but then I'm also not a quarter million bucks in the hole for student loans. And considering they go to college for four years, medical school for another four and then follow up with at least three years of residency to specialize, we're talking decades before they start making a comfortable living.

I'm a nurse, so I know just how arrogant and self-centered some MD's can be. I also know how hard most of them work. My mother always nagged me to go to medical school. I'd do everything in my power to persuade anyone I loved not to do so. Sure, I have a cousin who's a surgeon who lives in a MacMansion and drives a jag. I also notice that he doesn't have much of a life.
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:48 PM
Response to Reply #101
104. I remember in 1984 how the doctors were making ten grand per angioplasty.
Two of those per day, and you're making money.


That was '83.

But when a catheter cost hundreds, you can bet the guy using it makes even more.

Hell, I just spent four grand on a stinking septic design. Hell, I just paid ten grand on botany so I could prove to the county that I'm not building on some rare specie! Now that one hurt!
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FloridaJudy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:11 PM
Response to Reply #104
110. They may have charged ten grand
But they probably weren't making nearly that much. Factor in the cost of malpractice insurance, staff, and facilities, and you'd more than cut that in half. Heck, I know doctors who pay more than half their salary in malpractice insurance alone.

Still, there are MDs who make a mint. But I wouldn't trade places with most of them. When I leave at the end of my shift, I'm done. Except in extreme emergencies, I don't have to worry about getting a call in the middle of dinner or at three a.m. that forces me to return to work. And my day doesn't start at six a.m. with hospital rounds, and end with the same at six p.m. - usually much later since emergencies invariably crop up. When a nurse has to work a twelve hour shift, they give him or her most of the week off. Doctors have to do it 24/7.

There really are easier ways to make a living.
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:53 PM
Response to Reply #110
118. I'd have gladly been on call for those wages.
I remember a cardiologist would come in to interpret electrocardiograms after a dinner out on the town, all dressed up. I think it was $25 per ekg reading. Sheesh, you could make a hell of a lot of money in an hour doing that.

But you make a good point. Specialized and difficult to obtain education and skills. Maybe that's where we start making the changes. I don't know. The moment we start paying lower prices is the moment we get lower quality.

So it seems to me that there must be some middle ground where the patients don't lose out, and the doctors still perform with high standards.

Right now I'm throbbing from a root canal. A great dentist, by the way. But it sure doesn't look like there are any good solutions to high cost medicine. Maybe that is the price we pay for modern society. After all, the alternative to even bad medicine is better than none at all.
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FloridaJudy Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:30 AM
Response to Reply #118
122. I'd like to start by making education free
For everyone who qualifies. I've known a number of MD's from Northern Europe, and that's how it's done there. It's just as hard to get into medical school there as here, but once you're in, your expenses are covered and you get a small stipend. BTW, that's how I got my nursing education: there was a serious shortage then - as now - but politicians were savvy enough to realize the way to solve it was to encourage more to enter the field. Perhaps we could offset the free education by asking that new physicians devote a year to practicing in an under-served area.

The theme from Northern Exposure plays in the background...
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:08 PM
Response to Reply #122
158. It's easy to do. Kill military spending.
There is no need for it. Of course that's my opinion. But the alternative is a country with lots of great stuff. Like free education, electric power generation through renewable methods, community transit like we were having before they killed it in the beginning of the 1900's. And on and on.

But yes, I totally agree. That's exactly where we start.

The alternative is a country of fearful idiots who believe everything their war masters tell them to believe. And that doesn't just go for Republican leaders. We are a military based country.

Oh well. I guess one can dream.

By the way, I was interpreting electrocardiograms, and teaching interns to read them, when I was 16 years old. So no one can tell me that it's worth the... I forgot that they're all read by computer now, I suppose. But still, the price of this stuff is ridiculous. It's complex. We pay for quality. That's pretty much the bottom line. I'd rather have my tax money subsidize medical quality rather than Mil-spec quality.
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:45 PM
Response to Original message
102. I just got back from a $2000 root canal.
The anesthetic is still wearing off.

I'm not poor, and that hurts!

Hey, I've been saying for decades that our STANDARD OF LIVING IS GOING TO HAVE TO COME DOWN.

So there. I've said it publicly now. It's not something people want to hear. Including me.
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liberalhistorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:46 PM
Response to Original message
103. You think it's bad now, wait until MedFICO
becomes as ubiquitous as the damn FICO score. FICO has now developed a "medical credit" score for medical personnel to use in evaluating patients. I shit you not. Now, they claim that the patient's score will not affect treatment or treatment decisions, etc., etc, yaddayadda, you know the drill, but that's what we heard when the original FICO came out and we all know how accurate those "assurances" turned out to be (remember, it was only supposed to be used for lending purposes. Now it's used for everything under the sun, including insurance, employment, etc., where it has no business being used at all). Medical personnel, hospitals and clinics are already horrid when it comes to billing and collecting (just try finding a doctor who'll accept you if you're uninsured without a lot of upfront money, it's almost impossible), and thousands of deaths a year are the result. To the medical community, our lives are already worth only as much as what's in our wallets. Just wait until MedFico is really up and running.

And do you really think they'll care if people can't afford to pay them anymore? NO. They'll just cater to those who can still pay and the hell with the rest.
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Gregorian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:52 PM
Response to Original message
105. Malpractice insurance!
We use the legal system like aspirin. Everyone is terrified. And then there's insurance. And it is expensive because they know about the legal costs.

It's all tied together. And the sooner we can slowly start coming back to reality the better we'll be.

However that's done.
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tridim Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 10:53 PM
Response to Original message
106. My dog twisted her bad knee last night and I almost had a heart attack
She was fine 2 minutes later thank freaking gawd. I've already spent $1500 on that knee.
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:04 PM
Response to Original message
109. Telling those who take care of your healing to go fuck themselves. Smart. And mature.
Edited on Mon Jan-05-09 11:15 PM by newtothegame
Do your mommy and daddy know you're using their computer?

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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:28 PM
Response to Original message
111. I have a highly controversial idea: RAISE OUR WAGES
OMG! OMG! OMG!

:hide: :hide: :hide:
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Dreamer Tatum Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:39 PM
Response to Reply #111
113. Except for the people you want to buy stuff from, though, huh?
Just where do you think higher wages come from?
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:40 PM
Response to Reply #113
114. What?
That makes no sense
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Dreamer Tatum Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:44 PM
Response to Reply #114
117. You don't think raising wages will increase prices? nt
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:58 PM
Response to Reply #117
119. 2007 Blockbuster Inc CEO wage $11,582,994 - movie rental $3.99
Guess this guy's big salary didn't raise prices.

:shrug:
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Dreamer Tatum Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:06 AM
Response to Reply #119
120. I didn't ask you about one CEO.
Forget it - not likely to be an intellectual exchange.
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leftstreet Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:12 AM
Response to Reply #120
121. There's nothing 'intellectual' in suggesting the worker bees are harming the economy
whenever they demand higher wages.

But you keep cheerleading for those CEOs.
There are plenty of them and they appreciate your support.
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Dreamer Tatum Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:40 AM
Response to Reply #121
126. Like I said, not an intellectual discussion.
I asked about the wage/price spiral, and you bring up jackassed bullshit about CEOs.

My concern is empirical; yours is emotional.
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Joe Fields Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jan-05-09 11:43 PM
Response to Original message
116. I'd bet good money that if docs couldn't earn such decent livings,
their numbers would dwindle by half, maybe more.
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CreekDog Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:33 AM
Response to Original message
124. because you want your heart surgeon to work a night job
genius. :eyes:
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tomreedtoon Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:34 AM
Response to Original message
125. Time to de-regulate medicine!
There's an obvious solution to a lot of this. Instead of relying on medical professionals to handle a lot of medicine stuff, it's time for Americans to take it on by themselves.

Now, we can't do surgery, but why should we have to stand in line for a bacterial infection, and pay for a doctor to tell us we have a bacterial infection (that we damn well already knew) and get him to write the prescription for it?

In Europe, medicines are available over the counter that require a prescription in America. Why not legalize these things, so Americans can self-medicate?

And yes, people will make mistakes, mis-medicate and die. At least with drugs they will die without pain. The way the medical profession has it now, we die in pain.

And no, even if I could afford that fancy sarcasm icon that so many of you rich people have, I would not use it. I am being honest about de-regulating medicine.
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Hawkowl Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 02:22 AM
Response to Original message
131. I never pay full price anymore
Haggling. A Depression era skill I learned from my Jewish grandmother. Try it!
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MichaelHarris Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 04:07 AM
Response to Original message
133. you're
actually blaming doctors for the amount of your deductible? My wife is a physician and she has no control over your policy. I can tell you this, she gets about 15 to 20 percent of what she charges, that's all the insurance will pay. She's one of the few doctors left in eastern Washington and Idaho who took uninsured patients, she's even made free house calls. For you to make a blanket statement telling all doctors to "go fuck yourself" shows your limited knowledge of the subject as well as hatefulness. I could care less if you think your dog's life is less than 150 bucks, mine sure is.
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Cid_B Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 05:07 AM
Response to Original message
134. The reasoned rational response to your post is...
.... or what?
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HamdenRice Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 07:57 AM
Response to Original message
139. You are EXACTLY RIGHT
Some of the responses to your post show that, as the cliche says, "a little (economic) knowledge is a dangerous thing." A lot of DUers seem to believe that limiting wages for health professionals is some sort of violation of the market.

The problem is that there isn't really a market for health care professional wages, and in the absence of a functioning market, the government will basically have to step in a set wages.

There are many reasons that there is no functioning market for health professional wages, but I can think of two off the top of my head: (1) demand for many health services is (or should be) completely inelastic, and (2) there are more "agency" problems in health care than in almost any other industry.

As for (1), consider an appendectomy. This is now a safe, easy low cost (note: not low price) operation. If you get appendicitis and don't get the operation, you die. Let's say the cost of an appendectomy is $2,000. When the operation is "sold" in a market, the question is, what is the patient willing to pay for it? What is the value to the patient in terms of future wages, and life itself? The price a person is potentially willing to pay for an appendectomy is up to his entire life's wages, savings, property -- and even more because he prizes life above all other values. So the price could be up to millions of dollars for something that "costs" $2,000.

Therefore, the price of an appendectomy simply cannot be set by market forces.

As for (2), agency problems occur in economic theory whenever one person or party has to do something through another person (the agent). In health care, the patient is the customer or buyer. But all his decisions are made by agents: the doctor determines what care is needed because of his specialized knowledge, the insurance company pays his bills -- and it gets even worse in emergencies and operations, when agents make extremely expensive decisions on behalf of the "customer."

For this reason, prices have to be set before the customer is even a customer -- namely collectively through political processes.

There can be no functioning market system in professional health care wages any more than there can be a market in the services of firemen in the middle of fighting a fire.
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Mika Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:22 AM
Response to Reply #139
145. The average dental office overhead is about $500-$900 an hour.
That is if the staff is being paid a fair living wage, and the practitioner has a fairly modern practice.

Since the crash came I haven't paid myself. I made sure my staff and support crews get paid first.

I live modestly, treat people fairly, and I didn't come close to a six figure income last year (which is OK by me, because I didn't get into h-c to get rich).

In dentistry, most people don't realize that their time in the chair is only a fraction of the time spent on their case.



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HamdenRice Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:26 AM
Response to Reply #145
146. You are trying to generalize from your own situation
The point is not whether every dentist in the country is paid too much; it's whether the current system for pricing health professional services in a market makes any sense when the item being sold isn't properly considered a marketable commodity item.

As for dentistry in general, my SO works as a non-dentist in a dentistry training hospital program, and having known several generations of them who have come into the program and gone into private practice, in this part of the country, most dentists here truly believe dentistry is a license to print money.
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Mika Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:39 AM
Response to Reply #146
147. Actually I was contrasting my practice with others, that, as you say ..
.. treat their practice as a license to print money.

My point being, that not all h-c practitioners are greedy. I just don't feel that the blanket statement in the OP is fair to those of us who do try, despite overwhelming pressure, to provide fair service at a fair price.

I agree with your points.


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Burma Jones Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 08:54 AM
Response to Original message
142. There is already a tiered health care system
There are clinics in WalMarts, there are bargain basement health care providers. In the same way you can either shop at Food Lion or Whole Foods, you either pony up extra for better medical attention or save your money with lesser doctors.

There are still plenty of people that have more than enough money to pay extra for better health care. There's a reason, you know, that many parts of the country have physician shortages.
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Renew Deal Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 10:46 AM
Response to Original message
148. What are you ranting about?
The bank bailout passed and it didn't make a difference.
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lonestarnot Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:25 AM
Response to Original message
153. It's called pay REDUX.
:D
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merh Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 11:26 AM
Response to Original message
154. there is a doctor in the neighboring city
that runs a clinic/office where he charges a flat fee. He doesn't take insurance or medicaid, he simply charges something like $50 a visit

He makes a decent living and can support his wife and 9 kids. He has one employee and he said he is much happier than most he knows and is able to focus on treating his patients and caring for them.

It can be done, the flash that goes with the expectations of the status are what become costly. Oh, shiney things.

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OPERATIONMINDCRIME Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:26 PM
Response to Original message
159. They Can And Likely WILL Charge That Just Fine. You, On The Other Hand, WILL Pay If You Want Or
need the services.

You can spout at the mouth all you want. It doesn't change a damn thing and makes your OP come off as just a silly little irrational rant.
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leftofthedial Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 12:56 PM
Response to Original message
160. like the rest of Amurka,
we need a maximum wage

and an end to inherited massive wealth
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mike_c Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 01:21 PM
Response to Original message
161. I'm a "professional" and I work for a reasonable salary....
Academic science. We do good work, educate your kids, and nobody gets anywhere near to rich doing it. At least no one who actually works in the classroom and the lab.
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Laelth Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jan-06-09 02:01 PM
Response to Original message
162. I hear you.
I am a professional (an attorney) who's been in private practice for just over two years. I'm carrying $150,000 in law school student loan debt, and I've been in forebearace since I got out of law school (i.e. not paying back any of my loans yet because I can't afford to do so and feed my family at the same time). Most of my colleagues are lowering their rates for their services in an attempt to bring in more business and to reflect the economic reality in which we live. Very few people can afford attorneys in the best of times, much less in times of economic turmoil.

As for me, I can't really afford to lower my rates if I ever intend to pay back my student loans. Student loans are extremely difficult to bankrupt away. Guess I'll just have to find something else to do.

But I hear you when you tell me you can't afford my services. I can't even afford my own services. Times are rough, but some of us simply can't cut the rates we charge.

:dem:

-Laelth
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