Re: US healthcare system
Ergh I wrote my whole reply out only to close the page. Here I go again.
Ravi,
In Pakistan, qualities varies also for education. Children get education based on what their parents pay for. It doesn't make the system any better, instead its a recipe for keeping the status quo. Rich kids get better education (and better health care) and get richer and the poor stay where they belong. Now you will say, if you are so concerned why not open a school for poor kids. Yes, countless do but we are talking millions and no matter how many charities are out there the scope and the finances involved aren't enough to get everyone educated from private contributions alone (not to mention who pays for your education also decides what you study, hint hint madarasah) .
Is there any basis for saying that there is greater social mobility in nationalized education? Pakistan tried that for a while, and yes everyone was equally miserable, but not necessarily moving upwards.
I think the madrasa model is brilliant, if there is a little more oversight over the anti-state/terrorist elements. So what if they set their own agenda, doesnt the government have its agenda? Whos to say I should grow up hating India more than I hate Israel? Some of the best universities in America were Christian founded schools, as are a lot of the good private schools in Pakistan.
[quote]
Same is the case with health care. Its a behemoth of a problem facing millions. Just like its hard to find people willing to raise money to go to war and so the government has to tax to keep "us safe", why not tax to keep everyone healthy?
[/quote]
And have healthcare become something like the military industry complex? Scratch that its already there, sponsoring a lot of bills. Doubt they have as benevolent intentions as you though.
[quote]
In the US there are plenty of charities out there who help low income/no income families going through health crisis. Visit any of the religious based hospitals and you can easily find volunteers lurking around. I personally know doctors who put their insurance premium on line to see patients without insurance at a minimum charge and at the expense of losing money, which they could earn looking at rich patients otherwise. But even if there were hundreds of them, they don't have the clout/power or the means to negotiate what hospitals/doctors charge, drugs cost or to regulate how insurance and other health care providers work, only government can do that.
[/quote]
And that is the actual support for universal healthcare out there. Comparatively very few people volunteer and donate to hospitals providing care for everyone, while bloviating that the govt should provide care for everyone when talking to republicans.
Democrats are 50% of america, more or less right. Get them to pay half of what the want to tax as healthcare to such hospitals. Eliminate the middleman and the beureacracy get the insurance companies out of the picture (dont bother asking for insurance for those who dont have it). Because the middleman seems to cause as much harm as it does good.
Other than TOEFL, which they have to take to prove that they can speak English, foreign medical graduates (FMGs) take the exact same exams as US graduates. The only reason it may seem cumbersome is because the exams are spaced out through medical school in the US, as opposed to being taken all at once...and foreign medical schools aren't necessarily preparing their students for US exams. I see absolutely no reason why FMGs shouldn't have to pass the same exams as their American counterparts if they plan on competing for the same training spots. As it stands, the US is more open to letting FMGs practice than most other industrialized nations...there's no reason to drop the standards and let every Tom, Dick, and Harry from donation schools in the third world come here and practice.
They take the same exams (you meant USMLE right?) as their american counterparts. As I understand it the process is two exams, spaced out over a few months, then wait for a residency, then in-house training over there? Just takes way too long, even if its the same time as american doctors take.
Other countries have healthcare too. How about having equivalency at the level of medical associations with trustworthy countries, and then having a much less rigorous process?
[quote]
Furthermore, its absolutely ridiculous to compare medical care to computer engineering. If random IT guy from Bangalore screws up, it doesn't cost someone their life or their health...nor will IT guy face a multi-million dollar lawsuit for having made a mistake. Obviously there needs to be more stringent standards in place when we're regulating healthcare.
[/quote]
As it stands people are losing their lives and health at a very large scale anyway. The only thing you're saying is that we wont provide them potentially inferior (but much needed) care at the risk that they will file a lawsuit. The only thing standards are doing is depriving the lower classes of healthcare.. the insured will always be able to afford quality care.
Hospitals can enforce stringent standards at the level of their institutions. If you can afford it, go to one of those hospitals that only hires Amreeki thoroughbred doctors. If you're living in an urban ghetto, Im sure you'd appreciate being able to see ANYONE, even if they didnt jump through the USMLE hoops.
[quote]
In any case, why should physician wages be lower in the US? After at least 12 years of post-secondary training, plus approximately 300,000-500,000 dollars of educational debt, its absolutely absurd to expect physicians to work 60 hrs/week for 60K/year. They have every right to protect their profession from being flooded with poorly trained FMGs just to drop their wages...not to mention the fact that dropping physician wages wouldnt even have a dramatic effect on total healthcare expenditures.
[/quote]
Maybe they're overtraining them. Maybe produce lots of competant doctors instead of a few brilliant ones. You're right, people should expect to get what they paid in, but when you're expecting doctors to pay this much to be called doctors, you're raising the bar for access to those doctors to a level that many people in america are unable to afford. And if the 12 years post secondary training is actually useful instead of merely wasteful, it will not be wasted even in a market flooded with doctors, because we're still talking about a meritocracy. People are valued according to their skills in any competetive environment, which is what Im simultaneously arguing for. Private companies have never needed the government to tell how skilled a potential employee is. The root of the need to protect seems to be a realization that maybe a lot of doctors would have the same value in skills as those who trained for 12 years.
You sound like someone in the healthcare industry. Where does the bulk of healthcare expenditure go?
