Canada Premier comes to America for heart surgery

[werepossum]

I'm not at all convinced that we need insurance companies at all. Let's take them out of the equation, and let people keep the money they'd otherwise pay to those companies (and employers keep/redistribute what they pay insurance companies on their employees' behalf) and see what happens.

I once worked for a company that became self-insured. It put up some money and bought truly catastrophic insurance (like million dollar claims.) Didn't work too well, as the company was very slow in providing the money (to the point that a couple people almost lost houses due to cancer treatments, as the providers refused to provide more services if they weren't paid) but the concept is probably sound. However even self-insured companies have to have personnel (possibly outsourced) to do the myriad paperwork required in health care. You can't just mail out checks to everyone who sends a bill; you have to verify that the treatment actually took place, that the bill is accurate, and that the service is reasonably priced. Otherwise we'd have massive fraud. That is the main part of what insurance companies do, paperwork, which must be done even in a single payer system (you'd want to know for instance that someone had an appendix removed twice, even if everyone is covered for everything.) There are no free rides, and in my opinion government's inefficiencies outweigh the insurance companies' profits.

 

[zsdersw]

Well, their primary goal is to maintain/improve profits through a combination of two things:

- Calculating risk and raising prices for policyholders and,
- Paying doctors and hospitals as little as possible for any given procedure.

Why do they want to improve or maintain profits? The same reason as any other business; expansion, employee wages/salaries, satisfy investors.

 

[werepossum]

Well, their primary goal is to maintain/improve profits by calculating risk and raising prices for the insured and lowering what they pay to hospitals and doctors.

Yes - but they still pay providers better than does the government, since insurance companies can't use armed force or coercion and cannot force costs to be moved to others.

Insurance companies also relentlessly pursue efficiency since a more efficient competitor can take their accounts by offering lower premiums. Government has no such drive.

 

[zsdersw]

Insurance companies also relentlessly pursue efficiency since a more efficient competitor can take their accounts by offering lower premiums. Government has no such drive.

Doesn't work so well when choices in insurance companies are limited to two (usually), depending on where you live.

 

[werepossum]

Doesn't work so well when choices in insurance companies are limited to two (usually), depending on where you live.

Yes, that is a huge problem and needs to be changed. It helps states regulate them more easily, but if there are only two competitors then both can be relatively inefficient and still make good profits.

 

[JohnnyGage]

I agree with you on rountine and low cost medical care. But there will be a need for catastrophic insurance. And if our insurance industry was actually setup this way. I bet we wouldnt see the ridiculous amounts of inflation we see today in our medical industry. Right now for anything non-catastrophic the insurance industry is a private entitlement program. It is a needless middle man skimming profits off the top from the revolving money door.

You could call it, as it is now with insurance companies--a defacto single payer system. No one cares what routine labs cost because Aetna's got it covered. Now get a govt. single payer system and watch inefficiency grow to astronomic levels.

 

[soundforbjt]

For cheaper care... certainly not better care.

You are aware that we rank 32nd in the world in healthcare. oops, make that 37th

 

[mattpegher]

Obama said $2500 less per family. But that was on the campaign trail.

A friends daughter is at MUSC and they are telling her $350K her first year out. WTF. Who the heck is worth that? I think some cutting could be done there.

Could you provide more info. Is this first year out of what, school?, residency? What specialty? What is MUSC?

The average starting salary for primary care is about 100k after residency. The average debt is 156k which works out to about 12k per year in loan payment over 30 yrs (not eligible for tax credit due to income).

 

[RyanPaulShaffer]

For the wealthy, the US has the best health care in the world. Top of the line doctors and technology all available for you...if you can afford it, that is.

For the rest of us, not so much. It's all right, but there are some glaring issues and huge room for improvement. However, nobody in a position of authority has even shown a glimmer of interest in truly addressing the issues.

 

[highland145]

Could you provide more info. Is this first year out of what, school?, residency? What specialty? What is MUSC?

The average starting salary for primary care is about 100k after residency. The average debt is 156k which works out to about 12k per year in loan payment over 30 yrs (not eligible for tax credit due to income).

Medical University of SC. Going to be an M.D. 1st year of school was $65k for tuition/labs/room/board etc. Matt was flipping out and the counselors said,"No sweat, just borrow it. She'll make $350K her first year out." I trust him to give the details like they were presented to him but I don't necessarily trust the counselor.

This is showing $24.6 for tuition http://www.matchcollege.com/college/218335/Medical-University-of-South-Carolina/SC#tuition_and_fees

If you add the extras I mentioned above, including labs, you might get to $65K.

This gives a range but it's less than $350K average. I know she is mega smart but I don't know her specialty. http://jobs.aol.com/articles/2010/02/01/medical-doctor-salary-overview/

 

[Amused]

You are aware that we rank 32nd in the world in healthcare. oops, make that 37th

Based on subjective criteria that favors socilized systems over others.

 

[mattpegher]

Medical University of SC. Going to be an M.D. 1st year of school was $65k for tuition/labs/room/board etc. Matt was flipping out and the counselors said,"No sweat, just borrow it. She'll make $350K her first year out." I trust him to give the details like they were presented to him but I don't necessarily trust the counselor.

This is showing $24.6 for tuition http://www.matchcollege.com/college/218335/Medical-University-of-South-Carolina/SC#tuition_and_fees

If you add the extras I mentioned above, including labs, you might get to $65K.

This gives a range but it's less than $350K average. I know she is mega smart but I don't know her specialty. http://jobs.aol.com/articles/2010/02/01/medical-doctor-salary-overview/

That 350 is highly inacurate. First she is still in school. So for the first 3-4 years she will most likely make less than 40k. My salary for residency was 23k/ year from 1992-1996. Most primary care in my area (NY/NJ/PA) do not pass 200K even after 10 years in practice.

 

[soundforbjt]

Based on subjective criteria that favors socilized systems over others.

Yes, that favors things like life expectancy, birth deaths, etc...things that only socialist countries should care about...

 

[highland145]

That 350 is highly inacurate. First she is still in school. So for the first 3-4 years she will most likely make less than 40k. My salary for residency was 23k/ year from 1992-1996. Most primary care in my area (NY/NJ/PA) do not pass 200K even after 10 years in practice.

I'll talk with him this weekend and see if he has any new info. That sure seems like a ton of $$ and education for the end results. Better that McD's but...

Since you're in the industry, where is the waste and what do you think can be done to help costs?

 

[mattpegher]

I still think that most of the waste is the 30% off the top for financing health care.

decrease unnecessary testing due to defensive medicine, ie tort reform.

Free clinics for the indigent for non-emergency care, staffed adequately that it would be preferable to waiting in the ER. Staffed with mid-level providers. This would keep many non-emergency patients who have no intention of paying for care, out of the ER where care is the most expensive.

Redistribute reimbursement from the specialists to primary care, to increase the number of primary care physicians, the amount of time they can spend with you, and emphasize prevention esp with regard to htn, cholesterol and DM.

A systematic program to eliminate tobacco completely. 50% of the patient that I see in the ER have significant increase in disease because of history of tobacco use.

I am sure there are other but these seem to me to be the big ones

 

[highland145]

I still think that most of the waste is the 30% off the top for financing health care.

decrease unnecessary testing due to defensive medicine, ie tort reform.

Free clinics for the indigent for non-emergency care, staffed adequately that it would be preferable to waiting in the ER. Staffed with mid-level providers. This would keep many non-emergency patients who have no intention of paying for care, out of the ER where care is the most expensive.

Redistribute reimbursement from the specialists to primary care, to increase the number of primary care physicians, the amount of time they can spend with you, and emphasize prevention esp with regard to htn, cholesterol and DM.

A systematic program to eliminate tobacco completely. 50% of the patient that I see in the ER have significant increase in disease because of history of tobacco use.

I am sure there are other but these seem to me to be the big ones

What do you mean " financing health care"?

So when are you going to do us all a favor and run for office?

 

[umbrella39]

Pst OP, this guy is having a valve repair and doesn't want his sternum cracked.

I work at one of the top hospitals in the nation and guess what, this whole bullshit line about "Seems the Canadian system offers a much cruder surgery requiring breaking some bones" is just that.... BULLSHIT. It has nothing to do with Canada as much as you would like to paint it as such. We used to have a fake heartsurgeon posting here, I am sure he can verify.

When we do valve repairs we break your sternum just like we do when we do bypass surgeries, no incisions under the arm. I guess we are barbaric crude heathens here at U of M.

 

[mattpegher]

What do you mean " financing health care"?

So when are you going to do us all a favor and run for office?

I mean insurance companies operating expenses. And as for office, I am a physician, not a politician, there is a clear difference in the mind set. I treat all equally, I do not bargain with the lives of those in my charge, and I am not spending 90% of my efforts trying to maintain my own job.

 

[Atreus21]

Pst OP, this guy is having a valve repair and doesn't want his sternum cracked.

I work at one of the top hospitals in the nation and guess what, this whole bullshit line about "Seems the Canadian system offers a much cruder surgery requiring breaking some bones" is just that.... BULLSHIT. It has nothing to do with Canada as much as you would like to paint it as such. We used to have a fake heartsurgeon posting here, I am sure he can verify.

When we do valve repairs we break your sternum just like we do when we do bypass surgeries, no incisions under the arm. I guess we are barbaric crude heathens here at U of M.

So then why did he come the US for surgery?

 

[Slew Foot]

I'll talk with him this weekend and see if he has any new info. That sure seems like a ton of $$ and education for the end results. Better that McD's but...

Since you're in the industry, where is the waste and what do you think can be done to help costs?

Unless youre going into a surgical subspecialty (neruo, spine, certain types of ortho), Youre not getting close to 350k. And thats after piling on 5-7 years of residency trainign at 40-50k/yr.

Most primary care, pediatrics, internal medicine, ER, PMR, will top out at 250K if youre lucky.


250-400 if youre in derm, anesthesia, radiology, general surgery, ENT, most internal med subspecialites(cardiology, GI, etc..)

You wont get over 400K unless youre doing somthing fantastic.

Salaries are for what I see in CA.

 

[Slew Foot]

So then why did he come the US for surgery?

Here at UC Davis, we just started this year doing bypass surgery robotically with incisions in the armpit without cracking the chest. We do some vavle repairs percutaneously but only for those we think are too sick to survive a bypass surgery.

 

[Slew Foot]

A systematic program to eliminate tobacco completely. 50% of the patient that I see in the ER have significant increase in disease because of history of tobacco use.

I am sure there are other but these seem to me to be the big ones

I firmly believe that alcohol, tobacco, drugs, overeating, and under activity account for 85% of the total health care costs in the country. Trauma and genetic disease make up most of the rest.

 

[mattpegher]

I firmly believe that alcohol, tobacco, drugs, overeating, and under activity account for 85% of the total health care costs in the country. Trauma and genetic disease make up most of the rest.

Your spot on there.

 

[Orignal Earl]

Here at UC Davis, we just started this year doing bypass surgery robotically with incisions in the armpit without cracking the chest. We do some vavle repairs percutaneously but only for those we think are too sick to survive a bypass surgery.

Canadian cardiac surgeons say there was no need for the premier of Newfoundland and Labrador to cross the border for world-class health care.

The treatment Danny Williams received in the United States is available in at least four Canadian centres including hospitals in Vancouver, Montreal, Ottawa and Toronto, doctors told CBC News.

Williams has made no apologies for following what he said were doctors' orders in flying to Miami to have "minimally invasive" surgery earlier this month to repair a leaky heart valve.

However, Montreal cardiac surgeon Dr. Hugues Jeanmart finds that medical advice puzzling.

"I was very surprised, especially for the reason he [Williams] advanced, saying that we didn't have this kind of expertise in Canada, which I completely disagree with," he said.

Jeanmart repairs heart valves using the latest in robotic technology. Instead of open-heart surgery, the operation is performed through an incision under the arm, so there is no large chest scar and there are other benefits as well, Jeanmart said.

"There's less pain, less bleeding, less chance of infection and the main point is faster recovery after these kinds of surgery."

There is a wait-list in Montreal of up to three months, but urgent cases can get the surgery right away, Jeanmart said.

http://www.cbc.ca/canada/newfoundland-labrador/story/2010/02/23/williams-surgery023.html

 

[sandorski]

For cheaper care... certainly not better care.

If "Cheaper" is all you can get, it's Better by default.