Universal Healthcare in the USA

[Victorian Gray]

An interesting article with some numbers from the Canadian system. Take it for what you will:

Canadians use average of $220,000 in public health care over lifetime

André Picard

PUBLIC HEALTH REPORTER — The Globe and Mail

Published Tuesday, May. 14 2013, 3:00 PM EDT

Last updated Tuesday, May. 14 2013, 3:26 PM EDT

Canadians consume, on average, just over $220,000 in publicly funded health-care services over a lifetime, newly published data show.

Spending is fairly consistent across income groups, despite significant differences in the health status of rich and poor, according to the analysis from the Canadian Institute for Health Information.
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People in the lowest-income group have $237,500 in lifetime health costs, compared with $206,000 for the highest-income group. The wealthy live an average of five years longer than the poor. But the wealthy also tend to be healthier, so their lifetime cost to the health-care system tends to be less.

“That five-year gap is one of the more macabre details of the study,” Keith Denny, senior researcher for health systems analysis and emerging issues at CIHI, said in an interview. “It evens things out a bit.”

Another surprise in the findings is that the rich and the poor pay roughly the same percentage of their incomes to fund medicare – the publicly funded health-insurance program.

The lowest-income Canadians (those earning less than $24,000 a year) pay 5.8 per cent of their income for health care, while those in the highest-income group (more than $72,000) pay 7.5 per cent. Of course, that does not mean that they pay equal amounts of money. The poor pay, on average, $1,020 a year, compared with $8,650 for the wealthy.

In Canada, money to pay for health costs come almost exclusively from taxes. Personal income taxes account for 49 per cent of health spending, sales 16 per cent and corporate income taxes 14 per cent, and the balance from a variety of other tax measures. Unlike many countries, Canada does not have user fees or co-payment.

The idea of insurance is to pool revenues and spread risk, for people to essentially “pay it forward” when they are younger and collect on the benefits later in life. It is not entirely clear how much of their health costs Canadians pay in taxes, but studies out of Britain and Australia show that, in each major income group, about 70 per cent of people pay for the lifetime health costs and the other 30 per cent need to dip into the pool.

The new data show that health-care costs are the equivalent of 24 per cent of income for lower-income Canadians, compared with 2.9 per cent for higher-income ones.

According to the calculations from CIHI, having publicly funded health care is equivalent to an 18.3-per-cent boost in income for the country’s poorest citizens, and results in an income loss of 4.6 per cent for the wealthiest. For middle-income Canadians, it is pretty well a wash, the equivalent of a modest 2-per-cent gain in income.

Put another way, medicare is an effective way not only of ensuring access to health-care services but also of redistributing income. “What the numbers tell us is that publicly funded health care makes Canada more equal, more fair,” Mr. Denny said.

“There was a time when social programs were redistributive, that was the purpose,” he added. “I’m not sure we think of that any more, but it’s still the case here.”

Canadians spent $207-billion for health services in 2012. That includes $145-billion in public spending and $62-billion in private spending.

That works out to $5,948 per capita. However, the health services people use vary considerably with age, rising to $6,223 per capita after the age of 65 and $20,113 for those 80 and older. Those numbers are averages and do not account for differences between income groups.

The new research examines only the public spending, which is 70 per cent of overall health spending in Canada. This suggest that overall lifetime spending is about $320,000 per person when private spending is factored in.

http://www.theglobeandmail.com/life...ic-health-care-over-lifetime/article11913571/

 

[Blanky]

Insurance has contributed hugely to the joke that is the US healthcare system. I have from two reliable individuals recently these scenarios:

1) Went to the ER in Canada from the US, ergo no Canadian coverage. Had an accident requiring stiches. Visit to the ER including stitching by a physician: $165. That was 100% out of pocket all said and done

2) Went to the ER in the US because thought baby was coming early. Spent a few hours in the ER. Never saw a single doctor. Bill: $3k (to insurance. I'm sure insurance
"negotiated" a lower rate by 2/3rd or something stupid).

Although I have "good" insurance and make good money, thus am protected to a degree to much of the stupid shit others aren't, I am not too blind to see that the US needs a single payer system. The more I experience health care the more it's so obvious.

NPR covered a few nights ago the fact that a ton of physicians in a given hosptial's ER are not in the same network as that hospital. Therefore, you're having a heart attack, you find an in-network hospital, but you get screwed because the ER doc who saw you isn't in network. It's really just fucking ridiculous. It isn't democrats or republicans' faults; it's both of theirs that they let the country get to this, and the fault of the cheerleaders on either side who support it.

At the very least the concept of in network out of network should be prohibited, penalty is firing squad. If you're a mother effing doctor and you're performing a given procedure you get a given amount of money. That's how other countries do it and it works fine. With this, insurance stops with the in/out bullshit. The only reason any of this is even legal is because Washington is owned wholesale by lobbyists. It has nothing to do with what's good for customers, or for the healthcare system.

 

[Zodiark1593]

Have you seen the cost for our current healthcare system? It's absurd. When I owned my company in CA healthcare costs were a major problem. We were facing rising premiums each year around 15%. The number of denied claims that took months to deal with was staggering. Our system is both expensive and cumbersome.

Too many Americans don't seem to understand that their employer pays a huge sum to cover them. Have a great insurance plan with a low deductible and low copays? It's because your company is subsidizing your costs. However most Americans do not enjoy this luxury. The average cost to Americans is staggering.

You have to remember that these universal healthcare systems provide more than just doctors visits for that extra tax burden. Affordable daycare, maternitty leave, sick leave, mental healthcare, and so on.

Tacking on an extra tax burden while eliminating our current insurance, deductable, and copay system and reducing the costs to employers can only be seen as a good thing unless you work for the insurance companies and big pharamecuticals.

So how exactly are we going to shit a tax brick? Only if we are imbeciles and don't implement it properly. There are many different universal or national systems out there that work. Ours doesn't. It's straight up retarded and just throwing your hands up and complaining about the tax bill is defeatest don't you think?



Dig a little deeper on those stats? I have lived in other countries. You are just throwing out a random talking point about how all the statistics are wrong, there is a conspiracy, and we have it great here. That is non-constructive.

I just don't subscribe to defeatest and politically polarized opinions like yours. This is America. We could do it if we wanted to. Everyone else has.

Honestly you need to take your political shill hat off and look at this objectively. This is not a R vs D discussion. Neither side is doing us any favors.



So just like my example with the hip surgery we have some anecdotal evidence here. However how do we objectively explain that people in these countries live longer and have better health than Americans?



Defeatest. Could be true but it's not constructive. Surely we can get this done? You are of the opinion that there's nothing to do but suffer with the current system. What will you do when you want to retire but your SO has cancer and you can't afford to quit your job because of the rising healthcare costs? Will that make you happy?



It is not a democrat vs republican argument. Neither side has done shit for us. Both sides have made things worse.

You do bring up something that I found to be an interesting observation. When you live in a country that has universal healthcare the people are much healthier and happier. In the US for example if you're having mental problems you still have to go to work. This creates more problems. With a national healthcare system you can take the time off to take care of your health before returning to work as a productive employee.

too much time to delete all but the one paragraph on my smartphone...

My point isn't to suffer, yet to work with what we have. For example, we still have health insurance, expensive as it is, better than bankruptcy. In addition, there may be hope for universal healthcare yet, if we had another Roosevelt in charge (not that I'd vote to such a president btw).

 

[doubledeluxe]

too much time to delete all but the one paragraph on my smartphone...

My point isn't to suffer, yet to work with what we have. For example, we still have health insurance, expensive as it is, better than bankruptcy. In addition, there may be hope for universal healthcare yet, if we had another Roosevelt in charge (not that I'd vote to such a president btw).

The problem is that even with health insurance it's a giant headache and still causes bankruptcies and financial hardship. It still doesn't cover things that are covered in other nations. Our system is yielding poor results.

If we're gonna just sit around and wait for good leadership we might really be waiting a long time. We're currently looking at the possibility of Hillary Clinton vs Jeb Bush. The ultimate in turd sandwiches.

No. I believe that what needs to happen is protests. People need to hit the streets in Washington by the millions. Force our poor leadership to make real change.

Unfortunately Americans simply don't know any better and have been brainwashed to think that anything collective is bad. We vote for things that are against our own interests. We complain about things that aren't even bad. Just in the last 24 hours we've had multiple people complain about our postal service despite it being the best in the world. I have no idea where that idea comes from but what hope is there for Americans to stand up and demand a real healthcare system when we can't even agree on whether our postal system is fantastic or the other myriad of obvious issues like equal rights for all our citizens?

 

[blankslate]

Insurance companies will literally kill in order for to keep that from happening.



....

 

[doubledeluxe]

They can't kill 10 million people marching on Washington.

The USA's largest gathering was to celebrate the Red Sox winning. That's really sad. It was only 3 million people too. In fact all of our largest gatherings were sports related.

Our largest protest that wasn't sports related was in San Francisco and was due to Proposition 8. A whooping 1.5 million.

The civil rights march where Martin Luther King made his I have a dream speech? 250,000.

We really suck at voicing our opinions for change.

 

[doubledeluxe]

So according to the Institute of Medicine 30% of all our healthcare spending is unnecessarily. Today that's over $1,000,000,000,000 dollars.

http://en.wikipedia.org/wiki/Institute_of_Medicine
http://en.wikipedia.org/wiki/Unnecessary_health_care

Here's an article by consumer reports of all places lol

http://www.consumerreports.org/cro/...ests-and-treatments-are-unnecessary/index.htm

 

[werepossum]

And, based on discussions I've had with friends that live in Canada and the UK, we get helped a lot faster here in the US. A friend of mine in the UK had to wait over a year to get knee surgery due to the lag time between referrals and tests. She also had to get carpal tunnel surgery and they didn't start PT for her until they had enough evidence that she wasn't recovering quickly enough. She told me that this was not at all uncommon there.

Friend in Canada had blood in her urine. Docs put the fear of God in her had told her it could be cancer. Then she had to wait over 2 months for tests. Found out it was just due to a hernia, but she had to wait almost another 2 months for the surgery.

My favorite Canadian story is the guy who had brought his dog in to the vet. The vet recommended an MRI and, when asked when that could be done, told the man it could be done immediately. Surprised, the man asked why his dog could get an MRI immediately but it took him several months after a heart attack. The vet grinned and said something to the effect of "your dog doesn't have National Health Care."

Nonetheless, I'm flipping to favor "free" national health care. I have zero confidence that we'll do a good job of it, but now that the feds have seized control of health insurance the free market is doomed. Already people like myself working for small businesses have been driven to policies most doctors will not accept for new patients and many hospitals do not accept. Roughly a quarter of this nation's doctors already do not accept new patients on the Obamacare exchange policies, both because the pay rate is so low (like my own, where my deductible went up but provider reimbursement went way down) and because they fear they will not get paid at all (because so many low income people have selected cheaper high deductible policies and because the law requires that insurance be honored for 90 days after the insured stops paying the premium - but the insurer only has to pay the first 30 days of that.) We're rapidly becoming a three-tired level - really good insurance (government and large employers), poor insurance (individuals and small to medium employers), and uninsured. This is by design, and it's only going to get worse as more freebies are mandated while provider reimbursement continually drops. And people like myself are going to be where the pain is most inflicted. I'm folding early. Take it over; it's not like we're still really a people with much concept of standing on our hind legs anyway.

 

[TheVrolok]

Because the system is so completely broken that it's impossible to fix.

1). This will never happen because the doctors union is extremely powerful.

What doctors union, and how?

3). Expand the role of nurses. 99% of the things doctors do can be handle by a nurse.

Not sure how to respond to that, because it's absurd.

4). Drugs should not require prescriptions. How much time and money is wasted on seeing doctors to fill prescriptions? Buying ADD medication should be just as easy as buying cough medication. Can you imagine how expensive cough syrup would be if it needed a prescription? Instead of $10, it might cost $100 or $200. On top of that, you would need to pay another $100 just to get a doctor to say you're allowed to have it. This is such a stupid system.

Equally ridiculous.

 

[doubledeluxe]

My favorite Canadian story is the guy who had brought his dog in to the vet. The vet recommended an MRI and, when asked when that could be done, told the man it could be done immediately. Surprised, the man asked why his dog could get an MRI immediately but it took him several months after a heart attack. The vet grinned and said something to the effect of "your dog doesn't have National Health Care."

This is stupid. I can get my veterinarian to perform procedures on my pet faster than I can get them in the USA too.

Interesting article: http://www.nytimes.com/2011/10/29/h...ften-mislead-doctors-warn.html?pagewanted=all

 

[doubledeluxe]

Roughly a quarter of this nation's doctors already do not accept new patients on the Obamacare exchange policies

I googled this immediately. Doesn't seem to be accurate. The links are all to propaganda websites.

 

[TheVrolok]

Yes, but many common medications can and should be prescribed by nurse practioners or possibly even lower trained medical professionals. Hell, for medicines which are topical or should really be available OTC a LPN would probably suffice. It's complete overkill that you need an MD to prescribe simple meds like birth control pills and bacitracin. Heck, just allowing that and the feds helping subsidize the setup of clinics staffed with LPNs could probably handle 80% or more of the typical medical needs for the uninsured.

All topicals should be prescribed by NPs or even lower trained professionals? I suppose you think all topics are OTC hydrocortisone cream and bacitracin? There are quite a few topicals that can have significant side/adverse affects that do require a bit more education for use. Complete ignorance..

My GF who is a nurse seems to know more about what's going on with her patients than the MD does most of the time. When she talks about work, it sounds more and more like the MD is just a pen in a lab coat waiting on the next tee time.

I'm sure she has no bias whatsoever?

 

[fskimospy]

I googled this immediately. Doesn't seem to be accurate. The links are all to propaganda websites.

Also, even if true, nearly entirely irrelevant. The question is if people have access to quality care.

Similar claims were made about Medicaid. When they actually asked medicaid recipients of they had problems finding care, they said no.

 

[doubledeluxe]

I have a friend who worked for a think tank in New York and his experiences there were eye opening. This is an aside but when you start talking about things like 25% of doctors refusing to accept Obamacare and the links are to think tanks or just plain fringe websites then it's worth checking to see what those sites stand for. I wouldn't waste my time on some crazy website called The Conservative News Network for a Free America or Progressives for a New America (made both of those up) but something like say the Heritage Foundation really does warrant a closer look. It's a think tank. What is it's purpose and is it biased?

Their sole purpose is to write articles and papers for conservatives to use to reinforce their position. It has a revolving door of politicians working for them and is tied at the hip to conservative legislators. Their current president is a former senator who led the tea party movement and resigned to take on the position for at least $1,000,000 dollars.

You would be far better off finding a source that is non-biased if you want to have an intelligent discussion.

 

[Matt1970]

I wouldnt. It would be less than most people insurance premiums and i have the added "jesus-like" quality of knowing its caring for everyone

Why would it be less? You have to factor in the costs for the people that are currently not insured and I get the sneaking suspicion we will have a significant jump in doctor visits once universal coverage kicks in. No factor in our government never does anything small so we would see a bureaucracy probably like no other. I am sure that will eat any cost savings we may get by removing the insurance industry. And what of the insurance industry anyways? Are we just going to tell all the people that are employed with them they are out of a job and the companies themselves are out of business without compensation? Universal coverage may save costs in the long run but it may take a very very long time to see those savings.

 

[doubledeluxe]

Why would it be less? You have to factor in the costs for the people that are currently not insured and I get the sneaking suspicion we will have a significant jump in doctor visits once universal coverage kicks in. No factor in our government never does anything small so we would see a bureaucracy probably like no other. I am sure that will eat any cost savings we may get by removing the insurance industry. And what of the insurance industry anyways? Are we just going to tell all the people that are employed with them they are out of a job and the companies themselves are out of business without compensation? Universal coverage may save costs in the long run but it may take a very very long time to see those savings.

Do you have anything to back any of this up? Why does it work in EVERY OTHER developed nation on earth?

 

[fskimospy]

Do you have anything to back any of this up? Why does it work in EVERY OTHER developed nation on earth?

They never have an answer for this other than that America is somehow uniquely awful.

 

[werepossum]

This is stupid. I can get my veterinarian to perform procedures on my pet faster than I can get them in the USA too.

Interesting article: http://www.nytimes.com/2011/10/29/h...ften-mislead-doctors-warn.html?pagewanted=all

Couldn't be much faster. Two of our employees have suffered mild heart attacks in the last five years; both were in MRIs or CAT scans within one or two hours of being seen in the emergency room to check for tissue damage.

I googled this immediately. Doesn't seem to be accurate. The links are all to propaganda websites.

The only people publishing numbers are the Medical Group Management Association, a non-partisan trade organization for physician groups, which found with actual surveys that 23.5% of all physicians they cover are not accepting ACA-plans. Their results certainly are being attacked, but their survey covers groups containing 40,000 doctors; that's a pretty hefty chunk, almost five percent of the population. When is the last survey you've seen covering almost five percent of the population studied? In addition, one common attack against the MGMA survey is that it is not necessarily representative of solo practitioners, but solo practitioners are already an endangered species, down to 32% of all physicians and vastly more common among older doctors facing retirement soon anyway. (This is because doctors increasingly need more bargaining power to offset the ever-decreasing reimbursement rates of Medicare/Medicaid as well as private insurers.)

Further, even though this number is under attack, it may well represent an underestimate rather than an overestimate. Of the four doctors I can consider mine, one does not take my new insurance at all. All three of the others take it for existing patients, but will not accept new patients with this insurance. It's posted at the front desk. In the MGMA survey, each of those physician groups would be counted among the 76.5% who do accept ACA-exchange plans - but none of them would accept a new patient with that policy.

The MGMA numbers are also in line with the tone of The Physicians Foundation's 2010 survey of 100,000 physicians in all types of practice. Although this survey did not directly ask this question, many of the same issues are noted. http://www.physiciansfoundation.org...the_Decline_of_Physician_Private_Practice.pdf

 

[doubledeluxe]

http://www.politifact.com/truth-o-m...email-claims-214000-doctors-refuse-take-pati/

Here's an analysis.

Our ruling

A chain email claimed that more than 214,000 American doctors are "opting-out of Obamacare exchange plans." That is based on a survey of a select group of doctors and even the makers of the survey said it can’t be extrapolated for the entire country. Further, of the doctors responding to the survey, 42 percent said they weren’t participating in marketplace plans because they were never asked to, not because they were "opting out."

The estimate is the result of a flawed methodology and a misreading of survey data. We rate the claim False.

 

[Spungo]

What doctors union, and how?

Did you even attempt to google this?
http://en.wikipedia.org/wiki/American_Medical_Association#Politics

Not sure how to respond to that, because it's absurd.

Without googling, name some things doctors do that nurses are incapable of doing. For each of those things, how often does that happen?

They never have an answer for this other than that America is somehow uniquely awful.

Because it is uniquely awful. A guy saying he doesn't believe in evolution would have roughly 0% chance of winning a federal election in any other OECD country. That's standard practice in the US. Believing in reality actually makes someone a minority in the republican party. Believing in climate change is another thing that makes someone a minority in the republican party. The US is a lot closer to Iran than it is to Germany in terms of backwardness. Death penalty for 16 year olds? We do that. Extreme sexual repression? Yep we do that. Refuse to teach kids about sex? We do that. Teach creationism in schools? We do that. We also allow a very high level of corruption. In countries like Canada, you're not allowed to donate a billion dollars to a political campaign. It's illegal. It's illegal in most countries. Most people realize bribery is a bad thing, but not us. That bribery is what makes our institutions suck so bad. Companies like McDonalds lobby to allow food stamps to work at McDonalds. They don't do that in Canada. I don't even think Canada has a food stamps program.

The anti-government people like myself assume that everything the US government does is eventually corrupted. Food stamps was a great idea. We had food lines during the great depression, and that really sucked. Over time, the food stamps program morphed into a monster. How did it happen? Corruption happened. I would love to have the health system Canada has, but I have no confidence in our government. It'll start like Canada's system then morph into something truly horrible. That's what happened to our school system. Our public schools went from good to horrible while we spend more on school than almost any other country. It's because of corruption.

 

[TheVrolok]

Did you even attempt to google this?
http://en.wikipedia.org/wiki/American_Medical_Association#Politics

Naturally I assumed you meant the AMA, I was just hoping you'd actually expand upon your "ideas." I would like to know in detail how the AMA actively (and purposefully) limits the amount of physicians. How about funding for training positions? Where does it come from? How are they opened?

Without googling, name some things doctors do that nurses are incapable of doing. For each of those things, how often does that happen?

... diagnosing and managing medical conditions. QED. I mean, it's such a dumb statement, I don't even know where to begin.

 

[MomentsofSanity]

Couldn't be much faster. Two of our employees have suffered mild heart attacks in the last five years; both were in MRIs or CAT scans within one or two hours of being seen in the emergency room to check for tissue damage.

You think Canadians wait months for those same procedures in emergency circumstances?

My mother had a fall yesterday morning breaking her hip. While in hospital they did the x-ray and found what they believe is cancer. In the 24 hours since then she has had a second round of X-rays, CT scan and bone scan.

We don't have to wait if we don't want to either. You can pay for scans on your own at private clinics. If you want it free for non emergency matters there could be some wait but in most cases it's not a long wait.

 

[Jeff7]

Everyone will shit a brick when they see the tax bill for universal care.

And they'll surely blame government rather than greedy shits in the companies that are fine with charging $10 for a single aspirin tablet, or thousands of dollars for something simple like stitches.
If I damage my car and then work out with the auto body shop to bill insurance $10k for $1k of work and we'd split the rest, that's fraud. If a hospital does it, it's business as usual. The difference is that they can afford more free-speech/$$$ than I can, therefore their opinions on the situation matter more to politicians.

I've read that we already pay more in taxes for healthcare than most countries with universal care and we have to pay for private insurance on top of it.

Unfortunately the government is corrupt and effectively run by large companies and wealthy private interests, and they'll make sure the system is rigged to wring every last dollar out of the masses.

A doctor visit for me is about $20 after I get past the $300 deductible ($700 max for family). A MRI or Catscan costs me less than $100. If I need to get an operation which includes knee or hip replacement it's occurs as soon as the doctor/hospital has an opening, normally 2 to 3 weeks. My max out of pocket is $2,000 individual/$4,000 family. Emergency coverage is at in-network prices though I haven't found a facility that doesn't accept the insurance that the company I work for uses to administer their plans.

I pay $325/month for a family plan that includes dental and vision. My prescription cost $10 for a 30 day supply and $20 for a 90 day supply, generic of course and sometimes it's less depending on the drug. Company pays 80% on name brand drugs.

Based on what my colleagues pay for universal healthcare at the European locations it's not that much different.

We just had a meeting to review the changes to our healthcare plan.
Our original provider told us recently the cost would be increasing by 55%, and that there'd be no negotiation or other offers.

Eventually something was worked out shortly before the enrollment deadline, but there were of course some changes.


- ~$4/week now for a single person on the plan, up from $2.50.
-/+ Tobacco surcharge.
- Higher copays.
+ Certain types of preventative care are covered 100%. No copay, no deductible.
+ $1500/$3000 deductible is unchanged.
+ $1250/$2500 deductible reimbursement from employer is unchanged.
- For the month of December, non-emergency treatment at one of the city's hospitals will also not be covered. The two major providers here can't play nice together.


Certainly better than the dire predictions they were giving a few weeks ago.

Why would it be less? You have to factor in the costs for the people that are currently not insured and I get the sneaking suspicion we will have a significant jump in doctor visits once universal coverage kicks in. No factor in our government never does anything small so we would see a bureaucracy probably like no other. I am sure that will eat any cost savings we may get by removing the insurance industry.

A significant jump in doctor visits? Yeah, it really sucks that selfish people can go to the doctor when they're sick or injured. It might even end up catching some illness early that'll then require expensive treatment that someone will have to pay for.
Can't they just suffer and politely die early? That'd save the rest of us some money.



Though I have this odd feeling that having a healthy society would eventually end up being good for the overall economy. Find a potentially disabling illness early thanks to readily available preventative care, treat it early, and now you don't have another person whose productive working years were cut short by a decade or two, and you don't have a family that has to spend more time trying to stay afloat. They might even have disposable income and be able to go out and buy things, which is something you might find in a healthy economy.

And what of the insurance industry anyways? Are we just going to tell all the people that are employed with them they are out of a job and the companies themselves are out of business without compensation?

And what of the candlemaking industry anyways? These electric lightbulbs will damage that industry. Are you going to tell them that they're going to be out of jobs? Outlaw lightbulbs!
Or hell, here's a disruptive one: Aluminum. Until the late 1800s, aluminum metal was rarer than gold, and at least as valuable. Then some people figured out how to inexpensively extract aluminum from its ore. They should have thrown them in prison and burned the research, as this surely caused big problems for the wealthy few who owned lavish items made of aluminum.

Universal coverage may save costs in the long run but it may take a very very long time to see those savings.

Yes, because long-term thinking is for small-minded morons. Short-term's where it's at. Screw the future!

 

[doubledeluxe]

lol

 

[Hayabusa Rider]

Naturally I assumed you meant the AMA, I was just hoping you'd actually expand upon your "ideas." I would like to know in detail how the AMA actively (and purposefully) limits the amount of physicians. How about funding for training positions? Where does it come from? How are they opened?

Well it just has to be, right?

Healthcare is a fascinating topic. Virtually no understanding of the system, but they understand all anyway. Oh well, remember one of my old sayings, "No one knows you job better than someone who's never done it."