Re: Another triumph OT

In article <3kt060FvtpebU1@xxxxxxxxxxxxxx>, "CatNipped"
<lcrews@xxxxxxxxxxxxxx> wrote:

> "Christina Websell" <spamfree@xxxxxxxxxxxxxxxxxxxxxxxxx> wrote in message
> news:3ksu5dFvjsu5U1@xxxxxxxxxxxxxxxxx
> >
> > "Monique Y. Mudama" <spam@xxxxxxxxxxxxxxxx> wrote in message
> > news:slrndeiegu.h59.spam@xxxxxxxxxxxxxxxxxxxxxxxx
> > > On 2005-07-28, Christina Websell penned:
> > >>
> > >>>
> > >> Heh. You have different sort of doctors in the US obviously. The
> > >> doctor who sent me to hospital as an emergency could not recall it a
> > >> week later. If I went and said "I have just had this and that op
> > >> for whatever awful illness and what do you think about me going back
> > >> to work?" I know what he would say. IF YOU WANT TO!! I know
> > >> because it was the same after my very intricate eye surgery. No
> > >> considering about whether it might harm me to go back too soon, just
> > >> if I wanted to.
> > >
> > > After reading your posts about this illness as well as some other
> > > comments I've heard here and there, I am horrified by the state of
> > > medicine in England.
> >
> > It isn't all like that here, I saw a superb occupational health doctor
> and
> > I so wished she was my doctor. (Earning extra money on top of being a
> local
> > doctor too far away for me to be her patient :-( )
> > You might wonder why I stay with my doctors as they seem so useless.
> >
> > This is why. They all came from Kenya in the 60's and are grazing
> > along
> > until retirement, making no effort at all to keep up with modern
> > medicine.
> > However, they know this and if there is anything that does not fit into
> > "coughs, colds and sore holes" as my grandmother used to put it, they
> > will
> > refer you to the hospital immediately.
> > Which just have might saved my life. Unlike another doc at a different
> > practice who knew best (not) and failed to send my friend's mother to
> > hospital until it was too late. She died.
> >
> > Tweed
>
> I don't know Tweed, it sounds terrible there and in other countries that
> have socialized medicine (not going just by your experiences as far as
> horrible pain management, unreasonable waiting in doctor's offices and
> emergency rooms, etc.). One of the reasons that I'm *against* socialized
> medicine here in the states is because of the medical care we can get
> here
> (even though we have to pay through the nose to get it).

Too many people think the options are "socialized medicine" and the
existing US system that is largely employer based. In fact, most
healthcare economists, and even both candidates in the last Presidential
election, accept the employer-based system is broken. What is not
realized is that there are free-market alternatives, one of which exists
today in the Federal Employees Medical Plan. Both Presidential
candidates suggested certain small businesses could buy into the plan.

Now that we have an exceptionally odd couple of Hillary Clinton and Newt
Gingrich cooperating on healthcare, and also agreeing the employer-based
system is collapsing, something might actually happen. Hillary's plan
had lots of features of the Federal Employees' system, but added some
mandatory, even criminal, aspects that were not acceptable. Further, she
did everything possible, it seems, to close the development process for
the plan and then bring it out in a politically unwise way. I hope she
learned from that. I don't especially like Gingrich's politics, but he
is extremely smart and has a better sense of public relations.

>
> I live in Houston which is the "world capital" for a lot of medicine -
> our
> medical district attracts patients from all over the world - especially
> the
> M. D. Anderson Cancer Center.

You're in trouble, when the mobs of Godfather DeBakey and Godfather
Cooley hear about mentioning anything except cardiac surgery first, with
respect to Houston. (Michael DeBakey pioneered cardiac and vascular
surgery in WWII, and his greatest student and protege was Denton Cooley.
They had a spectacular breakup and haven't spoken in years. They each
head the heart service at two hospitals across the street from one
another -- the Berlin Wall wasn't as much as an obstacle.)


>My gastric surgeon is *SO* good and
> world-renown that he has surgeons come from all over the world to study
> under him. It was very reassuring to me to know this before my surgery
> (and
> proved to be true, I've never had a *single* problem that I hear other
> people have had after the very same surgery I had).
>
> As crass as it sounds, doctors here are "motivated" to become the best in
> the world, because then they can get millions of dollars for their
> knowledge. My doctor makes *SURE* he knows my name, my medical history,
> my
> family, my likes and dislikes, my exercise habits, my allergies, my
> medicines, and everything else that is pertinent to me medically or
> psychologically - he get paid *BIG* bucks to do so (thankfully most of
> them
> by my insurance company)!

This isn't universal. My endocrinologist used to do primary care and
made a lot more money. He now restricts his practice to endocrinology,
and bills insurers for visits at a shorter-time visit than he actually
uses. He tells me he is much happier, as he has time to treat his
patients as he would want to be treated, and usually also has medical
students or residents for community teaching.

>
> This is the same reason I think we ought to quadruple the pay teachers
> get -
> they are the people who are training the people who are going to take
> care
> of the world when *we* get old, so I want them to be motivated to be the
> best teachers they can be! ;>
>
> Before anyone brings up the problem of people without insurance, we do
> have
> provisions here for that - any hospital that has *any* kind of federal
> funding *MUST* accept anyone who needs treatment regardless of their
> ability
> to pay. And those patients get the benefits of the learning and
> knowledge
> of those doctors who *do* get the big bucks from those patients with
> insurance or who *can* pay.
>
It's not quite as general as that. The EMTALA legislation requires, as
you suggest, that hospitals that take any sort of funding evaluate
everyone -- but ONLY at the emergency room, and ONLY while the patient
is not yet fully evaluated, or is medically unstable. Now, the latter
can turn into weeks for a gang shooter who forgot to duck, where someone
with progressive bone cancer might get pain relief and a quick discharge.
.

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