<p>alwaysamom… i wasnt fear mongering…i also have lived in both, and worked in both… i also think it is ridiculous that i pay almost 16K per year for bc family coverage… i honestly dont know what the premiums are for ohip anymore but know it wouldnt come close to that. HOWEVER, when people talk about free healthcare in canada, it really isnt “free” there are trade-offs… taxes and budgets… which system do people want? as a country… we will have to decide… Personally i think we need health insurance reform not healthcare reform</p>
<p>Canadians have nothing to do with “doctors going broke” - the topic of this thread. On the other hand, yes, Canadians are helping “US doctors NOT going broke” and I hope they continue. However, if few years, they will not be here, we all will have to go to India, both Canandians and Americans.</p>
<p>In the 1980s there was a push by the insurance companies to privatize the semi-public Blue Cross/Blue Shield health insurance. They claimed they could run it more efficiently than the 4% margin used by BC/BS. Typical private health insurance companies now take 30% of the health care dollars.</p>
<p>Countries with public health care all have the same issue - they run on tax revenue and the government does not always allocate enough for the changing demographics and the volume of people they need to see. But they still spend less than half per person of what we spend here, even with 40% uninsured. It’s not about the money; we spend way more than any other country on health care. It’s about the sanctity of the profits. </p>
<p>The only thing that has decreased over the past years is the Dr. salaries. An anasthesiologist I know made $500k in 1980. He works many more hours now for about half that. A primary care doc I know made $170k in 1977, but about $120k now working for one of the hospital clinics, about the same pay of a good programmer in our area.</p>
<p>^MD was wotking for the Hospital for $170 in 1977? If not than $170 is not comparable to $120. Another note is that while MD’s in our area easily making what you mentioned, good programmers are very happy with about half of it, yes, $60k for programmer is awesome - coming from programmer with over 30 years of experience in various industries on many different platforms and writing software in several languages. the same goes for engineers. In addition, there is not job security for neither of them. I got my very wide experience because I was out of job 9 times, at least I enjoyed more and more great references with each job that I lost.
I have personal experience with centralied Helth Care. It is horrific, you do not want it, but it is not our choice, it is done. So, get money saved for trips to India.</p>
<p>Seattle area programmers are paid better than average. Interns at Microsoft get the equivalent of $85,000/year. It might be worth noting that half of their new hires are from out of the country. Programmers in 1977 made about $30,000/year, or roughly 1/6th the pay of a primary care doctor, but now make about the same.</p>
<p>My wife’s office pays $205/hr for IT tech support, the same as she pays her lawyer.</p>
<p>^That does not mean that good programmer in your area is getting $120K on average. It also does not mean that this good programmer was never unemployed. None of programmers in our are are making the same as MD and many (all?) have been unemployed. The same goes for engineers. Not all programmers made $30k in 1977. I started at my first job in 1982 for $12k/year, but was overly excited about getting THE JOB, almost broke my leg jumping and falling down after recieving that tel#, will never forget it. None of people in my graduating class that I spoke to were getting jobs in our area with unemployment of about 17% (very high currently also). At the same time, none of the MD’s (as far as I know) were unemployed (none now either), many engineers were unemployed in 1982 though. Many families left somewhere else.</p>
<p>MiamiDAP- Yes, my numbers may be skewed from what you have experienced, so I will explain where I get them. I live in Microsoftland and have friends who are programmers and friends who work in personnel. Microsoft hires are very selective. I know many others who left Microsoft for Google, Amazon, and others, generally for about the same pay but sometimes for much more.</p>
<p>In 1978 I was in high school trying to decide between computers and engineering. Starting salaries were $22,000 for programmers with a BS and $28,000 for BSEE grads. Typical average salaries were $8-10,000 more per year than starting salaries. 1982 engineering graduates from my engineering school were getting offers in the $32,000/year range.</p>
<p>^it is a huge diff. between your and my area. However, do you know unemployed MD? I do not, despite of all other differences. Salary level is insignificant in comparison of job security. Salary level also reflects the cost of living, and our place arguably is one of the cheapest in the country in regard to everything, real estate, insurance, food, clothing, private schools,…every single aspect of life except maybe electricity.</p>
<p>According to NY Times, “If you want to make the most money over a lifetime, your best bet, as it turns out, is to go to medical school. Physicians and surgeons earn a lifetime average of $6 million, compared with $4.5 million for chief executives and legislators and $4.4 million for those who work in securities or financial services.”</p>
<p>You may check it here.</p>
<p>[It's</a> Not Just the Degree, but What You Study - NYTimes.com](<a href=“http://economix.blogs.nytimes.com/2011/08/04/its-not-just-the-degree-but-what-you-study/]It’s”>It's Not Just the Degree, but What You Study - The New York Times)</p>
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<p>And how many of those programmers have required education of 10-12 years? You’re trying to compare apples to oranges here…</p>
<p>“Countries with public health care …”</p>
<p>Maybe we should be careful about definitions. Does the following seem accurate?</p>
<p>A. The Beveridge fully public systems of, e.g., Britain and Hong Kong
B. The Bismarck gov’t-regulated semi-private systems of, e.g., Germany and France
C. The Canadian hybrid of A and B (gov’t funded private delivery?)
D. The U.S. private system with *relatively<a href=“compared%20to%20A,B,C”>/i</a> little gov’t regulation (in the process of changing to more like B)
E. Systems we might call non-systems, cash systems, etc.</p>
<p>I lived in Germany for five years and consider their system to be very good, much better that the U.S. system, but I don’t know how their doctors fare financially compared to elsewhere.</p>
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<p>Wow I would hate to see the government regulation in other countries. Health Care is heavily regulated…</p>
<p>^ Perhaps “relatively little” is misleading. The powerful differences in regulation are that in A, B and C everyone is covered and no one loses coverage (not tied to employment). In B you choose one of the providers when you enter the work force, and you can stay with them forever, even when changing jobs.</p>
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That statement is true of every profession, and has been all my life. It’s pretty much what distinguishes “profession” from “business.”</p>
<p>Here’s an example from the legal profession: If a lawyer agrees to take on a case and the the client stops paying but insists that the lawyer continue, the lawyer can’t just “quit.” He has to get permission from the judge to withdraw - and that permission isn’t always granted. Particularly if it happens on the eve of trial, the lawyer is going to have to proceed and try the case, even though he’s not going to be paid - even if he has uncovered evidence which makes him think the case is a loser. I’ve seen it happen.</p>
<p>No point in caterwauling about it. ;)</p>
<p>In Hong Kong, everyone is “covered” as long as you check in at a government hospital or clinic. Almost no one I know who considers him/herself upper middle class(HK standard) go to a government sponsored clinic/hospital. There are tons and tons of physicians in private practices who only accept cash and their rates for an office/hospital visit are higher than that in the US. Their practices are also thriving.</p>
<p>The bottom line is that everyone can get medical care very cheaply if you are willing to go to a government clinic or hospital. According to my friends, quality of care isn’t too high if you are really sick.</p>
<p>I doubt Americans will find this type of 2 tier/class systems acceptable.</p>
<p>There is already a several tier/class system in the US. Those who can’t afford medical care for whatever reason go to urgent care, ERs (who generally can’t turn anyone away), or the community health center that cares for folks who are un/underinsured. Those who have resources go to the HMOs, private pay docs/clinics & hospitals. </p>
<p>Those who can’t afford medications try to get whatever they can when they go to wherever they get healthcare. Sometimes they are fortunate and can get samples, soemtimes they start splitting their medications or space them out further than they are supposed to, just to make them last, sometimes they order on-line from other countries or who knows where. I see and know people on both sides of the tier/class and it isn’t pretty. Those who do not get good care often get sicker and stay hospitalized longer. We as a society still end up paying for these costs and some of the hospitals that provide care end up going bankcrupt, as two of our hospitals just did this year. The state also has to provide grants and other aid to help the other hospitals stay in business.</p>
<p>I don’t have answers but we as a society definitely need to find some because things are not working well as they are.</p>
<p>Perhaps this is because private practices are economically inefficient. If doctors can pool equipment and resources to reduce costs, then this should be done.</p>
<p>It’s a much larger problem than that, especially for hospitals. There are many patients in our HI hospitals that do not need accute care but DO have medical needs and there is no place to discharge them (sometimes they remain patients in accute care wards for many, many years). This is a HUGE waste of resources on many levels and causes a lof of other problems as well. I do not believe HI is unusual in this but only know about this from the bankruptcies of the two hospitals that closed its doors and from speaking with several in the medical profession that see this all the time.</p>
<p>Don’t know how economically efficient or inefficient private practices ARE but do see how the physicians I see are compensated vs. how much time they spend with their patients. Don’t know how they can make ends meet. When I see MDs & have procedures at places like National Jewish, a research medical center & other medical centers, they charge an overhead fee AS WELL AS a MD fee; my insurer has not grumbled about paying it. It is quite significant. Have never seen a private physician charge an overhead fee.</p>
<p>in terms of health risk management, which is a public interest, it makes no sense to have the public purse (which is already large and as such, faces decreased risk and has various advantages) contract out to private insurance companies to finance its own public health programme. If you think about this, this is really what is happening.</p>
<p>private insurance would occupy those extra niches where the public externality is less strong, i.e. vacation health, elective or experimental end-of-life treatments, etc; concurrently the public obligation to fund such things would mostly cease.</p>
<p>public budgets are well-equipped to pool the risk of their constituents to fund universal “core health” programmes, without having to rely on a middleman insurance company (underequipped local governments could tap into state and federal frameworks)</p>
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<p>I wonder why doctors in your area are so much below published average physician salaries?</p>