Regardless of your economic prowess, and no one doubts that you know voodoo economics better than anyone, or your certainty that your personal vision of morality demands that those who work hard and save should pay for those in need, whether their student debt, subway fares, and certainly medical care no matter how radical, extreme or costly, in perpetuity, what about Donald?
Yeah I’m not sure you are gonna find as many people as you think to do what it takes to get into medical school and through residency for 120k a year. Not when statistically the people who get into medical school are the top students in the country and most could get into anything else they wanted to.
We go to medical school become we love to the profession and love taking care of patients. But it’s really hard and stressful work. Patients die when we make wrong decisions. It keeps you up at night. We are willing to pay pro athletes millions but you want to pay the person who holds your life in his or her hands 120k. Interesting.
Can you believe this selfish bastard who won’t sacrifice himself for the good of others, who have a right to free medical care because, well, why not? The problem for Donald is that he put in the time, the effort, the sacrifice to become a doc. And you didn’t. Maybe you couldn’t. But he could and did.
All I can say is this. I worked really hard in college and in medical school so that I could get into a competitive residency. I spent 120’hrs a week for 5 years. Now I work 80 hrs a week see 500 patients a month and do about 50 operations.
I’m in call 15 days a month. And let’s be honest I have my phone all the time because even if I’m not on call I still get calls. I deal with Medicare every day telling me what I can and can’t do for my patient after I spent all that time learning what was best for my patient. Instead some uneducated bureaucrat tells me what to do.
If Medicare for all passes and they cut what that pays me by 3/4ths, then I’m throwing my phone in the ocean and good luck finding a doctor that answers the phone. I’m not doing it for less. And I promise you I’m not alone.
All the angsting about morality isn’t going to buy his Porsche. He’s not saying he doesn’t care deeply about his patients, but that he’s done what it takes to become a physician and wants to enjoy a rewarding lifestyle for his effort. You think he’s a sick and disgustingly amoral person because he won’t sacrifice for the sake of those you cry sad tears over.
Guess what? You can’t make him. But buried in there is someone who can. The Bureaucrat. There will be folks in the bowels of government deciding how much Donald will be paid for every surgery, every office visit, every phone call. And that will be whatever that bureaucrat decides is the “right” amount, which may take into account the cost of a Porsche or not.
You can’t be Donald. You can’t decide that your passionate vision of morality for the marginalized and vulnerable come at his expense, because you’ve decided it should. But you can be the bureaucrat who decides Donald’s reimbursement rates.
Many people believe that physicians (and some lawyers, but only the evil ones) make too much money. What makes you think you get to decide how much someone else is entitled to earn? You didn’t put in their effort. They did. You didn’t do their residency. They did. No matter how passionately you think you get to dictate the world to someone else, they don’t have to do it, because you aren’t the boss of them and, frankly, no one cares what you feel.
So you may believe you’re absolutely, morally right, but Donald isn’t going to play ball. There are two options; either you can make the medical profession akin to the priesthood, where they take an oath of poverty and sacrifice their lives to the common good, or we can have a medical profession made up of people whose skill level might earn them a gender studies doctorate in a phone-in college.
Some folks worked a whole lot harder than others and want to reap the benefits. In their worldview, they may be entirely wrong to want this. But that’s not going to change Donald’s desire to have the life for which he worked so hard. And when the unduly passionate fill the ranks of the Department of How Much Docs Should Earn, and decide that Donald doesn’t need a Porsche that comes at the expense of the poor being unable to get free health care, what do you plan to do when Donald no longer applies to med school, no longer does his 120 hour weeks during residency, no longer takes phone calls any time of the day or night?
But if not selfish, greedy Donald, surely someone will care enough about the poor to become a physician, to sacrifice their Porsche for the good of society? But it won’t be you, since you already know that your future is as a bureaucrat deciding the morality of overpaying docs for the sake of the marginalized. Plus, you suck at math but are brilliant at deciding other people’s morality, so it only makes sense that you get to tell Donald what he deserves to earn.
Like you, I won’t feel badly that Donald doesn’t get his Porsche. But I might be a bit miffed that smart, competent people prefer not to have their financial futures decided by you, passionate bureaucrat, leaving me without Donald when I need some decent medical care.
There’s a good chance that the poor won’t mind, as they’re getting medical care for free and beggars can’t be choosers (or you get what you pay for). But your decisions as bureaucrat mean my medical care might be at your mercy as well. I’m not dying for your passionate sense of morality or because you hate Porsches. When I’m on the operating table, I want a competent surgeon, not one willing to work on the cheap. But you, dear passionately moral bureaucrat, will have driven them all into coding, where the real money is.
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It’s hard to believe someone as presumably intelligent and educated as this fella would say something as stupid as “I should get paid as much as a millionaire pro athlete because reasons”.
Reasoning worthy of a high school freshman.
Not sure that was his point in raising pro athletes. You might want to revisit that.
Doctors don’t get reimbursed for phone calls.
Lawyers do. They would if there was a code for it.
We do if we use Skype. I’m told there are multiple codes. The one used depends on the nature and purpose of the consultation.
And by the way, there will be less docs, with or without the proposed policy changes. This was foreseen. As a cost-reducing stop-loss measure, we’re seeing a ramp-up of filling the ranks with more PAs and NPs. The legislature is considering a further expansion of their allowable duties and autonomy. (i.e., what they can do/order without an MD signing off).
The lower cost non-MD practitioners is also seen as a means of putting a competitive downward pressure on the docs that remain.
As someone said in another thread, it won’t be Medicare For All, but Medicaid For All.
You asked for it, you got it, Toyota.
The world needs more doctors, and the world needs more smart people doing medicine. Obviously, the best way to achieve this is obviously to pay doctors less money, impose more annoying rules on them, and perhaps top it off with a bit of social insult.
Personally, I like the response from KimMcNiff, who has “two master’s degrees” and earns 45k/year working, apparently, the same hours as a top surgeon. One wonders what the master’s degrees actually are: apparently, not economics.
That doesn’t mean her two master’s degrees aren’t valid.
You’re assuming he’s a good doctor. This whole post is just a strawman. We have the most expensive healthcare on Earth and it’s not the best unless you’re ultra rich. The middle class can find itself in poverty over an operation even with insurance. That’s the issue. If some cultural fix is required of our doctors so they take their oath seriously so what. We want a better world, you nasty old Boomer. For the third year in a row the life expectancy of men in this country has shrunk. Enjoy your countdown to oblivion with your greed and entitlement.
You have a brilliant future as a government bureaucrat.
“We want a better world, you nasty old Boomer. For the third year in a row the life expectancy of men in this country has shrunk.”
Well which is it, a better world or a better country?
Some years ago, I read doctors in Europe get the equivalent of about 80,000 USD. Maybe that is better now.
Today’s nursing professionals deal with the same stressors noted by Donald, but for much lower compensation.
Eventually, training costs will need to be subsidized if doctors can’t earn enough to justify med school costs, but things are probably headed that way. There will be people who will do it, and they will be however competent they are. Sooner or later, all of us will die, and it will be sooner for many if we have to have a system where everyone is entitled to a standard level of care.
The barriers to entry for nursing might not be quite as rigorous.
The more the job sucks, the less rigorous the barriers to entry can be.
In Germany employed physicians, e. g. in hospitals, make from 50.000 (Assistenzarzt, assistand doctor) up to 280.000 € (Chefarzt, chief physician) when payed by tariff. As practitioner they make between 180.000 € (neurology) up to 850.000 (radiology). Source: Destatis (Deutsches Statistisches Bundesamt). From 50.000 € you can’t make a living, but at least a lot of practitioners can afford their Porsche (one of my brothers in law, a famous bavarian internist, drives a bycicle. But a expensive one!).
Germany has an obligatory all-round carefree healthcare system which costs 380 Billions per year or 4.500 € per capita (Destatis) and works surprisingly well (my experience). I wonder, why a comparable system in the US should cost 5 Trillions per year – extrapolated by population the german system would cost ~1.5 Trillions.
Why, indeed. A few hundred million reasons come immediately to mind.
Name some.
Joe. Phyllis. Pedro. Harry. Susan. Is this still making a big whooshing noise over your head?
And no, this doesn’t mean you’re fascinating and let’s discuss this further.
Ima type really slow so you can follow. Millions, as in people, because we’ve got a lot more of them than Germany, and they’re far more diverse than Germany, so the comparison doesn’t necessarily scale.
Do you need me to do it again in interpretative dance?
If someone else has to pay for it, or give it to you, it’s not a right.
This includes housing, food, medical care, clothes, transportation, employment and sex.
Pretending that access to any of the above is a right is a sign of a disconnect from reality so large that it should disqualify one from voting.
The Real Kurt
“But you, dear passionately moral bureaucrat, will have driven them all into coding, where the real money is.”
I’ve been a coder almost as long as you’ve been a lawyer, and while a relatively small number of folks make the real money, many of us are driving twenty year old vehicles and living in shoebox houses, hoping that maybe THIS job will be the “real money” job. 😉
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It’s bad form in this here Hotel to speak of useless old cars with busted radios unless you bring the doughnuts.