In Part III.a, I outlined the healthcare provider variable that is currently impacting the delivery of healthcare services. There is a shortage of the front line provider and the shortage is only going to grow worse in the decades to come. This shortage also has an impact on the cost of delivering healthcare services as well as the availability such services to all citizens.
The shortage of qualified physicians, especially general practice physicians, and other healthcare providers is a crisis that will only get worse over the next two to three decades. The education and training is both time consuming and expensive. Based on the need to counteract this crisis, it is only appropriate that the federal government should become involved. It should take on a role that is both supportive to the current system and active toward the improvement of service delivery to the un-served and to the underserved within the population. This can only be achieved by placing control of the program/s under direct control of the U.S. Public Health Service.
The first step is to use public funds to open 50 new government owned and operated medical schools and teaching hospitals. These schools and hospitals would be established in underserved areas of the nation. Although owned and operated by the federal government, these institutions would be staffed by a combination of public health professionals and private teaching professionals. The ultimate goal is to graduate 100 new doctors per year from each institution for a net gain of 5,000 new physicians each year. The primary focus would be on those fields of study with the greatest need such as general practitioners and family medicine. Not only would the public medical schools train new physicians, but also other healthcare professionals; including physician assistants, dentists, and nurses. Included would also be graduate school candidates for PhDs in medical research.
The cost of the education and training of public health medical schools and teaching hospitals would be free of charge to the students with an agreement of a period of service in the public healthcare system or military. Recommended would be that physicians would serve for eight years, physician assistants, PhDs and dentists serve for six years, and nurses for four years.
The second step is to establish public hospitals and clinics in the most underserved areas of the nation. These clinics and hospitals would be staffed by graduates and others from the public healthcare medical schools, serving out their terms of service. Service fees for the hospitals and clinics would be based on the patient’s ability to pay for such services. There would be a sliding fee assessed based on the ability to pay. The public hospitals and clinics would also accept insurance third party payment for such services. Included in the hospitals and clinics would also have government funded pharmacies.
The funding of the program could be easily achieved along with additional funding to Medicare, Medicaid and CHIPS by assessing a National Sales Tax of 5% on all retail sales and services, excluding food and prescription drugs. This would generate an estimated $211 billion per annum. This would be more than enough to satisfy present and future requirements until the nation can transition to a NHS.
By increasing the supply of healthcare delivery personal, the impact could force a reduction on the cost of the healthcare delivery with the government funded hospitals and clinics providing a downward pressure on service delivery costs.
As far as the salary structure; while in training they would receive a stipend and upon graduation physicians would be paid around 130K per year while in service. This is adequate since they won't have to be paying off student loans and the costs for their practice will be covered. Other healthcare professionals would also be compensated adequately for their professions. The placement of hospitals and clinics in under served areas would provide a much greater social benefit than the current system that is driven by market forces. I would eventually like to see Medicare, Medicaid and CHIPS folded into the system so that these entitlement recipients would go to the government facilities to get healthcare services and drive the costs down for providing such services. (continued)
Liberals always have great ideas to help the poor, disadvantaged, etc. They want SOMEONE else to move there, help them, serve them. Yet, they never do. Why is that? Maybe Bren, Lyle, and Keith (after he pays the loan back of course!) could move to a disadvantaged area and start helping.
Then you have all those countries the left likes to hold up as an example that have loooooooooong waiting lines for basic care. And finally Canada sets the price that they pay for drugs. Their price structure covers the cost of making the drug, but forces the cost of research and development (which is the largest cost in a drug) onto the rest of us. If Lyle wants to built teaching clinics and hospitals in the inner city, that's fine, but if it becomes government owned it will be a disaster. If he want's the government to sponsor it, like a public university, that's fine, as long as we pull the money out of some other program. We have enough government disasters out there, it wouldn't be too hard to find. But STOP THE INSANE SPENDING!!! No country ever taxed itself into prosperity!
Correct, he has not said they would receive less training. However, if you artificially inflate a system that is always the end result. The government has no track record of increasing the quality of a system. Not to mention, those that currently cannot become doctors probably should not become doctors. If the issue is the cost of education or the availability of institutions, then it requires people of strong drive and high intelligence in order to take on the debt of education and get accepted into the medical institution. Eliminating these pre-qualifications of drive and intelligence by creating a system that opens the doors to people with less drive and intelligence you are by default lowering the standards it requires to become a medical professional. Even if you keep the same high standards of education, you have only created more of the existing problem we face in higher education. That is people attending who don't belong, doing so on the governments dollar and the eventual lowering of standards to reduce the drop out rate. Instead of flooding the system with doctors and lowering the standard of care; why not change the way patients use the system and there by lowering the demand for needless medical visits and procedures.
To cover the salary, you are talking about $650million for the first years graduates. If we pretend you don't have to pay existing medical professionals, it doubles every year assuming the same graduation rate. By year 5 we are $33 billion if you only include those that have graduated your system. Where does this money come from? When do you stop pumping out medical professionals and if the number of doctors out numbers the patient load, are they still paid a salary? I think like every progressive government plan, the first year or two looks workable; however, it always burdens later generations with cost over runs and unsustainable systems.
The key to all true liberal ideas, "the system would not be free for those who can pay". In other words the government gets to pick the winners and losers in the medical game. Since the government will determine what "pay" means. You aren't fixing anything. The takers will continue to burden the system and the producers will become a smaller and smaller group contributing less and less. The result will be the few paying for the many and system that will be crushed under it own weight.
"The funding of the program could be easily achieved along with additional funding to Medicare, Medicaid and CHIPS by assessing a National Sales Tax of 5% on all retail sales and services, excluding food and prescription drugs. This would generate an estimated $211 billion per annum. This would be more than enough to satisfy present and future requirements until the nation can transition to a NHS. ******************** "more than enough". If it's more than enough, then how about we scale it back to JUST enough? Or how about maybe a little less than enough to discourage the kind of things that ordinarily happen when government entities are given x amount of money - they spend it all? Once again, this all hinges on the theory that the government knows best how to spend the taxpayers' money, so more of it going into the government's hands, even if it's "more than enough" than is actually needed, is more of a good thing in the long run.
Also, your claims that the U.S. is responsible for most of the new equipment is only partially true. That, however, is not due to our industry, but from our university and college institutions. We are facing more and more competition from companies outside the nation. New procedures come from all over the globe and the US doesn't have a lock on it. I don't know where you get this idea that people under NHS are waiting in long lines to receive routine care. That has never been my experience. The only thing that people often wait on are elective, non life threatening, procedures. The pharmaceutical industry has been ripping us off for years. I would suggest that the basic research should be done under government funding at colleges and universities and pharmaceutical companies become only what they are, manufacturers. The government would open up new drugs to all manufacturers and let the free market decide winners and losers.
Again it is patients taking ownership of the system that will save the health care system. Not dumping huge amounts of cash into it because that doesn't fix the problem.
And then there is the timeliness of treatment. Rather than squeezing the patient into a schedule, we provide services right away. http://www2.dailyprogress.com/news/cdp-news-editorial/2010/feb/14/us_has_best_health_care_in_world1-ar-80904/
It would also be helpful if you'd provide links to some of this source info you're using, if you have it.
Many of my sources can be found in my article Part-III.a. www.aamc.org and www.globalhealthfacts.org are good places to start. Also the Census Bureau has a great deal of information as well as www.ncbi.nlm.nih.gov.
http://www.fraserinstitute.org/publicationdisplay.aspx?id=2147484001 http://www.thedailybeast.com/articles/2012/06/20/canadian-healthcare.html http://www.usnews.com/opinion/blogs/peter-roff/2009/07/28/statistics-show-canada-healthcare-is-inferior-to-american-system http://www.city-journal.org/html/17_3_canadian_healthcare.html
Your argument is fundamentally flawed. You are stating a problem: That we do not train enough physicians and other credentialed caregivers. Your solution is to create a new very large tax and have the government run a program in which these caregivers are forced to work for less than market value in poor neighborhoods in exchange for free education. The argument is flawed because your solution is not trying to most efficiently solve a shortage, but rather address primary care in poor neighborhoods for folks that use the emergency room as primary care. Medical academia has produced and continues to produce caregivers. If we need more caregivers a better answer is to let the market stimulate the need and they will respond. You have a rather weak response to this and offer no supporting data...that they cannot or will not respond? A further flaw in your solution is the assumption people would be interested in working for less and in an environment that might not be safe. Engagement is important for workers, forced labor does not engage people. The best thing we can do to help people in this country is to get them working again, high taxes and government reliance stifles that. We lead the world in innovation, we need to let the folks that convert innovation to something operational (e.g. Steve Jobs) blossom. They improve our lives, create jobs, and give opportunities to others.
In 1996 there was a concern that we were producing too many physicians. Now we are running a deficit. The established medical community are the ones stating that nearly 7 to 10 thousand more physicians are needed per year. With only 137 medical schools available, it is impossible to educate and train that many more physicians. Therefore, the government is the only entity that can gear up and meet the demand. It is a national issue and requires a national approach that market forces cannot address. If the market could solve the problem then would have already. I think many healthcare service providers are concerned about the additional supply of physicians and others placing a downward pressure on compensation made by many of the providers. As far as placing healthcare providers in under served areas at below market compensation beings to question; are physicians and other healthcare providers entering the profession for the money or to practice medicine.
“The most important thing to do if you find yourself in a hole is to stop digging.” ― Warren Buffett
Try this reversal: "Conservative officeholders who refuse to raise taxes as a matter of conservative principles are creating deficits." or, Take the myth of the family budget - clearly it is a"manipulation of the idea of deficits"-"The national budget does not function like a family budget at all." clearly,"Wealth disparity is power disparity. Extreme wealth results in political power that ordinary citizens do not have." And, "extreme conservatives seek to control women's sexuality and reproductive health by enacting what they characterize as 'small' policy proposals and measures..." the extreme conservatists inflict damage daily. It poisons the human spirit. It destroys democracy.