just got back in today from a checkup by a specialist. he recommends a couple of tests later in the month, but otherwise no issues. just dotting the i's and crossing the t's sort of thingy.

the insurance will pay (hopefully), and if not, then medicare, and in the worst case i'll get billed. but the medical people will have covered their bases. no sense in letting something slip by that a specialized test might discover/detect.

i like modern day medicine. it's good because it helps keep us alive, fight off infections, treat disease, excise tumors, etc. etc.

on the other hand, sometimes i wonder: the longer the medical people can keep us alive by administering "life-giving" help, the more the insurance carriers will have to pay out, read: income for the medical providers, and the more medicare will run the numbers. running the numbers for cost-effectiveness, what a concept. is the idea to minimize medicare cost, extend patient life, maximize or minimize doctor revenue? hmm, i don't know. what about dr. paul? what is his opinion?

how much should be invested by gov't as a pymnt to the medical/big pharma industry to keep a citizen alive one more day? i'd like to know the answer to that one.

Socialist and libs see everyone as part of the collective, decisions concerning value of life, what is appropriate expenditure to keep someone alive is made by the collective. That’s where we’re headed, seems to me.

Conservatives see the individual as central to that decision making process.

Big Pharma has made real advances in healthcare, but there is a cost, a price to pay. As it stands we Americans pick up the tab, the rest of the world gets cutting edge medicine for pennies on the dollar.

Lots of issues; healthcare delivery is definitely in a state of flux, lots of forces pulling in different directions. How it shakes out, I don’t know.

DF

IIt used to be about doctors and patients. Now it is about medical group business offices and insurance company business offices.

Both docs and patients are being played.

Well, GUS, that's the $64 zillion question. I've read figure such as 80% of all health care money goes to treat the last 12 months of life and some 2/3 to treat for the last 90 days.
Naturally, it's a bit more involved than simple math, but it brings to the the big question that faces any single payer system:

Where do we draw the line?

At that point, it is no longer about humanitarian compassion and effort, it is about dollars and cents. You Gus, would be just another number, a commodity that gobbles up resources that are finite and in demand.

Time to pull the plug on you.

No. Docs and patients paying the high premium insurance plans are being screwed. You think you can do testing, expensive lens calculation, cataract sx and iol implantation and care for the patient with expensive medical techs and billing and insurance premiums and building and electricity and expensive billing computer programs and expensive EHR programs etc and come out ahead for a medicare/ins payment of $300. YGBSM.

The patients paying the insurance are paying for the care of several other people also and getting screwed.

How do you come out ahead for treating a medicare patient for $60 when it costs you $80 for the patient to be seen? Thats why docs dont want to see medicare patients.

If the libs get complete control of the heath care system you better heed the expiration date stamped on the bottom of your left foot.

Bend over, look at your ass in a mirror, and see how many years it says you have left.

Don't worry about it too much Gus - if you start feeling lousy and get some mortal news - relax and be proud that you are getting ready to take one for the team.

don't waste too much sleep over my demise. i might be one of those "mystical" types that believe that in one quick breath one can be w/Jesus, or someone similar. that is, without the body, in heaven or some such. just sayin.

meanwhile, if the doctors, the medical profession, modern technology, and Big Pharma can keep one alive for one more day, how much additional will the average nursing home profit? now, we're getting down into the weeds, where the reality exists.

Healthcare is a business not a service!

Unless youre a dr providing a service for free the govt says they are paying for you.

Don't know the cumulative .gov answer to that one, but I can tell you the VA definitively drew the line at sucking the liquid out of my Dad's lungs one more time.

Yeah, that must be why I see all the doc's living in old single wides, driving beat up,rusted out old jalopy's and digging through dumpsters for returnable bottles. GMAFB.

Blackheart,

your's don't?

I sometimes wonder when I go to the Doctors' office in the rural areas I choose to live I get seen mostly by PA's and NPs? Is it because of the high cost of medical school that doctors nowadays choose to live in more gentrified areas where they can make more money so they don't have to live in single wides and drive beat up old jalopies?

I'm guessing the business office of the medical group still gets the same amount for the service as coded that they would have if I had been seen by a MD. So collect the same but you get to pay the PA less ?

And why can a p**s ant place like Karachi Pakistan have a hospital with Free imaging that costs over $4K here?

Geno

With all the other bums who did a minimum of 11 years post-secondary (out of pocket), so they could work 60 hours a week for the next 35 years.

along with the average age for a doctor is about 58 y/o when they pass on...

Local middle age nurse practitioner, good, caring, conscientious woman, gave up her small private practice to be the primary caregiver at a hospital satellite clinic, one of several located around in small towns, all belonging to a hospital in a nearby city.

With the job change the cost of her office visits doubled, lab tests more than doubled in price, and instead of writing prescriptions for lesser costs generic equivalent drugs when ever possible as she previously had in her private practice, she started prescribing more and more expensive brand name drugs.

Apparently two years of running things the way the hospital dictated was all she could stomach as she recently resigned and opened up her private practice again.

A young new NP of about a year or two took her place at the satellite clinic.

... and the beat goes on, and the beat goes on, and on - and on - and on....

My brother does taxes for one of our local small town doctors. He makes nearly 750,000 per year, owns the little brick building he operates out of across the street from his house and his wife is his nurse and receptionist. I feel so sorry for him having to scrape by on such a paltry sum. Oh yeah, the median yearly income for an individual {male} around here was less than 30,000 per year according to the latest statistics. Median household income 43,000.

In the private sector, without service, not a business for long.

In the govt model, less of an issue. The bureaucracy perpetuates itself regardless.

DF

I usually see a NP when I go to a regular {primary care} appt. here too. My primary care Dr. is often on vacation. The virgin Islands and Grand Canyon this past year alone that I know of because she told me. I dated an RN that worked at a local, small town hospital between wife #1 and wife #2. That was 10 years ago now and she was making 50K a year back then. In contrast my brother has been a high school history teacher here for 20 years and makes 55K presently. The folks working in the medical field are doing OK financially.