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Bernie Sanders HQ! *A decent human being. (8 Viewers)

The entire system is also rigged for the benefit of insurers, for-profit-hospitals, pharma, and medical device manufacturers. It isn't a heroic assumption that a huge amount of excess economic rents could be clawed back from those industries. That, along with reducing administrative overhead, ought to leave enough pie left for doctors not to be forced to get jobs driving for Uber.

Of course reform will be difficult and complicated. Many things that are worthwhile are.
I think we can agree Pharma is it's own separate issue.  

There are 6100 hospitals in America, 1300 are for profit.  So, about 20%.  There's a lot more hospitals struggling to stay afloat. 

I think insurance companies and hospital administrators are your main problems.  But I don't think eliminating insurance and giving the Federal government the wheel is the answer.

 
I think we can agree Pharma is it's own separate issue.  

There are 6100 hospitals in America, 1300 are for profit.  So, about 20%.  There's a lot more hospitals struggling to stay afloat. 

I think insurance companies and hospital administrators are your main problems.  But I don't think eliminating insurance and giving the Federal government the wheel is the answer.
It works in 32 of the 33 most developed countries in the world. We are the lone hold-out. And almost all of those countries have better average healthcare outcomes than we do.

ETA: Ok, I didn't read your reply carefully enough. Universal insurance exists in 32 of 33, not fully nationalized healthcare. I don't believe we would need to completely move to a nationalized system to reap a huge portion of the benefits we are talking about though.

 
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It works in 32 of the 33 most developed countries in the world. We are the lone hold-out. And almost all of those countries have better average healthcare outcomes than we do.
Yeah.  It's a great line that people repeat over and over.  We're different in a lot of ways.  And I think we'd have to make a lot of concessions that we don't want to in order for it work like the rest of the world.  We also have the lowest or one of the lowest numbers of physicians per capita.  And giving the government control of health care doesn't solve that--i would argue it will worsen it.

 
Yeah.  It's a great line that people repeat over and over.  We're different in a lot of ways.  And I think we'd have to make a lot of concessions that we don't want to in order for it work like the rest of the world.  We also have the lowest or one of the lowest numbers of physicians per capita.  And giving the government control of health care doesn't solve that--i would argue it will worsen it.
Does this bring us around to education funding?

 
Yeah.  It's a great line that people repeat over and over.  We're different in a lot of ways.  And I think we'd have to make a lot of concessions that we don't want to in order for it work like the rest of the world.  We also have the lowest or one of the lowest numbers of physicians per capita.  And giving the government control of health care doesn't solve that--i would argue it will worsen it.
The main way we are different is that we don't have it. And that our current "system" is a Frankenstein's monster that has been optimized to benefit a handful of industries. It is a legacy system problem. Those can be very hard to solve. And obviously the industries that are enjoying the excess economic rents will fight it tooth and nail.

That doesn't mean it isn't worth trying to do so.

 
Does this bring us around to education funding?
No?  Unless someone wants to show me where Medical school seats are going unfilled by the masses.  Most schools have extensive wait lists.  Getting into medical school is very competitive and most people eat the loans with ungodly interest rates to make it happen.  We're just not churning them out fast enough--and we're not incentivizing people to go into primary care.  

There's a website called Student Doctor Netowrk that has it's own message board full of students breaking their necks to get into medical school.  I got 260,000$ of unsubsidized and grad plus loans with no credit and no co-signer.  I absolutely don't believe the funding is the doctor shortage driver.  More medical schools maybe.  But funding, no.

 
No?  Unless someone wants to show me where Medical school seats are going unfilled by the masses.  Most schools have extensive wait lists.  Getting into medical school is very competitive and most people eat the loans with ungodly interest rates to make it happen.  We're just not churning them out fast enough--and we're not incentivizing people to go into primary care.  

There's a website called Student Doctor Netowrk that has it's own message board full of students breaking their necks to get into medical school.  I got 260,000$ of unsubsidized and grad plus loans with no credit and no co-signer.  I absolutely don't believe the funding is the doctor shortage driver.  More medical schools maybe.  But funding, no.
Making it cheaper would reduce the economic harm of potentially lower future doctor pay though.

 
Making it cheaper would reduce the economic harm of potentially lower future doctor pay though.
Eh.  

I'll maintain a lot less people are going to go through 4 years of college, 4 years of medical school, 3+ years of residency for substantially lower money.  

I'm saying you need to incentivize primary care with more money and you're talking about making the less money more palatable. 

 
Eh.  

I'll maintain a lot less people are going to go through 4 years of college, 4 years of medical school, 3+ years of residency for substantially lower money.  

I'm saying you need to incentivize primary care with more money and you're talking about making the less money more palatable. 
Well, again I think you could help bridge physician shortages by incentivizing doctors to immigrate.

 
Well, again I think you could help bridge physician shortages by incentivizing doctors to immigrate.
That's got it's own set of problems.  You have to be board certified in the US.  Our hospital has a Nephrolgoist who was a board Certified Surgeon in Pakistan but was going to have to re-do surgical residency to Practice here.  So...he did a medical residency and became a nephrologist.  We've got a Cardiologist that is Indian and was doing Primary care before he came to America.  Had to re-do stuff, and here we are.  

While we could try to change that--in some cases it may lead to substandard care.  

 
I think we can agree Pharma is it's own separate issue.  

There are 6100 hospitals in America, 1300 are for profit.  So, about 20%.  There's a lot more hospitals struggling to stay afloat. 

I think insurance companies and hospital administrators are your main problems.  But I don't think eliminating insurance and giving the Federal government the wheel is the answer.
My wife is a director at a foremost non-profit Children's hospital in California. In reality its a total for-profit organization.

 
My wife is a director at a foremost non-profit Children's hospital in California. In reality its a total for-profit organization.
Care to elaborate?  

Between med school, residency and my real job I've worked across 3.  Most profits are given back in terms of "write offs" for patients that can't pay.

 
Care to elaborate?  

Between med school, residency and my real job I've worked across 3.  Most profits are given back in terms of "write offs" for patients that can't pay.
I worked on a few audits of hospitals in Mississippi during my time there, I always thought what an awful business.  Those places were all in the red.  Granted that wasn't my primary line of business but from those that I saw and the few I worked on, brutal stuff.

 
 Most profits are given back in terms of "write offs" for patients that can't pay.
They do a lot of this too. They also gouge whatever they can as well. 

But they have a board which makes an obscene amount. And they divert funds into their myriad of offshoot programs and businesses.

 
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That's got it's own set of problems.  You have to be board certified in the US.  Our hospital has a Nephrolgoist who was a board Certified Surgeon in Pakistan but was going to have to re-do surgical residency to Practice here.  So...he did a medical residency and became a nephrologist.  We've got a Cardiologist that is Indian and was doing Primary care before he came to America.  Had to re-do stuff, and here we are.  

While we could try to change that--in some cases it may lead to substandard care.  
Is it possible, just possible, that the AMA fundamentally has an economic motivation to make accreditation for medical schools and certification for immigrant doctors more difficult than it actually needs to be?

 
Is it possible, just possible, that the AMA fundamentally has an economic motivation to make accreditation for medical schools and certification for immigrant doctors more difficult than it actually needs to be?
I'm honestly not even sure of the AMA's role in the situation.  But I'll readily concede that they're the worst medical organization.  I don't belong to it.  I don't feel that they represent my interests or the interests of physicians.  I don't feel that they do a great job of representing patients.  I think they collect a lot of money to do their own politics.  

As to your point about financial...maybe?  I do think there has to be some demonstrated competency before someone that's not trained here practices.  I think failure to require something opens up a ginormous pandora's box.  

 
I'm honestly not even sure of the AMA's role in the situation.  But I'll readily concede that they're the worst medical organization.  I don't belong to it.  I don't feel that they represent my interests or the interests of physicians.  I don't feel that they do a great job of representing patients.  I think they collect a lot of money to do their own politics.  

As to your point about financial...maybe?  I do think there has to be some demonstrated competency before someone that's not trained here practices.  I think failure to require something opens up a ginormous pandora's box.  
Oh, you absolutely have to have something. The question of whether there is an economic incentive for these licensing bodies (which are made up of American doctors, I presume) to make it more difficult than it needs to be is a separate issue.

Obviously we don't want poorly trained doctors hurting patients. I am just a little cynical about the process, given how reticent the medical self-regulating bodies are to sanction or toss out doctors for poor care.

 
Is it possible, just possible, that the AMA fundamentally has an economic motivation to make accreditation for medical schools and certification for immigrant doctors more difficult than it actually needs to be?
Just to clarify, the AMA doesn't accredit medical schools. The Liaison Committee on Medical Education (LCME) is the accrediting body for MD schools (DO schools are accredited by the Commission on Osteopathic College Accreditation). The AMA is a sponsor of the LCME and certainly has some influence on it, but the LCME is really more closely tied to the Association of American Medical Colleges (AAMC). 

Residency programs and fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Board certification standards are set by the American Board of Medical Specialties (ABMS). 

Don't know that any of that changes the underlying discussion, but maybe it does. It is a complicated system and I think the AMA is a smaller part of it than most believe.  

 
Just to clarify, the AMA doesn't accredit medical schools. The Liaison Committee on Medical Education (LCME) is the accrediting body for MD schools (DO schools are accredited by the Commission on Osteopathic College Accreditation). The AMA is a sponsor of the LCME and certainly has some influence on it, but the LCME is really more closely tied to the Association of American Medical Colleges (AAMC). 

Residency programs and fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Board certification standards are set by the American Board of Medical Specialties (ABMS). 

Don't know that any of that changes the underlying discussion, but maybe it does. It is a complicated system and I think the AMA is a smaller part of it than most believe.  
Its pertinent knowledge. and delivered to our fingertips.

thank you.

 
Just to clarify, the AMA doesn't accredit medical schools. The Liaison Committee on Medical Education (LCME) is the accrediting body for MD schools (DO schools are accredited by the Commission on Osteopathic College Accreditation). The AMA is a sponsor of the LCME and certainly has some influence on it, but the LCME is really more closely tied to the Association of American Medical Colleges (AAMC). 

Residency programs and fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Board certification standards are set by the American Board of Medical Specialties (ABMS). 

Don't know that any of that changes the underlying discussion, but maybe it does. It is a complicated system and I think the AMA is a smaller part of it than most believe.  
Thanks for the useful clarifications. I don't know that it changes it either, since I think my concerns could potentially apply to just about any self-regulatory organization. 

 
Bernie is informed that Russia is trying to help his campaign: 

https://www.washingtonpost.com/national-security/bernie-sanders-briefed-by-us-officials-that-russia-is-trying-to-help-his-presidential-campaign/2020/02/21/5ad396a6-54bd-11ea-929a-64efa7482a77_story.html

Hmm. Trying to help Bernie, trying to help Trump. What lessons should we draw from this? 
Obvious answer: That Russia believes Trump can beat Sanders in the general election, quite possibly because they feel most confident that a disinformation campaign against Sanders will be especially effective. 

 
Bernie is informed that Russia is trying to help his campaign: 

https://www.washingtonpost.com/national-security/bernie-sanders-briefed-by-us-officials-that-russia-is-trying-to-help-his-presidential-campaign/2020/02/21/5ad396a6-54bd-11ea-929a-64efa7482a77_story.html

Hmm. Trying to help Bernie, trying to help Trump. What lessons should we draw from this? 
It's going to be a glorious day when your two least favorite candidates are the two nominees. I will be laughing all the way to the voting booth.

 
Obvious answer: That Russia believes Trump can beat Sanders in the general election, quite possibly because they feel most confident that a disinformation campaign against Sanders will be especially effective. 
That’s part of it. The other part is that Bernie is an extremist, an isolationist who might not be willing to support Ukraine or our commitment to NATO. 

 
That’s part of it. The other part is that Bernie is an extremist, an isolationist who might not be willing to support Ukraine or our commitment to NATO. 
I don't think expressing a desire to be non-interventionist is that extreme, frankly. And having a foreign policy that limits adventurism is not the same as being an isolationist.

 
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I don't think expressing a desire to be non-interventionist is that extreme, frankly. And having a foreign policy that limits adventurism is not the same as being an isolationist.
Understood and I won’t argue the point. 

But- MY point is that I don’t think Putin would mind a Sanders Presidency. 

 
You're a fantastic human being my dude. The world needs more of you.
Nah, we're all just trying to make it imo.

I love what I do; I help unit directors and charge nurses see insights into their units that they'd never be able to see any other way. Our goal is to grow leaders out of our nurses because turnover is ridiculous.

Our president speaks with us every two months in a staff meeting. He stands there before us, an auditorium of some 200 corporate Nashville employees, bringing up Medicare For All since at least December of 2018. It just kinda makes me laugh, it seems so transparent the motive behind saying things like, "It will leave more people uninsured than any other plan." I don't even know how to begin to twist myself to that viewpoint.

The wild thing is that I get to actually interact with our nurses. Their view on healthcare in America vs what our company president talks about is so different. They are compassionate people that want the best for everyone, they're not political in the slightest.

I don't know, I'm kinda drunk and rambling. Makes you think. ;)

 
Bernie is informed that Russia is trying to help his campaign: 

https://www.washingtonpost.com/national-security/bernie-sanders-briefed-by-us-officials-that-russia-is-trying-to-help-his-presidential-campaign/2020/02/21/5ad396a6-54bd-11ea-929a-64efa7482a77_story.html

Hmm. Trying to help Bernie, trying to help Trump. What lessons should we draw from this? 
Unsurprisingly Berns response to this news is 100 times better than Donald. Low bar and all but nice to see.

 
I've got news for the Republican establishment. I've got news for the Democratic establishment. They can't stop us.

Bernie Sanders (@BernieSanders) · Twitter
Bernie calling out his own team.  

 
I didn’t think so either. 

Billions being paid out, like double the amount for the auto bailouts which were loans, for a problem created by Trump which has no end.

How do Dems not even bring this up. Instead they spend all their time #####ing about each other. 
No idea.  I don't know how the GOP isn't bringing up such egregious acts of "socialism" (as they define it) either...weird isn't it?

 
timschochet said:
That’s part of it. The other part is that Bernie is an extremist, an isolationist who might not be willing to support Ukraine or our commitment to NATO. 
I'm pretty confident this would be the "cherry" on top from Russia's perspective.  It's pretty clear, their primary goal is to sow discord in the American people.  If they achieve that, they win in a huge way.  Anything that comes out of that is an afterthought in terms of their objectives.  You and I know both know this, but please, help them by doing exactly what they want you to do Tim.

 
jm192 said:
Care to elaborate?  

Between med school, residency and my real job I've worked across 3.  Most profits are given back in terms of "write offs" for patients that can't pay.
How much would you say the hospital loses annually on inability to pay?

 
I tend to agree. Until someone publishes a direct way Russia is interfering, the claims of on-line trolls and fake memes don't move the needle.  
The next time someone goes hard on the "OMG BERNIE BROS ARE SO MEAN!" angle Bernie's campaign should just say they're Russia sowing discord and spin them all into a BS logic pretzel

 
Would not be surprised if a significant amount of the public tune out anything regarding Russia.
The timing of the media on this Russia bs is easy to see through.  

The corporate elites dont want Bernie to win.   Each week, it'll be something new to replace the failed attempt from the week before, like Bloomberg being pathetic in the debate.  

It's getting to be almost as scripted as watching the Bachelor.  

 

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