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Oh, I wish for the best of both systems. I confess that I don't know

everything I should about the Canadian way. It seems to me that you

guys do a better job of spreading the care around to everyone. It

seems to me that we do a better job of getting the care to those who

have jobs that cover their troubles, and in the way that we choose.

But we also provide it, too often, in the least efficient and most

costly manner -- folks who get their usual medical care in emergency

rooms, for example, because they cannot pay for regular visits to

primary health care providers.

What I want is a system that manages to give the most excellent care

to the greatest number of folks, notwithstanding what their employers

provide. With the greatest convenience and efficiency to all, of

course.

I am totally split about the rest of how things work. I know that

doctors work sooo hard here... But I think they also limit their

numbers, so that they can be part of that elite who make major bucks.

I would not want to have a doc in my family; I've seen how hard they

do go at it. And I cherish every one who takes care of me and my

small family.

But I wish they'd ease up a bit, be more rested and at ease when

they're working, and have salaries more in line with the rest of us.

On the other hand, I also want access to excellent care, and

instantly, when there's an emergency.

I would be(and will be, and have been) most happy, though, to

welcome the care from anyone recruited by any of my many docs

to " cover " in an emergency and spare my professionals the time to

rest, regain their equipoise and enjoy life with their families --

which I think many U.S. docs sacrifice to maintain their availability

to their patients. I believe that I get better care when my docs also

care for their emotional and physical functioning.

I grieve for the poorest among us here in the U.S., old and young,

who have no voice in establishing these choices. There are truly

cruel stipulations, which I detest.

I am also one who questions spending megabucks to save a person --

infant or oldster -- whose quality of life will predictably be low,

just for the sake of prolonging things. I know of one instance in

which an infant, born prematurely, spent at least 2.5 years in

intensive neuro-natal care unit, with no hope of an able life. I

shudder to think what that money could have done to provide prenatal

care for thousands of other children.

My own mom went through open heart surgery which she wanted, and I

would not have denied her, but which provided miserable quality of

life for about a year after the operation. She had good and bad

times, and I still question which outweighed the other. It was her

choice, and I went with her there, not knowing, still, whether to

have regrets.

End of sermon.

Cammie

> One minute you're complaining about braces next minute you're

rubbing

> it in to the Americans on this site about our health care system ...

>

> Dude, i think those braces are on too tight. ;-)

>

> By the way, I'm an Albertan - we pay all those transfer dollars to

> your province so you too can have nice health care... I have no

> problem it, but there is no reason to gloat and make our fellow

> Americans envious...

>

>

>

>

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I agree with some of the things that you say, Cammie. I think the

optimal system would involve some elements of the public health care

system where anyone who needs care will have access to it. But I

also like the fact that I can pay out of pocket and choose the doc I

want and get care in a fast and efficient manner. I have seen a

number of reports about Canadians with cancer who are unable to get

care or some diagnostic tests in a timely manner. Also, having grown

up in a country with much-loaded universal healthcare, I saw all the

drawbacks of it first hand. The only way to get quality care for you

was to pay the doc under the table.

I do disagree with you about doctors' salaries. As you said

yourself, you see how hard they work. Plus, don't forget about that

$200,000 debt for medical/dental school they have when they're done

with schooling. Who on earth would want to become a doctor if

they're compensated just as the rest of us? They work their asses

off, they have tons of responsibility on their hands, their schooling

takes enourmous amounts of time compared to other professions. Why

be a doctor if you can't at least have a nice lifestyle in exchange

for having no life outside of work? This topic is dear to my heart

since my husband is a medical resident. There is not a day goes by

that we don't wonder if he should stay in medicine. Most people who

go into medicine are very smart, and could easily do something else

if they chose to. Same with my husband - he was a computer

programmer before med school. If doctor's salaries went down to be

comparable with that of a programmer, guess what? He'd be a

programmer. It's just easier, especially when you have a wife and a

kid. Don't get me wrong, doctors love patient care. But they also

make a lot of sacrifices, and they need to be compansated for it.

And when they're not adequately compansated, you either don't have

enough docs, or those that you do have are low quality (experienced

first hand in the universal healthcare system).

I also agree with you about questioning the need of heroic efforts to

save some very sick premature babies or elderly. However, it is not

always up to us. I have a couple of elderly sick relatives who have

undergone expensive treatments. But in their cases, they requested

it.

Ok, time to go to work...:)

Take care everyone.

> > One minute you're complaining about braces next minute you're

> rubbing

> > it in to the Americans on this site about our health care

system ...

> >

> > Dude, i think those braces are on too tight. ;-)

> >

> > By the way, I'm an Albertan - we pay all those transfer dollars

to

> > your province so you too can have nice health care... I have no

> > problem it, but there is no reason to gloat and make our fellow

> > Americans envious...

> >

> >

> >

> >

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Rakushka, you got to the post before me, and I think you put it more eloquently

than I could. Good luck to your family, and your husband. I think doctors

deserve much respect.

Thanks!

~Cathy

Re: Let's go to Utopia...

I agree with some of the things that you say, Cammie. I think the

optimal system would involve some elements of the public health care

system where anyone who needs care will have access to it. But I

also like the fact that I can pay out of pocket and choose the doc I

want and get care in a fast and efficient manner. I have seen a

number of reports about Canadians with cancer who are unable to get

care or some diagnostic tests in a timely manner. Also, having grown

up in a country with much-loaded universal healthcare, I saw all the

drawbacks of it first hand. The only way to get quality care for you

was to pay the doc under the table.

I do disagree with you about doctors' salaries. As you said

yourself, you see how hard they work. Plus, don't forget about that

$200,000 debt for medical/dental school they have when they're done

with schooling. Who on earth would want to become a doctor if

they're compensated just as the rest of us? They work their asses

off, they have tons of responsibility on their hands, their schooling

takes enourmous amounts of time compared to other professions. Why

be a doctor if you can't at least have a nice lifestyle in exchange

for having no life outside of work? This topic is dear to my heart

since my husband is a medical resident. There is not a day goes by

that we don't wonder if he should stay in medicine. Most people who

go into medicine are very smart, and could easily do something else

if they chose to. Same with my husband - he was a computer

programmer before med school. If doctor's salaries went down to be

comparable with that of a programmer, guess what? He'd be a

programmer. It's just easier, especially when you have a wife and a

kid. Don't get me wrong, doctors love patient care. But they also

make a lot of sacrifices, and they need to be compansated for it.

And when they're not adequately compansated, you either don't have

enough docs, or those that you do have are low quality (experienced

first hand in the universal healthcare system).

I also agree with you about questioning the need of heroic efforts to

save some very sick premature babies or elderly. However, it is not

always up to us. I have a couple of elderly sick relatives who have

undergone expensive treatments. But in their cases, they requested

it.

Ok, time to go to work...:)

Take care everyone.

> > One minute you're complaining about braces next minute you're

> rubbing

> > it in to the Americans on this site about our health care

system ...

> >

> > Dude, i think those braces are on too tight. ;-)

> >

> > By the way, I'm an Albertan - we pay all those transfer dollars

to

> > your province so you too can have nice health care... I have no

> > problem it, but there is no reason to gloat and make our fellow

> > Americans envious...

> >

> >

> >

> >

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Guest guest

I doubt that either of us is going to solve this one...

But you say:

" I do disagree with you about doctors' salaries. As you said

yourself, you see how hard they work. Plus, don't forget about that

$200,000 debt for medical/dental school they have when they're done

with schooling. Who on earth would want to become a doctor if

they're compensated just as the rest of us? They work their asses

off, they have tons of responsibility on their hands, their schooling

takes enourmous amounts of time compared to other professions.'

Nobody can change the responsibilities, of course, and I agree they

are enormous. But so are those of a nurse, or a day care provider,

for that matter... And training? Ask a college prof how many years of

expensive training went into grad school in any subject...

As for how hard they work: Yes, they do. And they bring training and

skill to their work. But honestly, don't you think it would be better

for everybody if they would share the load (and the money) with more

folks with training? I don't know about you, but I'd just as soon not

be treated by, say, an intern who's been working 90 hours (or more) a

week for the past six months. Nor by a cardiac surgeon who's been on

his feet for the past 36 hours, for that matter. Train more docs --

Am I mistaken in thinking that there are plenty of bright folks out

there who would like to go to med school, and could go, if they could

afford it and there were the slots for them?

I will gladly see one of my primary physician's partners, any time,

so that they can distribute the load in a way such as to give all of

them decent time with their families and friends, or for reading a

novel, or whatever. I think it's important to everyone to have time

for refreshment of the soul and the skills.

I do know that malpractice insurance is outrageous. I think that

should be remedied, but I don't know how.

I also know that the doctors who treat me do up to a fourth (and

perhaps more) of their practice as write-off business, caring for

folks who can't pay.

I guess I'm too idealistic. I do know that my docs enjoy the

lifestyle and the security. But I like to think that they're in

medical practice not just because it's lucrative, and that if they

had as much personal satisfaction being computer programmers, that's

what they'd be doing. No slams meant against your husband. I'm sure

he is admirable, self-sacrificing and generous.

But I live in a state where, for instance, it is not uncommon for

charitable dental clinics (when poor kids have access to them) to put

steel crowns all across a child's baby teeth to preserve them.

Because they can't afford regular dental treatment. Braces are no

fun, but can you imagine what that does to a 5-year-old kid, to have

a real metal mouth like that?

Also where many poor and uninsured folks get their primary medical

care in emergency rooms -- which I think I've read is the very most

expensive and least efficient way to do it.

I do believe we need some changes. Apparently neither I, who have

studied all this litte, nor Mrs. Clinton, who brought her best brains

and the resources of many experts, have come up with the answer.

Sadly, neither has anybody else that I know of.

And yessm. I particularly appreciate that when something deadly

threatening comes up, our docs can move heaven and earth to get it

tended to. I have been the beneficiary of that, and am more grateful

than I can tell you!

Best,

Cammie

> I agree with some of the things that you say, Cammie. I think the

> optimal system would involve some elements of the public health

care

> system where anyone who needs care will have access to it. But I

> also like the fact that I can pay out of pocket and choose the doc

I

> want and get care in a fast and efficient manner. I have seen a

> number of reports about Canadians with cancer who are unable to get

> care or some diagnostic tests in a timely manner. Also, having

grown

> up in a country with much-loaded universal healthcare, I saw all

the

> drawbacks of it first hand. The only way to get quality care for

you

> was to pay the doc under the table.

>

> I do disagree with you about doctors' salaries. As you said

> yourself, you see how hard they work. Plus, don't forget about

that

> $200,000 debt for medical/dental school they have when they're done

> with schooling. Who on earth would want to become a doctor if

> they're compensated just as the rest of us? They work their asses

> off, they have tons of responsibility on their hands, their

schooling

> takes enourmous amounts of time compared to other professions. Why

> be a doctor if you can't at least have a nice lifestyle in exchange

> for having no life outside of work? This topic is dear to my

heart

> since my husband is a medical resident. There is not a day goes by

> that we don't wonder if he should stay in medicine. Most people

who

> go into medicine are very smart, and could easily do something else

> if they chose to. Same with my husband - he was a computer

> programmer before med school. If doctor's salaries went down to be

> comparable with that of a programmer, guess what? He'd be a

> programmer. It's just easier, especially when you have a wife and

a

> kid. Don't get me wrong, doctors love patient care. But they also

> make a lot of sacrifices, and they need to be compansated for it.

> And when they're not adequately compansated, you either don't have

> enough docs, or those that you do have are low quality (experienced

> first hand in the universal healthcare system).

>

> I also agree with you about questioning the need of heroic efforts

to

> save some very sick premature babies or elderly. However, it is

not

> always up to us. I have a couple of elderly sick relatives who

have

> undergone expensive treatments. But in their cases, they requested

> it.

>

> Ok, time to go to work...:)

> Take care everyone.

>

>

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Nobody respects doctors more than I do, Cathy. (At least the good

ones, which most of them are. There are a few bad apples I've

encountered, and I'll spare you what I'd do with them. But such is

the case always, everywhere.)

I am deeply in the debt of about a dozen of them, and if any one

of 'em called me right now and said, " I need a can of Pepsi at the

local hospital (or anywhere else) at 2 a.m. Will you do it? " I would

answer, " Yes -- do you want diet or regular? " and move heaven and

earth to have it there on time...

Cammie

> > > One minute you're complaining about braces next minute you're

> > rubbing

> > > it in to the Americans on this site about our health care

> system ...

> > >

> > > Dude, i think those braces are on too tight. ;-)

> > >

> > > By the way, I'm an Albertan - we pay all those transfer

dollars

> to

> > > your province so you too can have nice health care... I have

no

> > > problem it, but there is no reason to gloat and make our

fellow

> > > Americans envious...

> > >

> > >

> > >

> > >

>

>

>

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Guest guest

I don't know that we really have a doc shortage. A great number of

people are being trained abroad, and docs are encouraged to come to

the U.S. from other countries (as long as the can pass the qualifying

exams). The other thing that most docs are located in suburban

areas, and not many want to go work in rural areas, where they are

really needed.

Many of the problems that you describe are related to our health care

system, not the docs. And as far as responsibility is concerned: a

nurse or anyone else does not have as much responsibility as a doc.

Have you ever seen a nurse sued in a malpractice case? The doc is

the captain of the ship, so to speak. I would expect my OS to take

full responsibility for my care. He is the one who's responsible for

my final outcome, not a nurse at the hospital (even if she screws up

and pumps me up with the wrong medication). And btw, a college

professor has less years of training (4 years BS and about 5 years Ph

D, compare that to 4 years bach + 4 years med school + at least 3

years residency). Also, college professors don't pay for their

graduate education - it is usually paid for by research grants.

Of course, docs are in it for personal satisfation. That's why my

husband went to med school. However, personal satisfaction does not

cut it when you consider the whole picture: a kid to support,

mortgage and outrageous bills to pay. You can pay the docs less when

you take away the costs of med school and some of the

responsibility. In the current environment, it is impossible, and

is forcing more and more docs out of business.

> I doubt that either of us is going to solve this one...

>

> But you say:

>

> " I do disagree with you about doctors' salaries. As you said

> yourself, you see how hard they work. Plus, don't forget about that

> $200,000 debt for medical/dental school they have when they're done

> with schooling. Who on earth would want to become a doctor if

> they're compensated just as the rest of us? They work their asses

> off, they have tons of responsibility on their hands, their

schooling

> takes enourmous amounts of time compared to other professions.'

>

> Nobody can change the responsibilities, of course, and I agree they

> are enormous. But so are those of a nurse, or a day care provider,

> for that matter... And training? Ask a college prof how many years

of

> expensive training went into grad school in any subject...

>

> As for how hard they work: Yes, they do. And they bring training

and

> skill to their work. But honestly, don't you think it would be

better

> for everybody if they would share the load (and the money) with

more

> folks with training? I don't know about you, but I'd just as soon

not

> be treated by, say, an intern who's been working 90 hours (or more)

a

> week for the past six months. Nor by a cardiac surgeon who's been

on

> his feet for the past 36 hours, for that matter. Train more docs --

> Am I mistaken in thinking that there are plenty of bright folks out

> there who would like to go to med school, and could go, if they

could

> afford it and there were the slots for them?

>

> I will gladly see one of my primary physician's partners, any time,

> so that they can distribute the load in a way such as to give all

of

> them decent time with their families and friends, or for reading a

> novel, or whatever. I think it's important to everyone to have time

> for refreshment of the soul and the skills.

>

> I do know that malpractice insurance is outrageous. I think that

> should be remedied, but I don't know how.

>

> I also know that the doctors who treat me do up to a fourth (and

> perhaps more) of their practice as write-off business, caring for

> folks who can't pay.

>

> I guess I'm too idealistic. I do know that my docs enjoy the

> lifestyle and the security. But I like to think that they're in

> medical practice not just because it's lucrative, and that if they

> had as much personal satisfaction being computer programmers,

that's

> what they'd be doing. No slams meant against your husband. I'm sure

> he is admirable, self-sacrificing and generous.

>

> But I live in a state where, for instance, it is not uncommon for

> charitable dental clinics (when poor kids have access to them) to

put

> steel crowns all across a child's baby teeth to preserve them.

> Because they can't afford regular dental treatment. Braces are no

> fun, but can you imagine what that does to a 5-year-old kid, to

have

> a real metal mouth like that?

>

> Also where many poor and uninsured folks get their primary medical

> care in emergency rooms -- which I think I've read is the very most

> expensive and least efficient way to do it.

>

> I do believe we need some changes. Apparently neither I, who have

> studied all this litte, nor Mrs. Clinton, who brought her best

brains

> and the resources of many experts, have come up with the answer.

> Sadly, neither has anybody else that I know of.

>

> And yessm. I particularly appreciate that when something deadly

> threatening comes up, our docs can move heaven and earth to get it

> tended to. I have been the beneficiary of that, and am more

grateful

> than I can tell you!

>

> Best,

>

> Cammie

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