Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Insurance executives make too much money. Not doctors.

Even if that’s morally true it’s not an explanation for systemic costs. One CEO making too much is a drop in the bucket relative to hundreds of thousands of doctors making much more than European/Canadian/Australian doctors.

It's not once CEO, OP. Each insurance company has multiple subsidiaries--for "utilization management" (Maximizing denials), pharmacy benefits managers, etc. And each of these has dozens of executives with email jobs, many making 7-8 figure salaries.. And of course, each of these insurance companies pays out huge $$$ to PR shills and lobbyists to keep the racket going.

No wonder the government is cracking down on this fraud.

Babe I hate to break this to you but the current government is not cracking down on any fraud

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

There are nurse anesthetists who administer meds and monitor vitals, but they have to be supervised by an anesthesiologist for both legal and safety reasons (you need someone who is in charge and qualified to make certain decisions especially in the event of anything unusual happening). Becoming a nurse anesthetists requires a lot of extra training for an RN and is a very high paid nursing specialty (among the highest paid nurses, along with surgical RNs).

Turns out it just takes a ton of training to participate in the riskiest medical procedures and to be responsible for a person's life while they are unconscious and being operated on. And that's expensive (not to mention the equipment used in these procedures which is often costs more than all the people in the room combined).

Why should UHC and its ilk care about patient safety or outcomes? That’s why insurance companies push for less training for doctors, making patients use AI before they can see a doctor, etc. They rake in our hard earned wages while occasionally tossing us a few bucks for the lowest quality care possible.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Insurance executives make too much money. Not doctors.

Even if that’s morally true it’s not an explanation for systemic costs. One CEO making too much is a drop in the bucket relative to hundreds of thousands of doctors making much more than European/Canadian/Australian doctors.

It's not once CEO, OP. Each insurance company has multiple subsidiaries--for "utilization management" (Maximizing denials), pharmacy benefits managers, etc. And each of these has dozens of executives with email jobs, many making 7-8 figure salaries.. And of course, each of these insurance companies pays out huge $$$ to PR shills and lobbyists to keep the racket going.

No wonder the government is cracking down on this fraud.

I’m all for getting rid of insurance companies and going single-payer, but executive pay isn't much of an issue. There are about 1,000 doctors per health insurance executive.

That dog wom’t hunt. The insirance executives are pure parasites who make an order of magnitude more $$$ than internists and family med doctors.

I disagree that doctors as a whole make too much -- med school is insanely expensive and an arduous education, especially when you add residency and fellowships to it. I don't think most doctors are overpaid. I definitely don't think internists, pediatricians, or ER docs are overpaid. Some of them are underpaid when you consider the stress of their jobs.

*Some* specialists are overpaid, and our healthcare system also has some messed up priorities that result in excessive referrals to specialists, increasing overall healthcare costs. An example would be that all ortho issues are referred to orthopedic surgeons even if there is no indication for surgery. I have been seeing an orthopedic surgeon for 15 years for back and pelvic issues but have never had surgery. The surgeon takes scans, prescribes meds, and refers me for PT with specific instructions. I don't understand why a surgeon must do this, but they do.

What is annoying is that my insurance pays a premium for these visits to my ortho, but caps the number of PT visits they'll cover, when it's really the PT who is helping me the most, since my issues are non-surgical. I would love to stop seeing the ortho, get my scans done by a tech instead of at the orthos office, and have them sent to my PT, and then get more PT sessions covered by insurance. But this is not an option available to me.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

There are nurse anesthetists who administer meds and monitor vitals, but they have to be supervised by an anesthesiologist for both legal and safety reasons (you need someone who is in charge and qualified to make certain decisions especially in the event of anything unusual happening). Becoming a nurse anesthetists requires a lot of extra training for an RN and is a very high paid nursing specialty (among the highest paid nurses, along with surgical RNs).

Turns out it just takes a ton of training to participate in the riskiest medical procedures and to be responsible for a person's life while they are unconscious and being operated on. And that's expensive (not to mention the equipment used in these procedures which is often costs more than all the people in the room combined).

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Insurance executives make too much money. Not doctors.

Even if that’s morally true it’s not an explanation for systemic costs. One CEO making too much is a drop in the bucket relative to hundreds of thousands of doctors making much more than European/Canadian/Australian doctors.

It's not once CEO, OP. Each insurance company has multiple subsidiaries--for "utilization management" (Maximizing denials), pharmacy benefits managers, etc. And each of these has dozens of executives with email jobs, many making 7-8 figure salaries.. And of course, each of these insurance companies pays out huge $$$ to PR shills and lobbyists to keep the racket going.

No wonder the government is cracking down on this fraud.

I’m all for getting rid of insurance companies and going single-payer, but executive pay isn't much of an issue. There are about 1,000 doctors per health insurance executive.

Anonymous wrote:

Anonymous wrote:Insurance executives make too much money. Not doctors.

Even if that’s morally true it’s not an explanation for systemic costs. One CEO making too much is a drop in the bucket relative to hundreds of thousands of doctors making much more than European/Canadian/Australian doctors.

It's not once CEO, OP. Each insurance company has multiple subsidiaries--for "utilization management" (Maximizing denials), pharmacy benefits managers, etc. And each of these has dozens of executives with email jobs, many making 7-8 figure salaries.. And of course, each of these insurance companies pays out huge $$$ to PR shills and lobbyists to keep the racket going.

No wonder the government is cracking down on this fraud.

The problem is not them
Making touch but stealing too much

Doctors make any too much money. Look at Air Traffic Conrollers. They are in charge of keeping orders of magnitude more lives safe than doctors. Scientists invent drugs that save millions of lives, not practicing doctors. Millions of people would die without electrical engineers who keep the grid running. Yet all those other professions probably make 5-10x less. Physicians salaries contribute to our out.of control costs.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

Or just ask your cleaning lady to do it.

o

We're not all anesthesiologists. Not everyone has a cleaning lady.

But yes, you basically could swap in a cleaning lady for an anesthesiologist. Just have the RN monitor vitals and have the cleaning lady take notes.

It's absurd that we're letting anesthesiologists get away with this racket.

I mean the fact that you think anesthesiology is an unimportant subset really tells me all I need to know here. I mean, oh, it's only the thing most likely to kill you, we don't need specialists for that, am I right?

Again, there's plenty of experience around the world demonstrating the safety of gastroenterologist-administered propofol during colonoscopies. The safety data shows this is just a money grab. Unless gastroenterologists are worse in the US than in other countries.

There are times when an anesthesiologist or a CNA is appropriate, but they're also used when they're not needed.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

Or just ask your cleaning lady to do it.

o

We're not all anesthesiologists. Not everyone has a cleaning lady.

But yes, you basically could swap in a cleaning lady for an anesthesiologist. Just have the RN monitor vitals and have the cleaning lady take notes.

It's absurd that we're letting anesthesiologists get away with this racket.

I mean the fact that you think anesthesiology is an unimportant subset really tells me all I need to know here. I mean, oh, it's only the thing most likely to kill you, we don't need specialists for that, am I right?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

Or just ask your cleaning lady to do it.

o

We're not all anesthesiologists. Not everyone has a cleaning lady.

But yes, you basically could swap in a cleaning lady for an anesthesiologist. Just have the RN monitor vitals and have the cleaning lady take notes.

It's absurd that we're letting anesthesiologists get away with this racket.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

Or just ask your cleaning lady to do it.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.

It doesn't take long to withdraw a scope, and an anesthesiologist isn't going to be doing much on you during brief period.

You're basically paying the anesthesiologist to monitor vitals, which an RN could do for a fraction of the cost. There's probably already an RN there, so really you just need to add another tech to take notes

This isn't a hypothetical. Other countries do this without any worse outcomes.

Anonymous wrote:

Anonymous wrote:The problem is you can't cut the pay of doctors while medical schools cost hundreds of thousands of dollars. If doctors aren't paid a decent salary, no one's going into medicine because of the extreme debt load.

And the paths Boomer doctors used (military, for instance) have been severely curtailed.

You can't cut the pay of the lowest paid doctors. You can certainly cut the pay of radiologists, anesthesiologists, dermatologists, and orthopedic surgeons. We also don't need as many of some of them.

For instance, there's no reason gastroenterologists can't administer propofol themselves during basic screening colonoscopies, which would come with a huge cost savings. But gastroenterologists are worried about pissing off the anesthesiologists by not throwing the lucrative, easy cases to them.

and if you have a bad response to the propofol, should your GI leave the scope in your backside and work on your airway? Finish the scope and hope you’re still breathing when he is done? How about you and your family take this approach first and let us know how it goes.