TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 I've yet to see an industry produce better results when you a) decrease the incentives for the best and brightest to pursue a career in that field, and b) decrease the level of competition for those still interested. Everything about your approach is counter intuitive. Link to comment Share on other sites More sharing options...
Rob's House Posted November 20, 2012 Share Posted November 20, 2012 I've yet to see an industry produce better results when you a) decrease the incentives for the best and brightest to pursue a career in that field, and b) decrease the level of competition for those still interested. Everything about your approach is counter intuitive. Birddog would rather have Cameron doing his diagnosis than House. And he wants to make that decision for you too. Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 (edited) I've yet to see an industry produce better results when you a) decrease the incentives for the best and brightest to pursue a career in that field, and b) decrease the level of competition for those still interested. Everything about your approach is counter intuitive. that's probably because your intuition is gordon gecko like. "b." is just not true as illustrated by my references. it's just as competitive to get into a canadian or uk med school as compared to a us school despite the fact that orthopedists or neurosurgeons often make less than1/2 of their counterparts in the us. i'll take data over your intuition every time. oh, and their outcomes data are comparable despite lower costs...wonder why costs are lower? Edited November 20, 2012 by birdog1960 Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 Birddog would rather have Cameron doing his diagnosis than House. And he wants to make that decision for you too. That's because he doesn't understand the applied economic principals of human motivation and incentivization, and supply and demand. He also, for some reason, erroneously believes that you can produce better cost outcomes in medicine by chasing away everyone who understands finance. Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 That's because he doesn't understand the applied economic principals of human motivation and incentivization, and supply and demand. He also, for some reason, erroneously believes that you can produce better cost outcomes in medicine by chasing away everyone who understands finance. look at the data. then cite some that supports your contention and refutes mine. Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 (edited) that's probably because your intuition is gordon gecko like. "b." is just not true as illustrated by my references. it's just as competitive to get into a canadian or uk med school as compared to a us school despite the fact that orthopedists or neurosurgeons often make less than1/2 of their counterparts in the us. i'll take data over your intuition every time. oh, and their outcomes data are comparable despite lower costs...wonder why costs are lower? The laws of supply and demand, and incentivization and human motivation can't be repealed or handwaved away. The only reason your data leads to your conclusion is because outcomes are scored differently in the countries references, and many negative outcomes are simply discarded. You're comparing apples and oranges. Edited November 20, 2012 by TakeYouToTasker Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 (edited) The laws of supply and demand, and incentivization and human motivation can't be repealed or handwaved away. The only reason your data leads to your conclusion is because outcomes are scored differently in the countries references, and many negative outcomes are simply discarded. You're comparing apples and oranges. citation? and for the sake of argument lets ignore outcomes 9although i'd be very interested in your supporting data. how do you hand wave away the level of competition for med school spots in these well established socialized medicine systems? Edited November 20, 2012 by birdog1960 Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 look at the data. then cite some that supports your contention and refutes mine. Here's the thing; it's not going to effect me or my family personally, as I'll just go ahead and spend what I need for top of the line care, and buying my way to the front of the line. Your grand experiment is going to do incredible damage to the large majority of the middle and working classes, however. So, no. I'm not going to waste anymore time trying to convince a self-righteous idiot that medicine is no different than any other human endeavor in the history of the world. I'm simply going to sit back, and laugh at you when you have to start dealing with the consequences of the mess you've loudly insisted on creating. Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 Here's the thing; it's not going to effect me or my family personally, as I'll just go ahead and spend what I need for top of the line care, and buying my way to the front of the line. Your grand experiment is going to do incredible damage to the large majority of the middle and working classes, however. So, no. I'm not going to waste anymore time trying to convince a self-righteous idiot that medicine is no different than any other human endeavor in the history of the world. I'm simply going to sit back, and laugh at you when you have to start dealing with the consequences of the mess you've loudly insisted on creating. so you're admitting you have no data to base your contention on. Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 Wait... Did you really just ask me to cite the law of supply and demand? Really? Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 (edited) Wait... Did you really just ask me to cite the law of supply and demand? Really? no, i asked for data specifically refuting that admissions to med schools in 2 large socialized systems are comparable to admissions to us med schools. the question being discussed is whether the affordable care act will lead to lower quality doctors. i've cited evidence that it won't. you've cited none. and one more piece of evidence: there are some pretty qualified docs in mass. in places like boston and they have a system very similar to obamacare (some good reading in last months esquire about romneycare. bet you didn't know his portrait as governor in the state house has him holding that bill in one hand.) Edited November 20, 2012 by birdog1960 Link to comment Share on other sites More sharing options...
TakeYouToTasker Posted November 20, 2012 Share Posted November 20, 2012 so you're admitting you have no data to base your contention on. The data has been posted here many times in many threads. You didn't have the decency to examine it then, so why would I waste my time on you now? The ship has sailed, and I'm not in the habit of crying over spilled milk. I simply adapt, and excell, doing what I need to stay a few steps ahead of the self-righteous do-gooders, and many miles above the huddled masses you trample in your pursuit of counter-intuitive utopian ideals. I don't care to have the fight anymore, because it's easier for me to simply buy my way out of the mess you've created. The ones you'll have to answer to are the ones to whom you're doing real harm. It's your problem, and it's their problem. I'm above your problems. Link to comment Share on other sites More sharing options...
Doc Posted November 20, 2012 Share Posted November 20, 2012 So wait. England's population is 20% the size of the US while Canada's is 10%, they don't have near the same same population demographics, have cheaper med schools, and nothing close to the same tort systems, and you're comparing them to the U.S.? Nevermind that their socialized healthcare systms are failing? LOL! And your "I'm convinced there are excellent candidates..." is nothing more than a misguided belief on your part, while having fewer doctors would be a disaster for the U.S. Link to comment Share on other sites More sharing options...
3rdnlng Posted November 20, 2012 Share Posted November 20, 2012 so you're admitting you have no data to base your contention on. Statistics can be twisted anyway a person wants. Let's say Canadian and U.S. open heart surgeries are considered to be equally successful via statistics. Did anyone take into account the people that died in Canada waiting for surgery? Considering that the Canadian system had healthier people to operate on then maybe the U.S. system is even better. TYTT is right. You can't beat the law of supply and demand. Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 So wait. England's population is 20% the size of the US while Canada's is 10%, they don't have near the same same population demographics, have cheaper med schools, and nothing close to the same tort systems, and you're comparing them to the U.S.? Nevermind that their socialized healthcare systms are failing? LOL! And your "I'm convinced there are excellent candidates..." is nothing more than a misguided belief on your part, while having fewer doctors would be a disaster for the U.S. avg tuition for canadian med school is about 13K so not much different than in state tuition to a us med school and when you're talking about halving a neurosurgeons salary the tuition differences become pretty insignificant. the difference in population is mitigated by the difference in available spots. it's the percentage admitted that is salient to the discussion and those numbers are very similar. Statistics can be twisted anyway a person wants. Let's say Canadian and U.S. open heart surgeries are considered to be equally successful via statistics. Did anyone take into account the people that died in Canada waiting for surgery? Considering that the Canadian system had healthier people to operate on then maybe the U.S. system is even better. TYTT is right. You can't beat the law of supply and demand. show me some "twisted" statistics that support your position. in earlier discussions on comparisons of quality of care, what has been presented here are criticisms of the type of data i'm presenting but never original data that shows the opposing contention. let's see it. Link to comment Share on other sites More sharing options...
3rdnlng Posted November 20, 2012 Share Posted November 20, 2012 avg tuition for canadian med school is about 13K so not much different than in state tuition to a us med school and when you're talking about halving a neurosurgeons salary the tuition differences become pretty insignificant. the difference in population is mitigated by the difference in available spots. it's the percentage admitted that is salient to the discussion and those numbers are very similar. show me some "twisted" statistics that support your position. in earlier discussions on comparisons of quality of care, what has been presented here are criticisms of the type of data i'm presenting but never original data that shows the opposing contention. let's see it. http://www.theglobeandmail.com/life/health-and-fitness/canadians-waiting-longer-for-surgery-report-finds/article4201630/ http://www.cbc.ca/news/health/story/2007/10/15/waittimes-fraser.html Just a couple examples. Google "Wait times for surgery in Canada" and see how many different articles there are. Hey, you asked for it. Link to comment Share on other sites More sharing options...
Doc Posted November 20, 2012 Share Posted November 20, 2012 avg tuition for canadian med school is about 13K so not much different than in state tuition to a us med school and when you're talking about halving a neurosurgeons salary the tuition differences become pretty insignificant. the difference in population is mitigated by the difference in available spots. it's the percentage admitted that is salient to the discussion and those numbers are very similar. In 2010, the average debt load for a US med school grad was $158,000. And again, differences in tort systems mean a neurosurgeon in Miami pay $237,000 a year, while in Toronto it's $30,000. And you can talk bout the percentages admitted, but after Obamacare, that will surely be as different as everything else I mentioned. And again, those socialized systems are failing. Link to comment Share on other sites More sharing options...
birdog1960 Posted November 20, 2012 Share Posted November 20, 2012 http://www.theglobea...article4201630/ http://www.cbc.ca/ne...mes-fraser.html Just a couple examples. Google "Wait times for surgery in Canada" and see how many different articles there are. Hey, you asked for it. never seen wait times for surgery reported as a medical outcome. you've redefined the term as currently used in scholarly publications. but ok. wait times are longer. no argument. but again, wasn'[t the discussion about the quality of doctors and ability to attract good ones? In 2010, the average debt load for a US med school grad was $158,000. And again, differences in tort systems mean a neurosurgeon in Miami pay $237,000 a year, while in Toronto it's $30,000. And you can talk bout the percentages admitted, but after Obamacare, that will surely be as different as everything else I mentioned. And again, those socialized systems are failing. average neurosurgeon made somewhere around 250K in canada in the stats i found. even after expenses, do you know any that made less than double that here? and good job cherry picking miami which is probably the worst spot in the country for that stat. i guess i asked for twisted statistics and i got em. and your assurance that the numbers will be different is convincing as mine sans the data. Link to comment Share on other sites More sharing options...
Doc Posted November 20, 2012 Share Posted November 20, 2012 never seen wait times for surgery reported as a medical outcome. you've redefined the term as currently used in scholarly publications. but ok. wait times are longer. no argument. but again, wasn'[t the discussion about the quality of doctors and ability to attract good ones? average neurosurgeon made somewhere around 250K in canada in the stats i found. even after expenses, do you know any that made less than double that here? and good job cherry picking miami which is probably the worst spot in the country for that stat. i guess i asked for twisted statistics and i got em. and your assurance that the numbers will be different is convincing as mine sans the data. Toronto is the Miami of Canada. Other Canadian neurosurgeons elsewhere pay 1/3 to 1/2 less than in Toronto. And in 2005, the average malpractice was over $100,000 and is surely higher now. So taking that premium and your $250K salary, who would become a neurosurgeon? As for my assurance, it's far more realistic than yours. Link to comment Share on other sites More sharing options...
3rdnlng Posted November 20, 2012 Share Posted November 20, 2012 never seen wait times for surgery reported as a medical outcome. you've redefined the term as currently used in scholarly publications. but ok. wait times are longer. no argument. but again, wasn'[t the discussion about the quality of doctors and ability to attract good ones? average neurosurgeon made somewhere around 250K in canada in the stats i found. even after expenses, do you know any that made less than double that here? and good job cherry picking miami which is probably the worst spot in the country for that stat. i guess i asked for twisted statistics and i got em. and your assurance that the numbers will be different is convincing as mine sans the data. If I remember correctly you are a GP, but if say for example you were a cardiologist and you had a patient with acute angina and needed a by-pass, would you think that a 4 1/2 month wait time might decrease his chances of living past 4 1/2 months? The discussion was about the quality of healthcare, not how you would like to frame it. I was talking about how statistics don't always show a true picture. That was the post you responded to. Link to comment Share on other sites More sharing options...
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