Thanks Henry. While I must say that I understand what your commenter was saying, your response adds clarity and understanding about a completely broken system. I do not envy you.
Once upon a time in the mid '80's, I was, shamefully, a life and health insurance salesman, then a broker. If I believe something, I have the gift to help you believe it too, therefore I was successful. On the flip side of that gift for me; is this: If I find out it isn't true, I do not have the ability to lie to you; just cannot do it .... not virtue signalling, that's just the fact. After a couple of years I began to see the crime of selling medicare supplements to old people and even worse; selling term life combined with annuities to young families and presenting them as investments. Was cruising down a country road one day with one of my agents who was sitting there with a Texas Instruments LED calculator in his lap. He abruptly announces, after running the numbers all of the way out for the duration of the plan, that if interest rates fall below about 9%, at the end, the plan will be worthless. I pulled into a grocery store parking lot and for an hour or more we ran the numbers; I became nauseated, returned home, cancelled the appointment. I had already questioned the medicare supplement business, realizing that the healthcare system was artificially inflated by insurance money that add nothing to actual care of patients. All of this came crashing down for me; we went from a comfortable degree of affluence to my beautiful young wife getting food from her Mother's pantry to feed our children. Personally, I was able to get back on my feet, landed a job with a company that actually manufactured the best product in their field, on earth. I only left there four months ago after 32 years. Have wondered all of this time why no one will state the obvious; that health "insurance" is a gigantic criminal hustle. Insurance executives and the stock holders in large insurance companies are the ones making the money; and they add ZERO to actual healthcare. How do you think they pay the big bonuses to the yacht owning executives? How do you think they build skyscraper building for their headquarters? The health insurance industry is a criminal enterprise and should not exist.
"Why is it that we consistently elevate the VERY WORST among us to positions of authority and responsibility and are surprised when it all turns into a steaming pile of crap? "
We don't elevate them, the powers that be select them. We get the illusion of choice at the ballot box. It's not an accident or a coincidence that "people" keep getting put in office who choose to do things in an extremely inefficient and harmful way. The reason such things are inefficient is because the money is going to their patrons in some way, and that is why it won't change no matter how much regular people vote, protest, or complain.
===
It sounds like the AMA is similar to the legal professions version. Certain types of people somehow get selected (see above) for important positions, no matter how the vast majority of practitioners feel. Then that organization advocates for things that benefit the top 100 firms and top 3 law schools, which often harms us little guys in a way that makes it even harder to compete with the big guys. And politicians act like that organization speaks for all lawyers, and justifies them passing whatever was advocated for.
===
I worked within a state's medicaid admin for awhile, and it was eye-opening. I see medical care becoming more bifurcated, with those on welfare getting "totally awesome unlimited care" on paper but the only practitioners who accept it are specially designed to be profitable at medicaid rates. In other words, MDs and office staff who barely speak English, careful attention to the bare minimum legal standard of care, etc. While everyone else learns to ask a new provider if they take MA, and if they do, avoid it like the plague. Cuz they might actually get the plague.
Excellent article as always. I took a keen interest in this passage:
"Well, duh, there IS a relative shortage of physicians in certain specialties and geographic locations. Resources are not evenly distributed. Population shifts are occurring all the time, and the populations growing as well ..." Also the charts that followed.
Two reasons:
* There is a huge population shift back to exurban and rural as the major metros become hell holes due to a multitude of reasons.
* The specialties cannot survive without the GP. I say that from a observation as a patient with a healthcare plan you cannot get to a specialist without a referral from a GP. When many GP's retire out and few replacements on the way the feedline becomes chocked. So 'the system' is in a sense falling into a Thucydides’ trap of their own making.
Observations?
One final word. I have noticed that there are some physicians who are moving to a subscription based model. You pay a monthly rate to the physician and receive a given bundle of services. Any thoughts on the matter?
Kinda a long post, my apologies in advance, but your post triggered me....
I always enjoy reading your posts, and once again, you are on point.
As a way of background, I am Canadian by birth and was pre-med in the 1980's when the single payer system really began to be managed by "administrators" and less by physicians. My physician family members talked me OUT of pursuing medical school. I went into industrial chem and made a boatload but it wasn't very soul satisfying. Did the grad school gig in "human genetic engineering" and realized academia was not for me. Ended up returning to the quasi-healthcare space, using my STEM credentials managing a biomedical reference lab; as a research associate; in hospital admin supporting outpatient services; a clinical manager and finally, after I had emigrated to the US, in the Govt Relations division (lobbying) of a "lesser" medical association in DC in the late 90's. Big Pharma back then was the big gorilla; AMA was second, and the subsidiary medical associations at that time bent the knee to the AMA. A front row seat to how the sausage was made engendered a lot of well placed cynicism.
Fast forward now- before most people were aware of the covidiocy, I was already on the HCQ/Ivermectin train and had IVM, NAC, etc on standby with good results. Our youngest, who is a cancer survivor who had to endure a lifetime dose of pencil beam radiation, was told by the resident "off the record" to take fenben and menben on a rotating basis for life - the institution she was treated in had done some studies with great results, but since they were generic and there was no cash to be made, the follow on clinical studies never happened.
SitRep now? I am exploring academic programs to be a master herbalist as part of my contribution when the system completely fails. Looking for an evidence based program with a licensure exam at the end and not just woo-woo and have narrowed it down to three solid candidates. Might as well put all those hours in the library learning biochem, toxicology, virology, micro, genetics etc to good use and be of some value to my family. Reading the literature and saving off line heretical in vivo studies with promise that don't make Big Pharma happy.
And yes, our family has gone the concierge route. Our primary pulled the yellow handle when the major healthcare system they worked for deciding they would dictate how they could practice medicine, down to what topics could or could not be discussed with patients. It's the way of the future. Our annual costs having "opted out" are less than the premiums we paid to be "in the system". And - using natural supplements and lifestyle changes, we are all off the major meds typical for our age and profile and are in excellent health.
Oh - and according to family, the Canadian system is FUBAR beyond all recognition. Every single family member either MD or RN, has thrown in the towel and retired. Good luck finding a primary who can accept new patients. To the Americans who praise it because it's "free" - hardly. It's "prepaid" with exorbitant taxes, AND monthly premiums, for subpar service.
While doctors have their own set of issues, more severe the more recently they graduated, most of the problems seem to be driven by people in the "health care" profession that are not engaged in actual health care of any sort. This is the same issue we see in public schools.
I am honored you chose to make a substantive reply, Doc Samizdat. I will try to be less terse next time.
"Moving on, true totalitarians? Shutting down other schools of thought? My Deep South location has loads of chiropractors and naturopaths, plenty of sources of alternative care, and with the internet, it’s available to just about everyone. Hell, we have Eastern Medicine available here. "
What I meant was, all alternatives (except osteopathy) were shut down, about 100 years ago. And I am told that apart from some bone manipulation, a DO education is the same as MD. All the other alternatives you list are not doctors. And those among the doctors who try something else, often end up persecuted or crucified. Remember Semmelweiss? It hasn't stopped. The American Cancer Society used to keep a blacklist of all the doctors who dared to step outside the radiation/chemo dogma. Maybe they still do.
I think the behavior of most docs during covid has proven my point. Official "fear and loathing" for those few physicians who publicly stepped out of line. Even now, the lies still haven't stopped. And jabbing babies with the shitvaccine? Where are the doctors in masse protesting, stopping this horror?
Thanks Henry. While I must say that I understand what your commenter was saying, your response adds clarity and understanding about a completely broken system. I do not envy you.
Once upon a time in the mid '80's, I was, shamefully, a life and health insurance salesman, then a broker. If I believe something, I have the gift to help you believe it too, therefore I was successful. On the flip side of that gift for me; is this: If I find out it isn't true, I do not have the ability to lie to you; just cannot do it .... not virtue signalling, that's just the fact. After a couple of years I began to see the crime of selling medicare supplements to old people and even worse; selling term life combined with annuities to young families and presenting them as investments. Was cruising down a country road one day with one of my agents who was sitting there with a Texas Instruments LED calculator in his lap. He abruptly announces, after running the numbers all of the way out for the duration of the plan, that if interest rates fall below about 9%, at the end, the plan will be worthless. I pulled into a grocery store parking lot and for an hour or more we ran the numbers; I became nauseated, returned home, cancelled the appointment. I had already questioned the medicare supplement business, realizing that the healthcare system was artificially inflated by insurance money that add nothing to actual care of patients. All of this came crashing down for me; we went from a comfortable degree of affluence to my beautiful young wife getting food from her Mother's pantry to feed our children. Personally, I was able to get back on my feet, landed a job with a company that actually manufactured the best product in their field, on earth. I only left there four months ago after 32 years. Have wondered all of this time why no one will state the obvious; that health "insurance" is a gigantic criminal hustle. Insurance executives and the stock holders in large insurance companies are the ones making the money; and they add ZERO to actual healthcare. How do you think they pay the big bonuses to the yacht owning executives? How do you think they build skyscraper building for their headquarters? The health insurance industry is a criminal enterprise and should not exist.
Educational. A few things I'd add:
"Why is it that we consistently elevate the VERY WORST among us to positions of authority and responsibility and are surprised when it all turns into a steaming pile of crap? "
We don't elevate them, the powers that be select them. We get the illusion of choice at the ballot box. It's not an accident or a coincidence that "people" keep getting put in office who choose to do things in an extremely inefficient and harmful way. The reason such things are inefficient is because the money is going to their patrons in some way, and that is why it won't change no matter how much regular people vote, protest, or complain.
===
It sounds like the AMA is similar to the legal professions version. Certain types of people somehow get selected (see above) for important positions, no matter how the vast majority of practitioners feel. Then that organization advocates for things that benefit the top 100 firms and top 3 law schools, which often harms us little guys in a way that makes it even harder to compete with the big guys. And politicians act like that organization speaks for all lawyers, and justifies them passing whatever was advocated for.
===
I worked within a state's medicaid admin for awhile, and it was eye-opening. I see medical care becoming more bifurcated, with those on welfare getting "totally awesome unlimited care" on paper but the only practitioners who accept it are specially designed to be profitable at medicaid rates. In other words, MDs and office staff who barely speak English, careful attention to the bare minimum legal standard of care, etc. While everyone else learns to ask a new provider if they take MA, and if they do, avoid it like the plague. Cuz they might actually get the plague.
Excellent article as always. I took a keen interest in this passage:
"Well, duh, there IS a relative shortage of physicians in certain specialties and geographic locations. Resources are not evenly distributed. Population shifts are occurring all the time, and the populations growing as well ..." Also the charts that followed.
Two reasons:
* There is a huge population shift back to exurban and rural as the major metros become hell holes due to a multitude of reasons.
* The specialties cannot survive without the GP. I say that from a observation as a patient with a healthcare plan you cannot get to a specialist without a referral from a GP. When many GP's retire out and few replacements on the way the feedline becomes chocked. So 'the system' is in a sense falling into a Thucydides’ trap of their own making.
Observations?
One final word. I have noticed that there are some physicians who are moving to a subscription based model. You pay a monthly rate to the physician and receive a given bundle of services. Any thoughts on the matter?
Dr S
Kinda a long post, my apologies in advance, but your post triggered me....
I always enjoy reading your posts, and once again, you are on point.
As a way of background, I am Canadian by birth and was pre-med in the 1980's when the single payer system really began to be managed by "administrators" and less by physicians. My physician family members talked me OUT of pursuing medical school. I went into industrial chem and made a boatload but it wasn't very soul satisfying. Did the grad school gig in "human genetic engineering" and realized academia was not for me. Ended up returning to the quasi-healthcare space, using my STEM credentials managing a biomedical reference lab; as a research associate; in hospital admin supporting outpatient services; a clinical manager and finally, after I had emigrated to the US, in the Govt Relations division (lobbying) of a "lesser" medical association in DC in the late 90's. Big Pharma back then was the big gorilla; AMA was second, and the subsidiary medical associations at that time bent the knee to the AMA. A front row seat to how the sausage was made engendered a lot of well placed cynicism.
Fast forward now- before most people were aware of the covidiocy, I was already on the HCQ/Ivermectin train and had IVM, NAC, etc on standby with good results. Our youngest, who is a cancer survivor who had to endure a lifetime dose of pencil beam radiation, was told by the resident "off the record" to take fenben and menben on a rotating basis for life - the institution she was treated in had done some studies with great results, but since they were generic and there was no cash to be made, the follow on clinical studies never happened.
SitRep now? I am exploring academic programs to be a master herbalist as part of my contribution when the system completely fails. Looking for an evidence based program with a licensure exam at the end and not just woo-woo and have narrowed it down to three solid candidates. Might as well put all those hours in the library learning biochem, toxicology, virology, micro, genetics etc to good use and be of some value to my family. Reading the literature and saving off line heretical in vivo studies with promise that don't make Big Pharma happy.
And yes, our family has gone the concierge route. Our primary pulled the yellow handle when the major healthcare system they worked for deciding they would dictate how they could practice medicine, down to what topics could or could not be discussed with patients. It's the way of the future. Our annual costs having "opted out" are less than the premiums we paid to be "in the system". And - using natural supplements and lifestyle changes, we are all off the major meds typical for our age and profile and are in excellent health.
Oh - and according to family, the Canadian system is FUBAR beyond all recognition. Every single family member either MD or RN, has thrown in the towel and retired. Good luck finding a primary who can accept new patients. To the Americans who praise it because it's "free" - hardly. It's "prepaid" with exorbitant taxes, AND monthly premiums, for subpar service.
While doctors have their own set of issues, more severe the more recently they graduated, most of the problems seem to be driven by people in the "health care" profession that are not engaged in actual health care of any sort. This is the same issue we see in public schools.
I am honored you chose to make a substantive reply, Doc Samizdat. I will try to be less terse next time.
"Moving on, true totalitarians? Shutting down other schools of thought? My Deep South location has loads of chiropractors and naturopaths, plenty of sources of alternative care, and with the internet, it’s available to just about everyone. Hell, we have Eastern Medicine available here. "
What I meant was, all alternatives (except osteopathy) were shut down, about 100 years ago. And I am told that apart from some bone manipulation, a DO education is the same as MD. All the other alternatives you list are not doctors. And those among the doctors who try something else, often end up persecuted or crucified. Remember Semmelweiss? It hasn't stopped. The American Cancer Society used to keep a blacklist of all the doctors who dared to step outside the radiation/chemo dogma. Maybe they still do.
I think the behavior of most docs during covid has proven my point. Official "fear and loathing" for those few physicians who publicly stepped out of line. Even now, the lies still haven't stopped. And jabbing babies with the shitvaccine? Where are the doctors in masse protesting, stopping this horror?
Thank you for listening. Much appreciated.