That is nice, but is not not what I replied to. In any case the training takes place in the UK with all the costs and training involved.
None of the “previous” links you posted gave any numbers from Hawaii.
That was predicted in the UK at the establisment of the NHS. It failed to materialize. It was predicted in Canada, when UHC was established. It failed to materialize. It was, as far as I know, prediced in all the countries that transitioned to UHC at the time it was introduced, and it never materialized in any of them.
But honestly, if it didn’t happen in Canada which has a huge border with the US, a country where doctors are paid far better and the climate is more pleasant, the drain isn’t going to be worse elsewhere. Canada is about as bad as I expect it gets.
It is a minor Public Health measure used when comparing countries health care systems. Basically, while having more doctors than you need does not significantly affect a systems performance, having fewer than needed causes performance to drop sharply.
Probably not. First off, the better doctors will be the more experienced ones, who are more established. Money is less of a motivator than you think at this level. You are in general well into diminishing returns for more oney at this point. Your kids having a good environment, your spouse a good job, happiness with what you do etc, are going to count for more at this level.
Doctors that move location on the average tend to be young, inexperienced and footloose. In addition, observe that the average quality of physicians is probably higher in single payer countries.
And that is a bit of a problem. Single payer is more economically efficient and costs less money that the current US mishmash of public systems. But single payer as an additional layer on top of those systems will be more expensive.
Actually, it is 30 % of current graduates. And its hardly because native born are unwilling to become doctors! Which is, bluntly put, a ridiculous idea. I assure you that no university place in medicine is left open at the end of clearing!
In recent history, the UK government has paid for university, and physicans spend many years being educated, and require labs and practice placements. They are expensive. When the demand for physicans rise, it is far cheaper to just hire readily educated medical staff from the thrid world. (An option I have browsed a couple of times myself.)
That is an actual reason. However, you seem to assume there will be a significant pay cut and that it will affect interns.
:rolleyes:
Post #26
If the topic is going to shift to foreign-educated physicians, the US has its fair share as well. The latest number I saw was over 25% of residency slots are filled by FMGs (which I guess compares to the 40% number for the UK mentioned above).
One study’s results showed that foreign-born doctors do not have worse outcomes than US-born ones, although US-born but foreign-educated doctors do. (2010 study linked here: http://content.healthaffairs.org/content/29/8/1461.abstract)
It happened. As in “major demographic exodus of British-trained doctors in the late 1950s and early 1960s”.
In the 90s about 1% of doctors every year left for the US. And you underestimate the difficulty of moving from country to country vs. moving from state to state. There is a huge difference.
The link is not about Hawaii. About the whole US. You really don’t read the links you give, do you?
I actually do, but on this case:
:smack:
I had a link to another report on the Hawaii costs in mind.
Still, unless you can show that Hawaii is not part of the USA we will have to assume that the numbers for Hawaii are fewer.
Don’t you think any who fulfills his state’s licensing requirements would be perfectly adequate? And most of the time adequate is all you need. This isn’t the 19th Century, when the country was full of half-schooled quacks doing more harm than good and well-schooled doctors were not much better.
Michael Moore said it best: In discussions of health-care reform, “The health insurance companies are the enemy and should not have a seat at the table.”
From the war-ravaged UK to Canada, which was just setting up UHC. If single payer was the reason, it seems peculiar that doctors would wait 7-13 yeand then go to another single payer country.
Cite please? In any case, we can assume that Canada is a worst-case. It seems coverable by graduating more doctors than in the US, something that is neccessary anyway, given the large patient-flow from the US to Canada.
http://www.cfhi-fcass.ca/sf-images/default-source/images/mythbuster_migration_chart.jpg?sfvrsn=0
Shows 500-700 physicians leaving a year in the 90s. That’s about 1%. Note that this is a “mythbuster” site so they wouldn’t exaggerate the numbers.
Cite?
Thank you.
Phantoms in the Snow, Health Affairs, is the best work I am aware of on Canada-US patient flow. Less work has been done on the other direction but a report for Ontario’s Health Minister on the subject is pretty good. I don’t think the report is online, but reports on it is.
I feel this forlong hope of a Canadain medical official speaking of the system being clogged up by Americans bear mentioning:
“Anyway, we hope it’s a temporary phenomenon, until President Clinton gets his health plan through.”
Your post said “large patient-flow from the US to Canada.” Why would you give me the link for the flow from Canada to the US?
So it is not patient flow. It is medical fraud. There is a lot of it, but it has nothing to do with “patient flow from the US to Canada”. That presupposes non-fraudulently-obtained medical care.
I have had a lot of experience (unfortunately) with doctors. All of them “fulfilled their state’s licensing requirements”. Some of those experiences were good. Some were horrendous. So - maybe “most of the time adequate is all you need”. But it’s those times when adequate won’t do that are life-defining. And you never know, when you go to your doctor, if it’s one of those times.
Sounds better than not having a doctor at all. As me and some family members do.
1-10 americans buys drugs from Canada.
Doctors list paperwork and bureaucracy as major reasons they are burned out. If Vermonts single payer system creates a system that streamlines administration it will hopefully reduce that motive. Also (I have no idea if this is true) if saving time on paperwork allows doctors to spend more time with patients then they may get a better work/life balance, another major burnout factor for doctors.
Plus a lot of people have ideological or moral reasons for supporting single payer. So there could be a move towards Vermont for some doctors who find their system more moral, streamlined and ideologically sound.
People will have to wait and see what happens.
State jobs seem pretty highly desired, so state compensation seems fairly good in the eyes of many.
And for those who love the profession I can see no better happening then getting rid of the nightmare of insurance paperwork and overhead and just be able to practice medicine.
Now doctors who are just in it for the money may move, but those are in it for the money.
Plenty of rich folks for them to work for. Maybe not that many, but hey, it’s healthy competition! Be good for them, competing for that fairly limited population. Who knows, might even revive the custom of the “house call”! Assuming they are willing to present themselves at the tradesman’s entrance, of course.