Over half of Mississippi's rural hospitals risk closing

Gaius · 2022-11-23T15:22:16.177Z

Possible.

I’m not mad at doctors or anything.

I get upset at folks who blame the private insurance industry when
66% of the insurance payments are made by the government
US doctors get 3 times what French doctors get, and
we have the world’s only jackpot lawsuit industry.

The real costs are obvious.
Distracting from those obvious problems for political gains is criminal.

zantax · 2022-11-23T15:24:24.952Z

Guvnah:

zantax:

Nobody is going to waste four or more years in med school for less in the US.

Plus startup costs for a practice. And especially, plus malpractice insurance.

And it’s not just four either, then you have three years as a crappy pay intern. More for specialists. Already like roughly 30-40 percent of doctors say if they had it do over they wouldn’t choose the profession. Every general practitioner my daughter talked to prior to going to med school told her to pick something else. But she wasn’t in it for the money and really, given her personality and make up she had no choice, she is driven to heal and help people. She will deserve every dime she earns and the people lucky enough to get her services will be getting a bargain.

Guvnah · 2022-11-23T15:29:35.897Z

WuWei:

Averages are tricky.

Especially when it is used in isolation.

Startup costs for a practice can be like a whole mortgage. Ditto a quarter million in education debt once they graduate. Tack on 25-50K in annual malpractice insurance for a lot of doctors.

But too many people just see the average income, and default to class warfare.

zantax · 2022-11-23T15:31:24.535Z

Takes a ridiculously high salary to justify sitting out of the work place for ten or fifteen years.

Guvnah · 2022-11-23T15:37:05.126Z

BTW, once you become a doctor, you have to keep up with the latest training, procedures, practices…

We want our doctors to be perfect. If they make a mistake, we want to sue the hell out of them. (Thus, the high malpractice insurance rates, to address our litigious society.) We want it all from them.

But now it seems we don’t want to pay them for it.

Gaius · 2022-11-23T15:37:53.421Z

Guvnah:

WuWei:

Averages are tricky.

Especially when it is used in isolation.

Startup costs for a practice can be like a whole mortgage. Ditto a quarter million in education debt once they graduate. Tack on 25-50K in annual malpractice insurance for a lot of doctors.

But too many people just see the average income, and default to class warfare.

No class warfare on my part (although it is understandable you might think that of me.) I am merely trying to point out how obvious it is that blaming “the corporate insurance industry” is way way way off base.

zantax · 2022-11-23T15:41:30.518Z

Gaius:

Guvnah:

WuWei:

Averages are tricky.

Especially when it is used in isolation.

Startup costs for a practice can be like a whole mortgage. Ditto a quarter million in education debt once they graduate. Tack on 25-50K in annual malpractice insurance for a lot of doctors.

But too many people just see the average income, and default to class warfare.

No class warfare on my part (although it is understandable you might think that of me.) I am merely trying to point out how obvious it is that blaming “the corporate insurance industry” is way way way off base.

So is blaming doctor salaries, they account for around ten percent of medical costs, cut them in half and you save five percent, which inflation will erase in one year. Or less, definitely less given medical inflation rates.

zantax · 2022-11-23T15:43:31.774Z

A lot of it is what they are doing with my mother right now, giant gobs of government money being spent to give her a few more pain wracked months at end of life.

Guvnah · 2022-11-23T15:48:27.156Z

Gaius:

I am merely trying to point out how obvious it is that blaming “the corporate insurance industry” is way way way off base.

Yeah, I think that’s off base too.

DougBH · 2022-11-23T18:59:35.932Z

Ben_Natuf:

its a good thing we paid for their student loans so they don’t need more government money

Mississippi had a program that paid for doctors student loans for poor areas. This seems to have been discontinued.
I hope you are not talking about that $10,000 grant by Biden that has been blocked in court.

https://www.msfinancialaid.org/state-medical-education-forgivable-loan-med/

WorldWatcher · 2022-11-23T19:01:11.893Z

Just to point out.

After the 200+K debt to get through medical school, there is another 3-7 years of residency before becoming a full fledged independent doctor.

WW

DougBH · 2022-11-23T19:06:47.212Z

Wages and salaries account for 56% of hospital costs.

Definitive Healthcare

Top hospitals by total operating expense

Learn about the top 20 hospitals in the U.S. by total operating expenses in 2021.

zantax · 2022-11-23T19:09:29.600Z

DougBH:

Wages and salaries account for 56% of hospital costs.

https://www.definitivehc.com/resources/healthcare-insights/top-hospitals-total-operating-expense#:~:text=Wages%20and%20benefits,equipment%20used%20to%20provide%20care

More then just doctors work at hospitals.

Gaius · 2022-11-23T19:16:09.719Z

WorldWatcher:

Just to point out.

After the 200+K debt to get through medical school, there is another 3-7 years of residency before becoming a full fledged independent doctor.

WW

EVERY field from plumbing to teaching to being a cop comes with substantial promotions and pay increases when you have adequate experience. Doctors are not even mildly unique in that regard.

EVERY country has some form of residency. US doctors are not at all unique in that regard.
.
.
.
.
I generally find it does not matter what you and i think is fair. Maybe you think it is fair that US doctors get more than 3 times what French doctors do and maybe I don’t. What does matter is supply and demand not our ideas of fairness.
We import doctors by the planeload (we don’t produce enough of them.)

In the US foreign-born doctors are

50% of those practicing geriatric medicine,
40% of those practicing critical care, and
25% of general practitioners.

Even so we still have a massive shortage of doctors and need a 40% increase just to match the standards of other developed nations. We are Namibia!

It is easy to imagine that if food supplies or oil supplies or internet service were cut that deeply, prices of those things would increase 200-300%. That is exactly precisely what is happening to us in medicine.We are Paraguay!

DougBH · 2022-11-23T19:22:13.734Z

So why can other countries produce doctors more plentifully? Perhaps consideration should be given more to quantity. It doesn’t really help to have the best medical training institutes if you can’t find a doctor.
Also telling, the ones who were trained abroad wind up treating the old people. Guess who’s expendable.

TheRedComet · 2022-11-23T19:22:19.773Z

I’m honestly surprised my county still has its local hospital. Only about 10,000 people here in the county.

Gaius · 2022-11-23T19:43:48.970Z

DougBH:

So why can other countries produce doctors more plentifully?

I am sure a small part of it has to do with free college and free Med school (like France)
When you know from age six that such things are free you set your goals higher than if it is later explained to you “Med school means you will graduate with $240k in debt but you will make $218k a year more than French doctors” (the truth here in the US.)

But I am also sure that would fix only a tiny part of the problem. anyone who is capable of being a doctor can understand "a one time loan of $214k is pretty small compared to the $316/a year you’ll average as a doctor.)

Yes we do need to produce more doctors but free college and free med school won’t make a dent in the problem.

Nemesis · 2022-11-23T19:49:20.982Z

With a growing and aging population the entire healthcare system including how we train and staff medical professionals has to be re-evaluated.

Guvnah · 2022-11-23T20:30:19.414Z

DougBH:

So why can other countries produce doctors more plentifully?

Careful with that, or you’ll find yourself arguing for a solution rooted in socialism.

WuWei · 2022-11-24T02:01:51.173Z

DougBH:

Wages and salaries account for 56% of hospital costs.

https://www.definitivehc.com/resources/healthcare-insights/top-hospitals-total-operating-expense#:~:text=Wages%20and%20benefits,equipment%20used%20to%20provide%20care

Top heavy?