physasst Posted August 4, 2014 Share Posted August 4, 2014 I'm sure you can do it. when I was at my heaviest it was because I was working 220 hrs+/mo at 3 jobs and was associate chief of a community emergency dept. I was always either working or in meetings. I never exercised. I ate like crap. pictures of me taken during that time don't look anything like I look today. some of my long time friends don't even recognize those pix as me as all the extra weight seems to migrate to my face....:) one of the wake up calls for me was almost being denied life insurance due to cholesterol issues...(now normal with exercise, weight loss, and lots of supplements). Yep....I got heavy over the past ten years....too much work, research, school, etc. I got up to 248 this winter. I've lost 28# since April 1st, and looking to lose another 30... Mike Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 4, 2014 Share Posted August 4, 2014 Once I get my GCS off of 3 and above 8, the weight will start to come back off. I've got a wider range of pant sizes in my dresser/closet than most retailers. Link to comment Share on other sites More sharing options...
Guest Paula Posted August 4, 2014 Share Posted August 4, 2014 It makes me so happy to read about men and their weight problems. Link to comment Share on other sites More sharing options...
SocialMedicine Posted August 4, 2014 Share Posted August 4, 2014 --Most countries do not have single payer but the infrastructure including clinician reimbursement is often very different. --Over use of testing, liability concerns, medicalization, exorbitant salaries, over documentation (need for huge admin staff) contribute to cost. --I would support certain forms of a single payer system. --I would not support a salary reduction for myself .... but I am not being overpaid and I think any independ panel would agree. Link to comment Share on other sites More sharing options...
Moderator ventana Posted August 4, 2014 Moderator Share Posted August 4, 2014 If single payer Medicare comes to America, MDs, PAs, and NPs are going to take a HUGE pay cut. Single payer government can set the reimbursement rates by fiat and give providers a "take it or leave it" middle finger. The government would have a lot more pricing power than blue cross/blue shield would. It's not an accident that providers in single payer countries get paid a lot less than american providers. fear tacticts and nothing more..... Who will take the hit is the hospitals and the insurance companies...... not the individual provider - except for maybe a few high earners /out layers Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Author Moderator Share Posted August 4, 2014 docs in countries with single payor do just fine. they make a bit less but also get a lot more in terms of non-financial benefits. look at england as a model. avg fp doc still makes well over 200k, drives a sports car, gets more vacation, etc. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 4, 2014 Share Posted August 4, 2014 Or if you do emergency medicine in London they may give you a BMW motorcycle to run around on while responding to calls. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Author Moderator Share Posted August 4, 2014 they pay U.S. PAs 90k for a 35 hr work week in the U.K. with great benefits(like included child care, etc). I have looked at several jobs there. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted August 4, 2014 Share Posted August 4, 2014 Ahhh, but do they provide BPL season tickets to team of choice? I wonder what their liability situation is like "over the pond"? I don't know that I've ever heard/seen any comments regarding same. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Author Moderator Share Posted August 4, 2014 the NHS covers malpractice. I have a friend who works in Bristol, england. loves it. they schedule him interchangeably with a doc for every shift. no supervision unless he asks for it. full scope of practice including intubations, central lines, codes, etc Link to comment Share on other sites More sharing options...
Deanj59 Posted August 4, 2014 Share Posted August 4, 2014 docs in countries with single payor do just fine. they make a bit less but also get a lot more in terms of non-financial benefits. look at england as a model. avg fp doc still makes well over 200k, drives a sports car, gets more vacation, etc. According to an 2004 analysis by the Congressional Research Service (CRS) the average compensation for general practitioners is $118 in the UK, not $200K. United States general practitioners make roughly $43k more than in the UK. The discrepancy among specialists between those two countries is $80k. Now, OECD states that self-employed GPs make 3.4 times the average, so that may be the reason for his higher wage. The report can be found many places on google, but this site has a lot of other interesting information on physician compensation in the United States. http://www.physician-salary.org/ Another bit of information from the CRS is that the UK just happens to be the country just below the US in terms of pay. Therefore is it an accurate depiction of physician compensation worldwide when you pick the 2nd highest in the world? France was also featured prominently in his film (which has a much lower average compensation) but physician pay was not addressed. Here is a nice chart again from the CRS on physician's pay worldwide: http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/ Now, that is data from 2004 and Moore's movie was made in 2007. I looked for more recent data, but could only find OECD's recent health report which doesn't include the US and is only expressed as a ratio of renumeration to the average wage. Link to comment Share on other sites More sharing options...
Guest Paula Posted August 4, 2014 Share Posted August 4, 2014 ^^^^^ What a pointless video. So Michael Moore is advocating for the one-payor system and apparently thinks having one nice house and a nice car and one television is what we all should settle for...yet he has how many houses? How many cars? Does anyone think that Hollywood producers need to be put on salary and restricted to one nice house, one nice TV and one nice car? I do. If it's good for us it's good for them....the 1%ers like MM. Sorry, EMEDPA I flamed. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Author Moderator Share Posted August 4, 2014 in the context of the movie he was responding to people who say single payer systems put clinicians into poverty. that was the point, they don't. Link to comment Share on other sites More sharing options...
68W2PA Posted August 4, 2014 Share Posted August 4, 2014 If single payer Medicare comes to America, MDs, PAs, and NPs are going to take a HUGE pay cut. Single payer government can set the reimbursement rates by fiat and give providers a "take it or leave it" middle finger. The government would have a lot more pricing power than blue cross/blue shield would. It's not an accident that providers in single payer countries get paid a lot less than american providers. This isn't necessarily a bad thing. A strong argument can be made that the inreasing opportunity costs of healthcare (projected to be 20% of GDP) are far more detrimental to society than a small income reduction. Healthcare costs are rising and there is no greater means to reduce these costs than through monopsony. As for how much the government may reduce wages... we are able to look at how much providers get paid in the US under fully socialized systems. Most PAs working for the VA or military make decent money with good beneifts. Just about every PA at the VA I have met was a GS12 or GS13. In the military, it is common for PAs to make over $100k. As has been said already, many providers in other nations with single payer systems do OK. I know some Canadian docs that pull in over $200k. They have much much less debt, less malpractice, and better benefits. I would think if you had sweeping reforms that included education and malpractice, most would be content. Heck... just the savings in administrative costs alone would cover keeping wages decent. I guess I am a bit biased because I work in and participate in a completely socialized health system and I really like it. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 4, 2014 Author Moderator Share Posted August 4, 2014 According to an 2004 analysis by the Congressional Research Service (CRS) the average compensation for general practitioners is $118 in the UK, not $200K. United States general practitioners make roughly $43k more than in the UK. The discrepancy among specialists between those two countries is $80k. Now, OECD states that self-employed GPs make 3.4 times the average, so that may be the reason for his higher wage. The report can be found many places on google, but this site has a lot of other interesting information on physician compensation in the United States. http://www.physician-salary.org/ Another bit of information from the CRS is that the UK just happens to be the country just below the US in terms of pay. Therefore is it an accurate depiction of physician compensation worldwide when you pick the 2nd highest in the world? France was also featured prominently in his film (which has a much lower average compensation) but physician pay was not addressed. Here is a nice chart again from the CRS on physician's pay worldwide: http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/ Now, that is data from 2004 and Moore's movie was made in 2007. I looked for more recent data, but could only find OECD's recent health report which doesn't include the US and is only expressed as a ratio of renumeration to the average wage. as you said this was 2007. in france folks work 30 hrs/week and are required to take 6-8 weeks vacation, get leave after having kids, etc. I think if you took away student loans most docs wouldn't have a problem with making 200k/yr. I will say it, and many here will think it blasphemy, but I don't think docs need to make 400-600k/yr. look at canada on your scale. not too shabby for an fp with no debt. Link to comment Share on other sites More sharing options...
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