It's so bad you have to pay people to move to Vermont - Page 23

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  1. #221
    Quote Originally Posted by cdskier View Post
    I think the average person has absolutely no idea how much time, money, and effort goes into creating a single new drug. People are quick to say "well it only costs $1 to manufacture drug xyz so why do they charge $100 for it". Meanwhile they completely ignore the cost of the R&D and clinical trials and paperwork to get it discovered and approved in the first place. Who pays for that if we demand lower drug costs? Do we then rely on government grants to fund research? In which case we're now back to everyone paying for the R&D anyway (albeit indirectly so the cost is just part of that big black hole where taxes go).
    Oh, lord, THIS.

    People are completely clueless about how much it costs to bring a new medication to market. And clueless is the polite word. You also have the real morons of society out there who think cancer would be cured, but if pharma cured cancer then it couldn't profit from it. Those people are so stupid they shouldn't be allowed to slice a bagel unsupervised.

    That said, I do think pharma as an industry should have a marketing campaign to educate the masses, and shame on pharma for not doing so. Given most people have "absolutely no idea" what it costs to bring a new therapy to market as you say, it makes it simple for lying politicians to demonize the entire pharma industry as "greedy", or to try to take one evil pharma example (opioid misuse, etc..) and make it seem like every company is doing this to tar-and-feather all pharma & biotech companies.

    Quote Originally Posted by deadheadskier View Post
    BG.....apologies for deleting your post
    I still see it.
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  2. #222
    "But the lack of primary care providers in Vermont is a looming crisis. In rural Vermont, some practices have been unsuccessfully recruiting new physicians for more than six years. Recent workforce data shows that there is a need for 69 new primary care providers in Vermont right now. With 36% of Vermont’s primary care doctors over age 60, this need will only escalate."

    -- Fay Homan, VTDigger, 8 January 2020 (today)

  3. #223
    "The tax commissioner is forecasting a 6% hike in education taxes next year. Nearly 40% of the projected rise in school spending is tied to healthcare."

    -- VTDigger, 10 December 2019

  4. #224
    Quote Originally Posted by eastern powder baby View Post
    Let's talk about capitalism a minute because I don't think our healthcare system is particularly capitalistic. As the guy with the flowery language about hitting trees mentioned, the consumer has no idea how much their healthcare will cost before they get it. Therefore, they have no way to determine which provider offers the best value. Clinics seem to be helping to break this mold, but we're far from a price transparent system. Without price transparency, it's very difficult to argue you're dealing with a functioning capitalist industry. Fixing prices is rarely the answer; enabling competition is a much more efficient solution.

    Before we go assuming that more government is the answer, I wanted to highlight that medicine and education costs are rising the fastest of just about any industry I can think of (I could genuinely be missing one though). Government has its hands all over these - medicine is well documented here, and the advent of government baked student debt has fueled skyrocketing education costs. My generation was sold a load of nonsense when we were told it didn't matter what we majored because our education was priceless. Just sign on the dotted line. I notice you cited that government subsidises these smaller offices that run perpetual losses. I have a feeling they've given hospitals perverse inventives to over spend, but that's just a hunch from reading the tea leaves of what you wrote.

    Pharma is a huge issue, too. 100% agree. We subsidize the rest of the world's pharma costs. I don't know how it can get fixed the way our patent laws are set up. I'm no lawyer. Still, I don't see why nationalizing medicine is necessary to achieve pharma remuneration changes.

    Regarding people who point to foreigners coming to America for care. Actions speak louder than words. It's the same concept I brought up about Vail not being bought in on catastrophic climate change. There's a reason why people come to the US for treatment: universality ultimately leads to rationing. It's plenty noble to want care for everyone, but it's not wise to dismiss this simple fact as the misguided utterances of toothless fact-hating conservatives.

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    Yep, the healthcare unicorn is out there. Damn trying to even replicate proven, better performance standards achieved elsewhere around the world. Waste of time. Go for the unproven ideology or bust!

    All them capitalist docs are going to run to the ski hills, set up shop and offer two for one transparently priced colonoscopies. May the doc who drives the scope for the cheapest price win!

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  5. #225
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    It's so bad you have to pay people to move to Vermont

    Quote Originally Posted by Orca View Post
    "But the lack of primary care providers in Vermont is a looming crisis. In rural Vermont, some practices have been unsuccessfully recruiting new physicians for more than six years. Recent workforce data shows that there is a need for 69 new primary care providers in Vermont right now. With 36% of Vermont’s primary care doctors over age 60, this need will only escalate."

    -- Fay Homan, VTDigger, 8 January 2020 (today)
    True story. I attended the UVM College of medicine graduation in 2011. The keynote speaker raved about how awesome Vermont was in trying to put together a single-payer system. You could hear an audible grown from the medical graduates. Nearly all of them were packed up and leaving the state because of this. With a good size amount of student debt no one could afford to work in Vermont. Did folks want to stay? You bet.

    And that single payer healthcare plan? Well Shumlin scrapped that literally days after he got the supporters to vote for him for his last term. Even he realized the cost was simply too ridiculously high and not sustainable. But hell, he played to the supporters to get their votes and then ditched them.


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  6. #226
    Quote Originally Posted by deadheadskier View Post
    Yep, the healthcare unicorn is out there. Damn trying to even replicate proven, better performance standards achieved elsewhere around the world. Waste of time. Go for the unproven ideology or bust!

    All them capitalist docs are going to run to the ski hills, set up shop and offer two for one transparently priced colonoscopies. May the doc who drives the scope for the cheapest price win!
    Healthcare is complex and any healthcare system is extremely complex. Does any system on Earth really have it figured out?

  7. #227
    Quote Originally Posted by Orca View Post
    "But the lack of primary care providers in Vermont is a looming crisis. In rural Vermont, some practices have been unsuccessfully recruiting new physicians for more than six years. Recent workforce data shows that there is a need for 69 new primary care providers in Vermont right now. With 36% of Vermont’s primary care doctors over age 60, this need will only escalate."

    -- Fay Homan, VTDigger, 8 January 2020 (today)
    It's a HUGE investment and debt load to go to med school + enrollment is limited due to lack of residency programs. So kids are bowing out of that track.

    I'd argue we need to realign our medical training focus though and suggest the bigger problem with care accessibility and affordability is due to a lack of NPs and PAs more so than docs. We've got 1.1M physicians in the US. About 400k NPs and PAs, yet those professionals can do 90% of what a Physician can do.

    We should be working to more than flip those numbers. Drop down to 400K docs and increase the number of PAs and NPs to 2 million workers? Quality of care would go up, costs would go down.





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  8. #228
    Quote Originally Posted by Orca View Post
    Healthcare is complex and any healthcare system is extremely complex. Does any system on Earth really have it figured out?
    Cost/Outcome (meaning length of natural life)

    would be the best formula right?







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  9. #229
    Quote Originally Posted by deadheadskier View Post
    Yep, the healthcare unicorn is out there. Damn trying to even replicate proven, better performance standards achieved elsewhere around the world. Waste of time. Go for the unproven ideology or bust!

    All them capitalist docs are going to run to the ski hills, set up shop and offer two for one transparently priced colonoscopies. May the doc who drives the scope for the cheapest price win!

    Sent from my XT1635-01 using AlpineZone mobile app
    We actually have evidence of capitalism driving costs down in areas like Lasik surgery. Freestanding ORs have also become cheaper ways to take your kids in for a broken arm down here in the NJ suburbs. So, if you're paying attention, this is about much more than class warfare sloganeering. Taking your kid to see a professional for half the cost of the hospital is a wonderful thing for everyone.

    I'm decidedly not saying our system is prefect - even satisfactory. It's certainly missing key elements of capitalism, so I really don't think it's correct to call it capitalistic without heavy caveats.

    If you think socialized anything is the best option, I'd suggest examining the issue again. Even the smartest and best intentioned planning boards are not capable of figuring out what individuals want better than the individuals do when left to their own devices. That's a major reason why freer societies are more prosperous. Individual decision-making is like the using big data (billions of transactions) to planning boards' broad brush model.

    You're clearly more involved in medicine than I am. Can you even address my basic question of why pharma reform and socializing medicine are necessarily related? If you take over healthcare and don't change patent law, aren't we in the exact same place regarding pharma prices? Conversely, if we reform patent law on it's own, we'd see the benefits of lower drug pieces unless I'm missing something.

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  10. #230
    Quote Originally Posted by eastern powder baby View Post
    We actually have evidence of capitalism driving costs down in areas like Lasik surgery. Freestanding ORs have also become cheaper ways to take your kids in for a broken arm down here in the NJ suburbs. So, if you're paying attention, this is about much more than class warfare sloganeering. Taking your kid to see a professional for half the cost of the hospital is a wonderful thing for everyone.

    I'm decidedly not saying our system is prefect - even satisfactory. It's certainly missing key elements of capitalism, so I really don't think it's correct to call it capitalistic without heavy caveats.

    If you think socialized anything is the best option, I'd suggest examining the issue again. Even the smartest and best intentioned planning boards are not capable of figuring out what individuals want better than the individuals do when left to their own devices. That's a major reason why freer societies are more prosperous. Individual decision-making is like the using big data (billions of transactions) to planning boards' broad brush model.

    You're clearly more involved in medicine than I am. Can you even address my basic question of why pharma reform and socializing medicine are necessarily related? If you take over healthcare and don't change patent law, aren't we in the exact same place regarding pharma prices? Conversely, if we reform patent law on it's own, we'd see the benefits of lower drug pieces unless I'm missing something.

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    I can't speak to drugs / patent laws as it's not my wheelhouse. I'd have to think about it.

    As for surgery centers? Sure, great lower cost option and a good business to be in....in high population density areas. Timely that you brought it up in a thread about VT. Know how many Ambulatory Surgery Centers exist in VT? 1! I helped open it last year. I don't anticipate seeing a major influx of them up there though. They simply lack the population density for it to make business sense for most docs to open a practice.

    The other factor there is in rural areas, surgical services are literally the only reason hospitals can keep their doors open. They lose money in every other department. Do you think communities are going to want to give up a close ED and Extended Care option when Gramma gets the flu just so little Jimmy can get a cheaper fix for a broken arm?

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