----- Original Message ----- 
From: "Dan Minette" <[EMAIL PROTECTED]>
To: "'Killer Bs Discussion'" <[email protected]>
Sent: Friday, May 25, 2007 5:18 PM
Subject: RE: U.S. health care


>
>
>> -----Original Message-----
>> From: [EMAIL PROTECTED] 
>> [mailto:[EMAIL PROTECTED] On
>> Behalf Of Ronn! Blankenship
>> Sent: Thursday, May 24, 2007 7:45 PM
>> To: Killer Bs Discussion
>> Subject: RE: U.S. health care
>>
>>  Let us presume as was the case in the cases I have
>> heard of on other lists that the families are ordinary middle-class
>> working people who when it comes to cars typically look for a
>> late-model used Chevy rather than a new car of any type and 
>> certainly
>> never imagine themselves owning a BMW (except perhaps in their
>> daydreams when they win the Powerball lottery) and that no one can 
>> be
>> considered "at fault" for the problems that the child was born
>> with:  the parents were as far as anyone knew or could tell 
>> healthy,
>> did not smoke, drink alcohol, use drugs, work in a factory or other
>> environment where they were exposed to toxic chemicals or use such 
>> at
>> home or in some second job or hobby, did not engage in any other
>> risky behaviors, did not have any known genetic defects, had early
>> and regular pre-natal care (during which we presume nothing amiss 
>> was
>> detected, or at least not until it was too late medically or 
>> legally
>> to do anything about it), nothing untoward happened during labor 
>> and
>> delivery, etc.
>>
>> How should such cases be addressed by the US health care system?
>
> It will have to be addressed by some sort of health care rationing. 
> The
> only question is when and how. We may not be there now, but there 
> will be a
> point at which we cannot afford to give the best health care that's
> available to everyone....even if that's the focus of the entire 
> economy.
>
> How we do that rationing is a very difficult decision.  This is one 
> reason
> that I think we should start working towards the most reasonable 
> rationing
> system we can have as soon as possible.
>
What I gather from what you are saying Dan, is that the people who pay 
for the health care system are going to have to settle for less in 
order to preserve the status quo otherwise. I am taking "health care 
rationing" in it's simplest terms here, and doing my best to avoid 
extrapolation of your words. So please expand on this if I am 
misunderstanding you.

I've worked in a few hospitals here in Houston and everyone of them is 
undergoing large expansions. One is left to wonder who is paying for 
all this construction if not the end customers. In every hospital I 
have worked in, doctors are daily treated to sumptuous meals (for free 
of course) in a lavish (as compared to any other hospital facility) 
dining room. And the food served is of a quality not seen in any other 
part of the hospital, prepared in a separate kitchen solely for the 
doctors. I've seen this at St. Joseph, a relatively poor hospital, and 
at M.D. Anderson, a rich state run hospital.
I know this to be the case at the other hospitals in the Houston 
Medical Center because my company works in pretty much all of them.

If one were to drive through the medical center and observe all the 
construction (every bit of it medical expansion) one would be hard 
pressed to understand how we would need medical care rationing.
A walk through the parking lot where doctors park their 
vehicles.......well....they are obviously not worried about fuel 
efficiency.
I live next door to St. Johns Hospital. They have commercials on TV 
promoting their hospital, saying they have over 900 doctors on staff. 
This is a small hospital.
St Josephs used to advertize on the NPR affiliate saying similar 
things. M.D.Anderson is currently advertizing on the NPR station. All 
this advertizing costs *us*.
I've worked in Central Stores at St Joes and what the hospital pays 
for simple pieces of plastic is amazing. So when people complain about 
the pharmas, I tend to be somewhat sympathetic. It seems to me that 
the entire medical industry is being treated as a cash cow by anyone 
who can get a hand in the till.

Maybe what we need is a new economic model for medical care. Not for 
the patients and insurance providers, but at the operational level. 
There is far too much ostentation currently and the expansion I see 
belies rationing.
And perhaps doctors should consider a pay cut? (<G> As if the fat cats 
would even consider it) It may be that some austerity now would 
prevent a bubble collapse later.

(Hey!? Did I just coin a term? Medical Care Bubble?)

Qualifiers: I'm in a big city with a very very large medical research 
and care center. It may be that my views are skewed by proximity to a 
growth sector of the industry.


xponent
M.D.Anderson Cancer Center Maru
rob


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