I am enjoying how the US is being compared to a country that:
* Controlled its post world war II baby boom with public exhortation among other things.
* In the 1970's began to actively encourage educated females to have children and actively encourage uneducated females to get sterilized.
* After realizing they had gone to far with the post world war II family planning programs, are now offering bonuses to get people to have babies as their replacement rate is too low.
* The elderly are only 8.3% of its total population as opposed to a much higher percentage in the U.S.
Point: It is not enough to say: "such and such country has a better healthcare system than we do so we should mimic it." We should also be asking questions such as:
* Does such and such country have a large elderly population like we do?
* Do the people of such and such country have the same ethnicities that we do?
* Do the people of such and such country have high salt diets like we do?
* Do the people of such and such country have high sugar diets like we do?
* Do the people of such and such country exercise more or less than we do?
It's easy to have a superior health care system when your people are less inclined to be 60 lbs overweight, less inclined to be lifetime smokers, less inclined to be life time drinkers, etc. In fact, at that point I'd say most any health care system would work. It's easy to boast a superior infant mortality rate when most of your moms are highly educated women (remember: you discourage the uneducated ones from having kids) who know to keep their diet clean to avoid things like gestational diabetes.
The issues of health care in the US are the result of a high demand but low supply. Too many people in this country are sick - even the young generation (they are all overweight and diabetic). Further, the issues you as doctors deal with include, but are not limited too:
* A population that honestly expects to be healthy and have a pill to cure everything without any effort on their parts. Let's be truthful, most of the stuff you guys deal with is completely preventable if the patient would just stop eating at McDonalds and get a Gold's Gym membership.
* Attempts by the government to control the pricing fluctuations that are the result of supply and demand. Remember your economics class? How much more money would some of you be charging if you could charge what you wanted? I have seen many complaints on this forum from those of you who consider your reimbursements for some procedures to be completely unfair (read: to low).
* Criticism created by the fact that too many doctors are poor business people. I'm sorry, but I think way too many doctors should just work for a group or hospital as an employee since they don't have a clue as to how to run a business. I hear doctors complain all the time about employee issues, IT expenditures, dealing with accountants, and all this other stuff that "stops me from seeing patients every second of every day." Sorry for your tough luck, but all that goes with managing a business and many doctors simply have no idea how to difuse employee issues, budget for various expenditures, or figure out what their accountant is asking for. In many cases your college did not make you take business classes while you were getting your degree. In other cases doctors fail to realize that just because they are a ninja with a scalpel doesn't mean they are Warren Buffet with a bank account.
Unfortunately, there are no easy answers to any of these problems. Even if you can wave a magic wand to make everyone stop eating junk food and start doing 3 hours of cardio at the gym every week it's already too late. Most of the damage has been done already. We have one of the largest baby boomer populations in the world and they all suffer from a life time of smoking and drinking (remember back in the 70's and 80's when you were growing up how it seemed that EVERYONE smoked?). We have too many youths that are already diabetic.
As a society, we should have started seeking answers to these problems 20 years ago. Since it is already pretty much too late, we have 30 more years to go before things start getting better.
JamesNT
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