[jpgvm]

Medicine isn't a business as far as a government is concerned.

It's a utility that exists to protect the investment in it's citizens such that their full productivity can be achieved.

It's in a country's best interest to achieve the highest possible standard of care for all citizens, not just those that can "afford it".

Treating medicine as a business only works for the very top of the totem pole and over time leads to increasing degradation of the labor force. i.e what you are seeing in America right now.

Nobody in Australia ever wonders if they should call an ambulance if they are injured or worried they could be very ill, they just pick up the phone and dial 000. They are guaranteed as citizens of Australia to have access to life saving care whenever and wherever in our borders. They do so with no fear that they will financially ruin themselves.

In Australia we would go as far to call this a basic human right.

[forum_ghost]

What you are writing about is aspirational utopian fantasy.

What I wrote is harsh reality informed by two decades of being elbow deep in bodily fluids.

You may not like it, but you aren’t getting the best physician just because you developed some far out ideas how the best talent in the world must fix your problems.

Guess what, physicians are free people too, even free to refuse any patient for any reason.

They just want top dollar, and move where the pay is best, that’s all.

You wouldn’t move for a 10x higher salary? You would deny everything that would bring to your family?

[jpgvm]

I don't see how it's fantasy if it already exists in my home country...?

[RGamma]

~Two decades of social atomisation and commercial brainwashing have left their traces...

[forum_ghost]

What exists in Australia is exactly what the US has: private payers that get preferential access, and then Medicare for the poor/everyone else. People avoiding appointments they cannot afford. Psi service refusing to take Medicare patients. Unavailable pharmaceuticals in Australia that one can easily access in the US. You even have US-style HMOs.

It’s just a US-lite system compared to Canada (which like Cuba outlaws private healthcare, but has a grey healthcare market because the public system is broke), and NHS(which is broke like Canada, but at least you can pay private).

1) Patients avoiding appointments due to costs, just like the US:

“Almost impossible to get bulk billed’: patients avoid seeing doctors due to out-of-pocket costs”

https://amp.theguardian.com/australia-news/2022/may/12/almos... Private healthcare is better in Australia:

2) Private healthcare where cash suddenly trumps virtue-signalling on the internet.

Paying cash money? Jump the queue! The poor can languish and die while on waitlists.

“Public patients requiring elective surgery for cancer, heart conditions and other serious health issues face longer waiting times than their privately insured counterparts in public hospitals, according to a new report. ”

https://thenewdaily.com.au/life/wellbeing/2017/12/06/private...

3) Refusal of public patients.

In some cases, physicians don’t even take any Medicare patients -at all-.

Let’s take a rather relevant specialty for this thread, psychiatry:

“Psychiatry costs in particular are prohibitive. One reader reported paying $300 for 20 minutes with a psychiatrist, while another said they paid $900 for the first session and $500 for subsequent sessions. Another reader said her one-hour psychiatry session cost $435, and the Medicare rebate “didn’t even cover half”. Another reader, Jamie, said she had paid $220 and received $76 back from Medicare, but that her initial appointment was $600.”

Congrats! You are paying American rates! Good job Australia!

https://amp.theguardian.com/australia-news/2021/apr/19/like-...

My goodness, isn’t this a huge surprise! Highly trained people want to get paid even in Australia, news at 11. Who could’ve guessed.

Money talks. It’s that simple. Why is that so hard to accept?

Engineers used to move to Bay Area to get the best possible salaries, but we should suppress doctors who even as much attempt to move overseas for bigger pay checks, lol?

[fzeroracer]

What you've mentioned is objectively wrong and has nothing to do with reality. The US is not leading in healthcare outcomes or anything of the sort. And even then, there's more to life than just strictly salary. Things like retirement benefits, socialized healthcare, safety nets etc all contribute to reasons why this occurs.

Also as a side note: US doesn't have a physician surplus: It has a physician shortage. By your logic, we should see no issue in finding physicians, doctors etc because they should all want to relocate to the US where the salary is the highest.

[forum_ghost]

Anyone who keeps talking about averages or statistical outcomes does not understand the first thing about medicine: there is no averages.

Because of deep sub-specialization you only have an agglomeration of outliers that are really good at what they do, and then the plankton, just like in every profession.

You can either have someone that knows exactly what he’s doing, or someone who rarely does it. A large part of medicine is guesswork, and you want someone who’s seen enough to be doing the guessing.

There is no shortage of physicians if you have the money. You can see the absolute best physician of your choice literally tomorrow if you have enough money to name a hospital wing. They’ll just see you while they eat their lunch, or come in an hour earlier.

The shortage you are talking about, is a shortage of competent, qualified saints willing to forego compensation after spending a decade in training to treat the poor.

If your expectation is that the top talent should for peanuts - do you really think there can be no shortages? You are literally asking for saints and miracles.

P.S. >there's more to life than just strictly salary. Things like retirement benefits, socialized healthcare, safety nets etc all contribute to reasons why this occurs.

$2-3 million/year solve all of the above. There is more to life, but 90% of every graduating class are there for money, nothing less.

[fzeroracer]

No, I'm talking about a very literal shortage of physicians in the US. Not a shortage of saints or whatever tangent you're going on. The US has a physician shortage. I will repeat under your argument there should be no physician shortage in the US because the US has among the highest salaries for physicians. This should not happen by the argument you keep repeating.

The fact that someone can see a physician tomorrow with enough money is irrelevant because with enough money they are no limited to the US. Experts are not located entirely within the US, hence why many millionaire/billionaires will travel for medical aid because other countries might have people with more expertise in XYZ.

The rest of your comment is completely irrelevant to the argument I'm making.

[forum_ghost]

>This should not happen by the argument you keep repeating.

you do not understand how the industry works. salaries are high because the supply is constrained.

supply is capped. by residency availability.

doctors, like many others, don't want to live in some areas, and supply ends up being unevenly distributed.

In any major US metro, you can see a cardiologist TOMORROW. Don't even have to be a millionaire.

https://www.merritthawkins.com/uploadedFiles/MerrittHawkins/...

Let me guess, next will be "but muh AVERAGES"?

You can remain average. Best of luck.

[dang]

Can you please edit the swipes out of your comments? You've posted good things but unfortunately they're interspersed with hostile/inflammatory bits, and we're trying to avoid the latter here. It's not what this site is for, and it destroys what it is for.

https://news.ycombinator.com/newsguidelines.html