GM, Ford, Chrysler to meet with Bush to discuss Health Care and Trade Policy
Registered User
Joined: Jun 2001
Posts: 4,600
From: Pewee Valley, KY
I fail to see how insurance not covering well visits (although my horrible insurance even covered 2 well visits per year but did not cover sick visits) is in any way a fault of the MDs. MDs exercise no control over insurance companies, outside of that wielded by any other consumer. Insurance companies are created to make money for their shareholders, so the free market is what dictates what you get for your premiums.
I also disagree that other healthcare professionals undergo as rigorous training as MDs. I'll let total hours of education speak for me on this.
In practice the Logan College program provides students 4,965 hours in numerous areas relevant to the successful practice of a chiropractic physician. 800 hours are dedicated to hands-on adjusting courses.
I can't seem to locate the number of hours that MD schools require but if you can feel free to compare.
Registered User
Joined: Jun 2000
Posts: 3,463
From: SoCal
Let’s first of all keep in mind that our employers are NOT responsible for our healthcare or providing healthcare insurance…over the years, what was just a benefit offered voluntarily by employers to entice people to work for them has now become a “right” (at least in some people’s minds). The last time I read the Constitution, I didn’t see anything in there about either private employers or the government being responsible for providing either healthcare or healthcare insurance to citizens.
However, I suspect employers who now offer healthcare insurance would gladly cover some of the costs being shifted to employees (in the form of more base pay) in exchange for getting off the merry-go-round of ever increasing healthcare insurance premiums.
That said…
What I’m suggesting is building upon the MSA model that already exists and that’s already been mentioned.
Essentially, everyone would be required to fund their own medical expenses through a combination of something like the already existing Medical Savings Account coupled with catastrophic healthcare insurance to handle major/extremely expensive procedures (cancer treatments, heart bypass, etc).
The major component is the medical savings account which acts and is administered much like a 401(k). There would be a mandatory minimum deduction from an employee’s paycheck every month (although the employee could contribute more up to some predetermined ceiling) which could be invested in various investment vehicles (just like a 401(k) is today. Employers could “match” contributions to a point if they wished.
This savings account would be funded with before-tax dollars and would grow tax-free and so long as the money was used to pay for healthcare expenses, there would never be any tax consequences. At age 59 ½ (or some other predetermined age), any funds in the savings account would be available to use for other purposes including retirement income with no tax consequences – in fact, there would probably need to be some mandatory draw-down provision like there is with IRAs.
The person receiving the healthcare from their doctor/provider would be responsible for paying for it – they would either do so out of pocket or by utilizing their savings account funds…this would have the advantage of bringing free-market pressure/competition on the healthcare industry as people began to take real responsibility for their healthcare expenses and be intimately involved in the payment for those services rather than being insulated from all of that as they now are. I suspect a lot of people would opt to pay for most of their minor expenses totally out of pocket rather than “unplug” their medical savings and deplete it for minor costs but the main point is that THEY would make that decision.
Obviously, the premium payments for the catastrophic coverage would also have to be a mandatory deduction from pay as well but of course, the premium amount would vary depending on the amount of the deductible and health of the person applying for coverage.
Here is how the math might work for the savings portion:Let’s assume we have an 18 y/o employee just starting out earning $10/hour gross ($1,733/month (before tax) and $1,300/month after tax). If the MSA mandatory were 5% of his gross pay; that would be a deduction of $86/month or about $1,040/year. Assuming he never used his savings account but paid for minor costs out of pocket, after 40 years (age 58) he would have approximately $894,000 in his MSA (at an average 12% return which would be an average rate of return for a decent mutual fund). Note that this example is assuming that this person never gets a pay raise or promotion in that 40 year period!
Even if a person never did ANY other saving of any kind he would be able to retire with some real dignity and might not have to become a Wal-Mart greater just to keep food on the table…if he did any savings at all over and above the minimum he could be very wealthy when he reached retirement age.
At the same time, if the individual person who is getting medical care is truly paying for it himself, he is going to be a much more cautious consumer than are most patients today…as it is right now, most of us don’t really care if an annual physical costs $150 or $95 because we’ll probably never know what it really costs and even if we know we don’t really care because “insurance is taking care of it”…we pay our $20 (or whatever) co-pay and that’s were it ends for us. If, however, we were writing the check out of our MSA account or our personal checking account, we might start to care if our doctor is charging us a lot more for the same physical than a doctor just up the road and healthcare providers would feel some pressure to “compete” on price with the other providers that are looking for business.
Obviously, the above is just one example and a very simplistic one at that but the point is that there are other options to simply expanding the current broken system…there are ways to make people personally responsible for their health and their healthcare and the payment for that healthcare.
However, I suspect employers who now offer healthcare insurance would gladly cover some of the costs being shifted to employees (in the form of more base pay) in exchange for getting off the merry-go-round of ever increasing healthcare insurance premiums.
That said…
What I’m suggesting is building upon the MSA model that already exists and that’s already been mentioned.
Essentially, everyone would be required to fund their own medical expenses through a combination of something like the already existing Medical Savings Account coupled with catastrophic healthcare insurance to handle major/extremely expensive procedures (cancer treatments, heart bypass, etc).
The major component is the medical savings account which acts and is administered much like a 401(k). There would be a mandatory minimum deduction from an employee’s paycheck every month (although the employee could contribute more up to some predetermined ceiling) which could be invested in various investment vehicles (just like a 401(k) is today. Employers could “match” contributions to a point if they wished.
This savings account would be funded with before-tax dollars and would grow tax-free and so long as the money was used to pay for healthcare expenses, there would never be any tax consequences. At age 59 ½ (or some other predetermined age), any funds in the savings account would be available to use for other purposes including retirement income with no tax consequences – in fact, there would probably need to be some mandatory draw-down provision like there is with IRAs.
The person receiving the healthcare from their doctor/provider would be responsible for paying for it – they would either do so out of pocket or by utilizing their savings account funds…this would have the advantage of bringing free-market pressure/competition on the healthcare industry as people began to take real responsibility for their healthcare expenses and be intimately involved in the payment for those services rather than being insulated from all of that as they now are. I suspect a lot of people would opt to pay for most of their minor expenses totally out of pocket rather than “unplug” their medical savings and deplete it for minor costs but the main point is that THEY would make that decision.
Obviously, the premium payments for the catastrophic coverage would also have to be a mandatory deduction from pay as well but of course, the premium amount would vary depending on the amount of the deductible and health of the person applying for coverage.
Here is how the math might work for the savings portion:Let’s assume we have an 18 y/o employee just starting out earning $10/hour gross ($1,733/month (before tax) and $1,300/month after tax). If the MSA mandatory were 5% of his gross pay; that would be a deduction of $86/month or about $1,040/year. Assuming he never used his savings account but paid for minor costs out of pocket, after 40 years (age 58) he would have approximately $894,000 in his MSA (at an average 12% return which would be an average rate of return for a decent mutual fund). Note that this example is assuming that this person never gets a pay raise or promotion in that 40 year period!
Even if a person never did ANY other saving of any kind he would be able to retire with some real dignity and might not have to become a Wal-Mart greater just to keep food on the table…if he did any savings at all over and above the minimum he could be very wealthy when he reached retirement age.
At the same time, if the individual person who is getting medical care is truly paying for it himself, he is going to be a much more cautious consumer than are most patients today…as it is right now, most of us don’t really care if an annual physical costs $150 or $95 because we’ll probably never know what it really costs and even if we know we don’t really care because “insurance is taking care of it”…we pay our $20 (or whatever) co-pay and that’s were it ends for us. If, however, we were writing the check out of our MSA account or our personal checking account, we might start to care if our doctor is charging us a lot more for the same physical than a doctor just up the road and healthcare providers would feel some pressure to “compete” on price with the other providers that are looking for business.
Obviously, the above is just one example and a very simplistic one at that but the point is that there are other options to simply expanding the current broken system…there are ways to make people personally responsible for their health and their healthcare and the payment for that healthcare.
I like it. It sounds similar to what President Bush had proposed for social security. I think with some tweaks like adjusting how much money is available for people under 18 or who don't/can't work for whatever reason. Say a fund put together by their parents to get them started. Or a employer tax that builds a large pool of money from employers who now don't need to offer Health insurance that could be used to fund those less fortunate.
I think too if you paid a higher percentage into your health fund at younger ages and that rate decreased with age it would help build up the fund for those who may need an expensive surgery at an early age.
I could see some problems with the plan because it would have seem to favor those with higher incomes.
Well thats all fine and good but it doesn't fix the problems GM and Ford have now. Your right the employer is not obligated to give us healthcare and thats fine but they do and more importatly they have. I work in insurance and when you insure someone you better plan on insuring them and everything else they do or touch.
That being said I see no problem with GM or Ford asking for some help. If they get it or not thats fine. The airlines have dumped their pension obligations with the govenrment why wouldn't GM or Ford ask for help on health care or even the pensions. I don't like it but I don't like the idea of GM and Ford being bankrupt even more. Pay a little now or a lot later.
Let me tell ya a short but sad story. My grandmother was a widowed dependent from my grandpa's 28 years of GM loyalty. After he passed in '77 my grandmother has lived on his pension and health care longer than he was actually employed. And in the end when she got very sick she spent over a month in the hospital. She underwent several surgical interventions just to diagnose the the problem. Once they determined it was her liver well there was not much more to do. Before she passed in Sept. 05 GM and Blue Cross/Blue Shield spent almost $150K. God rest her soul. But this illistrates the point of why healthcare is soo expensive for GM, Ford and Chrysler. Nobody could have imagined that in the 40's when some of the people like my grandfather were hired would you be paying out pensions until 2005 and a tremendously expensive health care for an aging population.
Registered User
Joined: Mar 2001
Posts: 4,000
From: TX Med Ctr
Conventional medicine, as opposed to 'alternative' treatments. I don't know if anyone has ever used the word allopathic since I have been here anyway. Besides, contemporary medicine taught in allopathic school is "evidence based medicine". Part of that evidence deals with risk factors and risk reduction which is of course preventative medicine.
I disagree with the notion that your coverage has anything to do with what is medically necessary.
Whatever bodies and committees that are created to review the literature and develop recommendations. Most are NIH funded. I do have an AMA membership card in my wallet, so maybe I am part of the conspiracy...
Hours to get in is irrelevant. It is the hours spent in medical school and in residency that are. That 3 year number is pretty remarkable, considering you would need to be working about 72 hours a week with no weeks off to obtain that. Not that it couldn't be done since a 3 year residency is going to give you around 4000 hours of training, and I personally spent 16 hours in the hospital today as only a 3rd year student. At any rate doctors in this country are training for typically at least 7 years in medical school and residency. Specialists and surgeons spend even more time training. Neurosurgery here is seven years, for a total of 11.
Who advises insurance companies on what is 'medically nessissary'? MDs.
Who sets the primary standard of care that people follow? AMA.
Ok I just looked up what number of hours I get in my program and here is what it says on our website, logan.edu.
All this within 3 1/3 years. That is in addition to my 130 hours in my undergraduate program.
I can't seem to locate the number of hours that MD schools require but if you can feel free to compare.
All this within 3 1/3 years. That is in addition to my 130 hours in my undergraduate program.
I can't seem to locate the number of hours that MD schools require but if you can feel free to compare.
Registered User
Joined: Jun 2001
Posts: 4,600
From: Pewee Valley, KY
Looks like this just got interesting.
So you wouldn't reffer to a chiropractor as a non allopathic provder, huh?
Well different definitions. Evidence based healthcare can be provided outside of the MD model. The difference here that you are not getting is one of philosophy. The Medical or traditional model of health care is that diseases are caused by outside factors on the body, pathogens, correct? Thinks like bacterium, viri, and traumatic injuries. That is what is taught at your school correct? Chiropractors and formerly Osteopaths, before they were brought into the medical model, operate on a vitalistic model. One which states that 'dis-ease', note not disease but 'dis-ease', is not the natural state of the body but can be brought on by structural problems of the body. The Chiropractic model differentiates from the Osteopathic model by suggesting that the nervous system is the ultimate controller of the body, as opposed to a fluid circulatory system. Chiropractic also has within its philosophical model that there is some 'thing' within the body which cannot be measured or tested and they call that innate intelligence. So this 'thing' is what tells the body how to function, which genes to activate at which specific cells. MDs do not traditionally believe in this, since and I am sure you can attest, is not taught in medical school.
So you have never heard of something being denied, like say a CT because it wasn't medically necessary? Really, because it happens all the time. Must not have spent much time in an office or had much experience with insurance.
I didn't say it was a conspiracy but there should be representation from those outside the AMA, of which there is little to none.
Well if you would like I could find out from the administration at school how much clinic time DCs get at Logan before they graduate.
As for hours being irrelevant I think your previous post disagrees with this statement.
Now how many hours is the regular medical program no residency?
Well these are credit hours which are not clock hours so there would be some discrepency. But yeah that is how long the program takes and it pretty much fills up your life.
Note that DCs don't have to do a residency. We get clinical training during our regular school hours so we do not need to perform a residency afterwords. Some students do a preceptorship during their last semester in order to be more comfortable within a clinical enviroment but they must have fulfulled a large number of prerequisites before being eligible for this program.
That is great and all but do those just going into general practice need to do a residency? I don't think they do and so they wouldn't have the, I am guessing 2 year, residency so that would take it down to 5 years. As for specialists or surgeons and their extra time I am glad because if someone is going to be cutting me open I hope they know their stuff better than ANYONE in their field.
BTW Matt I am happy to answer any questions that you have about the qualifications or education we go through in Chiropractic school. I want you to understand that I firmly believe that medical doctors are not only needed but needed badly! I just don't believe that they are the end all that many people do. Call it my personal belief, call it my professional belief but given what I know about my future and what I know about the medical profession I have not doubt that I made the right move for me.
Conventional medicine, as opposed to 'alternative' treatments. I don't know if anyone has ever used the word allopathic since I have been here anyway. Besides, contemporary medicine taught in allopathic school is "evidence based medicine". Part of that evidence deals with risk factors and risk reduction which is of course preventative medicine.
Well different definitions. Evidence based healthcare can be provided outside of the MD model. The difference here that you are not getting is one of philosophy. The Medical or traditional model of health care is that diseases are caused by outside factors on the body, pathogens, correct? Thinks like bacterium, viri, and traumatic injuries. That is what is taught at your school correct? Chiropractors and formerly Osteopaths, before they were brought into the medical model, operate on a vitalistic model. One which states that 'dis-ease', note not disease but 'dis-ease', is not the natural state of the body but can be brought on by structural problems of the body. The Chiropractic model differentiates from the Osteopathic model by suggesting that the nervous system is the ultimate controller of the body, as opposed to a fluid circulatory system. Chiropractic also has within its philosophical model that there is some 'thing' within the body which cannot be measured or tested and they call that innate intelligence. So this 'thing' is what tells the body how to function, which genes to activate at which specific cells. MDs do not traditionally believe in this, since and I am sure you can attest, is not taught in medical school.
I disagree with the notion that your coverage has anything to do with what is medically necessary.
Whatever bodies and committees that are created to review the literature and develop recommendations. Most are NIH funded. I do have an AMA membership card in my wallet, so maybe I am part of the conspiracy...
Hours to get in is irrelevant. It is the hours spent in medical school and in residency that are.
As for hours being irrelevant I think your previous post disagrees with this statement.
I also disagree that other healthcare professionals undergo as rigorous training as MDs. I'll let total hours of education speak for me on this.
That 3 year number is pretty remarkable, considering you would need to be working about 72 hours a week with no weeks off to obtain that.
Not that it couldn't be done since a 3 year residency is going to give you around 4000 hours of training, and I personally spent 16 hours in the hospital today as only a 3rd year student.
At any rate doctors in this country are training for typically at least 7 years in medical school and residency. Specialists and surgeons spend even more time training. Neurosurgery here is seven years, for a total of 11.
BTW Matt I am happy to answer any questions that you have about the qualifications or education we go through in Chiropractic school. I want you to understand that I firmly believe that medical doctors are not only needed but needed badly! I just don't believe that they are the end all that many people do. Call it my personal belief, call it my professional belief but given what I know about my future and what I know about the medical profession I have not doubt that I made the right move for me.
Registered User
Joined: Jun 2001
Posts: 4,600
From: Pewee Valley, KY
Ok, I seem to have gotten this thread WAY off topic. And for that I apoligize since that was not my intention. I suggest that we move this conversation to a thread in the lounge since that is the best forum for it. So please all further discussion about the traditional vs alternative providers should be directed to this thread.
Registered User
Joined: Jul 2002
Posts: 1,579
From: The Land of Pleasant Living
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