New OMA notice - cuts to fees

[Wayward son]

Originally Posted by lostintime

Once you open the gates, then it becomes a slippery slope.

Who cares? Trust the free market.

FMG's are kind of different than allied health and mid-levels, kind of unfair to lump them all together. At least they have gone through licensing PHYSICIAN exams? That's a completely different story than mid-levels. The problem is that a lot of these things aren't exactly isolated. Suturing isn't exactly JUST suturing. You're not a technician, you have to consider surgical complications, other medical histories, wound healing, etc. And that's why a lot of mid-levels can't act independently (or shouldn't at least ethically).

So what you are saying that as a consumer of health care I am subject to the will of the free market, but at the same time I can't decide that I want to be seen by someone who significantly cheaper, but doesn't consider all those other things like surgical complications and wound healing. I must be FORCED to buy your services, or the services of someone else who meets the non-free market standards that you as group are imposing for the benefit of your group (An oligopoly, almost the exact opposite of a free market in every way). You decide for me that I am not competent enough to decide on inferior, but satisfactory, treatment for a much cheaper price. That is the opposite of a free market. Pure hypocricy.

[Wayward son]

Originally Posted by lostintime

Maybe you're not that aware about the legal profession either. I've talked to people in law and they say that that's why para-legals have been under their wing to protect their own interests. Using that analogy, a lot of the work that lawyers can officially do, para-legals can "technically" also do.

I am aware that it is not a free market.

[lostintime]

You're subject to the will of the "free market" as well for anything else. Products that harm people or don't pass safety regulation aren't allowed in the other consumerism "free market" either. Free market is NOT equal to free-for-all. Some people might argue about whether those "safety regulations" are fair. That's the matter of life.

What you're asking for is a more neutral party deciding what is safe healthcare or not. Kind of had to remove all physicians from that party considering they make up evidence-based guidelines and clinical care practices. Unless you only make it some party of people who no longer practice and have nothing to gain from it. Kind of idealistic.

[aaronjw]

I agree, let's free market health care. It'll significantly drive down physician costs as they all clamor to compete with each other. They could try to oligopoly the market but we know physicians are greedy bastards who want the most for themselves so they'll continue to compete on price.

Oh wait, what I describe is a true free market and that's not what it wanted by hose advocating for it.

[Wayward son]

Originally Posted by lostintime

You're subject to the will of the "free market" as well for anything else. Products that harm people or don't pass safety regulation aren't allowed in the other consumerism "free market" either.

I am allowed to take risks. I am allowed to buy a car that is cheaper even if it doesn't have all the safety features that a more expensive car does. I am allowed to go hang gliding. I am allowed to live in a neighborhood that has a higher crime rate than other neighborhoods.

In your free market fantasy there is only one reason why I would be allowed to do all those things, but not be allowed to just as freely go to an IMG, ND, Chiroprator, or private citizen any of whom may be able to do whatever procedure I want done at a competency I find satisfactory for a price I find satisfactory. And that reason is you feel that others should be subject to the the free market but that you should be protected from the free market. You feel that MDs provide better service (for instance a lower complication rate), but you don't feel that such better service would truly be valued in a true free market, hence barriers to entry are enacted and maintained.

Quality health care does not work in a free market. This was studied by Nobel Prize winner Arrow in the 1960s who found that unpredictability, barriers to entry, asymmetical information as well as other features make health care completely unsuitable for a free market.

[lostintime]

I think it's just on a spectrum of things. There's a lot of safe guards for the food that is being sold. You're NOT allowed to take those risks for a cheaper price. Supermarkets get closed down by Public Health if they don't meet standards, same with restaurants. Those places may very well be cheaper, but they get closed down. Sure you can go search for some in the back alley.

I agree there is "more" of a free market for most consumerism than healthcare, but the examples you've been providing could very easily be countered.

Cars can't be sold without a seat belt. Some people may want to take that risk for a more cheaper car. No can do.

So maybe you should change your argument to the fact that the problem is who is setting the standards, NOT whether it's a free market or not. A lot of things are regulated and considered "free market". By your standards, NOTHING that is sold in Canada is part of a free market because everything goes under safety regulations or some sort of law/regulation.

[Wayward son]

Originally Posted by lostintime

By your standards, NOTHING that is sold in Canada is part of a free market because everything goes under safety regulations or some sort of law/regulation.

Yes, that is exactly my argument. Free-market nuts complained when child labor laws were put in place, but the people understood that true free markets are not desirable (and rarely even possible). People who call for a free market are being disingenuous. We are going to have regulations no matter what. If this honestly was spoken then people could decide which regulations work best under which circumstances. Instead it is claimed that the choices are big government or the free market. Not true at all.

Of course, in reality they are not actually calling for a free market, but understand that making such a claim is more beneficial for their interests then explaining the truth. They could say that what they are advocating is a health care system which still has regulations, but keeps regulations that benefit one group of people and gets rid of regulations that protect another group of people (usually the rich over the poor). So Barriers to entry regulations to protect MDs are required, but regulations to protect the consumer in their most desparate time of need? No, that's socialism. It is more appealing to say we should have a "free market."

[aaronjw]

interesting article: http://news.nationalpost.com/2012/05...l-spur-exodus/

some funny comments too lol

[Robin Hood]

Originally Posted by aaronjw

interesting article: http://news.nationalpost.com/2012/05...l-spur-exodus/

some funny comments too lol

Excellent way to portray physicians as greedy, but maybe what's said in this article is not far from the truth. You see physicians threatening to see less patients and go to the US just because now, they will earn 250k rather than 300k (or something like this, I'm not claiming exact figures, but that's how it looks like). It also seems physicians are holding patients as hostages to keep their high salaries.
Oh and this statement is pure BS:
“For the past eight years, I’ve spent no less than 80, 90 hours a week in the hospital and it often gets far more excessive than that,” he said. “You don’t go into medicine because you want to be filthy rich. To put this much effort into something for 17 years, you could probably do better.”
If it wasn't for the money, the pool would be the quarter of what it's now.

[A-Stark]

Originally Posted by Robin Hood

Oh and this statement is pure BS:
“For the past eight years, I’ve spent no less than 80, 90 hours a week in the hospital and it often gets far more excessive than that,” he said. “You don’t go into medicine because you want to be filthy rich. To put this much effort into something for 17 years, you could probably do better.”
If it wasn't for the money, the pool would be the quarter of what it's now.

Well, the quoted individual just finished (I presume) a general surgery residency and fellowship, so I don't know why you suggest those hours are BS. They're almost certainly accurate.