Użytkownik "Iks" <o...@p...com> napisał w wiadomości
news:3D067E97.2060302@polbox.com...
MEKU wrote:
> PAnowi i Panie .. ja tylko chcialem zapytac..
> Az tu przy okazji taka dyskusja ..
> hm.. cos jest chyba w tle ..( patrz : niezadowolenie ze Służby Zdrowia)

Taaak. Niezadowoleni sa pacjenci (z jakosci) i lekarze (z wynagrodzenia).
To samo mozna powiedziec o rolnikach, nauczycielach, gornikach...

Problem jest w tym, ze niektorym bardzo trudno pojac, ze zyjemy
w biednym kraju - 90% placi 19% podatku. Dopoki sie ludzie nie
wzbogaca - bedzie bryndza.
Jesli sie na SZ sklada kupa ludzi biednych (ale przeciez nie chorujacych
rzadziej niz bogaci) to jest ona taka jaka jest. I lepsza nie bedzie.
A jesli bedziemy dalej zwiekszac obciazenia (np. skladki na SZ jak ktos
juz tu postulowal) to nikt sie nigdy nie wzbogaci.

Prywatyzacja tez nie jest panaceum. W Polsce mamy dosc zarloczny
(bo mlody) kapital, a w medycynie na zwrot z poteznych inwestycji
trzeba czekac latami. ...

Sytuacja w Stanach i Kanadzie - państwowe i prywatne ubezpieczenie, ale mają
przynajmniej zdywersyfikowane finansowanie , a u nas " single payer system "
, w dodatku "politician s dependent".

A tłumaczyć nie mam czasu/nie chce mi się.



"Public policy is that doctors will spend less and less time on each
patient
due to progressive reduction in fees. Private insurance is a slow and
no pay process, in order to force doctors to spend less time and provide
less service."


The above comment certainly characterizes the experience in this part of
Canada [Ontario].

As the true value of each service has been allowed to drop, relative to
inflation, the number of services per practitioner has risen as a
compensatory strategy. These trends show no signs of abating.

In a situation where there is a monopoly "single-payer" system, lowering
fees produces more services. This is exactly the opposite of a "free
market" model.
----------------------------------------------------
----------------------

Alas and alack..... (I suppose!)....... there is nothing I can disagree
with here. All too true. My only hope is that if we keep talking and more
docs come to be politicized, we might be able to muster a reasonable lobby,
with information that is quite different than the insurance companies or
lawyers. Most docs are not political creatures. It turns my
stomach. But... no one is going to do it for us. The ACP and the IOM are
some voices in the wilderness, that are heard. Peter

At 11:28 PM 6/4/2002 -0500, you wrote:
>Message From: Robert
>
>Message From: Peter
>Bob:
>
>It has taken me some time to get to the comments you so carefully
>elaborated. I think you are wrong, but with what I take to be an
optimistic
>reason. My comments are appended below yours, in italics, but overall, I
>take the IOM comments to mean a direction for the future, which, it seems
to
>me, is a system not based on HMO's, and is based on the values they are
>proposing.
>
>Peter
>
>
>*****
>
>Hi Peter,
>
>I agree that those things advocated by the Institute of Medicine are
>desirable. I just don't see those things taking place during my lifetime.
>Our system is driven by federal political considertations, big
corporations,
>and states governments.
>
>1. Medicare - Promise more to ever more people, but don't come up with more
>money to pay for it. Blame the doctors for everything. Make everything
the
>doctor does a potential felony. Medicare ruined many hospitals, which
>down-sized their skilled staffs (including nurses) to compensate for
>inadequate payment under the DRG system. Some hospitals just went out of
>business. In our area, many "primary care" doctors will not accept
patients
>who are on Medicare. They take too much time, for too little money, for
too
>much civil and criminal liability.
>
>2. Big corporations - The iron law of wages still applies. Because medical
>care, financed by employer-supplied insurance, is just as much a part of
>compenstion as salary, they seek to minimize their expenses. Medical care
>may keep an employee on the job, but at a high cost. If the employee dies
>or quits, the cost is zero. Lousy care for dependents is an even better
>deal. The employee can keep working despite the demise of a family member.
>
>3. States - Medicaid is a no-win situation for a politician. More money
for
>Medicaid does not bring gratitude and votes. It just takes money away from
>state appropriations that could net support and campaign contributions from
>special interests. So, the states starve Medicaid.
>
>4. Money talks.
>
>5. We are not the source of the money, at least as far as elected officials
>are concerned.
>
>*****
>
>Lawyers and insurance companies are the strongest lobbies. Doctors are a
>weak lobby. The results are as expected.
>
>Bob



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