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Author Topic: The American Constitution  (Read 81030 times)

Alan Goldhammer

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Re: The American Constitution
« Reply #340 on: June 09, 2019, 05:13:51 pm »

There's a variety of reasons doctors might choose to earn a living from something other than medicine. Money is but one of them. It played no part in my decision.

Jeremy
Quite right.   There will never be a shortage of doctors in the US but there can be a poor distribution.   More worrisome are the closing of lots of small rural hospitals.

Addressing some points raised by Joe and Alan about Obamacare,  it is not to blame.  Premiums and co-pays are going up for everyone.   I am on the board of a non- profit with a large endowment that provides health insurance to research fellows at a major biomedical research institution.   I serve on both the insurance and investment committees.   I have first hand knowledge about the rate of premium increases and utilization.   All it takes is a couple of premature births to put the program in trouble and increase premiums in subsequent years.   It is a complicated issue.

There are also a number of physicians groups that support some form of universal insurance coverage here in the US.  Medicare for all is not the only possible model.
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Tony Jay

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Re: The American Constitution
« Reply #341 on: June 09, 2019, 07:25:26 pm »

So, where is the disagreement?
There is absolutely no unpaid remuneration!
You tried to make out that there was...

You seem to have a problem with short-term memory!
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Slobodan Blagojevic

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Re: The American Constitution
« Reply #342 on: June 09, 2019, 07:41:37 pm »

There is absolutely no unpaid remuneration!
You tried to make out that there was...

Please quote where I said that.

I said the exact opposite, and I repeat:

... Not really working for free, but spending two years on recertification, while not working, i.e., not receiving a salary...

Alan Klein

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Re: The American Constitution
« Reply #343 on: June 09, 2019, 08:06:25 pm »

Quite right.   There will never be a shortage of doctors in the US but there can be a poor distribution.   More worrisome are the closing of lots of small rural hospitals.

Addressing some points raised by Joe and Alan about Obamacare,  it is not to blame.  Premiums and co-pays are going up for everyone.   I am on the board of a non- profit with a large endowment that provides health insurance to research fellows at a major biomedical research institution.   I serve on both the insurance and investment committees.   I have first hand knowledge about the rate of premium increases and utilization.   All it takes is a couple of premature births to put the program in trouble and increase premiums in subsequent years.   It is a complicated issue.

There are also a number of physicians groups that support some form of universal insurance coverage here in the US.  Medicare for all is not the only possible model.


What other models?

Tony Jay

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Re: The American Constitution
« Reply #344 on: June 09, 2019, 09:07:41 pm »

I have a friend who underwent a medical certification program in America. Had a chat with her this morning. She said that the process might take 2-3 years. She also said that the medical part is hardly trivial.

Here is a transcript from our chat, so see for yourself (pardon her typos, she was at work, and generally not caring about typos):
What your friend is referring to is the United States Medical Licensing Exam also known as the USMLE's.
No one, under ANY circumstances, can practise medicine in the US without passing this exam. This applies to domestic medical school graduates as well as international graduates...

If your friend was silly enough to travel to the US FIRST before writing this exam and then complain about having to sit around not earning while preparing for and writing these exams then they only have themselves to blame!

I know plenty of people who have written, and passed, the USMLE's. In every case they stayed at home and worked locally while preparing and writing these exams. One is NOT required to go to the USA to either prepare or write these exams.

As for the content that is examined the USMLE's concentrate a lot on cell biology and genetics - these topics are often not well covered in undergraduate medical courses that are located outside Western Europe, Canada, and Oceania. So, yes, it may take time to adequately prepare for these exams...

However, all you have done is move the goalposts! It still has nothing to do with your assertion that doctors are required to work without pay... No doctor can work in a particular jurisdiction until they have fulfilled the conditions for registration!
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Slobodan Blagojevic

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Re: The American Constitution
« Reply #345 on: June 09, 2019, 10:05:09 pm »

...your assertion that doctors are required to work without pay...

Oh, for God's sake Tony, stop it!!!

Prove it or stop it! Please quote where I "asserted that doctors are required to work without pay"

If you do not quote me, and do not apologize, I will report you to the moderator for harassment, something I have rarely, or ever, done. But enough is enough.

EDITED to remove inappropriate language, with my apologies for it. I regret the strikethrough part.
« Last Edit: June 10, 2019, 11:21:28 am by Slobodan Blagojevic »
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Alan Goldhammer

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Re: The American Constitution
« Reply #346 on: June 09, 2019, 10:57:27 pm »


What other models?
regulated  insurance markets as they have in Germany,  Switzerland,  and Holland.   TR Reid, a former Washington Post correspondent,  wrote a nice book on this topic about a decade ago.   When he was posted abroad he and his family had experience with a number of heath systems with positive results.

One can also do a voucher system where everyone buys a basic insurance policy.   You can also buy secondary coverage if desired.   This eliminates all corporate sponsored plans as well as Medicare and Medicaid.   HR departments would love this as it gets them out of the healthcare business.
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Jeremy Roussak

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Re: The American Constitution
« Reply #347 on: June 10, 2019, 03:07:05 am »

Slobodan, watch your language.

Jeremy
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Rob C

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Re: The American Constitution
« Reply #348 on: June 10, 2019, 07:28:26 am »

I read that the ambassador - or some other guy with a title - from the States said that if the UK leaves Europe, trade negotiations with that country - America - will be expected to include the health sytem. Where do some of these guys think they are coming from, to almost end a sentence with a proposition, which I narrowly avoided doing.

Hands off! Don't mess with a better way than the one you have at home. You know, like the little fox wot lost its tail and wanted the rest to have theirs chopped of too?

Yet, yet, his buddy (if he has one) Farage may say it will save us an additional 350 million pounds a week. Be sure the blonde one will not be out of tune either. Bad politics is infectious, it seems: one shaken pair of hands, and away we go.

Rob

Alan Klein

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Re: The American Constitution
« Reply #349 on: June 10, 2019, 07:46:56 am »

I read that the ambassador - or some other guy with a title - from the States said that if the UK leaves Europe, trade negotiations with that country - America - will be expected to include the health sytem. Where do some of these guys think they are coming from, to almost end a sentence with a proposition, which I narrowly avoided doing.

Hands off! Don't mess with a better way than the one you have at home. You know, like the little fox wot lost its tail and wanted the rest to have theirs chopped of too?

Yet, yet, his buddy (if he has one) Farage may say it will save us an additional 350 million pounds a week. Be sure the blonde one will not be out of tune either. Bad politics is infectious, it seems: one shaken pair of hands, and away we go.

Rob

There's no health care rules in the new USMCA trade agreement between the US, Mexico and Canada.  Why do you assume there will be between America and the UK?  I can't imagine Britain giving up its healthcare system or America insisting they do.

jeremyrh

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Re: The American Constitution
« Reply #350 on: June 10, 2019, 08:10:00 am »

I read that the ambassador - or some other guy with a title - from the States said that if the UK leaves Europe, trade negotiations with that country - America - will be expected to include the health sytem.

Yes, the ambassador. Also Trump said the same thing.
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Rob C

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Re: The American Constitution
« Reply #351 on: June 10, 2019, 08:40:19 am »

There's no health care rules in the new USMCA trade agreement between the US, Mexico and Canada.  Why do you assume there will be between America and the UK?  I can't imagine Britain giving up its healthcare system or America insisting they do.

Simply because your man over here said that was his country's position. You couldn't make these things up without fearing being taken for a raving lunatic.

But hey, just like the current spat with Mexico: yesterday we say we hit you today, today we say we won't. Cool stuff designed to impress a very red neck into thinking positive thoughts about imminent domestic salvation. Russia must be pouring out the champagne, unable to believe its luck.

International diplomacy was not invented just for fun; it's the language that ensures co-existence will result in mutual survival; riding roughshod over it means one thing: you lose international respect and credibility and put yourself outwith civilised, common rules of behaviour. A good way for a pariah to be born.
« Last Edit: June 10, 2019, 08:47:04 am by Rob C »
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Alan Klein

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Re: The American Constitution
« Reply #352 on: June 10, 2019, 08:59:57 am »

Simply because your man over here said that was his country's position. You couldn't make these things up without fearing being taken for a raving lunatic.

But hey, just like the current spat with Mexico: yesterday we say we hit you today, today we say we won't. Cool stuff designed to impress a very red neck into thinking positive thoughts about imminent domestic salvation. Russia must be pouring out the champagne, unable to believe its luck.

International diplomacy was not invented just for fun; it's the language that ensures co-existence will result in mutual survival; riding roughshod over it means one thing: you lose international respect and credibility and put yourself outwith covilized, common rules of behaviour. A good way for a pariah to be born.


Haven;t people figured out that Trump is always negotiating?  He's always looking for an edge.  He always asks for more than he expects to get in the end.  The problem is Europeans aren't use to it.  Previous presidents rolled over and were weak, feckless. They gave away the store.     They're not use to a strong president.  Yes, even nasty at times. 

Look at the problems we have with China.  They're stealing us (and you) blind.  They follow no rules. 

Mexico is allowing illegals to pass through their country to invade our land.  They could stop that overnight as they do with illegals who want to stay in Mexico.  They put those people in their jails.  So Trump is squeezing them.  Rightfully so.  Don't European countries stop illegals?  International diplomacy is a two-way street. You can't expect America to play by rules that you don;t play by.   

degrub

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Re: The American Constitution
« Reply #353 on: June 10, 2019, 09:14:16 am »

the Chinese do follow a rule - work for themselves for the benefit of greater China.
We made decisions to not place certain technology in PRC because of that rule.
A business working in PRC ignores that at their peril.
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Alan Klein

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Re: The American Constitution
« Reply #354 on: June 10, 2019, 09:27:06 am »

the Chinese do follow a rule - work for themselves for the benefit of greater China.
We made decisions to not place certain technology in PRC because of that rule.
A business working in PRC ignores that at their peril.

Good for you.  What country are you in?

Of course, China often insists that companies have to give them their technology to work or sell in China.  So you have only certain ways to limit.  But China also outright steals intellectual property.  Then they manufacture those products at less cost.  Why do business with thieves.  I don;t know if tariffs will work, but we have to do something to stop the stealing.   It's not right and no way to do business. 

32BT

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Re: The American Constitution
« Reply #355 on: June 10, 2019, 09:30:42 am »

Good for you.  What country are you in?

Of course, China often insists that companies have to give them their technology to work or sell in China.  So you have only certain ways to limit.  But China also outright steals intellectual property.  Then they manufacture those products at less cost.  Why do business with thieves.  I don;t know if tariffs will work, but we have to do something to stop the stealing.   It's not right and no way to do business.

How is that not right?
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degrub

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Re: The American Constitution
« Reply #356 on: June 10, 2019, 09:35:53 am »

US. It is not just the Chinese though. We had a fun case once - a Japanese company manufacturing materials in PRC stole one of our processes outside of PRC, came to us and basically said - either do a JV with us or we will beat you on price world wide". They were after getting into the US market because of certain restrictions they could not breach. We couldn't afford to loose the  global market so we did the JV. But we were able to keep them out of the US market by withholding a few technology tricks they could not figure out that would have allowed them to meet the import restrictions.
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Alan Klein

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Re: The American Constitution
« Reply #357 on: June 10, 2019, 09:47:16 am »

How is that not right?

Well, they can do whatever they want.  But we don't have to do business with them if they do or challenge them with other measures.  When I was in business, there were people and companies I refused to do business with because they were lousy payers or were plain cheats.  Trade is a two-way street.  If one side has its thumb on the scale, why would you want to business with them?

How did you treat your customers and business partners? Sure, you can negotiate hard.  That happens all the time.  But,  I'm sure you were forthright and honest.   Well, countries should be too. 

degrub

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Re: The American Constitution
« Reply #358 on: June 10, 2019, 11:20:41 am »

unfortunately, that is not always the working assumption in Asia. It is more "how can i take advantage of this without being obvious" rather than "honest" and straightforward. A significant cultural difference to western  values.
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Alan Klein

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Re: The American Constitution
« Reply #359 on: June 10, 2019, 11:46:38 am »

unfortunately, that is not always the working assumption in Asia. It is more "how can i take advantage of this without being obvious" rather than "honest" and straightforward. A significant cultural difference to western  values.
So because the other guy cheats, we should lower ourselves and cheat too to even it up?   Here's a magazine cover relating to that kind of thumb on the scale approach to business.
https://www.google.com/search?q=thumb+on+the+scale&rlz=1C1CHBD_enUS746US746&tbm=isch&source=iu&ictx=1&fir=a6zNIVxgNP3PEM%252CzbOPNv8I5HNY_M%252C_&vet=1&usg=AI4_-kTmjWwX_s5Mk57tz8kbHWRvS9SLHw&sa=X&ved=2ahUKEwjT5pW4oN_iAhWRd98KHcxxBgwQ_h0wDXoECAwQBA&biw=1745&bih=961#imgrc=a6zNIVxgNP3PEM:&vet=1
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