🚀 go-pugleaf

In article <1992Jun30.195431.14274@mprgate.mpr.ca>, 
    mcvey@mpr.ca (Iain McVey) writes:

> 
> This socialism you seek seems to include a built in class distinction.
> What is it about the profession of medicine that makes people believe
> doctors should make so much of a better living than the people who pay
> for their services?
> 
	How about:

		- the length of time it takes to learn the profession.
		- the stress of making life-or-death decisions.
		- the long hours of work and expectation of availability
		  virtually 24 hours/day.
		- the requirement to pay substantial overhead costs
		  (office costs and equipment) from this income [ it's the
		  gross income that's being capped, not net ]

	Why should the income of the client have any bearing on the income
of the doctor  [ should people get price breaks on cars 
because of their income ]. Because of health insurance the
client is not paying directly, so his income is irrelevant.

> These doctor's wages are being capped, not cut.  When was the last time
> you saw a poor doctor?  I for one would rather see the money being spent
> on health care get spent on medical equipment, and opening extra hospital
> beds, rather than increasing the salary of doctors.
> 
  Poor is a relative term. Many doctors make less money than lawyers,
accountants, real-estate agents, stockbrokers. To me a
good physician has more value to society than any of the above (maybe not
to a particular client, but to the population in general)

> Perhaps you should also have mentioned to the american's listenning that
> BC uses government funds to pay for a pension fund for our highest paid
> professionals, namely doctors.  Not only are our doctors well paid over
> a very long professional career, but we as taxpayers then make sure they
> maintain that standard of living into their retirement.  One would think
> that government pension plans are better suited for the masses of lower
> paid citizens, who can not draw from such long and prosperous careers,
> to save for retirement.
> 

  A pension plan is just a different way of apportioning money from the same
pot. It was presumably intended to have tax advantages for the doctor over
just getting more direct income. This is the kind of thing that goes on
all the time in the private sector ( ie making business decisions with an
aim to reducing tax liability ), if the doctors were willing to take a lower
fee because the pension plan was created then that's a fair decision 
[whether or not it was a "good" deal is not relevant, the goverment of the
day made it and the doctors have a right to expect the current goverment
to live up to the commitment]

  It seems to me that the focus of the government's efforts is wrong. I
acknowledge that health care costs are substantial ( although they are
not any greater portion of the GNP today than they were 10 years ago ), but
there is also a great deal of waste in the system ( unnecessary visits
to the doctor, people being placed in expensive acute care facilities because
there aren't enough long term care beds available, people being hospitalized
so that the system will pay for expensive drugs that they could administer
at home but would then have to pay for themselves ). Granted, in many cases
a particular physician may be contributing to the problem, but the system
as a whole does little to prevent the abuse or to provide the necessary
alternatives [ more long term care beds, certain drug costs paid by insurance
plan, better home care support ]. The blanket approach of capping fees 
penalizes the doctors who are providing necessary services as well as
the abusers.

========================================================================
Malcolm Dunnett    Malaspina College         Email: dunnett@mala.bc.ca
Computer Services  Nanaimo, B.C. CANADA        Tel: (604)755-8738