I’ve been thinking about trust among tour guides, mortgage brokers, and doctors. I don’t like not trusting people I hire to be my experts — whether on tour, in a bank, or in the hospital.
I’m in a crisis of trust with banking and medicine. I like my investment guy…but I don’t trust him. I don’t understand that business, and I don’t really believe he can do his work without being corrupted by the conflicts of interest he deals with when he advises me where to stow my money. It’s the same with brokers who knowingly sold thousands of Americans mortgages they didn’t understand and could never pay. This makes me sad.
I just gave a fundraiser talk for my HMO (GroupHealth in Seattle). One of my big fears is that my doctor will get me on some prescription medicine for the rest of my life in part because it is profitable to him (or the medical industry in general) for me to take that drug. I learned that my HMO has an ethic higher than that, and that the doctors there willingly make less money in order not to sell their souls by pushing pharmaceuticals on innocents like me. I told my HMO friend that I don’t want “choice”…I just want accessible, efficient, and affordable medicine motivated by my body’s needs, not a doctor’s bottom line.
(Coincidentally, I put my HMO to work fixing a hernia. I had surgery two days ago and was really impressed by the organization and the whole process. Writing this blog entry is the only work I’ve done all day.)
While tourism is small potatoes compared to banking and medicine, its corrupting influences can be instructive. I started my tour company 30 years ago out of a similar frustration with the existing system. Naive tourists were shuttled through Europe by slick tour guides who kept them in the dark and took them shopping for kickbacks. In Amsterdam, they skipped the Van Gogh Museum (which cost the tour company $10 a head and offered no kickbacks) for the diamond-polishing place (free and offering 20 percent kickbacks on diamonds purchased). Because of this violation of trust, a generation of Americans has seen diamonds in Amsterdam…but no Van Goghs.
Ages ago in my work as a tour organizer, I realized that the norm in the industry was to recommend trip cancellation and interruption insurance (both to avoid any liability if something went wrong, and to get a 30 percent commission from the insurance company). I figured the insurance companies were making a third, the travel agent was making a third, and the tourists were paying triple the actual value of the insurance — which they often shouldn’t have purchased in the first place. To recommend this (and get that 30 percent commission) might have been really profitable, but it seemed dishonest to me. Instead, I figured the overall cost of insuring all the travelers on my tour program would be something I could more efficiently include in the tour. By “self-insuring,” I could provide that coverage while adding only about 30 percent of the cost of the normal insurance coverage to the cost of our tours.
This is related to what my HMO is attempting to accomplish — and perhaps what our nation needs to do with medicine in general. (All statistics agree that Europeans — who have defragged their health costs smartly — spend one third what we do for health care.) I make money by offering a good tour, not by pushing a highly commissionable product. I like to think doctors want to do the same (but, as Flip Wilson explained, “The system makes them do it”).
Considering the challenges confronting our government and society today, I keep coming back to this trust issue. I think of all the clever young students lured into professions in medicine and finance and banking because there’s lots of money to be made, and I lament the loss of trust. Our money says “in God we trust”…but what about the rest of us?
Good posts (observations). It’s the opposite of that whole, “Greed is Good” mantra that so prevails in today’s culture. I think we’ve become so cynical as a society that we don’t really “Trust” anyone anymore and we begun to define “Success” as getting the better of (i.e., taken advantage of) the other guy.
Rick, your comments on tour insurance are interesting and, I think, worthy of expanding on in some fashion in another forum, if you haven’t already; what would you advise against serious illness and/or injury that can disrupt a vacation and might require an early return? What is your advice for independent travelers and those traveling with tour groups to other parts of the world that you don’t cover–Middle East, Asia, Latin America–and those groups require proof of insurance? Or parts of the world where a terrorist strike can disrupt a vacation? If anybody knows where Rick has addresse this issue previously, let me know–I need to bookmark it. Thanks.
Rick,Late last night I happened to watch your Iran story/trip on PBS.I had been to Iran in 1968,and other countries around the Med. while in the USAF.I didn’t have a chance to travel the backroads as much as I would have liked.I did mingle with the locals as much as possible and stayed away from the tourist traps.It’s a true shame that most Americans have no idea what the “real” people of the rest of the world are like.I’m so glad that I had the chance to walk the side streets,eat the local foods and hear the voices and sounds of those places.It’s my opinion that most of the rest of the world is more social,do more walking,and are not as plastic as we seem to be.Take the road less traveled,be open,and learn something for yourself would be my suggestion to anyone willing to explore. Thank you,enjoyed every minute of Iran.
Rick you have reason to worry as we all do in whom to trust. The other day my ex who is Cardiologist was complaining how the economy was hitting his practice hard- people lose jobs and health care benefits or people have to pay more into copays and thus go to the doctor less.In doctor speak I hear that meaning we have to squeeze people elsewhere and do more tests that we might not have done some which cost alot of money. As for mortgage brokers I think we all have duty of our own due diligence..if it seems too good it is. I am sure somewhere in the paperwork it spells out what you are expected to pay, too many people just sign without reading because they want what they want and think things will get better later. And financial investors or financial advisors I am wary of from the getgo as they make their money not on what is best for you but what is profitable for them and often sell life insurance or annuities that give them a big shot of money up front but of little benefit to you. Again due diligence listen to what they offer and then research. I have had outstanding experiences on your tours and good experiences on trafalgar, globus and insight as well. I would chose yours hands down but they are very expensive so sometimes you have to take the lesser expense and substitute and do your own thing, go to the Van Gogh yourself while they are visiting the diamond place. It is all about personal accountability.
Are you kidding me?? Most of my doctor collegues are in the red now with required insurance costs, frivolous law suits , and required changes into techno-medicine. While pharmaceutical companies make large profits, doctors are never tied into that profit……the Stark laws. Doctors don’t sell medicines. JJ
Great points Rick! I would add religion to this mix of trust issues. I am just reading World lit only by fire by William Manchester. In it he describes the state of the Catholic church 500 years ago how it was all about greed for money and power. The first thing I thought of was the televangelists of today with their phone lines open to accept tonations for their opulent life styles. It is so difficult for me to fathom that in todays day and age people are still falling for a scam like that. They are just preying for the old and frail of the society. I find is apalling. How is it possible to twist the beautiful message of love and kindness by Jesus to this? It is amazing how the organized religion still has such a strangle hold on the American society. The same way the medical industry is just there for profit and not cures. It is to their best interest for you to stay infit and unhealthy and hooked on medications for the rest of your life. US has a long way to go with these issues and I do not have any trust for the greed to lessen any time soon. There will always be unscrupulous people ready to take what they can from the good unsuspectin people.
As an MD, this is a very sad and ignorant post. If you stepped into the shoes of a clinician for one day, your head would spin with the stresses and responsibilities of taking care of thousands of patients. You honestly believe doctors benefit from prescribing certain medications. That is as opposite from the truth as one can get. I mean for pete’s sake, your job is to travel around Europe for a living…..what are you talking about?
Kaarina, perhaps you should talk to a few cancer survivors, who have been helped to recover by caring and skillful doctors and other health care professionals. Or talk to some social agencies who do everything in their power to assure competent care for all, even those who cannot pay for it. Ignore the televangelists and talk to your parish pastor, priest or rabbi and offer to help them in their work with the sick and broken in our society. You’ll feel a lot better, and you won’t have time to complain.
Yes, Rick, what about all those young people lured into fields such as medicine because they can make so much money? Maybe they need it to pay off their tuition loans–at some medical schools the yearly cost can be over $60,000. And let’s not forget those young people who are studying for the ministry or the priesthood. We all know the big bucks they will earn. In addition to you eagerness to comment on international affairs, have you now decided that you will play the role of the cynic about everything else? Maybe it’s time to get back to Europe and return to what you do best.
Check out the film Sicko by Michael Moore. Your eyes will be opened. It’s quite a slick movie touting healthcare. I am almost sold on some sort of national health coverage/insurance.
Good God Rick you sound totally paranoid. Doctors don’t make money off the pills they prescribe especially HMO doctors.HMO docs are told you prescribe formulary or the most least expensive medication to keep cost down. I had thought of taking a tour with your company and when I worked the numbers it came out that for every double room you book you pocket one of the two persons fee as profit. If you look at what you charge and what the hotel says they charge you are making a decent profit margin on the second person in the room. Do I say you are unethical or robbing me? NO ..I say that get the benefit of seeing a place I want to see or just don’t go because I feel I am getting riped off. I always take private travel insurance as I was ill in Europe one and it cost me a whole day waiting to be seen and a fortune because I had not been advised to get insurance. I think our country has outstanding medical care and would rather be in a comfortable private hospital here undergoing laser knife surgery instead of a hospital ward in Europe still using the human hand slicing and dicing. We even take our OTC meds for granted..here our ibuprofen is enteric coated in Europe it is not and tears up your stomach.
Rick, you’ve another firestorm in this blog if the first dozen responses are any indication. This traveler loves to read every energetic blogback (my word?) as learning comes from answers to a failure of clear communication. Here your blog clarity began well, yet slipped some through middle and end. Medical types seem to have the advantage with experience, so perhaps this subject needs more in-depth background. Ask your HMO Q&A expert about these blogbacks. Also on your tours insurance is vigorously suggested via the reliable company you often include the brochure of, in pre-tour followup/detail letters, so now (at 66) I alway buy. Great blogging. larry from springfield
Rick, I think you need to check your sources. I PRESCRIBE medications, I don’t sell them. Whether I presribe an old blood pressure medication like hydrochlorothiazide (old, cheap, and effective), the newest combination pill, or nothing at all, I get paid the exact same amount. Likewise, about 60% of all tests I order are probably unecessary, but I order them not because I get a kick-back (I don’t), but because I need to cover all of my bases in case, God forbid, I get sued someday (I wonder if the loser-pay-all legal system in Europe helps keep costs down by making frivolous lawsuits too expensive?). Despite it all, though, I love seeing patients and can’t imagine a better job in the world. That’s why I entered my profession, not that I was “lured” into it “because there’s lots of money to be made.” Love of the job is what gets me up everyday at 4:30 am to round on patients, not love of money.
Rick, GREAT posting!! First of all, I hope that you are feeling better and make a quick recovery. With respect to physicians and prescriptions, you are very accurate when it comes to the INFLUENCE of the “pill pushers” on some of the doctors. I used to see a physician who had tons of pharmacy reps in and out–and he offered plenty of samples–THEN, I had to pay. WOW! I am on Social Security due to MS and nearly went broke paying for these meds. I switched doctors and found that generic drugs were equally effective and far less expensive–like $4.00 per month versus $82.00 a month!! My former doctor also benefitted by having lunch catered in for his whole staff EVERY day–by the pharmacy reps. I often heard reps trying to schedule lunches and lunch hours were fully booked up for six (6) months!! Several reps even offered to bring in morning or afternoon coffee!! Another doctor–a specialist–recommended a prescription for me that would have run about $2000 a month—and Medicare even supplemented with an HMO–would still only cover a marginal portion of the cost. Oh, and that $2000 a month drug not only cost a LOT more than I receive a month, it carried a warning that it “could cause a fatal brain infection.” In my view, physicians, bankers, ANY service provider is “hired” by me and I have the authority to “fire” as I see fit. If more people had that attitude, service providers would be held to a higher standard and outside influences would be less effective. BTW–I declined the prescription that could cause a fatal brain infection and fired that doctor. It feels good to declare “You’re Fired!”
About 4 years ago I had a hernia operation. My insurance paid for most of it. I guess I paid about $200 of the $1200 or $1400. I asked what it would have cost if i didn’t have insurance and just walked in off the street. About $2400 is the answer I got. Sounds like the uninsured are double-screwed.
To the doctors posting here: Nobody likes it when their professional practices are called into question. And I’d like to think that most doctors always do what’s exclusively in the best interests of their patients. But just look at the vast sums of money pharmaceutical companies pour into marketing–from “ask your doctor about” advertising, to bursting expense accounts dedicated to wooing physicians–and it’s just common sense to stop and ask yourself: Are we really doing what’s in the best interests of the patient? If we’d have asked these questions a few years ago about home-buyers, our economy would be in a very different place right now.
I had a double hernia surgery 2 weeks ago and just recieved my EOB. I was in an obervatory pseudo recovery room for about 10 hours and it cost nearly $7000 just for the room and “observation” ($19,900 for the whole shabang). I had a few pills, my blood pressure taken by a PCT that probably earns $15.00 p/h and had my bandages changed. That does not seem like $7000 worth of care. My highly trained Dr and anisthesiologist were not even 20% of the bill. My issue and skeptisim lies within the hospitals themselves. go figure my verification word was “unwell”
By way of illumination, not confrontation, not all of our money says “In God We Trust”. The mid-1907 through mid-1908 St. Gaudens $20 Gold coins lacked this motto. Purportely, when questioned about it, Teddy Roosevelt is said to have remarked that “my God is not so small that his name needs to appear on money.” Knowing him to have been a pretty effective politician and populist, I think this story is apocryphal, but the coins are not.
Definitely a good post for discussion. I am going to make an assumption based on my interpretation of what you wrote. I guess this is a call for social medicine? Both our current system and social medicine have their drawbacks. Out current system is all about profit so you see this as being charged more than you should so that others make a profit. While socialized medicine may be lower out of pockets costs, we still pay for it through our taxes. And in many countries (including many in Europe), the quality of care has gone down as many well intentioned doctors have become nothing more than assembly line workers shuffling people in and out as quickly as possible. I would recommedn an overhaul to our current system. Change it so that there are price ceilings and some standarized costs for certain things. Hospitals and doctors can still remain private but people also aren’t ripped off either. If doctors and hospitals want to remain profitable, they can do so knowing the limits they can charge for certain things, finding efficient and better medicines through research, all while providing quality care. We probably need a hybrid system (yet one that is very different from the one in France). Our system insn’t perfect and it could use some changes. But social medicine has many drawbacks as well. You would be exchanging one faulty system for another so why not reform the one we already have?
Hope you are feeling better. I really think that doctors have their hands tied. I just had GallBladder Surgery 6 weeks ago. And I felt like no one would commit to doing anything. My troubles started in September and my Surgery was February. If they don’t cross all T’s And dot all I’s and run a million tests first nothing can be done. We need doctors not to be dictated by insurance people. It is scarey to think non doctors are letting you have treatment or not. As far as investment people go, my parents are in there 80’s and have taken care of their own mony their whole life (conservative investments) and now when all there friends have lost everything, they are in a beautiful assit living place living out their life confortably and not burdening their children to have to care for them. Oh, and my experience with prescriptions again is totally dicatated by what Blue Shield says I can have.
Rick, I hope you are feeling better and on your way to a speedy recovery. You must be feeling the effects of some of your drugs after reading this post. You know, I have the same “trust” issues with the travel industry. You know those guys that do tours, sell books and post unbelievable posts on their websites? All the best.
Do you want to know why meds are so expensive? First billions of dollars of research is done by MD’s, PhD’s, MD/PhD’s, botonists, geneticists, cellular biologists, physicists, ect. People who have spent 5-10 years just in higher education alone. And don’t forget that all their classes had labs that doubled the amount of school work and hours they invested. So should they be paid commensurate with their education? Next, human testing has to be done which is not without expense. Last, they will only be allowed to sell their product for a limited number of years (7-10) before their corner on the market expires and legally other companies can then sell it generically. So when those companies put a price tag on their meds, they must first make a large enough profit to pay for their breakthroughs, cover their busts, and then have money to start on the next wonder drug. And don’t forget insurance for when they are sued and to give it away to all the people who can’t afford it but somehow think they are ENTITLED to it anyway.
SO, WHERE IN EUROPE DID YOU HAVE YOUR SURGERY?
Interesting blog and very timely. I hope you feeling much better. As someone mentioned, I would like you to address travel insurance. Do you purchase travel insurance every time you or your family member goes to Europe, Costa Rica, etc? If so where do you purchase it or do you have a special plan since you are in the industry and travel all the time. The AIG (four letter word at this time) travel insurance brochure included in your tour packets cost an arm and a leg (over $300 for me). I recently purchased airline tickets to Europe through Travelocity and bought their insurance for $19.95 which covers emergency medical evacuation. My health insurance covers me world wide (not an HMO) and I pay dearly for it. There are so many things I don’t understand why travel insurance is needed and why it costs so much. Perhaps you could address this in a separate blog. Thanks!
One of my Writing Gems is ===== “Wouldn’t you rather trust everyone all of the time and be wrong once in a while, than trust no one at any time, and be right once in a while.” ===== I used that idea in my business many times, but never when a lawyer was involved. They don’t know the meaning of the word trust. For example, one afternoon I sold a house. The buyer and I agreed on the price, the down payment, and all the other details, and were to meet at the Escrow office at 9 AM the next day. The buyer pulled out a tablet and his checkbook, and started to write. I said, “We agreed to meet at the Escrow office at 9 in the morning, and if we can’t trust each other that long, we should find that out right now, not after some papers are signed, and money paid.†The man was shocked, but agreed I was right. I used that idea of trust many times in both business and personal life. As for mal-practice insurance, that should be purchased by the patient, not the Dr., just like you purchase insurance along with your airline ticket. You should be able to purchase insurance to cover any incident you wish, medical, travel, auto, life, investment. But the key words are, “You pay for it.â€
I’ve read that drug companies spend more money on advertising than research. To those that are still supporters of our disfunctional health care system: It is strangling us, from the smallest families to the largest corporations. If it takes a crisis to reform it, so be it.
Hasty, overly-broad generalizations are seldom accurate. I deeply appreciate the care I have received over my life time from doctors and nurses. Some are incredibly good at what they do while others are less so. When you meet one that is not up to your standards, stop, turn around and find another one. I am a capitalist and have been my entire adult life; however, for capitalism to work we need an educated society, willing to allow some to fail and others to win, and absolutely need to have a moral, ethical citizenry. Government, through voter support, draws the line at how far we are willing to allow people to fail before being propped up. Tax policy allows the gov’t to dictate how much individuals can win. I am concerned about the gap between the poor and the rich in the US; those outlandish salaries need to stop; tax all earnings over one million at 90% for a few years until we can begin to trust corp. boards not to be so stupid when handing out compensation packages to management. Outlaw homelessness by opening farms and ranches where people must work to eat and are provided tech schools and other educational opportunities to learn trades and skills for jobs in society. Sometimes the invisible hand does not need to be so invisible. Get well soon, Rick!
Advance warning – if you’re not interested in how Rick’s comments apply to the medical world, skip my posts, and yes, it’s going to take more than one, given the character limit, for me to say what I want to contribute. Firstly, I’m NOT an MD. I’m a software author, and I’ve worked, on contract, for three of the biggest pharmaceutical companies in the world. I’ve also worked for a small medical software house, and via there, got to know another company who are relevant to this discussion. Should anyone feel that it makes a difference, I’m British, but living in the USA since I married an American, so I’ve seen both the British National Health Service and the American insurance-driven model at first hand. On the R&D front, I’ve seen how much pharmaceutical research can cost, and it’s not cheap. From what I knew of (European?) patent law, though, the drug companies get the exclusive rights to their drug for twenty years (not seven, or ten) starting when they file for the patent. The fact that the lifetime of a branded drug is less than that is due to the fact that the pharmas choose to file the patent at an early stage – the trade-off between the lifetime of their drug before it can go generic, and the security of ensuring that a competitor can’t beat them to it, is their call. They DO charge whatever price will maximize those profits, though, which is why you see the uninsured importing drugs from outside the USA, despite what the FDA might recommend. And yes, setting your price to maximise your profits is a standard practice – I’m just a little uneasy about it under what is effectively monopoly conditions when you have a branded drug. Now, to move on to doctors and how they prescribe different drugs. Someone mentioned about their doctor giving them free samples of an expensive branded drug, only to find they could then get a much cheaper generic. Well, duh! Doctors are only going to give out what free samples they’re given (continued below)
Get well soon. glad to know your operation went well.
and does it really come as a surprise to anyone that they only get supplies of branded, i.e. expensive, drugs? If any of the MDs posting here have heard of a company giving out free samples of a generic, then I’ll take their word for it, but will be totally amazed, because after all, the doctors don’t control which company the drugstore buys its generics from. As regards drug companies “influencing” doctors, I can only recount a visit which I was on to a company in Maryland – that company’s business was to send round surveys to doctors trying to find out which other doctors they would call if they needed some advice in a particular area. When those surveys were returned, the company concerned plugged the answers into some social networking software (I’m not going to explain that, if you don’t know what it means, Google will find you plenty of references). Once they had identified the “influential” doctors for a particular area, the results were sold to the pharmaceutical companies to help them “target” their “marketing efforts”. Before the MDs here try to have me deported, I’m NOT, of course, alleging direct bribery. I AM suggesting (because that’s how we were told it worked) that things like invites to conferences would be sent out on the basis of this data (never heard of them queueing up to buy the surgery staff lunch, though). As regards the billing side of things, then I think the whole mess stinks. The insurance companies are trying to screw the MDs, the MDs aren’t exactly sitting back and taking it (limited as to what I can say here), and the biggest injustice of all is the billing of the uninsured. I ended up in an emergency room in New Jersey about 10 years ago. Due to a typo on my details, the hospital had me flagged as uninsured, and sent me a bill. I got it sorted out PDQ, of course, but the hospital accepted LESS THAN ONE TENTH of what they billed me in full settlement from my insurance company. That CANNOT be right.
Regarding any kind of medical research, much of it is funded by grants and donations. I am involved in showing dogs and my particular breed (Dobermans) has a genetic bleeding disorder for which the Doberman Pinscher Club of America collected massive amounts of money to donate to a university doing research to find the genetic marker for the disorder. In addition to the money, club members also donated their dogs’ DNA for these studies. After it was all said and done and a marker was found, they sold the rights to the testing to a for-profit company that now charges us 3 times what would be a profitable amount. People in the know–professional medical lab technicians–have said that with all overhead accounted for, the test costs the company about $15. The company could comfortably make a profit charging $50. Instead they charge $149. If we are lucky, they occasionally throw us a bone and have a special on the testing (usually $99 with a minimum of 25 dogs being tested). Because of this example, I take with a big grain of salt any claims as to how hard it is for companies like this to make a profit.
Socialized Medicine-Right now I can’t think of one thing the govenment is managing well. Do we really want a politician to tell us we can’t have a treatment that would save our life because it costs too much?
Any different than having someone at an HMO do it?
And while both the government and private industry have their share of things they do well and not so well. I can think of plenty of things the government does well and plenty that private industry does not.
Rick, Thanks again for sharing your insights as well as your lack of information on topics that would be better served by someone who is a bit more informed. You seem to imply that most doctors are pushings meds and making money off of it. I happen to be married to a doctor and work with many of them. If you researched this topic a bit more (like others topics you are ill-equipped to comment on) you would find that many if not most do not make a dime from prescribing meds and often prescribe generics to keep costs low for their patients. You have much more credibility when you comment on the dishonesty in the tour industry than you do in healthcare. Fondly, A Rick Steves fan who wishes you would stick to topics that you are more equipped and more informed to handle.
can’t think one one thing the government is hadling well? My gosh! My mother gets her social security check like clockwork and it is correctly calculated each time. She has had both hips and a knee replaced…on medicaside, I believe. I am estatic about the mail service we have in this country. I’m 57 and have never lost a letter. I’m very grateful for our usa infrastructure of roads, bridges, etc. Pretty damn proud of our military. Our educational system is wonderful. I could go on all day long about how many things work well…no body bats 1000 and I hope that is not what you expect.
Okay, does anyone REALLY know ALL the details concerning the health care system?????? I don’t, but I have had a lot of people in the industry tell very different versions of the story. I used to trust (like an idiot) my doctor, until I witnessed him asking my husband what drugs he needed while he sat with his pen and prescription pad ready to accommodate. When hubby OD’D on Oxycotine and was in the hospital for days…my doctors partner explained that doctors are taught in medical school to push drugs. He told me that people like me who are not eager to take drugs before trying every other means of healing, are in the minority. And that most patients want a quick fix rather than hear they need to lose weight, eat better foods, etc… “To Push drugs!” in medical school. And if you think “kickbacks” aren’t had, your head is in the sand. As far as the comments in defense of doctors positions on all this, I have heard from doctors that if it wasn’t for the insurance companies, they could do MORE for patients for LESS. And that it is the INSURANCE companies who are telling the medical field how to run a hospital and how to treat patients. A friend of mine has cancer, with minimal insurance coverage. He met with a hospital to get set up on chemo treatments and the costs involved. He got a second opinion from a much better hospital and found a $6000 a treatment difference in price. Now come on. What’s the deal. Note that his insurance only covers $1000 a treatment. I think the first hospital was seeing green. And stockbrokers…. Don’t even get me started. Anyone who gives their hard earned money to these people…. My advise, don’t save it at all, go on one of Ricks Tours instead. Or, give it to a stockbroker and kiss it goodbye while THEY go on a nice trip. Get a book on money and investing and learn to do your own investing. (online or with Schwab) To sum all this up… GREED! GREED! GREED!
Rick, hate to disagree with your take on “healthcare” in Europe. I have experienced the socialized care in the U.K. and some on the continent. They spend less because they tell the elderly if they need something to expensive, tough. They have healthcare rationing boards that decide who is contributing and who isn’t. Recently one Hospital was under fire for just turning sheets over in beds cause it was cheaper than washing. I lost a 34 year old cousin from a mild stroke that he was unable to get a doctor for for two hours after reporting. The Amb. arrived and then called for an EMT and the he called for a doctor. E was brain dead by the time they approved the expensive drug that would have controlled the stroke. We have the best care in the world because it is still profitable. But I am sure Pres. B.O. will kill that industry to.
Um, we do not have nearly the best care in the world. We DO, however, far outspend the rest of the world. Whether it’s pharma getting unconscionably rich, doctors getting “legal” graft, or the insurers playing all sides against each other, the ONLY formula that matters is we spend by far the most on healthcare, almost doubling our next closest competitor, Switzerland (and that figure is estimated to double in the next 10 years) [sidenote: doctors incomes in the U.S. are double every major industrialized country except Germany] So we pay the MOST… but here’s the kicker, the U.S. ranks between 37th and 74th in the world in healthcare (depending who you ask and measuring things as diverse as response times to the numbers of uninsured.) Though we do have the best ranked emergency care. Among the top 12 industrialized nations, we are 10th in life expectancy, FIRST in infant mortality, and Death rate of 1-to-4 year olds and 15-24 year olds. That is a BROKEN system, if I’ve ever seen one. In medicine, like in media, technology and intellectual property, the old models of profit and ownership are, if not crumbling, evolving into more progressive, democratized systems. Some form of socialized healthcare is inevitible in ANY advanced society, if the option is tens of millions without healthcare.
I was recently dissapointed by The Times, the English newspaper. In an article titled ‘Six brilliant budget hotels in…. Rome’ (http://www.timesonline.co.uk/tol/travel/where_to_stay/article5987293.ece) the author doesn’t explain that #1 and #2 in the list are pretty much the same company. The impression is that the author is either a) lazy – not wanting to do more research and b) doing someone a favour. Am I expecting too much transparency perhaps? I’ve blogged about this here: http://www.rome-rentals-co.com/blog/everything-else/the-times-travel-authority Cheers, Lawrence
I really don’t think docs are out to make a buck prescribing pills (at least in the commission sense). Most learn in med school that if a patient goes home without a prescription, they’ll find another doctor who’ll write a prescription. For some reason too many patients equate pills with good medicine. I look for doctors that give me alternatives to prescriptions. Maybe if more patients did that, it would change the way medicine is practised. As far as investments are concerned. If I had money, I’d go to a trust department at a bank. They give you a lot of service for a very small fee. Alternitavely, I would choose an investment advisor who works on fee rather than commission to eliminate the conflict of interest you mention.
Very nice…….I’m sure it will help many people….. job without office
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