paguyomd

I know stuff has to cost, but why does it cost SO much?

Healthcare in the US is twice as much as it is in other countries. The reason why this is is because everyone is gaming the system, for example, insurance companies, health industries, businesses, lobbyists, government officials, even the public at times, everyone. This created the 13 major problems that has led to the crisis in our healthcare system. These 13 major problems are 1) abuses by patients, 2) over utilization by healthcare professionals, 3) profit motivated companies (this includes both for-profit and non-profit), 4) malpractice and litigation, 5) defensive medicine, 6) new technological advances in healthcare, 7) illegal immigrants and non-permanent residence, 8) capping and limitation of medical benefits, 9) fraudulent claims, 10) lobbying and politics, 11) isolating the public from the actual cost of their care, 12) health attitude of Americans (though changing), 13) cumbersome paperwork.

Medicare is the most efficient system in the United States today (and the VA is very efficient as well) so why doesn't our government care about the well being of its citizens? Why isn't Medicare an option for any citizen?

Medicare is working fairly well for only a limited number of our population. The way it is set up now is not through a single-payer unlike those of Canada, United Kingdom, and other countries. The ones who are implementing our current system are only looking for their own advantage. My proposal is basically expanding Medicare for all, but set up in a way that eliminates all the problems with our present healthcare.

Coming to America in the 60s, why did you choose Minnesota over more popular places for Filipino physicians like Albany, NY?

When I first moved to the US, I was in New York for two years on internship. I applied to various Ivy League institutions for residency. However, Minnesota was the first institution that accepted me before my deadline as a resident physician, so I signed and mailed the contract. 24 hours later, the other institutions I applied to also accepted me!

What are boomer physicians doing to protect the next generation of physicians from mid level creep? I've heard stories of new doctors being laid off to be replaced by an NP, what can older docs do to help the young ones out?

I believe that the best way for older physicians to help the younger physicians is by becoming politically active alongside the younger physicians and advocating for the proper roles of the physician and other healthcare providers.

During my time, before the emergence of doctor's assistants, there was a lot of demand to save money for medical services. Initially, mid-level health providers were allowed to do some physicians work in order to save money. Over the years, more mid-level health providers became politically active and asked for higher wages. This has evolved into the current situation, and a lot of the older physicians believe that they have lost their freedom to practice medicine and that everything is overly controlled by the business of insurance.

Yes, if majority of US citizens call their state representatives, senators, governors, etc. and advocate strongly for it. Politicians will only listen to the constituents that interact with them. Therefore, we all need to flood them with emails and phone calls of what we want. This is why lobbyist have so much power.

Do you have any tips for figuring out if a doctor is useless or good early on rather than having to experience them making some insane diagnosis/give insane advice/say something awful?

In this day and age, we really have to advocate for ourselves to find good care. Always have a primary doctor or family doctor that you can go back to. If your first encounter with your doctor isn't good, it's okay to change them. Ask your peers who their primary doctors are, or call clinics or hospitals to see who they would recommend. Your primary physician can help you navigate and recommend specialists to help you. Unfortunately, insurance companies have networks that prevent you from going out of network and limits your choice of physician. I believe that we should be able to choose our own physicians regardless of networks!