Friday, July 18, 2014

Ouch

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From @metabolome. The truth, it hurts.

14 comments:

  1. That used to be my favorite pastime - composing snide replies on membership invitations and mailing them back in supplied prepaid envelopes. Sadly, for some reason they stopped sending those to me.

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  2. Bring the MoviesJuly 18, 2014 at 2:50 PM

    I like putting fast food coupons in pre-paid envelopes for credit card applications, and mailing them back. And Im an old fart at that.

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  3. In years (well, decades) gone by, I had been known to include a piece of lead sheet in the prepaid envelope. These days, I suspect Homeland Stupidity would come after me... It would definitely show as a shadow on the X-ray. gr

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  4. oldnuke if not HS then perhaps EPA would send you a fine as a serial polluter. I for one am curious to any rationale for return Pb sheet? Did it make envelop over weight so additional postage had to be collected or just because you had access to supply? (I recall old MS systems used to require gold leaf that came in sheets which occasionally went missing, and was suspected to have beenmailed home to some Asian country, until the prof in charge locked in his office and doled out after confirming was needed)

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  5. Unfortunately, the ACA may make med school a not such a great option. Very high debt on completion (certainty) and capped salaries (probably) will make it unattractive to anyone that does not want to be a slave to debt.

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    1. Can you figure out a way to make a good, long bet out of this, Harry? I bet capped salaries for MDs are very far off in the future (not happening in 10 years, say.)

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    2. Capped salaries are here. With the changes to the healthcare system private practices are closing up shop and doctors are joining major hospitals. With government controlling prices of healthcare how is this not capped?

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    3. CJ: Any physician who accepts Medicaid or Medicare patients has a de facto cap on his/her salary. Medicaid/Medicare reimbursement rates are fixed and are not strictly indexed to market forces. Additionally, reimbursement is typically pennies on the dollar of physician expense and the time to reimbursement is lengthy, requiring the physician to carry that expense forward for months. Here's a good article from Forbes: http://www.forbes.com/sites/peterubel/2013/11/07/why-many-physicians-are-reluctant-to-see-medicaid-patients/

      Now, substitute ACA for "Medicaid/Medicare" and you have the same situation with a different name.

      So, I'll take that bet, short term or long. How about an after dinner drink of the winner's favorite adult beverage at an ACS meeting? I really like 18-25 year old single malt Scotch; and the best Scotch is the one I don't pay for.

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    4. 1) Medicare is single-payer - program controls the horizontal, the vertical, contrast, etc. Obamacare runs through insurance companies - there isn't a single payer, so no one to enforce pay standards (at least, any more than insurance companies set them now). If the coverage standards Obamacare has favor big insurance companies enough to form an oligopoly, or the program is changed to single-payer (unlikely), then setting (effective) caps on doctor pay would be more possible than now, but not a guarantee unless single payer is put into law.

      2) Doctors don't have to take insurance, so the insurance companies don't have the uniform ability to set pay. If they have enough patients willing to pay upfront to see them, they can get what they can get.

      3) If the government paid for med school, they would have the legal ability to force doctors to work (at least a certain amount) in their health care system. The high costs that might make it hard for doctors (even if single-payer doesn't happen; no one likes insurance companies, and they make money in part by not paying claims, so doctors still have uncertainty in wages, even when their competition is limited by med school admissions) come with the ability to make money from graduating with them. Single payer would likely require the gov't to pay for education; it still might not be worth it for potential students to go to med school (because the government could remove the scarcity constraints that in part make them hard to replace as doctors), but the debt wouldn't necessarily be a factor in that decision.

      In my area, at least three of the four major hosital systems have engaged in significant expansions (university hospital built a 15-story building; religious hospital A added a neuromedicine center, and added a heart hosital about seven years earlier; religious hospital B is also adding significant capacity; don't know about local children's hospital). They must think (perhaps wrongly) that they can make money; it's possible that that's coming from doctor salaries, but they'd have to have added leverage that does not seem obvious to do so. If not, then they must be anticipating making money (if donations came and they thought adding capacity would cost them money, they could be doing something else with the money, or renaming current facilities).

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  6. Postage due. And I had access to plenty of it; even I'm not crazy enough to send uranium in the mail. gr

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    1. A friend of mine's mother detested the law school she attended. She'd fill their pre-paid envelopes with pennies and write "you need this more than I do" on the slip.

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  7. Whenever the ACS calls me asking to join we inevitably hit the questions about why I will not. I tell them I will not rejoin until they stop supporting policy that is bad for employment of US citizen chemists.

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    1. I agree. That and two other factors are why I stopped my ACS membership years ago and haven't regretted it once: the fact that it's skewed almost entirely in favor of academia and helping academic chemists at the expense of those of us who work in industry (where there's a subtle undercurrent of disdain toward it), and the fact that the editorials and articles are written from such a politically biased viewpoint that it's almost comical.

      It was a waste of my money for which I got no benefit other than having a copy of C&EN every month to flip through quickly before throwing it out, and a free mug every year. No thanks.

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  8. Speaking of alternative careers - they may turn out to be a really iffy proposition:

    http://www.careerbuilder.com/jobseeker/jobs/jobdetails.aspx?Job_DID=J3J71W63WK3SNTMNQY2&siteid=cb001&showNewJDP=yes&ipath=EXINDsep_google_feed

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