my connection with the tea party

[kandrathe]

And this way of thinking among many people is exactly why 'they' can continue enriching themselves.

They enrich themselves because we buy their stuff.

Probably most 'tea-party voters' would if you give them choices between simple things without telling them who's opinion this is, relate much more with a left wing democrat ideology but they are imprinted to hate anything that is left wing. People are not rational. And that is what the filthy rich class uses to keep things going their way.

Uh,huh. Money and the desire of it is evil, and greedy. Those filthy, dirty, stinking... People are not rational.

And don't forget, those top 1% you are talking about got the chance of becoming so rich because the way the society is build up favors them.

You mean like Warren Buffet, or Bill Gates. Yes, WE put them at the top of the Forbes 500.

Say, you sell arms, and your friends in politics invade a few countries that benefits you tremendously. OF course going to war just to support oil and arms industry luckily never happens....

I'm sure you mean this euphemistically. My friends don't sell arms, or invade countries or benefit me tremendously. Aye, no blood for opium either.

Anyhow...is it strange that you would be asked to support your fellow American citizen that can't support himself a bit? For example because he was send out to fight in Iraq because that was more or less the only choice he had, he became handicapped and when back he was left to arrange things all by himself which isn't easy because handicapped people are not really good employees is what they say?? (or at least think).

I don't have a problem with helping people in need. I have a problem with using the force of government to take money away from people to give it away arbitrarily to voting constituencies.

Of course it is a choice you make, and a choice I can respect....but what I don't respect is all the sweet talking around it to explain why some people deserve to have bad healthcare just because they were unlucky.

When it comes down to it... We cannot afford to give everyone all the healthcare they need. Death wins in the end. Most of the expense of our health care is tied up in care at the end of life. If everyone pays in pennies, and extracts dollars the system goes bankrupt. Well, that's the way of it. Politicians try to sell you the soft soap, that there is another way where everybody gets what they want. But, it's a ponzi scheme... One that may play out for decades before the economic system meets it's end. Eventually, like Greece, the piper must be paid.

[Jester]

And of course, our politicians wonder why we keep having recessions and depressions, and though we get out of them, they try to look for solutions to prevent them from occurring again. Thus far they have failed, and that is because there are no solutions. No amount of "deregulation" can prevent these booms and busts. As Marx said, they are an INEVITABLE part of a capitalistic system such as ours. The sooner politicians can take their blinders off and realize this, the better off they and the rest of us (or almost the rest of us ) will be.

For once, I think I agree with you - these booms and busts are inherent to the system. Except... what is the alternative? What would politicians do, except throw up their hands and declare their powerlessness?

-Jester

[kandrathe]

Basics.

My first thought was... tl;dr... Use paragraphs. Please.

I had a really interesting thought earlier today. I find it ironic how the Tea Party and the far right in general embrace free-market, get-the-government-out of my life economics, but only when it benefits them.

Everyone who disagrees with you is in the tea party/far right.

Privatize profits, socialize losses. Companies like Goldman & Sachs and AIG, contrary to popular belief, LOVE socialism (but like capitalism, only when it benefits them). This "too big to fail mentality" is what killed American capitalism, if you think about it. It is a myth: No firm is too big to fail, none. If it failed, it failed.

Democrats & Republicans RAN to shore up these institutions. It was not a tea party thing.

When small businesses fail in a capitalistic system, they have to suck it up most of the time. But now giant lending firms on Fraud Street and other transnationals can simply rely on this new (or rather not so new if you think about it) concept of socialism for the rich, capitalism for everyone else.

Small businesses don't suck it up. They get flushed, and the owners/investors might lick their wounds and try again.

To me, it is just further evidence to reinforce the idea that not only are social democracies superior to capitalistic ones, but that in fact capitalism (even if it's not 'pure' capitalism) and true democracy are now INCOMPATIBLE since the political process now allows those with greater wealth to have more political clout than the rest of us, since corporations are now treated as individuals.

They are incompatible since once the people realize they can vote themselves money... Lucky for us, we have a Republic based on representative democracy.

"A democracy is always temporary in nature; it simply cannot exist as a permanent form of government. A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship." -- Alexander Fraser Tytler

The Citizens United decision needs to be overturned.

I guess you had a random thought segue. I think it is fine if corporations want to be treated as citizens, as long as their citizenship and loyalty is American. Unfortunately, their allegiance is not to the preservation of our republic.

Throw in a right-wing controlled media that spoon feeds citizens who can't think for themselves about what is best for them by creating a predetermined social discourse, the majority of whom drink it up like kool-aid, and Marx's concept of 'false consciousness' is illuminated.

You mean of course that Murdoch owned alternative to the left wing controlled media. It would be much better (for you) if all media and propaganda were controlled with a unified voice.

I think the Tea Party, more so than any other group I can recall in at least contemporary American (or even international) politics, exemplifies this concept almost perfectly. Normally I would feel sorry for these people, its one thing to be ignorant, but its an entirely other thing to be WILLFULLY ignorant as they are, thus when things go bad for them they do not have my sympathy (now I sound like one of them, but I can't help it). But this doesn't merely apply to business.

Yes, some of them even bought into the milksop campaign of "Hope and Change" without every questioning "Hope for what, and what will change?" Talk about false consciousness.

It also applies to families that think a 'for profits' healthcare system is great but then wonder why they have to choose between losing their home, all their retirement savings (if they have any), and hundreds of thousands of dollars in medical bills to pay for their mothers cancer treatment or let her die.

Is this an anecdote, or just another random thought? I have a vivid imagination too. I saw Les Miserables, and I've read David Copperfield.

And of course, our politicians wonder why we keep having recessions and depressions, and though we get out of them, they try to look for solutions to prevent them from occurring again. Thus far they have failed, and that is because there are no solutions. No amount of "deregulation" can prevent these booms and busts. As Marx said, they are an INEVITABLE part of a capitalistic system such as ours. The sooner politicians can take their blinders off and realize this, the better off they and the rest of us (or almost the rest of us ) will be.

Right. The only way to prevent boons and busts is to restrict the free flow of capital. Slavery to the state would resolve that problem.

[Jester]

"A democracy is always temporary in nature; it simply cannot exist as a permanent form of government. A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury. From that moment on, the majority always votes for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy, which is always followed by a dictatorship." -- Alexander Fraser Tytler

/headexplodes

-Jester

[kandrathe]

/headexplodes

Lol.

[eppie]

And of course, our politicians wonder why we keep having recessions and depressions, and though we get out of them, they try to look for solutions to prevent them from occurring again. Thus far they have failed, and that is because there are no solutions. No amount of "deregulation" can prevent these booms and busts. As Marx said, they are an INEVITABLE part of a capitalistic system such as ours. The sooner politicians can take their blinders off and realize this, the better off they and the rest of us (or almost the rest of us ) will be.

I agree. What the tea party and neocon voters don't understand, or don't want to understand is that many companies have a much bigger power over them then the government.
So why would you be in favour of the government not interfering with your life while at the same time you find it OK that a company does......with companies you are SURE that their first interest is making profit.

---

But, it's a ponzi scheme... One that may play out for decades before the economic system meets it's end. Eventually, like Greece, the piper must be paid.

Indeed, another example of a country where they pay too little taxes.
Same as in Italy. Italians are the richest europeans (personally), most of them own houses without having mortgages and they don't have much other debts either. Mainly this is because they all evade taxes.

Results are of course a bad working government.....a traffic infrastructure that is probably even worse than the one in the US, scary hospitals, a police force that doesn't work efficiently or not doesn't work at all etc. But if you want tpo earn money, the government wont bother you....they even wont check if you declare the correct income.

[kandrathe]

I agree. What the tea party and neocon voters don't understand, or don't want to understand is that many companies have a much bigger power over them then the government.
So why would you be in favour of the government not interfering with your life while at the same time you find it OK that a company does......with companies you are SURE that their first interest is making profit.

I'm sorry. What is the difference again? Who is Hank Paulsen? Who is Jeff Immelt? Who is George Kaiser? Who is Robert Rubin?

There is no difference between the government and the corporations. Yes, there are some in the Tea Party who get it. For example, Palin On Politicians And Crony Capitalism: "I'm Not For Sale"

On crony capitalism: "So many of them, they arrive in Washington, DC of modest means and then miraculously throughout the years they end up becoming very, very wealthy. Well, it's because they derive power and their wealth from their access to our money, to taxpayer dollars."

"They use it to bail out their friends on Wall Street. And their corporate cronies. And to reward contributors. And to buy votes via earmarks. There is so much waste. And there is a name for this. It's called 'corporate crony capitalism,'" she said.

Yup, those tea party people are so stupid. Or, maybe your bias is showing.

[eppie]

Yup, those tea party people are so stupid. Or, maybe your bias is showing.

So what is now exactly the issue with spending tax payers money on a more fair health care system for example. If you apparantly all know about the ways politicians and big companies make money, why not spend the money directly on the simple guy in the street?
I don't take this from Palin and from republicans in general.

I never hear these stories in Sweden, Denmark, Finland, the netherlands canada etc. I hear them from Italy, Greece, the US, Zimbabwe, russia.
I must agree with fireicetalon; it looks more like socialism for the rich and capitalism for the poor.

I mean if a person dares to say these things (like Palin does) why not start a big campaign against funding of candidates to pay for their election campaigns? I mean who can take her seriously. Just like in e.g. Italy polticians are a special class that don't really care about the normal people...but is that because the US government collects taxes or is there another reason? For example that not everyone has the same chances, even though on paper they should have?

[kandrathe]

So what is now exactly the issue with spending tax payers money on a more fair health care system for example. If you apparently all know about the ways politicians and big companies make money, why not spend the money directly on the simple guy in the street? I don't take this from Palin and from republicans in general.

The disagreement that tea party folks have with the current direction, and trend in health insurance is that it is replacing the private sector with government (socialism). They don't have any faith that the government would do better, and in most(all) cases where the government takes over, things cost more and we get lower quality (e.g. postal service). Rather than diagnose and cure what ails our health care system, they have taken the knife to it. Politicians aren't very good analysts, and so their solutions tend to be knee-jerk and popular (e.g. if we call it "The Patriot Act" it must be patriotic). In 1973 they drove everyone onto HMO's with the illusion of containing costs. It never happened.

The simple answer is that there is no simple answer. First you need to separate health maintenance from emergency care. When it comes to emergency care (and unplanned catastrophic illness), no one will set a limit on how much to spend. If my boy were dying from a bee sting, and the antidote was a million dollars I'd buy it and figure out how to pay for it later. In this way, health care is not like a normal commodity. Technology has allowed us to have expensive treatments for what were otherwise terminal illnesses. Often they don't even work, but people take the chance that they can cure themselves or their loved ones. Whether it be the evil insurance company, or the evil death panels, someone needs to be the voice of reason both to scrutinize the efficacy of treatment, and to indicate whether the prescribed treatment should be undertaken for that particular patient. This is what has worked for socialized medicine in those places that have implemented it. The government becomes the final say in what care gets delivered. If you disagree and can afford it, you come to the US and buy the treatment you can't get in your own country. Here, when people can't afford it, they go to Mexico to buy the same treatment at reduced price.

The not so simple answer to health care costs is that from an economic perspective we need to increase the supply, and reduce the demand. This will bring the price down so that it will be affordable. How do you do that? First, you get rid of the stranglehold that the AMA has on medical schools. We need to vastly increase the number of doctors and nurses produced for the next 20 to 30 years just to keep up with the number of retiring boomers. Second, we need that "death panel" as a independent medically astute arbitrator to review medical treatments and indicate to patients (and their insurance companies) what will be efficacious.

So, here is an idea. Let's treat medicine like the peace corps. If you join the peace corps, or Americorps and serve for 4 years after college, they pay off 70% of Perkins student loans. Let's do the same for doctors and nurses. Create a health corps, pay them a living wage, and send fresh doctors and nurses into places in the US that need them. Give grants to colleges to create or expand their medical programs.

Then you have the pharmaceuticals. I guess I'd apply the same type of incentive of helping with grant funding for advances in treatments and in return, the company would release the drug to market, for double the full patent period, with a very marginal profit. There is a role for government leadership in using tax dollars to create win-win situations for companies and consumers. Our problem is that the government has become one sided enabling the companies to win, but the people lose both our tax money and in the marketplace.

Again, I'll reiterate. Not surprisingly, most of the money spent in the US on health care is spent during the last years of a persons life. The money is often spent attempting to revitalize a patient beyond help. Example --> The story of Terence Bryan Foley

I never hear these stories in Sweden, Denmark, Finland, the netherlands canada etc. I hear them from Italy, Greece, the US, Zimbabwe, russia. I must agree with fireicetalon; it looks more like socialism for the rich and capitalism for the poor.

FIT looks at the current mess, which is mostly created by fools and interventionists who've become "public servants" to feather their own nests, and claims "see free market capitalism doesn't work". It's like the nation version of Munchhausen's by proxy. The best example is how our Congress approaches "Stimulus", which would be laughable if it weren't so tragic. "What we need is another dose of the same poison that made us sick in the first place." What's worse is that it's administered by the same addle brained doctors (take your pick... Paulsen, Bernancke, Reid, Boehner, Pelosi, Bush, Obama -- there is little difference in their cluelessness).

I mean if a person dares to say these things (like Palin does) why not start a big campaign against funding of candidates to pay for their election campaigns? I mean who can take her seriously. Just like in e.g. Italy politicians are a special class that don't really care about the normal people...but is that because the US government collects taxes or is there another reason? For example that not everyone has the same chances, even though on paper they should have?

You are right. We need to implement laws to restrict our politicians. We need better campaign financing laws. We need laws to reign in crony capitalism. We need to find honest politicians with principles who will vote away their own power. How hard is that?

I would start with some fundamental reforms to how Congress can spend money. Like, only on means tested programs that benefit all US citizens equally with only need being discriminated. This would eliminate stupid pork barrel spending to bring home the bacon to congressional districts. Student loan program, fine. Backing loans for Solyndra, nope. We can talk about research and development grants, but only if they are offered based on their contractually direct benefits to all US citizens.

End social security payments for the wealthy. Raise the retirement age to 67 now, and 72 by 2015. Eliminate the cap on SSI for the wealthy, and use that to reduce the withholding rate for everyone. Offer an incentive to stay off the dole, whereas you increase your payments by x% for every year you remain employed.

For Medicaid, and Medicare, convert the system to vouchers where the government offers a fair market rate for health insurance, but the individual is free to use that voucher for any insurance they choose. Allow health insurance portability between employers, and across state lines. Allow people to create a tax free retirement/education/health care account where they can save money for future rainy days. Many states, including mine, have a special catch all means tested program for anyone not covered by health insurance (and even due to preexisting conditions). Our uninsured rate was just a few % (like 4-5) before that program, and now it is nearly zero. Even so, I would create a tax penalty for insurance companies that either deny based on pre-existing conditions, or terminate insurance altogether. I'm fine with a cap on yearly benefits, or even lifetime benefits so long as the consumer is well informed. Insurance companies shouldn't have to go bankrupt just to satisfy everyone who wants every treatment. The insurance I have now is very affordable, but I pay out of pocket the first $5000 for the family, or $3000 per individual (we typically hit the $5000 mark about May, so we save that up in a health care savings account from June to December).

With the current system of employer provided (and COBRA) health insurance, there will always be some people between programs due to unemployment (which is actually another stupidity of government). For example, when I was laid off in Fall of 2008, I was able to extend by insurance through COBRA for awhile (but it is very expensive -- you also pay what the employers was paying). After awhile, that expires, but my family did not qualify for any social safety net because my former annual income was too high (never mind that my current income was zero). Realistically, the only way to avoid falling through the cracks now, if you are not poor already, is to have a nest egg of at least $25K to enable you to afford open market (non-group rates) health insurance for a year. The only way to change this is to reduce the price such that we can shift 100% of the cost to the individual/family, and make that insurance portable.

[Jester]

So, here is an idea. Let's treat medicine like the peace corps. If you join the peace corps, or Americorps and serve for 4 years after college, they pay off 70% of Perkins student loans. Let's do the same for doctors and nurses. Create a health corps, pay them a living wage, and send fresh doctors and nurses into places in the US that need them. Give grants to colleges to create or expand their medical programs.

Either you pay them more than the market rate (either with salary, or by forgiving loans, which is just money coming out a different chute), in which case you save no money, or you pay them less, in which case, they'll just go straight into private practice because it pays better.

Unless, of course, you made it mandatory. THAT would save some money, but it would also restrict the number of applicants to med school, since graduation would mean 4 years of what I would see as public service, but some might see as indenture...

-Jester

[kandrathe]

Either you pay them more than the market rate (either with salary, or by forgiving loans, which is just money coming out a different chute), in which case you save no money, or you pay them less, in which case, they'll just go straight into private practice because it pays better.

The math needs to work out. Figure the average doctor leaves college with at least $100K, and probably more like $150K in loans (unless you are ivy league). The current average starting salary (depending on specialty) varies between about $100K and $350K. So, I would give them $100K salary and pay off at the same rate as peace corps (15% for the first two years, 20% for two additional years.) The net cost (above their service earned salary) would be about $27K per year per doctor, while the benefit would be (less the $100K paid salary) more like $50K to $75K average per year per doctor. As the number of physicians increases in the market, the salaries would begin to decrease and so a mechanism would need to be in place to adjust the rates accordingly. Use the same methodology for nursing. There is the whole self-actualization thing about joining the volunteer corps too. You might even make it a more break even program by charging the hospital or clinic a market rate less 10% per physician. The program would then just cost pretty much the administration.

Unless, of course, you made it mandatory. THAT would save some money, but it would also restrict the number of applicants to med school, since graduation would mean 4 years of what I would see as public service, but some might see as indenture...

I would make it a choice (each year of service would require re-enlistment). But, a big worry of doctors is getting out from under their mountain of debt to enable them to begin to build a practice. It would be good for newly graduated physicians too.

[Jester]

The math needs to work out. Figure the average doctor leaves college with at least $100K, and probably more like $150K in loans (unless you are ivy league). The current average starting salary (depending on specialty) varies between about $100K and $350K. So, I would give them $100K salary and pay off at the same rate as peace corps (15% for the first two years, 20% for two additional years.) The net cost (above their service earned salary) would be about $27K per year per doctor, while the benefit would be (less the $100K) more like $50K to $75K average per year per doctor. As the number of physicians increases in the market, the salaries would begin to decrease and so a mechanism would need to be in place to adjust the rates accordingly. Use the same methodology for nursing.

How is this scheme any different from the government just hiring doctors straight out of med school?

-Jester

[kandrathe]

How is this scheme any different from the government just hiring doctors straight out of med school?

Not much. Except, that our culture wouldn't look at it that way. Joining the army, or peace corps to pay off college loans is not seen as socialism, but rather a patriotic civic duty. Go figure. But, probably since it is temporary sacrifice where the person is contributing toward the betterment of society. The daughter of one of my cousins went to the Air Force academy, then medical school through the service, served her residency at a VA hospital and is now in medical practice with zero debt.

It's the same thing, without the military part.

[eppie]

[quote='eppie' pid='189763' dateline='1317120404']So whThe disagreement that tea party folks have with the current direction, and trend in health insurance is that it is replacing the private sector with government (socialism). They don't have any faith that the government would do better, and in most(all) cases where the government takes over, things cost more and we get lower quality (e.g. postal service).

But I don't think this is a law of nature.
E.g. in the Netherlands we had (have) a wave of privatizing government run things like health insurance, energy, trains postal service and in our case things have become more expensive....sometimes a little better but the main difference we see is more commercials on TV and stories about top managers with huge salaries and bonuses.
At least when the government does something and it is too expensive the money goes to normal people working (e.g. having 10 postmen doing the job of 6). If a company does something too expensive the money goes to bonuses of top managers.

[Zenda]

Again, I'll reiterate. Not surprisingly, most of the money spent in the US on health care is spent during the last years of a persons life. The money is often spent attempting to revitalize a patient beyond help. Example --> The story of Terence Bryan Foley

I hope your point is not that this is a waste of money. The widow in the story from your link seemed pretty glad she was with her husband for another 17 months, instead of the 3 months it would have taken without (expensive) treatment.

"Only I know that those 17 months included an afternoon looking down at the Mediterranean with Georgia from a sunny balcony in Southern Spain. Moving Terry into his college dorm. Celebrating our 20th anniversary with a carriage ride through Philadelphia’s cobbled streets."

[kandrathe]

But I don't think this is a law of nature.

E.g. in the Netherlands we had (have) a wave of privatizing government run things like health insurance, energy, trains postal service and in our case things have become more expensive....sometimes a little better but the main difference we see is more commercials on TV and stories about top managers with huge salaries and bonuses.

Ok, regulation causes chaos to conform. Deregulation causes chaos in returning to market forces. Big salaries and bonuses is a separate issue best left to be between the boards of directors and stock holders. I agree they need to be more accountable to stock holders, so perhaps just some laws that give the stockholders more of a vote on executive compensation.

I worked at a railroad here in the US, just after deregulation under Jimmy Carter. Suddenly, we had to compete and with all this track as overhead. The first thing I helped them set up was an analytic center where they could evaluate the cost benefits of every segment of their track. We sold off unproductive lines to Coops and newly formed short line RR. Trucking picked up a huge part of the short haul business. And, we had to have something new, customer service. It took about a decade for all the chaos, bankruptcies, and mergers to settle down. The second department I built for them was a labor renegotiation group. Railroad compensation had become ridiculous during the period of no competition. Our modern diesel electric trains still had crews suited for the 1800's (e.g. Conductor (no caboose or passengers, electronic waybills), 2 brakemen (to watch left side and right side), fireman to stoke the boiler, engineer, and a back up engineer). There were over 180 different ways that these guys could earn pay (e.g. backing up the train, getting off to flip a switch, coupling or uncoupling cars, coming into the station late). Then, there was the 100 mile rule. They could only crew the train for 100 miles (the distance a train could travel in a day back in the 1800's). After 100 miles (at 50mph), they'd need to stop and change crews (usually met in the middle of nowhere by a taxi to drop off and pick up), but of course, they got paid a days wages. It was stupid. No business can operate this way.

At least when the government does something and it is too expensive the money goes to normal people working (e.g. having 10 postmen doing the job of 6). If a company does something too expensive the money goes to bonuses of top managers.

Ah, but that government waste came from over taxing the people. This waste (malinvestment) drags on the economy perpetually as these government programs never really get smaller until their is a crisis. If a company is wasteful, eventually it is reflected in their stock price. If they mess up badly enough, they go bankrupt. Problem solved.

[Jester]

How is this scheme any different from the government just hiring doctors straight out of med school?

Not much. Except, that our culture wouldn't look at it that way. Joining the army, or peace corps to pay off college loans is not seen as socialism, but rather a patriotic civic duty. Go figure. But, probably since it is temporary sacrifice where the person is contributing toward the betterment of society. The daughter of one of my cousins went to the Air Force academy, then medical school through the service, served her residency at a VA hospital and is now in medical practice with zero debt.

It's the same thing, without the military part.

Okay. So it's socialized medicine, re-branded as something more palatable to Americans?

Fine by me.

-Jester

[kandrathe]

Okay. So it's socialized medicine, re-branded as something more palatable to Americans?

Fine by me.

Sort of. It wouldn't have the same entrenched bureaucracy feeling since the participants would be temporary, and not permanent employees. I would look at it more like a government run temporary staffing organization (e.g. Accountemps), where instead of the workers being cost plus 10%, they would be cost minus 10%. Of course, the long term social goal would be more than just providing affordable care, it would be to increase the number of people in the profession to reduce the overall costs and bring physician salaries more in line with other similarly skilled professionals.

A good indicator of what the government should be providing home grown incentive's would be the professions for which they authorize H1B visas.

[Jester]

Sort of. It wouldn't have the same entrenched bureaucracy feeling since the participants would be temporary, and not permanent employees.

Temporary employees *increase* bureaucracy, they don't decrease it. Turnover is more work, not less, because hiring someone involves fixed costs, and a mess of paperwork.

I would look at it more like a government run temporary staffing organization (e.g. Accountemps), where instead of the workers being cost plus 10%, they would be cost minus 10%. Of course, the long term social goal would be more than just providing affordable care, it would be to increase the number of people in the profession to reduce the overall costs and bring physician salaries more in line with other similarly skilled professionals.

Why would doctors work there for cheaper? Civic duty? Doctors might be interested more than most, but then, they should already have factored that in to their choices of specialization. (Boob jobs, or family practice?) If they have debts to pay off, their goal would be revenue maximization, no?

But more importantly, how can you increase the number of physicians by hiring at lower than market wages? (Or, if you pay good wages, how can you reduce costs by paying out more money?)

I'm all for the idea. I just don't see where the savings are supposed to come from.

-Jester

[kandrathe]

Temporary employees *increase* bureaucracy, they don't decrease it. Turnover is more work, not less, because hiring someone involves fixed costs, and a mess of paperwork.

Having run a consultancy, I understand the overhead involved. There are three main functions, hiring, placement, and administration of benefits. The ratio for the first two is about 1 per 20 employees, and the last is about 1 per 30. Assuming you could recruit 50,000 health care corps volunteers, that would equate to about 6500 government jobs managing the program (or about $650 million). By comparison, Americorps costs about $1 billion per year.

Why would doctors work there for cheaper? Civic duty? Doctors might be interested more than most, but then, they should already have factored that in to their choices of specialization. (Boob jobs, or family practice?) If they have debts to pay off, their goal would be revenue maximization, no?

But more importantly, how can you increase the number of physicians by hiring at lower than market wages? (Or, if you pay good wages, how can you reduce costs by paying out more money?)

I'm all for the idea. I just don't see where the savings are supposed to come from.

The doctors would get a fair market rate. Maybe just not as much as they could going into private practice, but that is a risk too. This way, they could negate a big part of their debt, get experience, and be altruistically contributing to society.

A company like Accountemps exists to make at least a 15% profit. They do this by charging a higher than normal hourly rate. Companies hire them because they are an expense, rather than on operational payroll. Also, the benefits are paid by the staffing company. The company who hires the temp is free to flex their workforce as needed without the expense of hiring and firing. When I said cost less 10 %, I expected the government to eat the 10% loss (about $500 million). I'm just throwing these % around though by gut feel based on experience, you might be able to create a system with less overhead, and tighter margins reducing the overall cost and achieving the same results.