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Tue Jul 28 12:47:23 BST 2009

Fiona,
I think the current problem is not so much the shifting goalposts, but rather the clouded picture that is being presented.  Unlike Mr. Bjorn's assertion that those who are so far opposed are ignorant, to date there have, been no real and clear details given of the new plan, and so everyone is basing their opinions on ignorance.
Ron

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Fiona Wallace
Sent: Monday, July 27, 2009 8:35 PM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: Centrist vs Local Social Systems

If you're going to make a case for this you need to stop shifting the  
goalposts. First govt employees have no incentive to be productive,  
now govt systems are simply 'unworkable'. Obama is going to make the  
health system 'unworkable' like the others. What, exactly, do you mean?

There seems to be a lot of complaining about possible changes, but  
very little factual evidence about why those changes will, or will  
not, work. Just the inevitable 'private good, government bad' that  
seems to pass for rational discussion in the States nowadays. Everyone  
seems to be ignoring the fact that the govt is currently bailing out  
the private sector with billions of dollars that could have been  
better used elsewhere.

As Pret has pointed out, working only in high-level trauma care offers  
a somewhat skewed view of the health system. Only a tiny minority of  
the population ever requires these services. What is important is  
excellent primary care and appropriate and timely access to secondary  
care on an inpatient and outpatient basis. Plus being able to change  
employment without having to worry about losing health insurance. And  
rationalisation of preventive treatment - which inevitably means  
making it free - to reduce costs further downstream, without letting  
moralising interfere.

Fiona.

On 28/07/2009, at 8:45 AM, McSwain, Norman E Jr. wrote:

> I know that that are plenty of workable systems elsewhere. I am  
> lucky enough to see some of them at work. The reality however is now  
> we are faced at making the US system work without bankrupting the  
> entire country. Our president has suggested a system that does not  
> improve the healthcare provided but only shifts the cost to the  
> government from the privates. Like it or not, we cannot suddenly  
> make ours like others. Unfortunately that is what he is trying to do  
> but without looking at the whole picture. We have several unworkable  
> government systems Making the healthcare system unworkable like the  
> others will be very BAD for our patients. He is changing the good  
> without changing the bad and making a system that will be much more  
> expensive than our current one.
> Norman
>
> Norman McSwain MD
> Trauma Director, Charity Hospital
> Professor of Surgery, Tulane University
> New Orleans LA
> 504 988 5111
> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu>
>
> ________________________________
>
> From: trauma-list-bounces at trauma.org on behalf of Fiona Wallace
> Sent: Mon 7/27/2009 5:25 PM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: Centrist vs Local Social Systems
>
>
>
> Capitalists seem to struggle with the concept that there are many of
> us in the health service for whom a fat paycheck is not the driving
> force. The vast majority of people I have worked with both in medicine
> and nursing consider it primarily vocational.
>
> There are doctors and nurses in many first world countries who work
> for a salary that most in the States would consider risible, yet do an
> excellent job within a variety of systems. The nursing staff I
> currently work with are all on permanent contracts as government
> employees, yet there is no dead wood and everyone, without exception,
> works well and extremely hard.
>
> Sorry, Norman - you need to step outside your own system and see what
> is really possible elsewhere.
>
> [because after all, Goldman-Sachs is such a shining example of how
> private banking has done so much for the ordinary American. http://www.smirkingchimp.com/author/matt_taibbi
>  ]
>
> Fiona
>
>
>
>
>
>
> On 27/07/2009, at 7:35 AM, McSwain, Norman E Jr. wrote:
>
>> Sorry to disagree but I think it is the system that has failed or
>> has allowed the entity to fail. There are many other well known
>> similar systems that failed when they have become 'federalized' .
>> One of these is well known medical system and the other one is a
>> travel agency. Both of these systems started off with very good
>> intentions until the members lost the incentive to be productive and
>> were just looking for a place to remain protected and get their
>> paycheck. More interested in the paycheck than the service that they
>> were supposed to provide to the public. But of course that is a
>> person opinion from one who is capitalist who believes in being
>> required to be productive in order to get paid.
>>
>> Norman
>>
>> Norman McSwain MD
>> Trauma Director, Charity Hospital
>> Professor of Surgery, Tulane University
>> New Orleans LA
>> 504 988 5111
>> norman.mcswain at tulane.edu <mailto:norman.mcswain at tulane.edu>
>>
>> ________________________________
>>
>> From: trauma-list-bounces at trauma.org on behalf of Doc Holiday
>> Sent: Sun 7/26/2009 2:24 PM
>> To: .Trauma List
>> Subject: RE: Centrist vs Local Social Systems
>>
>>
>>
>>
>> From: nmcswai at tulane.edu
>>
>>
>>> left out the other 'wonderful' social system...US postal service...
>>
>> ==> When it comes to nationally sponsored bodies he may have also
>> left out the US Military and the judicial system, not only the
>> USPS... There are success stories and failures, be they among
>> capitalist entities or "socialised" ones or "federalised" ones;
>> likely therefore that it is the entities which are at fault, not the
>> sysem within which they live. The UK postal office is not held up as
>> an example of success either.
>> _________________________________________________________________
>> Windows Live Messenger: Happy 10-Year Anniversary-get free winks and
>> emoticons.
>> http://clk.atdmt.com/UKM/go/157562755/direct/01/
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