Federal Residencies

In the middle of a mostly-worthless Slate article I found the following factoid which was new and shocking to me, and apropos of our previous healthcare discussions:

Through Medicare, the federal government funds the more than 100,000 residency slots in the several hundred teaching hospitals in the United States (to the tune of $80,000 per resident per year, on average).

Wow. I hadn't really thought about how residencies got funded, and figured government had some significant role, but that the feds fund all of them outright? I mean, you can't get any more socialized than that. There's a pretty strong data point in favor of the argument that our current system in no serious way resembles free-market healthcare.

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well Tros- the profession is

well Tros- the profession is heavily influenced by prescription drug companies. It's just the working of the free market though- the drug companies "subsidize" Doctors by providing them with information (read: sales pitches) on their new drugs. The effects of this "free exchange" are what you're complaining about.

Legal medicine in this

Legal medicine in this country is a priesthood. Period. My mother is brainwashed by a psychologist that tells her it's ok to take an antideppressant repackaged as a diet pill, but if I smoke pot it will increase ADD symptoms that I don't have. Because I am not an impulsive, hyperactive loudmouth, the shrink tells her that ADD is really caused by a disorder of motivation. I can concentrate on things when I want to. That's bad. I need medication. The one I tried this past spring (Strattera) made me impotent. I had to ride the bus to New York City to see this guy in order to get it.

Greg, your math is wrong.

Greg, your math is wrong. 100,000 * $80,000 = $8,000,000,000 and eight billion bucks isn't so hard to hide in an official budget of more than $212 billion...and that was way back in 1999. The Bush Administration's estimate for total Medicare spending for 2004 was more than $250 billion.

I'm shocked about the sheer scope of this as well. It's an instant constituency for preserving the status quo.

Whoa, wait a minute. Do the

Whoa, wait a minute. Do the math here.

100,000 residency slots times $80,000 equals $80 billion dollars. Not likely.

Someone is playing with numbers here. Perhaps counting dollars paid for care for Medicare patients as subsidies to residency programs? It's good to hear that residents are making $80,000 per year on average, or is it?

I understand your point,

I understand your point, Matt. I would only take issue with you're comment because I am confident that the psychiatrist I am complaining about is part of the problem.

"Adults with ADHD tend to have lower rates of professional employment, more frequent job changes and lower self-esteem. These serious consequences, both personal and professional, highlight the need for effective treatment of the disorder," said Lenard Adler, M.D. Dr. Adler is a psychiatrist and director of the Department of Neurology, Attention Deficit Hyperactivity Disorder Program, and associate professor of clinical psychiatry and neurology at the New York University School of Medicine.

When my parents asked him about the reaction I posted earlier, he told them that my opinions were based on my "unscientific" experience. The psychologist who refered my parents to him told them that I have an urgent need for regular therapy sessions.

Tros that may be true in

Tros that may be true in this case, but I think that my opint is valid for your lagrer point about the industry as a whole.

-Matt

matt27: well Tros- the

matt27:

well Tros- the profession is heavily influenced by prescription drug companies. It's just the working of the free market though- the drug companies "subsidize" Doctors by providing them with information (read: sales pitches) on their new drugs.

This is true enough, except that it's not "the working of the free market."

Pharmaceutical companies are willing and able to pour huge amounts of money and labor into lobbying physicians because (1) they have enormous profit margins on new drugs, and (2) their new products are usually not easily substitutable (if a doctor wants to prescribe something like X, she will probably have to prescribe X itself rather than a near-identical competitor). But (1) is mainly the result of (2) and (2) is not the result of the workings of the free market. It's the result of government-enforced patent monopolies. (N.B.: whether you or not think patent protectionism is justifiable, characterizing the behavior of government-backed monopolists as "the working of the free market" is just an inaccurate description of the situation.)