It seems that the subject on most people's minds these days is "Medical Cost". The problem is that all I hear is, "how are we going to pay for higher and higher medical cost"? Why don't we ever hear anything about lowering medical cost? Obama's solution is that he is only going to pay 50% of the doctor's bill and thus save 50% on the medical cost. If he can do it, why can't we all do it on things like food, education and housing? Because, we all know that not paying our bills is "not" a solution. What we need to do is to "reduce" the medical cost and there are ways to do just that. It starts by understanding where the costs come from. Don't hear much about that do you? Well, I have some ideas.
To keep this simple, I am only going to deal with the cost of doctors. I am not a doctor, but I have some kids who are, so I do know a little more than the average person. First, I need to set a few ground rules. Did you notice that doctors are licensed by the individual states? That means that Obama and the federal government are not the ones who either train or license our doctors. To make it a little simpler, some states have banned together to let doctors who are licensed in one state to work in their state. My point is that doctors are controlled by the states not Washington DC. That is key. We have a situation here in the USA where it takes longer and is more expensive to train a new doctor than any other country in the world. That is a fact. So that we are all working on the same level playing field, I would like to point out that the USA ranks 38th in life expectancy. I think that is a very good measure of the quality of our medical community. What causes our doctors to cost us so much? Now we are getting some place. In a prior blog, I pointed out that most doctors go to school from age 5 to about age 30 before they can be called a medical doctor. They spend some additional time doing what is called "residency". All of this has a cost in both dollars and lost income. It also means that the doctor will have a limited number of years to practice and thus get his investment back. I pointed out in a prior blog that our doctors go to school about as long as they practice. No other country in the world does it the way we do. Remember the states control the training of doctors. Did you ever wonder why they don't reduce the years of training required and let the doctors specialize right from the start? As an engineer, we specialized right from the start. If I was going to be a Chemical Engineer, why would I have to spend time and money taking courses that would have little or no application in my career? It should be the same for doctors, but it is just the opposite.
Did you ever wonder why so may retired people get their dental work done in Mexico and I mean just across the border? I talked to one person who paid less than 25% in Mexico for the same dental work that they could have gotten in the USA. He asked the Mexican dentist where he lived and he said that he lived in the USA and crossed the border every day to work in Mexico. He asked how he could do that and make a living just charging 25% of the rate in the USA. The dentist told him that he did not spend thousands of dollars and years going to a USA dental college. He went to a college in Mexico right out of high school and learned every thing that he needed to know in just two years. Now he did not have to charge the same rates as in the USA since he had a much smaller investment to have to recover, plus he did not have to deal with the complex and expensive regulations that we have in the USA. This is the way it works in most of the world, but not in the USA.
What I would like to see is some state breaking out from the pack and cleaning up their medical schools and their regulations. Why do you think something like that has not happened? The state of Texas cleaned up their Tort laws affecting medical liability and lawyers started moving out of the state. In my small town, there are at least 5 lawyers for every doctor. You have to ask, "how many lawyers can a single doctor feed". A famous Chinese philosopher once said, "a long trip starts with the first step". Who is going to make this "first step" to clean up our medical system? It is not going to come out of Washington DC, it has to happen at the state level and it has nothing to do with insurance.
