Thursday, July 03, 2008


I have a variation on Donald Rumsfeld. This is what I've been telling myself at those times when I think I ought to have a better, higher paying job:

"You don't make money with the job you want, you make money with the job you have."

It's the summer doldrums as far as the election goes. I wish both candidates could agree to a simultaneous two weeks vacation. It would do them and us a world of good.

Obama's Father's Day speech was excellent. His speech on patriotism was also well done. His endorsement of faith-based social action groups surprised many.

McCaine is viable. He is behind but he is not losing ground.

BACK TO HEALTH CARE. I met a nurse last week in the medical library at the hospital where I work. She said she was going back to school to become a Nurse Practitioner. I told her I was very glad she was doing that, because --

America needs about a 100,000 more nurse practitioners and a 100,000 primary care physicians.

While Obama and McCaine debate who is going to pay for health care, the underlying problem remains --- a top heavy health care system with million dollar MRI's stacked up like so many SUVs in the parking lot. Sure, you don't have to wait for an MRI scan, you just need a $1,000 in your pocket, or an insurance company that will pay for it.

It's like if movie tickets cost $50, you would never have to wait in line either.

But the real need is at the level of basic care. If Congress passes a bill for universal health care, we will quickly discover that we lack the manpower to deliver on that promise -- because we lack the resources on the ground.

Got to MD Salaries on the Internet for a look at physician salaries around the country and in various specialties. Cardiologists and Anesthesiologists make the most money, often well over $300,000 per annum.

But Primary Care doctors and Pediatricians are at the low end, averaging around $125,000. That's still a pretty good living, but who can blame the docs for going for the high-paying specialties.

So, we need more Family Doctors and somehow we have to encourage and reward those who choose that profession.

Meanwhile, Wal-Mart is not waiting for Congress to act. They have plans to open more than a thousand medical retail clinics in their stores. The clinics will be located right next to the pharmacy. They will be staffed by Nurse Practitioners who can diagnose common ailments and write prescriptions. You don't need a doctor for the common cold, a diaper rash, or an ear infection.

The Nurse Practitioner can quickly judge if the problem is more serious, but most often she can deal with it herself.

A visit to these clinics will cost less than $60. No appointment necessary. It's quick and convenient, and half what it would cost at a doctor's office.

Of course, it doesn't solve the whole problem. Like what if you don't have the $60.

But it's a step in the right direction.

Frog Hospital does not favor government or market-based solutions. We are only interested in what works.

So, on this Fourth of July, let's salute our American heroes -- the Nurse Practitioners.

1 comment:

Anonymous said...

Very interesting info. It seems market has power even when talking about health care. On the other hand, everything takes time and as Keynes said: "In long period we are all dead"
Hope your country will do the right step after elections. I am selling optional health insurance with disability insurance in Canada and conditions for free market are terrible here. You can have MRI at least if you can pay for it. Here you can't do can just wait. Or travel to USA for treatment...
Take care!