I think they're going to cost too much.

Why would quality be sacrificed? Mr. Ruble hasn't suggested that the doctors would receive less training that current medical practitioners receive.

@J.B. Schmidt...No one said that we would be reducing quality and replacing it with quantity. If you read Part III.a, I clearly stated that there are more than 45,000 applicants each year and only 19,000 are accepted under our current system. Even the established medical community agrees that we need to educate and train more physicians, to the tune of 7 to 10 thousand more per year. The problem is that the private sector cannot open up another 50 new medical schools, just too expensive for the private sector. Through my proposed plan we can add quality physicians and still increase the quantity.

As far as the salary structure; while in training they would receive a stipend and upon graduation physicians would be paid around 130K per year while in service. This is adequate since they won't have to be paying off student loans and the costs for their practice will be covered. Other healthcare professionals would also be compensated adequately for their professions.

The placement of hospitals and clinics in under served areas would provide a much greater social benefit than the current system that is driven by market forces. I would eventually like to see Medicare, Medicaid and CHIPS folded into the system so that these entitlement recipients would go to the government facilities to get healthcare services and drive the costs down for providing such services. (continued)

@Bren
Correct, he has not said they would receive less training. However, if you artificially inflate a system that is always the end result. The government has no track record of increasing the quality of a system. Not to mention, those that currently cannot become doctors probably should not become doctors. If the issue is the cost of education or the availability of institutions, then it requires people of strong drive and high intelligence in order to take on the debt of education and get accepted into the medical institution. Eliminating these pre-qualifications of drive and intelligence by creating a system that opens the doors to people with less drive and intelligence you are by default lowering the standards it requires to become a medical professional. Even if you keep the same high standards of education, you have only created more of the existing problem we face in higher education. That is people attending who don't belong, doing so on the governments dollar and the eventual lowering of standards to reduce the drop out rate. Instead of flooding the system with doctors and lowering the standard of care; why not change the way patients use the system and there by lowering the demand for needless medical visits and procedures.

You don't think opening up 50 and staffing 50 new medical schools and teaching hospitals with all that entails (why in G-ds name we would need 50 of them...talk about throwing out the concept of economies of scale...) and then ramming through enough students to produce 100 graduates ready to roll per school isn't going to result in a necessary drop in the quality of output, you're not thinking it through. If we're talking about doing this over a 20-30 year time span, perhaps. If you're figuring this is something that can be up and running effectively in any less time than that, extremely unlikely.

@J.B. Schmidt...(continued) With the funding system I am proposing the cost of such a system would, after establishment, not require all of the revenues raised and the surplus would be rolled into Medicare, Medicaid and CHIPS, helping to relieve the current shortfall in funding of these programs. With the entitlements receiving services from the public health service, with a much lower administrative cost, the system would automatically be 20% cheaper. Also, the system would not be free for those who can pay, either out of pocket or through personal third party insurance; also driving down the service costs. All in all it is a win/win since it is a system where all are paying a flat tax through retail purchases of goods and services. Everyone now has skin in the game. If we have a system in place that can accommodate entitlement recipients, then alternative funding systems can be crafted to lower the overall costs of providing healthcare.

@Lyle
To cover the salary, you are talking about $650million for the first years graduates. If we pretend you don't have to pay existing medical professionals, it doubles every year assuming the same graduation rate. By year 5 we are $33 billion if you only include those that have graduated your system. Where does this money come from? When do you stop pumping out medical professionals and if the number of doctors out numbers the patient load, are they still paid a salary? I think like every progressive government plan, the first year or two looks workable; however, it always burdens later generations with cost over runs and unsustainable systems.

@Lyle
The key to all true liberal ideas, "the system would not be free for those who can pay". In other words the government gets to pick the winners and losers in the medical game. Since the government will determine what "pay" means. You aren't fixing anything. The takers will continue to burden the system and the producers will become a smaller and smaller group contributing less and less. The result will be the few paying for the many and system that will be crushed under it own weight.

Here's the part I got a kick out of...

"The funding of the program could be easily achieved along with additional funding to Medicare, Medicaid and CHIPS by assessing a National Sales Tax of 5% on all retail sales and services, excluding food and prescription drugs. This would generate an estimated $211 billion per annum. This would be more than enough to satisfy present and future requirements until the nation can transition to a NHS.

********************

"more than enough". If it's more than enough, then how about we scale it back to JUST enough? Or how about maybe a little less than enough to discourage the kind of things that ordinarily happen when government entities are given x amount of money - they spend it all?

Once again, this all hinges on the theory that the government knows best how to spend the taxpayers' money, so more of it going into the government's hands, even if it's "more than enough" than is actually needed, is more of a good thing in the long run.

You hit the nail on the head Bob! Lyle, Bren and the other Socialist all feel that nationalized healthcare is the way to go, and the best way to start is to get a funding mechanism in place that would never go away.

@Bob McBride...The 50 new medical schools is not my number but from the research done by the established medical community. They are estimating that we need an additional 10,000 physicians per year to provide for the nation's healthcare needs. The establishment of these medical schools is something the federal government can do whereas if we wait for the private sector to do it, it'll never happen in time and we'll continue to only have 14.7 physicians per 100,000. The fewer the physicians available to practice the higher the cost. Substantially increasing the number of practicing physicians will increase the supply of physicians resulting in a reduction in cost of service.

As Lyle proposes more government funding of medical training, it may be the government that has caused the problem. Since 1965 the government has founded residency programs and in effect controlled the number of doctors entering the medical profession. In 1996 we had a surplus of doctors and the government was paying teaching hospitals to reduce the number of residence they took in by 25%. Not to mention the major cause for the influx of patients is do to the government providing free medicine to those it deems poor. They in turn, having no ownership in the system, use it recklessly. AHA will increase that demand because people will again be able to use features that if they had to pay for directly they might not or would not use.

Again it is patients taking ownership of the system that will save the health care system. Not dumping huge amounts of cash into it because that doesn't fix the problem.

Lyle, what kind of time frame are you talking about in terms of being able to pump to 10K doctors/year?

It would also be helpful if you'd provide links to some of this source info you're using, if you have it.

@Bob McBride...My time frame would be to have everything fully up and operating in 10 years. I would set a goal of 5 new medical schools coming on line each year beginning in 2014.

Many of my sources can be found in my article Part-III.a. www.aamc.org and www.globalhealthfacts.org are good places to start. Also the Census Bureau has a great deal of information as well as www.ncbi.nlm.nih.gov.

I'd say that's ambitious by a long margin, but then again we're talking about something that makes a lot of assumptions regarding approval, funding, tax law, restructuring an entire an industry, potential opposition and the ability of the government, in general, to properly run a program of the kind of magnitude you're talking about. You're right that in only the government would (I'm not sold on could) tackle something of this nature. The ability to make major mistakes, have humungous overruns that can be covered by literally commandeering boatloads of money while essentially remaining unaccountable lies only with the government.

@The Anti-Alinsky....How do you determine we are the leaders in healthcare quality? Most measures that are used say we are not. We have lower longevity than all other developed nations, more infant mortality, genuine lower health, etc. You need to do more research before you make such statements.

Also, your claims that the U.S. is responsible for most of the new equipment is only partially true. That, however, is not due to our industry, but from our university and college institutions. We are facing more and more competition from companies outside the nation. New procedures come from all over the globe and the US doesn't have a lock on it.

I don't know where you get this idea that people under NHS are waiting in long lines to receive routine care. That has never been my experience. The only thing that people often wait on are elective, non life threatening, procedures.

The pharmaceutical industry has been ripping us off for years. I would suggest that the basic research should be done under government funding at colleges and universities and pharmaceutical companies become only what they are, manufacturers. The government would open up new drugs to all manufacturers and let the free market decide winners and losers.

@ The Donny Show....LOL; I have and I do.

Lyle, where are all the new procedures coming from? The US! Why do you think the Saudi royal family keeps coming here? Why do we keep hearing ads from local hospitals about foreign patients checking into their hospital for treatment?

And then there is the timeliness of treatment. Rather than squeezing the patient into a schedule, we provide services right away. http://www2.dailyprogress.com/news/cdp-news-editorial/2010/feb/14/us_has_best_health_care_in_world1-ar-80904/

And if that wasn't enough of a resource:

http://www.fraserinstitute.org/publicationdisplay.aspx?id=2147484001

http://www.thedailybeast.com/articles/2012/06/20/canadian-healthcare.html

http://www.usnews.com/opinion/blogs/peter-roff/2009/07/28/statistics-show-canada-healthcare-is-inferior-to-american-system

http://www.city-journal.org/html/17_3_canadian_healthcare.html

@GearHead...We're not broke. Just as in Wisconsin, we weren't broke. We have the capital resources and potential to put into place this and many other programs. We need to prioritize differently. It's never a lack of money but where the money goes. That's the very basis of differences in fiscal planning. I find the political right to be very myopic in their approach and looking for simply solutions to complex problems.

Sorry Lyle, but Gearhead is right. We are broke. We are beyond broke. We are 15.861 TRILLION in debt. That's more than 50 THOUSAND per citizen. (source: http://www.usdebtclock.org/ )Think about having a 50 THOUSAND dollar credit card debt, what would you do? Most of us would call Peter Francis Geraci and declare bankruptcy.

“The most important thing to do if you find yourself in a hole is to stop digging.”
― Warren Buffett

@Lyle, you have an amazing capacity to ignore reality as it slaps you upside the head. We have a barn fire blazing away. Most thinking people would grab a bucket and get busy. But here you sit under a shade tree and are so busy planning an addition to the barn, you are oblivious to the sound of beams, joists and rafters crashing to the floor. What the political left needs to do is find itself a constituency, now that it got clobbered in the recall elections. Offering new plans to use other peoples money to satisfy the latest liberal wet dream will no longer get it done. You're a dinosaur, Lyle, on its way to creating a little more oil for the rest of us.

@Johnny Blade...The plan I am proposing is not asking to print more money. By my own calculations, ten years of a national sales tax would reduce the overall deficit for healthcare by two trillion dollars over ten years. Once we ho to an NHS, the percentage of GDP that the nation spends each year would be around 13 to 15 percent. I am clearly setting aside ideology to come up with unique solutions. Can you say the same?

@Phil M...You raise interesting points. We have a recognized shortage of physicians to care for the "baby boomers" who will be retiring in large numbers. In addition, we have nearly 17% of the population that is either under served or not served at all except in E.R. rooms. There are two primary issues here; 1) an imbalance in the available supply of healthcare professionals; and 2) the affordability of quality care to roughtly 50 million Americans.

In 1996 there was a concern that we were producing too many physicians. Now we are running a deficit. The established medical community are the ones stating that nearly 7 to 10 thousand more physicians are needed per year. With only 137 medical schools available, it is impossible to educate and train that many more physicians. Therefore, the government is the only entity that can gear up and meet the demand.

It is a national issue and requires a national approach that market forces cannot address. If the market could solve the problem then would have already. I think many healthcare service providers are concerned about the additional supply of physicians and others placing a downward pressure on compensation made by many of the providers. As far as placing healthcare providers in under served areas at below market compensation beings to question; are physicians and other healthcare providers entering the profession for the money or to practice medicine.

are you insane or simply full of yourself?