Links 8/20/09

Autonomous tech ‘requires debate‘ BBC. Everyone dust off your Asimov.

Health Care Reform and single payer – an Australian perspective John Hempton (hat tip reader Kalle). From my two years in Australia a few years back, I though the care was top notch, very cheap compared to here, and no problem with queuing (it took 2-3 weeks to get an appointment with some specialists, no worse than in NYC). They do have a problem getting doctors to work in bush towns. Hempton also gives it high marks.

Has Mortgage Modification failed? Baseline Scenario

Destroying Market Overcapacity — Literally Paul Kedrosky

JP Morgan Bails Out California John Carney (hat tip reader John D)

Citigroup’s Asset Guarantees to Be Audited by TARP Bloomberg

Wall Street ponders pay czar’s move on clawbacks Reuters, Having made so much noise, he now has to collect a scalp.

China’s fiscal stimulus fading fast FT Alphaville (hat tip reader Don B)

Bradley Birkenfeld told U.S. authorities in 2007 that he helped Americans set up secret bank accounts in Switzerland. Thousands are soon expected to be exposed for dodging U.S. taxes Los Angeles Times (hat tip DoctoRx)

Hedge fund bets millions that gas price will triple Financial Times

Cost control not coverage is the key to health reform Financial Times

Antidote du jour:

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  1. fresno dan

    Health Care Reform and single payer – an Australian perspective

    "Australians are almost as fat as Americans."
    OMG, I thought they were all gorgeous string bikini wearing babes and rugged 'roo boxing blokes.
    Sounds like a nice system – but the showstopper is that physicians went from 5X average income to only 1.5X income. I remember reading that physician income in the Netherlands is also just average.
    There is nothing intrinsic to being a physician that demands an income higher than an accountant. Indeed, the model of the lone purveyor of the medical service probably hinders the adoption of modern technology and cost saving measures. I wonder how many prescriptions are written because doctors feel compelled to "do" something, and how many tests are run to get a fee.

  2. cian

    A lot of Australian doctors (and GPs in the UK also) work part time around childcare. In the UK, doctors receive a fairly low salary until they finish their training (which takes several years). So this may distort the figures somewhat.

    One of the problems with the US system is that many of the tests which are run have a high false positive, which means many procedures may well be unnecessary (this is true of both prostrate and breast cancers, for example).

  3. Anonymous

    As an Australian who's best friend happens to be a physician I can state without a doubt that Australian doctors are earning much more than 1.5x average income – the real figure is much more like 4x to 5x.

    Given that that their university training is almost free I don't think many Australian doctors have too much to complain about.

  4. emca

    This comment from the Hempton article:
    "Most doctors however have structures in place that produce this low salary to minimize tax. The real income for an average GP working full time would be closer to 5 times average salary, or about the same as 30 years ago as you note"
    – which would second the comment made above.

    The blog entry makes it clear that there are some definite losers and winners in any market reform. In the case of health care its business burdened with the increasing costs of employee benefits, verses the medical support establishment (not necessarily primary doctors) which benefit from unhindered consumption of service as well as "fee for service" delivery. (cynically I might add, that this fits the bill for a nation of consumers not producers)

    The core problem, as the article suggests, in the U.S. is not availability of service, but a means of containing the costs of the health care behemoth itself. On this lever politics in this country has failed…again.

    Analogy to that other social sector, finance, is painfully obvious. I don't see how any long-term solution can be managed given the current environment of haves and wannabes, the hapless have-nots.

    Incidentally I also couldn't help but noting, that under the Australian system, its private insurance that's the burden and problem, not public service, which is not going to pay for anything outside minimals on the taxpayer's dime (therefore is more cost effective),and who the healthy, the sure(s) of insurance, gravitate toward.

    Also this stood out; much of the work primary care physicians do is to avoid the specter of ligation, not what is needed for effective patient care. From a personal perspective, although I'm not in the medical arena, I can vouch for that observation, as I have spent woefully too much time and money waging a 'safe rather than sorry' battle.

  5. Thatcher

    I grew up in Australia and have wondered why the Australian model isn't discussed more. As mentioned in the piece it is not perfect but it delivers pretty good outcomes. I do know that the private health insurance sector was under pressure a number of years ago but a lot of what I heard was that the coverage under Medicare (the name of the system) meant that people didn't feel the need for private insurance; until they were on a waiting list!

    We were visiting Australia last Fall and my wife needed to see a doctor with a minor complaint. We were able to see a doctor at a local clinic after a very short wait and paid AUD $50.

    I think the crux of this issue is how a society views access to medical care. Is it a fundamental right or subject to ability to pay? I think Australia and many other countries have decided that it is a fundamental right.

  6. RPB

    Put these idiotic cap and trade schemes into law and NG will spike quickly and a new LNG cartel will be established. But at least our money will flow more towards Russians, Persians, Africans and Pickens (T Boone) than Arabs, right?

    Watch and see.

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