Peter_Puget

I believe it's warm and snowing at Index right now (ie wet but climbable)

I am hard at work typing up my Cooperstown trip report. The annual post season trip to the hall of fame always is wonderful. They even have the giants 2010 display up.

Jayb – I think that blaming a "shortage" of PCPs alomost entirely on the implementation of the RBRVS payment system is biting off a bit too much. Check this out: http://www.gao.gov/new.items/d08472t.pdf The RBRVS payment system took effect in 1991. By the way - what's your opinion of the RVBRS in general? Seems like a ludicrous Soviet-Style price-control apparatus that has it's intellectual roots in the labor theory of value, can't possibly coordinate supply and demand or keep pace with technology and other factors that change how care is delivered much more rapidly than their prices can adjust, is subject to public-choice distortions like you'd get if you had a commission of farmers setting grain prices, etc, etc - but what's your opinion? I think it's much better than the old "usual and customary" methodology of old. Definitely not perfect. What I think physicians really hate most about the system is that it provides a very easy way to track their productivity. Both large physician groups and hospital owned practices base pay agreements primarily on productivity and strategic marketing goals.

Jayb – I think that blaming a "shortage" of PCPs alomost entirely on the implementation of the RBRVS payment system is biting off a bit too much. Check this out: http://www.gao.gov/new.items/d08472t.pdf The RBRVS payment system took effect in 1991. Which part? Scanned and saw an acknowledgment of the RVBRS's effect on compensation for specialists vs generalists, but didn't see anything suggesting that it wasn't having a negative effect on the number of primary care physicians. There are other factors at play, such as the work isn't seen as terribly rewarding/challenging/etc by lots of folks in the doctoring business, isn't well respected, etc - but the fact that dermatology is one of the hardest, if not the hardest specialty to get into shows that pay and working conditions trump just about everything else in determining how many people want to work in a given specialty. Check out the table on page 2.

Jayb – I think that blaming a "shortage" of PCPs alomost entirely on the implementation of the RBRVS payment system is biting off a bit too much. Check this out: http://www.gao.gov/new.items/d08472t.pdf The RBRVS payment system took effect in 1991.

You are truly an idiot. Fuckin Dwarf!

That explains so much..... link

Those Republifucks Obami messing with those noble scientists again!

I suspect actual earnings is dependent upon the type of physician. (Anesthesiologists make over $200k) I am sure you are also aware of the chronic shortage of Drs. in Australia. Don’t have time to find a more current article but check this out. https://www.mja.com.au/public/issues/179_04_180803/letters_180803_fm-3.html There is also a shortage of physicians in Canada and amazingly enough I bet if you check out Mass, problems are starting to develop there as well.

Yep class all the way! Thats why I find you so damn adorable!

Let’s say the base pay differential was such that Metro drivers earned $6.5 more than their oppressed free market brothers. Let’s say additional costs (benefits) of 40% base wage were incurred by the King County. That brings the total differential to $9.1. The annual premium for 1.0 fte of driver is $19k/annum. Now the interesting thing isn’t that taxpayer for the most part are willing to pay this differential. What is surprising is that (and here is an example inspired by Tvash’s AMA comment) that the County pays this premium because of vested interests and not because it is the best use of tax receipts. Here's the example: Because they can push cost such as caring for drug abusers and the mentally incompetent off on someone else – in this case local hospitals – they pay this premium to driver instead of funding efficient social welfare programs. Local hospitals pick up the tab in a relatively inefficient way and pass it along to all of us. Or another way to view it is how many after school programs can be funded with $19k. How many battered women could be sheltered?

No worries J_B you're the only guy for me! <3

Tvash - I provided several comparison positions. I'll will add one more: Shuttle bus drivers for several large corporations in the Seattle area earn less than metro drivers. But your point about school drivers is a good one. Those working less than full time often earn more in base pay if they have reduced benefits. So it is quite probable that we should actually discount the school drivers wage rate in order to be comparing apple to apples. Perhaps Mr Math can help us there.......

So back the drivers….the question is not whether they make as much money as you hot as shit cc.commies but rather are they overpaid compared to what they would earn outside of the government/union monopoly. I think the answer to that is yes. For example school bus drivers earn a wage far lower than Metro drivers. The median greyhound driver wage is less than the lowest tier Metro driver! http://www.payscale.com/research/US/Employer=Greyhound_Lines%2c_Inc./Hourly_Rate I am sure if we started including benefits into the calculation The spread between Metro and free® market would be even greater.

Go to the source ! Mickey Newbury!

Wait I've heard you before I think! Yes from this documentary on MSNBC - you get up and speak at a Democratic caucus several years ago! [video:youtube]

What's amazing is a guy like Saul link has found ways to be intellectually challenged. Think how much smarter Obama must be to have never been challenged intellectually!

I think J_B was taking issue with the impact illegal immigrants have on representation in congress. States with large populations of illegal immigrants receive a disproportionate number of seats in the House of Representatives because noncitizens are included with citizens.

You're just like Barak baby! Link on p3

Hold on there Mr Tvash! Clearly you are a superior individual. Why waste your time with these losers? Come help run my campaign for minority leader! Your country calls!

Another boner by Obama!

I see it this way a guy is psyched about climbing and posts a video. Sure it may not be to everyones taste but it doesn't deserve the harsh reception it got. At the start there were several good posts on aiding technique and a link to a good resource. I figured why move those to spray. In any event why move the original post to spray? Many of the replies were in bad taste; the original post was not.

Here's your answer prole:

Obviously you're a good father. I hope Kevbone is paying attention.