Dino Rossi

[prole]

If this is what passes for a sense of humor in your book then your social pariah status is well-earned. Christopher Hitchens meets Gallagher...

 

Affirmation of the day!

 

I've taken to humming the strains of this song in my head and smiling when I run into someone who has literally no idea what an antigen is, much less an adjuvant, chimes in with news that they'll be spacing out their vaccinations because - based on what they heard at their Mommy-Yoga class in Fremont - they don't want to have their infant exposed to too many "antigens" all at once.

 

Oh, I didn't say he probably isn't right. I'm saying he's a humorless, ideologically fixated twat. "Edgy"...

[JayB]

If this is what passes for a sense of humor in your book then your social pariah status is well-earned. Christopher Hitchens meets Gallagher...

 

Affirmation of the day!

 

I've taken to humming the strains of this song in my head and smiling when I run into someone who has literally no idea what an antigen is, much less an adjuvant, chimes in with news that they'll be spacing out their vaccinations because - based on what they heard at their Mommy-Yoga class in Fremont - they don't want to have their infant exposed to too many "antigens" all at once.

 

Oh, I didn't say he probably isn't right. I'm saying he's a humorless, ideologically fixated twat. "Edgy"...

 

Open-minded is one thing, gullible is another, no?

 

Another affront to open-mindedness below!

[video:youtube]

 

 

 

 

[prole]

Being skeptical is one thing, taking up a high-minded crusade to "debunk" what are relatively minor phenomena amidst a sea of daily commercial swindle, fakery, despoilment, and exploitation on a colossal scale is another. Your perspective is seriously out of whack.

[Hugh Conway]

Unfortunately for me, Diderot, D'Alembert, Turgot, Rousseau, D'Holbach, etc lead directly to Burke, Locke, Hume, Gibbon, Smith, etc - and once I veered off into Menger, Mises, and Hayek I was pretty much doomed to pariah status in progressive enclaves. This after alienating a good many social conservatives with the whole agnostic evolutionist schtick.

 

sweet cut n' paste

 

nothing says seattle like dogmatic book learned opinions and pedantic style

 

None of the above were giving personal interviews at the time.

 

 

didja at least get to give ole Milton Friedman a BJ before he passed on?

[Peter_Puget]

You realize that the resource-based relative value scale has done more to distort compensation towards specialists and procedures and away from GP's and prevention than any other set of incentives in the history of American medicine?

 

But I suspect that you have not idea what the RBRVS is, what its origins are, or how it distorts the practice of medicine.

 

http://motherjones.com/mojo/2009/10/blame-doctors-americas-primary-care-doctor-shortage

 

http://www.thestranger.com/seattle/lessons-from-the-abyss/Content?oid=999924

 

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.

 

[JayB]

You realize that the resource-based relative value scale has done more to distort compensation towards specialists and procedures and away from GP's and prevention than any other set of incentives in the history of American medicine?

 

But I suspect that you have not idea what the RBRVS is, what its origins are, or how it distorts the practice of medicine.

 

http://motherjones.com/mojo/2009/10/blame-doctors-americas-primary-care-doctor-shortage

 

http://www.thestranger.com/seattle/lessons-from-the-abyss/Content?oid=999924

 

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.

 

 

 

[JayB]

You realize that the resource-based relative value scale has done more to distort compensation towards specialists and procedures and away from GP's and prevention than any other set of incentives in the history of American medicine?

 

But I suspect that you have not idea what the RBRVS is, what its origins are, or how it distorts the practice of medicine.

 

http://motherjones.com/mojo/2009/10/blame-doctors-americas-primary-care-doctor-shortage

 

http://www.thestranger.com/seattle/lessons-from-the-abyss/Content?oid=999924

 

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?

[Hugh Conway]

The AMA is a union cartel? Who'd ever have thunk that

 

if unions are so bad why don't you return the portion of your collective earning you "aren't entitled too"

[JayB]

The AMA is a union cartel? Who'd ever have thunk that

 

if unions are so bad why don't you return the portion of your collective earning you "aren't entitled too"

 

Not a union, but definitely a rent-seeking cartel of the highest order. Put a bill completely liberalizing medicine and abolishing price controls, grant me the power to change everything with a single stroke of the pen, and I'd gladly sign it.

 

I think that most physicians would actually make more money under a liberalized regime with dramatically less third party payment, and patients would get better care, so it's not clear to me that the net effect of the cartel getting in bed with Uncle Sugar is necessarily positive for my household.

 

 

[Hugh Conway]

Not a union, but definitely a rent-seeking cartel of the highest order. Put a bill completely liberalizing medicine and abolishing price controls, grant me the power to change everything with a single stroke of the pen, and I'd gladly sign it.

 

So Jay_B's a fan of unrealistic magic bullets. Who'd have thunk that?

[olyclimber]

[video:youtube]9USqGsV9gk8&NR

[mattp]

Jay,

 

I agree with you that government employee salaries and other compensation costs comprise the lions’ share of most government agencies’ costs. That is clear and obvious.

 

I don’t argue with the assertion that government employee’s unions are looking out for their members’ interests and that, further, the “pull” they muster is not necessarily in yours or my interest. But that is true of pretty much every “group” that is organized in the American economic and political landscape. Many people would argue that the pursuit of self-interest is synonymous with efficiency (are you among them?).

 

However, you seem to have a fetish about public employees. You ask where I get this notion?

 

I'm voting against every single tax measure that comes up until all state workers move to defined contribution retirement plans, the minimum retirement age is 65, and both Until that day arrives, there's plenty that can be cut without touching services.

 

By this I take it that you believe that no matter what else may be at stake you intend to stick it to the state workers. All that matters is that these government workers have an unfairly sweet deal and you don't care what the issues may be until they lose it.

 

That is called "war."

 

[Hugh Conway]

took you long enough libdope

[AlpineK]

In case any of you missed the news Dino Rossi lost the election and conceded defeat to Patty Murry. FYI

 

 

Possibly somebody should change the thread title to

My cock is bigger than yours!

[JayB]

Jay,

 

I agree with you that government employee salaries and other compensation costs comprise the lions’ share of most government agencies’ costs. That is clear and obvious.

 

I don’t argue with the assertion that government employee’s unions are looking out for their members’ interests and that, further, the “pull” they muster is not necessarily in yours or my interest. But that is true of pretty much every “group” that is organized in the American economic and political landscape. Many people would argue that the pursuit of self-interest is synonymous with efficiency (are you among them?).

 

However, you seem to have a fetish about public employees. You ask where I get this notion?

 

I'm voting against every single tax measure that comes up until all state workers move to defined contribution retirement plans, the minimum retirement age is 65, and both Until that day arrives, there's plenty that can be cut without touching services.

 

By this I take it that you believe that no matter what else may be at stake you intend to stick it to the state workers. All that matters is that these government workers have an unfairly sweet deal and you don't care what the issues may be until they lose it.

 

That is called "war."

 

Woah! War seems a touch strong for converting to a 401(K) style retirement plan and paying a bigger share of health-care expenses - particularly when the alternative is sticking it to the people that rely on government services the most, just about all of whom are way worse off than the average person employed by the city, county, or state.

 

Self interest can certainly drive efficiency in conditions of open competition where alternative to becoming more efficient is going under, but since going under is an impossibility when you're talking about a taxpayer funded monopoly, there's no reason to believe or evidence to suggest that the self-interest of public sector unions has done much to inspire the kind of efficiency that might persuade the public to forgo any talk of reform.

 

I actually think that it'd be in public employee unions interest to take the lead on reforming the cost structure and improving efficiency, since that would likely make the electorate more receptive to approving the taxes necessary to stave off much more severe cuts driven by straight-up budget shortfalls.

 

I'd personally rather have a job with a 401(K) and higher-cost sharing on my health insurance premiums than be unemployed, and the next budget cycle will give public sector employees the opportunity to contemplate that choice. I think that the unions are hoping that this economic downturn is temporary, and that either higher tax revenues or a dramatic change in voter sentiment will make it possible to avoid things like pension reform. That's possible, but after looking at the numbers my conclusion is that here - as in Greece - math will take over at some point.

 

We'll see.

[Fairweather]

By this I take it that you believe that no matter what else may be at stake you intend to stick it to the state workers. All that matters is that these government workers have an unfairly sweet deal and you don't care what the issues may be until they lose it.

 

That is called "war."

Can't believe I missed this little gem. Forgive us, Matthew, if we remain unconcerned.

[Hugh Conway]

I'd personally rather have a job with a 401(K) and higher-cost sharing on my health insurance premiums than be unemployed

 

I'd rather blowjobs from Giselle Bundchen, but that's me.

[mattp]

I know you are not concerned, Fairweather. Neither is JayB.

 

I'm voting against every single tax measure that comes up until all state workers move to defined contribution retirement plans, the minimum retirement age is 65, and both...

 

A combination of tax increases and cuts to social security, medicare/medicaid and military expenditures is needed for anything like a balanced budget yet Jay is focused on a smokescreen.

[Fairweather]

I know you are not concerned, Fairweather. Neither is JayB.

 

I'm voting against every single tax measure that comes up until all state workers move to defined contribution retirement plans, the minimum retirement age is 65, and both...

 

A combination of tax increases and cuts to social security, medicare/medicaid and military expenditures is needed for anything like a balanced budget yet Jay is focused on a smokescreen.

 

S-T-A-T-E, Matt. State. ¿Comprende? A pretty weak dodge--even by your standards. But never mind all that; I want to hear more about this war you're planning!

Edited November 15, 2010 by Fairweather

[rob]

I'd support war with oregon. We could take em.

[AlpineK]

I'd support war with oregon. We could take em.

 

 

Think globally act locally

[Peter_Puget]

You realize that the resource-based relative value scale has done more to distort compensation towards specialists and procedures and away from GP's and prevention than any other set of incentives in the history of American medicine?

 

But I suspect that you have not idea what the RBRVS is, what its origins are, or how it distorts the practice of medicine.

 

http://motherjones.com/mojo/2009/10/blame-doctors-americas-primary-care-doctor-shortage

 

http://www.thestranger.com/seattle/lessons-from-the-abyss/Content?oid=999924

 

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.

[prole]

[video:youtube]

[Off_White]

I'd support war with oregon. We could take em.

 

If we conquered Oregon, all their bacon maple bars are belong to us.

 

[Peter_Puget]

You realize that the resource-based relative value scale has done more to distort compensation towards specialists and procedures and away from GP's and prevention than any other set of incentives in the history of American medicine?

 

But I suspect that you have not idea what the RBRVS is, what its origins are, or how it distorts the practice of medicine.

 

http://motherjones.com/mojo/2009/10/blame-doctors-americas-primary-care-doctor-shortage

 

http://www.thestranger.com/seattle/lessons-from-the-abyss/Content?oid=999924

 

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.