# Doctors strike in Great Britain...



## billc (Jun 1, 2012)

Well, it seems as if the Doctors in the National Health Service of Great Britain will be going on strike on June 21.   Hmmmm...I can't remember the last time American doctors have gone on strike...oh, that's right, they don't work for the government...yet...
Apparently, there are doctors who won't strike that day and will continue to do their job.  The striking doctors will create a huge back log of patients and it could take months to clear the back log.

http://dailycaller.com/2012/06/01/doctors-in-britain-to-strike/



> Doctors in Britain plan to strike on June 21, The Telegraph reports.
> 
> The British Medical Association, the union for doctors in Britain&#8217;s  socialized medical system, says that doctors will postpone non-urgent  operations and other nonessential appointments that day, resulting in a  &#8220;very serious impact on waiting times, not only for the patients on that  day but all subsequent patients in the following weeks and months,&#8221;  according to the Department of Health.
> The strike would be the first by doctors in Britain in almost 40 years.
> The strike comes in response to the government&#8217;s pension proposals  for doctors. The Royal College of Nursing also opposes the government&#8217;s  proposals, but the nurse&#8217;s union prohibits strikes that will affect  patients, unlike the BMA.



Read more:  http://dailycaller.com/2012/06/01/doctors-in-britain-to-strike/#ixzz1wYuRKnof
​


After 2014, will we eventually  see the same thing here in America?  Will we have seens of one Doctor performing an appendectomy while three other doctors stand around and watch?


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## Steve (Jun 1, 2012)

Actually, in America, if they worked for the government, they would be legally unable to strike.  Just, you know, for what that's worth.


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## Makalakumu (Jun 1, 2012)

Steve said:


> Actually, in America, if they worked for the government, *they would be legally unable to strike*.  Just, you know, for what that's worth.





If the government demands that you work and can throw you in jail if you don't, isn't that damn close to slavery?


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## Steve (Jun 1, 2012)

Makalakumu said:


> If the government demands that you work and can throw you in jail if you don't, isn't that damn close to slavery?


They won't throw you in jail.   They would fire you as Reagan did to the Air Traffic Controllers when they went on strike in 1981.

http://en.wikipedia.org/wiki/Profes...ollers_Organization_(1968)#August_1981_strike

Federal employees do, however, have recourse in the form of arbitration when there is a labor dispute.


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## Tez3 (Jun 1, 2012)

I would point out that they never went on strike when we had Labour governments, it takes special people to make the doctors stirke...a Conservative Prime Minister and Health Minister...this man http://www.independent.co.uk/news/u...tack-cuts-to-frontline-nhs-staff-7746775.html
http://www.dailymail.co.uk/news/art...drew-Lansley-Keep-mean-dreary-views-life.html
http://www.liverpooldailypost.co.uk...ns-90m-nhs-mersey-cash-snatch-99623-31079791/

Yes, you can certainly trust the Tories when it comes to healthcare here...to cut, damage and generally destroy it.


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## K-man (Jun 1, 2012)

billcihak said:


> Well, it seems as if the Doctors in the National Health Service of Great Britain will be going on strike on June 21.   Hmmmm...I can't remember the last time American doctors have gone on strike...oh, that's right, they don't work for the government...yet...
> Apparently, there are doctors who won't strike that day and will continue to do their job.  The striking doctors will create a huge back log of patients and it could take months to clear the back log.
> 
> After 2014, will we eventually  see the same thing here in America?  Will we have seens of one Doctor performing an appendectomy while three other doctors stand around and watch?


Mmm! I wouldn't be worrying too much about one strike in 40 years. (Actually it's not really a strike anyway, a protest really.)  The US system isn't anything to write home about. 

http://www.reuters.com/article/2010/06/23/us-usa-healthcare-last-idUSTRE65M0SU20100623



> (Reuters) - Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday.
> The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.
> "As an American it just bothers me that with all of our know-how, all of our wealth, that we are not assuring that people who need healthcare can get it," Commonwealth Fund president Karen Davis told reporters in a telephone briefing.


This report is a couple of years old.  Maybe that is why Obama is trying to improve the medical services for Americans.          :asian:


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## K-man (Jun 1, 2012)

Actually, here's a more recent study.

http://www.jonbarron.org/natural-health/us-health-care-costs-high-quality-low



> [h=2]US Health Care Costs Far Exceed Other Nations; Quality Does Not[/h]Its no secret that medical care costs more in the U.S. than in other nations. Its also no surprise that U.S. health care quality doesnt necessarily match the exorbitant costs.  And it may not even be that surprising to you, if you follow the news, that the quality of care in the U.S. is no better than in nations that spend far less. Even so, a new study by the Commonwealth Fund provides a rather shocking view of the extent of the gap between the U.S. and everyone else.
> The study compared health care costs in 13 industrialized nations including Australia, Britain, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Sweden and the U.S. The U.S. spends an average of $8,000 annually, per capita, on medical care, compared to $5,000 per capita in runner-up nations Norway and Switzerland. At the bottom of the list, Japan and New Zealand spend a mere fraction of what the U.S. does -- a full two-thirds less.[SUP]1[/SUP]
> The higher U.S. health care cost, by the way, doesnt necessarily indicate that U.S. citizens have more to spend.  In fact, U.S. health care costs are way out of proportion to income. According to the Commonwealth report, Based on national income and health spending in other OECD countries, a linear regression would predict that U.S. health spending would be $4,849 per capita or 11 percent of GDP [gross domestic product].[SUP]2[/SUP] Thats far less than the 17 percent of the gross domestic product actually spent.
> Nor does the higher spending in the U.S. provide citizens with better access to doctors or better health care quality. Rather, the U.S. has fewer practicing physicians per 1000 people than all the nations in the study except Japan. As a result, people in the U.S. had fewer doctor consultations than in almost all the other nations, and there are far fewer available hospital beds in the U.S. than the median. (Of course, thats not necessarily a terrible thing given the high rate of medical errors in U.S. hospitals, but thats another topic entirely.) And while the average hospital stay for acute care was shorter in the U.S. than in most nations, the average health care cost was $18,000, compared to $5,000 in France and Germany, or $10,000 in Sweden and Norway.
> ...


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## Sukerkin (Jun 1, 2012)

:nods:  Aye, it is something I have been bringing up every now and again; mostly when the 'self harmers' (as I mentally call them) bang on about Obama-care i.e. those who reject socialised medicine because it's 'Commie' and so cut off their nose to spite their face.  

As Cap'n Bob explained it to me, the proposed revised system was not really an NHS as Tez and I would recognise it and it certainly had some problems buried in the detail but it was a heck of a lot better for the majority of people than the system the American's have suffered under for so long.


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## elder999 (Jun 1, 2012)

Sukerkin said:


> :As Cap'n Bob explained it to me, the proposed revised system was not really an NHS as Tez and I would recognise it and it certainly had some problems buried in the detail but it was a heck of a lot better for the majority of people than the system the American's have suffered under for so long.



Well, no Mark-it's not a "heck of a lot better at all. It's a huge bone to the corporate entities called "insurance companies." Instead of one choice as an employee, or two or three plans to choose from, I'll soon be confronted with an array of choices, dependent upon what "preexisting conditions" I have that the insurance company now has to cover, or what problems I can expect in the future. For a "perfectly healthy" person, this is not as big a problem, but-speaking for myself-I already spend close to $80 a month on medications that aren't covered by my insurance-I can't imagine navigating all of it as I get older. Luckily, even if I need a procedure like a heart/lung transplant, I can afford to pay out of my own pocket, but most people-especially in the middle class, never mind the poor-are not so fortunate, and the quagmire that "Obamacare" will prove to be will ensure that only the  very upper-middle class ,the  wealthiest  and the poorest will be able to deal with emergent health issues. Even then, I expect that there will be new protocls for what can or can't be done and for whom.

We already had a government sponsored medical coverageprogram here-it's called Medicaid-ostensibly for the very poorest-and the best thing to do would have been to expand it to cover everyone, and do away with insurance companies, if he was going to do anything.......


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## granfire (Jun 1, 2012)

k-man said:


> actually, here's a more recent study.
> 
> http://www.jonbarron.org/natural-health/us-health-care-costs-high-quality-low



but it's private!!!!!!


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## Sukerkin (Jun 1, 2012)

Quite agree, mate, given the parameters you describe.  That is considerably worse than the picture I had in my memory from previous discussions on the topic.  

The reason why I phrased it as "better" is because it was a first step towards a proper universal health care rather than the, to my English eyes, horrible system in place.  Now a step in the wrong direction can be a terrible thing but if it gets you moving away from something bad and seeking for something good then it has merits.


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## billc (Jun 1, 2012)

From the American Enterprise institute on healthcare...

http://www.aei.org/article/health/health-care-101-the-truth-about-health-spending-in-america/



> *Doesn't the U.S. spend too much on health care?
> Critics argue that the U.S. spends too much and gets too little especially compared to single-payer systems such as Great Britain's or Canada's. But the U.S. also has the largest gross domestic product (GDP) on the planet. The issue is whether the U.S. spends too much given its much higher GDP per capita relative to other countries. The conventional wisdom says the U.S. spends 60 percent more than it should given its income. But a more accurate analysis of the same data shows that the U.S. spends only 1.5 percent too much. In contrast, France spends 19 percent too much, while single-payer countries spend at least 20 percent too little. This suggests a degree of rationing most Americans would find unacceptable.*





> *But don't other countries better control health spending?
> It turns out that they do not. In terms of growth of inflation-adjusted health spending per person, the U.S. is actually  right in the middle of the packamong its G7 competitors, and this has been true for nearly five decades.  Moreover, the real health spending per capita in Great Britain and Canada has exceeded that of the U.S. since 2000, and these are the same single-payer countries that critics of the U.S. point to as having a vaunted advantage in cost control.*





> *Does this mean that U.S. doctors are overpaid?**
> Not so fast. Compared to the average citizen, American doctors do appear to be paid more than doctors elsewhere. That is, relative to GDP per capita in their respective countries, U.S. medical specialists and primary care doctors earn about 50 percent more than their foreign counterparts. But U.S. specialists earn only 37 percent more than high earners (95-99th percentile of the earnings distribution), whereas in the rest of the OECD, specialists earn 45 percent more than high earners in their own countries.  *





> *Health Outcomes
> *
> 
> *Doesn't the U.S. have a much higher infant mortality rate than other countries?
> Many of the international comparisons of health outcomes are deeply flawed. The U.S. currently ranks 43rd internationally in infant mortality. Unfortunately, no consistent standard exists for reporting infant deaths across countries. Preterm birth (that is, births at less than 37 completed weeks of gestation) is a key risk factor for infant death, yet the United States is one of only eight countries that categorize extremely premature infant births as "live births," despite these babies' very low odds of survival. Specifically, "many nations do not report any live births at less than 23 weeks' gestation, or less than 500 g, despite the presence of vital signs." This may sound like a minor reporting difference, but a Philadelphia study found that when all deaths of infants delivered at 22 weeks' gestation were excluded from its birth statistics, that city's measured infant mortality ratedeclined by 40 percent.*





> The aggregate statistics also mask this important reality: if we categorize births by length of gestation, the U.S. ranks second, third or fourth as compared to major European countries, in that it achievesthe lowest infant mortality rates for every birth category examined prior to full-term (22-23 weeks, 24-27 weeks, 28-31 weeks and 32-36 weeks). Only Norway and Sweden (whose populations are much more homogenous and physically fit than America's) achieve consistently better results.





> *Don't Americans have a much lower life expectancy than those elsewhere?
> The U.S. ranking of 39th in life expectancy is likewise thoroughly misleading. When life expectancy figures are appropriately adjusted to account for violence-related deaths, the U.S. ranks number one among OECD nations in life expectancy at birth (without this adjustment, the nation ranks 15th). The disproportionate number of U.S. deaths due to violence is the principal reason our nation ranks so low overall. These fatalities include all gunshot-related deaths, all homicides and suicides, and deaths due to automobile accidents or other injuries. Such deaths arise from social causes, lifestyle choices or imperfections in public efforts to reduce such deaths, such as highway safety. These fatality rates nothing about the quality of U.S. medical care.*
> *But doesn't the U.S. have worse health outcomes than its major competitors?
> The U.S. does perform worse on so-called avoidable deaths amenable to medical treatment. However, this measure also has many flaws, not the least of which is that such deaths constitute only a fraction of overall deaths. As a general proposition, the U.S. has superior medical outcomes for conditions in which medicine makes a difference.*



An article mentioned above showing some of the flaws in healthcare comparison studies...

http://www.aei.org/article/health/h...-how-does-the-us-health-care-system-stack-up/



> In fact, if one goes further out on the age curve to age 80 and over, one finds that the U.S. probably leads the developed world in life expectancy.
> These differences highlight the U.S.'s focus on subsidizing health care for the elderly, for whom medical interventions are more frequent, costly, intensive, and arguably more beneficial, and to whose future health non-medical factors matter less on the margin. (Their likelihood of voting is also higher&#8230 A study published earlier this month in Demography finds that at age 55 and beyond, Americans are sicker by far than the English, yet older Americans don't die earlier than their British counterparts: Death rates were equivalent for 55-to-64-year-olds, and beyond age 65, Americans had a slightly greater probability of survival. Why is this so? Perhaps because the U.S. health care system diagnoses and treats illnesses (particular among the elderly) more aggressively than does the National Health Service--though, of course, all that extra screening and more intensive treatment costs more money.





> Essentially, Richard Cohen's column is an overwrought, highly politicized reaction to the periodically shallow rhetoric of some Republican officeholders who refer to U.S. health care as the best in the world--which, in some respects, U.S. health care is: for instance, in cancer detection and treatment and in a number of relatively sophisticated procedures for life-threatening illnesses. But that's not the point. The real issues are (1) how to improve it, particularly in terms of more consistent quality and greater affordability; and (2) how to refrain from worsening it, along with the economy, through a harmful prescription (Obamacare). Some Republicans have focused more on #2 than #1, which is equally important but more complex, but correcting their emphasis is hardly the most important mission we face.


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## K-man (Jun 2, 2012)

OMG! 



> *Don't Americans have a much lower life expectancy than those elsewhere?
> The U.S. ranking of 39th in life expectancy is likewise thoroughly misleading. When life expectancy figures are appropriately adjusted to account for violence-related deaths, the U.S. ranks number one among OECD nations in life expectancy at birth (without this adjustment, the nation ranks 15th). The disproportionate number of U.S. deaths due to violence is the principal reason our nation ranks so low overall. These fatalities include all gunshot-related deaths, all homicides and suicides, and deaths due to automobile accidents or other injuries. Such deaths arise from social causes, lifestyle choices or imperfections in public efforts to reduce such deaths, such as highway safety. These fatality rates nothing about the quality of U.S. medical care.*


This opens a whole new can of worms!  If the other countries adjust their figures for local influences does that change the figures too? Seems to me, there might be some other areas, other than straight healthcare, that need to be addressed in the US, that perhaps don't have the same effect on longevity in other first world countries.     :asian:


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## WC_lun (Jun 2, 2012)

17% of US GDP is spent on healthcare.  It is also the leading cause of bankrupcy.  An estimated 19 thousand people die each year (2009 figure) because they cannot afford to go to a doc.  Many many more are undertreated or wait until a minor affliction becomes a serious one.  Those underinsured or uninsured are paid for by hugely inflated charges by many doctors and just about every hospital.  The healthcare system is a huge issue and a big drain on our economy.

Like many, from my experience having used America's healthcare system extensively, I think a single payer system would have been better for everyone, but the insurance companies.  Instead we have forced policies with private insurance companies.  If regulated well, it could work, but it will take much longer to reduce the cost of healthcare.  If the current push to reduce regularions succeed, we are going to be in for a rough time.  Unregulated insurance companies with the kind of money being talked about will be a nightmare.  It does make me chuckle when people call it socialized healthcare, since it is actually the opposite.


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## Sukerkin (Jun 2, 2012)

A very good thumbnail of the situation that makes the inherent issues and problems very clear, *WC* :tup:.

I had forgotten what a camel the proposed new system was, with all it's canards and compromises - thank you to you and Elder for re-reminding me, for I had fallen back into the trap of thinking that it was the first step towards an NHS type of health care :bows:.  I blame the fact that, on the forums, we keep calling it Socialised Medicine, which is a good thing in my view but, as you say, that is not what it is.


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## Sukerkin (Jun 2, 2012)

With my Mentor hat on tho', I must gently guide posters more closely back to the topic of the OP.  Please recall that the Study regulations stipulate that serious discussions in this forum must not wander too far from the original point of conversation.  I realise that a comparison of the two medical funding systems is related to the topic, I just fear that we shall walk away from that into talking about what is right and wrong in the American health service.


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## WC_lun (Jun 2, 2012)

Oops, sorry!


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## Makalakumu (Jun 2, 2012)

Steve said:


> They won't throw you in jail.   They would fire you as Reagan did to the Air Traffic Controllers when they went on strike in 1981.
> 
> http://en.wikipedia.org/wiki/Professional_Air_Traffic_Controllers_Organization_(1968)#August_1981_strike
> 
> Federal employees do, however, have recourse in the form of arbitration when there is a labor dispute.



What if, as in the case for many doctors, you run your own business?  Should the government be able to force you to work?


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## Steve (Jun 2, 2012)

I'm not sure we are talking about the same thing.  But few doctors own their own practice anymore.  It's still somewhat common with dental and vision, but the insurance situation in america (on both the consumer side and the business side) makes it much safer and more lucrative for doctors to work for someone else.

Yes, though.  Ifyoure employed by the government, it can force you to work.  Police, firefighters, any federal employee... All unable to strike.  Teachers too, but they're doubly screwed in that they also have no right to arbitration.  This is why teachers end up striking even though it's illegal for them, to do so.  


Sent from my iPad using Tapata


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## K-man (Jun 2, 2012)

Steve said:


> I'm not sure we are talking about the same thing.  But few doctors own their own practice anymore.  It's still somewhat common with dental and vision, but the insurance situation in america (on both the consumer side and the business side) makes it much safer and more lucrative for doctors to work for someone else.
> 
> Yes, though.  Ifyoure employed by the government, it can force you to work.  Police, firefighters, any federal employee... All unable to strike.  Teachers too, but they're doubly screwed in that they also have no right to arbitration.  This is why teachers end up striking even though it's illegal for them, to do so.
> 
> ...


Doesn't sound like me to be the "Land of the Free".    :asian:


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## Steve (Jun 2, 2012)

K-man said:


> Doesn't sound like me to be the "Land of the Free".    :asian:


Oh good.  Now we get the anti-american zingers.  
Part of the job.  If you choose to accept the position, you also agree contractually to waive your right to strike.   They're free to get another job.  Or they're free to strike, and their employers are free to fire them for it because they're in breach of contract.  And they they're free to get another job. 

Freedom is often a matter of perspective.  

Teachers, though... they're screwed.


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## Makalakumu (Jun 2, 2012)

Again, what if you own your own practice? Can the government force you to work? Can they suspend your license...I mean permission slip? How much of your labor is owned by others?


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## Steve (Jun 2, 2012)

Are you asking a question you already know the answer to?  I don't know of any law that requires any self employed person to stay in business.    If you do, I'd appreciate it if you'd just get it out.  


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## CanuckMA (Jun 2, 2012)

Steve said:


> I'm not sure we are talking about the same thing.  But few doctors own their own practice anymore.  It's still somewhat common with dental and vision, but the insurance situation in america (on both the consumer side and the business side) makes it much safer and more lucrative for doctors to work for someone else.
> 
> Yes, though.  Ifyoure employed by the government, it can force you to work.  Police, firefighters, any federal employee... All unable to strike.  Teachers too, but they're doubly screwed in that they also have no right to arbitration.  This is why teachers end up striking even though it's illegal for them, to do so.
> 
> ...



Interestingly enough, in Canada most doctors own their own practice. They bill the province for the services they render, and from that pay the rent, office staff, etc.  They're not government employees, they're self employed, but only bill a single entity.


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## Makalakumu (Jun 2, 2012)

Steve said:


> Are you asking a question you already know the answer to?  I don't know of any law that requires any self employed person to stay in business.    If you do, I'd appreciate it if you'd just get it out.
> 
> 
> Sent from my iPad using Tapatalk



It's merely a matter of principle. If the government doesn't own your labor, they can't tell you when to work or when not to work. And if they do, they are essentially making a claim on your person. Hence my slave comment earlier.


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## K-man (Jun 2, 2012)

Steve said:


> Oh good.  Now we get the anti-american zingers.
> Part of the job.  If you choose to accept the position, you also agree contractually to waive your right to strike.   They're free to get another job.  Or they're free to strike, and their employers are free to fire them for it because they're in breach of contract.  And they they're free to get another job.
> 
> Freedom is often a matter of perspective.
> ...


Not meant to be anti American. Just with all the discussion of freedom of speech, right to bear arms etc, I would have thought that the right to withdraw labour can be appropriate under some conditions, even if you do have a contractual arrangement.  

Also, there is no way I would suggest Americans are not 'free'. I certainly wouldn't like to live in any of the Middle Eastern countries or Zimbabwe. It's more that we may not be as free as we think.      :asian:


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## Steve (Jun 2, 2012)

Makalakumu said:


> It's merely a matter of principle. If the government doesn't own your labor, they can't tell you when to work or when not to work. And if they do, they are essentially making a claim on your person. Hence my slave comment earlier.



So then, they don't because they don't?  I'm drug addled right now with a terrible cold so I'm probably missing things.  But the government doesn't force people to work.  Even federal employees are free to not work any time they want.  Like any other employee, though, they risk losing their job.  By your logic, any employee is essentially a slave, because they are required to work by their employer.  


Sent from my iPad using Tapatalk


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## Makalakumu (Jun 3, 2012)

Steve said:


> So then, they don't because they don't?  I'm drug addled right now with a terrible cold so I'm probably missing things.  But the government doesn't force people to work.  Even federal employees are free to not work any time they want.  Like any other employee, though, they risk losing their job.  By your logic, any employee is essentially a slave, because they are required to work by their employer.
> 
> 
> Sent from my iPad using Tapatalk



My line of thinking is specifically directed at doctors, especially those that own their own practices. For any employee, a strike is a risk.


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## Carol (Jun 3, 2012)

K-man said:


> Not meant to be anti American. Just with all the discussion of freedom of speech, right to bear arms etc, I would have thought that the right to withdraw labour can be appropriate under some conditions, even if you do have a contractual arrangement.



And that is accurate.  The right to withdraw labor can be appropriate, in some conditions, even if you do have a contractual agreement...and withdrawing labor doesn't have to mean striking.  A large school system in Mass recently had a work "slowdown".  The teachers arrived in time for their first class and left immediately after their last class.  No arriving early, no discussions with a student before class, no helping students after class, no grading papers at home, no sports, no clubs, no extracurricular activities, no field trips, no school dances.



> Also, there is no way I would suggest Americans are not 'free'. I certainly wouldn't like to live in any of the Middle Eastern countries or Zimbabwe. It's more that we may not be as free as we think.      :asian:



As a libertarian, I agree with you.  And with freedoms such as Freedom of Speech and the Right to Bear Arms, not all Americans are in agreement with what limits, if any, should be on such freedoms. Heck, we're not even in agreement over what the freedoms (or more accurately, the constitutional protections) are supposed to mean.  Perhaps that is a by-product of freedom....we are all free to be individuals with individual points of view.  

One thing for sure...freedom is simple in theory but it sure is complicated in practice. :asian:


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## oftheherd1 (Jun 3, 2012)

Steve said:


> I'm not sure we are talking about the same thing.  But few doctors own their own practice anymore.  It's still somewhat common with dental and vision, but the insurance situation in america (on both the consumer side and the business side) makes it much safer and more lucrative for doctors to work for someone else.
> 
> Yes, though.  Ifyoure employed by the government, it can force you to work.  Police, firefighters, any federal employee... All unable to strike.  Teachers too, but they're doubly screwed in that they also have no right to arbitration.  This is why teachers end up striking even though it's illegal for them, to do so.
> 
> ...



Employees of the federal government may be prohibited from joining unions; may be allowed to have unions, but not strike, or be a member of a union and allowed to strike.  It all depends on the conditions of employment which will be spelled out as part of the hiring process, and usually in the job announcements.  Even for those not allowed to form unions, or join one, they have protections through EEO.  Not a perfect system perhaps, nor a promise of every complaint being taken care of to the employees satisfaction, but a system that seeks to prevent supervisors from taking action not based on well documented poor employees.  Like any system, it depends on the people involved, on both sides of the issue.


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## JWLuiza (Jun 3, 2012)

They don't own the labor, but much of our (Physician...err or in my case soon to be) income is based on Medicare/d. You aren't contractually obligated to work but you do have to meet certain requirements to have access to medicare or aid patients. If you leave the program you are also locked out for two years. These patients are barely profitable and in some cases are cared for at a loss. However the government currently is threatening a substantial cut in the payments for doctors. If it becomes unpalatable many doctors will just stop taking these patients, be locked out for two years and the patients will experience even greater difficulty getting into appointments. The gov't (both parties) know this is untenable and repeal the pay cut months at a time, preventing doctors from lobbying on other issues. It's kind of a cluster f**** right now.


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## Tez3 (Jun 3, 2012)

Here, GP practices are owned by the practice partners, usually the doctors , they are contracted to the NHS to provide services. They provide some private services like holiday innoculations, medicals for driving licenses etc. Often the premises are NHS owned but not always.


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## Jenna (Jun 3, 2012)

From a purely personal anecdotal perspective, having made use of hospital services on both sides of the Atlantic, I will say the service I received in the US (some years ago) FAR surpassed what I get here in the UK. Having said that, I do not know what I would have done had my employer not covered me for hospitalisation in the US whereas here I do not directly pay for it and get a poorer service.. 

All I know is that I would not want a car that was built by the government here.. *it would look like a Trabant*! so why must I have surgery provided by the government here? then it is ME who ends up looking like a Trabant.. anyways.. anecdotal..


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## Steve (Jun 3, 2012)

Makalakumu said:


> My line of thinking is specifically directed at doctors, especially those that own their own practices. For any employee, a strike is a risk.


But you're speaking hypothetically.  That's what I'm not understanding.  You're speaking to a philosophical position, but one that doesn't really exist.  Right?

Doctors who own their own businesses are not required by the government to work.  And while it would be pretty dumb, they'd be free to go on strike against themselves.  And if you have information that suggests otherwise, I'd love to hear it.


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## Steve (Jun 3, 2012)

oftheherd1 said:


> Employees of the federal government may be prohibited from joining unions; may be allowed to have unions, but not strike, or be a member of a union and allowed to strike.  It all depends on the conditions of employment which will be spelled out as part of the hiring process, and usually in the job announcements.  Even for those not allowed to form unions, or join one, they have protections through EEO.  Not a perfect system perhaps, nor a promise of every complaint being taken care of to the employees satisfaction, but a system that seeks to prevent supervisors from taking action not based on well documented poor employees.  Like any system, it depends on the people involved, on both sides of the issue.


5 USC 7311


> An individual may not accept or hold a position in the Government of the United States or the government of the District of Columbia if he -
> 
> advocates the overthrow of our constitutional form of government;
> is a member of an organization that he knows advocates the overthrow of our constitutional form of government;
> ...





While some positions are bargaining unit and others are not, I've not heard of any Federal employee or agent able to strike.  If you can point to a specific PD that can strike against the Federal Government, I'll gladly admit my mistake.


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## oftheherd1 (Jun 3, 2012)

Steve said:


> 5 USC 7311
> [/LIST]
> 
> While some positions are bargaining unit and others are not, I've not heard of any Federal employee or agent able to strike.  If you can point to a specific PD that can strike against the Federal Government, I'll gladly admit my mistake.



Well, I won't be able to double check that until tomorrow, since I will have to talk to some people I know,  You may be right.  I will let you know if I am wrong when I get that clarified.  I mostly stated that out of the knowledge of how powerful some government job unions are.


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## Makalakumu (Jun 3, 2012)

Steve said:


> But you're speaking hypothetically.  That's what I'm not understanding.  You're speaking to a philosophical position, but one that doesn't really exist.  Right?
> 
> Doctors who own their own businesses are not required by the government to work.  And while it would be pretty dumb, they'd be free to go on strike against themselves.  And if you have information that suggests otherwise, I'd love to hear it.



Correct. I don't know if this is an actual scenario, but since it is a fact that many doctors own their own practices and since all doctors belong to professional organizations that could coordinate a strike, it could be possible for a doctor who owns his own practice to go on strike. Therefore, it could also be possible, in a system where the government pays all the bills, for the government to literally force the doctor to work.


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## Steve (Jun 3, 2012)

It seems to me that there are some pretty fundamental misunderstandings about what a strike is, who strikes, who can strike, and why they might choose to strike.

What incentive would a doctor who owns his own business have to strike?

Also, i think there is some confusion between the terms influence, regulation and slavery or loss of freedom.


Sent from my iPad using Tapatalk


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## Makalakumu (Jun 3, 2012)

Steve said:


> It seems to me that there are some pretty fundamental misunderstandings about what a strike is, who strikes, who can strike, and why they might choose to strike.
> 
> What incentive would a doctor who owns his own business have to strike?
> 
> ...



Why couldn't a professional organization organize a strike against a government that was mandating conditions that were unfair? Could a doctor who owns a private practice and who felt unjustly intruded upon engage in a strike? I acknowledge that this doesn't fit the traditional definition of a strike, but then again, doctors are a profession that don't typically go on strike. Perhaps this precedent redefines the term?

Also, in my opinion, influence, regulation, and slavery are degrees of coercion and therefore are degrees of loss of freedom. The government is a monopoly on the use of force in a society. When the government makes a recommendation, the implicit threat of government force is enough to curb many peoples behavior. When the government makes a law, the government is directly threatening you with a threat of violence if you do not obey. If this threat is applied to labor, as in the case of doctors, the government is literally taking away the doctors ability to choose whether or not they want to work. Whether the government chooses to revoke the doctors permission slip to practice or throws the doctor in a cage for refusing to practice, the result is the same. It's a loss of freedom and rhymes with the concept of slavery.


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## K-man (Jun 3, 2012)

Jenna said:


> From a purely personal anecdotal perspective, having made use of hospital services on both sides of the Atlantic, I will say the service I received in the US (some years ago) FAR surpassed what I get here in the UK. Having said that, I do not know what I would have done had my employer not covered me for hospitalisation in the US whereas here I do not directly pay for it and get a poorer service..
> 
> All I know is that I would not want a car that was built by the government here.. *it would look like a Trabant*! so why must I have surgery provided by the government here? then it is ME who ends up looking like a Trabant.. anyways.. anecdotal..









 Edit ... My picture didn't come up. Damn!!






   Twice!! Double Damn!!

*Jenna,* I'm sure your recent surgery made you a very impressive looking Trabant!


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## Tez3 (Jun 4, 2012)

Jenna said:


> From a purely personal anecdotal perspective, having made use of hospital services on both sides of the Atlantic, I will say the service I received in the US (some years ago) FAR surpassed what I get here in the UK. Having said that, I do not know what I would have done had my employer not covered me for hospitalisation in the US whereas here I do not directly pay for it and get a poorer service..
> 
> All I know is that I would not want a car that was built by the government here.. *it would look like a Trabant*! so why must I have surgery provided by the government here? then it is ME who ends up looking like a Trabant.. anyways.. anecdotal..



To say that the whole NHS is poor is unfair to say the least. The British people like and want the NHS, if you don't like it you don't have to use it, no one is forcing you to, take out insurance and go private. If you chose to use our free service then go throught the proper channels if you want to make it better. there's commitees that the public are invited to be one and public forums for the NHS.

For every complaint about the NHS there's thousands of satisfied patients whose lives have been saved and/or improved by the excellent service here, that includes my mother, brother, daughter and myself.


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## Sukerkin (Jun 4, 2012)

I have to say that my treatment when I had my bike accident was excellent but standards have dropped terribly when it comes to the day-to-day things.  Nursing care is particularly noted on that score - the days of nurses being so highly skilled that they guided the doctors are long gone (indeed many of them went to America for the much higher wages they could get for less responsibility).


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## Sukerkin (Jun 4, 2012)

K-man, how are you trying to link your images? The code you are using at present directs the focus to a Page Not Found error.  If you have them uploaded into your Martial Talk storage area you should just be able to past the code in for the picture in question (use the second code string rather than the first).


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## Jenna (Jun 4, 2012)

Tez3 said:


> To say that the whole NHS is poor is unfair to say the least.


I did not say this.. I think you had mis-read.

If you would like my opinion, the NHS will be better operated in private ownership.  If you do not like my opinion, that is also fine


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## Tez3 (Jun 4, 2012)

Jenna said:


> I did not say this.. I think you had mis-read.
> 
> If you would like my opinion, the NHS will be better operated in private ownership. If you do not like my opinion, that is also fine




You think that because you are too young to know what the UK *was* like in private hands. Frankly it was horrendous, people died for lack of the money to pay for care, infant mortality was high, children died of preventable illnesses, to wish us back to that....?

The problem with the NHS is that under Thatcher she tried to make it private, that's what has been eating at it, now we have another Conservative government who are trying to sell it off. 

Only the 'horror' stories reach the media about the NHS, no newspaper prtints the good stories however try watching the programmes about the Great Ormand Street Hospital or read up on the work doen by our leading hospitals, you'll be surprised. The nursing problem, look to the Tories for that, they created the problem and serve only to make it worse.

http://www.guardian.co.uk/society/2010/nov/18/nhs-best-free-access-healthcare

Like the crime figures ( which are falling not rising) the NHS is the subject of the greatest generalisation and the worst perceptions, are standards actually falling or is the media just more accesssible and persistance, no news sells like bad news. Of course there's things wrong, there always is in any organisaton, however the majority of British people are satisfied with the service they get and sadly they keep quiet about it. The problems are political rather than medical and because the government is trying to turn it as a business this problem is common to businesses...the need to cut staff to save money, the need to cut costs and the need to earn revenue. Get the Tories out and let us have a government that cares about the people's health, then you'll see a proper working NHS, one fit for the people. Put the blame firmly where it belongs...on the Tories and let us have the NHS we deserve.


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## Brian R. VanCise (Jun 4, 2012)

I am sure there is good within the UK's health care system.  However, having been involved in the medical field for quite a while and around doctor's and nurses regularly the ones I have met that came from the UK had nothing good to say.  Not a thing!  Now this may be a relatively small sample and of course a biased sample because they left the country or fled it as they refered to it for a better situation. (ie. here in the US)  The picture they paint is bleak from the doctor's and the nurses perspective and frankly they did not have other good things to say about overall quality for patients compared to here in the US.  In the UK it sounds like it might be advantageous for the doctor's to strike!

Now in regards to the strike thing here in the US there is simply no incentive for doctor's to strike here.  They simply lose money and a lot of it.  That money believe it or not is what keeps their business afloat paying quite a few employee's.  They simply have no incentive to strike.  None!


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## Sukerkin (Jun 4, 2012)

As I noted earlier, Brian, a lot left for more money and less responsibility.  I can't say as I blame them as the staff really have been put through the ringer over the past thirty years - there is a reason why an awful lot of our medical people are no longer British in terms of the land of their birth.

The problems lie in the bureaucratic oversight more than anything else tho' - too many layers of non-effective management eating away at resources.  When my father was in for his heart operation a couple of years back you might recall my comments on how far the NHS had fallen from when I was in getting my arm done?


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## Brian R. VanCise (Jun 4, 2012)

No doubt Sukerkin you are much closer to how the system operates in the UK than I or anyone else who has not experienced it.  I can only relate what I have heard from doctor's and nurses that have come here to the states.

I might add that being close to the medical system here in the US that there are a lot of problems with how the system here works. (a lot)


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## Tez3 (Jun 5, 2012)

One of the problems not just with the NHS is that it's far easier to whinge about it that actually praise it. It's human nature to talk down something rather than say well actually someof it's pretty good. We all do it, look at all the Americans here who tell us everythings thats wrong about their country, who posts up saying well I think this is good or that is. The perception given by people who only see the cup half empty is that the NHS is falling apart and we are all dying for lack of care, this smears all the good work done by hard working people in the NHS who are busy saving lives evreyday. I just get really tired of people who choose to only see the black side of everything and don't lift a finger to actually try and make things better.
Ofc ourse people who have gone to work in America will tell you how bad it is here, they won't say it's good will they, they won't say well actually I left because I want more money.

http://www.telegraph.co.uk/health/h...sfaction-with-NHS-even-among-Tory-voters.html

_"Prof John Appleby highlighted figures showing that two-thirds of people are now either very or quite happy with the state-run health care, the largest proportion since the in-depth British Social Attitudes study began in 1983. _

_In addition, 80 per cent of those questioned said they were satisfied with their GP while the public perception of A&E and outpatient services in hospitals has risen over the past decade as spending tripled under Labour. _

_A separate survey published on Tuesday found that 90 per cent of women who had surgery to treat breast cancer rated the care they received as excellent or very good. _

_It comes after ministers were accused of &#8220;burying good news&#8221; by failing to publish another poll showing record satisfaction with the NHS, in case it undermined their case for radical reform of healthcare"

http://www.guardian.co.uk/society/2011/mar/19/nhs-andrew-lansley-healthcare-reform_


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## Jenna (Jun 5, 2012)

Tez3 said:


> You think that because you are too young to know what the UK *was* like in private hands. Frankly it was horrendous, people died for lack of the money to pay for care, infant mortality was high, children died of preventable illnesses, to wish us back to that....?
> 
> The problem with the NHS is that under Thatcher she tried to make it private, that's what has been eating at it, now we have another Conservative government who are trying to sell it off.
> 
> ...



You would forgive me for not quite understanding what you are saying and but as I read your reply.. your tone you are implying that I am too young to hold my own opinion that differs from yours? pffft.. well so you are older and wiser and have more experience than me that is fine and but my opinion it is as valid as yours. I had typed a reply outlining my experience of hospitalisation in UK and USA and but there is no point to it.. I am glad your hospital experience is positive.. I wish you well..


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## Sukerkin (Jun 5, 2012)

I think you might have taken that to heart in a way it was not meant, my dear friend.  I don't believe it was intended to be taken as anything other than a face-value observation of chronology and experience .


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## Tez3 (Jun 5, 2012)

Jenna you have indeed taken it the wrong way, I'm too young to remember the time before the NHS, however my father isn't and his and others stories of the unnecessary deaths and suffering before the NHS are heart rending. My father's best friend died at the age of 14 from diphtheria, when I was three there was a huge outbreak of polio in this country, the polio vaccines wasn't introduced until the 1960s.
http://news.bbc.co.uk/1/hi/events/nhs_at_50/special_report/123511.stm

You wish me well, however I'm not, I suffer and have done for a number of years from relapsing and remitting MS, I have entensive experience of hospitals all around the UK. My brother had liver disease, the extent of the treatment he had was amazing, my mother had a heart condition again her treatment was good, my father's treatment also. 
I'm not alone in thinking that while there are problems with the NHS it still has a lot to be proud of.
http://www.dailymail.co.uk/health/a...icas-hospital-stars-NHS-So-did-best-care.html

We have several cutting edge hospitals here, John Radcliffe, Morrfields Eye Hosp, University College, the leading ENT hospital, Newcastle Hospitals where they recently performed the first heart transplant on a baby here as well as having a leading neuro role, of course Great Ormand Street, Aberdeen and of course Birmingham http://www.nhs.uk/Livewell/Militarymedicine/Pages/Newhospital.aspx. Leeds is a huge centre for cancer and cardiac care.

Jenna you didn't say in what ways you thought that the British care was less than the American care, we don't have the single rooms, the 'luxuries' that perhaps Americans expect when they go into hospital and they pay for. Did you receive sub standard care from the doctors and nurses? Did they botch treatment? In which ways did the treatment fall short of the American equivalant? Or was they way we do things different here, we rarely get to chose which drugs we have, I've seen ads in American magazines telling people to ask their doctor for specific drugs. We tend to have less invasive surgery, we have more 'natural' births as you can't elect to have either a Caeserian or an induced birth to happen when it suits you, you do however have 'gas and air' while in labour. You do have free emergency care in accidents and emergencies from some of the best paramedics going, you will airlifted to hospital by helicopter if necessary, not just to the nearest hospital but to the best specialist hospital.

People complain of waiting times in A&Es but what they don't say is that they were seen by the triage nurse and they had to wait because a sprained ankle takes a lower priority than a head injury, it's a shame if you have to wait for treatment but if it's a minor injury the place to go to is a minor injuries unit not the A&E.


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## billc (Jun 5, 2012)

She may be older Jenna but that doesn't mean she is wiser, and your first hand experience from receiving medical care in both countries is interesting to hear.  Could you elaborate on what you experienced?  It would be interesting to hear exactly what you found so different, if it isn't too personal.  Thanks.


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## oftheherd1 (Jun 7, 2012)

oftheherd1 said:


> Employees of the federal government may be prohibited from joining unions; may be allowed to have unions, but not strike, or be a member of a union and allowed to strike. It all depends on the conditions of employment which will be spelled out as part of the hiring process, and usually in the job announcements. Even for those not allowed to form unions, or join one, they have protections through EEO. Not a perfect system perhaps, nor a promise of every complaint being taken care of to the employees satisfaction, but a system that seeks to prevent supervisors from taking action not based on well documented poor employees. Like any system, it depends on the people involved, on both sides of the issue.



Well, two out of three ain't bad.   :uhyeah:



oftheherd1 said:


> Well, I won't be able to double check that until tomorrow, since I will have to talk to some people I know, You may be right. I will let you know if I am wrong when I get that clarified. I mostly stated that out of the knowledge of how powerful some government job unions are.



Well, it took me longer than 'tomorrow' to find the person I wanted for an answer.  But... see below.



Steve said:


> 5 USC 7311
> [/LIST]
> 
> While some positions are bargaining unit and others are not, I've not heard of any Federal employee or agent able to strike. If you can point to a specific PD that can strike against the Federal Government, I'll gladly admit my mistake.



Thanks for the link you provided.  It is quite clear.  As well, I talked to the person I wanted to, got directed to another, and talked to that person.  They both agree, you are quite correct.  Strikes are not allowed by US government employees.  I was mistaken.


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## shinbushi (Jun 7, 2012)

As long as there is no strike of the Doctor.  that would be just wrong :dalek:


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## JWLuiza (Jun 7, 2012)

I can't wait for the next season!!! Bowties are cool!


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