HSE proposed pay cuts for junior doctors from February 18th...

maninasia

Yes honesty and diligence are important in business but the degree varies according to the situation, and that is the honest truth. What do you think 'marketing' and 'advertising' really are? Being a doctor or medical student you will be very familiar with drug companies and their claims.

Doctor's certainly do interact with the real world and have to make complex decisions, but at the same time are insulated from it by their position in society and their being part of a large organisation and basically having a guaranteed income (even if it might be a difficult income to earn sometimes, as any job can be), that's a fact. You have a defined role to play.

It's similar to a judge or barrister, they deal with all the vagaries of human life in their working day, but at night-time they can take off safe in their secure homes and secure state incomes backed up the apparatus of the state.

tallaght01

maninasia wrote: »

I couldn't even begin to go into all the ways the national health system is superior to Ireland's.

Ireland needs to shape up in so many ways, that's why emigrating is often a good thing, something that can be embraced.

I don't know what country you're talking about, but you'll have a tough time convincing anyone that the health service in most Asian countries is better than Ireland[s (except the likes of Japan and Singapore)

maninasia

The health service is excellent in Korea, Taiwan, Hong Kong, Malaysia (less so but cheap), Japan, Singapore and more. Believe me, I know from personal experience and other Irish out here..they all marvel at the difference. Perhaps some of you should come out and take a look at what is going on. These countries are flying ahead while Ireland is stagnating with many unresolved problems. Ireland is building a 20% unemployment knowledge economy (the last property and government jobs based economy didn't work out too well), nice one.

Almost no waiting lists, almost equal health coverage for all workers, 30 euro/mth contribution per head (only slightly less or more depending on your working or not), no chaotic A&Es, brand spanking new hospitals, equal choice between public and private, well educated often multilingual doctors, all the latest generation medical equipment, sanitary facilities, large numbers of personnel available due to lower salaries, GPs visits for 10 euro, heavily subsidised drugs. Sounds like BS but it's the truth! You see this is where 'smarts' don't matter as much as having a well thought out and equitable system. You can have all the 'smart' consultants in the world but useless if it takes 1 year to see them, by that time your disease may have progressed severely. I believe in less elitism and more resources available to patients. If I want to see a consultant I can see one within 3 days, for anything!

The only drawback in some of the systems is overuse of patient visits, short visit times and overprescription of drugs due to cheapness.

SleepDoc

maninasia wrote: »

The health service is excellent in Korea, Taiwan, Hong Kong, Malaysia (less so but cheap), Japan, Singapore and more. Believe me, I know from personal experience and other Irish out here..they all marvel at the difference. Perhaps some of you should come out and take a look at what is going on. These countries are flying ahead while Ireland is stagnating with many unresolved problems. Ireland is building a 20% unemployment knowledge economy (the last property and government jobs based economy didn't work out too well), nice one.

Almost no waiting lists, almost equal health coverage for all workers, 30 euro/mth contribution per head (only slightly less or more depending on your working or not), no chaotic A&Es, brand spanking new hospitals, equal choice between public and private, well educated often multilingual doctors, all the latest generation medical equipment, sanitary facilities, large numbers of personnel available due to lower salaries, GPs visits for 10 euro, heavily subsidised drugs. Sounds like BS but it's the truth! You see this is where 'smarts' don't matter as much as having a well thought out and equitable system. You can have all the 'smart' consultants in the world but useless if it takes 1 year to see them, by that time your disease may have progressed severely. I believe in less elitism and more resources available to patients. If I want to see a consultant I can see one within 3 days, for anything!

The only drawback in some of the systems is overuse of patient visits, short visit times and overprescription of drugs due to cheapness.

And the reason we don't have all this is because of "moany" doctors.

tallaght01

maninasia wrote: »

The health service is excellent in Korea, Taiwan, Hong Kong, Malaysia (less so but cheap), Japan, Singapore and more. Believe me, I know from personal experience and other Irish out here..they all marvel at the difference. Perhaps some of you should come out and take a look at what is going on. These countries are flying ahead while Ireland is stagnating with many unresolved problems.

Almost no waiting lists, almost equal health coverage for all workers, 30 euro/mth contribution per head, no chaotic A&Es, brand spanking new hospitals, equal choice between public and private, well educated often multilingual doctors, all the latest generation medical equipment, sanitary facilities, large numbers of personnel available due to lower salaries, GPs visits for 10 euro, heavily subsidised drugs. Sounds like BS but it's the truth!

The only drawback in some of the systems is overuse of patient visits, short visit times and overprescription of drugs due to cheapness.

Which country have you described there?

I agree Singapore, Japan and HK have excellent systems, as I said above.

But I know Taiwan are still trying to role out free access to basic healthcare to the population, and don't anticipate it for a number of years.

I know the Malaysians have a lower life expectancy than us, significantly higher child mortality rates, and they spend less on healthcare.

North Korean healthcare is a disaster on so many levels.

South Korea generally only spends about half of what we do on health, and they only really get a sightly better male life expectancy, but lower health life expectancy overall. They also have a slightly higher child mortality rate. We have twice as many docs per head of population, double the amount of dentists, and we have about 10 times more nurses per head of population.

I suspect a lot of Irish over there use the private sector for healthcare.

opinion guy

Ok you mentioned Malaysia. I know some malaysian doctors. Their working conditions are APPALLING. They work even crazier hours than we do - 1 in 2 calls and **** like that that they don't get paid for. That is why if you go into any Irish hospital you will find quite a number of Malaysian doctors working here. Cause as **** as our system is - its better than theirs.

You are talking thru yer arse.

But nevermind that - what exactly is your point ? You are just ranting on various topics. What is it you are trying to say ?

maninasia

Mostly about Taiwan. Taiwan has a system that covers almost the entire population for a very small monthly contribution. it has done for over 10 years already! To say they have an excellent public health system is an understatement. The facilities are superior to Ireland. The working conditions far superior. The education of medical staff I would say equivalent. The real access to proper healthcare, about 1000% better for the patient, from GP to registrar to consultant! That is what the healthcare system should exist for, the patient (this same system extends to dental healthcare too).

http://www.npr.org/templates/story/story.php?storyId=89651916

Taiwan is a country that most Irish people would probably see as developing and very capitalistic (which it is in most ways but they focus their social welfare on providing education and healthcare for almost all the citizens).

I want to point out a lot of misunderstandings about the supposed superiority of Ireland's system compared to many others. The other point I want to make is that private hospitals in Taiwan work under the national health reimbursement system. There is almost never any need to go fully private, although you can obviously pay for better rooms etc, but for surgeries public hospitals are seen as the best choice with the best equipment and surgical teams etc. Doctors are available weekdays and Saturdays and GPs are available morning and night in many local clinics, it's all billable under the national health card except for initial amount from 5 to 15 euros. The national health card is a chipped card which makes integration with IT systems very efficient also.

Having had emergency surgery in Taiwan, it has indeed been an excellent and fulfilling experience overall to deal with the well trained and numerous courteous nurses and doctors of the public health system.

I pointedly didn't talk about Thailand which has excellent private hospitals at reasonable (although not cheap) rates, I wanted to compare like for like in public systems.

maninasia

opinion guy wrote: »

Ok you mentioned Malaysia. I know some malaysian doctors. Their working conditions are APPALLING. They work even crazier hours than we do - 1 in 2 calls and **** like that that they don't get paid for. That is why if you go into any Irish hospital you will find quite a number of Malaysian doctors working here. Cause as **** as our system is - its better than theirs.

You are talking thru yer arse.

But nevermind that - what exactly is your point ? You are just ranting on various topics. What is it you are trying to say ?

And you are talking as a selfish person, I'm talking about how health systems should exist for the betterment of the patient. You should be thinking about how the whole should be improved, then your working conditions will improve too.

I mentioned Malaysia as it is very cheap to get medical care there and it is of good quality although I don't have direct experience of it.

opinion guy

maninasia wrote: »

And you are talking as a selfish person, I'm talking about how health systems should exist for the betterment of the patient. I mentioned Malaysia as it is very cheap to get medical care there and it is of good quality although I don't have direct experience of it.

So sorry what is it you do for a living again Mr Nobel Peace Prize Winning Troll?

And what, exactly, is selfish about expecting patients to be cared for by a doctor who is sufficiently rested to make safe decisions ?


Again - what is your point ? Do you have one ?

maninasia

Read about Taiwan, google it on the internet, learn a little about the world. Better still go to Taiwan to experience it yourself.

maninasia

opinion guy wrote: »

So sorry what is it you do for a living again Mr Nobel Peace Prize Winning Troll?

And what, exactly, is selfish about expecting patients to be cared for by a doctor who is sufficiently rested to make safe decisions ?


Again - what is your point ? Do you have one ?

Didn't see you mention anything about the efficiency of healthcare or the care of the patient, conspicuously absent. The healthcare system is obviously broken in Ireland.

opinion guy

maninasia wrote: »

Didn't see you mention anything about the efficiency of healthcare or the care of the patient, conspicuously absent.

So you think sleep deprived doctors are efficient then ?

Again - WHAT DO YOU WANT ? WHAT IS YOUR POINT ?

maninasia

What is your point? I just see capital letters.

tallaght01

maninasia wrote: »

Mostly about Taiwan. Taiwan has a system that covers almost the entire population for a very small monthly contribution. it has done for over 10 years already! To say they have an excellent public health system is an understatement. The facilities are superior to Ireland. The working conditions far superior. The education of medical staff I would say equivalent. The real access to proper healthcare, about 1000% better for the patient, from GP to registrar to consultant! That is what the healthcare system should exist for, the patient (this same system extends to dental healthcare too).

Taiwan is a county that most Irish people would probably see as developing and very capitalistic (which it is in most ways but they focus their social welfare on providing education and healthcare for almost all the citizens).

I want to point out a lot of misunderstandings about the supposed superiority of Ireland's system compared to many others. The other point I want to make is that private hospitals in Taiwan work under the national health reimbursement system. There is almost never any need to go fully private, although you can obviously pay for better rooms etc, but for surgeries public hospitals are seen as the best choice with the best equipment and surgical teams etc. Doctors are available weekdays and Saturdays and GPs are available morning and night in many local clinics, it's all billable under the national health card except for initial amount from 5 to 15 euros. The national health card is a chipped card which makes integration with IT systems very efficient also.

Having had emergency surgery in Taiwan, it has indeed been an excellent and fulfilling experience overall to deal with the well trained and numerous courteous nurses and doctors of the public health system.

I pointedly didn't talk about Thailand which has excellent private hospitals at reasonable (although not cheap) rates, I wanted to compare like for like in public systems.

AT the end of the day, while Taiwan's health service enjoys high public satisfaction, they're borrowing through their asses for it. They just can't pay for it. So it's not really true that they're managing health in any realistically sustainable way.

Plus their health indices are no better than ours.

dissed doc

maninasia wrote: »

Can you give me a lend of your 'tunnel vision' glasses, I'm having a hard time debating with you. Read the comments of doctors from the horses mouth, open the link.

Over 20% of doctors will become consultants, something like 200,000 k/year. That's actually a high % to make such a high wage of any profession.

That is not true. Under 1 in 10 reach a level where they are eligible for being a consultant. There are 1400 consultants in Ireland, and there have been ~ 500-600 graduates for the past 20 years, every year. In a fifteen year training period (from graduation to completing specialist training and being able to work as a consultant) there are 7500 graduates. The 1400 consultants are the product of 30-45 years as it includes the very senior ones from the next early training cycle.

Right now there are 8 consultant jobs being advertisied in Ireland, across all specialities. With 600 graduates a year, I put that at 1 consultant job for every 75 graduates.


[/QUOTE]

maninasia

You are very wrong. Almost every country the world over operates their health system on borrowed money. Every single one except for the gulf states is my guess. The Taiwan system provides great efficiency and value for money and very broad coverage for the population, you would agree if you had direct experience of it. Yes there is mismangement of money, tell me what public system doesn't. The important point, the system works!

To make a very crude comparison
Ireland: 7% of GDP on healthcare, workers go private (sh$t availability and affordability) (Ireland is a bankrupt country)
Taiwan: 6% of GDP on healthcare, workers go public (excellent availability and affordability) (Taiwan has some of the highest foreign exchange reserves in the world and a relatively low national debt with one of the world's strongest economies)

http://tecosf.blogspot.com/2010/06/taiwan-ranked-worlds-8th-most.html


What is very important is timely and affordable access to the healthcare practitioner and their facilities, I see that as a huge problem in many countries.

I agree with the last point by the way, I'm sure it's not as easy for doctors going forward with more competition in Ireland for limited places, that's why I said emigration will have to embraced.

dissed doc

maninasia wrote: »

.....and look at how easy you had it with the state paying 100,000 euro in fees and didn't ask for anything in return,

The state asked for 60%+ income tax rates from his/her parents to fund the universities. FDI wasn't exactly forthcoming from Microsoft or Google back in 1960s or 1970s. The "gubberment" isn't some magic money tree, it's paid for by taxes, most likely his parents' taxes.

In return, they got someone to work as a doctor in very unattractive positions for a period of time.

tallaght01

maninasia wrote: »

You are very wrong. Almost every country the world over operates their health system on borrowed money. Every single one except for the gulf states is my guess. The Taiwan system provides great efficiency and value for money and very broad coverage for the population, you would agree if you had direct experience of it. Yes there is mismangement of money, tell me what public system doesn't. The important point, the system works!

What is very important is timely and affordable access to the healthcare practitioner and their facilities, I see that as a huge problem in many countries.

Yea but there's borrowing money and there's borrowing money. Taiwan only spends about 5 or 6% of GDP on health! And look what they get for it. There's no way they aren't up to their nuts in debt to finance it.

opinion guy

maninasia wrote: »

I agree with your last point by the way, I'm sure it's not as easy for doctors going forward with more competition in Ireland for limited places, that's why I said emigration will have to embraced.

Hmm. You also said:

maninasia wrote: »

You need to wind up your 'holier than though' attititude and look at how easy you had it with the state paying 100,000 euro in fees and didn't ask for anything in return, now you got a well paid job in a nice country, enjoy the lifestyle and don't look back. People should be grateful for what they have.

So which is it - are docs supposed to stay in Ireland and be grateful for what they have ? Or are they supposed to be ingrates and emigrat. You've advised both ?

By the way, by any chance are you drunk right now ?

maninasia

tallaght01 wrote: »

Yea but there's borrowing money and there's borrowing money. Taiwan only spends about 5 or 6% of GDP on health! And look what they get for it. There's no way they aren't up to their nuts in debt to finance it.

Ireland spends 7% of GDP on health and look what you get for it. That 7% is mostly borrowed money at high interest rates.

maninasia

opinion guy wrote: »

Hmm. You also said:



So which is it - are docs supposed to stay in Ireland and be grateful for what they have ? Or are they supposed to be ingrates and emigrat. You've advised both ?

By the way, by any chance are you drunk right now ?

Attack the message not the messenger.

tallaght01

maninasia wrote: »

Ireland spends 7% of GDP on health and look what you get for it. That 7% is mostly borrowed money at high interest rates.

That;s me point!

opinion guy

maninasia wrote: »

Attack the message not the messenger.

But I've asked you what the message is and you won't tell me.

So I repeat:

So which is it - are docs supposed to stay in Ireland and be grateful for what they have ? Or are they supposed to be ingrates and emigrat. You've advised both. Which are we to listen to ?

maninasia

tallaght01 wrote: »

That;s me point!

Ok sorry, I didn't read it right. Do you mean Ireland is up to it's necks in debt to finance it? Taiwan is not, although it must borrow like almost all countries.

maninasia

opinion guy wrote: »

But I've asked you what the message is and you won't tell me.

So I repeat:

So which is it - are docs supposed to stay in Ireland and be grateful for what they have ? Or are they supposed to be ingrates and emigrat. You've advised both. Which are we to listen to ?

My point is to stop moaning and get on with it..cause that's the way the world works. At least you are better off than most. Otherwise fight the system, but I don't see much fight in Ireland.

tallaght01

maninasia wrote: »

Ok sorry, I didn't read it right. Do you mean Ireland is up to it's necks in debt to finance it? Taiwan is not, although it must borrow like almost all countries.

The point I'm making is that Taiwan are SERIOUSLY up to their bollocks in debt, and are really feeling the strain of supporting healthcare. That's because you can't only spent 5% of GDP on health and just abolish waiting lists.

I'm saying it's unsustainable. Most people recognise that. I think even the Taiwanese have admitted it.

opinion guy

maninasia wrote: »

My point is to stop moaning and get on with it..cause that's the way the world works. At least you are better off than most. Otherwise fight the system, but I don't see much fight in Ireland.

Well from what my doc friends tell me fighting the system isn't really an option. Its a small world in irish medicine - people are afraid of consequences of causing trouble

maninasia

They are not seriously in debt, their financial system is very strong, no banking or financial crisis, no significant unemployment or social welfare bill to pay and they have recently completed reform of the health system to increase premiums. Almost ALL countries borrow to finance their health systems, and usually at higher than the 6% of GDP that Taiwan contributes.

Taiwan overall does not have borrowing requirements at anything equivalent to Western nations and has huge foreign reserves along with a very stable and currently growing economy. Taiwan's economy will grow at about 8-10% this year and also has a new trade deal with China about to be signed which will encourage further foreign investment and more exports, in short the future is fairly bright, economy wise.

maninasia

opinion guy wrote: »

Well from what my doc friends tell me fighting the system isn't really an option. Its a small world in irish medicine - people are afraid of consequences of causing trouble

It's up to people to stand up for themselves, at the end of the day nobody will do it for you.

tallaght01

maninasia wrote: »

They are not seriously in debt, their financial system is very strong, no banking or financial crisis, no significant unemployment or social welfare bill to pay and they have recently completed reform of the health system to increase premiums. Almost ALL countries borrow to finance their health systems, and usually at higher than the 6% of GDP that Taiwan contributes.

Taiwan overall does not have borrowing requirements at anything equivalent to Western nations and has huge foreign reserves along with a very stable and currently growing economy.

Well then how much are they borrowing to finance health?