Model Y Demo Drive in US

[Jason71]

But obvious here is the huge disparity within the EU. Within the US also there can be one, e.g. on Dairy. I am still buying a gallon of milk for $2.89 which must be among the lowest prices in the western world.

Yes that is good value but the UK has a lot of cows so ours is pretty cheap as well. We don't sell milk by the gallon but that equates to 76 cents per litre. biggest we sell most places is 6 pints for about £2.15 which works out as 77 cents per litre so looks like you just pip us but, I am guessing if you went to one of the big milk producing states in the US it would be even cheaper.

 

[EatsShoots]

If $$$$$ was your major motivation, the medical profession in the US certainly shouldn't be of your job list, the hours aren't even that long.

$1million joint house hold income really would be the minimal I would expect in the US for the roles we are doing in the NHS (senior clinical academic with international reputation and senior clinical leadership/management in a £1billion+ turn over organisation). But I think very few NHS doctors are motivated go and find work in the US health care system regardless of the pay.

https://www.washingtonpost.com/business/2023/08/04/doctor-pay-shortage/

Lobbying is far too strong in this country. Physicians are, like any group of people, motivated to maximize their own income and reduce competition. The problem is it impacts the rest of us as well. Rather like NYC taxicabs lobbying to keep their supply artificially limited (at one point it cost $1M to buy a medallion, which was needed to simply drive a taxicab), we see the same thing in the USA with doctors. It's not like it's a new profession, and we cannot pretend that there are not perfectly capable, and motivated people who would make great doctors who aren't being pushed out of it due to availability of schooling and enormous tuition costs.

As my parents never failed to remind me, in the UK it was (still is?) possible to go from high school into med school, whereas in the USA you at least need an undergrad, and often more.

General Practitioners in the USA make peanuts compared to specialties, which must also be having an impact on their availability. As far as I know it's even harder to get a GP in Canada, with multi-year waiting lists very common.

I don't particularly begrudge well paid physicians because it is a hellacious journey to become one, and there are other lucrative careers (e.g. computer science) with a small fraction of the required schooling, but we could and should be bringing more on board.

 

[WannabeOwner]

possible to go from high school into med school,

Yes. University entrance exams in 6th Form (age 18), and then study Medicine as your degree at University. University entrance for medicine requires (AFAIK) the highest level of exam results, so only cream-of-crop need apply.

 

[gangzoom]

As my parents never failed to remind me, in the UK it was (still is?) possible to go from high school into med school, whereas in the USA you at least need an undergrad, and often more.

All very off topic……

I couldn’t speak or read/write a single word of English at 10, I was told by my school I would never get the grades or pass the interview for med school. I had a file thicker than the entire works of Shakespeare at the dean’s office in med school because I didn’t ‘conform’ to the way things were taught, I somehow managed to not get kicked off the course despite arguing with just about every Prof in the school .

Some 20 years on, I’m now 2 steps below the CEO position in one of the biggest acute care trust in England, and at 41 I don’t intend on stopping developing my self/career any time soon. If I still have a direct line manager above me at 45 I would be disappointed at my self.

I feel absolutely honoured, privileged, and lucky to do the job I do, the fact I get paid to do my job is frankly unbelievable. The NHS has a place in my heart that’s only 2nd to my family, I go to work because I love everything the NHS and everything it stands for, and most (if not all) the colleagues, peers I work with I’m sure feel the same way.

 

[EatsShoots]

All very off topic……

I couldn’t speak or read/write a single word of English at 10, I was told by my school I would never get the grades or pass the interview for med school. I had a file thicker than the entire works of Shakespeare at the dean’s office in med school because I didn’t ‘conform’ to the way things were taught, I somehow managed to not get kicked off the course despite arguing with just about every Prof in the school .

Some 20 years on, I’m now 2 steps below the CEO position in one of the biggest acute care trust in England, and at 41 I don’t intend on stopping developing my self/career any time soon. If I still have a direct line manager above me at 45 I would be disappointed at my self.

I feel absolutely honoured, privileged, and lucky to do the job I do, the fact I get paid to do my job is frankly unbelievable. The NHS has a place in my heart that’s only 2nd to my family, I go to work because I love everything the NHS and everything it stands for, and most (if not all) the colleagues, peers I work with I’m sure feel the same way.

wow! More disclosure: both of my parents were docs from england. My dad hated the NHS so much he pulled us outta the country when I was a young kid I'm glad you have a job you love, few are so well situated!

 

[ACarneiro]

wow! More disclosure: both of my parents were docs from england. My dad hated the NHS so much he pulled us outta the country when I was a young kid I'm glad you have a job you love, few are so well situated!

<WAAAAY off topic>

It's a love-hate relationship
It has some things that are utterly infuriating, and the level of bureaucracy and box-ticking is frankly astounding. I really strongly believe that we don't need more staff, we need less bureaucracy. Also a quasi-communist system which is poor at incentivising productivity or excellence.
I kid you not, I once was asked to submit a form to confirm that I'd submitted another form to confirm that I had had a certain discussion with a patient. Bonkers!

BUT

Show me a healthcare system that is not resource-constrained;
The same "quasi-communism" allows a level of collegiality which competitive systems don't ("I have no trouble giving my colleague a helping hand, he's not going to be competing with me for the promotion so I don't have to stab him in the back" kinda thing);
It tends to be quite accessible and fair in the distribution of resources to those who need them most;
The people are generally REALLY trying to do the right thing (although sometimes there are disagreements about what "the right thing" actually is)

I am a senior doctor in one of the largest acute trusts in the UK and absolutely adore my job. I would have moved back home (I'm an EU immigrant) a long time ago if I didn't enjoy my job so damn much

</WAAAAY off topic>

 

[pdk42]

It’s good to hear from so many of you who are active medics in the NHS and who are committed to it so strongly. Having spoken to many American friends, I’m deeply grateful that we don’t have the same system as they have. They spend much more as a % of GDP on health care, but overall outcomes, esp life expectancy and infant/mother mortality, are lower than most comparable economies. The problem is the amount of money taken out by the middlemen - mainly the HMOs and the insurance providers. And that’s before we get into the disparity of care according to income/social group. No health system is perfect, but the overly monetarised US system is failing too many people.

 

[ACarneiro]

This could be a whole thread in itself.

I would respectfully (and somewhat hypocritically, bearing in mind my earlier post) suggest we just go back to discussing the Model Y.

 

[thyname]

What is “NHS”??? Sorry for being a dumbass American

 

[Drew57]

What is “NHS”??? Sorry for being a dumbass American

National Health Service - free for all UK citizens & paid for out of taxation. It has its failings but is a much loved national institution, filled with amazing and dedicated front line staff.

 

[gangzoom]

Having spoken to many American friends, I’m deeply grateful that we don’t have the same system as they have. They spend much more as a % of GDP on health care….

The US is heading towards spending 25% of their GPD on healthcare!!!….and as you say US system outcomes are no better than the NHS, in many areas actually worse.

What is “NHS”??? Sorry for being a dumbass American

I was working last weekend, one of the patients I managed had emergency repair of their entire aorta after they collapsed on the street from one of the best vascular surgeons in the country, than had 20+ days in intensive care. She needed urgent treatment over the weekend for kidney failure, but because her blood vessels were in such a bad state it took me, 3 senior consultant anaesthetics, an intervention radiologist working on a Saturday evening to eventually get a tube into her blood vessel to treat her kidney failure.

All of the above treatment was totally ‘free’ to the patient, no questions asked about insurance, ability to pay, or any expectation for payment after treatment.

When I was much junior doctor, I remember seeing a 45 year old man come into ED as I started my shift, I realised he was having a massive heart attack, I called the Cardiologist oncall who took him for an urgent assessment of heart blood vessels. I kid you not, as I was finishing my shift, I saw him been pushed into the OR, I asked the patient what he had been told, his answer ‘They are taking me for emergency open heart surgery doc’.

Again from literally being picked up off the street, to open heart surgery within 8hrs, all for zero cost to the patient - either at point of care, or post care.

The equality of health care in the UK thanks to the NHS is literally world leading, I cannot think of any where in the world where the ability of someone to pay has so little impact on quality of the health care they will receive. It’s an ideology that for me is worth fighting to keep for as long as possible .

 

[Jason71]

Again from literally being picked up off the street, to open heart surgery within 8hrs, all for zero cost to the patient - either at point of care, or post care.

Sadly these days it seems to take that long just to get an ambulance. I speak from recent experience of sitting with a semi concious cyclist with a head injury and being told the wait would be 5-7 hours.

Edit BTW we put him in a car and A&E took one look at him am he was being treated 5 minutes after arrival.

 

[Adopado]

Morning commute into work some years ago ... ended up lying on the road holding my damaged leg after motorbike incident ... I already realised I had serious multiple fractures (at least "closed") ... sirens in the distance ... I was picked up, taken to hospital, assessed and x-rayed ... waited all day but was then told I would be operated on that same evening ... consultant turned out to be a leading light in developing and writing up a particular technique where a titanium rod is inserted down length of tibia to hold sections together. Next morning I was on my feet with elbow crutches and being told that I can put full pressure on the leg when standing if I could bear a bit of pain! Brilliant. Though officially "signed off" from work for a period I was back a few days later though on crutches for a while. Leg remains 100%.

When the NHS works it really is fantastic. No time and resources wasted registering insurance claims or worrying about costs. Most of us will need it at some point in our lives so the fact that you are automatically a "paid up member", merely based on being a UK citizen, is amazing.

 

[Hurricane]

This could be a whole thread in itself.

I would respectfully (and somewhat hypocritically, bearing in mind my earlier post) suggest we just go back to discussing the Model Y.

I think your suggestion has fallen on deaf ears. I’m non the wiser about MY but I’ve learnt a lot about healthcare

 

[ChooseFreedom]

Don't get ill!!!

Physicians have some of the highest pay in the US as a result of high cost for patients. Our joint house hold income in the US/Canada wouldn't be far short of $1million per annum as a very conservative estimate, multiple folds higher than what the NHS pays us. However the NHS has a value that's worth far more than $$$$$.

Places like Singapore have also tempted us in the past with reward packages unimaginable in the UK, but again, UK culture and values is something quite unique that goes beyond simply finances.

How Much Does Health Insurance Cost In 2024?

The Affordable Care Act (ACA) marketplace at Healthcare.gov lets you compare health plans that are sold in the marketplace. The cost of health insurance in the ACA marketplace varies by insurance company, where you live, which plan and metal tier you choose, how many people are covered, your age, wh

www.forbes.com

The physicians get surprisingly little of these healthcare costs. It's the insurance companies that keep most of it.