"Gang of Six" quietly working on a realistic budget deal

[Shygui]

You've got to go more basic than that: address the supply of medical attention. That means two things: first, and most basic, is to increase the supply of doctors. How to do that? Get a dozen new medical schools built, to give us a total of, say, 4,000 new doctors a year. Then establish community immediate-care clinics, which would take the people who really don't need an emergency room but need attention promptly. That many doctors would allow four hundred or more such new clinics to be established annually (make half of medical school costs a tax credit for doctors who go there for five years, or something).

The Republicans should even go for that -- it's government involvement, but only to make a healthier free market.

Building new medical schools won't help, unless these new schools bring the price of educating a doctor down VERY significantly.

There are plenty of people who would become doctors, but they don't want to spend that long in school. Not to mention spend the 6+ figures to attend medical school on top of the Bachelor's education. The cost-benefit isn't there for the "general practice" doctors our medical system lives off of.

 

[BostonPirate]

Building new medical schools won't help, unless these new schools bring the price of educating a doctor down VERY significantly.

There are plenty of people who would become doctors, but they don't want to spend that long in school. Not to mention spend the 6+ figures to attend medical school on top of the Bachelor's education. The cost-benefit isn't there for the "general practice" doctors our medical system lives off of.

Lets not think that bringing the cost of medical school down will not have a negative impact on this country. New England thrives economically because we have Harvard, MIT, Berklee, Northeast U, Boston U, Boston College, and MANY more internationally respected smaller colleges. There are about 35 universities in the Boston Metro area. We are a very VERY wealthy city because we get a constant influx of money from not only around the nation but around the world.

This system brings middle and upper middle class spenders to our area for four to eight years at a pop. It is external income for is. We sell education and information better and more successfully than any other city in the nation.

IF Boston loses that cash it will suffer, and so the northeast and new england are mot going to be signing on to lowering medical tuitions... or tuitions of ANY sort. Our pork is pell and student loan support.

It pays well to be on the side of progress. Mass is the frontrunner in education and civil rights. what people dont get is that there are honorable ways to BOTH improve our nation while improving ourselves and engaging in capitalism.

Harvard and MIT will intentionally keep the cost of medical and legal educations high setting the standard for all the rest of the med schools in the nation.

 

[Kulindahr]

Building new medical schools won't help, unless these new schools bring the price of educating a doctor down VERY significantly.

There are plenty of people who would become doctors, but they don't want to spend that long in school. Not to mention spend the 6+ figures to attend medical school on top of the Bachelor's education. The cost-benefit isn't there for the "general practice" doctors our medical system lives off of.

Interesting point. I'm going to have to ponder that one. Maybe a revamping of the medical education system is in order.

 

[Kulindahr]

Harvard and MIT will intentionally keep the cost of medical and legal educations high setting the standard for all the rest of the med schools in the nation.

So Massachusetts is dedicated to keeping medical costs high for everyone. Yay.

This is called "greed". It's especially called greed because Harvard at least has an endowment big enough it could cut the cost of educating a doctor by a huge amount -- like wipe out the cost of getting the bachelor's degree. MIT I'm not so sure of.

So Boston could have another medical school to keep your money flowing, if you're so worried about profiting from everyone else's misery. But I don't really care if Boston gets a tiny bit less wealthy so the rest of the country can benefit. We need more doctors, back to the point where one doesn't have to schedule an appointment to get seen.

And if people in Boston don't want to give up a little wealth for the sake of the rest of the country, then we have a name for that, too: Republicans.

 

[Jack Springer]

I needs to be injected over and over again the reason we're in this particular mess.

The House did not pass a budget last year.

Why?

 

[BostonPirate]

So Massachusetts is dedicated to keeping medical costs high for everyone. Yay.

This is called "greed". It's especially called greed because Harvard at least has an endowment big enough it could cut the cost of educating a doctor by a huge amount -- like wipe out the cost of getting the bachelor's degree. MIT I'm not so sure of.

So Boston could have another medical school to keep your money flowing, if you're so worried about profiting from everyone else's misery. But I don't really care if Boston gets a tiny bit less wealthy so the rest of the country can benefit. We need more doctors, back to the point where one doesn't have to schedule an appointment to get seen.

And if people in Boston don't want to give up a little wealth for the sake of the rest of the country, then we have a name for that, too: Republicans.

We provide the technologies that are driving the new energy movement. Our contributions to the research community through harvard are legendary, as MIT is for Planetology and space and medical research. If there is a scientific breakthrough in this nation its at least 90 percent probable that it emanated from our educational system.

But we pay heavily for that in taxes. We invest in education because our future litterally depends on it. For Our investments out of state students pay well and fight for the chance to do it. We are not holding a gun to anyones head. They are free to find better services elsewhere and some do in california.

we have wealth because we double down in the financial sectors and insurance.

Forbes lists us as number one in quality of life

http://econpost.com/business/top-10-states-forbes-quality-life-index

We have the second most stable and robust economy in the nation

The University of Massachusetts report released Monday says employment over the past few months has expanded at the fastest rate in decades, while only one state, Texas, has added more jobs over the past year.

The Boston Globe reports that growth has been spurred by worldwide demand for technology products, but a struggling national economy threatens to undermine the demand, putting the state's recovery at risk.

The entire medical industry depends and is dominated by New England which brings us ballanced budgets and money to invest in our cities.

Healthcare industry top states by percentage of state economy 2008
Healthcare gross domestic product in $ billions
Rank State Healthcare GDP State percentage
1 Maine $5.6 11.2%
2 Vermont $2.6 10.2%
3 Pennsylvania $53.6 9.7%
4 Rhode Island $4.5 9.6%
5 Massachusetts $34.6 9.5%

http://econpost.com/industry/healthcare-industry-top-states-percentage-state-economy

Fifty percent of all medical industry dollars comes into New England. The contributions in research that we make to the nation is unrivaled.

We are not ashamed of charging for educating good doctors, because we are training the people that are going to discover cures for diseases that we don't even know exist yet.

Do we live well? yes. Aside from the housing market, while the rest of the nation was having a recession we were busy paying our way.

Here are our 2008 financial figures.....

Massachusetts is one of the states where the government sector is not one of the top 5 contributors to the economy. In many states, the government sector is either 2nd or 3rd, in Massachusetts it is the sixth largest sector.

Massachusetts economic development and output
The economic output of the state of Massachusetts was $365 billion in 2008. That figure is based on current 2008 dollars (nominal GDP), while the inflation adjusted GDP, real GDP, based on prices in the year 2000, was $312 billion in 2008, according to data from the U.S. Department of Commerce.

The statistics for economic growth show Massachusetts GDP grew at 3.37% in nominal terms in 2008 compared to 2007, in real terms the growth was 1.95%.

During the years of 2000-2008, Massachusetts GDP grew at an annual rate of 3.6% in nominal terms and in real terms the economy grew by 1.6%.

http://econpost.com/massachusettseconomy/massachusetts-gdp-size-rank

During the recession we were expanding and hiring more than before.

what we are dedicated to, kulindahr, is preserving american standards and values while inproving our own individual lives.

We are acheiving it when the rest of the nation is falling apart. We are not perfect. our housing market hit us hard, but those figures for growth above are the 2008 figures when real estate was collapsing entirely.

So while the rest of the nation was contracting economically we were expanding. We have not hidden our methods.

We insure civil rights to all, we have universal healthcare, we have a state minimum wage that is much higher than the nation, and we tax ourselves for what we spend without whining.

In fact there was a referendum on lowering state income taxes last november and it failed. The people of massachusetts choose to pay MORE in taxes to insure we are all cared for.

of course there was that big dig oopsy... HA... but we are paying for our own mistakes with ballanced budgets. We are not high rolling extravanant people. We just prefer to spend more and get better quality services for our citizens.

 

[PSCGuy]

It's not just med schools. It is standard policy in higher education to keep tuition rates in line with other "competitor" schools. That's why private schools cost so much more than public schools, where it is harder to raise tuition.

Take undergraduate institutions like Harvard or Princeton, with multi-billion dollar endowments. They could operate without charging any student tuition. Yet they do anyway because they can get away with it -- students will keep paying. Or, take a mid-level school. I entered Villanova in fall 2004, and yearly tuition (excluding room and board) was something like $30,000. For the year 2010-2011, it is $41,000. Has the quality of education at Villanova changed all that much? No. What HAS changed is how many students apply to Villanova. So they can afford to price-out some students, and make up for it with other, richer, ones. This is typical at most private colleges. (Remember, this is tuition EXCLUDING room and board.)

 

[BostonPirate]

It's not just med schools. It is standard policy in higher education to keep tuition rates in line with other "competitor" schools. That's why private schools cost so much more than public schools, where it is harder to raise tuition.

Take undergraduate institutions like Harvard or Princeton, with multi-billion dollar endowments. They could operate without charging any student tuition. Yet they do anyway because they can get away with it -- students will keep paying. Or, take a mid-level school. I entered Villanova in fall 2004, and yearly tuition (excluding room and board) was something like $30,000. For the year 2010-2011, it is $41,000. Has the quality of education at Villanova changed all that much? No. What HAS changed is how many students apply to Villanova. So they can afford to price-out some students, and make up for it with other, richer, ones. This is typical at most private colleges. (Remember, this is tuition EXCLUDING room and board.)

Universities usually invest all of their profits in either research or scholarship programs. If people want an equal education I suggest you tell the new republican house to not strip public education and PBS out of the budget.

Living alumni - More than 323,000, over 271,000 in the U.S., nearly 52,000 in some 201 other countries

Nobel laureates - 44 current and former faculty members

University income (Fiscal Year 2008 ) - $3,482,317,000

University expenses (Fiscal Year 2008 ) - $3,464,893,000

Endowment (Fiscal Year 2008 ) - $27.4 billion

http://www.harvard.edu/about/glance.php

looks like record breaking profits to me!!!

These universities are bankrolling future technology research for generations.

Harvard University’s endowment earned an investment return of 11 percent for the year and was valued at $27.4 billion as of June 30. The return was 160 basis points above what would have been earned by the Harvard Management Company’s (HMC) benchmark policy portfolio.
“Fiscal year 2010 was an important and productive year for the Management Company,” said Jane Mendillo, president and CEO of HMC. “We generated strong returns and improved the flexibility of the portfolio while actively managing our risks and pursuing innovative investment strategies.”
The University’s endowment provides critical funding for Harvard’s educational and research objectives. In fiscal 2010, distributions from the endowment contributed more than a third of the University’s operating budget. Endowment income supports Harvard’s academic programs, science and medical research, and student financial aid programs, which permit the University to admit qualified students regardless of their ability to pay. Harvard’s endowment also enables the University to undertake specific activities that donors have supported over time, targeted to areas such as financial aid, faculty salaries, and facilities maintenance.
The University remains committed to supporting financial aid for undergraduates, which is expected to increase about 7 percent for fiscal 2011. More than 60 percent of Harvard undergraduates are receiving need-based scholarship aid this year, totaling $158 million, and two-thirds now graduate debt-free.

hmmm

so if you live in a state that has a good school system, you have a shot at a free pass to a very good future.

But you have to have the important primary and secondary educations to get there.

 

[Kulindahr]

So if the oi companies all jacked up their prices by ten percent a year for the next ten years, you'd have no problem with that if they used it to build up an investment fund and do research?

 

[BostonPirate]

So if the oi companies all jacked up their prices by ten percent a year for the next ten years, you'd have no problem with that if they used it to build up an investment fund and do research?

That does not equate in anyway. Are you really comparing oil drilling technology to researching a cure for aids and cancer?

 

[Kulindahr]

That does not equate in anyway. Are you really comparing oil drilling technology to researching a cure for aids and cancer?

Research into energy is just as important as medical research -- in fact without a good energy supply, today's medical equipment will be useless.

 

[BostonPirate]

Research into energy is just as important as medical research -- in fact without a good energy supply, today's medical equipment will be useless.

we do just as much energy research as we do medical. We focus on windfarm technologies and next generation solar power.

“There’s a lot of applications that are possible with these organic solar cells,” said Venkataraman. “One that I can think of is having a backpack covered with solar cells that you can actually power your iPod with. Or I can actually have a window which, if it’s in the path of the sun, a curtain of it which is made up of organic solar cells can create energy.”

However, there is no guarantee on how well the molecules can pack. Every batch of produced molecules can be different, making it harder to produce efficient solar cells. Venkataraman wants to figure out a way for molecules to assemble into structures which will actually yield efficient solar cells.

http://dailycollegian.com/2010/11/2...ssors-pioneering-alternative-energy-research/

MIT has its own nuclear powe generator and has heavily invested in researching that technology....

"There is no question that the up-front costs associated with making nuclear power competitive, are higher than those associated with fossil fuels," said Dr. Moniz. "But as our study shows, there are many ways to mitigate these costs and, over time, the societal and environmental price of carbon emissions could dramatically improve the competitiveness of nuclear power"

The study offers a number of recommendations for making the nuclear energy option viable, including:

• Placing increased emphasis on the once-through fuel cycle as best meeting the criteria of low costs and proliferation resistance;
• Offering a limited production tax-credit to 'first movers' - private sector investors who successfully build new nuclear plants. This tax credit is extendable to other carbon-free electricity technologies and is not paid unless the plant operates;
• Having government more fully develop the capabilities to analyze life-cycle health and safety impacts of fuel cycle facilities;
• Advancing a U.S. Department of Energy balanced long-term waste management R&D program.
• Urging DOE to establish a Nuclear System Modeling project that would collect the engineering data and perform the analysis necessary to evaluate alternative reactor concepts and fuel cycles using the criteria of cost, safety, waste, and proliferation resistance. Expensive development projects should be delayed pending the outcome of this multi-year effort.
• Giving countries that forego proliferation- risky enrichment and reprocessing activities a preferred position to receive nuclear fuel and waste management services from nations that operate the entire fuel cycle

http://web.mit.edu/nuclearpower/

These places are using that money to research ALL of that stuff kulindahr. When it is patented, it will earn for the endowments and then MORE research will be done.

Heavy investments in education and research are one of the most valuable commodities we have as a nation. Try to envision an america without all the acheivements of Harvard and MIT.

 

[Kulindahr]

So it's okay for a university to deliberately raise its rates as high as possible just because it can, purposely raising costs for everyone, but not for an oil company? It's okay for a university to keep its prices high so it can do energy research, but not an oil company?

 

[BostonPirate]

So it's okay for a university to deliberately raise its rates as high as possible just because it can, purposely raising costs for everyone, but not for an oil company? It's okay for a university to keep its prices high so it can do energy research, but not an oil company?

There are far less expensive universities across the nation. Their degrees are valued in relation to the standards of education in that state. If a state wants to do what we have done they have to invest heavily and longterm in education and resources. They have to develop a product... namely information... that is as vaaluable as ours.

Its not like we haven't been trying to get the rest of the nation to do as we have done.

Our efforts are dismissed as leftist... universities are heckled as grand bastions of liberalism. We think they are a shrewd investment that produces a superior quality of life.

If you are asking me to say I think its wrong to charge extra money so we can do research then you are crazy. YOU would be the first one to say that the government should not fund this stuff and the private sector should.

Meet the private sector that could.... and if the republicans succeed in stripping these educational funds out of the federal budget, we will be fine. The rest of the nation will fall farther behind us though.

 

[Kulindahr]

Your initial objection was to other medical schools being started, because it would cut into Mass. ability to deliberately ratchet up the cost of a medical education, an example the rest of the country follows.

I've been trying to point out that if you want to keep the competition small so you can keep your prices high, that's no different than being an oil company -- so long as it does research that benefits people, which energy research does.

So back to my original point: the country needs another couple dozen medical schools.

Maybe the ones in Mass. could clone themselves, to set the example.

 

[BostonPirate]

Your initial objection was to other medical schools being started, because it would cut into Mass. ability to deliberately ratchet up the cost of a medical education, an example the rest of the country follows.

I've been trying to point out that if you want to keep the competition small so you can keep your prices high, that's no different than being an oil company -- so long as it does research that benefits people, which energy research does.

So back to my original point: the country needs another couple dozen medical schools.

Maybe the ones in Mass. could clone themselves, to set the example.

I never said we intentionally ratchet up the price or that I wanted to keep the competition small. We have developed a very elaborate education and research comodity. It took a long time and it cost us alot of money.

This budget has to address the long term issues of economic development while addressing the short term economic crisis of debt.

I think you are also miscalculating. There will be no drop in the cost of medical school no matter how many you build.

the reality is that they are expensive to run and the product they offer is quite valuable.

 

[Kulindahr]

Lets not think that bringing the cost of medical school down will not have a negative impact on this country. New England thrives economically because we have Harvard, MIT, Berklee, Northeast U, Boston U, Boston College, and MANY more internationally respected smaller colleges. There are about 35 universities in the Boston Metro area. We are a very VERY wealthy city because we get a constant influx of money from not only around the nation but around the world.

This system brings middle and upper middle class spenders to our area for four to eight years at a pop. It is external income for is. We sell education and information better and more successfully than any other city in the nation.

IF Boston loses that cash it will suffer, and so the northeast and new england are mot going to be signing on to lowering medical tuitions... or tuitions of ANY sort. Our pork is pell and student loan support.

It pays well to be on the side of progress. Mass is the frontrunner in education and civil rights. what people dont get is that there are honorable ways to BOTH improve our nation while improving ourselves and engaging in capitalism.

Harvard and MIT will intentionally keep the cost of medical and legal educations high setting the standard for all the rest of the med schools in the nation.

I never said we intentionally ratchet up the price or that I wanted to keep the competition small. We have developed a very elaborate education and research comodity. It took a long time and it cost us alot of money.

This budget has to address the long term issues of economic development while addressing the short term economic crisis of debt.

I think you are also miscalculating. There will be no drop in the cost of medical school no matter how many you build.

the reality is that they are expensive to run and the product they offer is quite valuable.

Yes, you did.

And you claimed that reducing the cost of medical school would have a negative impact on the country! What it would really do is lower costs.

My argument was that more medical schools would give us more doctors, and THAT would lower costs -- if for no other reason than that people could get immediate care without having to pay $700 right off the bat just for going to the emergency room. Having immediate care clinics would cut annual costs by billions -- heck, when I was having a nasty allergy problem one summer, having an immediate care clinic to go to instead of an emergency room saved me (and my insurance company) over $5000!

We should have one such clinic for every 50,000 people in an urban area. The US has 100 million people in cities of 50,000 or higher. That translates to roughly 2,000 such clinics we need (actual number will be smaller because of rounding and existence already of a few such clinics). At a minimum of six doctors per clinic, that's 12,000 more doctors we should have -- at the very least.

With 159 medical schools in the U.S., that means -- to avoid crowding in existing ones (which are already resisting AMA pressure to increase class sizes), that would require twelve to sixteen new ones. I found an item that says three new ones are under construction, but since it gave no specifics it's not worth citing; if true, though, it means we should be building ten or more other right now as well.

With Harvard's wealth, it could easily 'clone' its own medical school.

 

[BostonPirate]

Yes, you did.

And you claimed that reducing the cost of medical school would have a negative impact on the country! What it would really do is lower costs.

If costs for education at harvard went down the research programs would go, not cost less. The cost of equipping the research facilities is immense, and they absorb that internally through the endowment. the country would lose academic medical research on cures for a HOST of illnesses if your type of ideas were enacted. Are you proposing to cap tuition costs legislatively on a private university? That is not very libertarian of you

And there are is also a harvard college, BTW... Not just a harvard university. This college offers ongoing education and two year night school programs that are very affordable through its extension school. It is just as easy to get a degree of Any sort through them, and they have open enrollment.

http://www.extension.harvard.edu/register/financial/

Tuition, ranging from $925 to $1,850 for undergraduate- and graduate-level courses, is listed with course descriptions. Full payment of tuition and the $50 nonrefundable registration fee is due at the time of registration. If you register during the late registration period, you are charged an additional nonrefundable $50 late fee.

AND when they graduate they get the prestigious Harvard degree that is so valuable in todays competitive job market. This program is partially funded by the endowment, so they are paying for this out of their own pockets. This supplies New England with an unprecedented ammount of nurse practicioners, btw.

These are vital to our universal healthcare system. There are many health needs that a nurse can easily help you with instead of a doctor, and the cost of an appointment with them is half that of doctors. This innovation in massachusetts is seen in our Community Health Centers, that Ted kennedy worked so hard on in his life.

These Community centers are a one stop NON emergency room kind of place. They offer Primary care, as well as all supporting clinical care, such as testing - from phlebotomy to colonoscopy, pharmacy services, mental health, dietician consultation.. ETC. This makes healthcare cheaper for us here. We can go to our community center, see a nurse, Then if needed or wanted, see our primary. we get test orders if needed and go to a different floor to do the tests. We can get our blood drawn while we wait for our prescriptions being filled.

having this diverse staff available in one place reduces overhead substantially while only having to bill doctors if there is something real and substantial involved. It basically puts triage back in the clinical setting, instead of the emergency setting, where it will cost one hundred instead of one thousand. It allows us to practice effective statewide preventative medicine instead of chasing catastrophic care costs.

Harvard is very good at what it does. I am surprised you are anti education to this degree.

The Doctors may pay more for their degree, but harvard uses that cash to train nurses that make doctors less needed.

Cutting healthcare and education in this bill will hurt the entire medical industry in many ways. Since new england houses 50 percent of it, there is not doubt that it would affect our economy.

I am NOT suggesting holding a commodity at an unnaturally high price. I am saying that you cant reduce the cost without harming cutting edge research in the nation. Thats not worth it.

 

[Kulindahr]

If costs for education at harvard went down the research programs would go, not cost less. The cost of equipping the research facilities is immense, and they absorb that internally through the endowment. the country would lose academic medical research on cures for a HOST of illnesses if your type of ideas were enacted. Are you proposing to cap tuition costs legislatively on a private university? That is not very libertarian of you

I haven't proposed capping anything -- merely pointed out that if Harvard can do as you said, and jack up tuition intentionally high so they can do research, thus prompting the rest of the country's medical schools to jack up their tuition as well, then you should have no objection to oil companies doing the very same thing.

If Harvard dropped tuition rates, then if associations are as you say, all the other medical schools would as well. New doctors wouldn't be under such a mountain of debt, so medical services would become cheaper.

The Doctors may pay more for their degree, but harvard uses that cash to train nurses that make doctors less needed.

So you should have no complaint if BP jacked its oil prices up so it could train workers for working on solar energy that makes oil less needed.

 

[BostonPirate]

Jack up is your term.

Harvard sets the cost of its degrees. It is aware of what kind of earning potential recieving a harvard degree gives to its alumni. If you will look above you will see that their budget is ballanced perfectly between human resourses and real estate costs versus tuition income. The research facility costs are extensive and that is the extra costs that have you riled.

There isn't some lonely scientist out there with a little lab and beakers, dilligently testing the HIV virus for mutations. There are High tech clean room units with the greatest american medical minds conducting research every day of every year. That lab is staffed to a greater degree by graduate students working on PhDs of Medicine, who not only are being trained in this field to go on and recreate the same at other universities, but are supplying valuable cheap if not free manpower hours to some of the most advanced medical labs in the nation.

That is how science, privately researched through universities, free of the constraints of the winds of politics, remains focused on its mission.

believe me there are universities that have to apply for grants, project by project at times. annually just for the most basic of programs to remain funded.

University income (Fiscal Year 2008 ) - $3,482,317,000

University expenses (Fiscal Year 2008 ) - $3,464,893,000

Endowment (Fiscal Year 2008 ) - $27.4 billion

Energy research is addressed. Do you trust the oil companies or Harvard and MIT to do research to find cheaper cleaner fuels?

You have this hang up with the oil thing, and I am telling you that focused education and research like that done at MIT bears short and long term profit for the entire nation that supercedes the comparison.

These universities aren't profit taking. They are budgeting research.

Theres a difference.