Compulsory Medical Service?

[Green Painting]

Please don't laugh at me.

I'm talking about a compulsory medical service in a medical corp in comparable manner and magnitude Compulsory Military Draft is carried out, in order to significantly reduce the cost of a universal health coverage.

The biggest problem is whether the drafted are capable enough to be trained as doctors and nurses. Secondly, whether they have enough time to carry out adequate training.

The reason why I ask this: I currently live in a country where not only soldiers, but policemen, firefighters, ambulance staff and rescuers are all manned by compulsory national service draftees, I wonder whether we can go one step more and introduce national service to Hospitals as well.

 

[aktarian]

Not a good idea, IMO. Simply because of training required which would then be discarded. It could work for certain jobs that require no medical knowledge (orderlies) but how many of those do you really need?

What could work is that you have some sort of compulsory national service with several fields. People can choose which one, taking into account their interests, studies etc. So somebody training to work in medicine anyway would work in a hospital, forrest service for those planning to work in that field later and so on.

Otherwise you are jsut wasting money to train people to work for certain time period after which they leave and never use that knowledge again. And you have to keep doing it over and over again and as soon as you reasonably well train one they are gone.

 

[RousseauX]

I'm talking about a compulsory medical service in a medical corp in comparable manner and magnitude Compulsory Military Draft is carried out, in order to significantly reduce the cost of a universal health coverage.

This might work in a country like Cuba where there are restrictions on travelling outside the country.

But how are you going to prevent high value labour from moving across borders if the alternative is presumably significant less profitable?

Also, how is this really different than Universalized Healthcare where medical personal are sort of public servants anyway?

 

[historyfool]

Isn´t/wasn´t that the norm in countries with alternative civilian service in a certain sense? I mean in Germany Zivildienstleistende worked mostly in childcare, geriatric care, some social services and healthcare. It was not terribly effective once the service time fell below 12 month, because sometimes training was as long as useful service or longer, but before that several draftees could replace a trained worker. Doctors though are not going to work, except maybe in the sense that they could start studying and afterwards do their compulsory service as full-blown doctors, before they really start getting paid.
Even if you only really want to replace a sizeable number of full-blown nurses you would need at least two or three years service time and a greater number of warm bodies. A really useful term of service (meaning even longer) would probably not be socially accepted unless perhaps it is seen as just punishment for avoiding military draft.

 

[I want to learn]

I thought this thread was going to be about everyone being drafted into a health boot camp. Which would probably be an efficient use of resources than this.

 

[Corbell Mark IV]

Not a good idea, IMO. Simply because of training required which would then be discarded. It could work for certain jobs that require no medical knowledge (orderlies) but how many of those do you really need?

What could work is that you have some sort of compulsory national service with several fields. People can choose which one, taking into account their interests, studies etc. So somebody training to work in medicine anyway would work in a hospital, forrest service for those planning to work in that field later and so on.

Otherwise you are jsut wasting money to train people to work for certain time period after which they leave and never use that knowledge again. And you have to keep doing it over and over again and as soon as you reasonably well train one they are gone.

In elder care, such need is quite high. This would be a source of huge savings.

And it would suck for everyone involved.

These draftees would do a crappy job because they don't want to be there. THat sucks for those who are being served by these draftees.


It would suck for the draftees, who are forced to empty bedpans and change old people's diapers for slave wages.


It would suck for people in the medical field who have their wages depressed by slave labor.

It would suck for people in the medical field who have to try to get work done with people who are only there because they have been forced to.


That's all the suckage that comes to my mind right now, but I bet there is more.


BUt it would save money.

 

[aktarian]

In elder care, such need is quite high. This would be a source of huge savings.

And it would suck for everyone involved.

These draftees would do a crappy job because they don't want to be there. THat sucks for those who are being served by these draftees.


It would suck for the draftees, who are forced to empty bedpans and change old people's diapers for slave wages.


It would suck for people in the medical field who have their wages depressed by slave labor.

It would suck for people in the medical field who have to try to get work done with people who are only there because they have been forced to.


That's all the suckage that comes to my mind right now, but I bet there is more.


BUt it would save money.

Good points. And it seems we agree this would only work for jobs that require no or minimal medical training. As historyfool pointed out, you need a lot of time to train even half decent nurse so at best you get few months of half decent service from such people. But you need to have people training them constantly and these trainers can't do their own job full time so you need more trained people to cover for that.

In the end I think you'd be better off just employing otherwise hard to employ people who have no marketable education or skills.

 

[rudebadger]

Please don't laugh at me.

...The biggest problem is whether the drafted are capable enough to be trained as doctors and nurses. Secondly, whether they have enough time to carry out adequate training.

Wait. What? You want to draft people first THEN force them to become medically trained? That sounds like a very bad idea to me.

If you need to increase the number of medical staff you could offer government grants or scholarships to med school students with the requirement for them to work a number of years in exchange for the loans.

Also try hiring trained foreign medical staff for your hospitals. Although you may have to have them to be able to speak your language.

 

[Reader347]

Also try hiring trained foreign medical staff for your hospitals. Although you may have to have them to be able to speak your language.

>
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This is already quite common in some countries.

 

[Tammany Tiger]

The U.S. has conducted a special "doctor draft" in the past, when physicians and health-care workers were in short supply in the military. The Selective Service Act is still on the books, and still provides for such a draft.

Green Painting's hypothetical raises an interesting question: can the U.S. conscript people for reasons not strictly related to national defense? The courts haven't decided this issue because it so far hasn't arisen per se. It would come up if, as a number of experts have recommended, Congress requires young adults to spend some time (1-2 years, typically) in some form of service, military or otherwise.

Courts have upheld requirements that high school students perform community service, analogizing it to the requirement of jury duty. However, most high school students are minors, and a 50-hour-per-year service requirement is far less burdensome than, say, two years as a hospital orderly or teacher's aide.

 

[idumea]

Compulsory education to age 22 including 5 years of "medical" training for everyone?

Sounds horrific to me, but everyone could in theory graduate with significant worldwide earning potential and could specialise at age 17 in nursing, dentistry, technical operation, management etc.

Although knowing how heavily doctors drink and smoke it is seriously unlikely to give your health service any savings, and you will experience a greater than usual brain drain if you cannot offer competitive wages for doctors and nurses.

 

[Flocculencio]

Not a good idea, IMO. Simply because of training required which would then be discarded. It could work for certain jobs that require no medical knowledge (orderlies) but how many of those do you really need?

It's perfectly possible- not training everyone as doctors and nurses but giving everyone paramedic Level 1 training. My vocation in the Singapore Armed Forces (we all have to do national service) is that of a combat medic sergeant and I'm Level 2 Paramedic trained. Our combat medical orderlies are all Paramedic level 1 trained. Level 1 training took two months or so and my level two course took 1 1/2 months on top of that.

I'd much rather see a form of national service here in Singapore where everyone was paramedic trained than the current system which forces people into military service and wastes two years of their time. At least then you'd have a population where everyone was CPR/AED trained and could take and monitor vital signs along with prvidign first responder care (splints, arresting haemorrhages etc.)

 

[sloreck]

There is no way that vast numbers of folks can be trained to paramedic level. Aside from the fact of the educational ability before you start the training (high school with decent science/math) which is NOT universal, its also a fact that certain manual skills are needed. Lastly, there is the personality needed to deal with all that - not all that common.

To "draft" doctors and other professionals, and not anyone would be unlikely to stand a constitutional challenge (unequal treatment) - as has been noted there was a special doctor draft, but this was in concert with a more general war and peacetime draft, and entering in to the doctor draft pool was the price for being deferred during your medical education.

Some countries have free (or near free) medical school, but a term of public service (2-3 years usually) is required in lieu of tuition.

The only way this works is if there is universal service required, and like in Germany you can opt for civilian service (like nursing home etc) instead of potential military service. "Draft" for doctors, nurses, dentists etc only won't fly.

 

[Flocculencio]

There is no way that vast numbers of folks can be trained to paramedic level. Aside from the fact of the educational ability before you start the training (high school with decent science/math) which is NOT universal, its also a fact that certain manual skills are needed. Lastly, there is the personality needed to deal with all that - not all that common.

It works in our system where a large group of conscripts are assigned to the Medical Corps every year. Our education system provides at least the basics of maths and science necessary and I'm useless with my hands but learned the skills needed to a decent enough level.

We can assess casualties for trauma, set a drip, splint fractures, monitor vitals, perform CPR, use an AED and so forth.

Only trained and qualified doctors (and nurses) can be Medical (or Nursing) Officers but pretty muych anyone can be trained to the standards of a Medical Orderly

 

[aktarian]

It's perfectly possible- not training everyone as doctors and nurses but giving everyone paramedic Level 1 training. My vocation in the Singapore Armed Forces (we all have to do national service) is that of a combat medic sergeant and I'm Level 2 Paramedic trained. Our combat medical orderlies are all Paramedic level 1 trained. Level 1 training took two months or so and my level two course took 1 1/2 months on top of that.

I'd much rather see a form of national service here in Singapore where everyone was paramedic trained than the current system which forces people into military service and wastes two years of their time. At least then you'd have a population where everyone was CPR/AED trained and could take and monitor vital signs along with prvidign first responder care (splints, arresting haemorrhages etc.)

It could be done, but it's still a bad idea. Has anybody ran the numbers on how much that costs and how often do you need it later?

As I said earlier, you'll end up spending a lot of money and time to train people and after their term is up and they choose to work in different field all that is forgotten. So you get a few months out of them for such large investment.

 

[Flocculencio]

It could be done, but it's still a bad idea. Has anybody ran the numbers on how much that costs and how often do you need it later?

As I said earlier, you'll end up spending a lot of money and time to train people and after their term is up and they choose to work in different field all that is forgotten. So you get a few months out of them for such large investment.

Agreed. I'm basing this on my own country which (IMO) wastes far more money on conscripting all male citizens for two years at the age of 18. Not having to waste the money on paying, feeding and supplying conscripts for two years should offset a few months medic training. For a country without an existing conscription programme, I agree it makes no sense. I'd just rather have that money spent on something useful to all rather than pointless military training.

 

[idonotlikeusernames]

Maybe in more socialist leaning timeline like you could make the university and vocational training required for most of the needed medical professions free in return for an X amount of service in the state health care system that way the people who sign up for it would at least know what they're getting themselves into. Plus after their time of service is up the graduates enter the presumably more lucrative private practice market free of crippling student debts and with valuable work experience to boot.

To be honest though far more money could be saved with a thorough overhaul of the patent system for drugs and reducing bloated management budgets that add nothing the actual quality of the health care provided. Though again this would be much more easy to accomplish with a not for profit health care system in place.

 

[sloreck]

I worked with HMs a lot as a navy doc - great people. HOWEVER in order to qualify for medical training (navy or army) you need to be a HS graduate and have fairly high scores on the AFQT. With folks with good background, smarts, and motivation you can do a lot - but that's not everyone. Furthermore, there are lots of folks with the smarts/education to be corpsmen/medics/paramedics who simply can't deal with blood, puke, etc.

Just like many other professions, not everyone can do it.

 

[Green Painting]

Agreed. I'm basing this on my own country which (IMO) wastes far more money on conscripting all male citizens for two years at the age of 18. Not having to waste the money on paying, feeding and supplying conscripts for two years should offset a few months medic training. For a country without an existing conscription programme, I agree it makes no sense. I'd just rather have that money spent on something useful to all rather than pointless military training.

When I asked this question, what I had in mind is to push for a cheaper, more widespread healthcare in poor developing countries. I feel that a developed country like Singapore can push for a European-style welfare state without the need to draft people into the medical service.

 

[Flocculencio]

I feel that a developed country like Singapore can push for a European-style welfare state without the need to draft people into the medical service.

Oh, I totally agree- activists and civil society in Singapore are trying to push the government slowly towards the idea of a welfare-esque state.

However, since we have an existing conscription system, and since first aider skills are always an asset in any situation in life, I'd rather see my tax dollars being spent training 18 year old in basic EMT skills rather than in buying Leopard tanks and F-35s.