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From a doctor's perspective, is it better to repeal or keep healthcare reform

Discussion in 'Allopathic' started by Lysinee, Mar 1, 2012.

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  1. Lysinee

    Lysinee

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    From a doctor's perspective, is it better to repeal or keep the healthcare reform bill?

    Thanks.
  2. Barcu

    Barcu

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    Depends what kind of doctor you are.
  3. Law2Doc

    Law2Doc 5K+ Member Moderator Emeritus

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    I think most doctors have conceded that healthcare is a mess and some form of change needs to happen, and is going to happen. Views are mixed as to whether the current act (no longer a bill) is workable, or whether some other plan would be better for the country. I think the embracing of midlevels under the administrations plan gives a lot if doctors pause.
  4. Phyozo

    Phyozo

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    This is a complicated question so I'll defer to those who have more experience, but my understanding of why the answer to your question is not straightforward is that no one really knows how the practical consequences of this act will play out...
  5. tobi44

    tobi44

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    I also don't have too much knowledge of this but I have heard the following
    Cons
    ---reimbursements for procedures will be cut, so doctors, especially specialist will be making less. I think that gov spending accounts for about 50% of the business in healthcare given medicare, medicaid/medical. Last I heard it was a 30% cut to medicare reimbursement to docs.
    ----more team based approach to medicine, which may mean empowerment of mid-level providers.
    ----higher taxes by 1% on households that make over 200k, which very well might be doctor homes to pay for all this healthcare.
    ----huge influx of people getting health insurance. General worry about how we are going to provide care for all these people when primary care is already at a shortage.

    Go ahead and correct me if I'm wrong on any of this, I am certainly not an expert....

    Even with these things I still think giving the millions of people access to some type of health plan is worth it.
  6. pkwraith

    pkwraith Avatar of Boris

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    Personally, I think cutting reimbursement would be a horrible way of healthcare reform. Physician salaries is just not a significant part of the costs, and would honestly be pretty short-sighted (but politically easy).

    Really need a long-term solution, such as a better focus on preventative health.
  7. surftheiop

    surftheiop

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    Most docs polarize to one side or the other, they either think the act should be completely thrown out or think that it doesn't do enough (ie. we need universal coverage). I don't think anyone really thinks this act is the optimal solution. Interestingly, I have noticed that this polarization also has strong predictive power for whether docs would encourage someone to enter the field. Those who think the act should be tossed tend to think that medicine isn't a good choice anymore, while those favoring UHC seem to be very optimistic. I take this to mean that both sides of the debate see the writing on the wall and know it will only be a matter of time till we get UHC.
  8. Rocher

    Rocher Hazelnut Goodness

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    I've noticed that pattern as well.
  9. Lysinee

    Lysinee

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    I know no one can predict its impact in the future. I am just interested in hearing opinions from doctors or future doctors.
  10. Phyozo

    Phyozo

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    I think the healthcare reform is a step in the right direction, but is by no means optimal. Still it opens up the discussion for further change, real change that we actually need. While we may save some $$ by cutting reimbursements, I believe this is the wrong place to be cutting funds. The reality is that we overspend on inefficient administrative costs and the ordering of unnecessary testing, a byproduct of defensive medicine (which has now become the standard of care and will continue to be so until we have some reform in the courts). Also, the issue of adding so many people into the system is a huge problem during our current PCP shortage and my bet is that midlevels will surely fill in the gaps and primary care docs may take on more of a preceptor role in overseeing clinics. Health care is hinged by access, cost, and quality. If you fix one aspect, in this case giving access to the majority of individuals, then in a finite resource system you can expect costs to increase and/or quality of care to decrease.
  11. neusu

    neusu Chief Resident

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    In the US, in the current system. Health care is both an unalienable right and an inelastic good.

    This means that no matter how much money you make, you are entitled to life saving measures. If you show up with a life threatening issue or seemingly so, you are entitled to treatment. You will still be issued a bill. You still owe money for having to use healthcare.

    Say you are an illegal immigrant and were drunk and assaulted and stabbed in the brain, among other areas. You are now paraplegic. You can not take care of yourself, nor has your family identified you. Welcome to American healthcare..

    Likewise, say you present to your PCP for confusion and have focal findings. Say he admits you to the hospital and gets an MRI brain and finds a cerebral abscess. Needless to say we operate to fix it and you don't wake up exactly like you were because you had an infection and associated edema.We treat you inpatient for 2 months. ID signs off Welcome to American healthcare..

    Very easy to bankrupt yourself or anyone involved unless you are insured (or even if you are not).

    Universal healthcare would help in allowing those who currently do not pay, pay; as well as those who currently do pay, pay more. Private health care will not go anywhere, just the government will pick up the tab for the bottom is all.
    Last edited: Mar 2, 2012
  12. sirenomelia

    sirenomelia

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    No, no doctor I respect agrees or wants Obama care.
    Added government intrusion will simply expand bureaucracy, paperwork and generate pseudojobs of useless people, increase costs, lower quality, and reduce patient choice. Forcing small businesses to pay for this will hurt the economy further, but this president doesnt care and has never had a real job and knows nothing. And we're going to force self employed or unemployed to buy their own insurance or else pay a fine. That makes sense. Let's also round up homeless people and put them in jail if they dont have a mortgage payment too.
  13. SteinUmStein

    SteinUmStein

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    This message brought to you by Fox News.

    To say that no respectable doctor wants Obamacare is a bit of a stretch.
  14. Beta Cell

    Beta Cell

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    I agree with the majority of this. What really astounds me is people who continue to press for universal healthcare. "Look at Canada" they say. If I ever want medical equipment from the 1970's, I'll head over there. I recently read an article about the famous MMA fighter, Brock Lesnar and his bout with diverticulitis on a hunting trip in Manitoba, Canada.

    Here's an excerpt from http://www.mmamania.com/2011/5/26/2...litis-illness-update-maybe-surgery-maybe-not:

    Stein, he never said no doctor wants Obamacare-- he said "doctor I respect." Let's not be pedantic here, if you want to draw party lines, I could have prefaced this statement with "brought to you by CNN" or "anyone in Portland."
  15. SteinUmStein

    SteinUmStein

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    Sorry, I should have clarified between "doctor he respects" and "respectable doctor". I never claimed that he said "no doctor wants Obamacare". Does that make sense? :laugh:
  16. anbuitachi

    anbuitachi

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    Some parts of the healthcare makes no sense at all and it's just politicians playing games to make them look like they are doing something that will help the general population. To the commoners eyes, lowering physician salary by 30% should be pretty helpful in cutting costs, when anyone with a bit of knowledge about it knows that physician salary is a very small part contributing to rising health costs. There are definitely problems with the new healthcare.
  17. Kevin Baker

    Kevin Baker

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    1. It's spelled inalienable right.

    2. Just because you say something is inalienable doesn't magically make it true.

    3. Health care is an elastic good. There is some inelastic baseline however.

    4. Illegal immigrants are not covered under the ACA.

    5. The ACA is by no means universal healthcare. It's a patchwork of regulations sewn together, fining people who opt out in order to ensure ~90% of Americans have access to some baseline level of care. What about the other 10%? Those who are illegal immigrants? Those who opt out? Migrants and those who never opt in.

    6. Private health care has worked well for a long time, even in Universal Healthcare Systems. But the ACA is still private insurance at it's heart.

    Don't pretend this is a long lasting fix. Don't pretend the act passed due to the good nature of our elected officials. It's not universal health care and the only reason it passed is it saves over a trillion in future spending. That's a trillion dollars out of health professionals pockets, not that I care about funding but I do want to point that number out. It's health care for the top 90% of Americans.

    It baffles me that our officials were given the choice between single payer and multi payer w/ private insurance, and somehow, invented their own system: compulsory private insurance for 90% of Americans. I honestly feel we're going to have to readdress the ACA in a few years and decide whether to go single payer or multi payer. But this patchwork of regulations is unsustainable and leaves 10% of people in the dust.
  18. Lysinee

    Lysinee

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    Billions of dollars can by saved by reducing or eliminating medicare fraud.
  19. IDBasco

    IDBasco Atypical agent

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  20. SteinUmStein

    SteinUmStein

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  22. HondoCrouch

    HondoCrouch

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    I assume youre referring to Obamacare, which had nothing to do with healthcare reform. Nobody who actually knows what's in that bill considers it healthcare reform.

    If anything its an insurance regulation bill.

    In any case, it will be struck down by the supreme court. If not, our republic is lost. Rome lasted 700 years and we are struggling to make it to 300.
  23. FutbolFanatic88

    FutbolFanatic88

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    Interestingly enough, we had a spokeswoman for a company focusing on compliance issues talk to some doctors at my school a few weeks ago, and according to her, the government recoups 23 dollars for every one dollar spent on investigating billing fraud. Anecdotal but still really surprising when I heard that the government is actually doing something efficiently relating to healthcare
  24. Lysinee

    Lysinee

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    Health Care Reform (Obamacare).


  25. GoodmanBrown

    GoodmanBrown is walking down the path.

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    Histrionics much? The Supreme Court may or may not strike the individual mandate which was a Republican idea before Democrats incorporated it into the bill.

    Either way, the individual mandate will not make or break the United States. While this law adds extra federal expenses in terms of subsidies to individuals and families buying health insurance, the much larger spending decisions regarding Medicare, Medicaid, Social Security, and defense will ultimately dictate the solvency of the US government.

    The Affordable Care Act makes some tentative, bashful attempts at cost control for Medicare & Medicaid. However, even if the law stands as written, we'll see very real changes in government in our lifetimes.
  26. crimedawg

    crimedawg

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    Bro, typical for someone who watches CNN. You didn't even read what he wrote.

    He is saying, "no doctor I respect..." that is a far cry from no respectable doctor wants obamacare....FACT.
  27. Beta Cell

    Beta Cell

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    I already called him on it. He actually edited his post, it used to just say "any doctor." He apologized though.
  28. JP2740

    JP2740

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    I don't know any doctors who support it. I only know doctors who've told me not to be a doctor.
  29. pupster

    pupster

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    Where in the Constitution does it say that health care is an unalienable right and an inelastic good?

    Health care is a NOT a right. If it's a right, then I guess doctors are slaves.
  30. CaptainSSO

    CaptainSSO

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    Our republic is lost! It's all black!! Everything's black!!
  31. CaptainSSO

    CaptainSSO

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    Well, "life, liberty, and the pursuit of happiness" is in the Declaration. And I would say no healthcare = no happiness, possibly no life.

    I just can't relate to these hardass lines of not wanting to see everyone get healthcare. I mean, wtf?

    So people with colon cancer who can't afford chemotherapy should just crawl into a corner and die?
  32. Mace1370

    Mace1370

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    No happiness isn't the same thing as being unable to pursue happiness. You need to figure out the difference between a positive and a negative right.
  33. IDBasco

    IDBasco Atypical agent

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    Bring us totals of what is spent on recovering money vs. what is recovered. Someone else mentioned its 1:23, which I don't believe for a second or there would have been a HUGE push to expand that effort years ago. Finding the largest ever case doesn't mean that billions will or have been saved.
  34. OneTyme

    OneTyme Kickin' it ol' school

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    There are lots of things that are not 'in the constitution' that our legal system has evolved to include under the basis of the constitution. You know, like women can vote, you have to pay people for labor, slavery is illegal, on and on.

    I think what the poster was referring to is the idea that there are aspects of medicine that are considered a right (EMTALA much?) and aspects of medicine that are an inelastic good. If you don't think that doctors are partially required to act in circumstances without pay, think again. If you are on duty and somebody shows up that needs care covered under EMTALA, you ARE GOING TO BE CARING for them. If they can't, or won't pay, you just provided a legally required service for free. It's a basic premise of our society, albeit an evolved one that has come about as time has passed and our ideals have changed.
  35. valkener

    valkener

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    There are many doctors supporting Obamacare and just as many opposing it. The AMA, for example, supported at least a big part of the bill.

    It's weird to hear people going into medicine that think not all people should have health care. In the end, it costs everyone if an uninsured person has to wait 10 years to get treated because his illness has gotten so bad that one of the local hospital has to treat him/her.

    Universal health care would hopefully prevent many people's diseases from progressing and costing society more in the end. At least this is an argument that I keep hearing in favor of Obamacare.

    We have to be honest and say that US healthcare sucks in regard to infant mortality . Not sure how all of this can be solved, but a black/white perspective won't help anyone. Unfortunately this is exactly what the US is famous for - a polarizing country where most people either are like "wtf" or "omg iluv".
  36. scarshapedstar

    scarshapedstar MD c/o 2016

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    I don't know any doctors who love treating uninsured patients. Quite the opposite.

    I do know plenty of doctors who are sick and tired of bending over backwards to please the useless skimming insurance companies, so in that regard they aren't fans of Obamacare.
  37. boggvir

    boggvir Sunny California

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    Doctors are slaves? Like police officers? Judges? We all have a right to a trial - that doesn't make judges "slaves". Can we please be adults here? You can disagree with healthcare reform without "omg the world will end".

    Anyway I don't like parts of it but short of universal health care, I support the individual mandate. I think it's probably 50/50 that it will be struck down. The conservative section of the court has a majority but the justices (including originalists like Scalia) have traditionally given congress wide powers under the commerce clause (reasoning is stare decises for Scalia). Again it's very possible it will be struck down, but I don't see it as a foregone conclusion one way or another.

    One sure result will be that physician, especially subspecialty, salaries will decline regardless of what happens. You could completely ignore healthcare reform and physician salaries will still drop due to Medicare (and then private insurance which follows Medicare).

    Long term I don't see any realistic option besides universal health care in 20 years. Regardless of what doctors want or libertarians or whoever else, the momentum just won't allow anyone to do anything but that.
  38. CaptainSSO

    CaptainSSO

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    That's semantics dude. Clearly you're not going to be able to pursue happiness if you have colon cancer and are dying because you can't get it treated.
  39. SteinUmStein

    SteinUmStein

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    There are no edits in any of my posts. Go ahead and check. :thumbup:
  40. IDBasco

    IDBasco Atypical agent

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    Well hell! I can't pursue happiness without food, clothing (illegal to be naked in public) shoes and a whole host of other things. I guess the constitution gives me the right to those things too!! Er, no, it really doesn't.:rolleyes:
  41. boggvir

    boggvir Sunny California

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    It's not in the constitution but we decided as a while back that we don't want people dying of starvation in the US. It's not a constitutionally protected right but it's certainly a right as far as I'm concerned. The constitution doesn't contain all the rights of US citizens, it just enumerates rights that congress is not supposed to impinge upon. Constitution doesn't "give" us any rights - it just stops the government from taking a certain number of them away. It's different to Europe where their constitution explicitly lists every right that a person has.

    I would consider not starving to death a "right", as well as recieving protection of police, and recieving essential medical care. You may of course disagree.
  42. CaptainSSO

    CaptainSSO

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    Way to to be a douche and completely miss my point.

    By the way, it's the Declaration of Independence and not the Constitution that discusses the "pursuit of happiness." Dumbass.

    Real easy to talk about how healthcare isn't a right when you yourself have it. Comes with being a privileged white kid I guess.

    Just to get this straight--all the people with cancer and no health insurance who can't afford the treatments deserve to die? You say they don't deserve healthcare, so let's call it like it is--they deserve to die?
    Last edited: Mar 2, 2012
  43. link2swim06

    link2swim06 PGY-1

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    They dont have the RIGHT to take my money that is for sure...

    Everyone is going to die, its not avoidable. I dont think the government's purpose is to maximize everyone's lifespan...I could explain why its mathematically impossible to have this type of policy in the next 50-150 years.
  44. OneTyme

    OneTyme Kickin' it ol' school

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    Aren't there like crap loads of docs that volunteer their free time at clinics, or take cases for uninsured on the side, or do stuff like fly to Africa to treat poor people (who I'm assuming are uninsured)?

    I'm not saying it's for everybody, but you have to be out of your gourd if you think that everybody thinks just like you.
  45. CaptainSSO

    CaptainSSO

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    Again..you're stating this from the privileged position of having access to healthcare. Everyone is going to die--we all know that, but if it were that simple, we wouldn't even have healthcare to begin with, or we'd all just blow our brains out right now because it's inevitable anyway. You're telling me you wouldn't seek treatment for an illness?

    Anyway, what is your mathematical theory? I am more interested in those kinds of arguments, logistical arguments, than I am with the idea that some people don't deserve healthcare. I just think that's a sick idea for people to believe.

    PRISONERS get access to health care. So you're telling me that the population as a whole doesn't deserve access to health care?
    Last edited: Mar 2, 2012
  46. pupster

    pupster

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    So...gee...I guess the gov't should just pay me $$$ for sitting on my gluts not doing anything?

    I did NOT say I don't want to see everyone get healthcare. Don't twist my words. What I said was that healthcare is NOT a right given by the US Constitution. Now, in other countries, it may be, and that's all good. However, in the United States, it's currently not a right.

    What I said is that healthcare is NOT a right. It is a responsibility.

    "If one does not accept responsibility for his or her actions, there are no consequences for a particular behavior and when translated into the delivery of medical care, that only means increased expenditure. “Rights” are either things you, as a free citizen, may do either without interference (with the implicit caveat that you do no harm to others during the conducting of the specific activity deemed a right) or may not be done to you without permission (such as search and seizure).

    What is implicit in a right is a protection but not a gift of goods and services created because of the work, sweat, time and capital investment of others. If healthcare is indeed a right, then these healthcare goods must then be seized forcibly, by law or by theft, from others who have provided them in what is a frank violation of their right not to be robbed of their property. This then begs the question of whether the absolute right to healthcare also involves the right to steal from those who produce the goods and services necessary for that care. In a broader sense one must also ask where do one’s rights end? Do they extend to food, or housing or a job?" -Mitchell Brooks
  47. pupster

    pupster

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    Exactly...which is why I resigned my membership fromt he AMA and joined the Association of American Physicians and Surgeons.

    Medicine is a BUSINESS. Sure, we're all indoctrinated to drink the Kool-Aid in medical school, but in the end, it's a business. If you don't pull in enough in collections or RVUss, you're not making partner or getting that promotion.

    Maybe that person should have taken personal RESPONSIBILITY for his/her health and his/her career/education. Not my problem. I'm already paying $$$ in taxes to fund people who go to the corner shop and buy Slim Jims with our tax dollars using EBT cards....

    "Hopefully?" People are gonna get sick regardless, and as medicine and technology improves, lifespans will increase. The average lifespan of Americans is at an all time high (http://well.blogs.nytimes.com/2009/08/19/us-life-expectancy-at-all-time-high/). Your statement about infant mortality fails to normlize for ethinicty/socialeconomic disparities; it's not solely a function of US healthcare "sucking."
  48. pupster

    pupster

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    :thumbup::thumbup::thumbup::thumbup::thumbup:
  49. Beta Cell

    Beta Cell

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    Records of edits only appear for edits made after a set period of time. If you edited it quickly (which I thought you had), without someone quoting the original text, there's no way for me to prove it. I'll just take your word for it.

    For example, I just edited this post twice.
  50. IDBasco

    IDBasco Atypical agent

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    LOL! Nothing pisses people off like pointing out their absurdity by adding more absurdity.

    :laugh:

    No rights given by the gov are in the DOI. But, if they are endowed by the "Creator" as per the DOI, rather than the gov, how exactly does that include free health care access courtesy of the gov, or rather, the taxpayer? Why do I get the feeling you don't believe in God or anything He could endow anyway? Just an expediency for you? Probably.

    You are a racist. Plain and simple. Care to continue here?

    There have been times I haven't had insurance for a year or more at a time. I won't argue over my parent's income growing up as you would just deny everything I say. Pointless to go there. Tell me how old I am, by the way, and my income for each year for the past 20 years...I'm waiting.

    Wow, look at you putting all these words in my mouth, Your jump-to-conclusions mat is getting quite a workout.

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