Painful Cuts Coming to Pain...Elections Have Consequences

[drusso]

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[callmeanesthesia]

“Elections have consequences”?? Total non-sequitur.
We all agree this trend is turning medicine into a bureaucratic mess run by nurses and MBAs, but the liberal/conservative divide has little to nothing to do with it. That graph goes all the way back to 2000, roughly equal numbers of years under Democratic and Republican administrations, and as you can clearly see, physician compensation is a nearly flat line all the way across.

 

[10KHertz]

It’s not just party elections, it’s about letting ASIPP and it’s members (LAX) selling out Pain Medicine to governmental handlers…

 

[DrMDAware]

It’s not just party elections, it’s about letting ASIPP and it’s members (LAX) selling out Pain Medicine to governmental handlers…

Real question – how so?

 

[GlowInTheDark]

Real question – how so?

Look at the recent changes to SI joint injections.

 

[manowar rules]

Yeah what exactly does ASIPP do besides spam me for money?

 

[Status Sciaticus]

Lol its almost a tag line at this point, and parroting it to SDN users like it wouldve changed the outcome is hilarious

 

[drusso]

“Elections have consequences”?? Total non-sequitur.
We all agree this trend is turning medicine into a bureaucratic mess run by nurses and MBAs, but the liberal/conservative divide has little to nothing to do with it. That graph goes all the way back to 2000, roughly equal numbers of years under Democratic and Republican administrations, and as you can clearly see, physician compensation is a nearly flat line all the way across.

Most "conservative" health policy ideas have never seen the light of day. What has been implemented has mostly come from liberal/welfare state advocates.

Just imagine how different things would look for physicians if more "conservative" policies were tried over the last two decades.

https://www.cato.org/making-health-savings-accounts-work-everyone

 

[10KHertz]

Real question – how so?

It’s similar to the Ama …
You sell out your constituents, kneel to the NIH/CMS masters , and you are granted validity to pander your coding books, CME courses, and other propaganda . Read LAX’s ‘extensive’ pain study archive. All biased nonsense to acquiesce his governmental managers/handlers …
Bundling , removal of codes, downgraded levels, dual blocks, no steroids, contrast for everything, one scs per lifetime , all LAX/ASIPP.
We need new leadership …

 

[clubdeac]

Most "conservative" health policy ideas have never seen the light of day. What has been implemented has mostly come from liberal/welfare state advocates.

Just imagine how different things would look for physicians if more "conservative" policies were tried over the last two decades.

https://www.cato.org/making-health-savings-accounts-work-everyone

we definitely wouldn't be in the hell hole mess we're in now. But of course the staunch liberals on this board will never own up to real consequences of their president, his administration and his policies and their direct role in stagflation, the recession and bear market, economic and international instability, open borders and the subsequent fentanyl crisis and the fact that we're on the brink of WWIII. Thanks Biden and all you that voted for him. It's been a great 2 years. 👍

 

[Baron Samedi]

we definitely wouldn't be in the hell hole mess we're in now. But of course the staunch liberals on this board will never own up to real consequences of their president, his administration and his policies and their direct role in stagflation, the recession and bear market, economic and international instability, open borders and the subsequent fentanyl crisis and the fact that we're on the brink of WWIII. Thanks Biden and all you that voted for him. It's been a great 2 years. 👍

Dang dude. Do we know where this Biden guy was when JFK was shot?

 

[deleted131481]

Maybe it's just me but I'm not following anything in this thread.

Lax and ASIPP are selling out to the government so they can sell us CME and enrich themselves?? I'm not an ASIPP member but aren't they the only group that does any advocacy for pain physicians (maybe SIS)?


HSA accounts are great. I'm sure it would benefit those who can afford them. Most people don't even contribute to their 401k so I highly doubt HSA make a difference for these.

And typical nonsense blaming Biden for every ill that happens in the world. Pretty sure he's responsible for my cat throwing up all over my house.

 

[powermd]

What exactly did President Trump do to help physicians?

For all the conservative whining about DEI in education, did Betsy DeVos do anything to stop it? Since you believe elections have consequences...well, a republican was elected. Did anything really change for the better? NO. It's a fallacy to believe anything more than market forces are involved. Money talks, and physicians just don't have enough. The corporate interests in health care, as well as education, continue to get their way. It looks like the Republicans may take over Congress this year. Are they going to do anything to help us? A new Trump administration, Desantis? Of course not. They'll continue to line their own pockets as well as their buddies.

All I hear in this forum is bitch bitch bitch and blame blame blame. We're powerless as far as the government goes, and that's that. All you have *some* control over is your own practice. So continue to build on your cash pay services. It's all we've got.

 

[Ducttape]

the entire system is broken, and it is working as it should.

our healthcare system is not for the patients.

it is not for the physicians, or nurses.

it is for big business - big pharma, big hospital, private insurance.

anyone who is blaming a poltiical party is oblivious to the fact that this is capitalism at its finest (if you are a supporter of profits trumping everything) or at its worst (if you believe that we should provide good healthcare to as many as possible).

 

[clubdeac]

Sometimes it’s too easy. You proved my point. Keep voting for idiots and terrible policies and we’ll get more of the same. Y’all do realize there’s such a thing as the lesser of two evils. You don’t have to vote for the worst option every time

 

[SSdoc33]

Maybe it's just me but I'm not following anything in this thread.

Lax and ASIPP are selling out to the government so they can sell us CME and enrich themselves?? I'm not an ASIPP member but aren't they the only group that does any advocacy for pain physicians (maybe SIS)?


HSA accounts are great. I'm sure it would benefit those who can afford them. Most people don't even contribute to their 401k so I highly doubt HSA make a difference for these.

And typical nonsense blaming Biden for every ill that happens in the world. Pretty sure he's responsible for my cat throwing up all over my house.

yeah, why can't cats get their sh$t together? its a huge problem. and would it kill them to do it the mudroom vs the expensive dining room rug?

 

[powermd]

Sometimes it’s too easy. You proved my point. Keep voting for idiots and terrible policies and we’ll get more of the same. Y’all do realize there’s such a thing as the lesser of two evils. You don’t have to vote for the worst option every time

And you're proving my point. It doesn't matter who you vote for. The system creates nominees who are not going to help physicians, period.

 

[drusso]

What exactly did President Trump do to help physicians?

For all the conservative whining about DEI in education, did Betsy DeVos do anything to stop it? Since you believe elections have consequences...well, a republican was elected. Did anything really change for the better? NO. It's a fallacy to believe anything more than market forces are involved. Money talks, and physicians just don't have enough. The corporate interests in health care, as well as education, continue to get their way. It looks like the Republicans may take over Congress this year. Are they going to do anything to help us? A new Trump administration, Desantis? Of course not. They'll continue to line their own pockets as well as their buddies.

All I hear in this forum is bitch bitch bitch and blame blame blame. We're powerless as far as the government goes, and that's that. All you have *some* control over is your own practice. So continue to build on your cash pay services. It's all we've got.

I've never seen a more pathetic, defeatist, brainwashed sentiment than the comments expressed here by physicians. Everyone has been castrated and just handed their balls over to mommy? Is that what our grandfathers would have done? Doctors can do whatever they want to change the power dynamic: Opt out of Medicare, quit working for Big Hospital, tell Medicaid to go pound sand, etc.

Everyone should feel inspired to grow their balls and change their destiny instead of just punching the clock, accepting unfair rules, and eating whatever RVU crumbs are thrown at us. Raise your middle fingers and point them at the people eating off your plate!

 

[SSdoc33]

I've never seen a more pathetic, defeatist, brainwashed sentiment than the comments expressed here by physicians. Everyone has been castrated and just handed their balls over to mommy? Is that what our grandfathers would have done? Doctors can do whatever they want to change the power dynamic: Opt out of Medicare, quit working for Big Hospital, tell Medicaid to go pound sand, etc.

Everyone should feel inspired to grow their balls and change their destiny instead of just punching the clock, accepting unfair rules, and eating whatever RVU crumbs are thrown at us. Raise your middle fingers and point them at the people eating off your plate!

and end up offering BS regenerative procedures to desperate patients for exorbitant amounts of money just to stay afloat. or only accept cadillac insurance. is that really a better option?

you cant have it both ways

 

[drusso]

and end up offering BS regenerative procedures to desperate patients for exorbitant amounts of money just to stay afloat. or only accept cadillac insurance. is that really a better option?

you cant have it both ways

Longterm, for shoulder OA, yes. What's your point?

Cureus. 2022 Sep 17;14(9):e29253. doi: 10.7759/cureus.29253. eCollection 2022 Sep.

Comparison of the Efficacy of Platelet-Rich Plasma (PRP) and Local Corticosteroid Injection in Periarthritis Shoulder: A Prospective, Randomized, Open, Blinded End-Point (PROBE) Study

Govind K Gupta 1, Shubhendu Shekhar 1, Zeya Ul Haque 2, Subhajit Halder 1, Amit K Manjhi 3, Arpita Rai 2
Affiliations expand
PMID: 36262947 PMCID: PMC9574604 DOI: 10.7759/cureus.29253
Free PMC article

Abstract
Background: Periarthritis or frozen shoulder, also called adhesive capsulitis, is characterized by stiffness and pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy, short-wave therapy, ultrasonic therapy, transcutaneous electrical nerve stimulation, hydrotherapy, analgesics, intra-articular injections, manipulation under general anesthesia (MUA), and surgical management. The application of intra-articular steroid injection has been a common and efficacious option in rapidly diminishing shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP) injections in frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of intra-articular injections of PRP and triamcinolone in patients of shoulder periarthritis in a population from the eastern region of India

Methodology: A total of 60 patients with periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of triamcinolone (40 mg/mL) intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis.

Results: The mean VAS score in the PRP and triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both pain and disability scores in the PRP group after 24 weeks.

Conclusions: The triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing pain and disability scores in terms of VAS and DASH scores.

Keywords: intra-articular injection; periarthritis; platelet-rich plasma (prp); steroid; triamcinolone.

Copyright © 2022, Gupta et al.

 

[SSdoc33]

Longterm, for shoulder OA, yes. What's your point?

Cureus. 2022 Sep 17;14(9):e29253. doi: 10.7759/cureus.29253. eCollection 2022 Sep.

Comparison of the Efficacy of Platelet-Rich Plasma (PRP) and Local Corticosteroid Injection in Periarthritis Shoulder: A Prospective, Randomized, Open, Blinded End-Point (PROBE) Study

Govind K Gupta 1, Shubhendu Shekhar 1, Zeya Ul Haque 2, Subhajit Halder 1, Amit K Manjhi 3, Arpita Rai 2
Affiliations expand
PMID: 36262947 PMCID: PMC9574604 DOI: 10.7759/cureus.29253
Free PMC article

Abstract
Background: Periarthritis or frozen shoulder, also called adhesive capsulitis, is characterized by stiffness and pain along with gradual loss of active and passive movement in the glenohumeral joint. More than 2-5% of the population suffers from periarthritis with a higher incidence in the age group of 40-60 years. The various treatment modalities used for its management include simple physiotherapy, short-wave therapy, ultrasonic therapy, transcutaneous electrical nerve stimulation, hydrotherapy, analgesics, intra-articular injections, manipulation under general anesthesia (MUA), and surgical management. The application of intra-articular steroid injection has been a common and efficacious option in rapidly diminishing shoulder pain and disability. Some recent studies reported a better outcome using platelet-rich plasma (PRP) injections in frozen shoulder cases. Hence, this randomized controlled trial was conducted to compare the efficacy of intra-articular injections of PRP and triamcinolone in patients of shoulder periarthritis in a population from the eastern region of India

Methodology: A total of 60 patients with periarthritis shoulder were allocated into two groups after randomization. Group A received 2 mL autologous PRP, and Group B received 2 mL of triamcinolone (40 mg/mL) intra-articular injection. Patients were followed up on the 4th week, 12th week, and 24th week. The assessment of pain and function using the visual analog scale (VAS) score and the Disabilities of Arm, Shoulder, and Hand (DASH) score, respectively, was done at each follow-up. The primary analyses of both primary and secondary outcomes were conducted in the intention-to-treat (ITT) population. SPSS version 24 (IBM Corp., Armonk, NY, USA) was used for data analysis.

Results: The mean VAS score in the PRP and triamcinolone groups was 14.33 ± 3.79 and 31.63 ± 7.62, respectively (p = 0.0001) after 24 weeks. The mean DASH score in the PRP and triamcinolone groups was 18.08 ± 8.08 and 31.76 ± 3.63, respectively (p = 0.0001), which shows significant improvement in both pain and disability scores in the PRP group after 24 weeks.

Conclusions: The triamcinolone group showed better short-term outcomes whereas PRP showed better long-term outcomes in reducing pain and disability scores in terms of VAS and DASH scores.

Keywords: intra-articular injection; periarthritis; platelet-rich plasma (prp); steroid; triamcinolone.

Copyright © 2022, Gupta et al.

my point is that you are always 2+ standard deviations away from sanity.

i am all for physicans advocacy. id love to see us unionize or do something similar.

but while you are "giving the middle finger to the man", you are only hurting yourself. if you cant offer a medicare pt an RF, then what are you even doing in this field? running centrifuges all the time is not the answer.

there are lots of body parts we treat. its lovely you throw out a study here and there. but our bread and butter -- spine -- doesnt really reposnd all that well to regenerative treatments yet.

 

[drusso]

my point is that you are always 2+ standard deviations away from sanity.

i am all for physicans advocacy. id love to see us unionize or do something similar.

but while you are "giving the middle finger to the man", you are only hurting yourself. if you cant offer a medicare pt an RF, then what are you even doing in this field? running centrifuges all the time is not the answer.

there are lots of body parts we treat. its lovely you throw out a study here and there. but our bread and butter -- spine -- doesnt really reposnd all that well to regenerative treatments yet.

I do RFA all the time for elderly patients with facet arthropathy. What's your point? I also middle-finger special interests who try to treat me like a door mat. Why can't I do both?

 

[Doctodd]

my point is that you are always 2+ standard deviations away from sanity.

i am all for physicans advocacy. id love to see us unionize or do something similar.

but while you are "giving the middle finger to the man", you are only hurting yourself. if you cant offer a medicare pt an RF, then what are you even doing in this field? running centrifuges all the time is not the answer.

there are lots of body parts we treat. its lovely you throw out a study here and there. but our bread and butter -- spine -- doesnt really reposnd all that well to regenerative treatments yet.

he's pushing the envelope, innovating.....necessity is the mother of invention. He's involved politically, academically, and more.

 

[RoloTomassi]

I might be opting out of Medicare if this continues. If enough doctors do and enough old people have to unfortunately pay the price, I would hope that will prompt some change

 

[SSdoc33]

I might be opting out of Medicare if this continues. If enough doctors do and enough old people have to unfortunately pay the price, I would hope that will prompt some change

you wont

been hearing this chatter for 15 years

 

[RoloTomassi]

you wont

been hearing this chatter for 15 years

I have one foot out the door. Weaned down to 5-10%. If volume of better payers increases, will pull the trigger.

 

[clubdeac]

I think the big question here is when will ssdoc quit practicing clinical medicine and go work for the insurance companies. I think he’d be awesome doing peer to peer denials. I see a bright future here

 

[SSdoc33]

I think the big question here is when will ssdoc quit practicing clinical medicine and go work for the insurance companies. I think he’d be awesome doing peer to peer denials. I see a bright future here

ooooooh. good one.

i tear holes in peer-to-peers and probably double your productivity.

if you dont like my politics, thats one thing. but check that at the gate when it comes to medical matters.

 

[SSdoc33]

I've never seen a more pathetic, defeatist, brainwashed sentiment than the comments expressed here by physicians. Everyone has been castrated and just handed their balls over to mommy? Is that what our grandfathers would have done? Doctors can do whatever they want to change the power dynamic: Opt out of Medicare, quit working for Big Hospital, tell Medicaid to go pound sand, etc.

Everyone should feel inspired to grow their balls and change their destiny instead of just punching the clock, accepting unfair rules, and eating whatever RVU crumbs are thrown at us. Raise your middle fingers and point them at the people eating off your plate!

don't move the goalposts.

did you opt out of medicare? because you are talking like you have. im not sure ANYONE on this board has.

my point is that the ex-construction worker on medicare should be offered the RF. he doesnt have the money to pay out of pocket for it. we shouldnt work for free or pennies on the dollar. but if you only offer treatments for cash, you will really be a boutique practice, catering to the rich. YMMV

 

[Ferrismonk]

the entire system is broken, and it is working as it should.

our healthcare system is not for the patients.

it is not for the physicians, or nurses.

it is for big business - big pharma, big hospital, private insurance.

anyone who is blaming a poltiical party is oblivious to the fact that this is capitalism at its finest (if you are a supporter of profits trumping everything) or at its worst (if you believe that we should provide good healthcare to as many as possible).

I agree with most of your post, but I would argue it's not capitalism at all. The reason big pharma, big hospital, and big insurance are the bane of our existence is because the government keeps subsidizing them. It's the same thing with higher education. If everyone paid cash (or the tax-free equivalent, HSAs) capitalism would actually exist in healthcare. In our current system the price/demand ratio is completely manipulated by government agencies.

I've never seen a more pathetic, defeatist, brainwashed sentiment than the comments expressed here by physicians. Everyone has been castrated and just handed their balls over to mommy? Is that what our grandfathers would have done? Doctors can do whatever they want to change the power dynamic: Opt out of Medicare, quit working for Big Hospital, tell Medicaid to go pound sand, etc.

Everyone should feel inspired to grow their balls and change their destiny instead of just punching the clock, accepting unfair rules, and eating whatever RVU crumbs are thrown at us. Raise your middle fingers and point them at the people eating off your plate!

And I would, if I didn't have $500K in student loans and a family to support.

 

[Agast]

“Elections have consequences”?? Total non-sequitur.
We all agree this trend is turning medicine into a bureaucratic mess run by nurses and MBAs, but the liberal/conservative divide has little to nothing to do with it. That graph goes all the way back to 2000, roughly equal numbers of years under Democratic and Republican administrations, and as you can clearly see, physician compensation is a nearly flat line all the way across.

When I told my patient that sedation will no longer be covered by Medicare, she exclaimed “That Joe Biden!!”

He’s a wiley ’un

 

[epidural man]

I agree with most of your post, but I would argue it's not capitalism at all. The reason big pharma, big hospital, and big insurance are the bane of our existence is because the government keeps subsidizing them. It's the same thing with higher education. If everyone paid cash (or the tax-free equivalent, HSAs) capitalism would actually exist in healthcare. In our current system the price/demand ratio is completely manipulated by government agencies.


And I would, if I didn't have $500K in student loans and a family to support.

I suspect health care has never functioned as a free market system (maybe in the 1800’s) . I don’t think it ever could. Maybe it would work - but we will never know.

Universal health care is the answer. People can squawk all they want about how this is socialism and socialism never works, but I don’t k ow what you call this system we have, but it isn’t capatilism/free market, and it can’t get much worse so hard to really argue against universal system.

I have belonged to a large socialized system (military health care) and it worked wonderfully for me. I loved it.

 

[RoloTomassi]

I suspect health care has never functioned as a free market system (maybe in the 1800’s) . I don’t think it ever could. Maybe it would work - but we will never know.

Universal health care is the answer. People can squawk all they want about how this is socialism and socialism never works, but I don’t k ow what you call this system we have, but it isn’t capatilism/free market, and it can’t get much worse so hard to really argue against universal system.

I have belonged to a large socialized system (military health care) and it worked wonderfully for me. I loved it.

Just had a Canadian patient who said their system is terrible for spine. Months to get MRI, months to see pain doc, months before ESI, months before surgical consult. He really needed a discectomy and it took over a year.

Military I think just works differently being a smaller subpopulation of young healthy people. Once it expands beyond that, it's a mess--look at VA.

 

[epidural man]

Just had a Canadian patient who said their system is terrible for spine. Months to get MRI, months to see pain doc, months before ESI, months before surgical consult. He really needed a discectomy and it took over a year.

Military I think just works differently being a smaller subpopulation of young healthy people. Once it expands beyond that, it's a mess--look at VA.

Yeah. Now I get care at VA. I love it. No problems. But admittedly, I’m pretty healthy.

Probably LOTS of ways to do single-payer health care.

Finding a single example system that doesn’t sound like it works well (Canada) as an argument against the concept is probably not a great argument against said concept.

 

[Doctodd]

Medical school tuitions won’t correlate with universal health care payment reductions.

 

[RoloTomassi]

Now I get care at VA. I love it.

Finding a single example of the one patient that's happy with the VA and using that as an argument for single payer concept is probably not a great argument for said concept

 

[clubdeac]

Yeah. Now I get care at VA. I love it. No problems. But admittedly, I’m pretty healthy.

Probably LOTS of ways to do single-payer health care.

Finding a single example system that doesn’t sound like it works well (Canada) as an argument against the concept is probably not a great argument against said concept.

I worked at the VA for 6 years. It’s a dysfunctional, broken system that has upside down incentives. The other pain doc had a wait time of 3 months and saw 8 patients a day with a 2 hr lunch break. All the while we were trying to figure out how to accommodate the overwhelming number of patients that needed our services. I wish this was an isolated incident but it wasn’t

 

[drusso]

I worked at the VA for 6 years. It’s a dysfunctional, broken system that has upside down incentives. The other pain doc had a wait time of 3 months and saw 8 patients a day with a 2 hr lunch break. All the while we were trying to figure out how to accommodate the overwhelming number of patients that needed our services. I wish this was an isolated incident but it wasn’t

VA was the birthplace of 60 min ESIs in the HOPD.

 

[epidural man]

“Elections have consequences”?? Total non-sequitur.

Totally agree.

The fact that people tend to think that “their” political leaders are actually a friend to THEIR way of thinking is pretty funny.

I don’t care what label you put on your leader, they hate you and will do everything they can, say what they must, to stay in power. Just because they say something that you like means absolutely nothing.

 

[RoloTomassi]

Totally agree.

The fact that people tend to think that “their” political leaders are actually a friend to THEIR way of thinking is pretty funny.

I don’t care what label you put on your leader, they hate you and will do everything they can, say what they must, to stay in power. Just because they say something that you like means absolutely nothing.

Prime example

 

[powermd]

I've never seen a more pathetic, defeatist, brainwashed sentiment than the comments expressed here by physicians. Everyone has been castrated and just handed their balls over to mommy? Is that what our grandfathers would have done? Doctors can do whatever they want to change the power dynamic: Opt out of Medicare, quit working for Big Hospital, tell Medicaid to go pound sand, etc.

Everyone should feel inspired to grow their balls and change their destiny instead of just punching the clock, accepting unfair rules, and eating whatever RVU crumbs are thrown at us. Raise your middle fingers and point them at the people eating off your plate!

Open your eyes, the middle class lost- us included. Big business won.

Sure, doctors can opt out of Medicare, stop working for the man, etc. But they won't, because the frogs make just enough $$ to stay in the "pot" while the water continues to heat up. Ask Steve, he's got a sweet HOPD gig.

I'm fairly envious of the doctor who owns the suite above me. Former colorectal surgeon who owns a small cosmetics empire (60 employees!!) and does "age management" on a subscription basis for $4k/yr. No insurance BS. He's got the right idea.

 

[Dr. Ice]

Medicine is a good gig for someone is not the primary bread winner in a household, been saying it for a decade…unless of course you are hopd employed in which case now a days it’s good for an entire family and a extended family

My close friend went to UVA undergrad, slept my my couch when I was a resident, then he traveled Europe off money he made while working as a student. Then did some bs masters of statistics at university of Chicago for 2 years. Now works for a bank in nyc doing “risk management” for 550k/year. No patients, no Insurance companies, no anything. Excel spreadsheets can be done remotely anywhere.

 

[SSdoc33]

Drusso managed to get this referendum question on the ballot. Lot of hard work he put in to it. I know this is a cause near and dear to his heart:

Oregon could be 1st state to make health care a human right

Oregon voters are being asked to decide whether the state should be the first in the nation to amend its constitution to explicitly declare that affordable health care is a fundamental human right. State Sen. Elizabeth Steiner Hayward, a main sponsor of the legislation behind the ballot...

www.yahoo.com

 

[drusso]

Drusso managed to get this referendum question on the ballot. Lot of hard work he put in to it. I know this is a cause near and dear to his heart:

Oregon could be 1st state to make health care a human right

Oregon voters are being asked to decide whether the state should be the first in the nation to amend its constitution to explicitly declare that affordable health care is a fundamental human right. State Sen. Elizabeth Steiner Hayward, a main sponsor of the legislation behind the ballot...

www.yahoo.com

You don't know half of it. I've had a few conversations with (Dr.) Steiner Hayward staffers and others, but they just don't get it. Even two of the idea's biggest proponents (physicians and one a physician and former Governor) backed it off.

https://www.bizjournals.com/portland/news/2022/10/18/kitzhaber-balllot-measure-no.html

"Making access to medical care a fundamental right, without effectively addressing equity and opportunity in accessing the social determinants of health, will undermine, rather than enhance the health of our society."

Oregon’s constitutional amendment for affordable health care sparks debate

The Lund Report

www.kpvi.com

“It’s likely that the Supreme Court would consider that,” Metz said. “I don’t know what they’d decide. The language is clear that a single payer proposal would be in great danger if this were in the Constitution.” Like medicine administered to a patient, the benefits need to outweigh the risks, Metz said, adding that he doesn’t see any benefits with the amendment."

It's like deciding to cap health care costs at 3% when inflation and labor cost is more than twice that. It's crazy. That puts me out of business. Tell me again that there is no "vast left-wing conspiratory?"

Supporting States In Setting Health Care Cost Growth Targets To Improve Affordability | Health Affairs Forefront

Some states have committed to setting and tracking an annual health care cost growth target, sometimes called a "benchmark." The Peterson-Milbank Program for Sustainable Health Care Costs supports such statewide cost growth target initiatives in five states..Experts help those states to develop...

www.healthaffairs.org

"Oregon and Connecticut have already set their health care cost growth targets and are expanding their capacity to collect and analyze health care spending data. Oregon set a target of 3.4 percent for five years in 2020, while Connecticut recently set a target of 3.4 percent for calendar year 2021, 3.2 percent for 2022, and 2.9 percent for 2023 to 2025."

But ideology is a powerfully addictive drug. And hardcore D's and others on the Left (many of whom post here on this forum) will not stop until they can get everyone to stand in line and get prostate exams at the post-office.

Pain physicians should read the handwriting on the wall and remember the words of Pastor MARTIN NIEMÖLLER and his observations of how insidiously ideology seems into human affairs and, eventually, our fundamental rights.

First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me

 

[voxveritatisetlucis]

Then did some bs masters of statistics at university of Chicago for 2 years. Now works for a bank in nyc doing “risk management” for 550k/year.

These jobs aren’t easy to get. There is a ton of risk involved and most finance/stats/whatever majors will never come close to making 550 per year. Also I guarantee that people overstate what they make by at least a factor of 1.5-2x

Statistically, most finance/stats/math majors will never even crack 150k

 

[Status Sciaticus]

View attachment 361289

Most "conservative" health policy ideas have never seen the light of day. What has been implemented has mostly come from liberal/welfare state advocates.

Just imagine how different things would look for physicians if more "conservative" policies were tried over the last two decades.

https://www.cato.org/making-health-savings-accounts-work-everyone

You don't know half of it. I've had a few conversations with (Dr.) Steiner Hayward staffers and others, but they just don't get it. Even two of the idea's biggest proponents (physicians and one a physician and former Governor) backed it off.

https://www.bizjournals.com/portland/news/2022/10/18/kitzhaber-balllot-measure-no.html

"Making access to medical care a fundamental right, without effectively addressing equity and opportunity in accessing the social determinants of health, will undermine, rather than enhance the health of our society."

Oregon’s constitutional amendment for affordable health care sparks debate

The Lund Report

www.kpvi.com

“It’s likely that the Supreme Court would consider that,” Metz said. “I don’t know what they’d decide. The language is clear that a single payer proposal would be in great danger if this were in the Constitution.” Like medicine administered to a patient, the benefits need to outweigh the risks, Metz said, adding that he doesn’t see any benefits with the amendment."

It's like deciding to cap health care costs at 3% when inflation and labor cost is more than twice that. It's crazy. That puts me out of business. Tell me again that there is no "vast left-wing conspiratory?"

Supporting States In Setting Health Care Cost Growth Targets To Improve Affordability | Health Affairs Forefront

Some states have committed to setting and tracking an annual health care cost growth target, sometimes called a "benchmark." The Peterson-Milbank Program for Sustainable Health Care Costs supports such statewide cost growth target initiatives in five states..Experts help those states to develop...

www.healthaffairs.org

"Oregon and Connecticut have already set their health care cost growth targets and are expanding their capacity to collect and analyze health care spending data. Oregon set a target of 3.4 percent for five years in 2020, while Connecticut recently set a target of 3.4 percent for calendar year 2021, 3.2 percent for 2022, and 2.9 percent for 2023 to 2025."

But ideology is a powerfully addictive drug. And hardcore D's and others on the Left (many of whom post here on this forum) will not stop until they can get everyone to stand in line and get prostate exams at the post-office.

Pain physicians should read the handwriting on the wall and remember the words of Pastor MARTIN NIEMÖLLER and his observations of how insidiously ideology seems into human affairs and, eventually, our fundamental rights.

First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me

 

[Baron Samedi]

You don't know half of it. I've had a few conversations with (Dr.) Steiner Hayward staffers and others, but they just don't get it. Even two of the idea's biggest proponents (physicians and one a physician and former Governor) backed it off.

https://www.bizjournals.com/portland/news/2022/10/18/kitzhaber-balllot-measure-no.html

"Making access to medical care a fundamental right, without effectively addressing equity and opportunity in accessing the social determinants of health, will undermine, rather than enhance the health of our society."

Oregon’s constitutional amendment for affordable health care sparks debate

The Lund Report

www.kpvi.com

“It’s likely that the Supreme Court would consider that,” Metz said. “I don’t know what they’d decide. The language is clear that a single payer proposal would be in great danger if this were in the Constitution.” Like medicine administered to a patient, the benefits need to outweigh the risks, Metz said, adding that he doesn’t see any benefits with the amendment."

It's like deciding to cap health care costs at 3% when inflation and labor cost is more than twice that. It's crazy. That puts me out of business. Tell me again that there is no "vast left-wing conspiratory?"

Supporting States In Setting Health Care Cost Growth Targets To Improve Affordability | Health Affairs Forefront

Some states have committed to setting and tracking an annual health care cost growth target, sometimes called a "benchmark." The Peterson-Milbank Program for Sustainable Health Care Costs supports such statewide cost growth target initiatives in five states..Experts help those states to develop...

www.healthaffairs.org

"Oregon and Connecticut have already set their health care cost growth targets and are expanding their capacity to collect and analyze health care spending data. Oregon set a target of 3.4 percent for five years in 2020, while Connecticut recently set a target of 3.4 percent for calendar year 2021, 3.2 percent for 2022, and 2.9 percent for 2023 to 2025."

But ideology is a powerfully addictive drug. And hardcore D's and others on the Left (many of whom post here on this forum) will not stop until they can get everyone to stand in line and get prostate exams at the post-office.

Pain physicians should read the handwriting on the wall and remember the words of Pastor MARTIN NIEMÖLLER and his observations of how insidiously ideology seems into human affairs and, eventually, our fundamental rights.

First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me

Are you seriously comparing Medicare reimbursement to the Holocaust? 😬

 

[Ducttape]

he's pushing the envelope, innovating.....necessity is the mother of invention. He's involved politically, academically, and more.

or he is the anachronistic dinosaur that runs around telling everyone "i remember the day when".....

Medicine is a good gig for someone is not the primary bread winner in a household, been saying it for a decade…unless of course you are hopd employed in which case now a days it’s good for an entire family and a extended family

My close friend went to UVA undergrad, slept my my couch when I was a resident, then he traveled Europe off money he made while working as a student. Then did some bs masters of statistics at university of Chicago for 2 years. Now works for a bank in nyc doing “risk management” for 550k/year. No patients, no Insurance companies, no anything. Excel spreadsheets can be done remotely anywhere.

as someone who has had a relative that worked on wall street for a bank for decades - it may sound good, but unlike our profession, someone sleeping wrong, or waking up with a headache, and at the snap of a finger, everything is all gone.

 

[SSdoc33]

You don't know half of it. I've had a few conversations with (Dr.) Steiner Hayward staffers and others, but they just don't get it. Even two of the idea's biggest proponents (physicians and one a physician and former Governor) backed it off.

https://www.bizjournals.com/portland/news/2022/10/18/kitzhaber-balllot-measure-no.html

"Making access to medical care a fundamental right, without effectively addressing equity and opportunity in accessing the social determinants of health, will undermine, rather than enhance the health of our society."

Oregon’s constitutional amendment for affordable health care sparks debate

The Lund Report

www.kpvi.com

“It’s likely that the Supreme Court would consider that,” Metz said. “I don’t know what they’d decide. The language is clear that a single payer proposal would be in great danger if this were in the Constitution.” Like medicine administered to a patient, the benefits need to outweigh the risks, Metz said, adding that he doesn’t see any benefits with the amendment."

It's like deciding to cap health care costs at 3% when inflation and labor cost is more than twice that. It's crazy. That puts me out of business. Tell me again that there is no "vast left-wing conspiratory?"

Supporting States In Setting Health Care Cost Growth Targets To Improve Affordability | Health Affairs Forefront

Some states have committed to setting and tracking an annual health care cost growth target, sometimes called a "benchmark." The Peterson-Milbank Program for Sustainable Health Care Costs supports such statewide cost growth target initiatives in five states..Experts help those states to develop...

www.healthaffairs.org

"Oregon and Connecticut have already set their health care cost growth targets and are expanding their capacity to collect and analyze health care spending data. Oregon set a target of 3.4 percent for five years in 2020, while Connecticut recently set a target of 3.4 percent for calendar year 2021, 3.2 percent for 2022, and 2.9 percent for 2023 to 2025."

But ideology is a powerfully addictive drug. And hardcore D's and others on the Left (many of whom post here on this forum) will not stop until they can get everyone to stand in line and get prostate exams at the post-office.

Pain physicians should read the handwriting on the wall and remember the words of Pastor MARTIN NIEMÖLLER and his observations of how insidiously ideology seems into human affairs and, eventually, our fundamental rights.

First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left
To speak out for me

Godwin


anyway, the ballot measure reeks of an unfunded mandate. this is more of a wish-list then actual policy. there are no specifics, and this is bound to be challenged endlessly in court because of the ambiguity of the language

 

[drusso]

Are you seriously comparing Medicare reimbursement to the Holocaust? 😬

No. Just illustrating the seduction of ideology and motivated reasoning. No one thinks they will be impacted by bad ideology until they are.