Why are most doctors against healthcare reform?

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uclaussr said:
I understand that quality will probably decline, and quantity will be focused what are the other reasons?
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0591ae417ed7db2ba06b003ac5055947_a061aca431601cbdcb95d975b467aa85.jpg


edit: post 300! I'm class incarnate
edit edit: money, government fails at pretty much everything it gets its grubby hands on, forcing everyone to buy insurance doesn't fall within the bounds of the constitution (unless you twist it until it's unrecognizable), eventual rationing of care
 
Two reason
1) increased pt load
2)decreased reimbursments
 
oar2386 said:
Two reason
1) increased pt load
2)decreased reimbursments
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This!!!

Oh and not to mention reason number 3

3)Increased beauracracy (spelling??). Increased govt. involvement = Increased DISORGANIZATION!!!!!!!!!! nuf said.
 
If this isn't a loaded question, I don't know what is.

I doubt most are against reform in general. It's clear what we have isn't working. It's just that currently, the most popular proposals may not be the best long-term solutions.
 
Because lawyers organizing healthcare reform = ******ed
 
tort reform would be nice. less reimbursement would not be nice.
 
I'm not sure any doctor is against "health care reform." Many are against increasing the role of government in healthcare (through Obamacare) because they believe a more free market system would

a. lower costs for patients
b. be more efficient (less regulations and bureaucracy)

Many also don't believe things like a mandate are constitutional, and they are skeptical of organized trial lawyers regulating their interests
 
patel2 said:
I'm not sure any doctor is against "health care reform." Many are against increasing the role of government in healthcare (through Obamacare) because they believe a more free market system would

a. lower costs for patients
b. be more efficient (less regulations and bureaucracy)

Many also don't believe things like a mandate are constitutional, and they are skeptical of organized trial lawyers regulating their interests
Click to expand...

Oh God. The Libertarians are going to start coming out of the woodworks.

i-like-this-thread.jpg
 
patel2 said:
I'm not sure any doctor is against "health care reform." Many are against increasing the role of government in healthcare (through Obamacare) because they believe a more free market system would

a. lower costs for patients
b. be more efficient (less regulations and bureaucracy)

Many also don't believe things like a mandate are constitutional, and they are skeptical of organized trial lawyers regulating their interests
Click to expand...
👍👍

Private insurance companies, useless bureaucracy, medicare, etc. all represent inefficiencies in medicine, both in terms of the time strain on physicians and simple drains of money from the system.

No one is against health care reform, but being told you'll be shot if you don't buy private insurance (corporatist government intervention) is not going to help anyone.
 
uclaussr said:
I understand that quality will probably decline, and quantity will be focused what are the other reasons?
Click to expand...

In a word, uncertainty. People prefer the status quo. A lot of docs feel they got hosed by managed care and capitation schemes back in the 90's, and the current reform law is just the same song in a different decade.

Besides, it's a lot more fun to complain than it is to study the issue in depth or even take some initiative regarding the reform effort itself.

You may be interested in the events surrounding the implementation of Canada's system in the 1960's. It was rather tumultuous.
 
1. Its hard to say "most doctors" are anything. Theres a huge range of opinions out there within the physician community.

2. Agreed with the above post about uncertainty. Docs have poured several years of their lives into their careers, and often have made massive investments in their practices in terms of equipment. If health reform ends up increasing the role of Government in healthcare, and bureaucrats later decide that your specialty or procedure X that you do should no longer be paid for, you may have just lost a massive investment (e.g. equipment for new surgical procedure).

3. Many doctors are against the idea that the way they practice medicine should be dictated by poorly trained bureaucrats or insurance company execs. This already happens to a great extent, but many are fearful that this would get even worse in a system with more government involvement.

4. No matter how bad the problems with the US system are, you can always make it worse. I'm not saying current reform efforts will do that, I'm just saying the "things are bad so we have to do something" argument isn't good enough.

Finally, my random personal thought is that while expanding coverage is good, there is no current way to pay for all the new people being added to medicaid roles. This will just force another healthcare crisis in the near future when states go bankrupt (federal gov't is as well, but its much easier for fed to borrow money then states)
 
Because a bunch of people without any medical training argued over a bill that they never read and managed to get it passed.

Every few years people forget how badly the government screws up anything it gets its hands on. Then initiatives like this start. Why, when the government can't manage a simple program like social security (take money from people now and give it back later) would anyone choose to give them more power in regards to their money and health?
 
Parts Unknown said:
In a word, uncertainty. People prefer the status quo. A lot of docs feel they got hosed by managed care and capitation schemes back in the 90's, and the current reform law is just the same song in a different decade.

Besides, it's a lot more fun to complain than it is to study the issue in depth or even take some initiative regarding the reform effort itself.

You may be interested in the events surrounding the implementation of Canada's system in the 1960's. It was rather tumultuous.
Click to expand...

For some reason in the 1960's the majority of Canadians felt it was socially acceptable to kill off a few individuals for the good of the whole.

Don't worry these same influences have been hard at work fixing these values into the american education system (Lord knows mine was, these people are voracious and I went to a "conservative" school), it's only a matter of time.

I do compliment whoever sued to legalize private practice again in Canada. Ultimately over time I think your system will be the best in the world. However you all are pretty repressive on the pharmaceutical companies so probably in things not regarding...medicine.
 
alwaysaangel said:
Because lawyers organizing healthcare reform = ******ed
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This ^

Specialists are also going to have their reimbursements decline so that it could be "on par" with primary care.

I can't wait till orthopedic surgeons, radiologists, anesthesiologists, plastic surgeons, etc. start making 200k a year. Yay for Obamacare!!! 🙄 /sarcasm
 
DoctwoB said:
1. Its hard to say "most doctors" are anything. Theres a huge range of opinions out there within the physician community.

2. Agreed with the above post about uncertainty. Docs have poured several years of their lives into their careers, and often have made massive investments in their practices in terms of equipment. If health reform ends up increasing the role of Government in healthcare, and bureaucrats later decide that your specialty or procedure X that you do should no longer be paid for, you may have just lost a massive investment (e.g. equipment for new surgical procedure).

3. Many doctors are against the idea that the way they practice medicine should be dictated by poorly trained bureaucrats or insurance company execs. This already happens to a great extent, but many are fearful that this would get even worse in a system with more government involvement.

4. No matter how bad the problems with the US system are, you can always make it worse. I'm not saying current reform efforts will do that, I'm just saying the "things are bad so we have to do something" argument isn't good enough.

Finally, my random personal thought is that while expanding coverage is good, there is no current way to pay for all the new people being added to medicaid roles. This will just force another healthcare crisis in the near future when states go bankrupt (federal gov't is as well, but its much easier for fed to borrow money then states)
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👍 Well said. Especially number 4.

I will also add that cost control is something that the politicians rarely bring up. Tort reform will actually do very little to control costs. One of the biggest things we need to do in this country is decrease futile care. Some call it "death panels" but the reality is we have this attitude in the US that we must preserve life at all cost. We need to start working against this attitude and encouraging earlier palliative care. This will decrease costs and improve the quality of end-of-life care (even if it cuts off the last 6 months of intubated ICU care - but there is no quality of life there anyway).
 
I strongly support reform. I just haven't heard any of the reforms actually make it to the voting floor that I would actually like to see implemented.
 
thesauce said:
Because a bunch of people without any medical training argued over a bill that they never read and managed to get it passed.

Every few years people forget how badly the government screws up anything it gets its hands on. Then initiatives like this start. Why, when the government can't manage a simple program like social security (take money from people now and give it back later) would anyone choose to give them more power in regards to their money and health?
Click to expand...

Thank you!
 
This is from Sep. 2009, before the Senate Finance Committee rejected the public option. But, from http://healthpolicyandreform.nejm.org/?p=1790:

Overall, a majority of physicians (62.9%) supported public and private options (see Panel A of graph). Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option (see Table 1). Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so.
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It's also tough because if we went with a totally public system we would almost certainly see worse outcomes with certain care and better outcomes with other care. The worse outcomes would come with the elderly, neonates and other very "vulnerable populations" and the general public should benefit as a whole, its just how you have to split up the pie and its unavoidable.

You then have out of control physician debt and declining reimbursements. This leads to so many systemic problems I don't even know where to start. If you have hundreds of thousands in debt how are you supposed to start a rural practice, why do you think physicians are all choosing a salary with a large practice...its painfully obvious to some (and not to others).

Then you have the varieties of selfish people who advocate for things in an imaginary world in which they have not yet lived. I think we need a 6 month poll on how new attending view our healthcare system when deferral is over.

The battle of healthcare reform is among people who are so famously rich it wouldn't effect them in a million years. That is the single most frustrating thing about this, as long as it doesn't affect them who cares what you say, a little god complex playing with other peoples lives, huh.

It all drives me up the wall and I honestly just hope I can pay off my loans and provide for my family in a way which indicates the 10+ years I "sacrificed" to save other peoples lives.
 
Monocles said:
Completely off topic, but what movie/show is that from? I must know!
Click to expand...

HBO's Rome. I think it only ran 2 seasons because they ran out of money and wanted to focus on Adams, but it was great while it lasted. Apparently they're making it into a movie though (let's hope it doesn't suck).

[YOUTUBE]http://www.youtube.com/watch?v=jPO2y19tKCE[/YOUTUBE]

[YOUTUBE]http://www.youtube.com/watch?v=GXL_VUaBtGI&feature=related[/YOUTUBE]
 
justaregularmed said:
It's also tough because if we went with a totally public system we would almost certainly see worse outcomes with certain care and better outcomes with other care. The worse outcomes would come with the elderly, neonates and other very "vulnerable populations" and the general public should benefit as a whole, its just how you have to split up the pie and its unavoidable.

You then have out of control physician debt and declining reimbursements. This leads to so many systemic problems I don't even know where to start. If you have hundreds of thousands in debt how are you supposed to start a rural practice, why do you think physicians are all choosing a salary with a large practice...its painfully obvious to some (and not to others).

Then you have the varieties of selfish people who advocate for things in an imaginary world in which they have not yet lived. I think we need a 6 month poll on how new attending view our healthcare system when deferral is over.

The battle of healthcare reform is among people who are so famously rich it wouldn't effect them in a million years. That is the single most frustrating thing about this, as long as it doesn't affect them who cares what you say, a little god complex playing with other peoples lives, huh.

It all drives me up the wall and I honestly just hope I can pay off my loans and provide for my family in a way which indicates the 10+ years I "sacrificed" to save other peoples lives.
Click to expand...

Well said!!!! :clap::clap:
 
Change is scary. Most people prefer the evil they know to the evil they don't.
 
thesauce said:
Because a bunch of people without any medical training argued over a bill that they never read and managed to get it passed.

Every few years people forget how badly the government screws up anything it gets its hands on. Then initiatives like this start. Why, when the government can't manage a simple program like social security (take money from people now and give it back later) would anyone choose to give them more power in regards to their money and health?
Click to expand...

This bolded above. nuf said.

And to be fair this is in most countries.

People think that socialistic idea of single payer systems will make things so much better but there's negatives too like longer wait times to see a doctor and other things of that nature that are faced by people in countries where a single payer system is in existence.

Want reform???

Disclaimer: Caps for emphasis.

Why don't we

1. REDUCE COST of medical education

2. INCREASE tort reform

3. REDUCE malpractice costs

4. REDUCE POWER yielded by insurance companies and pharma companies in dictating costs of care and medications respectively

There's more I'm sure, but this is only some of it.
 
Everyone go read this and then we'll discuss:
http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346


To answer the OP's question (albeit a very generalized assumption):
  1. They see that the average salary of physicians in other nations is below their own, and want to continue the status quo (although they do not realize that med school is essentially free for these doctors and they have little to no malpractice insurance)
  2. They buy into the laughable "HEALTHCARE REFORM IS SOCIALISM!!!!!!!!11" scare tactics of the right
America has the least efficient healthcare system of any industrialized democracy in the world. We spend the most, yet have millions of people suffer because they are uninsured. America is also the only industrialized democracy in the world that does not have a healthcare system with universal coverage.

As long as we have private insurance companies whose sole purpose is to increase profit margins (often times by flat out denying necessary coverage), healthcare is going to be a major fail in this country. The quality of care in this country is great, if you can afford it. No one is going to be turned down from an emergency room if they are wheeled in bleeding out. However, there is a significant number of Americans who do not qualify for Medicaid but cannot afford health insurance, and thus do not have access to care.

France, Switzerland, and Japan (just to name a few) have it figured out. There is not a significant wait time for care, yet they have universal access to high quality care.

I am fully convinced America has the best medical training and most skilled physicians of any country in the world. I am also fully convinced that America has the worst healthcare system of any industrialized democracy in the world. I, along with the majority of the industrialized world outside of America, feel healthcare should be a right, not a privilege (and I am a conservative). I do not think we will see any improvements to our system until the plurality of those in power feel the same way.

I implore everyone to read T.R. Reid's book I linked above. It's the most comprehensive comparative healthcare study I've found (and also an entertaining work).
 
dawgbone said:
Everyone go read this and then we'll discuss:
http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346


To answer the OP's question (albeit a very generalized assumption):
  1. They see that the average salary of physicians in other nations is below their own, and want to continue the status quo (although they do not realize that med school is essentially free for these doctors and they have little to no malpractice insurance)
  2. They buy into the laughable "HEALTHCARE REFORM IS SOCIALISM!!!!!!!!11" scare tactics of the right
America has the least efficient healthcare system of any industrialized democracy in the world. We spend the most, yet have millions of people suffer because they are uninsured. America is also the only industrialized democracy in the world that does not have a healthcare system with universal coverage.

As long as we have private insurance companies whose sole purpose is to increase profit margins (often times by flat out denying necessary coverage), healthcare is going to be a major fail in this country. The quality of care in this country is great, if you can afford it. No one is going to be turned down from an emergency room if they are wheeled in bleeding out. However, there is a significant number of Americans who do not qualify for Medicaid but cannot afford health insurance, and thus do not have access to care.

France, Switzerland, and Japan (just to name a few) have it figured out. There is not a significant wait time for care, yet they have universal access to high quality care.

I am fully convinced America has the best medical training and most skilled physicians of any country in the world. I am also fully convinced that America has the worst healthcare system of any industrialized democracy in the world. I, along with the majority of the industrialized world outside of America, feel healthcare should be a right, not a privilege (and I am a conservative). I do not think we will see any improvements to our system until the plurality of those in power feel the same way.

I implore everyone to read T.R. Reid's book I linked above. It's the most comprehensive comparative healthcare study I've found (and also an entertaining work).
Click to expand...

I honestly don't know of any intelligent person that believes enacting socialized medicine - yes, it is a socialized program - will turn us into the USSR.
 
gujuDoc said:
People think that socialistic idea of single payer systems will make things so much better but there's negatives too like longer wait times to see a doctor and other things of that nature that are faced by people in countries where a single payer system is in existence.
Click to expand...

This is primarily only true in Britain and Canada, who are notorious for their long wait times. Canada's long wait times are primarily due to a shortage of doctors, and the long wait times in Britain are due to the British National Health Service (NHS) having too much influence on elective procedures.

A single payer system is not necessary for reform and/or universal coverage (see: Japan and France).
 
NickNaylor said:
I honestly don't know of any intelligent person that believes enacting socialized medicine - yes, it is a socialized program - will turn us into the USSR.
Click to expand...

Then you don't watch Fox News. Or listen to Hannity or Limbaugh.

Wait, you said intelligent person. My bad.

And I didn't claim that they believe reform would turn us into the USSR. They (a large number of those against reform) are just afraid to change the status quo because of an irrational fear of socialism.

We already have socialized medicine for those that are over 65, those that are poor, and those that are in the military -- most people just don't realize this.
 
Last edited:
thesauce said:
Every few years people forget how badly the government screws up anything it gets its hands on. Then initiatives like this start. Why, when the government can't manage a simple program like social security (take money from people now and give it back later) would anyone choose to give them more power in regards to their money and health?
Click to expand...

The government does a decent job in managing Medicare/Medicaid/military medicine.
 
dawgbone said:
Everyone go read this and then we'll discuss:
http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346


To answer the OP's question (albeit a very generalized assumption):
  1. They see that the average salary of physicians in other nations is below their own, and want to continue the status quo (although they do not realize that med school is essentially free for these doctors and they have little to no malpractice insurance)
  2. They buy into the laughable "HEALTHCARE REFORM IS SOCIALISM!!!!!!!!11" scare tactics of the right
America has the least efficient healthcare system of any industrialized democracy in the world. We spend the most, yet have millions of people suffer because they are uninsured. America is also the only industrialized democracy in the world that does not have a healthcare system with universal coverage.

As long as we have private insurance companies whose sole purpose is to increase profit margins (often times by flat out denying necessary coverage), healthcare is going to be a major fail in this country. The quality of care in this country is great, if you can afford it. No one is going to be turned down from an emergency room if they are wheeled in bleeding out. However, there is a significant number of Americans who do not qualify for Medicaid but cannot afford health insurance, and thus do not have access to care.

France, Switzerland, and Japan (just to name a few) have it figured out. There is not a significant wait time for care, yet they have universal access to high quality care.

I am fully convinced America has the best medical training and most skilled physicians of any country in the world. I am also fully convinced that America has the worst healthcare system of any industrialized democracy in the world. I, along with the majority of the industrialized world outside of America, feel healthcare should be a right, not a privilege (and I am a conservative). I do not think we will see any improvements to our system until the plurality of those in power feel the same way.

I implore everyone to read T.R. Reid's book I linked above. It's the most comprehensive comparative healthcare study I've found (and also an entertaining work).
Click to expand...

Sounds great on paper to ban insurance companies from denying coverage based on preexisting conditions. But as long as insurance companies are unable to do this, no one is going to buy private healthcare until they get sick, creating an even more top heavy system. What on earth would be a young person's incentive to buy healthcare if they can just wait until they have a major illness (if their employer doesn't already provide it?). Any financially responsible, healthy person would surely realize this.

Slap on whatever mandate you want to remedy this, but good luck enforcing it. Even if the mandate isn't declared unconstitutional by the Supreme Court, the fines for not purchasing healthcare range from $80 to a max 950 dollars. At it's peak, it's still far less than the minimum 5000+ cost of a comprehensive plan. If insurance companies accept everyone without any bias, and individuals then refuse to purchase insurance and take the penalty instead, suddenly the costs for everyone on an insurance plan are going to go drastically go up.
 
dawgbone said:
We already have socialized medicine for those that are over 65, those that are poor, and those that are in the military -- most people just don't realize this.
Click to expand...
Yes, and the VA is the "best care anywhere." If thats true and we are going to model all hospitals after the VA just shoot me now. I have never seen more terrifying care, but they meet all their "measures" so its the "best."
 
dawgbone said:
The government does a decent job in managing Medicare/Medicaid/military medicine.
Click to expand...

Tell me you're kidding. VA hospitals are outmoded, inefficient nightmares. and that is just the tip of the iceberg of incompetence.
 
BionicMan said:
Tell me you're kidding. VA hospitals are outmoded, inefficient nightmares. and that is just the tip of the iceberg of incompetence.
Click to expand...
This. My rotations at the VA has yielded nothing but hatred for the inefficiency there. Good luck getting anything done on a weekend there.
 
BionicMan said:
Tell me you're kidding. VA hospitals are outmoded, inefficient nightmares. and that is just the tip of the iceberg of incompetence.
Click to expand...

VAs have the largest integrated EMR system in the nation. They pioneered mail prescriptions. They beat the private sector in fairly basic measures of quality. And patient satisfaction. And they have adapted to the increased burden derived from Iraq and Afghanistan without soaring per capita costs. All this while serving a patient base with higher rates of chronic disease and substance abuse than the general population.

Obviously the VA system has problems, but to outright bash them is to embrace a somewhat obsolete stereotype while turning a blind eye to the inefficiencies of the piecemeal private system.
 
I agree with most of the above. Hardly anyone that I've spoken to thinks that the current situation is ideal. However, it was quite obvious that Obamacare was nothing more than a political farce. The proposition of accommodating more dead weight into an already overburdened system without a coherent fiscal plan is inherently unsustainable. To make matters worse, the fact that nobody outside of the committee actually read the bill prior to voting was embarrassing, and further served to demonstrate that the proposal was nothing more than a poorly disguised political agenda.
 
patel2 said:
Location: Okinawa, Japan



4mceko5.gif
Click to expand...

And what are you implying with my location? Being stationed overseas is just hilarious...

As for the hate with my quote that the govt does a decent job with medicare/medicaid/military medicine, then well I guess we have different opinions of what "decent" means.

To me, decent is providing access to care those that need it. That is more than can be said for millions of Americans in our current system. And when I spoke of military medicine, I was not referring exclusively to VA hospitals. I was primarily speaking to the healthcare that active members of the military receive, in which everyone gets the quality care they need (for the most part) without ever having to worry about a bill. Is it perfect? No, but it's a hell of a lot better than leaving someone out in the cold.

I think a lot of you are confusing a system in which the government is the payer and a system that is government run. I'm all for private hospitals/private physicians, but the for-profit insurance system needs to gtfo.

Some of you may be thinking "BUT WHERE WE GONNA GET THE MONEY LOL". The answer is it is already there. We spend 16% of our GDP on healthcare, and an embarrassingly high 7% of that is spent on administrative costs. Get rid of the thousands of middle men in the insurance field, transition to electronic records, and reign in ridiculous malpractice insurance to eliminate wasted and inefficient spending.

The bottom line is that we have an incredibly inefficient system, and we need to develop a true will to fix it. We can look to other countries who already have it figured out as a model upon which to build.
 
Parts Unknown said:
VAs have the largest integrated EMR system in the nation. They pioneered mail prescriptions. They beat the private sector in fairly basic measures of quality. And patient satisfaction. And they have adapted to the increased burden derived from Iraq and Afghanistan without soaring per capita costs. All this while serving a patient base with higher rates of chronic disease and substance abuse than the general population.

Obviously the VA system has problems, but to outright bash them is to embrace a somewhat obsolete stereotype while turning a blind eye to the inefficiencies of the piecemeal private system.
Click to expand...

I can be a source to attest to this. Several of my Marines have received outstanding care upon returning from deployment, and walked away without ever having to pay a cent.

My wife recently gave birth at a Naval hospital, and we were incredibly pleased with the quality of service and skill of the healthcare providers. I refuse to believe this experience cannot be extended to the American population at large. It's already been done overseas, folks.
 
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