AMA "1 in 7" campaign

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You know, this is not a partisan issue, despite the attempt to drop the "H-bomb" into the discussion.

This may be Clinton's plan, but it is what Romney has already done as governor of MA.

You know he's a big tax & spend liberal!

You're right, this is not a partisan issue (not that I was trying to start a political discussion). And it is just Romney's work in MA that makes me worry about mandated health care. I do find comfort in the fact that most (if not all) plans out there don't take away the insurance we already have, but I don't think mandates are the right way to go for this country. Some people are still not going to get insurance whether it is mandated or not, and they are still going to end up in the ER. So EMTALA needs to be a funded mandate.
 
Oh, I feel bad for posting so much on this thread without addressing the original point. As a AMA member (I think my school signed me up), I sure wasn't consulted before they came out with this stuff and that is inappropriate. AMA needs to be speaking out on issues like the underpaying of medicaid and medical school loan accumulation and repayment.
 
Okay... I'll bite. I've been on my surgery rotation and haven't had much time to post, but I like this discussion and it seemed worth a little time.

Regarding the "keeping people healthier" argument: I have always believed and continue to believe that people don't value what you give them for "free." If they don't have to work for it, it will become just another service that people misuse.

It's really not that hard to stay healthy. I am certainly not the fittest person out there, but as long as I eat reasonably decent food and exercise occasionally (very occasionally this rotation...) I maintain my weight and stay pretty healthy. The reason people don't do that is because it is easier to be sedentary, eat whatever you want, and watch the great idiot box. Universal healthcare is not going to change that lazy mentality.

If we start giving out healthcare to everyone (especially if we allow the government to run it...) all we do is hamstring any motivation to be healthy because "who cares if I get sick... I mean... it's not fun, but at least I've got "free" healthcare."
 
You know, this is not a partisan issue, despite the attempt to drop the "H-bomb" into the discussion.

This may be Clinton's plan, but it is what Romney has already done as governor of MA.

You know he's a big tax & spend liberal!

The problem with this basing anything off what happens in MA, is that MA is not a fair comparison to most of the country. Not that you were saying this, but I've heard it said that, "hey... some state's already have programs in place."

That's all well and good for states that have a grand total of 3 illegal immigrants. Don't get me wrong, I have no problem seeing these patients doing what I can for them, but here in the southwest you can end up a little jaded when 2/3 of the people you see on your OB rotation at county are here illegally. I personally think that it is not our (as a nation or society) responsibility to insure these people.
 
You're right, this is not a partisan issue (not that I was trying to start a political discussion). And it is just Romney's work in MA that makes me worry about mandated health care. I do find comfort in the fact that most (if not all) plans out there don't take away the insurance we already have, but I don't think mandates are the right way to go for this country. Some people are still not going to get insurance whether it is mandated or not, and they are still going to end up in the ER. So EMTALA needs to be a funded mandate.

They mandated everyone in my home state (maybe it was a whole country thing) have car insurance. They get it long enough to get the tag, then cancel. Of course if something happens, i.e. a wreck, they can be put in jail for it.
 
Different strokes for different folks. I dont want some low life scum sucking politician dictating my healthcare.

Perhaps we should worry about food, clothing, and shelter first but thats not as sexy. Oh and education, they sure do love to cut that cost.

Hugely agree. (Can you agree hugely?)🙂
 
They mandated everyone in my home state (maybe it was a whole country thing) have car insurance. They get it long enough to get the tag, then cancel. Of course if something happens, i.e. a wreck, they can be put in jail for it.

Can you imagine jailing the people without health insurance? Or fining them? What kind of a disaster would that be? Not that that's what you were saying at all... I was just thinking out loud.
 
Can you imagine jailing the people without health insurance? Or fining them? What kind of a disaster would that be? Not that that's what you were saying at all... I was just thinking out loud.

:laugh: I did get that, but glad to see you clarified. And in some country they just jailed (they called it quarantined) all people with HIV/AIDS so that it made it look like socialized health care helped their country get healthy. Just info I heard from a classmate and I thought, wow. I can only imagine what would happen here if they tried something similar (not even necessarily with that group of people, any group of people).
 
Can you imagine jailing the people without health insurance? Or fining them? What kind of a disaster would that be? Not that that's what you were saying at all... I was just thinking out loud.

Then you'd not only have to pay for the health care they recieve while incarcerated, but also the room & board...
 
Then you'd not only have to pay for the health care they recieve while incarcerated, but also the room & board...

:laugh: Wow you have a point there. That is going to get quite costly.
 
:laugh: I did get that, but glad to see you clarified. And in some country they just jailed (they called it quarantined) all people with HIV/AIDS so that it made it look like socialized health care helped their country get healthy. Just info I heard from a classmate and I thought, wow. I can only imagine what would happen here if they tried something similar (not even necessarily with that group of people, any group of people).

Ugh... I hadn't heard that one. That's awful. Makes you remember how blessed we are even with some of our country's problems.
 
Then you'd not only have to pay for the health care they recieve while incarcerated, but also the room & board...

Yeah... that was actually what I meant by 'disaster.' 😉
 
I grew up in Canada and experienced their care first hand.

I keep trying to educate people about this. Yes, everyone gets free health care in Canada. The care they get is markedly inferior in terms of access, time to treatment, and quality of care. Unless you live in downtown Toronto, your care will be inferior to that received in the U.S.

You get nothing for free. If you want government provided care, you will pay for it both in higher taxes, and longer waiting times. I doubt that 90% of the population would be willing to see their level of care suffer so that the 10% can benefit.
Yet, statistically, the Canadians are healthier than us.
 
Yet, statistically, the Canadians are healthier than us.

How unhealthy can you get with only golden fields of wheat and the occasional moose to eat?:laugh:
 
The Canadian healthcare system has far lower administrative costs than ours, as does the VA if I remember correctly.

The fire service seems better off as a government function than private, as another example.

You know, as much as the VA computer system is pretty nice, I can't help but think back to an experience I had there on a medicine rotation. We had a patient, homeless guy, who had his knee rebuilt after a fracture. He required PT before D/C. He wasn't really interested in leaving the hospital, and he did everything he could to keep his warm $1000/day bed. After a while, he got wise, realizing that PT only stopped by once at the same time everyday. He conveniently chose this time to go out and smoke, and he bought himself an extra two weeks (aka $14,000 worth of time), because PT couldn't be bothered to go to the spot where he went to escape them everyday or return to the same place twice. It was one example, but nothing about the VA was a model of efficiency. I think that these statistics are way overblown, and all studies showing greater "efficiency" ought to be examined more closely for what constitutes "efficiency."

The Canadian Healthcare system is also broke.

A local fire department really cannot be compared to a national healthcare system.
 
You know, as much as the VA computer system is pretty nice, I can't help but think back to an experience I had there on a medicine rotation. We had a patient, homeless guy, who had his knee rebuilt after a fracture. He required PT before D/C. He wasn't really interested in leaving the hospital, and he did everything he could to keep his warm $1000/day bed. After a while, he got wise, realizing that PT only stopped by once at the same time everyday. He conveniently chose this time to go out and smoke, and he bought himself an extra two weeks (aka $14,000 worth of time), because PT couldn't be bothered to go to the spot where he went to escape them everyday or return to the same place twice. It was one example, but nothing about the VA was a model of efficiency. I think that these statistics are way overblown, and all studies showing greater "efficiency" ought to be examined more closely for what constitutes "efficiency."

The Canadian Healthcare system is also broke.

A local fire department really cannot be compared to a national healthcare system.

Be that as it may. I think all large organizations suffer from bureaucracy and inefficiency, and I don't agree with the prevailing sentiment that the government is automatically going to do everything worse than greedy bloodsucking corporations.

Also, universal coverage does not require that the government take over healthcare or that anyone give up private insurance. England and many other European countries have systems in which public and private healthcare exists side by side.

As for the original point of this thread, obviously there is not going to be a 100% consensus of the AMA's members on anything. I think that those who don't like the AMA's lobbying priorities would do well to express their views to the AMA. Complaining on SDN is not going to change anything.
 
Oh, I feel bad for posting so much on this thread without addressing the original point. As a AMA member (I think my school signed me up), I sure wasn't consulted before they came out with this stuff and that is inappropriate. AMA needs to be speaking out on issues like the underpaying of medicaid and medical school loan accumulation and repayment.

OK, I'm not trying to be toting the AMA banner here, but just a couple things.

First, The AMA has been, is currently, and will be continuing to speak out on the issues of the proposed Medicare cut (Medicaid is state run not federal, so your state medical society deals with Medicaid) and medical student debt. They were instrumental in the recent reinstatement of the 20/220 deferment policy and are working on other issues concerning this. If you are concerned about these and like issues, I suggest you come to Washington, D.C. for the AMA Medical Student and Resident Lobby Day March 30-31st where these very topics will be discussed with Congress.

Second, I think it a bit much to ask every single person's opinion prior to conducting business. The topic of health care for all was discussed ad nauseam and voted upon by students, residents, young physicians, physicians, ...... at recent AMA Annual/Interim meetings. Your chance to have your voice heard is to contact the leadership for your particular section of the AMA, the BOT member for your section, and go to the meetings where policy is made to speak your piece.

And now I exit Stage right leaving my Soap Box behind (at least for the moment). 😡
 
The AMA does speak out on medical student debt, medmal reform, and Medicare cuts. In fact, I've been to DC a couple times to lobby for improvements in these areas. For the last 1-2 years the AMA's top priority has been covering the uninsured, and it was voted on by the AMA delegation as lucky said previously. There is very little that the AMA does without the approval of the House of Delegates.

The AMA had better speak up about this issue now, or the lawyers, MBAs, and politicians will. Mike Leavitt (Secretary of Health and Human Services) told us bluntly in Las Vegas at the interim '06 meeting of the AMA the same thing. The AMA has worked incredibly hard to get a a universal healthcare proposal that is friendly to both doctors and patients. In fact, if you look at the remaining Presidential candidates you'll find that not a single one is proposing a single payer system. The AMA (and specialty societies) are directly responsible for the departure from the single-payer movement seen in the early 90s.

It's my opinion that if any of these current proposals make it into law that doctors will see increased reimbursements because there will be no more charity care.
 
OK, I'm not trying to be toting the AMA banner here, but just a couple things.

First, The AMA has been, is currently, and will be continuing to speak out on the issues of the proposed Medicare cut (Medicaid is state run not federal, so your state medical society deals with Medicaid) and medical student debt. They were instrumental in the recent reinstatement of the 20/220 deferment policy and are working on other issues concerning this. If you are concerned about these and like issues, I suggest you come to Washington, D.C. for the AMA Medical Student and Resident Lobby Day March 30-31st where these very topics will be discussed with Congress.

Second, I think it a bit much to ask every single person's opinion prior to conducting business. The topic of health care for all was discussed ad nauseam and voted upon by students, residents, young physicians, physicians, ...... at recent AMA Annual/Interim meetings. Your chance to have your voice heard is to contact the leadership for your particular section of the AMA, the BOT member for your section, and go to the meetings where policy is made to speak your piece.

And now I exit Stage right leaving my Soap Box behind (at least for the moment). 😡

ok, my bad. I guess I misunderstood because it seemed we were blindsided by the whole 20/220 thing, when I thought AMA would be engaged and warn us, and because I thought I would get an email with minutes or what was being planned/voted on rather than only newsletters with my membership.
 
[YOUTUBE]http://www.youtube.com/watch?v=mrMcwy2UnjU[/YOUTUBE]
 
An article from the a magazine was written about the medical care and whether it should be free or not.



The only "crisis" in health care in this country is that doctors are paid too little. (Also they've come up with nothing to help that poor Dennis Kucinich.)

But the Democratic Party treats doctors like they're Klan members. They wail about how much doctors are paid and celebrate the trial lawyers who do absolutely nothing to make society better, but swoop in and steal from the most valuable members of society.

Maybe doctors could get the Democrats to like them if they started suing their patients.

It's only a matter of time before the best and brightest students forget about medical school and go to law school instead. How long can a society based on suing the productive last?

You can make 30 times as much money as doctors by becoming a trial lawyer suing doctors. You need no skills, no superior board scores, no decade of training and no sleepless residency. But you must have the morals of a drug dealer. (And the bank wire transfer number to the Democratic National Committee.)

The editors of The New York Times have been engaging in a spirited debate with their readers over whether doctors are wildly overpaid or just hugely overpaid. The results of this debate are available on TimeSelect, for just $49.95.

"Many health care economists," the Times editorialized, say the partisan wrangling over health care masks a bigger problem: "the relatively high salaries paid to American doctors."

Citing the Rand Corp., the Times noted that doctors in the U.S. "earn two to three times as much as they do in other industrialized countries." American doctors earn about $200,000 to $300,000 a year, while European doctors make $60,000 to $120,000. Why, that's barely enough for Muslim doctors in Britain to buy plastic explosives to blow up airplanes!

How much does Pinch Sulzberger make for driving The New York Times stock to an all-time low? Probably a lot more than your podiatrist.

In college, my roommate was in the chemistry lab Friday and Saturday nights while I was dancing on tables at the Chapter House. A few years later, she was working 20-hour days as a resident at Mount Sinai doing liver transplants while I was frequenting popular Upper East Side drinking establishments. She was going to Johns Hopkins for yet more medical training while I was skiing and following the Grateful Dead. Now she vacations in places like Rwanda and Darfur with Doctors Without Borders while I'm going to Paris.

(Has anyone else noticed the nonexistence of a charitable organization known as "Lawyers Without Borders"?)

She makes $380 for an emergency appen..omy, or one-ten-thousandth of what John Edwards made suing doctors like her, and one-fourth of what John Edwards' hairdresser makes for a single shag cut.

Edwards made $30 million bringing nonsense lawsuits based on junk science against doctors. To defend themselves from parasites like Edwards, doctors now pay hundreds of thousands of dollars in medical malpractice insurance every year.

But as the Times would note, doctors in Burkina Faso only get $25 and one goat per year.

As long as we're studying the health care systems of various socialist countries, are we allowed to notice that doctors in these other countries aren't constantly being sued by bottom-feeding trial lawyers stealing one-third of the income of people performing useful work like saving lives?

But the Democrats (and Fred Thompson) refuse to enact tort reform legislation to rein in these charlatans. After teachers and welfare recipients, the Democrats' most prized constituency is trial lawyers. The ultimate Democrat constituent would be a public schoolteacher on welfare who needed an abortion and was suing her doctor.

Doctors graduate at the top of their classes at college and then spend nearly a decade in grueling work at medical schools. Most doctors don't make a dime until they're in their early 30s, just in time to start paying off their six-figure student loans by saving people's lives. They have 10 times the IQ of trial lawyers and 1,000 times the character.

Yeah, let's go after those guys. On to nuns next!

But Times' readers responded to the editorial about doctors being overpaid with a slew of indignant letters -- not at the Times for making such an idiotic argument, but at doctors who earn an average of $200,000 per year. Letter writers praised the free medical care in places like Spain. ("Nightmare" in the Ann Coulter dictionary is defined as "having a medical emergency in Spain.")

One letter-writer proposed helping doctors by having the government take over another aspect of the economy -- the cost of medical education:

"If we are to restructure the system by which we pay doctors to match Europe, which seems prudent as well as inevitable, we must also finance education as Europeans do, by using state dollars to finance the full or majority cost of higher education, including professional school."

And then to reduce the cost of medical school, the government could finance "the full or majority cost" of construction costs of medical schools, and "the full or majority cost" of the trucks that bring the cement to the construction site and the "the full or majority cost" of coffee that the truck drivers drink while hauling the cement and ... it makes my head hurt.

I may have to see a doctor about this. I should probably get on the waiting list now in case Hillary gets elected.

That's how liberals think: To fix an industry bedeviled by government controls, we'll spread the coercion to yet more industries!

The only sane letter on the matter, I'm happy to report, came from the charming town of New Canaan, Conn., which means that I am not the only normal person who still reads the Times. Ray Groves wrote:

"Last week, I had the annual checkup for my 2000 Taurus. I paid $95 per hour for much needed body work. Next month, when I have my own annual physical, I expect and hope to pay a much higher rate to my primary care internist, who has spent a significant portion of his life training to achieve his position of responsibility."

There is nothing more to say.
-Ann Coulter
 
EM2BE,

That is just outstanding! 😀👍😍
 
Good article, and I would agree with most of it... except I have to disagree with the whole thing out of principle if it was written by Ann Coulter...

That woman scares me.
 
Good article, and I would agree with most of it... except I have to disagree with the whole thing out of principle if it was written by Ann Coulter...

That woman scares me.

Have you seen her Adam's apple? Not small...
 
Good article, and I would agree with most of it... except I have to disagree with the whole thing out of principle if it was written by Ann Coulter...

That woman scares me.


On "principle", huh? Sounds very principled indeed.😴
 
Why should I work for free? Can someone please answer me that riddle.

Also why should I be forced to work for the government??
 
Why should I work for free? Can someone please answer me that riddle.
Because our society has decided that emergency medical care is a right. Because poor people died of treatable conditions outside of hospitals in the good old days before EMTALA.

Nobody is forced to become a doctor, and nobody is forced to go into emergency medicine. EMTALA is one of the defining features of the specialty. Some people, myself included, find that to be a plus. I'm sorry others feel it's such a burden.

Also why should I be forced to work for the government??
I have no idea what you're talking about here.
 
Why should I work for free? Can someone please answer me that riddle.

Also why should I be forced to work for the government??

Bad news for you man, you already work for the government. Just try to practice without medicare/medicaid reimbursement and see if you can afford to eat.

What I object to most is our lack of autonomy. We have no bargaining power, and we can't go on strike. Essentially the government can do whatever it wants to us without any fear of consequences or retaliation on our part.
 
What I object to most is our lack of autonomy. We have no bargaining power, and we can't go on strike. Essentially the government can do whatever it wants to us without any fear of consequences or retaliation on our part.

Truth.
This hits it on the head.
As p-knot said above, the decision to be a physician and practice EM is a choice. The tough bit is recognizing that those are basically the last times we get to choose our practice configuration.
Yep. For the time being you can jockey around for the group design and pay scheme that best fits your needs, but you still must treat all comers regardless of their ability to pay, follow directions, take meds, take responsibility etc.
We also have sacrificed any reliable modus of appeal when payment paradigms, patient loads, or municipal demands do not align with our personal objectives.
From the current debate it is clear that we will have some government mandated "healthcare for all". This is basically what we have now. Just ask our president.
The hopeful spot is the language of "coverage for all". To me this implies that treatment will be paid for by someone rather than the unfunded care that accounts for ~45% of EM today.
 
Ectopic,

You have said it countless times on this forum... Health care is a commodity and I fully agree.

The problem is that the arguments over health care are emotional. It is easy to say a person needs to pay for health care like anything else, its a lot harder to turn away a sick child because they are uninsured (not suggesting we should).

But the truth is if you put it on paper, health care should be treated like anything else, for ex. food, shelter and education are not truly free or equal in the way people are lobbying for health care.

Soup kitchens and homeless shelters are what are provided for food and shelter; not grade A meat and lobster. In a addition there are no committees suggesting that those who live in luxurious houses give half their homes to those that do not have shelter as well as prohibit people from eating expensive foods to supply food to all. Finally, education is not equal between some public (over populated class rooms) to private schools.

This relates to health care in that the above arguments suggest it is not just okay but expected that those you can afford quality immediate health care sacrifice that care for longer waits, inefficient, poor care so all may be treated. In addition to these changes those in a middle to high socioeconomic status should happily accept paying greater than 50% taxes to support this new system. Since, although we will all be equal in our access to health care, our financial support for that system will NOT be equal. For some reason it seems perfectly reasonable that the "rich" (aka those who can afford insurance now) pay more for worse health care in order to supply health care to all. Does any of this make logical sense?.... NO because it is an emotional argument.

None of the above sounds FREE, Capitalist or American. It may sound like a great idea to provide HC to all, but the reality is to do so we as a country would have to accept more Socialist, almost Communist views, far more than we already have.... I'm not ready for that, although it sounds great.

If we want that we should chemically sterilize all women to prevent teenage pregnancy, limit children to those who can afford to care for children (like the previous quoted China, 1 per couple), pay all people equal wages regardless of occupation because we are all equal, equal taxes etc

1. Health care is a privilege, commodity not a right. (ectopic)
2. We already have a two tier system, private and medicare/medicaid
3. I love the USofA but don't think govt run HC is a good idea ex. LA County, Medicare (potential 10.6% cut), Failing Social Security, or current Welfare nation etc etc.
 
Sigh. I guess I'm the only one on this discussion board who supports universal health care. I guess I'm either "too idealistic" or "too emotional"!

What if EP's salaries went up with universal health care . . . would that make a difference, or would you all still oppose it?
 
Wallowa,

you are absolutely right. The other financial thought for the ED is that pay could increase with increased insurance coverage and yes of course I think physicians in general would like.

My message was not meant to insult anyone by calling them "too emotional", it was just to state the the reason the issue is so difficult is because of the emotional component.

Personally, I don't like the idea of government regulated medicine. However, I do support increasing insurance cover to more American via government assistance, ex tax refunds solely for insurance etc. I support a two tier system like an expanded version of what we already have with private insurance and medicare/medical. However, I think expanding health care coverage to more people should not involve increasing the health care financial burden on those who already can afford health care, nor should it decrease their current quality of care to provide care to the "minority" of uninsured in the United States.

If salaries go up great, likelihood is down. ex. projected medicare cuts in

the future instead of increases = decreased compensation
in addition increased taxes = increased loss of income
(for our future tax bracket)
= double whammy 🙄

Keeping multiple insurance providers will protect our professional field. One payer,or the stereotypical universal health care, means everything is controlled by the government which could be disastrous.... see above equation🙂 We've given enough of our field away to outside sources. At this point we should try to help and treat as many people as we can without giving our professional field over to government control.

Ian
 
Sigh. I guess I'm the only one on this discussion board who supports universal health care. I guess I'm either "too idealistic" or "too emotional"!

What if EP's salaries went up with universal health care . . . would that make a difference, or would you all still oppose it?

I support universal health care. I'm ashamed that our country doesn't have this, in fact. And as for the argument of not trusting the government with health care, I really think corporations are more evil and less accountable to the public. Plus universal health coverage doesn't have to mean the government runs everything, although that would be more efficient and economical.
 
When has the federal government ever been efficient?
 
I went to a talk given by the director of the ED at my school's hospital last night and he had a couple of interesting points. If everyone in insured, EP salaries will probably increase (a payer mix of 100% > a payer mix of ~60-70%). Also, ED utilization will probably increase. This has apparently happened in Canada: even though everyone has a PCP, the PCPs are so overwhelmed that they actually send more people to the ED.
So, more money cause everyone pays and more people visiting...could be good.
That being said, if we let the government/medicare control reimbursement we're all going to be working for hamburgers...and not In 'N Out burgers either (I heard their hospital has a 100% payer mix and never has angry patients sitting in triage).
 
I went to a talk given by the director of the ED at my school's hospital last night and he had a couple of interesting points. If everyone in insured, EP salaries will probably increase (a payer mix of 100% > a payer mix of ~60-70%). Also, ED utilization will probably increase. This has apparently happened in Canada: even though everyone has a PCP, the PCPs are so overwhelmed that they actually send more people to the ED.
So, more money cause everyone pays and more people visiting...could be good.
That being said, if we let the government/medicare control reimbursement we're all going to be working for hamburgers...and not In 'N Out burgers either (I heard their hospital has a 100% payer mix and never has angry patients sitting in triage).

Medicare already controls reimbursement.

In Massachusetts, ED utilization went down by 28% after the implementation of universal coverage:
http://www.boston.com/news/local/ma...ding_in_reducing_hospital_visits_by_uninsured
 
What about EP reimbursement due to the decrease in census.

I hadn't realized/heard ED utilization went down in Mass as the number of uninsured went down. The premise of my comment was that ED census actually went up because PCPs were so much more overworked that they had to punt more people to the ED...
 
What about EP reimbursement due to the decrease in census.

It's possible, though it would be offset by a decrease in work.

There are several forces that would affect EP earnings if universal coverage became a reality:

+ higher percentage of insured patients, no more charity care due to EMTALA
- possible fewer (nonemergent) patients
- possible tax increases to pay for universal coverage

The decreased reimbursements some have suggested would be necessary to pay for universal coverage are a bit of a red herring, since they are already happening. It's clear that we are spending more on healthcare in this country than anyone really thinks is desirable and increased rationing of care will be necessary.

Anyway, I don't claim that physician salaries would rise if we had universal coverage (and I think it's really hard to predict what would happen) but I do support it because I think it's the right thing to do. Unlike some people, I acknowledge that one could disagree with my views and still be rational.
 
I was having a conversation with someone last night when they asked me what I thought about the mandate vs no mandate discussion during the Texas democratic debate the other night.

The truth is, nobody, especially me, knows what will happen. There are WAY too many moving parts in our healthcare 'system' to make a reliable prediction. Being physicians, we all have a tendency to believe in the infallibility of our knowledge base but, as a profession, we don't have a very good track record on this issue. The AMA was the largest opponent of the Medicare system, labeling it 'socialized' medicine, a term that continues to have a huge emotional impact in the debate today. In hindsight, physicians were huge beneficiaries of the system.

As to what is being proposed to achieve 'universal health care', I haven't seen any suggestions of a single payor system by a credible candidate. What I have seen is suggestions of increasing people's access to health insurance and offering subsidies for those who can't afford the premiums. That's substantially different than a single payor.

Take care,
Jeff
 
The decreased reimbursements some have suggested would be necessary to pay for universal coverage are a bit of a red herring, since they are already happening. It's clear that we are spending more on healthcare in this country than anyone really thinks is desirable and increased rationing of care will be necessary.

Our spending on healthcare has little do with access, and more do to with other factors:

1. Malpractice environment - unnecessary CT scans and lab testing.
2. Demanding patients
3. Obese patients who smoke. Obesity accounts for 80% of the medical problems I see on a daily basis (most related to diabetes and heart disease). This is unlikely to improve with more insurance coverage.
 
As to what is being proposed to achieve 'universal health care', I haven't seen any suggestions of a single payor system by a credible candidate. What I have seen is suggestions of increasing people's access to health insurance and offering subsidies for those who can't afford the premiums. That's substantially different than a single payor.

Again, how do you pay for that "increased access"? I already work through April every year just to pay my federal taxes. Should I be forced to work through June just so that we can cover more people?
 
Our spending on healthcare has little do with access, and more do to with other factors:

1. Malpractice environment - unnecessary CT scans and lab testing.
2. Demanding patients
3. Obese patients who smoke. Obesity accounts for 80% of the medical problems I see on a daily basis (most related to diabetes and heart disease). This is unlikely to improve with more insurance coverage.

#1 probably has a pretty small effect on health care costs.
http://www.jhsph.edu/publichealthnews/press_releases/2005/anderson_healthspending.html
http://www.cbo.gov/ftpdoc.cfm?index=4968&type=0&sequence=0
http://www.factcheck.org/article133.html

As for obesity, I recently saw a paper that indicated health care costs were lower for the obese because they die sooner. I can find the reference if interested.
 
#1 probably has a pretty small effect on health care costs.
http://www.jhsph.edu/publichealthnews/press_releases/2005/anderson_healthspending.html
http://www.cbo.gov/ftpdoc.cfm?index=4968&type=0&sequence=0
http://www.factcheck.org/article133.html

As for obesity, I recently saw a paper that indicated health care costs were lower for the obese because they die sooner. I can find the reference if interested.

Please cite that reference. In South Texas approximately 80% of the patients I treat are morbidly obese. The majority have diabetes and hypertension. Most of their visits are for diabetes-related issues.
 
Please cite that reference. In South Texas approximately 80% of the patients I treat are morbidly obese. The majority have diabetes and hypertension. Most of their visits are for diabetes-related issues.

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050037

So, actually, executing the obese could be the way to go here...perhaps it's an idea whose time has come? We could have universal coverage AND lower costs!

EDIT: we also need to encourage people to smoke more, of course.
 
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