Astro Advocacy Issue

[PhotonBomb]

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In light of the coming ASTRO advocacy day, it was posited on the ROHUB that one of ASTRO’s issues should be to endorse single payer/universal care. Pros/cons of this?

 

[RickyScott]

Gee, what do you think this would do to job market? Astro should be advocating for residency reduction. Period

 

[Gfunk6]

From a laymen's perspective, Medicare for all seems like a dandy idea. For people who understand healthcare, it would be an abject disaster.

1. Taxes - the revenue for universal health care needs to come from somewhere. It will be in the trillions of dollars. One can argue to siphon funds that were earmarked for something else (e.g. military funding) vs increasing taxes on all.

2. Hospitals would rapidly go under financially - it is will known that acute care centers lose money every time they see a Medicare patient (let alone Medicaid). They stay afloat by gouging HMOs and PPOs 300-400%+ of what Medicare pays. I'm not a fan of hospitals buying up private practices, monopolizing markets, and driving up costs - HOWEVER, let's be serious, we need acute care centers.

3. Health plans like Kaiser who do a good job at turning profit, rationing care, and limiting health care expenditure would go under, assuming there was a universal mandate.

4. Politics - there is zero chance that Sanders or any other candidate to pass this proposal through Congress.

There are more, but the above is a good start. I don't want to make it seem that I am a passionate advocate for the current system - I am not. However, we need baby steps to get where we need to go. We can't throw the proverbial baby out with the bathwater.

 

[OTN]

Only in medicine do we have members of an industry advocating for reduction in funding for said industry. By setting up a legal monopsony, that's precisely what single-payer health care is designed to do.

 

[PhotonBomb]

Only in medicine do we have members of an industry advocating for reduction in funding for said industry. By setting up a legal monopsony, that's precisely what single-payer health care is designed to do.

Not Me, Us.

Brah.

 

[FrostyHammer]

Legend has it that Liz Warren still can't admit that MFA will be paid for by increasing middle class taxes. She also still believes she can coerce Moscow Mitch to pass it in the Senate. Hah.

 

[RadOncMegatron]

ASTRO should not pick any side of a controversial political topic. My two cents on the issue is that universal healthcare advocates have identified major problems with our system, which is important. Unfortunately, coming up with solutions for such a vast problem is orders of magnitude more difficult. Given how severe the problem is, it is likely impossible to “fix.” The solutions of universal healthcare will fix somethings, but break other parts putting us at perhaps at the same if not worse place. To be fair, all solutions I have heard don’t do squat either. A partisan “solution” will all but guarantee disaster.

 

[OTN]

Liz doesn't really believe in MFA. Truth is the STEMI Sanders is the only real believer and he will never have the leverage to pass that type of bill.

She doesn’t really believe in anything

 

[evilbooyaa]

I will be tentatively allowing this thread despite it being political in nature due to the discussion of a single payer/Medicare-For-All discussion and it's relevance to ASTRO/Rad Onc.

Keep political discussion limited to discussion of MFA/single payer, or this thread will be closed and users given escalating warnings. Very short leash folks.

I think MFA will result in salary suppression across all of medicine, and therefore I am not for it, as I don't want to be doing even more work as an attending to maintain my salary.

 

[Chartreuse Wombat]

Why would anyone support a 40% wage reduction for doctors and a middle class tax increase? Only our wise members of the ASTRO Board would consider this a subject to discuss: Remember if you can negotiate Monopoly Rates-Choose Wisely. A bad idea

Amazon product ASIN B07N8FXVLL

 

[PhotonBomb]

Why would anyone support a 40% wage reduction for doctors and a middle class tax increase? Only our wise members of the ASTRO Board would consider this a subject to discuss: Remember if you can negotiate Monopoly Rates-Choose Wisely. A bad idea

Amazon product ASIN B07N8FXVLL

No one from ASTRO said this

One random person like you or I posted it on ROHub. Which is like posting on SDN except not anonymous

 

[Chartreuse Wombat]

ROHub is monitored. Not real time.

 

[deleted941485]

ASTRO should follow in the footsteps of the ACP and offer to full throated support of single payer healthcare.

It would be most consistent with their ideals of ruining the prospects for he younger generation by turning them into little lemmings who can quote EBM at the drop of a hat and take orders without question.

 

[PhotonBomb]

ACP did that?

 

[Tigerstang]

ASTRO should follow in the footsteps of the ACP and offer to full throated support of single payer healthcare.

It would be most consistent with their ideals of ruining the prospects for he younger generation by turning them into little lemmings who can quote EBM at the drop of a hat and take orders without question.

Bingo. Check ROHUB today. You were a day early.

 

[radoncgrad2019]

Bingo. Check ROHUB today. You were a day early.

you should elaborate?

 

[Tigerstang]

you should elaborate?

I could. Or, I could not spoon feed you and you could go there and read for yourself.

 

[domestique]

Astro obviously cannot and will not publicly advocate for something that is in clear direct opposition to the interests of the majority of the membership. I expect no formal position to be taken in either direction ahead of advocacy day this year.

 

[Tigerstang]

Astro obviously cannot and will not publicly advocate for something that is in clear direct opposition to the interests of the majority of the membership. I expect no formal position to be taken in either direction ahead of advocacy day this year.

ASTRO has been advocates for issues in direct opposition to the majority of its membership for years. While I don't disagree with you on this particular issue, I sharply disagree with your premise.

 

[domestique]

like what?

 

[Mandelin Rain]

Killing site neutrality as a possibility when the majority of it's membership were private practioners

 

[Tigerstang]

Killing site neutrality as a possibility when the majority of it's membership were private practioners

Bingo

 

[Neuronix]

I could. Or, I could not spoon feed you and you could go there and read for yourself.

You have to an ASTRO member to read those forums. Many of the SDN members are not ASTRO members.

I assume you're referring to the one post on there suggesting that ASTRO advocate for universal health care.

 

[Gfunk6]

To summarize the conversation on this topic on RO Hub (how should ASTRO advocate for you?) - the current topic has shifted to supervision requirements. As you know CMS eliminated the need for direct RO supervision in 2020 for hospital outpatient centers.

ASTRO's position (which was posted in RO Hub) is that it is important for direct supervision by an RO MD to always happen. Exceptions can exist in their mind but should be reserved for rural/undeserved settings.

However, the consistent feedback from ASTRO members on RO Hub is that direct supervision is an unnecessary burden on RO MDs. It should only be mandated for special procedures like HDR, SRS, and SBRT.

 

[evilbooyaa]

Bingo. Check ROHUB today. You were a day early.

ROHub does not equal ASTRO. It is a public forum, non-anonymous, where people are allowed to post their opinions. In the thread mentioned, one RO (who is retired/semi-retired IIRC) advocated for universal health care. If an official ASTRO statement develops in support of it (as was done by the ACP), then get back to me.

 

[domestique]

Killing site neutrality as a possibility when the majority of it's membership were private practioners

Astro is the smallest of small potatoes on that issue right there. I mean somewhere in the neighborhood of 0 influence relative to the other players on the field, to mix metaphors. I agree it would be nice for there to be 100% congruence between members' views of the world and that of the organization. But for some issues, bigger strategy/"transactional" questions are in play such as not directly opposing every other "provider"/hospital lobby on an issue like site neutrality. For single player, it isn't going to play out that way. ACP geniuses notwithstanding, every provider group and their mother knows they will take it 6 ways to Sunday with a single omnipotent price-maker as in single payer. Would be ugly AF not necessarily on day one but soon thereafter.

 

[BobbyHeenan]

To summarize the conversation on this topic on RO Hub (how should ASTRO advocate for you?) - the current topic has shifted to supervision requirements. As you know CMS eliminated the need for direct RO supervision in 2020 for hospital outpatient centers.

ASTRO's position (which was posted in RO Hub) is that it is important for direct supervision by an RO MD to always happen. Exceptions can exist in their mind but should be reserved for rural/undeserved settings.

However, the consistent feedback from ASTRO members on RO Hub is that direct supervision is an unnecessary burden on RO MDs. It should only be mandated for special procedures like HDR, SRS, and SBRT.

...as it relates to this, I wonder if people will start dropping their ACR or APEX accreditation if they stick hard to the direct supervision standard. What is ACRO's take on that?

 

[PhotonBomb]

some of you may still have 'High High Hopes' but it's done, son!

 

[RickyScott]

some of you may still have 'High High Hopes' but it's done, son!

I am trying to get my administration on board with this.