Do you belong to AMA?

[deleted65604]

When I was in med school, I felt obligated to belong to AMA. I felt that although it wouldn't really help my application for residency, that it would look bad if I wasn't willing to contribute to the biggest healthcare association that lobbies for doctors (just being cheap).

Now, I don't belong because they are pushing universal health care.

Why don't you belong to AMA?

If you do belong to AMA, why?

I had tons of colleagues in medical school jumping on the AMA band-wagon, and using it as a way to pad the old resume, getting useless positions like SECRETARY OF THE LOCAL CHAPTER OF AMA. In retrospect, I'm not sure that we accomplished anything other than supporting a big useless bureaucracy that doesn' have our best interest at heart.

A couple of interesting links below (I thought)

The first is a letter by the AMA endorsing legislation that will give us single payor coverage. The second is a rant by a physician telling about why he doesn't want to belong to the AMA.

http://blog.healthcareforamericanow.../715-house-hsr-letter_rangel-ama-endorsed.pdf

http://www.thehealthcareblog.com/th...vant-is-the-american-medical-association.html

How do we make things better in the AMA?

A- join and try to change the organization
B- refuse to join
C- tell everyone we know not to join

I keep getting flyers from the AMA about life insurance deals and finally lost it. I'm sending them the following letter back in their self-addressed envelope.

The AMA is a disgrace to US doctors. I wouldn't support you with dues money or with buying life insurance. How pathetic is it that a so-called medical association sells life insurance? If you fought for physicians, against socialized medicine and demanded malpractice reform (caps on non-economic damages, and having the loser pay the winner's legal costs as is done in every other civilized country), maybe more physicians would give you dues and you wouldn't have to prostitute yourself by selling life insurance.
My father is a member of IBEW, and throughout his life, the union has fought valiantly for improved working conditions and as a result, his job was much more bearable. I don't understand why a "medical association" wouldn't care most about the health and job conditions of America's most valuable medical resource, Doctors.
Please stop sending me mail. I wouldn't want the embarrassment of having someone think I belonged to your organization.

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Members don't see this ad.

 

[GeneralVeers]

This week's endorsement by the AMA of one of the Congressional plans to nationalize our healthcare system reaffirms why I am not a member and will not pay dues to the AMA.

They are ostensibly our union (the only national one we have) and should be representing the financial and professional interests of doctors above all else.

 

[Octagonecology]

When I was in med school, I felt obligated to belong to AMA. I felt that although it wouldn't really help my application for residency, that it would look bad if I wasn't willing to contribute to the biggest healthcare association that lobbies for doctors (just being cheap).

Now, I don't belong because they are pushing universal health care.

Why don't you belong to AMA?

If you do belong to AMA, why?

I had tons of colleagues in medical school jumping on the AMA band-wagon, and using it as a way to pad the old resume, getting useless positions like SECRETARY OF THE LOCAL CHAPTER OF AMA. In retrospect, I'm not sure that we accomplished anything other than supporting a big useless bureaucracy that doesn' have our best interest at heart.

A couple of interesting links below (I thought)

The first is a letter by the AMA endorsing legislation that will give us single payor coverage. The second is a rant by a physician telling about why he doesn't want to belong to the AMA.

http://blog.healthcareforamericanow.../715-house-hsr-letter_rangel-ama-endorsed.pdf

http://www.thehealthcareblog.com/th...vant-is-the-american-medical-association.html

How do we make things better in the AMA?

A- join and try to change the organization
B- refuse to join
C- tell everyone we know not to join

I keep getting flyers from the AMA about life insurance deals and finally lost it. I'm sending them the following letter back in their self-addressed envelope.

The AMA is a disgrace to US doctors. I wouldn’t support you with dues money or with buying life insurance. How pathetic is it that a so-called medical association sells life insurance? If you fought for physicians, against socialized medicine and demanded malpractice reform (caps on non-economic damages, and having the loser pay the winner’s legal costs as is done in every other civilized country), maybe more physicians would give you dues and you wouldn’t have to prostitute yourself by selling life insurance.
My father is a member of IBEW, and throughout his life, the union has fought valiantly for improved working conditions and as a result, his job was much more bearable. I don’t understand why a “medical association” wouldn’t care most about the health and job conditions of America’s most valuable medical resource, Doctors.
Please stop sending me mail. I wouldn’t want the embarrassment of having someone think I belonged to your organization.

Your post is perplexing to me. I guess I would have to say if you are going to make an argument you should probably start out with stating facts. You can't just post nonsensical fiction and try to get someone to take your side.

You claim the AMA supports Obama's "single payor" health care. This is nothing but pure fiction and lies. I understand it is the most common tactic of the right to scream socialism and single payor blah blah. There is only one problem with this. Obama never mentioned or pursued this as an option, neither has the AMA. You than post the AMA letter which clearly omits any support of single payor. So you make a point and then post your source as evidence which clearly refutes your point. Not too bright.

Here are the bullets from the AMA letter....

•
Promises to extend coverage to all Americans through health insurance market reforms;
•
Provides consumers with a choice of plans through a health insurance exchange;
•
Includes essential health insurance reforms such as eliminating coverage denials based on pre-existing conditions;
•
Recognizes that fundamental Medicare reforms, including repeal of the sustainable growth rate formula, are essential to the success of broader health system reforms;
•
Encourages chronic disease management and care coordination through additional funding for primary care services, without imposing offsetting payment reductions on specialty care;
•
Addresses growing physician workforce concerns;
•
Strengthens the Medicaid program;
•
Requires individuals to have health insurance, and provides premium assistance to those who cannot afford it;
•
Includes prevention and wellness initiatives designed to keep Americans healthy;
•
Makes needed improvements to the Physician Quality Reporting Initiative that will enable greater participation by physicians; and
The Honorable Charles B. Rangel
July 16, 2009
Page 2
•
Initiates significant payment and delivery reforms by encouraging participation in new models such as accountable care organizations and the patient-centered medical home.

Notice there is no mention of your "single payor" deal. What also strikes me as strange is the following: If you are en ER doctor you probably see over half of your patients for free as they are un-insured, indigent, etc. With this option, you would be paid by everyone you treat. This would only be better for you.....again, not too bright.

I know you are a doctor most are so partisan that most only care about anything coming from a democratic administration must be evil. Even when it would clearly only benefit you. You have been trained to bleat like the sheep in Animal Farm...."4 legs goood, 2 legs bad". Your mantra is..."anything reform/democrat is bad". This is silly seeing as how you as an ER doc will possibly see a dramatic increase in pay for your work as opposed to essentially being a half time volunteer.

So join the AMA, don't join it really doesn't matter. Ive got news for you....they don't care and they don't need you. Neither do the Democrats. The Republican party is so weak and embarassing at this point that they are not even a factor. The bills will pass and rightly so. Perhaps the right may want to get on the right side of history for once.

 

[dchristismi]

There is extensive discussion at Sermo regarding this, and the majority as I can tell oppose the AMA's lack of advocacy, for starters.

I am not an AMA member, and don't plan to rejoin. (I was in med school, for the same reasons you were, Jarbacoa.) And yes, the only thing I've ever seen from them is a lot of junk mail. The fact that so many practicing physicians have abandoned the AMA says a lot.

And really, at this point, I am of the opinion that I'd rather get paid well from a fraction of my patients than get paid crap by all of them. The VA is a prime example of what I don't want.

 

[Old_Mil]

The bills will pass and rightly so. Perhaps the right may want to get on the right side of history for once.

Since you're a first year medical student, I can understand why you don't fully grasp what "Canadian style health care" + "American style malpractice" will mean for your future career. I suggest you educate yourself on the issue by reading some old issues of Medical Economics.

 

[GeneralVeers]

Since you're a first year medical student, I can understand why you don't fully grasp what "Canadian style health care" + "American style malpractice" will mean for your future career. I suggest you educate yourself on the issue by reading some old issues of Medical Economics.

There's nothing like a discussion of socialized medicine to bring out the altruistic "save the world" attitude of the med students here. It's not their fault, it has been drilled into them since college. I was lucky in that the brainwashing didn't "take".

 

[deleted65604]

As we recently had a great discussion on the particular topic of socialized medicine, I don't think we need to beat that really dead horse (at least not now).

AMA states on their ethics website:
"... society has an obligation to make access to an adequate level of health care available to all of its members regardless of ability to pay..."

By giving everyone free healthcare, there is no incentive for anyone to pay for private health insurance. Employers would especially be de-incentivized to provide private health-care, and the majority of people except for the upper class would end up de facto on government provided health insurance.

We are using different words to say the same thing... single payor, socialized medicine, and government provided free healthcare... I don't see a real difference in the reality of the ideas expressed. It is all semantics, the idea is the same.

I'm not the only person who thought the AMA endorsal of the legislation was a betrayal and an espousal of single payor system. The AAPS did also. See the link below.

http://www.aapsonline.org/press/ama-sells-out-doctors.php

Is it just possible that my reading of the proposal and that of the AAPS might be the correct interpretation and you, Octagon, actually misunderstood it?

 

[dchristismi]

Nope, and will physicians be able to opt-out of a public plan? It's not as much an issue for EM, but I have exactly ONE pediatrician in my semirural area who takes new medicaid patients. Finding a medicaid-accepting internist? Ha. The red tape, paperwork, type of patient and crap for reimbursement have made medicaid more trouble than it's worth.

Many, many questions flying about this legislation...

 

[deleted65604]

THrough SERMO, I learned that AMA actually owns the CPT codes and that they get paid millions of dollars per year for physicians nationwide to use that database. They have helped create the nightmare that is modern charting and reimbursement.

http://www.jpands.org/hacienda/dunaway.html

http://www.healthleadersmedia.com/c...2_PHY/Sermo-Wars-with-AMA-Over-CPT-Codes.html

 

[deleted65604]

I'm not strongly opposed to socialized healthcare as long as there is rationing of healthcare and huge progress made in the area of malpractice reform.

What I can't bear is the proposed legislation currently supported by the AMA that makes no mention of malpractice reform.

Socialized healthcare without rationing of healthcare and malpractice reform will cause costs to sky-rocket and will make our lives utter misery.

 

[GeneralVeers]

I'm not strongly opposed to socialized healthcare as long as there is rationing of healthcare and huge progress made in the area of malpractice reform.

What I can't bear is the proposed legislation currently supported by the AMA that makes no mention of malpractice reform.

Socialized healthcare without rationing of healthcare and malpractice reform will cause costs to sky-rocket and will make our lives utter misery.

That's what I've been saying for years now (see my posts about leaving for New Zealand).

We are going to end up with the worst of both worlds. The terrible malpractice in this country is slightly offset by more autonomy, better salary, and better standard of living.

 

[docB]

No I don't belong to the AMA.

My most pressing reasons are pragmatic. It's expensive and I berely have time to keep up with the stuff I do with ACEP.

From a more political standpoint I don't think that they represent my views and I think they're hobbled by the mutually exclusive goals of acting as a policy setting body (do what we say with healthcare, we know best, we're the doctors) and acting as a quasi labor union.

While I do think that we need some kind of omnibus group that can represent doctors as a whole rather than the fragmented "screw that specialty to give it to my specialty" situation we have now I don't know that the AMA is really viable for that.

I guess I'd say I would like to see it get better and become more successful but I'm not willing to join it or work for it.

 

[GeneralVeers]

No I don't belong to the AMA.

I guess I'd say I would like to see it get better and become more successful but I'm not willing to join it or work for it.

The main problem with having any "union" for doctors is that we would lack the power that most unions have, namely to enact a work stoppage to blackmail for demands.

We are essentially slaves to the state, not able to strike if conditions become too deplorable.

 

[physicsnerd42]

I do belong to the AMA even though I don't agree with many of its positions.

Why?

As one of the Ob/Gyn attendings at my hospital says about AMA membership, "It's easier to piss out of the tent than to piss in."

Like it or not, the public thinks that the AMA represents all doctors. If you don't like their positions then join up and try to change them.

 

[DoctorMedic]

if only they would enact some tort reform, that would make it MUCH easier, and more welcome for whatever the govt wants to do with healthcare

 

[Jeff698]

Yes, I'm an AMA member.

While I don't agree with everything they do (although I agree with their recent endorsement and their justification for it: http://www.ama-assn.org/ama/pub/advocacy/health-system-reform.shtml), I think that they take the positions they do because it is the will of the members who show up and participate.

I've been to several meetings of the house of delegates and can tell you they are responsive to a fault.

Someone above was bemoaning the fact that they do nothing to push malpractice reform. Please.

Here's the URL to their advocacy issues page: http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy.shtml

First topic? Medical Liability Reform. Here's the URL: http://www.ama-assn.org/ama/pub/advocacy/current-topics-advocacy/practice-management/medical-liability-reform.shtml

Finally, the AMA is not a union. While is certainly supports better pay for physicians (the AMA lobbying of congress is the prime, if not only, reason the sustainable growth formula-dictated reimbursement cuts haven't taken place for the past several years), that isn't their primary mission. Rather it is: "To promote the art and science of medicine and the betterment of public health." Here's the URL for their mission related information: http://www.ama-assn.org/ama/pub/about-ama/our-mission.shtml

Again, I don't agree with everything they do and I'm not involved with them anymore in anything more active than paying my dues, but I think people should understand what they are and what they do before they say silly things.

If you don't want to be a member because they endorsed a bill you think is a really, really bad idea, fine. Just please don't say things that aren't true (like they do nothing about malpractice reform).

Take care,
Jeff

 

[deleted109597]

Was a member of the AMA. Even was a voting member of the HoD once. All while in medical school. Over time, I've noticed that the AMA has fewer and fewer old members, and has many more young members. I've also noticed that like AMSA, it is getting a decidedly socialist kick to it. Do I think people need healthcare. Absolutely. Do I think it needs to be free and more importantly, should they be able to actively subvert the care of their health by smoking/drinking/being fat/sitting down all day/getting disability? No. So I don't support the way the AMA is going, and haven't renewed my membership in 2 years. Eventually they stop sending you stuff though.
I did support them with medmal, spending many days on the hill at the state and federal level. Without a strong position though, the AMA hasn't done much at the federal level, and I think it is because they are too soft. As more people leave states without it, med mal will fix at the state level first.
At those days we also had a fair amount of talk about the SGR or importantly, how it wasn't actually sustainable. Every year there was a stopgap bandaid, but no plan for a permanent fix. If the AMA changes their rhetoric and gets better plans about their fixes, I may join again. But not when they're trying to take my legs out from under me with this quasi-socialist public option bull****.

 

[Cerberus]

I joined my first your of medical school but I somewhat regret it now. They are probably the most useless "union" in the world. They do absolutely nothing to further the interests of residents or physicians.

 

[GeneralVeers]

I joined my first your of medical school but I somewhat regret it now. They are probably the most useless "union" in the world. They do absolutely nothing to further the interests of residents or physicians.

The problem is that you cannot advocate for physicians AND patients at the same time.

The best thing for patients would be if all doctors worked 24 hours a day and saw everyone for free.

The best thing for doctors is to work as little as possible, see as few people as possible and collect the biggest checks.

AMA needs to decide which one they want to do, as these goals are mutually exclusive.

 

[Octagonecology]

should they be able to actively subvert the care of their health by smoking/drinking/being fat/sitting down all day/getting disability?

This made me laugh out loud. Does anyone else think it's quite ironic that the principal figurehead/mouthpiece of the right wing conservatives is a morbidly obese drug addict who sits down all day?

You can't buy this kind of comedy.

 

[Jeff698]

I joined my first your of medical school but I somewhat regret it now. They are probably the most useless "union" in the world. They do absolutely nothing to further the interests of residents or physicians.

Sigh.

The AMA is NOT A UNION. Or a "union".

Take care,
Jeff

 

[docB]

The AMA isn't a union in that it doesn't collectively bargain for its members in contract talks but it is an advocacy group that is calling for reforms that would benefit its members.

The NEA (National Education Assoc.) is a good example of a trade group with a similar problem. Veers' point is exactly right. You can't simultaneously argue for both sides of the equation.

 

[Hayduke]

"The best thing for doctors is to work as little as possible, see as few people as possible and collect the biggest checks".


I have enjoyed Veers take in the last few threads around the reform debate. He has cogently argued for the opposition to reform. I agree with large chunks of what he has sprayed.

The succinct type-bite quoted above is an exception.
This is my fourth career. It is my third in healthcare.
At 40+ I still believe the "naiive altruism" of my pre-med days. Medicine is one of the few spots in society where you get paid for doing good by people.

I appreciate the sentiment, but fortune or not, this is a job that has a core of putting other folks' interests above your own. I would argue that doing our job of taking care of folks while trying to break into the top 5% of the earners in the US are competing goals.

We are compensated by what our patients' think we are worth. I personally think my doing the deed is worth more than I could ever be paid. Meanwhile, I want a decent house and a good education for my kid. To attain these aims, my bosses (patients) need to know I give a $hit. Subterfuge perhaps for Veers et al. but critical to winning this fight.

 

[Jeff698]

We are compensated by what our patients' think we are worth.

Interesting. Sadly, it isn't true in the US about 99% of the time. It does make me think, though, how well we would be compensated if there were no insurance, like in the true FFS days before WWII.

If each of our patients had to pay, out of pocket, for our care, how much do you think the average EP would bring in a year?

My guess is that it would be significantly less than we make right now. Maybe 80-100K/year. Just a wild guess, though. I'd certainly guess that health care expenditures would dramatically decrease across the board with physicians taking a pretty big cut.

Take care,
Jeff

 

[GeneralVeers]

"The best thing for doctors is to work as little as possible, see as few people as possible and collect the biggest checks".


I have enjoyed Veers take in the last few threads around the reform debate. He has cogently argued for the opposition to reform. I agree with large chunks of what he has sprayed.

The succinct type-bite quoted above is an exception.
This is my fourth career. It is my third in healthcare.
At 40+ I still believe the "naiive altruism" of my pre-med days. Medicine is one of the few spots in society where you get paid for doing good by people.

I appreciate the sentiment, but fortune or not, this is a job that has a core of putting other folks' interests above your own. I would argue that doing our job of taking care of folks while trying to break into the top 5% of the earners in the US are competing goals.

We are compensated by what our patients' think we are worth. I personally think my doing the deed is worth more than I could ever be paid. Meanwhile, I want a decent house and a good education for my kid. To attain these aims, my bosses (patients) need to know I give a $hit. Subterfuge perhaps for Veers et al. but critical to winning this fight.

I was presenting the two opposite ends of the spectrum for patient/doctor goals. As you put it: "I give a $hit", but not at the expense of my own well-being both financial and emotional. My point (although exaggerated) was to demonstrate the two conflicting goals that the AMA tries to pursue. We still have to provide for families, have sufficient vacation, and good enough work environment to continue doing this job. To represent patient interests above all else is to put these things in jeopardy. All you have to do is look at the Joint Commission safety goals to realize that promoting the best interests of patients often harms our ability to care for them.

 

[GeneralVeers]

an we make right now. Maybe 80-100K/year. Just a wild guess, though. I'd certainly guess that health care expenditures would dramatically decrease across the board with physicians taking a pretty big cut.

Take care,
Jeff

Not necessarily. My family were doctors in Niagara Falls, Canada between 1850 and 1960 (when Canada enacted universal Medicare). They were general practitioners, and before Medicare was enacted they were almost entirely FFS. The good thing about FFS is that you can negotiate with the patient up front concerning costs, and their ability to pay. They lived in a large mansion, with servants, and were leading members of society. Sadly when Medicare was enacted in Canada their standard of living went down dramatically.

 

[Octagonecology]

Not necessarily. My family were doctors in Niagara Falls, Canada between 1850 and 1960 (when Canada enacted universal Medicare). They were general practitioners, and before Medicare was enacted they were almost entirely FFS. The good thing about FFS is that you can negotiate with the patient up front concerning costs, and their ability to pay. They lived in a large mansion, with servants, and were leading members of society. Sadly when Medicare was enacted in Canada their standard of living went down dramatically.

So you saying that your family actually had to downgrade to a smaller mansion and reduce their number of servants and the only thing that people got in return was free healthcare? Oh the humanity!!!

 

[GeneralVeers]

So you saying that your family actually had to downgrade to a smaller mansion and reduce their number of servants and the only thing that people got in return was free healthcare? Oh the humanity!!!

Actually they had to downgrade to a regular home and get rid of the servants altogether.

BTW I reject your assertion that the healthcare is free. Compare income tax rates ca. 1900 to income tax rates in the 1970s.

 

[Hayduke]

I was presenting the two opposite ends of the spectrum for patient/doctor goals. As you put it: "I give a $hit", but not at the expense of my own well-being both financial and emotional. My point (although exaggerated) was to demonstrate the two conflicting goals that the AMA tries to pursue. We still have to provide for families, have sufficient vacation, and good enough work environment to continue doing this job. To represent patient interests above all else is to put these things in jeopardy. All you have to do is look at the Joint Commission safety goals to realize that promoting the best interests of patients often harms our ability to care for them.

TRUTH
Well said.

These are the real nutmeats of this debate. I think both you and Jeff are hitting the point that no legislator nor representative body is willing to discuss.

What is a doctor worth vs. what should he be paid?

Unforunately,the AMA is the only entity currently recognized as representing the interest of all docs. We (the represented physicians) realize this is false, but right now they are the only voice we have.

I contribute a lot of coin and a ton of time to national and state ACEP efforts. I believe in the goals of the organization and feel that we work hard to further both physician and patient interests. But ACEP doesn't get face time on Today, NPR or CNN. Only the AMA does that.

Back to the OP, I joined the AMA to have some input in my national megaphone. They may not represent my interest on all issues, but they have carried the torch on my personal windmill of malpractice reform. That alone is worth my dues.

 

[bartleby]

Wherever you stand on the healthcare debate, I think that we all need to acknowledge that we can't afford to do nothing. The expansion in healthcare spending is such that "good years" are those in which there is only single digit growth.

Our "more must be better' attitude in the US drives costs up through increasing utilization. I sprained my knee and want an MRI. Why not? All it costs me is my copay.

What nobody is apparently willing to accept on any side of the debate is that we can do everything (and sometimes too much) for some people or not enough for everybody. Medicare is going to go broke dialyzing 85 year olds with dementia who will never eat a meal, recognize a member of their family, or spend a single day outside of a healthcare institution of some sorts. Then, they will die slow, agonizing deaths in an ICU at the taxpayer's expense.

When you look outside the glossy drug & equipment manufacturing ads, you realize that we spend more to get less than any other industrialized country when it comes to the standard metrics of success. I'm not talking about the wait time for an elective hip replacement... the real story. Infant mortality, life expectancy, etc. Either this gigantic morass of a problem will be dealt with now or the day after medicare's checks start bouncing.

 

[GeneralVeers]

Wherever you stand on the healthcare debate, I think that we all need to acknowledge that we can't afford to do nothing. The expansion in healthcare spending is such that "good years" are those in which there is only single digit growth.
.

That is false logic. While I agree that something PROBABLY should be done to improve our system, doing nothing is by far a more preferable choice to this steaming pile that Congress is trying to pass.

Doing nothing is most often a better alternative than doing something.....if that something is not well-thought-out, rational, or beneficial.

 

[Dimoak]

Until an appropriate middle-ground solution is found, the country will probably continue teetering between socialized and privatized healthcare, because neither extreme can work for long given the socioeconomic and political landscape.

If we endup with a true single-payer system, eventually some of the more "productive" members of society will get fed up with the "quality" of healthcare they're receiving and demand an opportunity to use their capital to purchase improved alternatives for themselves and their families. Entrepreneurs will take advantage of this, and there will be a renewed gradual shift to private healthcare opportunities, with the less financially sound or those unwilling to pay being stuck with the lower quality socialized option.

 

[GeneralVeers]

Until an appropriate middle-ground solution is found, the country will probably continue teetering between socialized and privatized healthcare, because neither extreme can work for long given the socioeconomic and political landscape.

If we endup with a true single-payer system, eventually some of the more "productive" members of society will get fed up with the "quality" of healthcare they're receiving and demand an opportunity to use their capital to purchase improved alternatives for themselves and their families. Entrepreneurs will take advantage of this, and there will be a renewed gradual shift to private healthcare opportunities, with the less financially sound or those unwilling to pay being stuck with the lower quality socialized option.

Wrong. In the healthcare bills currently before Congress there is a provision to get rid of "rich-people health insurance". The more socialist members of Congress have anticipated a migration of the well-to-do towards private insurance plans and they want to stop it.

Buried in the bill is a provision which states that if you change your health plan in any way, you cannot continue coverage and must purchase a "government approved" health plan. The language is vague, but government approved could mean pushing everyone into a public plan, or at the very least private HMOs. The goal is to equalize crappy care for everyone, and prevent well-to-do people from getting better insurance.

I'm sure Europe and Asia would love to have the health dollars of our rich when they get sick and seek better care than they will get in America.

 

[deleted65604]

This made me laugh out loud. Does anyone else think it's quite ironic that the principal figurehead/mouthpiece of the right wing conservatives is a morbidly obese drug addict who sits down all day?

You can't buy this kind of comedy.

Come on, the republican party is not the only source of comedy.

How funny is Pres. Obama talking about the emphasis on spending money on preventative medicine while the most expensive top-notch doctors in the nation can't get his sorry butt to quit smoking.

How about the democratic parties ultimate champion of woman's rights, Hillary Clinton. Her husband cheats on her, lies about it to her, and to the public...

"It depends on what the meaning of the words 'is' is." –Bill Clinton, during his 1998 grand jury testimony on the Monica Lewinsky affair

"It depends on how you define alone…" –Bill Clinton, in his grand jury testimony

"There were a lot of times when we were alone, but I never really thought we were." –Bill Clinton, in his grand jury testimony

"What's a man got to do to get in the top fifty?" –Bill Clinton, reacting to a survey of journalists that ranked the Monica Lewinsky scandal as the 53rd most significant story of the century

So, what does this pillar of feminism do? Does she stand up for woman's rights and divorce the guy? Does she stand up for herself and set an example for feminists everywhere? No, she shakes her head and says, "Boys will be boys."

She even runs for president and sends the schmuck around to campaign for her. I love Mitt Romney's quote on the what he thought of the Clinton campaign.

...the idea of Bill Clinton back in the White House with nothing to do is something I just can't imagine."

 

[deleted65604]

Some of the references in the health care reform legislation that I thought hinted at socialized medicine, single payor, or saying it in another way... providing free healthcare for everyone. (I've included my incredibly non-biased, informative, insightful, and oh, so humble interpretation in normal English)

Promises to extend coverage to all Americans through health insurance market reforms

Yea, market reform... Jarabacoa pays for it

Provides consumers with a choice of plans through a health insurance exchange

Choices for your health care... A. You pay for it B. Jarabacoa pays for it, which would you prefer?

Recognizes that fundamental Medicare reforms, including repeal of the sustainable growth rate formula, are essential to the success of broader health system reforms

My interpretation- sky is the limit, baby, let's spend, spend, spend.

Strengthens the Medicaid program

My interpretation- gives it to the entire freaking population

Requires individuals to have health insurance, and provides premium assistance to those who cannot afford it

My interpretation- again, gives medicaid to EVERYONE

Of course, much like the stimulus package, the actual legislation is so long and so vague and confusing, that in 5 years, there will still be only 0.00001% of our population that has read the thing, 0.000005% of people that presume to know the legal ramifications involved, and 0 people that will have the balls to stand in front of congress and say, "Wait, I haven't read the whole thing, and what I have read is confusing. Who wrote this thing, and what did you really mean to say?"

 

[Old_Mil]

If we endup with a true single-payer system, eventually some of the more "productive" members of society will get fed up with the "quality" of healthcare they're receiving and demand an opportunity to use their capital to purchase improved alternatives for themselves and their families. Entrepreneurs will take advantage of this, and there will be a renewed gradual shift to private healthcare opportunities, with the less financially sound or those unwilling to pay being stuck with the lower quality socialized option.

The problem is that in the 2 or 3 generations it will take for this to happen, the amount of human suffering at the hands of government bureaucrats can really add up.

 

[GeneralVeers]

The problem is that in the 2 or 3 generations it will take for this to happen, the amount of human suffering at the hands of government bureaucrats can really add up.

Obama says you are wrong. He's going to "bend the cost curve", "keep them honest", "pay for all reforms", and "let you keep your own insurance".

He's apparently very intelligent, educated, and well-spoken, so who are we to question him? He's obviously come across some successful healthcare formula that no one's tried before, and no one else knows about.

 

[Dimoak]

Wrong. In the healthcare bills currently before Congress there is a provision to get rid of "rich-people health insurance". The more socialist members of Congress have anticipated a migration of the well-to-do towards private insurance plans and they want to stop it.

Buried in the bill is a provision which states that if you change your health plan in any way, you cannot continue coverage and must purchase a "government approved" health plan. The language is vague, but government approved could mean pushing everyone into a public plan, or at the very least private HMOs. The goal is to equalize crappy care for everyone, and prevent well-to-do people from getting better insurance.

I'm sure Europe and Asia would love to have the health dollars of our rich when they get sick and seek better care than they will get in America.

How exactly is anything that I wrote "wrong"? The desire of the "well-to-do" to purchase better health insurance than the government alternatives will occur. My point was that if they are not allowed to do so, even if the government adds wording to that extent to the law, they will still find a way to achieve a superior alternative. If there will be enough public demand for a private option, the politicians will easily oblige and change the law provided that's where the popular vote will be.

 

[GeneralVeers]

How exactly is anything that I wrote "wrong"? The desire of the "well-to-do" to purchase better health insurance than the government alternatives will occur. My point was that if they are not allowed to do so, even if the government adds wording to that extent to the law, they will still find a way to achieve a superior alternative. If there will be enough public demand for a private option, the politicians will easily oblige and change the law provided that's where the popular vote will be.

You aren't wrong in your assertion that the rich will pay to get better healthcare.

It seems like the agenda has been set by the wing of the Democrats who are to the left of crazy who believe the following things:

1. That healthcare is a "right"
2. That everyone should have equal access to healthcare
3. No one should get better care than anyone else
4. Rich people must be bilked for as much as possible.

As a person in the top 1% of earners, they are going to try to stop you in every way possible from obtaining insurance that isn't "government approved".

 

[bartleby]

News flash: all insurance is regulated and government approved. The only difference is whether a private company or medicare is running the plan.

So let's keep everything just they way it is, because everything's perfect, right?

Some of your attitudes about the uninsured would be somewhat justified if there were 2 million people uninsured only because they were able bodied people who refused to work. There are millions of people who work one or even two jobs and still don't have insurance and will never be able to afford paying for it privately. So to suggest that people who do not have some entitlement to insurance through their employer has some sort of defect in their moral fiber is erroneous.

I did not spend 12 years of my life in higher education to become a glorified plumber. I feel a moral duty to care for people. I'm not a "sorry your sink's backed up, but if you don't have 250 bucks on you, fix it yourself" kind of guy. If you don't believe that there is some fundamental human right to basic healthcare at this point in your life, nobody is going to convince you otherwise. But to suggest that the belief in a right to healthcare is some sort of extreme leftist view is a gross misstatement.

You aren't wrong in your assertion that the rich will pay to get better healthcare.

It seems like the agenda has been set by the wing of the Democrats who are to the left of crazy who believe the following things:

1. That healthcare is a "right"
2. That everyone should have equal access to healthcare
3. No one should get better care than anyone else
4. Rich people must be bilked for as much as possible.

As a person in the top 1% of earners, they are going to try to stop you in every way possible from obtaining insurance that isn't "government approved".

 

[deleted65604]

Some great ideas and insights from the enemy of all democrats. OK, so he is pretty adamant, but that is just bluster. He really does have some good insights into the healthcare debate:

http://gretawire.blogs.foxnews.com/2009/07/24/rush-limbaugh-part-1/

 

[GeneralVeers]

News flash: all insurance is regulated and government approved. The only difference is whether a private company or medicare is running the plan.

All insurance is government regulated, not necessarily "approved". They are going to take regulation one step further, and it's been the stated goal of Democrats to reduce private health care consumption by eliminating PPOs and putting everyone into managed care plans. By putting into law a necessity for an "approved" plan, the government can very easily dictate how much healthcare YOU consume, and how much insurance you can buy.

So let's keep everything just they way it is, because everything's perfect, right?

I don't believe I've ever said that. There are problems that need to be addressed, however doing "nothing" is preferable to doing something disastrous. If the problem really is the uninsured, why don't they start by addressing that problem (i.e. covering the 20 million who legitimately don't have insurance), rather than putting 1/6 of the U.S. economy under government control.

Some of your attitudes about the uninsured would be somewhat justified if there were 2 million people uninsured only because they were able bodied people who refused to work. There are millions of people who work one or even two jobs and still don't have insurance and will never be able to afford paying for it privately. So to suggest that people who do not have some entitlement to insurance through their employer has some sort of defect in their moral fiber is erroneous.

I agree with you there, however the "public option" is going to amount to a welfare handout. It is not insurance. Welfare should be limited, targeted, and people should have incentives to get off of it and provide for themselves. I'd much rather give people a large tax incentive to buy their own insurance, than to give them another government welfare program.

I did not spend 12 years of my life in higher education to become a glorified plumber. I feel a moral duty to care for people. I'm not a "sorry your sink's backed up, but if you don't have 250 bucks on you, fix it yourself" kind of guy. If you don't believe that there is some fundamental human right to basic healthcare at this point in your life, nobody is going to convince you otherwise. But to suggest that the belief in a right to healthcare is some sort of extreme leftist view is a gross misstatement.

I don't disagree with you there (well except the healthcare right part), but I also didn't spend 11 years of my life training in order to become an indentured servant. I racked up an enormous amount of medical school debt, work long hours at a stressful job, and I expect to be well compensated. I don't think there's anything wrong with that.

The big problem I have with blanketly covering everyone, is we have completely taken away any patient responsibility. You're a 400-lb diabetic who's unemployed? Great, the government will provide everything for you. There is no incentive for you to lose weight, get a job or control your diabetes. When something breaks, you can come into the hospital and your "free" insurance will pick up the tab at taxpayers' expense.

Another question for you: If you think healthcare is a right, can you define it? Does everyone have the right to basic healthcare, or equal healthcare? If you have no insurance and are poor and get cancer do you have the "right" to go to MD Anderson and receive millions of dollars in free state-of-the-art cancer therapy, or does your "right" simply cover you to go to your local hospital for routine therapy? If it's a "right" and you come in demanding an MRI for your chronic back pain, am I infringing upon your rights if I decline to provide it to you?

This is the difference between healthcare "rights" and other rights afforded to you under the constitution. The Constitution spells out things that the government may not take away from you (speech, guns, legal rights, etc). It doesn't provide you with free material goods like food, housing, clothing etc. You cannot make something a right which involves the transfer of goods/services to another person. As I outlined above, when you start doing this, at what point does the right to free goods/services begin and end?

 

[seelee]

This made me laugh out loud. Does anyone else think it's quite ironic that the principal figurehead/mouthpiece of the right wing conservatives is a morbidly obese drug addict who sits down all day?

You can't buy this kind of comedy.

Who cares if Rush is a fat smoker as long as he pays for his own health care. Rush pays for all his own health care out of pocket. As long as he doesn't come to me asking for money to pay for his doctor bills, he can do whatever he wants.

And just so you know, Rush is no long addicted to prescription pain killers, and he has lost quite a bit of weight.

 

[GeneralVeers]

Who cares if Rush is a fat smoker as long as he pays for his own health care. Rush pays for all his own health care out of pocket. As long as he doesn't come to me asking for money to pay for his doctor bills, he can do whatever he wants.

And just so you know, Rush is no long addicted to prescription pain killers, and he has lost quite a bit of weight.

I agree with what you said. Rush is irrelevant to me, and doesn't speak for most conservatives.

The majority of health problems we see: heart disease, diabetes, high blood pressure, CHF, and COPD are due primarily to lifestyle choices. Most of these are caused (or exacerbated) by smoking and obesity, two risk factors that are clearly modifiable. I'm still not sure why I should be forced to pay for the lifestyle choices of others.

Rush can do as he pleases. He can smoke crack cocaine for all I care, so long as he picks up the tab for his medical bills.

 

[Old_Mil]

So let's keep everything just they way it is, because everything's perfect, right?

No, let's keep everything just the way it is because there's a whole lot more room to make things worse than there is for improvement.

 

[GeneralVeers]

No, let's keep everything just the way it is because there's a whole lot more room to make things worse than there is for improvement.

That's correct, at least with the current plan.

The current plan will:

- Increase spending
- Increase costs
- Increase the deficit
- Reduce quality of care
- Reduce doctor/patient autonomy

Still leave 8 million uninsured. This is not my opinion, all of this is according to the CBO estimates.

 

[Cerberus]

Sigh.

The AMA is NOT A UNION. Or a "union".

Take care,
Jeff

I am fully aware that the AMA is not a union in the sense that the Steelworkers Union is a union. Nonetheless, the AMA is suppossed to be the association speaking on befalf of physicians and advocating for us (something they fail at miserably). The AMA is slow, if ever, to act and when it finally does, it is usually meak and mild.

 

[Dimoak]

I'm not an expert on the matter, but for whatever it's worth, my 10¢ is that if the AMA was going to budge on Obama's healthcare, they shouldn't have let him cast away meaningful malpractice tort reform so easily. Healthcare reform isn't an individual sport, so why should physicians have to take the hardest hit "for the team"? Politicians shouldn't be able to tout European or Canadian style healthcare without including European or Canadian style lawsuit caps and educational costs.

 

[Jeff698]

So, here's the real skinny on how the AMA, by specialty, feels.

(I can't believe I'm actually posting this... from my mother no less):

The Allergists voted to scratch it, but . . .
The Dermatologists advised not to make any rash moves.
The Gastroenterologists had sort of a gut feeling about it, but . . .
The Neurologists thought the Administration had a lot of nerve.
The Obstetricians felt everyone was laboring under a misconception.
Ophthalmologists considered the idea shortsighted.
Pathologists yelled, "Over my dead body!"
while the Pediatricians said, 'Oh, Grow up!'
The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.
Surgeons decided to wash their hands of the whole thing.
The Internists thought it was a bitter pill to swallow, and the Plastic Surgeons said, "This puts a whole new face on the matter."
The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea.
The Anesthesiologists thought the whole idea was a gas, and the Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the a**oles in Washington.

Take care,
Jeff

BTW, since I'm in a tired, post-shift bout of intractable silliness:

The CDC has recommended that we become proficient at differentiating Avian flu from Swine flu as the management is different.

Avian flu needs a tweetment and swine flu needs an ointment.

I'm SO going to regret posting these after I've had some sleep.

 

[dchristismi]

OINKment, Jeff, OINKment!

😀😉😍