For whom are you voting???

[Crosnmafingers]

Hey everyone. I thought I'd open the discussion, since we're all so focused on the applications/interviews and could use the welcome diversion

Of course, we're all concerned about stances on healthcare and how it will impact us as physicians (and if honing further down is possible, specifically as cardiologists). I've been an "independent" in the past, voting for different candidates for different reasons, not really sticking to a party line.

But I think this election's different... Because the two party positions will be almost completely opposite in so many important ways...and because my career is approaching complete definition.

So, I'd like to focus the discussion on healthcare and the ramifications of each potential candidate on our future. A few questions to start the discussion that I thought of watching the debate tonight:

-Could Hillary's $110 billion healthcare plan be paid for by rolling back a tax cut on the richest Americans and optimizing the resultant efficiencies of a universal system? Is "universal" healthcare even efficient at all?

-Could Barack's $50 billion healthcare plan be paid for by rolling back a tax cut on the richest Americans? Would "all" people purchase healthcare if given a cheap choice? Does his plan introduce further burden on tax-payers when those who choose not to purchase end up utilizing the most resources?

-Are the days of $300K Cardiologists numbered if the Dems end up winning this election?

Discuss

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[muscles]

I have to think that reimbursement rates will decline dramatically if a socialized/universal care plan is implemented. Many people who trained back in the 90's have explained to me that the Clinton plan threatened to severely lower the payscale, resulting in a short period of time where specialties like interventional radiology were very non-competitive. However, once the Clinton plan fell through the cracks, radiology became competitive again when physicians found out they could work 6 hours a day and still haul in $800,000 yearly.

Secondly, back in the 90's, insurance companies and other large interest groups were able to shut the Clinton plan down dead in its tracks, not to mention that the plan was incredibly complex. I wonder if, should Hillary or Barack win in '08, if these companies will be able to do the same thing all over again. If the democratic party takes more seats in congress, universal care may have a better chance of passing - and it appears they may. Apparently, 28 republicans are retiring from the House at the end of this year, and 6 republicans are retiring from the senate. It is doubtful that the republican party will be able to hold on to all 34 seats.

Thirdly, another interesting topic is whether the government should even interfere with health care. Has government today not become much larger and more expansive than the original founders intended? After all, there was once a term called "limited government" that, as of late, has seemingly become obsolete, as the government advances on more and more aspects of society. Alternatively, some argue that healthcare is an inherent right for all to enjoy.

I personally don't like the idea of universal healthcare. I don't think that the system would improve by any means with more government involvement; I think that systems should be in place to enable the common man who wants to improve his situation, but I do not believe the government should be an ever-present safety net that saves people who are unwilling to work for themselves - as an example, why should the government intervene on the foreclosure crisis - I believe people should not engage in contracts when they know they cannot fulfill their end of the bargain, and expect the government to save them anyway. Similarly, in my part of the country, there is a large indigent population and my observation has been that the majority of people clearly could improve their own situation and obtain healthcare for themselves, IF they would apply themselves.

I imagine these comments will draw some controversy, but I think it is an interesting debate and hope to hear testimonies from other health professionals.

 

[cardsboy08]

Agree with muscles. There are many problems inherent to expectations of the current system that would make any univresal health care system fall apart. First off, the money has to come from somewhere, and this will either be from decreasing physician reimbursement, in particular for procedural specialties, increasing taxes, or removing other programs whether social or military programs. There needs to be a revamping also of the "higher end" of care. For example, is paying for a 80 year old guy's chemo to gain 2-3 weeks of life that will likely be spent in the hospital worth the social costs?

Any decision to pursue universal health care has to be paid for somehow, and despite what we think there is a pretty good number of people that thinks doctors are just super-rich businessmen looking to make a buck. I think most Democrat plans would somehow involve significant cuts in physician reimbursement.

I think there's a problem that needs to get fixed. However, I don't think anybody is willing to voice all the issues that come up. It's easy to say "healthcare for everyone" but the realities of implementing it especially in our medical culture are rarely considered by Republicans or Democrats.