Here we go again

[MarzMD]

c'mon 3% isn't going to break anybody's bottom line. Drive the camry for a few more years before picking up the new lexus and let more children/single mothers have access to healthcare.

additionally, I think I read somewhere that the 3% isn't off revenues I thought it was off net income, but I don't remember...

This is exactly the kind of thinking that allows politicians to keep crapping on doctors. Maybe 3 percent isnt a lot, but that is not the point. The point is that they are going to keep doing this if we allow them to.

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[emtji]

This is exactly the kind of thinking that allows politicians to keep crapping on doctors. Maybe 3 percent isnt a lot, but that is not the point. The point is that they are going to keep doing this if we allow them to.

what i think will ultimately happen:
- more states will end up moving in this direction.
- physicians ultimately get aggravated and people stop accepting univ health care/medicare/medicaid (depending on when this happens)
- physicians ultimately strike. govt declares strike illegal and fine unions (cheaper than physician tax= money saved!) or throw us in jail (good luck getting healthcare outside of the county jail...also, thanks for the free food and clothes).


over the long term:
interest in medicine decreases. *quality* applicants to medicine decreases. people start dying at the hands of less than competent docs.


honestly, what we need to fix the problem:
1. govt subsidies for farmers growing healthier foods; taxes on the alcohol/cigarette/nutritionless food makers
2. an age limit to the ICU. so tired of seeing all these pointless admissions for the 400 pound trach/PEG with decubs bigger than my head.

 

[turkleton]

We should follow the example of the dentists.

Don't accept medicare and squash any midlevel encroachments.

Being a physician these days is like death by a thousand cuts.

We have a far great social responsibility than dentists and can't in good conscience assimilate their way of practicing into ours. The unique problem with our field is walking that razor thin swords edge between social obligation and professional survival, which some people evidently are hell bent on disrupting.

This law is beyond preposterous. You're taxing the service provider to increase funds to allow for more services rendered?? Just save everyone paperwork and ask physicians to see people for free. Its a damn shame that the image of physicians our generation inherited- not the saintly 50's era doctor, but the 80's era greedy MD- combined with ignorance or disinterest at the nature of our training has generated the right environment forsingling out doctors to tax.

The problem is this a no win situation for us. Like the surgeons of WVa who went on strike a few years back, showing backbone for principle will be met with public outrage- abandonment of a huge responsibility by wealthy doctors seeking to protect their status. You accept the tax, the public will forget, and you're pretty much indicated you're ready to bend over again anytime medicare needs money.
As for the Camry and Lexus argument... fine, I'll do that... so long as everyone else does. By the time I'm finished with my training I'll have spent a full decade after college to become independent physician. I have friends on Wall Street ready to pack it in by then. Save me the sob story that my income at the point is the reason others aren't getting their health care. Last year Goldman handed out 36 billion dollars in bonuses. BONUSES. I don't hear anyone asking them to bear any of this social responsibility.

 

[CoolerTHANu]

what i think will ultimately happen:
- more states will end up moving in this direction.
- physicians ultimately get aggravated and people stop accepting univ health care/medicare/medicaid (depending on when this happens)
- physicians ultimately strike. govt declares strike illegal and fine unions (cheaper than physician tax= money saved!) or throw us in jail (good luck getting healthcare outside of the county jail...also, thanks for the free food and clothes).


over the long term:
interest in medicine decreases. *quality* applicants to medicine decreases. people start dying at the hands of less than competent docs.


honestly, what we need to fix the problem:
1. govt subsidies for farmers growing healthier foods; taxes on the alcohol/cigarette/nutritionless food makers
2. an age limit to the ICU. so tired of seeing all these pointless admissions for the 400 pound trach/PEG with decubs bigger than my head.

I'm pretty sure part of the plan is that to practice in the state you HAVE to accept Medi-Cal patients too

 

[sirus_virus]

Courtesy of CoolerTHANu
"c'mon 3% isn't going to break anybody's bottom line. Drive the camry for a few more years before picking up the new lexus and let more children/single mothers have access to healthcare."



It is statements like this that make me thank the lord jehovah I had the wisdom to get an MBA before entering medschool. The quicker I get on the business/ownership side of medicine the better for me. No way I am hanging out with guys like this. I'd rather be the one handing you your much deserved paycuts in the name of providing for "children/single mothers".

 

[Noeljan]

 

[Noeljan]

If you guys want to send how you feel about this,
email [email protected]
I find it funny the same politicians hounding doctors well deserved (probably should make more) salary have more money in a year than most doctors make in a lifetime. I am starting medical school this fall, and reading/hearing all this stuff about how powerless physicians have become make me worry. I am going to be one of those people who stand up for physicians rights!

 

[78222]

Why doesn't the AMA have any backbone and what can be done to force them to take charge? Is it going to take a new organization that is actually willing to stand up for physicians?

 

[deleted77919]

3% absolutely is a lot if it is taken off revenues, rather than profit. Do you have any idea how high the overhead is for physicians providing chemotherapy? They have to charge a lot beause the drugs cost a lot. Now imagine paying an extra 3% off that . . . it's possible that could run you out of business.

 

[deleted77919]

"physicians ultimately get aggravated and people stop accepting univ health care/medicare/medicaid (depending on when this happens)"

The problem is these taxes that have been proposed are on revenues whether or not you accept the state insurance patients.

 

[78222]

c'mon 3% isn't going to break anybody's bottom line. Drive the camry for a few more years before picking up the new lexus and let more children/single mothers have access to healthcare.

additionally, I think I read somewhere that the 3% isn't off revenues I thought it was off net income, but I don't remember...

First off, 3% is a significant sum of money. Try telling any corporation you are going to start taxing 3% of their revenue and see how they take it.

Second, there is ABSOLUTELY no reason the tax should be collected from the provider in the first place. If anyone should be paying an increased tax burden, it should be the recipients. Of course, in our current tax structure, most of the recipients of government funding healthcare pay absolutely nothing into the system to begin with. I have as much sympathy for the poor as anyone else and will focus on serving them - isn't that enough? Why should someone who is already taking a paycut by treating the poor, have an additional tax levied against them????? This is like taxing the soldiers extra to pay for the war in Iraq.

 

[Divine Furor]

Here's 2 cents, you can feel free to deduct 3%....

I have to say, nothing could sound more appalling than organizing a reactive response to this type of legislation than strikes. What century is this? Are we some skilled labor force in a corporation, are we in danger of confusing a lifestyle benefit for standard of living? Come on people, we are among the most highly educated, highly trained, highly skilled professionals in the history of all civilization, and the best emotional response we can muster is walking out on patient care under a Republican legislation? The ethical implications alone are disturbing. Does anyone remember that Hippocrates and his fellow founders did not charge for every case? That the idea of a physician taking money for every service rendered is, by all account, totally modern and problematic?

What I haven't read in any of these responses is the recognition that physicians have to start taking active political responsibility for legislative caps. That means no grousing after-the-fact, no forum board snarking, no threatening letters to politicians....that means grassroots community awareness and organizing. Taking time to learn how lobbying works, how politics actually operates, how to combat congress with deeds, not words. Unite the vote and the manpower...even if it sounds blase and cheesy...it's the only way. Indignant self-righteousness carries no real power, just media attention. Healthcare reform rests in our hands, and yes, in that IQ 80 voting block who only see that physicians make a fortune at the expense of their insurance costs....and NO ONE is giving them accurate, simple information about where their money is really going. If you can understand physio, I bet you can learn about taxes and political science.

But positivity is key...you can't approach learning politics or lobbying from the seat of rage and self-aggrandizement. It just doesn't work. Your patients are your voting block, not just the AMA. We have no business isolating the problem of healthcare just within people we "think" can understand what we're talking about....everyone needs ALL the information.

I think an M.D. can mean political power, but not if it's spent furthering the gulf between an educated professional, a semi-educated legislator, and the uneducated public.

 

[sirus_virus]

Here's 2 cents, you can feel free to deduct 3%....

I have to say, nothing could sound more appalling than organizing a reactive response to this type of legislation than strikes. What century is this? Are we some skilled labor force in a corporation, are we in danger of confusing a lifestyle benefit for standard of living? Come on people, we are among the most highly educated, highly trained, highly skilled professionals in the history of all civilization, and the best emotional response we can muster is walking out on patient care under a Republican legislation? The ethical implications alone are disturbing. Does anyone remember that Hippocrates and his fellow founders did not charge for every case? That the idea of a physician taking money for every service rendered is, by all account, totally modern and problematic?
What I haven't read in any of these responses is the recognition that physicians have to start taking active political responsibility for legislative caps. That means no grousing after-the-fact, no forum board snarking, no threatening letters to politicians....that means grassroots community awareness and organizing. Taking time to learn how lobbying works, how politics actually operates, how to combat congress with deeds, not words. Unite the vote and the manpower...even if it sounds blase and cheesy...it's the only way. Indignant self-righteousness carries no real power, just media attention. Healthcare reform rests in our hands, and yes, in that IQ 80 voting block who only see that physicians make a fortune at the expense of their insurance costs....and NO ONE is giving them accurate, simple information about where their money is really going. If you can understand physio, I bet you can learn about taxes and political science.

But positivity is key...you can't approach learning politics or lobbying from the seat of rage and self-aggrandizement. It just doesn't work. Your patients are your voting block, not just the AMA. We have no business isolating the problem of healthcare just within people we "think" can understand what we're talking about....everyone needs ALL the information.

I think an M.D. can mean political power, but not if it's spent furthering the gulf between an educated professional, a semi-educated legislator, and the uneducated public.

So is the idea of being in huge debt and getting your ass sued consistentlly by patients.

 

[78222]

Here's 2 cents, you can feel free to deduct 3%....

I have to say, nothing could sound more appalling than organizing a reactive response to this type of legislation than strikes. What century is this? Are we some skilled labor force in a corporation, are we in danger of confusing a lifestyle benefit for standard of living? Come on people, we are among the most highly educated, highly trained, highly skilled professionals in the history of all civilization, and the best emotional response we can muster is walking out on patient care under a Republican legislation? The ethical implications alone are disturbing. Does anyone remember that Hippocrates and his fellow founders did not charge for every case? That the idea of a physician taking money for every service rendered is, by all account, totally modern and problematic?

What I haven't read in any of these responses is the recognition that physicians have to start taking active political responsibility for legislative caps. That means no grousing after-the-fact, no forum board snarking, no threatening letters to politicians....that means grassroots community awareness and organizing. Taking time to learn how lobbying works, how politics actually operates, how to combat congress with deeds, not words. Unite the vote and the manpower...even if it sounds blase and cheesy...it's the only way. Indignant self-righteousness carries no real power, just media attention. Healthcare reform rests in our hands, and yes, in that IQ 80 voting block who only see that physicians make a fortune at the expense of their insurance costs....and NO ONE is giving them accurate, simple information about where their money is really going. If you can understand physio, I bet you can learn about taxes and political science.

But positivity is key...you can't approach learning politics or lobbying from the seat of rage and self-aggrandizement. It just doesn't work. Your patients are your voting block, not just the AMA. We have no business isolating the problem of healthcare just within people we "think" can understand what we're talking about....everyone needs ALL the information.

I think an M.D. can mean political power, but not if it's spent furthering the gulf between an educated professional, a semi-educated legislator, and the uneducated public.

There is a difference between willingly offering your service as a charity, and being forced to give up your income. The latter will only decrease access to care as fewer physicians are willing to work in these areas or with groups of people that can't provide insurance that will actually reimburse physicians. The problem with medical school is they don't teach you any business sense and like it or not, medicine is a business.

We are among the most highly educated, highly essential workforce in the US - why shouldn't we demand compensation for that? We are also the most heavily indebted and heavily worked.

Striking should never be taken off the table, if we give up our right to strike, we give up the only leverage we have. German, British, and Israeli doctors have all striked in the past, and this hasn't led to the collapse of their societies. We can't assume that politicians, catering to the lowest common denominator of society will do what is right for physicians or whats right for our patients. Taxing us isn't going to do a damn bit of good for our patients and its going to significantly hurt those who are in the lower paying fields.

And if you think doctors are going to get some grassroots movement to protect us, you are insane. First, most of the voting population views us as rich. Second, its hard to really get into an issue that doesn't affect you. Third, doctors aren't college kids, we don't have the time to go out and organize a "Grassroots" campaign. Fourth, you don't see corporations protecting themselves via grassroots campaigns - you see it done by heavy lobbying and having leverage over government.

 

[Noeljan]

So is the idea of being in huge debt and getting your ass sued consistentlly by patients.

 

[Noeljan]

Here's 2 cents, you can feel free to deduct 3%....

I have to say, nothing could sound more appalling than organizing a reactive response to this type of legislation than strikes. What century is this? Are we some skilled labor force in a corporation, are we in danger of confusing a lifestyle benefit for standard of living? Come on people, we are among the most highly educated, highly trained, highly skilled professionals in the history of all civilization, and the best emotional response we can muster is walking out on patient care under a Republican legislation? The ethical implications alone are disturbing. Does anyone remember that Hippocrates and his fellow founders did not charge for every case? That the idea of a physician taking money for every service rendered is, by all account, totally modern and problematic?

What I haven't read in any of these responses is the recognition that physicians have to start taking active political responsibility for legislative caps. That means no grousing after-the-fact, no forum board snarking, no threatening letters to politicians....that means grassroots community awareness and organizing. Taking time to learn how lobbying works, how politics actually operates, how to combat congress with deeds, not words. Unite the vote and the manpower...even if it sounds blase and cheesy...it's the only way. Indignant self-righteousness carries no real power, just media attention. Healthcare reform rests in our hands, and yes, in that IQ 80 voting block who only see that physicians make a fortune at the expense of their insurance costs....and NO ONE is giving them accurate, simple information about where their money is really going. If you can understand physio, I bet you can learn about taxes and political science.

But positivity is key...you can't approach learning politics or lobbying from the seat of rage and self-aggrandizement. It just doesn't work. Your patients are your voting block, not just the AMA. We have no business isolating the problem of healthcare just within people we "think" can understand what we're talking about....everyone needs ALL the information.

I think an M.D. can mean political power, but not if it's spent furthering the gulf between an educated professional, a semi-educated legislator, and the uneducated public.

You have got to be kidding me. So basically, doctors should go into huge amount of debt while in school, work 48 hour shifts during internship without time to even eat. Strive to be the best while constantly keeping up with new material, and have the constant fear of being sued by most people who don't even take care of themselves, not get paid? You have got to be joking. Oh and btw in the times you quote doctors had a much higher status/respect in society. Also, did not have to deal with patients who were never happy and could sue at the drop of a hat, etc. I am not a doctor yet, but I am friends with plenty of doctors and been around enough to know, I will fight for physicians rights as much as possible. We need to start getting people more involved in this.
I am all for helping others, heck I come from a poor background myself, but I am unwilling to be a slave. Let me tell you something though, the people I grew up around could not even comprehend the hard work and sacrifice it takes to become a physician. Many people cheat the system, and get tons of free things, when people who try to work and make a little bit are the ones who actually get screwed. If you have more questions about what I am trying to say just PM me.
Another thing, most people seem to have this idea that doctors are as rich as people in Hollywood. It is insane. None of the doctors I know make anywhere close.

 

[sirus_virus]

Dear Hippocrates,

If you can here me out there, I need you to wake up from your grave and come get a taste of modern day medical training. We actually use something called text-books these days, no more one page scrolls. Feel free to do us the honors of taking USMLE step 1 while you are here, and I must warn you that there is stuff called Immunology, genetics, pharmacology and pathology on this test, which might come as a shock to you, being as your entire medical knowledge comprises of 7 diseases and 1 anti-biotic.

Another thing that might shock the hell out of you is that you cannot do that whole "free" medical service thing you used to do without what we call malpractice insurance, which costs money. Also, don't think that just because you are Hippocrates and offering free service, that you will not get sued. If you make a mistake, it's your ass, and by 'ass', I mean it in every sense of the word, as some mistakes could actually land you in jail where funny things could happen to your ass. I am not going to talk about residency which I will like to leave as a pleasant surprise.

Now, when you are done, you can take your oath back to your grave and I don't ever want to hear from you or the hypnotized zombies your oath has produced.

 

[Divine Furor]

You have got to be kidding me. So basically, doctors should go into huge amount of debt while in school, work 48 hour shifts during internship without time to even eat. Strive to be the best while constantly keeping up with new material, and have the constant fear of being sued by most people who don't even take care of themselves, not get paid? You have got to be joking. Oh and btw in the times you quote doctors had a much higher status/respect in society. Also, did not have to deal with patients who were never happy and could sue at the drop of a hat, etc. I am not a doctor yet, but I am friends with plenty of doctors and been around enough to know, I will fight for physicians rights as much as possible. We need to start getting people more involved in this.
I am all for helping others, heck I come from a poor background myself, but I am unwilling to be a slave. Let me tell you something though, the people I grew up around could not even comprehend the hard work and sacrifice it takes to become a physician. Many people cheat the system, and get tons of free things, when people who try to work and make a little bit are the ones who actually get screwed. If you have more questions about what I am trying to say just PM me.
Another thing, most people seem to have this idea that doctors are as rich as people in Hollywood. It is insane. None of the doctors I know make anywhere close.

You just made my point a little. And I am neither "joking" nor "insane"...but my tone was idealistic and aggressive and I can understand a little below the belt fire-back. I'm not arguing that physicians should not be well compensated, nor that we should be enslaved by legislation...in fact I'm saying the opposite on that second point. I just think the approach is too mired in a sense of earned entitlement and anger, as opposed to clear-headed work on behalf of changing how communities that vote understand the issues they're voting on...and that has to come with additional effort above and beyond the natural attitude that "this is wrong, we should be paid more."

And as for the comment that we're med students and therefore don't have time to be organizing movements...well, tough then. If you can't get politically involved, even with the rigor of medical school, then you willingly forfeit your right to a political voice. Sorry. Those are just the facts.

Noeljan, I'd be happy to continue this discussion and hear your perspective. I also know a thing or two about the immense sacrifice involved in medicine, and I'm about to do it for myself. I'm sure you could enlighten my idealism, and I mean that sincerely. I just don't agree at this time that the obviously enormous economic and personal sacrifice medical students make to become doctors=entitlement to best wages and maximum protection under the law. That implies a causal connection that the voting public does not understand well enough and in a sense, must be proven through true community activism and information transfer.

 

[Divine Furor]

Dear Hippocrates,

If you can here me out there, I need you to wake up from your grave and come get a taste of modern day medical training. We actually use something called text-books these days, no more one page scrolls. Feel free to do us the honors of taking USMLE step 1 while you are here, and I must warn you that there is stuff called Immunology, genetics, pharmacology and pathology on this test, which might come as a shock to you, being as your entire medical knowledge comprises of 7 diseases and 1 anti-biotic.

Another thing that might shock the hell out of you is that you cannot do that whole "free" medical service thing you used to do without what we call malpractice insurance, which costs money. Also, don't think that just because you are Hippocrates and offering free service, that you will not get sued. If you make a mistake, it's your ass, and by 'ass', I mean it in every sense of the word, as some mistakes could actually land you in jail where funny things could happen to your ass. I am not going to talk about residency which I will like to leave as a pleasant surprise.

Now, when you are done, you can take your oath back to your grave and I don't ever want to hear from you or the hypnotized zombies your oath has produced.

Okay, virulent rage...that's fine. What would you suggest should be our medical ethic ideals, then? What would you suggest as a solution to the disparity between the goal of medicine and its realities? How about a positive spin?

 

[78222]

[/B] And as for the comment that we're med students and therefore don't have time to be organizing movements...well, tough then. If you can't get politically involved, even with the rigor of medical school, then you willingly forfeit your right to a political voice. Sorry. Those are just the facts.

Bollocks. That is why we have lobbying bodies such as the AMA. Grassroots movements are usually ineffective. The only way a grassroots movement will get anywhere is if it actually pulls in large numbers of the populace. That simply isn't going to happen with our situation. Besides, as bad as it may seem, we don't need the populace as long as we have the politicians. Look at the world in which we live. It is the corporate lobbyists who are getting their way - usually at the expense of everyone else.

 

[78222]

Okay, virulent rage...that's fine. What would you suggest should be our medical ethic ideals, then? What would you suggest as a solution to the disparity between the goal of medicine and its realities? How about a positive spin?

Reality and idealistic notions rarely coexist. Pragmatism is the ethics of a society that wants actual solutions to its problems.

 

[dutchman]

[/B]

You just made my point a little. And I am neither "joking" nor "insane"...but my tone was idealistic and aggressive and I can understand a little below the belt fire-back. I'm not arguing that physicians should not be well compensated, nor that we should be enslaved by legislation...in fact I'm saying the opposite on that second point. I just think the approach is too mired in a sense of earned entitlement and anger, as opposed to clear-headed work on behalf of changing how communities that vote understand the issues they're voting on...and that has to come with additional effort above and beyond the natural attitude that "this is wrong, we should be paid more."

And as for the comment that we're med students and therefore don't have time to be organizing movements...well, tough then. If you can't get politically involved, even with the rigor of medical school, then you willingly forfeit your right to a political voice. Sorry. Those are just the facts.

Noeljan, I'd be happy to continue this discussion and hear your perspective. I also know a thing or two about the immense sacrifice involved in medicine, and I'm about to do it for myself. I'm sure you could enlighten my idealism, and I mean that sincerely. I just don't agree at this time that the obviously enormous economic and personal sacrifice medical students make to become doctors=entitlement to best wages and maximum protection under the law. That implies a causal connection that the voting public does not understand well enough and in a sense, must be proven through true community activism and information transfer.

Yeah, I can just see you going to the grassroots and telling them how their free health insurance that you are expeted to pay for is bad for them. Look, for as long as you guys do not recognise that the only people that give a rats ass about physicians are physicians themselves, you will continue to get beatdown.

 

[snoozer]

[/b]

You just made my point a little. And I am neither "joking" nor "insane"...but my tone was idealistic and aggressive and I can understand a little below the belt fire-back. I'm not arguing that physicians should not be well compensated, nor that we should be enslaved by legislation...in fact I'm saying the opposite on that second point. I just think the approach is too mired in a sense of earned entitlement and anger, as opposed to clear-headed work on behalf of changing how communities that vote understand the issues they're voting on...and that has to come with additional effort above and beyond the natural attitude that "this is wrong, we should be paid more."

And as for the comment that we're med students and therefore don't have time to be organizing movements...well, tough then. If you can't get politically involved, even with the rigor of medical school, then you willingly forfeit your right to a political voice. Sorry. Those are just the facts.

Noeljan, I'd be happy to continue this discussion and hear your perspective. I also know a thing or two about the immense sacrifice involved in medicine, and I'm about to do it for myself. I'm sure you could enlighten my idealism, and I mean that sincerely. I just don't agree at this time that the obviously enormous economic and personal sacrifice medical students make to become doctors=entitlement to best wages and maximum protection under the law. That implies a causal connection that the voting public does not understand well enough and in a sense, must be proven through true community activism and information transfer.

I think your idealism is exactly what would get you into medical school in an essay. Unfortunately, pretty much after you get in, they'll give you a little speech about maintaining your idealism and not too long after that, you'll find yourself laughing your ass off that they even said that.

The average person does see a physician as a rich person, and in that sense, able to afford a pay cut, extra taxes, taking on free work etc. They don't see all those years spent buried in the library, inhaling formaldehyde or phenol in a lab, being tested over and over again, (no not just the USMLE, but your recertification exams, internal department exams, exams through residency, etc). We're already a pretty damn self regulatory group and we make it hard on ourselves to stay in this profession and earn our keep. And a 3% tax isn't nearly as small as it sounds.

And for you to expect that no one gets angered by these policies, I think that's denying that people feel angered when they are being unjustly treated. That's what's happening here, it's an exclusive and discriminatory tax, not to mention it's totally circular. Tax physicians for the work that they do ... so they can do more work. Best of luck btw, but I think that once you get there, you will see what we mean.