Is obamacare really bad for doctors?

[intcards]

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How does anyone decide how much anything is worth? A piece of gum, a house? The free market. You have a bunch of insurance companies all competing for patients as well as doctors and that competition dictates the rate. Obamacare undermines the free market competition. I am not saying what is right, I am just telling you cause and effect. Closing private practices curtails doctors salaries. Most doctors are not ok with that. Where will it end, how low will it go? It's not inconceivable that at this rate doctors could essentially end up being government employees. Thats a little bit of an extreme, but its not at all what most of us signed up for. This also changes how healthcare is delivered. Medicine used to be a small business enterprise, with most care being provided by small practices. Now it is being centralized to larger hospitals. If you think that hospitals are any less likely to order unnecessary tests you are mistaken. I am not saying hat this change is wrong for America but why would a doctor want a more limited, less autonomous practice environment and less pay?

 

[calvnandhobbs68]

How does anyone decide how much anything is worth? A piece of gum, a house? The free market. You have a bunch of insurance companies all competing for patients as well as doctors and that competition dictates the rate. Obamacare undermines the free market competition. I am not saying what is right, I am just telling you cause and effect. Closing private practices curtails doctors salaries. Most doctors are not ok with that. Where will it end, how low will it go? It's not inconceivable that at this rate doctors could essentially end up being government employees. Thats a little bit of an extreme, but its not at all what most of us signed up for. This also changes how healthcare is delivered. Medicine used to be a small business enterprise, with most care being provided by small practices. Now it is being centralized to larger hospitals. If you think that hospitals are any less likely to order unnecessary tests you are mistaken. I am not saying hat this change is wrong for America but why would a doctor want a more limited, less autonomous practice environment and less pay?

In the first place, healthcare hasn't been a free market for a long time. Healthcare will never be a free market because it's just a different market than anything else. When you have provisions where hospitals have to provide services for free (EMTALA), you can't have a free market. There are many ethical reasons (some of which the ACA addresses) for why healthcare cannot be a free market like you learn about in Econ 101. Also. think back to the rules dealing with the consumer in Econ 101 and you'll find another reason why it can't be. It will either be a heavily regulated private market, government controlled or a mixture of both (like we have now).

Secondly, how is Obamacare going to eventually end up making people government employees? Making people buy health insurance is not the same thing as putting them on a government insurance program. You do realize that these insurance plans are going to be from private insurance companies right? Yes, there is Medicaid expansion (as long as states accept it) but that's for a portion of the population who probably wouldn't be in the market anyway. Not to mention most doctors won't even see Medicaid patients...

Yeah medicine used to be a small business enterprise. We also used to tell people to lay in bed for a while and wish them good luck when they had a heart attack. Cardiology also used to not exist as a specialty. I mean, we used to not even have medical specialties. Just because something is how it used to be doesn't mean that's how it always should be. Want to try implementing cross-talking EMR among 10 different small practices for one patient when everyone is using their own vendor? It's hard enough trying to get them to cross-talk in the same hospital/outpatient system.

Also, like I mentioned before, many of these "small business enterprises" were basically driven by government reimbursements at a certain rate. Cardiologists realized they could make a lot more money by not being salaried, setting up practices and ordering an echo and nuclear test for every referred patient they saw. So were they really free-standing small businesses after all?

 

[jl lin]

First you try to impress us with your grade school Latin, then you try a clever "angles on head of pin" quote.

I can feel the butthurt from here.

You bonehead. I said nothing about angles on the head of a pin. LOL

And wow. You are really focused on butthurt. Hmmm. I will have to ask the attending psychiatrist here about the Freudian basis for that. Ah. Never mind. Whatever your deal is, you are clearly um, frustrated, if you know what I mean. 😉

I am thinking you are not in medical school at all. This kind of crap seems more like something from the pre-med forum--all this nonsense. I figured I'd give you as good as you give little bully. Please don't soak your keyboard with tears now.

No hard feelings. I hated to do it, b/c I liked your moniker, but I went ahead and put you on ignore too. I don't have to waste my time with one-dimensional, sexually frustrated children.

Back to the original topic. . .

 

[calvnandhobbs68]

You bonehead. I said nothing about angles on the head of a pin. LOL

And wow. You are really focused on butthurt. Hmmm. I will have to ask the attending psychiatrist here about the Freudian basis for that. Ah. Never mind. Whatever your deal is, you are clearly um, frustrated, if you know what I mean. 😉

I am thinking you are not in medical school at all. This kind of crap seems more like something from the pre-med forum--all this nonsense. I figured I'd give you as good as you give little bully. Please don't soak your keyboard with tears now.

No hard feelings. I hated to do it, b/c I liked your moniker, but I went ahead and put you on ignore too. I don't have to waste my time with one-dimensional, sexually frustrated children.

Back to the original topic. . .

Well that's unfortunate because I've actually addressed the topic at hand twice recently. Unlike you who still obviously feels so intellectually inferior that you're now focusing on one letter spelling errors.
That butt must really hurt.

Btw we are on the pre-med forum. I'm not sure where you think you are....

And yes, I know I've just responded to somebody who apparently put me on their ignore list.

 

[Renaissance Man]

You bonehead. I said nothing about angles on the head of a pin. LOL

And wow. You are really focused on butthurt. Hmmm. I will have to ask the attending psychiatrist here about the Freudian basis for that. Ah. Never mind. Whatever your deal is, you are clearly um, frustrated, if you know what I mean. 😉

I am thinking you are not in medical school at all. This kind of crap seems more like something from the pre-med forum--all this nonsense. I figured I'd give you as good as you give little bully. Please don't soak your keyboard with tears now.

No hard feelings. I hated to do it, b/c I liked your moniker, but I went ahead and put you on ignore too. I don't have to waste my time with one-dimensional, sexually frustrated children.

Back to the original topic. . .

This is the pre-med forum...and if anything a medical student is more likely to recognize the classical presentation of butt-hurtness.

 

[jl lin]

This is the pre-med forum...and if anything a medical student is more likely to recognize the classical presentation of butt-hurtness.

Wow. Another one with a butt-hurt fixation. Least I used horse toads only once. 😉


Anyway, I can see why you would think so. Thank you for making my point.

What was I thinking that a person who is supposedly an actual medical student would rise above the pre-med garbage? My bad. So the behavior and claim do not seem to fit in light of the youngster pre-med responses that keep rolling from a couple of people.


OK. So maybe this will help people get back on track:


http://pages.townhall.com/campaign/th-barack-obama-has-won/rc/pop

Great pic Mr. President.

 

[Geebeejay]

You bonehead. I said nothing about angles on the head of a pin. LOL

And wow. You are really focused on butthurt. Hmmm. I will have to ask the attending psychiatrist here about the Freudian basis for that. Ah. Never mind. Whatever your deal is, you are clearly um, frustrated, if you know what I mean. 😉

I am thinking you are not in medical school at all. This kind of crap seems more like something from the pre-med forum--all this nonsense. I figured I'd give you as good as you give little bully. Please don't soak your keyboard with tears now.

No hard feelings. I hated to do it, b/c I liked your moniker, but I went ahead and put you on ignore too. I don't have to waste my time with one-dimensional, sexually frustrated children.

Back to the original topic. . .

Thanks for butting in and ruining a constructive string of threads with your nonsense 🙄

 

[SpecterGT260]

I am thinking you are not in medical school at all. .

Whoa.... SH** JUST GOT REAL

🙄

SDN Mantra: When in doubt, question whether the other person is really a med student. Oh the irony of your previous ad hominem cries. This is the closest thing this thread has seen yet to a real instance.

 

[PikminOC]

This bickering has gone on long enough. It is not appropriate to call other SDNers "homeless" and "butthurt" is funny the first 2 times: it gets old fast.

Try to use your words...

Back to topic: this is the way dental care is going too, losing out on PP and the big corporate companies are taking over. Seeing as the oversight for us docs is going to be the govt..

EEEEK!!

I have said before that I have workd in the hospital setting: it is really not for everyone.

 

[calvnandhobbs68]

This bickering has gone on long enough. It is not appropriate to call other SDNers "homeless" and "butthurt" is funny the first 2 times: it gets old fast.

Try to use your words...

Back to topic: this is the way dental care is going too, losing out on PP and the big corporate companies are taking over. Seeing as the oversight for us docs is going to be the govt..

EEEEK!!

I have said before that I have workd in the hospital setting: it is really not for everyone.

I don't know, butthurt is still funny to me after the 200th time. However, your post just cracked me up considering you're the one on probationary status for having a multi-thread p*ssing match on here.

I don't get whats up with you and jl lin with your selective reading. You seemingly skip over the posts that actually discuss anything and then say something totally random.

 

[PikminOC]

I don't know, butthurt is still funny to me after the 200th time. However, your post just cracked me up considering you're the one on probationary status for having a multi-thread p*ssing match on here.

I don't get whats up with you and jl lin with your selective reading. You seemingly skip over the posts that actually discuss anything and then say something totally random.

I learned from the experience.

You guys really need to stop it with the ganging up on certain SDNers.

You guys are bullies.

Better to write something random to ease the tension than keep attacking one SDNer.

 

[SpecterGT260]

I learned from the experience.

You guys really need to stop it with the ganging up on certain SDNers.

You guys are bullies.

Better to write something random to ease the tension than keep attacking one SDNer.

I don't think you have accurately interpreted the situation (and it is probably because you seem fairly new to online communities). This isn't so much bullying as a feeding frenzy That poster is posting incoherent nonsense 90% of the time, attempting to belittle other posters with half-baked sarcasm (in a sort of "perception of intelligence is relative to one's own capacity" sort of thing), and is just catching back the crap he is flinging. Being on topic would be great, but IMO ignoring nonsense posts like the ones he is making looks more like acceptance than it does ignorance and anyone lurking the forum can leave horribly misinformed. The issue is that he is sticking to his guns.

 

[PikminOC]

I don't think you have accurately interpreted the situation (and it is probably because you seem fairly new to online communities). This isn't so much bullying as a feeding frenzy That poster is posting incoherent nonsense 90% of the time, attempting to belittle other posters with half-baked sarcasm (in a sort of "perception of intelligence is relative to one's own capacity" sort of thing), and is just catching back the crap he is flinging. Being on topic would be great, but IMO ignoring nonsense posts like the ones he is making looks more like acceptance than it does ignorance and anyone lurking the forum can leave horribly misinformed. The issue is that he is sticking to his guns.

Why does it seem like the same SDNers take it upon themselves to participate in the "feeding frenzy"?? Why do you guys feel like you have to take the responsibility to make sure the other person is shot down?

 

[calvnandhobbs68]

I learned from the experience.

You guys really need to stop it with the ganging up on certain SDNers.

You guys are bullies.

Better to write something random to ease the tension than keep attacking one SDNer.

If you'll take a look at the top of this page and at the end of the last one you'll find a couple on-topic posts that are good examples of actually addressing specific issues people have of the ACA and what might be affected by it. Then you'll see where old jl lin pops back in and starts saying ridiculous crap. Again with the selective reading.

The problem is if we just let people like jl lin spout off whatever crap she wants to, we'll end up with SDN looking like the comments on fox news articles.

 

[PikminOC]

better than msnbc..

 

[SpecterGT260]

Why does it seem like the same SDNers take it upon themselves to participate in the "feeding frenzy"?? Why do you guys feel like you have to take the responsibility to make sure the other person is shot down?

it isnt a "responsibility". Just a response. Don't over think it. The point of a forum is to discuss and debate topics of interest. Nobody gains anything useful if we all just accept every conflicting opinion as true. I still maintain that on very rare occasion I pick a fight around here. I just tend to be much more sarcastic much faster than the average poster, but it is still nearly always precipitated by someone else being a dill-****. Unless I don't care about the topic being discussed. Then they are free to **** away in whatever flavor they desire 👍 but entry and participation in a thread is out of interest in what is being said and not out of some perceived responsibility. That's what the mods do

 

[RomanTaylor]

better than msnbc..

Oh no he didn't!

 

[sector9]

This is a reminder to all posters that personal attacks are not allowed.

Keep it civil, please.

 

[Renaissance Man]

I learned from the experience.

You guys really need to stop it with the ganging up on certain SDNers.

You guys are bullies.

Better to write something random to ease the tension than keep attacking one SDNer.

Weren't you just on probation for following a poster around through threads and harassing and using personal attacks on him/her?

 

[PikminOC]

Am i continuing that behavior? Do you know for sure that is why I was put on probation? Do you know why the other person was banned?

NO.

 

[jl lin]

Weren't you just on probation for following a poster around through threads and harassing and using personal attacks on him/her?

Sigh. Oh good Lord. First, no I was not just on probation. I disagree over what transpired, but it's long been over, and really who cares?

I certainly never targeted and bullied people. I spoke out strongly, and it was complained about by a repeated pushing of the “report this post” button. I don’t believe in bullying or targeting people. I don't bully in real life, and I don’t do it on line.

People that bully have issues where they feel somehow compensated for their own insecurity (or for some reason get some perverse pleasure) by continually harassing or attacking others. It’s sad to see it here. It’s the kind of thing one sees if one works in the prison system. The butt-hurt comment is very reminiscent of such kind of abuse. Seriously. Think Shawshank Redemption..
It’s people at their lowest level trying to feel one up over someone else.

I cannot speak about Grover's situation. I don't know, and it's not my place anyway. And really, I couldn’t care less about it. So why would you? Renaissance, by bringing up something you don’t know anything about, you are instigating and also rationalizing the bullying and stupid nonsense.
It's just a continuing of the bullying and nonsensical behavior--definitely antagonistic and in and of itself worthy of a warning from the moderator IMHO. Of course if moderators dished out warnings for such stupidity as much as they could, they'd never get anything done. It should be sufficient that a moderator has put in a warning here already.



If you feel any real concern I would urge you to step back for a second, drop your biases, and think. NOT once has any of those getting off on the bullying addressed any specific point on the issue, partial, or otherwise to me. They have, however, repeatedly insulted me. When they say they didn't or don’t understand something written, they NEVER sought any kind of legitimate clarification. They just keep dumping insulting comments and hiding behind personal attacks. If they had any issue with anything specific, they could intelligently address it. They refuse to do so. End of story on that. So now I have to wonder if that is your motivation too Renaissance.

So let this be a line in the sand, OK? It is expected that we should all, myself included, post with respect to the topic, avoid personal attacks, ask questions when something legitimately doesn’t make sense (That may require a little bit of humility on the part of some.) or avoid the posts one doesn't understand or like, and move on with life.

Why are we, as intelligent, professional adults, incapable of stating whatever it is that we may not understand or something that is not clear or simply just disagree without personal attacks and innuendo? (Listen, your innuendo looks like a nice example above. Think about it.)

See what is going to happen is the thread will be closed or more action will be taken. Why does anyone have to let it go down like that? It's not cool at all.

I will respond to zero personal attacks on this thread. I will simply exercise my right to report them, b/c apparently, it is the only way to stop bullying—even after fair warning from a moderator. K?

Rest easy. My butt is fine. I’m fine, and I hope all of you are fine.

 

[jl lin]

Back to the topic...

Personally, with re: to the ACA, all the specific details as to how it will unfold and what it will mean in the near and long-term future for millions remains to be seen. Grover is quite right in saying "We'll see."


Historically, the federal government is not good, IMHO, in managing things, and something as far-reaching as this, which will impact so many people, well it more than makes me nervous.

We are already in quite a financial bind. How will this be paid for and meet all the requirements without somehow limiting care--especially to those that are most vulnerable--at first glance, the elderly comes to mind?


Secondly, I really don't think any of us can wrap our brains around all the zillions of regulations that will come down from on high.

Also, I have mentioned this before. Employers have been tightening their belts in fear of what this will mean to them in terms of expenses. This already HAS BEEN a big issue in terms of unemployment.
Hospitals, for example, have severely cut down hiring of nurses—or they have moved to hiring only part-timers. This is about money—cost—their bottom line--and honestly, they need to be concerned about that.

People need jobs, but employers are pulling in tight because of overall costs and taxation re: what exactly ACA will mean for them. This is not anything that has just occurred. Things have been moving in this direction since 2008. It's just that the "perfect storm" with banking and housing all converged at the same time as the movement toward this plan.

So, no, I don't feel like it is necessarily unreasonable to think that details of what ACA will mean will lead to a cliff dive. I'm certainly not alone in this regard. Many are very concerned, and of those concerned, many are physicians.

Sure physicians will always have a place, and most will always have a job. But what will that really look like in light of all of this? Again, as Grover stated, "We'll see." I fear that what we will see will not be all that great, especially in the long-term. I see exceptionally hard times ahead. I'm sorry if that opinion is bothersome to some.

 

[SpecterGT260]

Sigh. Oh good Lord. First, no I was not just on probation. I disagree over what transpired, but it's long been over, and really who cares?

.

He was talking to Grover

He even quoted Grover. Seriously wtf

Sent from my DROID RAZR using SDN Mobile

 

[jl lin]

He was talking to Grover

He even quoted Grover. Seriously wtf

Sent from my DROID RAZR using SDN Mobile

Obviously I have taken down the ignore feature. Now let's hope for the best.

I'm sorry. I did read that quickly. I thought he was referring to both of us, but whatever. My points still stand, and they also stand with regard to Grover. . .although I don't really think Grover gives rat's butt about such nonsense, which is cool.

Are you going to discuss the points I made on the topic or no?

 

[PikminOC]

The requirements that Medicare/aid have are so onerous already and the compensation is so low, many PP don't take these insurances. Those patients have to go to hospital clinics that can cover that loss of revenue and time.

It will be terrible for us if ALL of our patients are on the same insurance and it is similar to those govt insurances already out there.

 

[SpecterGT260]

Obviously I have taken down the ignore feature. Now let's hope for the best.

I'm sorry. I did read that quickly. I thought he was referring to both of us, but whatever. My points still stand, and they also stand with regard to Grover. . .although I don't really think Grover gives rat's butt about such nonsense, which is cool.

Are you going to discuss the points I made on the topic or no?

I had been with the exception of correcting your use of "ad hominem". It's weird that I got the ignore when most of my posts to you were both on topic AND in partial agreement with you as opposed to the others taking pot shots at you.

Maybe you read too quickly too often 😉

 

[SpecterGT260]

Sure physicians will always have a place, and most will always have a job. But what will that really look like in light of all of this? Again, as Grover stated, “We’ll see.” I fear that what we will see will not be all that great, especially in the long-term. I see exceptionally hard times ahead. I’m sorry if that opinion is bothersome to some.

Here is the thing: You cannot just cut doctor salaries or reimbursement without the ripples impacting patient care. My opinion (wishful thinking?) is that the system can only stress so much but largely cannot exist within the current american mindset in any way other than it currently does. There is plenty of room for increasing efficiency but that isn't what we are talking about here really.

Americans expect to be seen immediately for any ailment, for the doctor to immediately diagnose and prescribe a magic pill to make it all go away immediately, and they expect it to be cheap as free. Obviously not all of those things can happen at once, and costs have been rising as we, as a nation implementing policy on the matter, have catered to the "quick" aspect of this plan. As I have said before, seriously cutting reimbursements will cause medicine to lose its historical and popular appeal as a career choice. You either expand the doctor deficit take measures which will ultimately reduce quality of care but we cannot really have it both ways here.

I predict that at some point the american people will "Get what they asked for", realize that they hate the system that is in place because it lacks some arbitrary quality they thought they were getting, and things will rebound. I don't predict things ever being like the hayday of the last generation's docs, but I don't see it as dire as many do here either.

 

[syoung]

is it true that physician salaries make a paltry % in terms of gdp spent on health care? if so, lowering physician reimbursements won't make a dent in that huge hole.

 

[calvnandhobbs68]

Back to the topic...

Personally, with re: to the ACA, all the specific details as to how it will unfold and what it will mean in the near and long-term future for millions remains to be seen. Grover is quite right in saying "We'll see."


Historically, the federal government is not good, IMHO, in managing things, and something as far-reaching as this, which will impact so many people, well it more than makes me nervous.

We are already in quite a financial bind. How will this be paid for and meet all the requirements without somehow limiting care--especially to those that are most vulnerable--at first glance, the elderly comes to mind?


Secondly, I really don't think any of us can wrap our brains around all the zillions of regulations that will come down from on high.

Also, I have mentioned this before. Employers have been tightening their belts in fear of what this will mean to them in terms of expenses. This already HAS BEEN a big issue in terms of unemployment.
Hospitals, for example, have severely cut down hiring of nurses—or they have moved to hiring only part-timers. This is about money—cost—their bottom line--and honestly, they need to be concerned about that.

People need jobs, but employers are pulling in tight because of overall costs and taxation re: what exactly ACA will mean for them. This is not anything that has just occurred. Things have been moving in this direction since 2008. It's just that the "perfect storm" with banking and housing all converged at the same time as the movement toward this plan.

So, no, I don't feel like it is necessarily unreasonable to think that details of what ACA will mean will lead to a cliff dive. I'm certainly not alone in this regard. Many are very concerned, and of those concerned, many are physicians.

Sure physicians will always have a place, and most will always have a job. But what will that really look like in light of all of this? Again, as Grover stated, "We'll see." I fear that what we will see will not be all that great, especially in the long-term. I see exceptionally hard times ahead. I'm sorry if that opinion is bothersome to some.

Well now..this is quite a different tune than was being sung before. It seems someone has been using the prescribed cream.

I made a previous post concerning your statement that employers have been "pulling in tight" since 2008. This is not borne out by the change in unemployment rate over the past year or two. The unemployment jump in 2008 had absolutely nothing to do with health care reform whatsoever. There was no "perfect storm" of banking, housing and healthcare because healthcare reform wasn't even on the table during the jump in unemployment in 2008. So no, I have to disagree that somehow employers have been holding off hiring people for years based on fears concerning the ACA. If anything, they've been holding back hiring more people because they learned from 2008 that they want to be sitting on stacks of straight cash in the case of further volatility and not be basing their company finances on theoretical returns.

Yes, I've seen the news articles where companies say they aren't hiring more people or something because of the new healthcare bill costs...they say that about every single tax or regulation that comes around. Less regulation = More money. What do you think they're going to say?

I don't know what you propose to do about the financial bind. Somehow people get the idea that the government shouldn't make any Medicare cuts but should lower its spending at the same time? We can either decrease Medicare benefits, decrease Medicare reimbursements or do a combination of both. Of course decreasing reimbursements is the more politically palatable thing to do. I don't necessarily agree with this idea (for instance I'm personally very much in favor of increasing the minimum Medicare age) but that's the way things seem to be going for now. Like Specter said I think a big chunk of the problem is that people here want the best equipment and the best scans and the best doctors but don't want to pay any more for it.

 

[SpecterGT260]

is it true that physician salaries make a paltry % in terms of gdp spent on health care? if so, lowering physician reimbursements won't make a dent in that huge hole.

Yes. 6-8% depending on where you look.

Sent from my DROID RAZR using SDN Mobile

 

[jl lin]

I predict that at some point the american people will "Get what they asked for", realize that they hate the system that is in place because it lacks some arbitrary quality they thought they were getting, and things will rebound. I don't predict things ever being like the hayday of the last generation's docs, but I don't see it as dire as many do here either.

What do you mean by rebound?


As I understand big government, once it's got its hands on people's wallets, and once it has it's grip in terms of controlling things, it doesn't back down, and it's doesn't let go. This was part of the problem with getting OC into law in the first place--especially in "passing it before knowing what was in it." (Pelosi reference)
I always believed the bit about repealing it was a waste. No way government will give up control of it.

I think it's wise to be very wary of government. Listen, remember that originally one's SS number was never meant to be used for ID purposes. That's not how it ultimately went down. I think physicians have every right to be frightened here. It's not something they can keep their heads in the sand about...and now that it's here, it's not going to go away.

I think we will see a net loss of docs and students going into medicine...and as this continues, it will be more justification for mid level use. It's already happening now, and many in the government are too happy to expand control and use mid level providers in order to accomplish this...

Sorry for any typos. I have to type on iPad right now, and I don't type well on flat screens.

 

[Gut Shot]

is it true that physician salaries make a paltry % in terms of gdp spent on health care? if so, lowering physician reimbursements won't make a dent in that huge hole.

That's the problem with fee for service, man. When docs face reimbursement cuts they generally respond by increasing volume and/or finding new ways to milk revenue. Both lead to greater overall spending on healthcare, which in turn increases pressure to cut reimbursement.

Like it or not, the financial impact of each physician on health spending goes far beyond his or her own income.

 

[Gut Shot]

--especially in "passing it before knowing what was in it." (Pelosi reference)

Full Pelosi quote: "We have to pass the bill so you can find out what's in it away from the fog of the controversy."

When you rely on soundbite politics you admit to being a sucker.

 

[SpecterGT260]

What do you mean by rebound?


As I understand big government, once it's got its hands on people's wallets, and once it has it's grip in terms of controlling things, it doesn't back down, and it's doesn't let go. This was part of the problem with getting OC into law in the first place--especially in "passing it before knowing what was in it." (Pelosi reference)
I always believed the bit about repealing it was a waste. No way government will give up control of it.

I think it's wise to be very wary of government. Listen, remember that originally one's SS number was never meant to be used for ID purposes. That's not how it ultimately went down. I think physicians have every right to be frightened here. It's not something they can keep their heads in the sand about...and now that it's here, it's not going to go away.

I think we will see a net loss of docs and students going into medicine...and as this continues, it will be more justification for mid level use. It's already happening now, and many in the government are too happy to expand control and use mid level providers in order to accomplish this...

Sorry for any typos. I have to type on iPad right now, and I don't type well on flat screens.

As much as it can seem like it, the central government isn't a big money eating badguy out to screw everyone. It still answers to the people. But ONLY when they get collectively pissed off enough to say something. I think the public getting what it asks for in this situation, will play out such that health availability and quality suffers to an unacceptable level and people decide that maybe there are ways other than cutting reimbursement to get what they want. It is still a market driven business, even if it has external controls on it. I just see a cycle happening where you make medicine unattractive, fewer people go in, gaps expand, quality decreases, demand goes up, providers collect more money, medicine becomes more attractive... ect...

 

[jl lin]

Well now..this is quite a different tune than was being sung before. It seems someone has been using the prescribed cream.

I made a previous post concerning your statement that employers have been "pulling in tight" since 2008. This is not borne out by the change in unemployment rate over the past year or two. The unemployment jump in 2008 had absolutely nothing to do with health care reform whatsoever. There was no "perfect storm" of banking, housing and healthcare because healthcare reform wasn't even on the table during the jump in unemployment in 2008. So no, I have to disagree that somehow employers have been holding off hiring people for years based on fears concerning the ACA. If anything, they've been holding back hiring more people because they learned from 2008 that they want to be sitting on stacks of straight cash in the case of further volatility and not be basing their company finances on theoretical returns.

Yes, I've seen the news articles where companies say they aren't hiring more people or something because of the new healthcare bill costs...they say that about every single tax or regulation that comes around. Less regulation = More money. What do you think they're going to say?

I don't know what you propose to do about the financial bind. Somehow people get the idea that the government shouldn't make any Medicare cuts but should lower its spending at the same time? We can either decrease Medicare benefits, decrease Medicare reimbursements or do a combination of both. Of course decreasing reimbursements is the more politically palatable thing to do. I don't necessarily agree with this idea (for instance I'm personally very much in favor of increasing the minimum Medicare age) but that's the way things seem to be going for now. Like Specter said I think a big chunk of the problem is that people here want the best equipment and the best scans and the best doctors but don't want to pay any more for it.

I don't know what you mean about different tune.

Do you remember Hilary's healthcare plan? This whole idea has been in the works long before 2008. Of course there were/are other factors. But this is going to be expensive for businesses overall, and it will seriously hurt a good number of small businesses. Small business were contributing to employment as well, and in no small part.


Absolutely anticipatory anxiety has played a part in hiring freezes. This is pretty much common knowledge now.

They say this about regulation b/c it is the truth. When have you ever known regulation to not cost employers and businesses more money? Seriously?


Please don't address me again with any buttpaste or such comments. It's unnecessary, and you need to stop or be stopped. Let's be decent here. I am trying to be cordial.

 

[jl lin]

As much as it can seem like it, the central government isn't a big money eating badguy out to screw everyone. It still answers to the people. But ONLY when they get collectively pissed off enough to say something. I think the public getting what it asks for in this situation, will play out such that health availability and quality suffers to an unacceptable level and people decide that maybe there are ways other than cutting reimbursement to get what they want. It is still a market driven business, even if it has external controls on it. I just see a cycle happening where you make medicine unattractive, fewer people go in, gaps expand, quality decreases, demand goes up, providers collect more money, medicine becomes more attractive... ect...

I disagree. Government expansion means exactly that. As I said, once passed, I really didn't see how any repeal will come into play--however warranted it may be.


I am just saying that once the government gets its hands on something, it will not release control of it. The work of big government is never finished. It's like rust. It never sleeps. Please show how this has not historically been the case.

 

[SpecterGT260]

I disagree. Government expansion means exactly that. As I said, once passed, I really didn't see how any repeal will come into play--however warranted it may be.


I am just saying that once the government gets its hands on something, it will not release control of it. The work of big government is never finished. It's like rust. It never sleeps. Please show how this has not historically been the case.

What exactly is government going to get its hands on that it doesnt already have? The government already controls most of healthcare policy and spending which is why this is on the table in the first place.

 

[jl lin]

Full Pelosi quote: "We have to pass the bill so you can find out what's in it away from the fog of the controversy."

When you rely on soundbite politics you admit to being a sucker.

No, buying into that doublespeak is being a sucker in my view.

“But we have to pass the bill so that you can find out what is in it, away from the fog of controversy."

That's a total BS statement. And it was condescending as well. This is exactly how proponents of big government work. It says, "Just sign away for it, and then you will be SOOOO glad you did."

Will we? Again, as was stated by Grover, we will see. So far, it seems like a terribly fearful business to me.

 

[SpecterGT260]

Full Pelosi quote: "We have to pass the bill so you can find out what's in it away from the fog of the controversy."

When you rely on soundbite politics you admit to being a sucker.

I feel like that quote isn't much better. Moves from malicious to inept. Let's call it a lateral pass.

 

[calvnandhobbs68]

I don't know what you mean about different tune.

Do you remember Hilary's healthcare plan? This whole idea has been in the works long before 2008. Of course there were/are other factors. But this is going to be expensive for businesses overall, and it will seriously hurt a good number of small businesses. Small business were contributing to employment as well, and in no small part.


Absolutely anticipatory anxiety has played a part in hiring freezes. This is pretty much common knowledge now.

They say this about regulation b/c it is the truth. When have you ever known regulation to not cost employers and businesses more money? Seriously?


Please don't address me again with any buttpaste or such comments. It's unnecessary, and you need to stop or be stopped. Let's be decent here. I am trying to be cordial.

Again, lovin the different tune. Did you get a warning or something?

Again, don't know what you mean by "hiring freezes" for the most part. Did you take a look at overall unemployment rate change like I linked you to or are you conveniently ignoring that? I'm not even sure why you're bringing up Hilary's healthcare plan except to try to link it to the 2008 unemployment drop which I'd have to say is absolutely and totally wrong.

I'm not sure how this is "common knowledge" that anticipatory anxiety is causing hiring freezes. What, because the CEO of Applebees said so after Romney lost (just so he can prove to everyone just how bad things are gonna be)? The biggest thing I'm seeing affect hiring at the moment is whether or not this "fiscal cliff" issue will be worked out. Again, because it is uncertainty that causes these kinds of things. The ACA has been the law now for two years. Like I said, companies have already built it into their forward outlook and risk analysis.

My point was that they'll say that about any possible thing that'll cut into profits. Want to keep an oil company from drilling in a national forest? Well what about all the jobs that'll never be created! Regulations to keep companies from dumping chemicals into Lake Michigan? But the poor future possible workers who'll never have a job now because of those draconian regulations! I'm not saying regulations are all flowers and sunshine but we have to try to balance the regulation against benefit and in the case of the ACA there were regulations that needed to be made (ex. pre-existing conditions, lifetime cap changes) and some that are a little more iffy.

 

[jl lin]

I feel like that quote isn't much better. Moves from malicious to inept. Let's call it a lateral pass.

😎 I'm saying . . .

 

[jl lin]

Again, lovin the different tune. Did you get a warning or something?

Dude, honestly. I warned you. You are incredible.

 

[calvnandhobbs68]

Again, lovin the different tune. Did you get a warning or something?

QUOTE]



Dude, honestly. I warned you. You are incredible.

I'm not sure what you're talking about...because I'm saying I'm lovin the different tune?

There's also a whole paragraph below that you know. A couple.

 

[calvnandhobbs68]

.

 

[jl lin]

I'm not sure what you're talking about...because I'm saying I'm lovin the different tune?

There's also a whole paragraph below that you know. A couple.

You know what you are saying. You're back on ignore.

 

[SpecterGT260]

"We have to
rely on soundbite politics .

You are incredible.

I'm not sure I'm lovin below you

😎

 

[calvnandhobbs68]

You know what you are saying. You're back on ignore.

What a crime.

 

[Gut Shot]

I feel like that quote isn't much better. Moves from malicious to inept. Let's call it a lateral pass.

No, it moves from sinister to innocuous. There is a reason why those last seven words get conveniently trimmed off by certain parties.

 

[SpecterGT260]

No, it moves from sinister to innocuous. There is a reason why those last seven words get conveniently trimmed off by certain parties.

Meh... I tend to think there are people out there looking for soundbites regardless, and will present them in the most negative light possible. Personally I find it inept and irresponsible to suggest that we just pass it and see what happens. The quote alone is enough to make me think poorly of it. But most people won't look up the source anyways so why not make it sting a little bit more?

 

[jl lin]

No, it moves from sinister to innocuous. There is a reason why those last seven words get conveniently trimmed off by certain parties.

Not innocuous at all. It's doublespeak in that it makes the negative appear positive, limits, conceals, and prevents thought, and made the inevitably unpleasant burden of costs and regulations to follow appear attractive or tolerable without getting down to the details.

It's tantamount to "There, there. Sign the paper and don't worry your pretty little head over it. Now get back in bed and assume the position."

Really. It's insulting, and it was tactically elusive.