NYTimes: Doctors becoming more liberal

[235009]

Interesting read: http://www.nytimes.com/2011/05/30/health/policy/30docs.html

A welcome change in my opinion

---

Members don't see this ad.

 

[Pseudopseudonym]

Interesting read: http://www.nytimes.com/2011/05/30/health/policy/30docs.html

A welcome change in my opinion

This article makes some extreme reaches to validate it's suggestion that doctors in general are "going left."

More are working for hospitals. That means they are more liberal? Or might that be because fewer doctors are able to keep up with the financial burdens of private and/or solo/small group practice?

I find it hard to believe that because a group who represents a small number of physicians, in a very small state that has voted Democrat in every presidential election since 1988, we are seeing an overall shift in political affiliations of doctors...

Not to mention it references shifts at Harvard and in Oregon as well...both of which have never been anything short of far-left in my opinion.

 

[mauberley]

More are working for hospitals. That means they are more liberal? Or might that be because fewer doctors are able to keep up with the financial burdens of private and/or solo/small group practice?

I don't think the point was a direct "working for hospitals equals liberal" assertion. Rather, that more people working for hospitals meant fewer business owners, removing a major area of concern aligning physicians with typical conservative policy. This in turn means that those physicians are freer to prioritize other interests, such as areas of public health, when it comes to matters of legislation.

 

[235009]

This article makes some extreme reaches to validate it's suggestion that doctors in general are "going left."

More are working for hospitals. That means they are more liberal? Or might that be because fewer doctors are able to keep up with the financial burdens of private and/or solo/small group practice?

it is not a reach at all...if a doctor doesn't have to worry about running a small business (which involves paying additional taxes, paying for malpractice insurance, and providing employee benefits including health insurance) and instead has a steady salary he/she can worry more about the patients. This opens the door to supporting policies like healthcare reform and public health measures

 

[AntiHouseMD]

it is not a reach at all...if a doctor doesn't have to worry about running a small business (which involves paying additional taxes, paying for malpractice insurance, and providing employee benefits including health insurance) and instead has a steady salary he/she can worry more about the patients. This opens the door to supporting policies like healthcare reform and public health measures

By having a steady salary, I think the quality of health care will improve as doctors can advocate more for the health of their patients than for measures which help businesses. I completely understand why private practice doctors need to advocate for themselves, but having a steady salary helps doctors focus more on health matters rather than financial issues.

 

[Pseudopseudonym]

it is not a reach at all...if a doctor doesn't have to worry about running a small business (which involves paying additional taxes, paying for malpractice insurance, and providing employee benefits including health insurance) and instead has a steady salary he/she can worry more about the patients. This opens the door to supporting policies like healthcare reform and public health measures

How do you think hospitals make money? Patient turnover and procedures. Just because a physician works for a hospital absolutely does not = improved patient care. I would beg to differ. I know it's a bit off the original topic, but I think healthcare would be improved if more private practicioners were able to have solo practices without the tight margins. I don't think just because a physician is on salary means they will focus more on their patients' health. Not to mention that most LARGE hospitals are associated with centers for higher education which inherently have a more liberal population.

By having a steady salary, I think the quality of health care will improve as doctors can advocate more for the health of their patients than for measures which help businesses. I completely understand why private practice doctors need to advocate for themselves, but having a steady salary helps doctors focus more on health matters rather than financial issues.

Sorry but this is a bit naive. As I proposed above, the notion that just because a physician is on salary that they will focus more on their patients' overall healthcare and well-being is just short of preposterous. Whether we are talking about an individual practice or a large group, someone still has to meet the bottom line (i.e. patient turnover and procedures).

 

[mauberley]

Sorry but this is a bit naive. As I proposed above, the notion that just because a physician is on salary that they will focus more on their patients' overall healthcare and well-being is just short of preposterous.

You're shifting the argument from a physician's political alignment to their professional behavior.

 

[Slack3r]

it is not a reach at all...if a doctor doesn't have to worry about running a small business (which involves paying additional taxes, paying for malpractice insurance, and providing employee benefits including health insurance) and instead has a steady salary he/she can worry more about the patients. This opens the door to supporting policies like healthcare reform and public health measures

LOL, if you don't think that's a bit of a reach there's not a lot I can do for you...

 

[mauberley]

LOL, if you don't think that's a bit of a reach there's not a lot I can do for you...

Apparently this is true, since you can't actually articulate the reasons why it's a reach.

 

[Pseudopseudonym]

You're shifting the argument from a physician's political alignment to their professional behavior.

That's why I said above "sorry but this is a bit off topic." I wasn't the one that equated liberalism to caring more for patient's well-being and being for better public health measures...

 

[mauberley]

That's why I said above "sorry but this is a bit off topic." I wasn't the one that equated liberalism to caring more for patient's well-being and being for better public health measures...

Perhaps the better assertion is "doctors are supporting more traditionally-liberal policy measures," then.

 

[Pseudopseudonym]

Perhaps the better assertion is "doctors are supporting more traditionally-liberal policy measures," then.

Takes me back to my original point: using a small sample from Maine, Harvard and Oregon to say doctors are becoming more liberal shouts selection bias to me....

But whatever. If it's true then it's true.

 

[235009]

How do you think hospitals make money? Patient turnover and procedures. Just because a physician works for a hospital absolutely does not = improved patient care. I would beg to differ. I know it's a bit off the original topic, but I think healthcare would be improved if more private practicioners were able to have solo practices without the tight margins. I don't think just because a physician is on salary means they will focus more on their patients' health. Not to mention that most LARGE hospitals are associated with centers for higher education which inherently have a more liberal population.

My point was that each individual doctor at the hospital doesn't have to worry about the "bottom line" ....the hospital's CEO etc can worry about that. In a hospital the doctors don't have to bargain with individual insurance companies over reimbursement day in and day out and they don't have to worry about employing staff.

One point the article makes is that doctors were traditionally opposed to forcing employers to give employees healthcare because they were the employers who'd be stuck paying the bill but now that more doctors work for hospitals they look at it from the perspective of how it would benefit patients rather than how it can hurt their bottom line. As for supporting public health measures: when you're in the "business" of tending to sick people you want the demand for your services to be as high as possible and therefore fewer public health measures --> more sick people --> more "demand" --> more business --> more income.

Also I have no clue what "more private practitioners were able to have solo practices without the tight margins" means

 

[Slack3r]

Apparently this is true, since you can't actually articulate the reasons why it's a reach.

it is not a reach at all...if a doctor doesn't have to worry about running a small business (which involves paying additional taxes, paying for malpractice insurance, and providing employee benefits including health insurance) and instead has a steady salary he/she can worry more about the patients.This opens the door to supporting policies like healthcare reform and public health measures.

This seems like a logical progression to you? Having a salary and no overhead/malpractice automatically shifts political views?

You're taking a complex issue and creating a false dichotomy. The crux of the argument involves the premise that "caring for patients" and running a business are mutually exclusive, and that political leanings are solely based on these factors. So a doctor that no longer has to worry about malpractice will automatically favor public health initiatives is an absurd conclusion.

 

[Barcu]

My point was that each individual doctor at the hospital doesn't have to worry about the "bottom line" ....the hospital's CEO etc can worry about that. In a hospital the doctors don't have to bargain with individual insurance companies over reimbursement day in and day out and they don't have to worry about employing staff.

One point the article makes is that doctors were traditionally opposed to forcing employers to give employees healthcare because they were the employers who'd be stuck paying the bill but now that more doctors work for hospitals they look at it from the perspective of how it would benefit patients rather than how it can hurt their bottom line. As for supporting public health measures: when you're in the "business" of tending to sick people you want the demand for your services to be as high as possible and therefore fewer public health measures --> more sick people --> more "demand" --> more business --> more income.

Also I have no clue what "more private practitioners were able to have solo practices without the tight margins" means

I agree with this. Hospitals have more money, more patients, and some of these patients they are required by law to treat. There are people in the hospital who do worry about the bottom line and can pressure docs, but docs are much more removed from the finances than in private practice.

Now, how much this affects a docs thinking is hard to tell, but it's not "short of preposterous" to consider this line of reasoning.

 

[Pseudopseudonym]

My point was that each individual doctor at the hospital doesn't have to worry about the "bottom line" ....the hospital's CEO etc can worry about that. In a hospital the doctors don't have to bargain with individual insurance companies over reimbursement day in and day out and they don't have to worry about employing staff.

One point the article makes is that doctors were traditionally opposed to forcing employers to give employees healthcare because they were the employers who'd be stuck paying the bill but now that more doctors work for hospitals they look at it from the perspective of how it would benefit patients rather than how it can hurt their bottom line. As for supporting public health measures: when you're in the "business" of tending to sick people you want the demand for your services to be as high as possible and therefore fewer public health measures --> more sick people --> more "demand" --> more business --> more income.

Also I have no clue what "more private practitioners were able to have solo practices without the tight margins" means

Hospitals have to pay bills too...no sick people = no hospital. You're implying that a salary-based doctor doesn't want any sick people....think about that for a second.

Sorry: margins generally refers to the difference in the revenue and actual profit. Obviously, the difference in revenue and profit is what you have to pay (out of revenue) for overhead costs, employee wages, etc. Low margin implies that your revenue is being "eaten away" by your expenses. Generally, especially in terms of healthcare business, smaller businesses have smaller profit margins because their overhead costs more. This point was off topic, but I was just ranting about the fact that solo practicioners have effectively been run out of business because the overhead of running that practice is so high (e.g. tight margins).

 

[dyeguy21]

It is dangerous and ignorant to assume such a simple inverse relationship with business and the care of patients. You are just thinking less of yourself if you believe that you are unable to learn and accomplish both.

Hospitals and business can co-exist. This is the reason you are seeing so many new MD/MBA programs cropping up at schools nationwide.

In these programs you learn how to care for patients while understanding the political and monetary policy that goes on behind the scenes.

For instance, we all agree that infections caused in hospitals are bad. So why then when doctors go from sick patient to sick patient do they not wash their hands 60-70% of the time? This then leads to the question well just how bad is this not only for patients but for the ongoing economical health of the hospital. Turns out there is a very high correlation with non-washing, infections, and costly treatment. So you implement a program to "force" doctors to follow simple medical guidelines and viola you have saved money and increased revenue. It can be that simple sometimes.

A hospital needs income in order to exist, just like any other business. They deal in sick people who can afford to pay and do everything they can to help people who can't.

There is always a way to take better care of the patient and become more profitable, its not always easy or obvious, but the answer does exist.

EDIT: Also business doesn't always equal conservative and liberal doesn't always mean the downfall of business. If you think that way, then conservatives are for many, many small businesses that allow for perfect competition in the market and would never want to help corporations, while liberals want the conglomerate to succeed so that they can control all the doctors at once rather than have to manage the individual practices. Those don't really seem to be the lines people paint between the two groups, quite the opposite in fact.

 

[235009]

Hospitals have to pay bills too...no sick people = no hospital. You're implying that a salary-based doctor doesn't want any sick people....think about that for a second.

nope. not implying that at all. hospitals have a greater catchment area and therefore can attract more patients whereas a small private practice only attracts patients from a very small local catchment area. therefore demand is much more likely to outpace supply at a hospital. Though there is very high demand in highly populated areas (like cities), most places are very sparsely populated and your coverage area as a private practitioner does not include nearly as many patients as a hospital's would.

 

[dyeguy21]

hospitals have a greater catchment area and therefore can attract more patients whereas a small private practice only attracts patients from a very small local catchment area. therefore demand is much more likely to outpace supply at a hospital. Though there is very high demand in highly populated areas (like cities), most places are very sparsely populated and your coverage area as a private practitioner does not include nearly as many patients as a hospital's would.

So the article is trying to argue that by (comparing from retail) making a few big-box stores in town, rather than a multitude of small M&Ps, is a more liberal line of thought...

A hospital will have higher demand, and possibly all of it, when it is the only thing in existence. However, if constraints on private practices were eased, there would probably be many doctors that would rather spend their time running their own business than having to deal with corporate mandates.

This is indeed a part of the public dismay with the healthcare reform as it is forcing small <50 person practices to shut down and move to larger hospitals. The belief is that its hard to enact say a 10% cut on a private practice's revenue from Medicare or Medicaid (as a sort of penalty for not following a certain new guideline) because that may be below $20,000 which isn't a very large hit and thus, the private practice doctors may ignore the government mandate in favor of their own choice of treatment for the care of their patient.

However, take the same cut at a hospital and it adds up to large 7 digit sums and corporate now forces each doctor to follow the new guideline, regardless of the individual doctor's opinion, lest he has his salary docked.

Doctors aren't "becoming" more liberal, they are being forced to find a safe stream of income due to the uncertainty surrounding healthcare, joining a hospital is the most obvious choice.

 

[Pseudopseudonym]

So the article is trying to argue that by (comparing from retail) making a few big-box stores in town, rather than a multitude of small M&Ps, is a more liberal line of thought...

A hospital will have higher demand, and possibly all of it, when it is the only thing in existence. However, if constraints on private practices were eased, there would probably be many doctors that would rather spend their time running their own business than having to deal with corporate mandates.

This is indeed a part of the public dismay with the healthcare reform as it is forcing small <50 person practices to shut down and move to larger hospitals. The belief is that its hard to enact say a 10% cut on a private practice's revenue from Medicare or Medicaid (as a sort of penalty for not following a certain new guideline) because that may be below $20,000 which isn't a very large hit and thus, the private practice doctors may ignore the government mandate in favor of their own choice of treatment for the care of their patient.

However, take the same cut at a hospital and it adds up to large 7 digit sums and corporate now forces each doctor to follow the new guideline, regardless of the individual doctor's opinion, lest he has his salary docked.

Doctors aren't "becoming" more liberal, they are being forced to find a safe stream of income due to the uncertainty surrounding healthcare, joining a hospital is the most obvious choice.

Couldn't have said it better.

 

[Charles_Carmichael]

so the article is trying to argue that by (comparing from retail) making a few big-box stores in town, rather than a multitude of small m&ps, is a more liberal line of thought...

A hospital will have higher demand, and possibly all of it, when it is the only thing in existence. However, if constraints on private practices were eased, there would probably be many doctors that would rather spend their time running their own business than having to deal with corporate mandates.

This is indeed a part of the public dismay with the healthcare reform as it is forcing small <50 person practices to shut down and move to larger hospitals. The belief is that its hard to enact say a 10% cut on a private practice's revenue from medicare or medicaid (as a sort of penalty for not following a certain new guideline) because that may be below $20,000 which isn't a very large hit and thus, the private practice doctors may ignore the government mandate in favor of their own choice of treatment for the care of their patient.

However, take the same cut at a hospital and it adds up to large 7 digit sums and corporate now forces each doctor to follow the new guideline, regardless of the individual doctor's opinion, lest he has his salary docked.

Doctors aren't "becoming" more liberal, they are being forced to find a safe stream of income due to the uncertainty surrounding healthcare, joining a hospital is the most obvious choice.

+1

 

[Dbate]

So the article is trying to argue that by (comparing from retail) making a few big-box stores in town, rather than a multitude of small M&Ps, is a more liberal line of thought...

A hospital will have higher demand, and possibly all of it, when it is the only thing in existence. However, if constraints on private practices were eased, there would probably be many doctors that would rather spend their time running their own business than having to deal with corporate mandates.

This is indeed a part of the public dismay with the healthcare reform as it is forcing small <50 person practices to shut down and move to larger hospitals. The belief is that its hard to enact say a 10% cut on a private practice's revenue from Medicare or Medicaid (as a sort of penalty for not following a certain new guideline) because that may be below $20,000 which isn't a very large hit and thus, the private practice doctors may ignore the government mandate in favor of their own choice of treatment for the care of their patient.

However, take the same cut at a hospital and it adds up to large 7 digit sums and corporate now forces each doctor to follow the new guideline, regardless of the individual doctor's opinion, lest he has his salary docked.

Doctors aren't "becoming" more liberal, they are being forced to find a safe stream of income due to the uncertainty surrounding healthcare, joining a hospital is the most obvious choice.

This post doesn't make sense. Even if federal laws are forcing physicians to work for hospitals, the presence and experiences of physicians in a hospital setting are what alter their perception of certain laws, which leads to more liberalism.

Honestly, I don't understand why we don't just pay higher taxes so that medical care can be free for everyone. All the people who argue against this seem selfish and shortsighted to me.

 

[Avoidthetiger]

Honestly, I don't understand why we don't just pay higher taxes so that medical care can be free for everyone. All the people who argue against this seem selfish and shortsighted to me.

People don't like the government running things and overreaching their power. I am not in favor of more taxes so that everyone has healthcare. I am not a big fan of some of the countries that do tax their citizens to provide free health care - long lines, have to go to a PCP before seeing a specialist (which can take forever), lack of crutches or other basic items, large patient recovery rooms, the decision to not give you every type of test out there to determine what disease you might have. This is what I encountered as a child as a health insured individual in the US. I prefer the US system and I think it is worth $1-5000 of my dollars per year to have. Without getting the US government involved (except in cases of poverty where you can't afford it - medicaid). Now that US citizens shouldn't be barred from health insurance for previous condition - but might get charged more - I am still OK with that. Maintaining your health is important.

yes - there are flaws in the US system. But I don't particularly want a government run system. The current insurance companies reimburse doctors and hospitals more so than the government ever will.

 

[CaliDent383]

This post doesn't make sense. Even if federal laws are forcing physicians to work for hospitals, the presence and experiences of physicians in a hospital setting are what alter their perception of certain laws, which leads to more liberalism.

Honestly, I don't understand why we don't just pay higher taxes so that medical care can be free for everyone. All the people who argue against this seem selfish and shortsighted to me.

You're nuts. Don't you know that a new Mercedes is much more important than the lives of lazy welfare moochers?!?

 

[rxlea]

People don't like the government running things and overreaching their power. I am not in favor of more taxes so that everyone has healthcare. I am not a big fan of some of the countries that do tax their citizens to provide free health care - long lines, have to go to a PCP before seeing a specialist (which can take forever), lack of crutches or other basic items, large patient recovery rooms, the decision to not give you every type of test out there to determine what disease you might have. This is what I encountered as a child as a health insured individual in the US. I prefer the US system and I think it is worth $1-5000 of my dollars per year to have. Without getting the US government involved (except in cases of poverty where you can't afford it - medicaid). Now that US citizens shouldn't be barred from health insurance for previous condition - but might get charged more - I am still OK with that. Maintaining your health is important - but many individuals just don't seem to value it.

yes - there are flaws in the US system. But I don't particularly want a government run system. The current insurance companies reimburse doctors and hospitals more so than the government ever will.

Many patients have no control over their "previous condition". Just something to think about...

Sorry, don't mean to send the thread off topic...

 

[AntiHouseMD]

People don't like the government running things and overreaching their power. I am not in favor of more taxes so that everyone has healthcare. I am not a big fan of some of the countries that do tax their citizens to provide free health care - long lines, have to go to a PCP before seeing a specialist (which can take forever), lack of crutches or other basic items, large patient recovery rooms, the decision to not give you every type of test out there to determine what disease you might have. This is what I encountered as a child as a health insured individual in the US. I prefer the US system and I think it is worth $1-5000 of my dollars per year to have. Without getting the US government involved (except in cases of poverty where you can't afford it - medicaid). Now that US citizens shouldn't be barred from health insurance for previous condition - but might get charged more - I am still OK with that. Maintaining your health is important - but many individuals just don't seem to value it.

yes - there are flaws in the US system. But I don't particularly want a government run system. The current insurance companies reimburse doctors and hospitals more so than the government ever will.

I do agree with this, up to a point. If the patient suffers from issues solely related to poor choices (obesity, smoking, etc.), then that's one thing. However, I can't agree with charging someone extra who has re-occuring illnesses beyond their control, such as asthma or a weakened immune system. Also, the government shouldn't run health-care. Should there be government oversight to make sure insurance companies are operating appropriately? Should the government become involved in cases where the patient can't afford basic medical care? Of course.

The major concern I have with US health care is the fact that a businessman can overrule a doctor's opinion based on economic reasons. For example, a patient's treatment can be refused due to the company not covering it. That is one issue, in whatever way, must be limited.

 

[Avoidthetiger]

Many patients have no control over their "previous condition". Just something to think about...

Sorry, don't mean to send the thread off topic...

I agree (so I am glad that health care reform doesn't bar them from insurance); but many previous conditions do end up costing health insurance companies more - hence being charged more. regarding above poster - Asthma is a weird previous condition to charge for as many people grow out of it and their are drugs, weaken immune system can be too - as there are easy medications for that... but their is the increased risk of more doctors visit, hospitalizations. Even if the condition is out of your control, there is reasons why your health insurance would be more - as you are indeed more risky.

And sorry for that last sentence. I meant to remove it as I was about to get into an example about health care employees not even paying $25 a month for health care insurance. But some might argue that they had other bills to pay - rather then making sure their health was OK. Article.

. Should there be government oversight to make sure insurance companies are operating appropriately? Should the government become involved in cases where the patient can't afford basic medical care? Of course.

The major concern I have with US health care is the fact that a businessman can overrule a doctor's opinion based on economic reasons. For example, a patient's treatment can be refused due to the company not covering it. That is one issue, in whatever way, must be limited.

agreed and agreed.

Back on topic - I would agrue that the younger generation of physician might be more liberal, as a more wide array of individuals had access to medical school via loans. I imagine that in the past more conservatives when into medical school. But honestly, I can't prove this and I know many liberal and conseravtive older physicians. I think the only thing that has really changed is physicians care less about private practice issues as more and more work in hospitals. This doesn't mean that they aren't conservative or liberal in other issues. It just means private practice issues no longer are important to them.

 

[docelh]

I would think that the vast majority of people in the helping professions - health care, education, social services - tend to be more liberal.

Democrats have traditionally supported spending in those areas, while Republicans have opposed this. Besides the obvious self-interest, people in the helping professions tend to be more empathetic and don't prescribe to the free market Darwinism attitudes of global capitalism.

 

[Dbate]

People don't like the government running things and overreaching their power. I am not in favor of more taxes so that everyone has healthcare. I am not a big fan of some of the countries that do tax their citizens to provide free health care - long lines, have to go to a PCP before seeing a specialist (which can take forever), lack of crutches or other basic items, large patient recovery rooms, the decision to not give you every type of test out there to determine what disease you might have. This is what I encountered as a child as a health insured individual in the US. I prefer the US system and I think it is worth $1-5000 of my dollars per year to have. Without getting the US government involved (except in cases of poverty where you can't afford it - medicaid). Now that US citizens shouldn't be barred from health insurance for previous condition - but might get charged more - I am still OK with that. Maintaining your health is important.

yes - there are flaws in the US system. But I don't particularly want a government run system. The current insurance companies reimburse doctors and hospitals more so than the government ever will.

What are you talking about? The government is not some nefarious entity that wants to wreck havoc on our lives. We are the government! We vote for politicians, who advocate for laws we like or we vote them out of office. The entire concept of railing against the government is absurd to me.


Also, I am sure many people would prefer to wait a little longer to get medical care than to not even have the option for medical care because they can not afford it.

As a case in point, it is not just the "poor" who can't afford healthcare. Teachers in my school district couldn't even afford to pay for the healthcare provided through their employer. Healthcare costs (like most costs in the world) hit the middle class the hardest.

We should be more afraid of positions that advocate for no government intervention, as those are the ones that allow people to suffer, rather than allowing "The Government" to step in and help people.

 

[235009]

a bit off topic but i feel the need to point out a couple of facts...

I do agree with this, up to a point. If the patient suffers from issues solely related to poor choices (obesity, smoking, etc.), then that's one thing.

it has been show that many of these diseases that you would think are purely due to lifestyle choices have a strong genetic component. Obesity and addiction both have strong genetic links.

Asthma is a weird previous condition to charge for as many people grow out of it and their are drugs, weaken immune system can be too - as there are easy medications for that... but their is the increased risk of more doctors visit, hospitalizations. Even if the condition is out of your control, there is reasons why your health insurance would be more - as you are indeed more risky.

there are no "easy" medications for a weak immune system (i.e. congenital immunodeficiency) and the medications that are out there for some of these conditions are extraordinarily expensive

 

[mmmcdowe]

What are you talking about? The government is not some nefarious entity that wants to wreck havoc on our lives. We are the government! We vote for politicians, who advocate for laws we like or we vote them out of office. The entire concept of railing against the government is absurd to me.


Also, I am sure many people would prefer to wait a little longer to get medical care than to not even have the option for medical care because they can not afford it.

As a case in point, it is not just the "poor" who can't afford healthcare. Teachers in my school district couldn't even afford to pay for the healthcare provided through their employer. Healthcare costs (like most costs in the world) hit the middle class the hardest.

We should be more afraid of positions that advocate for no government intervention, as those are the ones that allow people to suffer, rather than allowing "The Government" to step in and help people.

I think most people would agree that the American culture is more distrusting of government than many Western countries, Canada for example. It definitely causes havoc, regardless of the validity of such concerns.

 

[ruiner]

Breaking News: Doctors in San Francisco are also liberal leaning.

 

[Avoidthetiger]

there are no "easy" medications for a weak immune system (i.e. congenital immunodeficiency) and the medications that are out there for some of these conditions are extraordinarily expensive

I apologize; I had only limited experience with an individual born with a weaken immune system. A sibling. Who only took a mediciation daily during their early life (it might have cost alot, no idea. Worth it regardless.) and hasn't taken anything in like ten years; and really hasn't had any complications regarding it. My sibling was worried about not getting health insurance due to this - and even an increased health insurance will be bad because it really has never been an issue. But - if the medications are alot or if it causes other issues - that is a reason to have increased insurance rates.

Dbate - I am glad that you believe your politicians are representing you. I only trust politicians on a local level - and even then barely. I would imagine if we were taxed more for health insurance - many of that taxes would actually go to other causes. I would really want to see a clear breakdown by the government of where my money is going if I was to ever trust them. I also distrust health insurance companies - but atleast they ideally get some oversight by the government. Who overseas the government? The UN? ha.

 

[docelh]

I think most people would agree that the American culture is more distrusting of government than many Western countries, Canada for example. It definitely causes havoc, regardless of the validity of such concerns.

Other governments just collect taxes and dispense it via social spending.

"Our" government has to police the current world order in cahoots with corporations, global finance, third world dictators, etc.

I think more Americans would trust government if they felt their tax dollars were well spent on them. I happen to think a lot of the conservatives probably feel this way too; they just happen to see that their dollars go to a lot of stupid things they don't support like corporate bailouts, useless wars, and agenda-driven or group-focused government spending.

 

[AntiHouseMD]

I apologize; I had only limited experience with an individual born with a weaken immune system. A sibling. Who only took a mediciation daily during their early life (it might have cost alot, no idea. Worth it regardless.) and hasn't taken anything in like ten years; and really hasn't had any complications regarding it. My sibling was worried about not getting health insurance due to this - and even an increased health insurance will be bad because it really has never been an issue. But - if the medications are alot or if it causes other issues - that is a reason to have increased insurance rates.

I don't know anyone with a weakened immune system, so I only know by hearing about it elsewhere. My thing is that life-saving medical care cannot be denied simply because a person can't afford it. I agree that rates should be slightly higher for someone who incur more costs, but you can't raise it to a level that makes it unaffordable (I assume you aren't thinking of a large increase). For example, if someone is found to have a brain tumor, an insurance company shouldn't be allowed to suddenly raise rates beyond that person's means. That is what I'm worried about. I'm concerned that a person could be denied medical care and die simply because it wasn't good financially. That's my main concern, and that is why I believe finances shouldn't play the prevailing role in medicine (they should be considered, but not make the final decision).

May have taken that beyond what you were talking about, but that's my opinion on the whole mess.

 

[Dbate]

I apologize; I had only limited experience with an individual born with a weaken immune system. A sibling. Who only took a mediciation daily during their early life (it might have cost alot, no idea. Worth it regardless.) and hasn't taken anything in like ten years; and really hasn't had any complications regarding it. My sibling was worried about not getting health insurance due to this - and even an increased health insurance will be bad because it really has never been an issue. But - if the medications are alot or if it causes other issues - that is a reason to have increased insurance rates.

Dbate - I am glad that you believe your politicians are representing you. I only trust politicians on a local level - and even then barely. I would imagine if we were taxed more for health insurance - many of that taxes would actually go to other causes. I would really want to see a clear breakdown by the government of where my money is going if I was to ever trust them. I also distrust health insurance companies - but atleast they ideally get some oversight by the government. Who overseas the government? The UN? ha.

The government annually publishes the budget: http://www.gpoaccess.gov/usbudget/fy12/pdf/BUDGET-2012-BUD.pdf

 

[Eric01]

What are you talking about? The government is not some nefarious entity that wants to wreck havoc on our lives. We are the government! We vote for politicians, who advocate for laws we like or we vote them out of office. The entire concept of railing against the government is absurd to me.

Typically when people are lamenting about the government they're specifically talking about the 535 congressmen and the legislative branch of government.

Right now congress is enjoying a 24% approval rating. I don't think they represent the people anymore.

I don't have the numbers in front of me, but I assume this has been the average for the past 6 or so years.

 

[235009]

Dbate - I am glad that you believe your politicians are representing you. I only trust politicians on a local level - and even then barely. I would imagine if we were taxed more for health insurance - many of that taxes would actually go to other causes. I would really want to see a clear breakdown by the government of where my money is going if I was to ever trust them. I also distrust health insurance companies - but atleast they ideally get some oversight by the government. Who overseas the government? The UN? ha.

you mean something like this: http://www.whitehouse.gov/issues/taxes/tax-receipt

i think you need to read up on the function of the UN. the UN has only recently become a topic of political debate because republicans started seeking to delegitimize it in the wake of its rejection of Bush's iraq war and its reflection of the growing global scrutiny being placed on israel's occupation of the west bank.

 

[MDub1]

Just wanted to point out that not all conservative individuals favor mercedes over helping others. I want to help every person that we can; I just maintain that there are more efficient ways to do it than a public-run system.

 

[Eric01]

you mean something like this: http://www.whitehouse.gov/issues/taxes/tax-receipt

i think you need to read up on the function of the UN. the UN has only recently become a topic of political debate because republicans started seeking to delegitimize it in the wake of its rejection of Bush's iraq war and its reflection of the growing global scrutiny being placed on israel's occupation of the west bank.

No that's horrible. There are many things that can be accomplished under the title of "Food and nutrition assistance"

"How much food, what types of food, what was the price of the food, who got the food, why these locations and not those, what were available other options to purchasing this type of food, how was the food transported, who grew the food, ..."

at the end of the day you're paying more in reporter salaries then you are in food for me to be satisfied with the government's ethics.

 

[Avoidthetiger]

For example, if someone is found to have a brain tumor, an insurance company shouldn't be allowed to suddenly raise rates beyond that person's means. That is what I'm worried about. I'm concerned that a person could be denied medical care and die simply because it wasn't good financially. That's my main concern, and that is why I believe finances shouldn't play the prevailing role in medicine (they should be considered, but not make the final decision).

I agree that I don't think insurance companies should overcharge people or make it unreasonable - but maybe they make it unreasonable because the 100k+ operation is too much ever for them. Part of the joy of living in the US, is that even if your insurance denies you the care - you can still receive it. You just get a big fat bill at the end - which I do believe is an issue... but atleast no one is denied care. In other countries (I was just talking about health insurance to someone from Jordan, for example), his family will show up for a simple endoscope procedure (it costs about $100 for the endoscope), but the hospital will ask for $5000 up front as a kind of security deposit (and saying that the excess money is in case something goes wrong). If you dont have that money, you don't get the procedure. Here in the US, you get the procedure and then get that $5000 bill - but at least then you have some ability to negotiate with the hospital. But we need more negotiation and safeguards as people should be bankrupted over their health - but they should be able to get that procedure regardless.

The government annually publishes the budget: http://www.gpoaccess.gov/usbudget/fy12/pdf/BUDGET-2012-BUD.pdf

Maybe I should have been more clean. if the government stated taxing more every year for health insurance - I would need them to gurantee that all that extra money is going directly into health care for all. The US budget to me is insane - and I would HATE if they took this opportunity to put more money it war or other non-health issues. Now - if the government did something like the federalhttp://www.ehow.com/about_5047991_federal-excise-tax.html tax on cigarettes where it all goes to the Children's health insurance program - I am OK with that. I just don't like a general increase of taxes where the money could go to fund any part of the budget - and I would like it very clear where a that new tax increase for health insurance coverage was going.

SkinMD - I don't believe the function of the UN is to monitor spending of other nations. Maybe it's somewhere in there. It's more to maintain the peace and improve the welfare of our world. I'm a big lover of the UN for it's human rights issue... but my joke above was that they are the only one above the US - but even they could do little to tell us to redirect our spending away from war and towards health care. If the public complains - what are we to do? Vote for new politicians? That would probably still let us down and not improve our federal budget.

 

[Espadaleader]

Listen. Business and healthcare do not mix. Period. In business, your primary goal is to make money - not to help patients. I would never, EVER, want to be in a position to have "money" and "patient" in my head at the same time, "I need to see x patients to break even etc." Healthcare is huge. I have seen people when I shadow earn a death sentence because they could not afford to attend their 3 month check-up with the surgeon. Idk, when you see it in real life it is creepy.

 

[JubJub603]

People don't like the government running things and overreaching their power. I am not in favor of more taxes so that everyone has healthcare. I am not a big fan of some of the countries that do tax their citizens to provide free health care - long lines, have to go to a PCP before seeing a specialist (which can take forever), lack of crutches or other basic items, large patient recovery rooms, the decision to not give you every type of test out there to determine what disease you might have. This is what I encountered as a child as a health insured individual in the US. I prefer the US system and I think it is worth $1-5000 of my dollars per year to have. Without getting the US government involved (except in cases of poverty where you can't afford it - medicaid). Now that US citizens shouldn't be barred from health insurance for previous condition - but might get charged more - I am still OK with that. Maintaining your health is important.

yes - there are flaws in the US system. But I don't particularly want a government run system. The current insurance companies reimburse doctors and hospitals more so than the government ever will.

This entire post is just precious. Do you really think countries with a form of socialized medicine (note: there are many types) ration crutches and other basic items? Better yet, do you actually think your OWN doctor performs every test available to him to figure out what you *might* have?

I'm just going to stop right now. I hope this is a troll.

 

[Avoidthetiger]

This entire post is just precious. Do you really think countries with a form of socialized medicine (note: there are many types) ration crutches and other basic items? Better yet, do you actually think your OWN doctor performs every test available to him to figure out what you *might* have?

I'm just going to stop right now. I hope this is a troll.

Haha, I might be acting a bit like a troll. I like playing the devil's advocate at times. I grew up under socialized medicine. crutches were not rationed - they just were not at the hospital nearest to me. A few people I knew who sprained their ankle, were advised that their might be crunches at the elderly home. And yes - part of the biggest complaint about US medical care is the over spending of doctors doing every test just to protect themselves. So yes, I will get every test available to figure out what I have.

I'm just trying to say socialized medicine may not be the answer. Neither is a insurance company with no government intervention.

 

[tabascosauce]

good good. we need more liberals.

 

[pmarank]

Listen. Business and healthcare do not mix. Period. In business, your primary goal is to make money - not to help patients. I would never, EVER, want to be in a position to have "money" and "patient" in my head at the same time, "I need to see x patients to break even etc." Healthcare is huge. I have seen people when I shadow earn a death sentence because they could not afford to attend their 3 month check-up with the surgeon. Idk, when you see it in real life it is creepy.

Business and healthcare have coexisted in the US for many years. You just cant have the mentality that "i need to save x patients to break even"... Many smaller practices could operate at a level that maximizes profit without taking away access to health care from many if things went back to the way they were. This may not be best for the poor which is where govt could come in and put our tax dollars to work.

 

[eli20]

Coexistance is a pretty weak relationship.

 

[Avoidthetiger]

good good. we need more liberals.

haha, the crazy part is I'm actually slightly more liberal than conservative.(i'm a moderate independent). Most issues social issue I lean left. Increased government spending on something huge like healthcare and I go right. I won't mind more federal taxes once our defense budget goes down.

 

[Espadaleader]

Business and healthcare have coexisted in the US for many years. You just cant have the mentality that "i need to save x patients to break even"... Many smaller practices could operate at a level that maximizes profit without taking away access to health care from many if things went back to the way they were. This may not be best for the poor which is where govt could come in and put our tax dollars to work.

Hmmm. I love slaughtering weak arguments like yours. Just because business and healthcare EXISTED together for many years DOES NOT mean that business is GOOD for medicine. Also, you secrectly agree with me "this may not be best for the poor which is where govt could come in and put our tax dollars to work". Whoa buddy. The poor are the people that need help the most. If you're going to support business, do a better job, because I guarantee other people can. Thank you.

 

[TriagePreMed]

I will be bold and venture that doctors haven't changed at all. What has changed is society's definition of "liberal" and "conservative." It seems that unless you want to kill abortion doctors, approve of rape and torture in the military, wars, having a police state, and believe in giving the rich everything they want, you're a liberal.