Obama addressing AMA

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sweetalkr

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In light of the popularity of my last thread regarding health care politics, I would like to inform ya'll that I heard on NPR this morning Obama will be addressing health care.
I briefly heard this, so take it with a grain of salt, that it seems primary care physicians and specialists will be splitting money. Basically one or the other will get richer, the other poorer.. guess who is going to lose money under this scenario?
Also, the AMA apparently has enough power over the people that if they believe there is something very bad for doctors, they can campaign against parts of the healthcare bill and change public opinion.
or in other words, I hope you sent in your 20$ to the AMA also (after you send it in to the ASAPAC of course!)
 
I just got done watching this and Pres. Obama keeps talking abou tthe one trilion dollars the plan will cost, but how it will at the same time save money and preserve reasonable reimbursment rates because "It's not a single payor system" (yet).

Now, here is where he looses me, he states that I can keep my own insurance if I like what I have-good, great, whatever. But, why would I want to when I can get a cheaper, tax payer subsidized, insurance plan that by law must be accepted by providers hence providing the same service as my private plan? This, to my feeble mind, seems to be exactly the "trojan horse" Pres. Obama was speaking of saying that this is not a trojan horse for single payor system.

Am I mistaken about this or are you all thinking this too?
 
" Obama also told the AMA that rising health care costs could force the United States to follow in the footsteps of a bankrupt automaker.

"If we do not fix our health care system, America may go the way of GM -- paying more, getting less and going broke," he said."

http://www.cnn.com/2009/POLITICS/06/15/obama.ama/?iref=mpstoryview

Wait, didn't GM fail due to healthcare liabilities owed to it's union?

"GM had over $5 billion a year costs in healthcare"....

http://www.nytimes.com/2009/02/17/business/economy/17auto.html

That's a lowball number I've seen.

I love how he claimed that we need to have tort reform, but then he quickly said: "Hold your horses guys, I don't support malpractice caps". Basically, here is a carrot for a soundbite, now screw you!

Guys, how can doctors be so naive? How can they not, after his speech today, immediately stand up, boo him out of the speaking location, and immediately pass a resolution condemning this socialist grab of >15% of our GDP?

Lots of people say that militant CRNAs are the biggest problem our specialty faces. I say the biggest problem is the socialist power grab our dear leader Chairman Maobama and Comrade Sebelius are leading against the fabric of what makes our nation great.
 
ericL said:
I just got done watching this and Pres. Obama keeps talking abou tthe one trilion dollars the plan will cost, but how it will at the same time save money and preserve reasonable reimbursment rates because "It's not a single payor system" (yet).

Now, here is where he looses me, he states that I can keep my own insurance if I like what I have-good, great, whatever. But, why would I want to when I can get a cheaper, tax payer subsidized, insurance plan that by law must be accepted by providers hence providing the same service as my private plan? This, to my feeble mind, seems to be exactly the "trojan horse" Pres. Obama was speaking of saying that this is not a trojan horse for single payor system.

Am I mistaken about this or are you all thinking this too?
Click to expand...

That's been my impression, too. It's like he's pissing on our legs and trying to tell us it's raining.
 
Gimlet said:
I didn't get a chance to watch...what was the reaction at the meeting? Did the AMA have a chance to tell him their viewpoint?
Click to expand...

Vague cheers, and one major booing when he said:

"Now, I recognize that it will be hard to make some of these changes if doctors feel like they are constantly looking over their shoulder for fear of lawsuits." Crowd cheers heaviest during entire speech.... then he says...

"Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That's a real issue. And while I'm not advocating caps on malpractice awards" Then the Boo's began. It was followed with:

"which I believe can be unfair to people who've been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines." basically political rhetoric.


He brushed off one of the biggest issues facing doctors. Just goes to show you, the government will make zero concessions to physicians , yet will expect physicians to make all the concessions to the government. God help us.
 
Gimlet said:
I didn't get a chance to watch...what was the reaction at the meeting? Did the AMA have a chance to tell him their viewpoint?
Click to expand...

nope, no q&a, and lots of applause lines 👎
 
RxBoy said:
Vague cheers, and one major booing when he said:

“Now, I recognize that it will be hard to make some of these changes if doctors feel like they are constantly looking over their shoulder for fear of lawsuits." Crowd cheers heaviest during entire speech.... then he says...

"Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That’s a real issue. And while I’m not advocating caps on malpractice awards" Then the Boo's began.



He brushed off one of the biggest issues facing doctors. Just goes to show you, the government will make zero concessions to physicians , yet will expect physicians to make all the concessions to the government. God help us.
Click to expand...

Good point, that was really the only mention he made of anything even vaguely resembling tort reform-seems this would be a pressing issue at this particualr conference. If everything else is going down the tubes monetarily, why should damage awards be allowed to increase (or even stay static) if those on the other end are losing their net worth...
 
RxBoy said:
Vague cheers, and one major booing when he said:

“Now, I recognize that it will be hard to make some of these changes if doctors feel like they are constantly looking over their shoulder for fear of lawsuits." Crowd cheers heaviest during entire speech.... then he says...

"Some doctors may feel the need to order more tests and treatments to avoid being legally vulnerable. That’s a real issue. And while I’m not advocating caps on malpractice awards" Then the Boo's began. It was followed with:

"which I believe can be unfair to people who’ve been wrongfully harmed, I do think we need to explore a range of ideas about how to put patient safety first, let doctors focus on practicing medicine, and encourage broader use of evidence-based guidelines." basically political rhetoric.



He brushed off one of the biggest issues facing doctors. Just goes to show you, the government will make zero concessions to physicians , yet will expect physicians to make all the concessions to the government. God help us.
Click to expand...


yep exactly..

he said a lot of what the doctors wanted to hear and stayed away from things we didn't want to hear for the most part...

Also his talks about how the $1 trillion dollar plan will pay for itself but that doesn't mean we won't have to initially pay for it with higher taxes...

also his plan to use generic drugs to save money on health care but if pharmaceutical companies can't make money how will we get new drugs developed?

And I agree with the others about why would someone pay what their paying now for health insurance if they can get the same thing at a much cheaper rate..

Too bad he didn't leave at least 10min for questions at the end I would loved to hear what some AMA members had to say on this issue.

over all he kept emphasizing how this plan will give doctors more time to be doctors and treat patients and not have to worry about the paper work that comes with the job.

I don't know I hope the AMA doesn't fall for this and stick to their guns.. what i think will happen though is he'll bundle everything together (like they do with many laws) and government officials will vote positively on one thing and that would mean they voted positively on the whole thing.. like his plan to make medical records one computerized system is great.. but that won't happen until the rest of his health plan gets passed.. so some might vote positively on the whole plan just to get one part of the plan that they want passed..

Although he did say that this is a limited opportunity and if it doesn't happen now it might never happen.. so maybe we can keep debating about this until his time in office runs out and that would be the end of the plan..
 
RussianJoo said:
also his plan to use generic drugs to save money on health care but if pharmaceutical companies can't make money how will we get new drugs developed?
Click to expand...

Are you kidding? Do you know what kind of insane profits these companies make? We should worry about doctors, the drug companies will be just fine no matter what happens.
 
ericL said:
I just got done watching this and Pres. Obama keeps talking abou tthe one trilion dollars the plan will cost, but how it will at the same time save money and preserve reasonable reimbursment rates because "It's not a single payor system" (yet).

Now, here is where he looses me, he states that I can keep my own insurance if I like what I have-good, great, whatever. But, why would I want to when I can get a cheaper, tax payer subsidized, insurance plan that by law must be accepted by providers hence providing the same service as my private plan? This, to my feeble mind, seems to be exactly the "trojan horse" Pres. Obama was speaking of saying that this is not a trojan horse for single payor system.

Am I mistaken about this or are you all thinking this too?
Click to expand...

And herein lies the key. Who is going to pay for insurance if they can get it from the government without paying for it (taxes aside)? Moreover, what business is going to keep paying for private insurance for its employees if they can just let the govt. pick up the tab?

How do you know when Obama is lying? His lips are moving...

As for this line about if we don't do it now we will never be able to, I call bull****. If it isn't viable in the future, how is it viable now? But just like Biden said, never let a crisis go to waste (even if the crisis really isn't a crisis- just convince people the sky is falling). I can't believe people voted for these clowns.
 
IDBasco said:
And herein lies the key. Who is going to pay for insurance if they can get it from the government without paying for it (taxes aside)? Moreover, what business is going to keep paying for private insurance for its employees if they can just let the govt. pick up the tab?

How do you know when Obama is lying? His lips are moving...

As for this line about if we don't do it now we will never be able to, I call bull****. If it isn't viable in the future, how is it viable now? But just like Biden said, never let a crisis go to waste (even if the crisis really isn't a crisis- just convince people the sky is falling). I can't believe people voted for these clowns.
Click to expand...


Well, hopefully a cheaper government provided insurance plan will force insurance companies to lower their premiums through competition. This could be a good thing for the consumer.

The whole mandatory physician participation thing is what rubs me the wrong way. Without being able to opt in/out of participation, physician reimbursement is going to drop.
 
IDBasco said:
And herein lies the key. Who is going to pay for insurance if they can get it from the government without paying for it (taxes aside)? Moreover, what business is going to keep paying for private insurance for its employees if they can just let the govt. pick up the tab?

How do you know when Obama is lying? His lips are moving...

As for this line about if we don't do it now we will never be able to, I call bull****. If it isn't viable in the future, how is it viable now? But just like Biden said, never let a crisis go to waste (even if the crisis really isn't a crisis- just convince people the sky is falling). I can't believe people voted for these clowns.
Click to expand...


he never said insurance would be free.. he said it would be government subsidized. so it will be cheaper than private insurance but people will still have to pay a monthly fee..not that it makes things any better for us, i am just saying from what he said he doesn't want to make this into free national insurance. i think it will just be based on your income. And he did mention a tax increase for the wealthy, which in his book is anyone making over $200K a year? 🙁
 
scudrunner said:
Well, hopefully a cheaper government provided insurance plan will force insurance companies to lower their premiums through competition. This could be a good thing for the consumer.
Click to expand...

It's not cheaper. It's funded through the taxpayer, i.e. YOU. Insurance companies ALREADY lower their premiums to attract individuals and companies to their plans. The PUBLIC plan will lower premiums to the point that private insurance CAN'T, and that means private insurance will FAIL. Also, the PUBLIC plan will cost shift even more to private insurance, leading to even MORE failure.

This is TERRIBLE for the consumer.
 
No malpractice award caps, that line makes me want to drop out of med school.

How about having the patients take on some of the risk in the system if they are going to be getting services at a reduced rate?
I actually think people should get reimbursed if damages were done, but not via the crazy system that we have now.

Also, doctors/hospitals should have the right to opt out of the system. Why should they be forced to just take whatever the government sees fit to give them? If we ever went to the single payer system, we'd all be basically slaves. I'd go back to private industry (unless they ran them all out of business as well).
 
scudrunner said:
Well, hopefully a cheaper government provided insurance plan will force insurance companies to lower their premiums through competition. This could be a good thing for the consumer.

The whole mandatory physician participation thing is what rubs me the wrong way. Without being able to opt in/out of participation, physician reimbursement is going to drop.
Click to expand...

I have a question about this.. how can it really be mandatory? i mean I hear of primary care private practices that are cash only. And aren't we aloud to deny care of new patients unless it's an emergency and even then they can be directed to the ER? Plenty of doctors don't accept medicare/medicaid...

so sure those places might lose business and be forced to accept government health insurance that way.. but if they have an established patient base can't they say I will not be able to provide my services to you unless you pay my fees, and say the government plan covers 1/3 of those fees have the patient write you a check for the other 2/3rds.


Plenty of doctors have billed me and my family after procedures because the insurance companies didn't pay them their full claims.. The insurance company would say we had a contract with the doctor and we paid him exactly what was said in the contract.. but those doctors billed my family and me for the difference and we ended up paying.... Did those doctors do something illegal? Cause this happened on many occasions by many different doctors. Even anesthesiologists would do the same, whatever the insurance company doesn't pay pass it on to the patient.
 
Mobama???? Who believes in this guy? AMA - another joke. WELCOME in SOCIALISM!
 
IDBasco said:
And herein lies the key. Who is going to pay for insurance if they can get it from the government without paying for it (taxes aside)? Moreover, what business is going to keep paying for private insurance for its employees if they can just let the govt. pick up the tab?

How do you know when Obama is lying? His lips are moving...

As for this line about if we don't do it now we will never be able to, I call bull****. If it isn't viable in the future, how is it viable now? But just like Biden said, never let a crisis go to waste (even if the crisis really isn't a crisis- just convince people the sky is falling). I can't believe people voted for these clowns.
Click to expand...

I think what he means by now is "lets get this s hit done before the mid-term elections" ohersiwse there is a distinct possibility of losing that precious fillabuster proof majority in the house....
 
RussianJoo said:
he never said insurance would be free.. he said it would be government subsidized. so it will be cheaper than private insurance but people will still have to pay a monthly fee..not that it makes things any better for us, i am just saying from what he said he doesn't want to make this into free national insurance. i think it will just be based on your income. And he did mention a tax increase for the wealthy, which in his book is anyone making over $200K a year? 🙁
Click to expand...

They don't need to make it free to knock private insurance out of the game. They just need to be (or appear) significantly cheaper- especially to the employer which is where most people get their private insurance from. They can just tax people (only the rich will have to pay- don't worry!!) to make up for any difference between collected revenue and what it actually costs to run the system. Hell, taken to the extreme, when the govt. couldn't deliver mail cheap enough to compete with private business, they outlawed the competition. Must be a nice option to have- if you're the government, that is.

This whole health care reform idea doesn't just potentially cost doctors income, it also will change how we receive care. Remember, we will always be patients too. I have no complaints with the system now from the point of view of a patient and I have been buying my own individual insurance for the past ~3 years.

Some things to ponder. If the govt. decides health care they are giving out is too expensive, what do they do? Raise taxes, cut benefits to the pts. or cut what they are paying hospitals/docs. Which of these is an attractive option to you as a future doc? As a future patient? Someone above said Obama is claiming docs will have more time with patients. How so? We are supposed to be short on docs as it is? Where does this new time come from? Extra hours worked? Midlevel expansion? Rationed Care?

They only real role I am ok with for government in regard to health care is to pay for people that cannot get private insurance because they cannot get a company to sell them one- such as people with chronic illness of various types. Private insurance isn't perfect, but I will take it over the government every time.
 
zrxtypxxszk said:
It's not cheaper. It's funded through the taxpayer, i.e. YOU. Insurance companies ALREADY lower their premiums to attract individuals and companies to their plans. The PUBLIC plan will lower premiums to the point that private insurance CAN'T, and that means private insurance will FAIL. Also, the PUBLIC plan will cost shift even more to private insurance, leading to even MORE failure.

This is TERRIBLE for the consumer.
Click to expand...


Premiums for good policies cost a fortune, and the companies still want to deny coverage and payment wherever and whenever possible. I'd like to see them straighten up and fly right. Real competition would do this... maybe. It's all speculation at this point anyhow. I don't buy into the doom and gloom theories though.
 
RussianJoo said:
but if they have an established patient base can't they say I will not be able to provide my services to you unless you pay my fees, and say the government plan covers 1/3 of those fees have the patient write you a check for the other 2/3rds.


Plenty of doctors have billed me and my family after procedures because the insurance companies didn't pay them their full claims.. The insurance company would say we had a contract with the doctor and we paid him exactly what was said in the contract.. but those doctors billed my family and me for the difference and we ended up paying.... Did those doctors do something illegal? Cause this happened on many occasions by many different doctors. Even anesthesiologists would do the same, whatever the insurance company doesn't pay pass it on to the patient.
Click to expand...

That's called "balance billing" and it's illegal in many areas, including the entire state of California. For the life of me I can't understand why. I believe there is a federal ban on balance billing for Medicare patients as well, so you'd better believe it will be a part of any public-option healthcare reform plan that passes.
 
IDBasco said:
They don't need to make it free to knock private insurance out of the game. They just need to be (or appear) significantly cheaper- especially to the employer which is where most people get their private insurance from. They can just tax people (only the rich will have to pay- don't worry!!) to make up for any difference between collected revenue and what it actually costs to run the system. Hell, taken to the extreme, when the govt. couldn't deliver mail cheap enough to compete with private business, they outlawed the competition. Must be a nice option to have- if you're the government, that is.

This whole health care reform idea doesn't just potentially cost doctors income, it also will change how we receive care. Remember, we will always be patients too. I have no complaints with the system now from the point of view of a patient and I have been buying my own individual insurance for the past ~3 years.

Some things to ponder. If the govt. decides health care they are giving out is too expensive, what do they do? Raise taxes, cut benefits to the pts. or cut what they are paying hospitals/docs. Which of these is an attractive option to you as a future doc? As a future patient? Someone above said Obama is claiming docs will have more time with patients. How so? We are supposed to be short on docs as it is? Where does this new time come from? Extra hours worked? Midlevel expansion? Rationed Care?

They only real role I am ok with for government in regard to health care is to pay for people that cannot get private insurance because they cannot get a company to sell them one- such as people with chronic illness of various types. Private insurance isn't perfect, but I will take it over the government every time.
Click to expand...

excellent points.. I never said i was for it.. i have family in countries with national health care and they're constantly complaining about the care they get.

wasn't medicaid made to help the poor get health care? if those people are too poor to buy their own insurance they should apply for medicaid and if they don't fit for medicaid well then maybe the government should change it's policies on who's accepted into medicaid...
 
Gimlet said:
That's called "balance billing" and it's illegal in many areas, including the entire state of California. For the life of me I can't understand why. I believe there is a federal ban on balance billing for Medicare patients as well, so you'd better believe it will be a part of any public-option healthcare reform plan that passes.
Click to expand...

yeah i mean it didn't sound fair to me as a patient..but what could i do.. the doctor provided care..



so what about the fact that private groups can simply decline patients who don't have private insurance or are willing to pay cash? how can the government force doctors to accept the national insurance if many don't accept medicaid or medicare right now? I know since anesthesiologists don't really pick who their patients are.. but the surgeons we work with do...
 
ericL said:
I think what he means by now is "lets get this s hit done before the mid-term elections" ohersiwse there is a distinct possibility of losing that precious fillabuster proof majority in the house....
Click to expand...

Someone gets it...

If this whole reform he's so quick to push really is a cost saving measure, there will ALWAYS be the opportunity to make such a change. Does he really believe we're that dumb (rhetorical, please don't answer that...)? He sounds like a used car salesman.

If this country is going to go down the tubes it will be because of an administration that has already quadrupled the previous administration's deficit (which was high enough) and is only half way through its first year. Yea hope and change!!! 👎
 
RussianJoo said:
so what about the fact that private groups can simply decline patients who don't have private insurance or are willing to pay cash? how can the government force doctors to accept the national insurance if many don't accept medicaid or medicare right now?
Click to expand...

These idiot policy makers do not understand that health insurance is not the cure to the health crisis. As a matter of fact, it simply exacerbates the problem. The state of Mass required by law all residents receive health insurance, whether public or private back in 2006. New stats are proving that the system is beginning to crack (http://www.news-medical.net/news/20...in-treatment-hampered-by-provider-supply.aspx)

Excerpt:
One in five adults reported being told in the past 12 months that a physician or clinic was not accepting new patients or would not see patients with their type of insurance (Sack, New York Times, 5/28). Lower-income residents had more difficulties finding a physician than higher-income residents, with 24% of residents enrolled in state-subsidized health plans, saying they were told that a physician did not accept their insurance, compared with 7% of residents with private coverage.

Mass has one of the higher supplies of health care providers. If something is done similar on the national level, could you imagine what would happen to the states who already have shortages?

Giving people insurance does not solve some of the core issues of the health crisis such as shortage of health care providers and facilities, dangerously unhealthy American lifestyles, and the practice of defensive medicine. As evidence shows... it will most likely exacerbate it.
 
RussianJoo said:
yeah i mean it didn't sound fair to me as a patient..but what could i do.. the doctor provided care..



so what about the fact that private groups can simply decline patients who don't have private insurance or are willing to pay cash? how can the government force doctors to accept the national insurance if many don't accept medicaid or medicare right now? I know since anesthesiologists don't really pick who their patients are.. but the surgeons we work with do...
Click to expand...


Easy. Mandate acceptance of the new government insurance in order to get a medical license. That's the heavy handed way. The subtle way is to engage in monopoly pricing to lower the costs to business (by taxing for the loss or running deficits or both) until all small businesses switch to the government plan because it is that much cheaper. Then especially anesthesiologists will be required to accept the plan. They will be required to accept it because most hospitals require their contracted anesthesia groups to participate with any payers that make up at least x% of the hospitals payer mix in order to get a contract.
 
RxBoy said:
These idiot policy makers do not understand that health insurance is not the cure to the health crisis. As a matter of fact, it simply exacerbates the problem. The state of Mass required by law all residents receive health insurance, whether public or private back in 2006. New stats are proving that the system is beginning to crack (http://www.news-medical.net/news/20...in-treatment-hampered-by-provider-supply.aspx)

Excerpt:
One in five adults reported being told in the past 12 months that a physician or clinic was not accepting new patients or would not see patients with their type of insurance (Sack, New York Times, 5/28). Lower-income residents had more difficulties finding a physician than higher-income residents, with 24% of residents enrolled in state-subsidized health plans, saying they were told that a physician did not accept their insurance, compared with 7% of residents with private coverage.

Mass has one of the higher supplies of health care providers. If something is done similar on the national level, could you imagine what would happen to the states who already have shortages?

Giving people insurance does not solve some of the core issues of the health crisis such as shortage of health care providers and facilities, dangerously unhealthy American lifestyles, and the practice of defensive medicine. As evidence shows... it will most likely exacerbate it.
Click to expand...

yep.. exactly..

but it looks like Maobama has that covered too.. http://www.aamc.org/newsroom/pressrel/2009/090505.htm

they plan on creating an extra 15,000 residency spots mostly in primary care... and of course 95% of those new spots will be taken by FMGs who'll gladly take medicare/medicaid and the new national health care patients.. cause it's better than driving a cab for a living.

[YOUTUBE]http://www.youtube.com/watch?v=EX6h-Ut-ZaE&feature=channel_page[/YOUTUBE]
 
No wonder the doctors don't trust this guy. Here you have a Chicago lawyer and his HHS secretray, a former trial lawyer, making decisions about the future of healthcare in this country.

Anybody want to ventrue a guess as to where this will lead to. Thats right a complete disaster.

The minute Mr. Obama's/democrats plan of universal medicare coverage takes effect, we will see massive numbers of doctors fleeing the healthcare system. Because at that moment, it will become economicially disasterous to practice medicine.
 
So, not only is our new health care plan going to destroy physician reimbursements AND stick physicians with the brunt of malpractice insurance, now we'll have an even harder time paying off student loans. If I remember correctly, medical schools in the UK and Canada are free or relatively inexpensive. My school was $40K/year just for tuition. It seems as if he's going out of his way to deter people from entering the field while also talking about the physician shortage.

What about this makes sense? We're making ALL of the concessions and getting nothing in return. He didn't even buy us dinner first...
 
I know many of us have been trying to figure out just what his 'health care reforms' entail, but that has been very difficult, since he isn't releasing the details, except in very small, calculated increments.

There will be big talking points released and commented upon relentlessly. Those may be interesting, but watch what isn't commented on, the little things that sneak through with sleight of hand.

We began residency orientation today, and I've already begun encouraging all of my classmates to join the ASA. My goal is 100% membership. I encourage all of you other residents to bring the subject up once in a while. We need to learn the true value of our specialty and convey that value to others. We can't be caught sleeping at the wheel. Resident membership is only $25/year. Go to the following website, print out some applications, and hand them out to your colleagues http://www.asahq.org/joinASA.htm
 
RabbMD said:
Easy. Mandate acceptance of the new government insurance in order to get a medical license. That's the heavy handed way. The subtle way is to engage in monopoly pricing to lower the costs to business (by taxing for the loss or running deficits or both) until all small businesses switch to the government plan because it is that much cheaper. Then especially anesthesiologists will be required to accept the plan. They will be required to accept it because most hospitals require their contracted anesthesia groups to participate with any payers that make up at least x% of the hospitals payer mix in order to get a contract.
Click to expand...


yeah... i guess it sucks being more or less a hospital employee...🙁
 
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