So I'm donating to this guy...

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DermViser

DermViser

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So the back and forth was between a politician (he's retiring at the end of this year) who said that those who were against the ACA were....you guessed it - racist.


However, it was the opposition's response that caught my eye, where he defends the sacrifice of doctors, based on his own personal experience with his daughter 0:58 - 1:36.
 
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StIGMA said:
Very worthwhile to to listen to this (including the brief mention that provider salaries/reimbursement is going to be slashed to support ACA in the future).
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Yup, doesn't get mentioned often that this is where the "cost savings" comes into play. Of course, when you slash reimbursement to a service, guess what? It doesn't get offered.
 
the ACA blows. watch a continued brain drain from primary care
 
Dave89 said:
Wow. Johnson eviscerated Rockefeller.

One objection: I'd advise Mr. Johnson to stop being offended at the "racist" label. It's meaningless.
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It isn't the meaning that's the problem. Calling someone a "racist" is a dead end game. You're already guilty and it squashes any debate. Perfect example: http://online.wsj.com/news/articles/SB10001424052748703724104575379200412040286

The medical school equivalent would be someone calling a medical student "unprofessional". After that accusation, you're already guilty and have to prove your innocence.
 
DermViser said:
It isn't the meaning that's the problem. Calling someone a "racist" is a dead end game. You're already guilty and it squashes any debate. Perfect example: http://online.wsj.com/news/articles/SB10001424052748703724104575379200412040286

The medical school equivalent would be someone calling a medical student "unprofessional". After that accusation, you're already guilty and have to prove your innocence.
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I agree with you that the effect is analogous to that of the "unprofessionalism" charge, but (at the risk of derailing the conversation) I have to say that I think the main difference is that "unprofessional" actually has a meaning. "Racist" does not.
 
Dave89 said:
I agree with you that the effect is analogous to that of the "unprofessionalism" charge, but (at the risk of derailing the conversation) I have to say that I think the main difference is that "unprofessional" actually has a meaning. "Racist" does not.
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On the contrary, depending on the medical school, the charge of "unprofessionalism" can be quite nebulous and is very much dependent on the person levying the accusation. Often times, it's used as a way to either get you to shut you up (even if your criticisms are valid), make you do what they want you to do (fill out course evaluations, etc.), or just to tell you that they don't like what you're doing (being 5 min. late to a lecture).

Both accusations are used to effectively to stop the other side from debating. When you accuse someone of either being "unprofessional" or "racist" the emphasis of the debate changes and the onus is then on the person being accused.
 
TheRobin said:
The thing that surprises me is that there are so few people in the room. Working hard or hardly working?
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Not a big watcher of C-Span?

Dave89 said:
Wow. Johnson eviscerated Rockefeller.

One objection: I'd advise Mr. Johnson to stop being offended by the "racist" label. It's meaningless.
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Eviscerated? I didn't see that. They both did some emotional drivel stuff with almost no substance.

He got obsessed with the "racist" accusation as a parry and attack on Rockefeller. He merely needed to address it once and move on.
 
Anastomoses said:
Not a big watcher of C-Span?


Eviscerated? I didn't see that. They both did some emotional drivel stuff with almost no substance.

He got obsessed with the "racist" accusation as a parry and attack on Rockefeller. He merely needed to address it once and move on.
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No. Johnson thoroughly trounced Rockefeller playing the race card against those who are against Obamacare.
 
6tc515t-625x330.jpg

Seriously though, this video is quite literally the worst liberal drivel I've seen related to Obamacare yet. What's next, "If you didn't vote for Obamacare, you don't care about the children!"
 
Mad Jack said:
6tc515t-625x330.jpg

Seriously though, this video is quite literally the worst liberal drivel I've seen related to Obamacare yet. What's next, "If you didn't vote for Obamacare, you don't care about the children!"
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Nope, not that you don't care about children. You wish for children to die in the streets.
 
DermViser said:
So the back and forth was between a politician who said that those who were against the ACA were....you guessed it - racist.


However, it was the opposition's response that caught my eye, where he defends the sacrifice of doctors, based on his own personal experience with his daughter 0:58 - 1:36.
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DV, this may have been the most important post I've seen from you. That is not an indictment of your posts but rather a certification of the importance of this one.

Thank you
 
DermViser said:
Nope, not that you don't care about children. You wish for children to die in the streets.
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Black children, no doubt. And I'm not even kidding. "You want to see minority children dying from lack of care, don't you?" will, almost word-for-word, come out of some liberal mouth once the Republicans hold the House and Senate.
 
My assessment of the above posted clips was this:

1. Rockefeller deflected from Obamacare entirely by tugging on "the source of opposition is a dislike of Obama's color" implying there is nothing wrong with the ACA. This is tactical on his part. They did with Iraq...they had to give the common person a simple reason for why terrorists were attacking "they don't like the American way of life" so the common person wouldn't have to wonder if there was something wrong with actual policy.

Rockefeller is offering race to assuage any concerns or uneasiness the layperson has as to why ACA is being attacked so staunchly.

2. Johnson gave a bleeding heart story of his daughter's TGA as an example of how great the medical system was already; I give him credit for pointing out hypocrisy in the Obama promise that if you like your current plan, nothing will change - but it has. Fine. 1 point Johnson. The rest was meaningless emails statistically coming to his office (unproven/biased) and then dismay at being called racist with a hot temper. Show for the constituents, I imagine.

Neither particularly sharp or en pointe. As a 'neutral" layperson myself, Johnson didn't help me understand why ACA is so bad. He didn't bring it home. I was waiting for it. That's my take.
 
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Venko said:
DV, this may have been the most important post I've seen from you. That is not an indictment of your posts but rather a certification of the importance of this one.

Thank you
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No offense, taken, as I readily admit, I can be a snarky ***** sometimes. 0:58 - 1:36 really spoke out to me and it was refreshing to see a Senator actually acknowledge physicians who truly sacrifice (time, their own physical/emotional health, sometimes even putting their own lives in danger) for their patients, emergency medicine is a good example of this.
 
Anastomoses said:
My assessment of the above posted meetings was like this:
1. Rockefeller deflected from Obamacare entirely by tugging on "the source of opposition is a dislike of Obama's color" - nothing wrong with the ACA. It's like they did with Iraq...they had to give the common person a wishy washy reason for why terrorists were attacking "they don't like the American way of life"; absolutely nothing to do with actual policy. So Rockefeller is offering race to assuage any question the layperson has as to why ACA is being attacked so staunchly.

2. Johnson gave a bleeding heart story of his daughter's TGA as an example of how great the medical system was already; I give him credit for pointing out some hypocrisy in the Obama promise that if you like your current plan, nothing will change - but it has. Fine. 1 point Johnson. The rest was meaningless emails statistically coming to his office (unproven/biased) and then dismay at being called racist with a hot temper. Show for the constituents, I imagine.

Neither particularly sharp or en pointe. As a 'neutral" layperson myself, Johnson didn't help me understand why ACA is so bad. He didn't bring it home. I was waiting for it. That's my take.
Click to expand...

He gave at least three perfectly legitimate takes (perhaps more - don't recall exactly) on how the ACA was bad, and none of them had to do with race.

Which made Rockefeller's "Well, you just don't like Black people" (I paraphrase) throwaway line look extremely petty and juvenile.

Thus... evisceration.
 
Dave89 said:
He gave at least three perfectly legitimate takes (perhaps more - don't recall exactly) on how the ACA was bad, and none of them had to do with race.

Which made Rockefeller's "Well, you just don't like Black people" (I paraphrase) throwaway line look extremely petty and juvenile.

Thus... evisceration.
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Sometimes our medical bias clouds what looks like "powerful argument". I see it on here quite a bit in some of our circle-jerking threads. It's not that I don't understand...it's just that when the choir starts chiming in with the preacher, we lose perspective of what outsiders see.
 
Dave89 said:
He gave at least three perfectly legitimate takes (perhaps more - don't recall exactly) on how the ACA was bad, and none of them had to do with race.

Which made Rockefeller's "Well, you just don't like Black people" (I paraphrase) throwaway line look extremely petty and juvenile.

Thus... evisceration.
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I think this is the only time I've seen you post outside the Lounge in... Well, a long while. And naturally, it's for a guy saying something about another guy being racist. You're nothing if not consistent.
 
Anastomoses said:
My assessment of the above posted meetings was like this:
1. Rockefeller deflected from Obamacare entirely by tugging on "the source of opposition is a dislike of Obama's color" - nothing wrong with the ACA. It's like they did with Iraq...they had to give the common person a wishy washy reason for why terrorists were attacking "they don't like the American way of life"; absolutely nothing to do with actual policy. So Rockefeller is offering race to assuage any question the layperson has as to why ACA is being attacked so staunchly.

2. Johnson gave a bleeding heart story of his daughter's TGA as an example of how great the medical system was already; I give him credit for pointing out some hypocrisy in the Obama promise that if you like your current plan, nothing will change - but it has. Fine. 1 point Johnson. The rest was meaningless emails statistically coming to his office (unproven/biased) and then dismay at being called racist with a hot temper. Show for the constituents, I imagine.

Neither particularly sharp or en pointe. As a 'neutral" layperson myself, Johnson didn't help me understand why ACA is so bad. He didn't bring it home. I was waiting for it. That's my take.
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Wrong.

Rockefeller said in the clip that those who don't want to fully implement the ACA and don't want to see it work have nefarious reasons for doing so, one of them that the President "maybe being the wrong color". The direct charge is that those who are against the ACA and it's implementation are doing so not based on a policy difference.

Johnson not ONLY spoke of his daughter's condition, but also on other issues - cutting reimbursement to providers which effectively cuts services bc it's no longer worth offering it, cutting of insurance plans that are no longer offered esp. to the young who DON'T NEED comprehensive healthcare plans covering **** like maternity care, and the so-called "savings" in premiums for one person is bc OTHER people are subsidizing it, cutting of investment and jobs in medical devices due to levying of a medical device tax etc. and the list goes on and on.
 
NickNaylor said:
Wow, Senator Rockefeller looked like a complete fool. I get a little tired of the "freedom, 'Murica" argument made by Senator Johnson, but Rockefeller makes it pretty difficult to be on his side when he says completely foolhardy things.
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I agree with you, but I took it more as freedom to take his daughter to the care where she needed it - Boston Children's and Chicago Children's. Young people who have no business buying comprehensive plans, from an actuarial standpoint, are now shoved into those comprehensive plans. Why? Definitely not bc they need it. With the Obamacare bill, people have lost the freedom to purchase health insurance that fits their specific needs - this is definitely true, and now we know why this is the case (young people who won't use it much, will be paying the tab for older, more sick people).
 
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I like the idea of Obamacare in terms of increasing insurance access, but the issues with it include 1) the ability of healthy young people to purchase catastrophic plans that did not cover the comprehensive things required for later in life (thus increasing the cost for the younger population), and 2) the whole issue of "if you like your doctor, you can keep your doctor" that has been pretty thoroughly debunked.

I'm not happy that Obama makes public speeches about how people doing unnecessary procedures is anything more than an extreme outlier.

At the end of the day, I'm not 100% sure how this is going to shake out for physicians, but I believe that from a patient perspective (especially if I ever need to purchase my own insurance), it's only better for you if you were financially unable to insure yourself, on the backs from many young people who had catastrophic plans or risked not having insurance at all.

That being said, I don't think it's all bad, and believe that insuring more people (so hopefully ER visits are covered more often), eliminating pre-existing conditions ,and requiring 85% or whatever of all premiums collected to go to patient care are good starts on this path.

I don't think the solution is to just straight repeal it, but rather modify what is put into place. Assuming the House and Senate go full Republican in 2014 (or by 2016), I hope the Republican leadership modifies the law instead of fully repealing it (as the House has tried to do like 50 times or whatever).
 
Insuring more people doesn't really matter when you have huge deductibles and copays which pretty much defeats the purpose of having insurance in the first place.
 
DermViser said:
So the back and forth was between a politician who said that those who were against the ACA were....you guessed it - racist.


However, it was the opposition's response that caught my eye, where he defends the sacrifice of doctors, based on his own personal experience with his daughter 0:58 - 1:36.
Click to expand...


Very impressive discussion by Johnson.

And super idiotic responses after his comments, "You want people to have no insurance... God help you." Wow. Some of the dumbest comments I've seen after a good discussion.
 
Anastomoses said:
My assessment of the above posted meetings was like this:
1. Rockefeller deflected from Obamacare entirely by tugging on "the source of opposition is a dislike of Obama's color" - nothing wrong with the ACA. It's like they did with Iraq...they had to give the common person a wishy washy reason for why terrorists were attacking "they don't like the American way of life"; absolutely nothing to do with actual policy. So Rockefeller is offering race to assuage any question the layperson has as to why ACA is being attacked so staunchly.

2. Johnson gave a bleeding heart story of his daughter's TGA as an example of how great the medical system was already; I give him credit for pointing out some hypocrisy in the Obama promise that if you like your current plan, nothing will change - but it has. Fine. 1 point Johnson. The rest was meaningless emails statistically coming to his office (unproven/biased) and then dismay at being called racist with a hot temper. Show for the constituents, I imagine.

Neither particularly sharp or en pointe. As a 'neutral" layperson myself, Johnson didn't help me understand why ACA is so bad. He didn't bring it home. I was waiting for it. That's my take.
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I think he explained some of it.

Insurance costs have increased for most everyone. Yes, more people are covered but the average premiums have gone up. It's more expensive to carry coverage now as a healthy 20-40 year old. Healthy people are paying for the uninsured now. His constituency is now paying 25% more.

The problem with obamacare is VERY simple. With a broken healthcare system, it did absolutely nothing to address the costs of the system. It only ADDED more people to a broken system.

What could change costs?

-Tort reform/defensive med (lawyers will sue anyone b/c they can commnad 30-40% of a settlement. Defensive medicine increases costs for everyone)

-Our system is becoming more and more inefficient with health records and documentation. Obamacare just doubled down on terrible systems. Also making billing so complicated forces physicians to work for large employers

-A good system will need great primary care. What do we have now? An influx of patients and not enough primary care physicians to see them. This means more emergency department visits and more spending on inefficient care. Is going to a random ED to treat acute illnesses going to be good long term? Physicians are declining medicaid patients because they are already full - where do you think those patients end up?


So yes, we added a whole bunch of patients to a broken system. If you had a building that was collapsing due to a poor foundation, would you try to fix it by building on top of it?
 
@JackShephard said:
I think he explained some of it.

Insurance costs have increased for most everyone. Yes, more people are covered but the average premiums have gone up. It's more expensive to carry coverage now as a healthy 20-40 year old. Healthy people are paying for the uninsured now. His constituency is now paying 25% more.

The problem with obamacare is VERY simple. With a broken healthcare system, it did absolutely nothing to address the costs of the system. It only ADDED more people to a broken system.

What could change costs?

-Tort reform/defensive med (lawyers will sue anyone b/c they can commnad 30-40% of a settlement. Defensive medicine increases costs for everyone)

-Our system is becoming more and more inefficient with health records and documentation. Obamacare just doubled down on terrible systems. Also making billing so complicated forces physicians to work for large employers

-A good system will need great primary care. What do we have now? An influx of patients and not enough primary care physicians to see them. This means more emergency department visits and more spending on inefficient care. Is going to a random ED to treat acute illnesses going to be good long term? Physicians are declining medicaid patients because they are already full - where do you think those patients end up?


So yes, we added a whole bunch of patients to a broken system. If you had a building that was collapsing due to a poor foundation, would you try to fix it by building on top of it?
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You're saying it better than Johnson did. But maybe he knows how the constituents think - and they understand heart wrenching stories?
 
evilbooyaa said:
I like the idea of Obamacare in terms of increasing insurance access, but the issues with it include 1) the ability of healthy young people to purchase catastrophic plans that did not cover the comprehensive things required for later in life (thus increasing the cost for the younger population), and 2) the whole issue of "if you like your doctor, you can keep your doctor" that has been pretty thoroughly debunked.

I'm not happy that Obama makes public speeches about how people doing unnecessary procedures is anything more than an extreme outlier.

At the end of the day, I'm not 100% sure how this is going to shake out for physicians, but I believe that from a patient perspective (especially if I ever need to purchase my own insurance), it's only better for you if you were financially unable to insure yourself, on the backs from many young people who had catastrophic plans or risked not having insurance at all.

That being said, I don't think it's all bad, and believe that insuring more people (so hopefully ER visits are covered more often), eliminating pre-existing conditions ,and requiring 85% or whatever of all premiums collected to go to patient care are good starts on this path.

I don't think the solution is to just straight repeal it, but rather modify what is put into place. Assuming the House and Senate go full Republican in 2014 (or by 2016), I hope the Republican leadership modifies the law instead of fully repealing it (as the House has tried to do like 50 times or whatever).
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Obamacare's goal was never to really increase access. Look at the "7 million" who signed up for Obamacare plans. How many of those people had their previous plans cancelled bc of Obamacare and so HAD to buy an Obamacare exchange plan to be covered again and to avoid a fine? And don't lie to me (not you) about plans being cancelled all the time. Obamacare is a MAJOR disruptor to the market.

The second part of the law has not been implemented yet. That part is to ratchet down reimbursements to providers or to not cover certain things (IPAB board)
if there isn't enough "evidence", by a politically appointed board.

Also how does insuring people is supposed to keep people out of the ER, not fund them. Studies that have come out covered by the media shows that in fact the number of ER visits have gone up. The whole point of doing this was to decrease the cost curve of healthcare services.
 
Anastomoses said:
You're saying it better than Johnson did. But maybe he knows how the constituents think - and they understand heart wrenching stories?
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Stories (in his case his daughter) are a better way to transmit information than policy wonk BS that most of the population won't understand. He also explained things further. Why this is difficult for you to understand is beyond me.
 
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"We, we absolutely can play back the tape.....but we're not going to." :laugh: what a powertrippin' triflin sonuvabitch. Much prop to Johnson - I'd have lost my temper alot faster than he did if I was dealing with someone so smug and petulant as Rockefeller.
 
wow i can't believe someone like rockefeller is even allowed to be there. he constantly dodged questions by either giving some ridiculous answer or simple targeting johnson, dodging questions by talking about johnsons temper.. and stuff like he does know what he wants, etc.. i can't believe the country is governed by ppl like this guy. who voted this dood in
 
chillaxbro said:
His story about his daughter is moot because they had insurance.
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Yes, he's talking about people who have insurance. There is absolutely no question that those who didn't have insurance have been "helped" by having insurance now (whether that leads to care is another story), esp. as it is now subsidized by everyone else. Bravo. The issue is the other 85% who were happy with their insurance.
 
This is an article from today:
How Obamacare Will Screw Black Doctors
http://www.thedailybeast.com/articles/2014/05/26/how-obamacare-will-screw-black-doctors.html
Some of the country’s best doctors have the worst patient satisfaction scores. Here’s why.
http://www.thedailybeast.com/articles/2014/05/21/the-mask-your-doctor-hides-behind.html
In fact, the most satisfied patients are 12 percent more likely to be hospitalized and 26 percent more likely to die, according to researchers at UC Davis. “Overtreatment is a silent killer,” wrote Dr. William Sonnenberg in his recent Medscape article, Patient Satisfaction is Overrated. “We can over-treat and over-prescribe. The patients will be happy, give us good ratings, yet be worse off.”
____________

Instead we find ourselves in another kind of world—one turned upside-down—where the most ethical doctors are ousted and the most servile are raised high. In this world, doctors are forced to violate their sacred oaths to keep their jobs. In this world, once-proud physicians are over-prescribing and over-ordering, grinning and pretending, stepping and fetching.
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While I think that the racial bias may be overblown (and believe me, I don't want to start a race debate), it brings up an excellent topic.

Tying pay to performance in medicine is among the dumbest things you can do.

There are so many situations where patients will rate their physicians lower. For example, do you work on the most complicated cases? You will likely have worse outcomes - which will be associated with more dissatisfaction. So now the doctors working the most difficult cases will be penalized. The doctors who deal with the easiest patients and cases will be praised. Think of CRNAs in anesthesia. They work all ASA 1 cases, while the fellowship trained doctor who is working on the ASA 3 cases with patients that have COPD, obesity, CAD, etc. - they will be "lower performing". Have a difficult patient? Just transfer it to a bigger better hospital, save your patient satisfaction scores.

Drug seekers will praise those who give them opioids - hence we're rewarding physicians who please patients who don't even know what's good for them. It incentivizes bad medicine. Want an MRI even though you have a grade 1 sprain with no red flags? Sure! Let's improve patient satisfaction. More antibitoics for viral infections? Sure!

This law was not well thought out.
 
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@JackShephard said:
This is an article from today:
This law was not well thought out.
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Au contraire, it was thought out perfectly. It's not about improving outcomes for patients. It's about cutting provider reimbursement without being obvious.

These morbidly obese diabetics with hypertension and heart failure and CKDIII want roll up to their PCP's office in their rascal scooter and they seem to think that a bunch of magic pills can reverse a lifetime of terrible choices. And if we don't order whatever medication they want or whatever expensive imaging test that Dr. Google says they "need," it somehow affects our pay?
 
maxxor said:
Au contraire, it was thought out perfectly. It's not about improving outcomes for patients. It's about cutting provider reimbursement without being obvious.

These morbidly obese diabetics with hypertension and heart failure and CKDIII want roll up to their PCP's office in their rascal scooter and they seem to think that a bunch of magic pills can reverse a lifetime of terrible choices. And if we don't order whatever medication they want or whatever expensive imaging test that Dr. Google says they "need," it somehow affects our pay?
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I think it's dangerous for us to object only on the basis that it hurts medical staff. There's an argument there...that it doesn't help patients to have their doctors demoralized and treated like pond scum but we need to find other reasons too. Things that hurt the nation, the average taxpayer.

Psai said:
Enterobius
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Correct. I had originally intended to only liken him to the disease. Good catch.
 
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