Stimulus Bill and Med School

[chillpillman]

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FYI: This post should not be about your political feelings toward the stimulus bill.

Instead, I was wondering what effects will it have on our education / career?

I've read some of the House Bill, but the compromise has yet to be determined. But the major complaints so far are all about the new health e-records that one cannot opt-out of - having some worry at the loss of privacy and others forecasting a slippery slope to government-controlled healthcare.

But here are the proposed estimated money-makers:
$20 billion for the e-records system for more efficiency and coordination
$4 billion for NIH research
$2 billion for clinics (new and renovations)
$0.6 billion for National Health Service Corps.
Halting a proposed reduction in IME payments to teaching hospitals

Promoters...
http://appropriations.house.gov/pdf/PressSummary01-15-09.pdf - see p10
http://www.aamc.org/newsroom/pressrel/2009/090128.htm

Complaints...
http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs
http://www.medicalnewstoday.com/articles/136558.php

Let me know if this summary is right and any changes that happen. Other than NHS Corps. is there a chance of any other changes in medical school funding?

 

[Tiger26]

What's the point of even attending anymore since now all our decisions regarding patient care will be in the hands of a govt board?

Seriously, I would've been less inclined if I knew we were getting ****ed.

http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_mccaughey&sid=aLzfDxfbwhzs

 

[chillpillman]

Tiger, I doubt such changes you worry about will happen without a fight, but it helps to be informed on whats going on. I'll still be a good doctor even if I have to fight government red tape to be one.

Here is more stimulus data thanks to CNN estimations:
House Bill --> Senate Bill (all amounts in billions of dollars)
Total Department of Health and Human Services: 19.28-->19.67
Office of the Secretary: 5.43-->3.00
NIH Research: 3.5-->10.0
Admin Children and Families: 5.2-->3.1
Admin on Aging: 0.2-->0.1
Health Resources and Services: 2.188-->1.958
CDC: 0.462-->0.412

Basically by my reading of these estimations the House wanted more bureaucracy money while the Senate voted for a portion of that money to be shifted towards research. We shall see how they compromise...

In the Department of Education funds...
Student Financial Assistance: 16.176-->13.930
Higher Education: 0.10-->0.05

Obviously most of this money is not for medical students (probably 95% undergrads) but I am wondering if any of it is for us?

Source: http://www.cnn.com/2009/POLITICS/02/10/stimulus.next/index.html#cnnSTCOther1

 

[DCDAWG]

Will this stuff only apply to patients on medicare and other government programs?
I dont see how they can legally have authority over physicians at private hospital treating a patient with private insurance..?
They can, however, set whatever standards they like for their specific programs- like medicare, etc. That doesnt seem too much different from an insurance company saying we arent going to pay for X treatment for X diagnosis- which is something the medical community already deals with.
If the bill does extend to all patients paying through something not sponsored by the government (which I dont see how it legally can)- then I anticipate a very strong reaction, since that really would be taking all decision-making autonomy out of physician's hands.

 

[DocPsychosis]

Will this stuff only apply to patients on medicare and other government programs?
I dont see how they can legally have authority over physicians at private hospital treating a patient with private insurance..?
They can, however, set whatever standards they like for their specific programs- like medicare, etc. That doesnt seem too much different from an insurance company saying we arent going to pay for X treatment for X diagnosis- which is something the medical community already deals with.
If the bill does extend to all patients paying through something not sponsored by the government (which I dont see how it legally can)- then I anticipate a very strong reaction, since that really would be taking all decision-making autonomy out of physician's hands.

Well, the government pays for more than half of all healthcare spending in the US via VA, Medicare, Medicaid, IHS, etc. so it's not actually that big a difference. And private insurers take a lot of cues off government programs, e.g. payments based on Medicare reimbursements, so it could go that way indirectly if not directly.

 

[Tiger26]

I mean at what point do they start advocating forced euthanasia for terminal diseases to cut their expenditures.

As someone who nearly died under a "wonderful" system of universal healthcare, these proposals are just unbelievable.

Department of Motor Vehicles efficiency + Hospital + "Providers" =>"Universal healthcare"

 

[DocPsychosis]

I mean at what point do they start advocating forced euthanasia for terminal diseases to cut their expenditures.

As someone who nearly died under a "wonderful" system of universal healthcare, these proposals are just unbelievable.

Department of Motor Vehicles efficiency + Hospital + "Providers" =>"Universal healthcare"

Wow, you combined a slippery slope fallacy, a useless anecdote, a red herring, and an accusation based on no facts into a single hilariously bad post. Do you have any basis for your conservatism, or you just hate them dadgum lib'ruls?

 

[UTBioMed]

I thank you DocPsychosis, I'm glad there are people that can see through the smoke and mirrors of the fear bred by people like Mr. Tiger there.

There is a large difference between socialized medicine and socialized healthcare, but the right seems to try and blend it all together into some evil hydra purported by the liberal 'elite.' We are still far from receiving a necessary and full universal socialized healthcare system, I strongly believe there is no way we will ever follow the path of socialized medicine.

There is one firm belief that holds strong no matter who you are and that is limited government intervention is best. The differences lie when government should be used, be it emphasized on national security, or on social programs in place to fight the injustices of common man. I prefer the latter however imperfect it may be, it still is used for that basic principle on which we are founded and that is the pursuit of life liberty and happiness. When the government has the ability to give health insurance to all Americans yet provide better insurance for those who already have it by eliminating administrative costs and profits, is that not the ultimate gial for thise who believe in the power of medicine?

We are taught to be healers of the sick, not for only the sick who can afford it. Give universal healthcare a chance and see what the results are and quality of life is like just one generation from now and tell me it was not worth it. Yes, it will take money to make money but our future lies in completely overhauling healthcare, whatever the price (that and education reform to incentivize the next generation of doctors).

 

[MOHS_01]

🙄

Allow providers to negotiate their rates, opt out of the system without unjust time penalties, free us from some of the needlessly cumbersome administrative hassles, and provide a more stable environment within which to conduct business and I'll go peacefully with your advocated annual $2+ trillion dollar statist policy.... otherwise you can keep your "piss on personal autonomy, liberties, and property rights" cause to yourself.

 

[Bart Clarridge]

...

We are taught to be healers of the sick, not for only the sick who can afford it. Give universal healthcare a chance and see what the results are and quality of life is like just one generation from now and tell me it was not worth it. Yes, it will take money to make money but our future lies in completely overhauling healthcare, whatever the price (that and education reform to incentivize the next generation of doctors).

The problem is that most people like thier healthcare. There is already a heavy degree of "socialism" even in the private side where there is cost shifting. It looks like some people want a huge paradim shift. Some people who don't know how to manage money. Why not just tell the bankers to go pound sand and take care of pepope who truely do not have access? Why not tort reform? And that's just a small part of the waste.

Your first line made me chuckle since a lot of us would have said the something similar back when we were premeds sippin' a latte studying in the coffe house. When you are up at 3 am and haven't slept and aren't going to...well, the abstract notion of "helping people" takes a back seat to wanting to help yourself--to a nap. You do that for a few years and see what happens to you. (Sometimes I think the interview committee people know we will become a bit bitter and search for the pie-in-the-sky attitude because if they start with normal people...look out ) It's not that patients' fault our system is like this, but it's not mine either. We should be very well compensated, especially in light of the money our government (and people in general) wastes on the less deserving (as I've said elsewhere, I'm not talking about welfare moms here).

Bottom line is that quality costs.

 

[YouISee]

I thank you DocPsychosis, I'm glad there are people that can see through the smoke and mirrors of the fear bred by people like Mr. Tiger there.

There is a large difference between socialized medicine and socialized healthcare, but the right seems to try and blend it all together into some evil hydra purported by the liberal 'elite.' We are still far from receiving a necessary and full universal socialized healthcare system, I strongly believe there is no way we will ever follow the path of socialized medicine.

There is one firm belief that holds strong no matter who you are and that is limited government intervention is best. The differences lie when government should be used, be it emphasized on national security, or on social programs in place to fight the injustices of common man. I prefer the latter however imperfect it may be, it still is used for that basic principle on which we are founded and that is the pursuit of life liberty and happiness. When the government has the ability to give health insurance to all Americans yet provide better insurance for those who already have it by eliminating administrative costs and profits, is that not the ultimate gial for thise who believe in the power of medicine?

We are taught to be healers of the sick, not for only the sick who can afford it. Give universal healthcare a chance and see what the results are and quality of life is like just one generation from now and tell me it was not worth it. Yes, it will take money to make money but our future lies in completely overhauling healthcare, whatever the price (that and education reform to incentivize the next generation of doctors).

If the profile tag "pre-med" refers to your current status, then it would totally explain your post along with other pre-meds. The real world doesn't give a feces about your views. That's why it can't be overhauled. You need insurance, pharma, and of course political cockholsters to be on board. They never will because they make too much of the current way while screwing over docs.

I REALLY REALLY suggest that most premeds should spend 1 devoted month in the hospital following around a resident even when things get ugly. Then you will realize that medicine is not what you think it is. It is production pressure and patients are just customers. They tend to not give a feces and only care about how fast their order can be processed. It's medical McDonalds. That creates customer satisfaction.

Spend your tuition money on BUSINESS and go ahead complete the pre-med courses. But do not go into medicine based on the fairy tales passed along to you. That was my mistake. Sure I could get out, but I'm 100K deep! If I would owe 200K like some other folks, I'd surely be screwed with that mortgage.