with the disaster the obamacare will be for doctors, why are there still so many applicants ?

[Lya]

---

Members do not see this ad.

chenzt handled this nicely.



You are misunderstanding the conversation here because you are looking at it from the patient's perspective rather than the physician's. If my patient mix includes 5% Medicaid and 5% uninsured, it is an improvement for me if the ACA changes that to 8% Medicaid and 2% uninsured. Does that clarify why an expansion of insurance coverage, including Medicaid, is a good thing?

I also agree with chenzt that Medicaid patients do not have the worst time obtaining care. Their choices might be limited, but they are not locked out of referrals. My hospital system treats quite a few Medicaid patients, everything from primary care and skin shaves to triple bypasses and radiation oncology. We eat a lot of the costs, but they are offset by other revenue and it keeps the state happy. From the patient's perspective t is far, far worse to be poor and uninsured, which often means relying on a patchwork of free clinics and the ER.

I understand your point. Do you know any data that shows Medicaid patients significantly outperform the uninsured in both health outcomes?


http://www.forbes.com/sites/theapot...effect-on-health-outcomes-vs-being-uninsured/

Avik Roy is a Republican and a Yale med grad who opposes wasting money on Medicaid. He is not claiming that Medicaid is bad (at least, intentionally); he simply claims that Medicaid is just inefficient and ineffective--money spent on Medicaid has lower return than we believe, almost comparable to the uninsured. He points out that the health outcome of Medicaid patients, even in Oregon (one of those states like Colorado that Medicaid reimbursement rates are relatively better than the other states), is not significantly better than that of uninsured patients. In his 40-age book, he briefly mentions how new Medicaid patients cannot get an appointment 66% of the time, compared to 11% for those with private insurance. Of course, it will vary depending on which state we are talking about, and I am sure this is better than having no insurance at all; however, considering the amount of money we spend on Medicaid ($450 billion per year, and $750 billion for the next ten years for Medicaid expansion), I am not sure whether the incremental "improvement" that you get as a physician post-ACA justifies this amount of financial investment.

Sure, I definitely agree with you that from the reimbursement point of view, the fewer uninsured patients you treat, the better a physician will be reimbursed compared to treating more uninsured patients. However, the financial improvement for you as a physician will be too small compared to the total amount of investments for Medicaid, and the patients' outcomes will probably not improve significantly, either. Overall, it sounds like a lose-lose scenario overall.

 

[Trismegistus4]

Look, this is really very simple. We live in a liberal society. The vast majority of not only premeds, but doctors themselves, are liberals. They favor the vast leveling project currently underway by the unaccountable, bureaucratic, technocratic elite. It doesn't matter that they themselves will make less money. Their goal of making everyone equal will be closer to fruition. Equality and nondiscrimination are the principles they care about, not their own incomes. The ACA is not the left's true goal, whcih is single-payer universal health care, but by placing another nail in the coffin of the private insurance system, it paves the way for single-payer. Hence they favor it. What is so hard to understand about that?

 

[Gut Shot]

I understand your point. Do you know any data that shows Medicaid patients significantly outperform the uninsured in both health outcomes?

Not off the top of my head, but when I have questions like this I generally consult Pubmed instead of Forbes.

Avik Roy is a Republican and a Yale med grad

Sounds like a real douchebag.

 

[chondroblast]

The vast majority of not only premeds, but doctors themselves, are liberals.

Actually in the most recent surveys the majority of physicians self-reported as being "fiscally conservative but socially liberal".

 

[SunsFun]

Actually in the most recent surveys the majority of physicians self-reported as being "fiscally conservative but socially liberal".

Yeah lol. Check sociopolitical sub forum. You will have to read through quite a lot of stuff to get to liberal opinions. Most people there are either conservative or libertarian.

 

[chondroblast]

Yeah lol. Check sociopolitical sub forum. You will have to read through quite a lot of stuff to get to liberal opinions. Most people there are either conservative or libertarian.

Maybe on this forum. I'm talking about in the real world.

 

[mcloaf]

Most people there are either conservative or libertarian.

Welcome to the internet.

 

[Lya]

Not off the top of my head, but when I have questions like this I generally consult Pubmed instead of Forbes.



Sounds like a real douchebag.

Well, the Oregon study is at NEJM, so you may find it there if you are still interested. I put the Forbes article because that was when I came across for the first time, but it looks like you didn't even care to look for the original study, even though you said you generally consult pubmed. When was the last time you generally consulted pubmed?

And that last comment implies you don't have anything else meaningful to bring to further the discussion. Well played.

 

[ciruji]

Well, the Oregon study is at NEJM, so you may find it there if you are still interested. I put the Forbes article because that was when I came across for the first time, but it looks like you didn't even care to look for the original study, even though you said you generally consult pubmed. When was the last time you generally consulted pubmed?

And that last comment implies you don't have anything else meaningful to bring to further the discussion. Well played.

Brb he is a" physician", I'm a pre-med and I gotta to agree on everything he says.

 

[Lya]

Brb he is a physician, I'm a pre-med and I gotta to agree on everything he says.

I did notice.

However, he just ignored the whole data and argument I presented. Instead, he focused on the first sentence I said that is not even relevant to this whole discussion.

http://www.nejm.org/doi/pdf/10.1056/NEJMsa1212321

After some quick google search, here it is. Dr. Roy is not even an author of this study, and the study I mentioned about 66% and 11% are done at UPenn. I am uncertain what exactly his comments brought to the table. With all due respect, his responses to my post did not reflect his credentials and years of experiences.

 

[Utenation]

Oh yes, please. I can hear Hillary taking the oath of office now...

Haha I thought that comment would get some reactions. Hillary was way ahead in the polls this time 8 years ago too.

 

[RogueUnicorn]

Look, this is really very simple. We live in a liberal society. The vast majority of not only premeds, but doctors themselves, are liberals. They favor the vast leveling project currently underway by the unaccountable, bureaucratic, technocratic elite. It doesn't matter that they themselves will make less money. Their goal of making everyone equal will be closer to fruition. Equality and nondiscrimination are the principles they care about, not their own incomes. The ACA is not the left's true goal, whcih is single-payer universal health care, but by placing another nail in the coffin of the private insurance system, it paves the way for single-payer. Hence they favor it. What is so hard to understand about that?

lol

 

[Gut Shot]

However, he just ignored the whole data and argument I presented. Instead, he focused on the first sentence I said that is not even relevant to this whole discussion.

Yeah, I ignored your argument because I don't find you very interesting. The Oregon Health Insurance Experiment made bigger waves last month when Taubman et al. published their paper on ED utilization in Science.

Dr. Roy is not even an author of this study,

Dr. Roy is not even a Dr. He attended MIT and attended Yale med, but did not obtain a degree from either. He has made a living staking out positions on healthcare that appeal to conservatives and wrapping them in intellectual terminology. In other words, he sounds like a real douchebag.

 

[WillburCobb]

My reaction to the creation of this thread and watching it unfold has been much akin to the "8 Phases of Goatse"
http://www.leghumped.com/2006/06/05/the-8-phases-of-goatse/

 

[Trismegistus4]

Actually in the most recent surveys the majority of physicians self-reported as being "fiscally conservative but socially liberal".

Which means liberal. In our society, the "one-drop rule" applies to conservatism: if you're conservative on one or a few issues, you're considered a conservative, even if you're liberal on everything else. This just proves all the more how liberal our society is. In reality, the one-drop rule should apply to liberalism: if you're liberal on one or a few issues, you're a liberal. These famous "fiscally conservative but socially liberal types" are walking contradictions, and as can be seen in endless online debates, when pressed, they show their true colors: their loyalty to social liberalism is much deeper than their supposed belief in fiscal conservatism.

 

[chenzt]

Which means liberal. In our society, the "one-drop rule" applies to conservatism: if you're conservative on one or a few issues, you're considered a conservative, even if you're liberal on everything else. This just proves all the more how liberal our society is. In reality, the one-drop rule should apply to liberalism: if you're liberal on one or a few issues, you're a liberal. These famous "fiscally conservative but socially liberal types" are walking contradictions, and as can be seen in endless online debates, when pressed, they show their true colors: their loyalty to social liberalism is much deeper than their supposed belief in fiscal conservatism.

Democrats: Regulate the economy and stay the heck out of the bedroom
Republicans: Stay the heck away from the economy and regulate the bedroom
Libertarians: Stay the heck away from both

I can see why sometimes economy should be more regulated, but in terms of ideology, libertarian/socially liberal economically conservative is the most consistent.

 

[boomshaketheroom]

Look, this is really very simple. We live in a liberal society. The vast majority of not only premeds, but doctors themselves, are liberals. They favor the vast leveling project currently underway by the unaccountable, bureaucratic, technocratic elite. It doesn't matter that they themselves will make less money. Their goal of making everyone equal will be closer to fruition. Equality and nondiscrimination are the principles they care about, not their own incomes. The ACA is not the left's true goal, whcih is single-payer universal health care, but by placing another nail in the coffin of the private insurance system, it paves the way for single-payer. Hence they favor it. What is so hard to understand about that?

I love truth by assertion and labeling entire groups based on a set of members. It is so easy and to make an argument if you get to just make statements such as the bolded one above because you want that to be true.

I think you are trivializing many things and implying motives that fit your own point of view. As a liberal, I don't want everyone to be equal. I want everyone to START equal and then see where people go (that whole equal opportunity thing). Sadly, that can never happen. Instead, some sort of equal outcome policies can help out the people who started way behind and don't have the same advantages other people had. I don't mean take all the money/products/land and give everyone the same amount, I mean public policies and programs that give the people who started behind a nudge or two. The whole "pull yourself up by the bootstraps" thing is super cool, but it is also super rare for anyone to get anywhere simply by working hard (100% guarantee you didn't).

Also, tell me why discrimination is a good thing. Your tone indicates you think nondiscrimination is bad. The main definition of discrimination is: the unjust or prejudicial treatment of different categories of people or things. I can;t see why you think unjust treatment of a group is good.

Finally, if we live in a liberal society, and these crazy liberals want equality, why does income inequality in the U.S. continue to increase? Because you imply that you do not like liberal policy, do you think income inequality is a good thing?

 

[DermViser]

Look, this is really very simple. We live in a liberal society. The vast majority of not only premeds, but doctors themselves, are liberals. They favor the vast leveling project currently underway by the unaccountable, bureaucratic, technocratic elite. It doesn't matter that they themselves will make less money. Their goal of making everyone equal will be closer to fruition. Equality and nondiscrimination are the principles they care about, not their own incomes. The ACA is not the left's true goal, whcih is single-payer universal health care, but by placing another nail in the coffin of the private insurance system, it paves the way for single-payer. Hence they favor it. What is so hard to understand about that?

Premeds - wouldn't surprise me. Many of them have never held a REAL job, and have been supported by their parents their entire lives, including paying for housing and tuition

Doctors - tend more to be social liberals, but fiscal conservatives, unless they're the radical AMSA type (who tend to be rich liberals anyways).

 

[DermViser]

Dr. Roy is not even a Dr. He attended MIT and attended Yale med, but did not obtain a degree from either. He has made a living staking out positions on healthcare that appeal to conservatives and wrapping them in intellectual terminology. In other words, he sounds like a real douchebag.

Yeah, and you'd be wrong about both as seen here: http://medicine.yale.edu/alumni/alumni_news/notes/article.aspx?id=6659 (Avik Roy, MED '00)

But please don't let facts get in the way of a good argument.

 

[Mel Belle]

Have you considered that people just like the prospect of being a doctor? Or that another president may be able to fix this mess?

 

[johnnycage377]

If only there were some fiscally conservative senator running for president in 2016 that was a doctor of some kind. I dunno, maybe an ophthalmologist or something.

Bashar al-Assad?

 

[Utenation]

Bashar al-Assad?

Hahaha well done sir.

 

[chenzt]

Yeah, and you'd be wrong about both as seen here: http://medicine.yale.edu/alumni/alumni_news/notes/article.aspx?id=6659 (Avik Roy, MED '00)

But please don't let facts get in the way of a good argument.

You are considered an alumni of a school regardless of whether if you actually received a degree. I have yet to see an article that address him as Dr. Avik Roy, Avik Roy MD, or any other variations. His bio on manhattan institute describe him as "graduated from high school in San Antonio, Texas and educated at MIT, where he studied molecular biology, and Yale University SOM". Curious don't you think that they described him as a graduate of his high school but omitted that part at his undergraduate or graduate schools?

 

[DermViser]

You are considered an alumni of a school regardless of whether if you actually received a degree. I have yet to see an article that address him as Dr. Avik Roy, Avik Roy MD, or any other variations. His bio on manhattan institute describe him as "graduated from high school in San Antonio, Texas and educated at MIT, where he studied molecular biology, and Yale University SOM". Curious don't you think that they described him as a graduate of his high school but omitted that part at his undergraduate or graduate schools?

Yes, I'm sure he just hopped from MIT to Yale Medical School without finishing his undergraduate degree, bc that's SO common. If you had taken the time to Google him you would have seen this:

Avik S. A. Roy M.D. - Bio - C-SPAN Video Library
www.c-spanvideo.org/avikroy‎

 

[chenzt]

Yes, I'm sure he just hopped from MIT to Yale Medical School without finishing his undergraduate degree, bc that's SO common. If you had taken the time to Google him you would have seen this:

Avik S. A. Roy M.D. - Bio - C-SPAN Video Library
www.c-spanvideo.org/avikroy‎

I stand corrected.

"On the question of biography: I haven't walked a mile in your moccasins, so you are more than welcome to point that out. I'm happy to learn from your experiences and your perspective, and I am open-minded about what to do. I went to medical school (at Yale), but the extent of my clincial training was my med school clerkships. I didn't do any postgraduate training. My undergraduate degree was in molecular biology (at MIT). My father was a molecular endocrinologist, so I grew up around science and medicine."

So an MD without residency training who never actually practiced medicine.

http://www.avikroy.org/2010/08/letting-go-of-death-panels.html

 

[DermViser]

I stand corrected.

"On the question of biography: I haven't walked a mile in your moccasins, so you are more than welcome to point that out. I'm happy to learn from your experiences and your perspective, and I am open-minded about what to do. I went to medical school (at Yale), but the extent of my clincial training was my med school clerkships. I didn't do any postgraduate training. My undergraduate degree was in molecular biology (at MIT). My father was a molecular endocrinologist, so I grew up around science and medicine."

So an MD without residency training who never actually practiced medicine.

http://www.avikroy.org/2010/08/letting-go-of-death-panels.html

As you've now acknowledged based on the facts that Gutshot's statement of: "Dr. Roy is not even a Dr. He attended MIT and attended Yale med, but did not obtain a degree from either. He has made a living staking out positions on healthcare that appeal to conservatives and wrapping them in intellectual terminology." --- is patently false. Yet even then, you move the goalposts, to where now since he hasn't completed a residency, this somehow how means he can't remark about medical economics and incentives, just bc they don't comport with your ideology.

 

[chenzt]

As you've now acknowledged based on the facts that Gutshot's statement of: "Dr. Roy is not even a Dr. He attended MIT and attended Yale med, but did not obtain a degree from either. He has made a living staking out positions on healthcare that appeal to conservatives and wrapping them in intellectual terminology." --- is patently false. Yet even then, you move the goalposts, to where now since he hasn't completed a residency, this somehow how means he can't remark about medical economics and incentives, just bc they don't comport with your ideology.

"He has made a living staking out positions on healthcare that appeal to conservatives and wrapping them in intellectual terminology" - not patently false, can still be true.

I stand corrected about his degree, I wasn't invested enough to google past the first couple results.

But I never set any goalposts. I never said something like "if he was an MD, then his views are credible." So I was just pointing out that even with his MD, he didn't complete his residency, and therefore never practiced. Which makes him less credible in my mind.

Lastly, never said he can't remark about healthcare policy, he has every right to. And I have every right to disagree.

 

[goft20]

That is why I am going to be rapper

Lol but seriously hasn't this topic been beaten to death regarding financial rewards of being a physician??

 

[Gut Shot]

Yeah, and you'd be wrong about both as seen here: http://medicine.yale.edu/alumni/alumni_news/notes/article.aspx?id=6659 (Avik Roy, MED '00)

On his own blog Roy states "I went to medical school (at Yale), but the extent of my clincial training was my med school clerkships." If he had an MD it would be all over his professional profile.

He does, however, state that he obtained a degree from MIT.

But please don't let facts get in the way of a good argument.

Indeed.

 

[Gut Shot]

If you had taken the time to Google him you would have seen this:

Avik S. A. Roy M.D. - Bio - C-SPAN Video Library
www.c-spanvideo.org/avikroy‎

I actually did see that, and disregarded it as a mistake made by some AV band geek intern at C-SPAN.

In person Congress calls him "Mister."

 

[DermViser]

I actually did see that, and disregarded it as a mistake made by some AV band geek intern at C-SPAN.
In person Congress calls him "Mister."

If you're going to use a nametag as to somehow support your argument. Then you should the right one:
Notice where his name tag says, in big bold letters: Avik Roy, MD.
In person, they call him, "Dr."

 

[IslandStyle808]

It's interesting that premeds think they are so smart and clever when the vast majority really don't know much about anything at all.

I think every single comment I have read from you is either sarcasm or your elitism. Some of us come from previous jobs such as being an engineer, law, or other professions. Some of us had masters degrees or even PhD degrees before pursuing medical school. You may know more about the medical profession, because your in medical school, but don't think you know more about the world around you because your in medical school.

 

[Augstartcodon]

I think every single comment I have read from you is either sarcasm or your elitism. Some of us come from previous jobs such as being an engineer, law, or other professions. Some of us had masters degrees or even PhD degrees before pursuing medical school. You may know more about the medical profession, because your in medical school, but don't think you know more about the world around you because your in medical school.

you're*****you're

 

[Gut Shot]

Notice where his name tag says, in big bold letters: Avik Roy, MD.
In person, they call him, "Dr."

Good God, they're Yalies. Nobody has every accused them of being very smart.

So why is it that this and the C-SPAN page are the only places where his MD can be found? It's not on his Forbes blog, it's not on his Manhattan Institute bio, it's nowhere to be found on the National Review, and it doesn't appear on his awful Encounter Broadsides book. For someone who supposedly holds a degree in medicine from Yale he is keeping his credentials very close to his chest.

 

[Gut Shot]

And, curiously, the Benjamin Rush Society omits Roy's MD here (although they list credentials for other participants, including two MD's, a PhD, and a MPP).