wow

[Anasazi]

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The following statement from the College was issued to media across the country today:

Statement from the American College of Surgeons Regarding Recent Comments from President Obama

CHICAGO--The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.

• Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.
• Three weeks ago, the President suggested that a surgeon's decision to remove a child's tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what's right for the patient.

We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President's remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.

We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.


I apologize if someone else already posted this, thought it might generate some response. I wonder if this kind of stuff will change the view of the college of surgeons on supporting Obamacare.

 

[DoctaJay]

I doubt that this was a direct mistake of Obama but more so in his team that gathers the facts. I am glad however the the ACS has stepped up and defended surgeons and their image. There is apparently misinformation be spread around by both sides by Obama and by unruly folks at the town hall meetings. I think this whole issue is showing the world the real American, and it aint pretty.

 

[Ariee]

This is a great post, Anasazi, right on!

I think the ACS did right by correcting the errors which Obama made during his speeches. Those points just show poor data gathering by his team.

Also of note, I watched the speech where he spoke about the "tonsils." There is actually a note about this on the Peds forum. He was at first stating that it was the Pediatricians that take the tonsils out.

The town-hall meetings are nuts. There seems to be a lot of strong emotion coming into play and I think some American's are letting their feelings/emotions get in the way of logic thought.

At times, I can't help but feel as if though Obama may have had a really bad experience with the Ob/Gyn that delivered his child, b/c during many of his speeches he expresses concern about how it was the nurse that tended to his wife, while the doctor was there for 5mins.
Did you hear Nurses for HealthCare Reform Speech: http://www.youtube.com/watch?v=HsDs...s&um=1&ie=UTF-8&sa=N&&feature=player_embedded

Although, I can respect his decision to appoint Dr. Benjamin to Surgeon General b/c she has a reputable public health history, what exactly is her experience in politics and administrative medicine?

 

[docmartin252]

If you watched the entire speech then you know that Obama was not "quoting facts," that perhaps his researchers made up or over-looked. However, he was using hyperbole in his examples to get a point across. At the time that he made these statements he was answering questions from the press corps, and it was not a prepared speech. Therefore, anything he stated was not prepared beforehand to be considered a great revelation to the American people.
That being said, is exaggerating or embellishing a good thing when any politician speaks on this matter? Definitely not. This very well could cause problems in the thinking of the American public, which may further polarize people's opinions. I think that misconception has caused some of these recent public forums to become spectacles, aside from these astroturf lobbyist. Hopefully a happy medium can be obtained from this circus.

 

[Handinhand]

If you watched the entire speech then you know that Obama was not "quoting facts," that perhaps his researchers made up or over-looked. However, he was using hyperbole in his examples to get a point across. At the time that he made these statements he was answering questions from the press corps, and it was not a prepared speech. Therefore, anything he stated was not prepared beforehand to be considered a great revelation to the American people.
That being said, is exaggerating or embellishing a good thing when any politician speaks on this matter? Definitely not. This very well could cause problems in the thinking of the American public, which may further polarize people's opinions. I think that misconception has caused some of these recent public forums to become spectacles, aside from these astroturf lobbyist. Hopefully a happy medium can be obtained from this circus.

That still doesn't exculpate him. He should not be making inflammatory comments like that no matter what, but throwing in his ignorance on the topic as well and it's just saddening. Saddening that he's trying to spearhead a radical reform on something he keeps proving to the American people he has absolutely NO clue about.

 

[radslooking]

Obama has been downgraded a few notches in my book. He keeps this up and he will not have a friend in the physician community. He needs to get his facts straight and his head out of his ass. He clearly doesn't have command of the details, or misrepresents the truth when he says such things. Either way, it's inexcusable.

 

[docmartin252]

I think what you fail to realize is that the current president attended law school and not medical school. Obama is much too intelligent to think that he's going to be able to write all the details to the bill himself without consulting people in the medical community. The posters on this forum are also much too intelligent to be lead to believe that he doesn't have advisers from everywhere giving their imput on what should be done. Not only that, it's not as though Obama can simply say, "okay, I just made a law, so everyone can just go ahead and follow it now." Any bill that is proposed must be passed by the House and the Senate before the president can sign or veto the bill. During this process there are a lot of ideas thrown around by many different people to make things tolerable for all of the different constituencies.

Also, it's not as if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England. This system of healthcare has been running since the end of WW II in the UK as well as France. Since hospital employees are government employees, there isn't a polarization of salaries amongst the specialties, so more people are willing to go into FM, rather than just choosing a specialty partially based on money. This would create less worthless trips to the ED and more preventative medicine could be implemented to avoid over crowding specialists. Much of the stress doctors currently face would be taken away too since they would not have to worry about malpractice insurance. This means that people would have to sue the government instead of physicians for their nonsense claims. This also frees up more of the doctor's time that would normally be devoted to billing and insurance varification, back to patient care.

We must also keep in mind that Obama isn't talking directly to the medical community alone. Unfortunately, the general population couldn't tell you the difference between Medicare and Medicaid. Therefore, things must be put in layman's terms so that people can understand what is being proposed so that people don't need to fear this new program. If you think that President Obama is not an extremely intelligent individual, then you are just kidding yourself. He's using similies to help John Q. Taxpayer understand what he is trying to do to improve their options for healthcare coverage, when most health insurance is too overpriced for people with lower income jobs. I don't understand why more conservatives aren't on board with this idea since one of their fundamental beliefs is an open market economy. A government option will create great competition for lowered costs, just like this recession has forced many (car, food, clothes, etc.) companies to make up all sorts of great "deals" for the customer. Anyway, I've made this post longer than I intended....but just keep in mind that sometimes you need to think outside the box.

 

[aequanimitas11]

Obama has been downgraded a few notches in my book. He keeps this up and he will not have a friend in the physician community. He needs to get his facts straight and his head out of his ass. He clearly doesn't have command of the details, or misrepresents the truth when he says such things. Either way, it's inexcusable.

This.

Also, I'm tired of everyone talking about how smart he and all his advisers are. They have shown a great deal of incompetence over the past several months and are currently demonstrating a huge disconnect from the American people.

 

[dynx]

I think what you fail to realize is that the current president attended law school and not medical school. Obama is much too intelligent to think that he's going to be able to write all the details to the bill himself without consulting people in the medical community. The posters on this forum are also much too intelligent to be lead to believe that he doesn't have advisers from everywhere giving their imput on what should be done. Not only that, it's not as though Obama can simply say, "okay, I just made a law, so everyone can just go ahead and follow it now." Any bill that is proposed must be passed by the House and the Senate before the president can sign or veto the bill. During this process there are a lot of ideas thrown around by many different people to make things tolerable for all of the different constituencies.

WHOA! law school...ahhhh, thanks!👍
The subtle condescending attitude in this post goes great with Obama's whole governing style.

Also, it's not as if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England. This system of healthcare has been running since the end of WW II in the UK as well as France. Since hospital employees are government employees, there isn't a polarization of salaries amongst the specialties, so more people are willing to go into FM, rather than just choosing a specialty partially based on money. This would create less worthless trips to the ED and more preventative medicine could be implemented to avoid over crowding specialists. Much of the stress doctors currently face would be taken away too since they would not have to worry about malpractice insurance. This means that people would have to sue the government instead of physicians for their nonsense claims. This also frees up more of the doctor's time that would normally be devoted to billing and insurance varification, back to patient care.

Maybe we don't think the model in england is done "correctly". I'm sure in all your "outside-the-box" thinking that might not have occured to you.
-the people would also have to sue the gov. instead of physicians for thier legit claims.
-The people would have to challenge a near immovable gov. if they tried to substitute acupuncture for surgery for some indications like they are trying in the UK.

We must also keep in mind that Obama isn't talking directly to the medical community alone. Unfortunately, the general population couldn't tell you the difference between Medicare and Medicaid. Therefore, things must be put in layman's terms so that people can understand what is being proposed so that people don't need to fear this new program. If you think that President Obama is not an extremely intelligent individual, then you are just kidding yourself. He's using similies to help John Q. Taxpayer understand what he is trying to do to improve their options for healthcare coverage, when most health insurance is too overpriced for people with lower income jobs. I don't understand why more conservatives aren't on board with this idea since one of their fundamental beliefs is an open market economy. A government option will create great competition for lowered costs, just like this recession has forced many (car, food, clothes, etc.) companies to make up all sorts of great "deals" for the customer. Anyway, I've made this post longer than I intended....but just keep in mind that sometimes you need to think outside the box.

Explain it in layman's terms with correct numbers. Is that too much to ask? What if I explained that you personally should pay 5 million in taxes a year because you make 50 million a year. Well, to the "layman" that sounds reasonable unless you know that docmartin never made 50 million a year and will likely never even see 5 million in his life...but the point is we want to take your money...so, you know, whatever...details right?

He is very intelligent. No doubt. He know's he's lying. Im not concerned that he's stupid.

The "gov option will create competition" is the most idiotic thing I have ever heard. You need to think outside the box and stop with the simplistic reflex vomiting back of one-liners that I'm sure served you well in undergrad but is going to be a little harder to utilize as(if) you advance in medicine.

 

[VincentAdultman]

Good thing for all you surgeons there are premeds around to set the record straight.

 

[Hernandez]

We must also keep in mind that Obama isn't talking directly to the medical community alone.

Since when did translation into laymen's terms mean exaggeration and blatant lies?

 

[dienekes88]

WHOA! law school...ahhhh, thanks!👍
The subtle condescending attitude in this post goes great with Obama's whole governing style.

About as subtle as a median sternotomy.

He is very intelligent. No doubt. He know's he's lying. Im not concerned that he's stupid.

And all I'm hearing from the media is crickets. Maybe I haven't been looking hard enough, though...

The "gov option will create competition" is the most idiotic thing I have ever heard. You need to think outside the box and stop with the simplistic reflex vomiting back of one-liners that I'm sure served you well in undergrad but is going to be a little harder to utilize as(if) you advance in medicine.

You missed the second half of it:
"gov option will create competition..."

"... and then slay it by undercutting everybody" 😉

"... and then decrease the burden of medicare/medicaid on the federal budget by slashing reimbursements... $15.99 for an amputation! $49.99 for a CABG!" 👍

Also, it's not as if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England.

Hilarious. You realize that most of the rankings that bash the United States also bash the UK, right? The latest ranking of preventable death published by the commonwealth fund in Health Affairs put the UK at 4th to last. Five years prior, it was 2nd to last (below the United States).

We must also keep in mind that Obama isn't talking directly to the medical community alone. Unfortunately, the general population couldn't tell you the difference between Medicare and Medicaid. Therefore, things must be put in layman's terms so that people can understand what is being proposed so that people don't need to fear this new program. If you think that President Obama is not an extremely intelligent individual, then you are just kidding yourself. He's using similies to help John Q. Taxpayer understand what he is trying to do to improve their options for healthcare coverage, when most health insurance is too overpriced for people with lower income jobs. I don't understand why more conservatives aren't on board with this idea since one of their fundamental beliefs is an open market economy. A government option will create great competition for lowered costs, just like this recession has forced many (car, food, clothes, etc.) companies to make up all sorts of great "deals" for the customer. Anyway, I've made this post longer than I intended....but just keep in mind that sometimes you need to think outside the box.

I get it. Layman's terms = exaggerating by 50x.

"Similies [sic]" such as...
1) falsely claiming that his plan was endorsed by the AARP?
2) claiming that the AMA represents all physicians?
3) using scare tactics that he himself condemns?
4) inflating figures?

 

[dienekes88]

Since when did translation into laymen's terms mean exaggeration and blatant lies?

When someone everyone wants to like started doing it?

The guy is made of Teflon.

 

[denner]

Good thing for all you surgeons there are premeds around to set the record straight.

Ya, I know, right? I mean, who was the idiot who let them out of their cages for the day? 🙄

 

[Chemdocx]

They need to beta test this stuff in the VA or some agency before they roll it out. Also, why not start with covering all kids and progress onwards as finances allow, at least you get more bang for your buck.

 

[JackADeli]

...unruly folks at the town hall meetings. I think this whole issue is showing the world the real American, and it aint pretty.

I actually think it shows Americans are passionate about their rights and will stand-up. Statements about 50K surgeon fee for an amp or congressional members asking why they should even read a piece of legislation before voting are actually the ugly parts. We should expect better from arguably the highest elected official in public office.

...I watched the speech where he spoke about the "tonsils." There is actually a note about this on the Peds forum. He was at first stating that it was the Pediatricians that take the tonsils out.

The town-hall meetings are nuts. ...I think some American's are letting their feelings/emotions get in the way of logic thought...

Clearly with misstatements about tonsils and amputations and unwillingness to read legislation prior to a vote.... all encourage a visceral emotional response. I am not sure what you propose would be the "logic thought" in the face of all this....

If you watched the entire speech ...he was using hyperbole in his examples to get a point across. At the time that he made these statements he was answering questions from the press corps, and it was not a prepared speech...
That being said, is exaggerating or embellishing a good thing when any politician speaks on this matter? Definitely not. This very well could cause problems in the thinking of the American public, which may further polarize people's opinions. ...these astroturf lobbyist...

I guess if he states blatantly innacurate/deceptive comments it is "hyperbole" while if someone disagrees with him... well that is "fear mongering"(according to the "popular press"). I guess the loud senior citizens are astroturf while the large bus loads of seniors to the voting booths... well that is just an exercise of one's constitutional rights....

Obama ...He clearly doesn't have command of the details, or misrepresents the truth when he says such things. Either way, it's inexcusable.

Agreed

...Any bill that is proposed must be passed by the House and the Senate before the president can sign or veto the bill. During this process there are a lot of ideas thrown around by many different people to make things tolerable for all of the different constituencies...

I am not sure you are aware.... the process proposed and practiced and/or encouraged to this point has been one of rapid passage of omnibus legislation without even reading the the legislation first. The administration during the campaign spoke of closely examined legislation without rapid passage.... now, it is all such an emergency according to them that congress must pass this or that in two weeks or less ... without even reading it.

Also, it's not as if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England. This system of healthcare has been running since the end of WW II in the UK as well as France. ...This would create less worthless trips to the ED and more preventative medicine could be implemented to avoid over crowding specialists...

You are presuming the "correct" way of health delivery is to derived by the systems of which you are apparently a fan. I am not sure more FPs solves the problem of ED trips. By the current figures, around 45 million have no health insurance, around half could afford it but choose not to purchase it, another large portion are illegal immigrants, final count comes to around 7-15 million citizens that do not have and can not afford insurance. I do not think increasing FPs will solve that nor will it necessarily decrease ED visits. The current proposals do not hold folks accountable for non-compliance one of the biggest etiologies for ED visits.

...A government option will create great competition for lowered costs, just like this recession has forced many (car, food, clothes, etc.) companies to make up all sorts of great "deals" for the customer...

Do you have a clue??? Have you tried to buy a car recently? I know a resident that can not afford a "compact car" because the prices are over inflated because buyers have throw away money... from government subsidies. You are seeing dealers expecting a 2-3K dollar profit mark up on small cars and getting because of federal subsidies. Also, it is the administrations own words and the words of it's supporters. They are not interested in competition. They want to ultimately eliminate competition and move to a single government payer. Listen to the presidents prior speaches, listen to congressman Frank, listen to congressman Kennedy.... This is not about creating a competitive system, it is about snaring the majority into a system that will transition to a single government system.

...I'm tired of everyone talking about how smart he and all his advisers are. They have shown a great deal of incompetence over the past several months and are currently demonstrating a huge disconnect from the American people.

Agree

Good thing for all you surgeons there are premeds around to set the record straight.

Obviously the world is saved.

Since when did translation into laymen's terms mean exaggeration and blatant lies?

I would like to know that too... but, oh yeh, it's called "hyperbole" when he says it.

 

[goooooober]

What is most concerning to me is that a group of non-physicians are making all the decisons and changes to healthcare that are going to dramatically affect our patients and us.

I mean it is scary how little WE have to say in this process. I miss the Republicans already (not in Whitehouse). At least they use to balance these jokers in congress.

And what's with the obsession of these Fu**** lawyers with physician salaries. What about the CEOs of healthcare compainies making oober-goober amounts of money per year by denying healthcare and benefits to people and reducing re-imbursements. Everytime the topic of healthcare reform comes up, the first thing the politicians talk about is physician salaries. It is disturbing. Do they really think that healthcare costs will be lower when they take away my $50,000 re-imbursement for amputations? Why and how can a lawyer tell me how much I can or cannot make per year?

I think regardless of how things turn out, it will be scary because of how little involvement and say we have in the process. With all of our education, we are essentially a group of sheep lead by herders that have no clue about being a physician, what it takes to become a physician, or what healthcare is. I wish we would be more involved in how our profession is run. Afterall, when was the last time a physician told a lawyer how much he can make?

I also want to say I deeply hate both those new nursing shows, Hawthorne and Mercy. I love how nurses are "saving patients from doctors" or "You treat the disease, I treat the patient". I can already see new battles brewing with nursing at work who become inflated with this television bull. All I know is if any of them ever grab my shoulders and yell "I WANT YOU TO BE BETTER" I will slap the sh** out of them (not condoning violence for others of course).

What else, what else? Oh yea, I have also been very constipated lately. Any solutions?

I know, I know, I am all over the place with my response. I am too tired for multiple posts. Peace out Gs.

 

[docmartin252]

WHOA! law school...ahhhh, thanks!👍
The subtle condescending attitude in this post goes great with Obama's whole governing style.

I'm sure you feel like you have to defend yourself at all times on this forum...must get tiring...but I was making no attempt at being condescending, just pointing out that he's a lawyer by profession and not a doctor.

Maybe we don't think the model in england is done "correctly". I'm sure in all your "outside-the-box" thinking that might not have occured to you.
-the people would also have to sue the gov. instead of physicians for thier legit claims.
-The people would have to challenge a near immovable gov. if they tried to substitute acupuncture for surgery for some indications like they are trying in the UK.

-Wouldn't it be inherent that "outside-the-box" thinking would mean that I considered other views on the subject, which again you fail to do. If you can show me anywhere in my post where I said that the NHS had a perfect system, or that everyone in America would be crawling over each other for a public option, then maybe you have a point there. However, I didn't presume that, and I don't think that there is any program out there that will make everyone perfectly happy. People will always whine and complain on any subject. Although, that thinking may not have occured to you.
-I'm sure that there are more worthless malpractice suits out there than legitimate ones...which again, was the point that I was making.

Explain it in layman's terms with correct numbers. Is that too much to ask? What if I explained that you personally should pay 5 million in taxes a year because you make 50 million a year. Well, to the "layman" that sounds reasonable unless you know that docmartin never made 50 million a year and will likely never even see 5 million in his life...but the point is we want to take your money...so, you know, whatever...details right?

I'm sure that you could quote perfect numbers verbatim on national television from every current study done on the subject, but perhaps our president doesn't have that keen of a memory. I'm sure that none of us have exaggerated to prove a point like, "if I have to take another night of call, I'll die."
Ummm...if I make 50 million, a tenth of my total yearly worth really isn't that much. If I'm not making 50 million, then how exactly could I be taxed on 50 million? If you are being taxed on 50 million, then your total net assets must be worth up to 50 million of taxable income. And these taxes that the government just wants to "take" from you also funds your road maintenance, mail, garbage collection, police, fire department, and military...but those are just details, right?

The "gov option will create competition" is the most idiotic thing I have ever heard. You need to think outside the box and stop with the simplistic reflex vomiting back of one-liners that I'm sure served you well in undergrad but is going to be a little harder to utilize as(if) you advance in medicine.

Whoa, and I thought "one-liners" were just quick blurbs without explaination to them, but your infinite wisdom is way beyond my years. I think it's laughable that so many cocky med students and residents think that they are mentally superior on topics outside of medicine. Sorry chief but I'm not fresh out of undergrad and have spent time outside of school in the real world. I'd be suprised if you've actually traveled outside the US and viewed first hand other health systems (and no not just England and France as in my examples). Just ask the people in our Armed Services, Senators, and Congressmen if they want to give up their free government option healthcare. I'm sure it would be in your best interest as (if) you move towards a successful career in medicine to treat others with a bit more humility, especially when you don't know their background. I'll just go ahead and appologize for a response that I'm sure in your opinion is just wasted server space, but I didn't know before writing my first post that you wrote public policy in your spare time.

 

[dynx]

I'm sure you feel like you have to defend yourself at all times on this forum...must get tiring...but I was making no attempt at being condescending, just pointing out that he's a lawyer by profession and not a doctor.

Nope, just pointing out that your attitude was condescending. Since others seem to have agreed maybe you should take a little time to reflect before you get butt-sore and lash out.

I didn't think you attempted to be condescending, im sure thats just your personality.

not tired at all thanks.

and again, we know...lawyer...not doctor. Got it.

-Wouldn't it be inherent that "outside-the-box" thinking would mean that I considered other views on the subject, which again you fail to do. If you can show me anywhere in my post where I said that the NHS had a perfect system, or that everyone in America would be crawling over each other for a public option, then maybe you have a point there. However, I didn't presume that, and I don't think that there is any program out there that will make everyone perfectly happy. People will always whine and complain on any subject. Although, that thinking may not have occured to you.
-I'm sure that there are more worthless malpractice suits out there than legitimate ones...which again, was the point that I was making..

I considered it. You said he'd have an idea of how to do it "correctly", implying that it was done correctly elsewhere to serve as a model. That was the point I disputed. When you realized that this was clearly a debatable point...you switched to defending yourself as if I put the word "perfectly" in your mouth. Wow...you must think everyone on here is stupid. The fact fact that you typed out a whole paragraph based on a straw man argument is pretty funny. You're really dedicated to this. But try to stick to your original argument...even if it sucks, just say it sucked and move on.

I'm sure that you could quote perfect numbers verbatim on national television from every current study done on the subject, but perhaps our president doesn't have that keen of a memory. I'm sure that none of us have exaggerated to prove a point like, "if I have to take another night of call, I'll die."
Ummm...if I make 50 million, a tenth of my total yearly worth really isn't that much. If I'm not making 50 million, then how exactly could I be taxed on 50 million? If you are being taxed on 50 million, then your total net assets must be worth up to 50 million of taxable income. And these taxes that the government just wants to "take" from you also funds your road maintenance, mail, garbage collection, police, fire department, and military...but those are just details, right?.

1. No I couldn't. But then I wouldnt just pull random numbers out my ass either. Like on rounds...if I had an idea idea the potassium was elevated I'd say "the potassium was high" I wouldnt say "7" randomly. You see the difference? No you don't.
2. WHOOOSSSHHHHH! thats the sound of the point shooting waaaaaay over your head.

Whoa, and I thought "one-liners" were just quick blurbs without explaination to them, but your infinite wisdom is way beyond my years. I think it's laughable that so many cocky med students and residents think that they are mentally superior on topics outside of medicine. Sorry chief but I'm not fresh out of undergrad and have spent time outside of school in the real world. I'd be suprised if you've actually traveled outside the US and viewed first hand other health systems (and no not just England and France as in my examples). Just ask the people in our Armed Services, Senators, and Congressmen if they want to give up their free government option healthcare. I'm sure it would be in your best interest as (if) you move towards a successful career in medicine to treat others with a bit more humility, especially when you don't know their background. I'll just go ahead and appologize for a response that I'm sure in your opinion is just wasted server space, but I didn't know before writing my first post that you wrote public policy in your spare time.

Thanks for appologizing in advance...indeed was a waste for you. You're allready in-bed with the idea and you'll pull whatever rediculous contortions you need to in order to keep your ego in-check (thats a dangerous tendency by the way, especially in medicine). Maybe not wasted on other people reading however. I think the glaring logical errors in your argument will maybe spark a desire to look deeper into the issues and see that people like you, that jump all over to defend obama may not be the most reliable thinkers and they should reflect and think about the arguments on both sides.

 

[radslooking]

one of the worst things about this is it reinforces whatever "greedy doctor" ideas people might have. We have enough misunderstanding already. The last thing you need is the President telling people you make 30,000 for an amputation. I mean, that's ******ed, cavalier, and damaging. What a stooge. I get his point, but he has this amazing ability to talk out of his ***** without getting his facts straight.

 

[sqtab]

http://www.youtube.com/watch?v=SSuzcPpHBUo

 

[VincentAdultman]

I'm sure that you could quote perfect numbers verbatim on national television from every current study done on the subject, but perhaps our president doesn't have that keen of a memory. I'm sure that none of us have exaggerated to prove a point like, "if I have to take another night of call, I'll die."

It's not that he didn't quote perfect numbers, he wasn't even in the right ballpark. In that case, our esteemed president needs to just STFU about it.

 

[docmartin252]

Nope, just pointing out that your attitude was condescending. Since others seem to have agreed maybe you should take a little time to reflect before you get butt-sore and lash out.

I didn't think you attempted to be condescending, im sure thats just your personality.

not tired at all thanks.

and again, we know...lawyer...not doctor. Got it.

It's incredible that you can determine spoken inflection over written words on the internet when you can interprit it any way you choose. Perhaps you should leave medicine to become a mind reader where your God given talent would be better served. My butt is perfectly pain free, thanks for caring...maybe you will be a good doc afterall. Not sure why you're still clinging to me being condescending about him being a lawyer, as I've already stated I said it just to make a point. And at least we both agree I wasn't being condescending.

I considered it. You said he'd have an idea of how to do it "correctly", implying that it was done correctly elsewhere to serve as a model. That was the point I disputed. When you realized that this was clearly a debatable point...you switched to defending yourself as if I put the word "perfectly" in your mouth. Wow...you must think everyone on here is stupid. The fact fact that you typed out a whole paragraph based on a straw man argument is pretty funny. You're really dedicated to this. But try to stick to your original argument...even if it sucks, just say it sucked and move on.

By "correctly," I was inferring that he would be able to implement his program in the proper way, instead of a haphazard sloppy way. Thus, this was never a "debatable point" in my mind, but thanks for reading my mind again, 0 for 2 for those keeping track at home. So in other words, correctly does not mean the best. You've made feeble attempts to put words into my mouth the entire time, but I never considered "perfectly" to be one of them. I do think people not willing to have civilized bebate on such an important issue is stupid, yes. It's not really a strawman arguement when I did refute other points and added my opinion as well. I'm not exactly sure how I've switched my point of view, but keep grasping at straws and we'll move on. It's funny that you haven't stated your views on why you are so against a public option, unless a public option has something to do with my intelligence and character...I'll inform my Congressman right away if it does.

1. No I couldn't. But then I wouldnt just pull random numbers out my ass either. Like on rounds...if I had an idea idea the potassium was elevated I'd say "the potassium was high" I wouldnt say "7" randomly. You see the difference? No you don't.
2. WHOOOSSSHHHHH! thats the sound of the point shooting waaaaaay over your head.

If you were explaining potassium levels to a person on the street, would you just give them numerical data that means nothing to them or explain what a high level indicates and contrast that with what a low level would mean? But if you did that, you would have to explain what every single number in between meant so that you weren't just using general polarities and lying to them. Since literal and not abstract thinking seems to be your only mode of mental process, this would be the only option for you.
2. Can you read my mind? No you can't. WHOOOSSSHHH! That's the sound of another swing and a miss for you, 0-3. You can take a seat now, thanks for playing.

You're allready in-bed with the idea and you'll pull whatever rediculous contortions you need to in order to keep your ego in-check (thats a dangerous tendency by the way, especially in medicine)...
people like you, that jump all over to defend obama may not be the most reliable thinkers and they should reflect and think about the arguments on both sides.

Yes I believe in the idea and so I state my opinions on why, that's how things get accomplished and that's how adults hold discourse. And if egos don't belong in medicine, there are a lot of dangerous doctors (especially surgons) terrorizing our countries hospitals. But perhaps you haven't been around the healthcare industry too long, but that's ok, you'll learn. Again I have yet to see you express any opinion ON THE ISSUE, let alone both sides. Perhaps you should sit down and look at both sides so that you may form your own (gasp!) opinion on the issue. Can't wait for your next response dynx, maybe you can read my palm next?

 

[VincentAdultman]

If you were explaining potassium levels to a person on the street, would you just give them numerical data that means nothing to them or explain what a high level indicates and contrast that with what a low level would mean? But if you did that, you would have to explain what every single number in between meant so that you weren't just using general polarities and lying to them. Since literal and not abstract thinking seems to be your only mode of mental process, this would be the only option for you.

Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.

You have no issues witht the president embellishing how much a doctor makes for a procedure by a facor of 50? Don't you think this may have a small impact on the American people's perception of physicians?

 

[dynx]

By "correctly," I was inferring that he would be able to implement his program in the proper way, instead of a haphazard sloppy way. Thus, this was never a "debatable point" in my mind, but thanks for reading my mind again, 0 for 2 for those keeping track at home. So in other words, correctly does not mean the best.

I edited out as much of the useless rambling as I could...hard as it was so prevelant.
I agree, he could implement a crapy system in the "proper way". Sure. If that point somehow makes the case for universal care in your mind then very well.

You've made feeble attempts to put words into my mouth the entire time, but I never considered "perfectly" to be one of them. I do think people not willing to have civilized bebate on such an important issue is stupid, yes. It's not really a strawman arguement when I did refute other points and added my opinion as well. I'm not exactly sure how I've switched my point of view,

You said - if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England
I responded - Maybe we don't think the model in england is done "correctly".
Your reply was - If you can show me anywhere in my post where I said that the NHS had a perfect system, or that everyone in America would be crawling over each other for a public option, then maybe you have a point there

I think that clarified that. If you need another rehash I'd just go ahead and read this thread over since you seem to be having trouble. Maybe you were responding to some fantasy post in your own mind where someone claimed you said the NHS is perfect...I don't know. As you astutely pointed out I cant read your mind.

but keep grasping at straws and we'll move on. It's funny that you haven't stated your views on why you are so against a public option, unless a public option has something to do with my intelligence and character...I'll inform my Congressman right away if it does.

As far as straws the only ones present in here are in your argument.
I'm glad to express my views but as mentioned before they would be wasted on you. You've made up your mind, I'd just like to show how ******ed your claims are so nobody else just takes your babble at face value...anyone that cares about my political views can PM me or see my posts in the SP forum.

If you were explaining potassium levels to a person on the street, would you just give them numerical data that means nothing to them or explain what a high level indicates and contrast that with what a low level would mean? But if you did that, you would have to explain what every single number in between meant so that you weren't just using general polarities and lying to them. Since literal and not abstract thinking seems to be your only mode of mental process, this would be the only option for you.

I'd say "high" and "low". Again, different from just making a number up.
maybe I CAN read your mind! remember I said

You see the difference? No you don't.

Spooky!

Yes I believe in the idea and so I state my opinions on why, that's how things get accomplished and that's how adults hold discourse. And if egos don't belong in medicine, there are a lot of dangerous doctors (especially surgons) terrorizing our countries hospitals. But perhaps you haven't been around the healthcare industry too long, but that's ok, you'll learn. Again I have yet to see you express any opinion ON THE ISSUE, let alone both sides. Perhaps you should sit down and look at both sides so that you may form your own (gasp!) opinion on the issue. Can't wait for your next response dynx...

I know you believe it. I'm happy you're stating your opinions. Again, it gives me a chance to point out how stupid your opinions are so other people that don't cling to their preconcieved ideas like you can see how poor the logical constructions behind your ideas are.

And ego isnt the problem...you have to read the WHOLE sentance, I know its hard but try it. The problem arises when you'll contort whatever information you need to in order to support your pre-concevied ideas so that your ego doesnt get bruised.

Anyway, Im happy that you keep responding to me but there are a couple other of posters trying to point out how lame your ideas are...you may want to glance at those posts too and try to learn something. I'm sure others watching your slow descent into half-cocked responses and willing ignorance of the discussion at hand are learning a lot and these other posters may have a new take on your stupidity that I'm not quite shinning light on.

maybe you can read my palm next?

Its to hairy.

 

[dienekes88]

By "correctly," I was inferring that he would be able to implement his program in the proper way, instead of a haphazard sloppy way. Thus, this was never a "debatable point" in my mind, but thanks for reading my mind again, 0 for 2 for those keeping track at home. So in other words, correctly does not mean the best. You've made feeble attempts to put words into my mouth the entire time, but I never considered "perfectly" to be one of them. I do think people not willing to have civilized bebate on such an important issue is stupid, yes. It's not really a strawman arguement when I did refute other points and added my opinion as well. I'm not exactly sure how I've switched my point of view, but keep grasping at straws and we'll move on. It's funny that you haven't stated your views on why you are so against a public option, unless a public option has something to do with my intelligence and character...I'll inform my Congressman right away if it does.

Dude, I'm just another arrogant idiot (because I'm disagreeing with you), but you said:

it's not as if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England.

... and then proceeded to talk about features of the system (reimbursement, etc.) not the implementation of the system.

That would suggest that "correctly" is referring to the system's ability to equalize reimbursement, decrease malpractice, and improve preventive care... and not the implementation. I'm not sure how people were supposed to read your mind, which you said would be impossible, if you never mentioned implementation.

I'm scoring this one against you, sorry.

If you were explaining potassium levels to a person on the street, would you just give them numerical data that means nothing to them or explain what a high level indicates and contrast that with what a low level would mean? But if you did that, you would have to explain what every single number in between meant so that you weren't just using general polarities and lying to them. Since literal and not abstract thinking seems to be your only mode of mental process, this would be the only option for you.
2. Can you read my mind? No you can't. WHOOOSSSHHH! That's the sound of another swing and a miss for you, 0-3. You can take a seat now, thanks for playing.

Unfortunately, K = 8 and K = 2 means nothing to Joe the Plumber. However, $50k means something.

Yes I believe in the idea and so I state my opinions on why, that's how things get accomplished and that's how adults hold discourse. And if egos don't belong in medicine, there are a lot of dangerous doctors (especially surgons) terrorizing our countries hospitals. But perhaps you haven't been around the healthcare industry too long, but that's ok, you'll learn. Again I have yet to see you express any opinion ON THE ISSUE, let alone both sides. Perhaps you should sit down and look at both sides so that you may form your own (gasp!) opinion on the issue. Can't wait for your next response dynx, maybe you can read my palm next?

I think we need some hugs around here.

 

[docmartin252]

You have no issues witht the president embellishing how much a doctor makes for a procedure by a facor of 50? Don't you think this may have a small impact on the American people's perception of physicians?

No, I absolutely agree with what you're saying. As I stated in my first post, it's not acceptable for any politician playing with big policy to embellish, or especially lie. I do take issue with that fact, however I'm defending the potential policy, not politician.

 

[GSresident]

Wow the forums blew up in the last couple weeks. I've been busy cutting off limbs for $50,000 a pop. LOL.

Everyone seems to be arguing that socialized medicine won't work because it is impractical. While they may be right, arguing practicality when you have accepted the basic premise of the socialists is a little, for lack of a better term, stupid. If you have accepted that healthcare is a right and you are arguing that socialized medicine shouldn't be instituted because it is impractical, please stop. Don't you see how futile it is to argue with someone when you have accepted his main premise?

 

[docmartin252]

You said - if the president has no idea how to get this accomplished correctly as he can model it after the NHS in England
I responded - Maybe we don't think the model in england is done "correctly".
Your reply was - If you can show me anywhere in my post where I said that the NHS had a perfect system, or that everyone in America would be crawling over each other for a public option, then maybe you have a point there

Right, he can use a model after a system that is already in place and working, which doesn't mean photocopy. This is much the same way that medical advances are made. If a doctor receives a referral where a particular treatment is not working, they take what is presented to them in the chart and attempt to augment it to gain better results. You start with a model and cut out and adjust what isn't working. This is again why ideas may be added or removed when going through the House and Senate.

As far as straws the only ones present in here are in your argument.
I'm glad to express my views but as mentioned before they would be wasted on you.

There you go being a gypsy again. Maybe you should state your views, then if they are beyond my comprehension we can discuss them and possibly bring to light a vantage point that neither of us had considered. Meaning, to open a discussion, which I assumed was the intent of the post. Because right now it seems as though you don't have anything to contribute, aside from attempting to find flaws in my opinions.

I'd say "high" and "low". Again, different from just making a number up.
maybe I CAN read your mind! remember I said Spooky!

Again, "high" and "low" still don't have an impact if a scale is not established for someone to understand. Is making up a number just for number sake wrong? Yes it definately is, as I stated in my original post.

And ego isnt the problem...you have to read the WHOLE sentance, I know its hard but try it. The problem arises when you'll contort whatever information you need to in order to support your pre-concevied ideas so that your ego doesnt get bruised.

An annonymous internet forum isn't going to rattle my ego or self-esteem. I'm sure it's easy to find fault when you aren't willing to reciprocate in your views on the subject.

Anyway, Im happy that you keep responding to me but there are a couple other of posters trying to point out how lame your ideas are...you may want to glance at those posts too and try to learn something.

I chose to respond to yours since you were the first to attempt to dissect line by line what I was saying in an attempt to just say my opinions were stupid rather than stating your opinion on why our current system is fine the way it is. Besides, this back and forth has been quite enjoyable. But since you do have opinions and do not wish to share them in a public forum, I assume for fear of ridicule similar to yours, I invite you to PM me so that we may trade ideas. If I am completely off target in my way of thinking, I would be more than happy to see what you have to say without any bickering. Hope this ends it. Take care.

 

[dienekes88]

I chose to respond to yours since you were the first to attempt to dissect line by line what I was saying in an attempt to just say my opinions were stupid rather than stating your opinion on why our current system is fine the way it is. Besides, this back and forth has been quite enjoyable. But since you do have opinions and do not wish to share them in a public forum, I assume for fear of ridicule similar to yours, I invite you to PM me so that we may trade ideas. If I am completely off target in my way of thinking, I would be more than happy to see what you have to say without any bickering. Hope this ends it. Take care.

Whoa whoa whoa whoa whoa... whoa whoa whoa whoa, Lois, this is NOT my batman cup.

All kidding aside.

As far as I can tell, nobody has said that the current system is fine the way it is. However, going backwards is not better than staying put.

 

[dynx]

Right, he can use a model after a system that is already in place and working, which doesn't mean photocopy. This is much the same way that medical advances are made. If a doctor receives a referral where a particular treatment is not working, they take what is presented to them in the chart and attempt to augment it to gain better results. You start with a model and cut out and adjust what isn't working. This is again why ideas may be added or removed when going through the House and Senate.

Well since you're intersted....
Why start with a NEW model. Why not start with the model we have "cut and adjust what isn't working"? Adding an entire gov. body to manage the exchange of insurance, a potential "public option" redistributing the pay scale to encourage less procedures and try to direct people into the jobs you want them to take is not a small "cut and adjustment". And doing it in 3 weeks or even 3 months or a year is fast, way to fast...no wait...its F*CKING CRAZY. Do you know how long it takes to get a medical liscense in the state of california? 4 months. Thats right. It takes them 4 months to gather existing paperwork and make sure a single person is okay to practice medicine. But now, somehow people have faith that the entire system can be revamped safely in half that time? Does that strike you as prudent? You say Obama is smart right? Did he just overlook the fact that this timeline was insanely stupid or is he more intersted in his politics than an actual solution?

There you go being a gypsy again. Maybe you should state your views, then if they are beyond my comprehension we can discuss them and possibly bring to light a vantage point that neither of us had considered. Meaning, to open a discussion, which I assumed was the intent of the post. Because right now it seems as though you don't have anything to contribute, aside from attempting to find flaws in my opinions.

1. Gypsy does no = fortune teller
2. See my views above....change should be done under the existing model. It should primarily focus on implementing change one piece of legislation at a time so that the effects can be monitored, things that work can be continued and things that don't can be eliminated. The role of the federal gov in future change should be:
a. Tort reform: I think caps are a good temporary measure but reform could be better implemented by having physician panels decide malpractice claims. I have seen plenty of review in MandM to believe that doctors (who do not personally know the doctor on trial of course) are fairly even-handed in calling people out when they make a mistake or letting things go when they didn't. In addition these professional commitees would be privy to all the facts and could expidite the removal of liscenses of dangerous physicians. Caps do potentially leave people poorly conpensated for real errors.
b. Insurance reform: No dropping people when they get sick. This should be common sense and would be easily passed if the gov wasnt taking so much in contributions. You should be able to sue your insurance company for bad outcomes related to dropped coverage or refusal to cover procedures/imaging in a timely fashion...currently this is very hard to do. The federal gov. could have a role in interstate commerce in the form of agreeing to a "minimum" coverage that is REALLY a minimum. By establishing a reasonable baseline you could eliminate interstate insurance brokers for the major insurance industry players and lower administrative costs.
c. Coverage for all children. I think it needs to be done. Most/almost all are covered. We need to be aggresssive about getting them into the fold and establishing early care.

there is more but I need to take off. Most of it can be done for little cost or...even a savings immediatly

Again, "high" and "low" still don't have an impact if a scale is not established for someone to understand. Is making up a number just for number sake wrong? Yes it definately is, as I stated in my original post. .

🙄

An annonymous internet forum isn't going to rattle my ego or self-esteem. I'm sure it's easy to find fault when you aren't willing to reciprocate in your views on the subject.

see above.

I chose to respond to yours since you were the first to attempt to dissect line by line what I was saying in an attempt to just say my opinions were stupid rather than stating your opinion on why our current system is fine the way it is. Besides, this back and forth has been quite enjoyable. But since you do have opinions and do not wish to share them in a public forum, I assume for fear of ridicule similar to yours, I invite you to PM me so that we may trade ideas. If I am completely off target in my way of thinking, I would be more than happy to see what you have to say without any bickering. Hope this ends it. Take care.

nobody said the system is fine...who's putting words in who's mouth? you need to learn to respond to what people are actually saying.

ridicule away...try not to make yourself look stupid in the process.

 

[JackADeli]

... There is apparently misinformation [to] be spread around ...unruly folks at the town hall meetings. I think this whole issue is showing the world the real American, and it aint pretty.

I responded to this originally with one perspective.

I actually think it shows Americans are passionate about their rights and will stand-up. Statements about 50K surgeon fee for an amp or congressional members asking why they should even read a piece of legislation before voting are actually the ugly parts. We should expect better from arguably the highest elected official in public office...

Now, having thought on the issue longer, I have an additional perspective/s. I still believe the "unruly" aspect in general is a positive representation of concern. However....

The/another ugly side is that this issue is showing Americans to be ignorant sheeps and dupes. Congress has been failing to read legislation for a very long time. The media has been misinforming for a long time. Yet, Americans have just believed "it" because they saw it on TV so it "must be true". It is quite pathetic. The congressional folks even have gone out to try and sell this or that legislation. They figure it would be easy. Just give the standard catch phrases and let media portrait it this way or that.... Then congress members are all flustered because they are actually asked line by line about the legislation they are selling.... and don't even know what is in it. Our trusting nature and desire to believe is the real ugliness.

Let's see:
1. ~20 years in a racist preachers church
2. Chicago patient dumping
3. "Why read the bill" (let's vote on the emergency)
4. Tonsils
5. $50k amputations
6. Government can do it more efficient (any track record of this?)
7. President, Kennedy, Frank, and others have all stated they want a single government system and/or believe this (current legislation) is the only means to inevitably transition everyone to such a program
8. Members of congress by far have no interest in being in such a system themselves
9. Villainize the community/constituents
10. Acorn bussing
11. AARP?
12. AMA?
13. No support for tort reform
14. etc....

But, we believe in change, cause we saw it on TV..... I guess this is an example of practice by emotion and not "evidence based". Now, we have the ACS supporting HR35xyz something or other because they actually believe it gets them some sort of position at the bargaining table.... Lord help us.

 

[Hampster10]

.

 

[JackADeli]

You lost me there (bold print in your previous post), I don't see what that has to do with your argument...

Was not attempting to make a "surgical" strike argument. It was a long but not exhaustive list of more recent issues that go toward the matter of trust and/or belief. Hence, issues that seem contrary to a reason to trust...

i.e. supposedly intelligent but unaware of your mentors positions on these issues; past statements towards single/socialized system and now seeming to change on that front; recently raised concerns of patient dumping in Chicago; false statements about tonsils & amputations; elected officials apparently not reading legislation (raises the question who is actually writing it); etc.... This all goes towards my opinion that "we" as Americans want to believe the best, even in the face of positions/actions to the contrary....

...Included are very important provisions that would keep insurance companies from setting artificial and unrealistic caps on the (monetary) amount of care a subscriber can receive, etc...

I don't disagree that there are some components that could be helpful. However, there is not a track record to suggest we should trust passage of an omnibus behemoth for some potentially beneficial components would be amended to exclude all the other stuff. Hence, again, the point of trust. Why should anyone believe support/endorsement of a specific and by all accounts significantly flawed piece of legislation gives any lobby organization some position in negotiating improvement... after passage? Once passed, it is passed. We don't accept a bad price in purchasing a house with the belief we can trust the seller and negotiate later... why would we do that with something so important as this. The(?your) take what you have and it can be fixed later... well, goes straight towards my point that we(?you) want to trust and believe the best. Further, not likely to be able to sit a negotiating table to repair a failed legislation if the agenda is to transition to a single government system. "Our" endgame/object is not even in line with what the administration is actually attempting. So, why trust & endorse with a false hope or belief that it will in some way get us a chair.

... It is criminal that a third party whose sole purpose for existence is profit, inserts itself between the patient and his healthcare provider...

I thought prior to insurance companies there was fee for service. Private industry does ultimately exist for profit. That is capitalism. I am not sure it is "criminal". I suspect then you want the socialism... thus it is not about competition and/or free market if you do not want the profit motive. Which is pretty much what Kennedy & Frank and others have said. Thus, the intent to pass a "transitional" system that will grow and ultimately lead to a single government system. i.e.:
http://blog.heritage.org/2009/07/31/barney-frank-public-option-is-best-way-to-single-payer/
http://www.youtube.com/watch?v=p-bY92mcOdk&feature=related

...someone else has to be out there giving them a run for their money- competition from the public/govt sphere.

...In any case competition is ALWAYS a good thing...

Competition would imply an ability to compete.... However, a government system would not have the same expense limits as a private corporation. If it over spends, it does not go bankrupt. It gets more federal funds (i.e. Social security/medicare/medicaid/etc....). That is not real competition. There are competition limits between the numerous insurance companies with the current laws. It is not improving competition to bring in another entity with comparatively no limits in funding (or exposure to financial failure in corporate sense) and none of the operating cost limits.... It is about transitioning:
http://blog.heritage.org/2009/07/31/...-single-payer/
http://www.youtube.com/watch?v=p-bY9...eature=related

You are entitled to your opinion....

...But I think it would be wise to make better informed posts about this very touchy issue.

However, as noted, my post was addressing an issue of emotion and/or trust, etc.... IMHO, it is fairly well informed. I have watched the footage of Kennedy/Frank/President, etc... with regards of perported plan/agenda/etc... for single government system and/or transitional system, have watched footage of congressional members not knowing what they are selling and/or declaring they don't see a purpose to read it, have looked at portions of the 1000page document, etc, etc...

regards.

 

[Hampster10]

.

 

[JackADeli]

...I'm not in favor of "socialism"... But I don't know that this proposal automatically converts the U.S. to a socialist country...

I agree, I do not think it will be instantaneously. I think it will be as the president or congressman Frank have said... it will transition us to that result. Thus, if I trust what they have said, I have no rational reason to believe this is about making a competitive environment.

...I am 100% in favor of fee for service, although that would sorely limit access for a large proportion of the population...I believe they provide access for people who might not otherwise be able to afford ffs...

I would love that too. However, as you said, it leaves a great deal of folks in bad financial state. That is why insurance came into existance. We may dislike or despise much of the insurance industry, but they have enabled a large amount of financial access to care...because of a profit motive.

...One thing I'm sure both sides of the argument agree on is that our current healthcare system leaves alot to be desired...At the very least, some policing of insurance companies is needed...

I think everyone agrees with that. Probably about half of the "suffering uninsured" the system is being revamped for are apparently able to purchase insurance and choose not to do it. Folks balk at a $20 clinic co-pay but pay hundreds of dollars for hair & nails. Many of my patients finance fancier cars and homes then I would ever consider.... The fancy car, vacations, nails, hair, etc... are all too important to be frugal and purchase health insurance. Then we should cry a river when someone has a car accident or cancer and failed to purchase healthcare... it's just like folks who over financed a home and now need a bail out to avoid foreclosure & eviction. I think some individual accountability is required (no I do not know the answer).

 

[dienekes88]

I agree, I do not think it will be instantaneously. I think it will be as the president or congressman Frank have said... it will transition us to that result. Thus, if I trust what they have said, I have no rational reason to believe this is about making a competitive environment.

I agree with most of what you've said.

However, I think it's a slippery-slope fallacy to assume that universal healthcare will necessarily lead to a socialized government, because each step is not necessary a foregone conclusion after the first. There is the concept of critical junctures and path dependence (Jacob S. Hacker's The Divided Welfare State is quite good), but it's too early to assume that such great institutional inertia would be generated that there would be no resisting the push towards unrestricted government intervention in industry, service, etc.

Major tax hikes across the board would be the first required step, and even the idealists hate to get pickpocketed by the government.

 

[45408]

It is criminal that a third party whose sole purpose for existence is profit, inserts itself between the patient and his healthcare provider and for the most part dictates the nature of the care that a patient receives.

But why single out health insurance?

Health care is not a right in this country, nor is it even the most necessary thing in your daily life. You pay for your food and water, and as far as I know, a grocery store's sole purpose for existence is also profit. There have also been non-profit insurance companies. They're dwindling though.

 

[JackADeli]

...I think it's a slippery-slope fallacy to assume that universal healthcare will necessarily lead to a socialized government...

Maybe, but, if we assume the individuals are "intelligent" and their stated plan/agenda on more then one occassion has been to design the "public option" as for lack of a better term a "tool" to drive us to a single payer government program, why should we believe otherwise? This is not a hypothetical prediction of possibilities, they are engineering/structuring it that way...

Thus, as stated, if I trust what they have said, I have no rational reason to believe this is about making a competitive environment. It isn't intended to do so.

 

[dienekes88]

Maybe, but, if we assume the individuals are "intelligent" and their stated plan/agenda on more then one occassion has been to design the "public option" as for lack of a better term a "tool" to drive us to a single payer government program, why should we believe otherwise? This is not a hypothetical prediction of possibilities, they are engineering/structuring it that way...

Thus, as stated, if I trust what they have said, I have no rational reason to believe this is about making a competitive environment. It isn't intended to do so.

I have no doubt that this is a step in the direction of eliminating competition in healthcare.

However, I was under the impression that you were saying that the socialist tendencies would expand into other realms, which I think is a leap in logic. I will admit that Big Gov't has a history of messing around in things that it shouldn't *cough* Agribusiness and Military-Industrial Complex *cough*.

The expansion of government would be self-limiting as the demands of taxes on the public (including the middleclass that Obama promised to avoid taxing) would result in a huge uprising.

 

[Paddington]

The town-hall meetings are nuts. There seems to be a lot of strong emotion coming into play and I think some American's are letting their feelings/emotions get in the way of logic thought.

Actually those people are thinking logically. It's the ****-for-brains leadership in this country that doesn't have a clue. The average American is smart enough to not buy into Obama's lies that a huge new government program can be implemented covering everyone when the government has no extra money to spend without raising taxes and preserving everyone's current level of service at the same time. Pure, unadulterated 100% bull****, anyone with an IQ greater than 85 knows this.

The reason why it's getting so bitter at these town hall meetings is that the ******s in Congress a) don't listen and b) don't even allow debate to take place, which means that the debate has now spilled out into the streets.

👍

 

[docmartin252]

To start off thanks dynx for posting your view of things, as I said a PM would have been just fine if you didn't want to respond on the public forum, but now I hope things can remain civil.

Adding an entire gov. body to manage the exchange of insurance, a potential "public option" redistributing the pay scale to encourage less procedures and try to direct people into the jobs you want them to take is not a small "cut and adjustment".

There should be no encouragement of limiting the number of necessary proceedures done, but rather, preventative measure taken by the PCP to help prevent proceedures from taking place that could be prevented in the first place. By redistributing the pay scale, we would hopefully intice more people in to FM who truely would like to be FM, but are turned off by the amount of salary the average FM earns. Many people just assume every doctor goes home at night and swims in $100 bills, which is obviously certainly not the case. However, this is why many people work hard to go to med school, because they have dollar signs in their eyes, but then they find out not all specialties are compensated the same and choose something more lucrative. Ideally (but not guaranteed), a more even pay scale would create physicians who are more satisfied with the work they are doing. Although, it still must be realized (when considering this possibility) that more goes into getting into a residency in a particular specialty than just saying, "I like this specialty, I'll just do that." Therefore, this theory has its pros/cons.

And doing it in 3 weeks or even 3 months or a year is fast, way to fast...no wait...its F*CKING CRAZY. You say Obama is smart right? Did he just overlook the fact that this timeline was insanely stupid or is he more intersted in his politics than an actual solution?

No matter the legislation, 3 months is very very quick indeed. If this was an idea that the president just pulled out of thin air and attempted to implement, then yeah, I would say Obama may need to get his head checked and stop attempting to jam through legislation. However, public healthcare has been an issue that has been debated since FDR was president. The Clintons had a healthcare plan set up and ready to send to Congress, however lobbyist groups filled a lot of pockets with money, including the Clintons, to get rid of any possiblity of that happening. Obama is smart IMHO, which is why I firmly believe that he surrounds himself with very smart people, while taking in many differing opinions. This is similar to what Lincoln did, as was described in Team of Rivals, which seems to be Obama's favorite book.

1. Gypsy does no = fortune teller

🙄 and yet you knew exactly what I was referring to....amazing

a. Tort reform: I think caps are a good temporary measure but reform could be better implemented by having physician panels decide malpractice claims. I have seen plenty of review in MandM to believe that doctors (who do not personally know the doctor on trial of course) are fairly even-handed in calling people out when they make a mistake or letting things go when they didn't. In addition these professional commitees would be privy to all the facts and could expidite the removal of liscenses of dangerous physicians. Caps do potentially leave people poorly conpensated for real errors.

I must agree, a panel of physicians is really the only way to conduct these claims, as no "expert," aside from possibly a specialist, needs to be brought in. As you stated, people will be more willing to offer an unbiased opinion when they don't know the person being reviewed. A cap does leave the possibilty that a person might get short changed, which is an issue that would need to be addressed before setting a law into place.

b. Insurance reform: No dropping people when they get sick. You should be able to sue your insurance company for bad outcomes related to dropped coverage or refusal to cover procedures/imaging in a timely fashion.

That's what the president's new option is meant to protect against as well. Being dropped for "pre-existing" conditions is not a valid excuse to drop somone from coverage IMO, since the insurance companies can bend that stipulation to their own legal interpretation. In addition, "experimental" procedures are another aspect that should be covered as long as your doctor approves it as a valid form of medical treatment. This is how government insurance works now, such as Medicare/Medicaid (despite the fact that it gets abused like a pack mule), since it is meant to cover the disabled and poor. Which leads to my next point, even if there is a low cost government option, that should not erradicate copays for PCP, specialist, or ED visits.

c. Coverage for all children. I think it needs to be done. Most/almost all are covered. We need to be aggresssive about getting them into the fold and establishing early care.

Again, this was another point Obama brought up as an aspect of healthcare that can not be overlooked. There is no reason why children through college students should not be insured. Again, government assisted programs such as Medicaid and Blue Cross' Health Choice have been used to prevent this. It is especially important to be aggressive about medical treatment for infants in the early stages of child development. I'm pretty sure that everyone is on board with this idea.

I'm glad that you posted your thoughts on how the current healthcare system could be improved upon. I didn't feel like any of your ideas were over my head, and it seems that we actually do agree on some issues of major importance. It has been my understanding that these very issues will be addressed in the option Obama is attempting to give every citizen. So hopefully the public option won't be as big of a monster as it has been made out to be.

 

[docmartin252]

design the "public option" as for lack of a better term a "tool" to drive us to a single payer government program, why should we believe otherwise? This is not a hypothetical prediction of possibilities, they are engineering/structuring it that way...

Thus, as stated, if I trust what they have said, I have no rational reason to believe this is about making a competitive environment. It isn't intended to do so.

I do feel as though this step is the key to a single payer system, which may not be the best answer for healthcare in our country...although maybe it is. Either way, I think that the public option may be a test as to whether the country can handle such a change.

Again I agree with you JAD that this may have nothing to do with a competitive market, however I do feel that it will cause insurance companies to change how they do business a bit. However, keeping the bank crisis in mind, it becomes clear that there needs to be specific laws if not a governing body set in place to monitor how big profits and transactions take place. Although a single payer system would eliminate these worries, a new set would crop up if you don't have faith in the government to properly regulate itself. The other problem is the question of whether or not the country is quite ready for a single payer system, or movement in that direction. I think most people would be pleasantly suprised how much smoother and easier the system could make things.

 

[JackADeli]

...I was under the impression that you were saying that the socialist tendencies would expand into other realms, which I think is a leap in logic...

No, I was not talking a complete take-over and "nationalization" of all industries. I was simply speaking to the fact that the current folks have stated they want the proposed legislation/s as instruments to facilitate take-over of healthcare and push to a single governement system. Thus, I see no reason to believe the current plan/s have anything to do with competition or strengthening the private business sector (of health insurance).

As for socialism beyond healthcare.... I don't necessarily invision a take-over of all industry, etc... However, I believe socialism from a industry standpoint is a somewhat "economics" based definition. I have heard that once a certain percentage of the economy/finance is controlled by government.... you meet that definition and are in a socialist nation.

... A decade ago U.S. government spending was 34.3 percent of GDP, compared with 48.2 percent in the euro zone—a roughly 14-point gap, according to the Organization for Economic Cooperation and Development. In 2010 U.S. spending is expected to be 39.9 percent of GDP, compared with 47.1 percent in the euro zone—a gap of less than 8 points. As entitlement spending rises over the next decade, we will become even more French...
...The catch is that more government intrusion in the economy will almost surely limit growth (as it has in Europe, where a big welfare state has caused chronic high unemployment)...

Given the current amount of the economy now under government control and what ever percentage healthcare may grow to under government control... we could meet the definition of a socialist nation.

JAD

 

[JayDoc06]

I do feel as though this step is the key to a single payer system, which may not be the best answer for healthcare in our country...although maybe it is. Either way, I think that the public option may be a test as to whether the country can handle such a change.

Again I agree with you JAD that this may have nothing to do with a competitive market, however I do feel that it will cause insurance companies to change how they do business a bit. However, keeping the bank crisis in mind, it becomes clear that there needs to be specific laws if not a governing body set in place to monitor how big profits and transactions take place. Although a single payer system would eliminate these worries, a new set would crop up if you don't have faith in the government to properly regulate itself. The other problem is the question of whether or not the country is quite ready for a single payer system, or movement in that direction. I think most people would be pleasantly suprised how much smoother and easier the system could make things.

Problem #1: legislation is almost never reversed after being passed, so this urge to "pass something, anything" is absolutely wrong

Problem #2: the government can't do anything right. They are not omnipotent, even though they act like it, and often times all laws they pass have so much collateral damage from "unforeseen effects" (due to above mentioned lack of omnipotentce) that we we are better off with no new laws of any type

Problem #3: with respect to your banking comment (since you brought it up and people get a huge free pass for throwing incorrect statements like that around, I feel the need to comment) the false sense of security created by entities like the FDIC and SEC led to runaway malinvestment because the government is supposed to protect everyone (moral hazard anyone?). Also the Federal Reserve monetary policies directly led to the bubble, and what do bubbles do, they pop.

Problem #4: what on earth makes anyone think that any new government intervention in the medical arena will be any better than medicare/medicaid? Those programs suck. The reason other insurance programs are the way are is because they follow medicares lead.

Problem #5: why would this plan (single payor system) not cause physician salaries to plummet? Physicians in France (accoording to one of those Sunday morning news shows i watched yesterday) make no more than $100k/year. Two problems- couldn't pay back debt and (I don't care if you baste me or not) physicians deserve to be paid well. OK fine, you say government will pay for all health care training/medical schoo eliminating that argument. Then we are truly civil servants in a socialist country.

Problem #6: what is the last thing the government did well/efficiently?

 

[JackADeli]

...By redistributing the pay scale, we would hopefully intice more people in to FM who truely would like to be FM, but are turned off by the amount of salary the average FM earns. ...a more even pay scale would create physicians who are more satisfied with the work they are doing. Although, it still must be realized (when considering this possibility) that more goes into getting into a residency in a particular specialty than just saying, "I like this specialty, I'll just do that." ...

My reply may have some politically incorrect generalizations. However, I think anyone having gone through medical school will understand the point.

1. Increased income for FPs & PCPs may increase the numbers in this field. That does not necessarily equate improved quality of care.
2. Surgeons can earn 180-250k starting after residency (there may be some exceptional extremes). FPs are being offered 100-150k. Surgeons, work a significant greater number of hours with significant more personal risk for that difference. Not to mention the extra years of training.
3. Has anyone ever rounded on a medicine service..... is it the epitome of efficiency?
4. How have those incentives to increase PCP been working for you? Plenty out there to encourage care in underserved areas. Surprisingly, the FPs & PCP are still choosing to work in the suburbs. You think increased salary accross the board will improve primary care in the underserved areas?

 

[njbmd]

Just to jump in here and stir the pot a bit: My biggest fear is that they will pass a piece of "crap" legislation that will do nothing or make the situation worse because that's what Congress does.

Why do I feel this way? Look at the economic stimulus bill. The feds can't do everything (or even most things) and certainly are not the solution to any crisis especially a health care crisis.

The problems with health care didn't happen overnight (they have been building for many years) and the solutions are not going to be a quick fix. There is no "one size fits all" but I am sure of one thing and that is that the current state of affairs can't continue.

All of those folks who are standing up parroting what they have heard from their pundits who know nothing, are not helping the situation. Every time I hear "socialist" or "death squads" or "killing grandma" (why is it not "killing grandpa"?), I want to hurl. This is like the blind men and the elephant.

Someone has to take leadership and suddenly a vacuum opens up and sucks the air out of the room.

 

[Castro Viejo]

I'm disappointed in both sides of the debate and the number of lies being thrown around. Yes, the death panels and the plug pulling thrown by the right are ridiculous.

Equally ridiculous, however, is the notion that somehow the only victims in healthcare are patients and that physicians, hospitals, and private insurers are making a killing off the backs of Americans.

Obama's calculus has always been to tweak a lie just enough so that it seems believable by his gullible constituency. $50,000 for an amputation? Come on now. Michelle Obama worked for several years as a senior vice president (making well over $400,000 per year) at a major academic medical center in Chicago whose patient base is over 40% MEDICAID, and I'm expected to believe that he really thinks a surgeon makes $50,000 on an amputation? Or that an otolaryngologist will decide to take out some kid's tonsils because he can "make more money doing that than treating him with medication?"

All Obama has done with these few irresponsible comments -- the rebuttals of which from both the ACS and the OHNS groups have yet to garner much air time on major news outlets -- is drive a bigger wedge between surgeons and their patients. Thanks a lot Mr. President for destroying the fragile bit of trust our patients still had until you decided that, at all costs, you would have to lie your way to remaking healthcare as you see it.

(A patient last week with a dead leg actually told me that he didn't want to be the guy who ended up paying for my BMW, so he refused an amputation... I've never been so insulted in my life, and for the first time I started hating my job...)

 

[JackADeli]

... Increased income for FPs & PCPs may increase the numbers in this field. That does not necessarily equate improved quality of care.
...incentives to increase PCP ...out there to encourage care in underserved areas. Surprisingly, the FPs & PCP are still choosing to work in the suburbs. You think increased salary accross the board will improve primary care in the underserved areas?

Those efforts have in numerous cases already failed.... a hungry FP can make an excellent income just as a fat and lazy surgeon can make a pathetic salary

...By redistributing the pay scale, we would hopefully intice more people in to FM who truely would like to be FM, but are turned off by the amount of salary the average FM earns. ...a more even pay scale would create physicians who are more satisfied with the work they are doing...

So, in general, this idea is IMHO why salary equalization amongst specialties and incentives to PCP will not work...

You cannot legislate the poor into freedom by legislating the wealthy out of freedom. What one person receives without working for, another person must work for without receiving. The government cannot give to anybody anything that the government does not first take from somebody else. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my dear friend, is about the end of any nation. You cannot multiply wealth by dividing it.

As for the patients, if we look at what they are most focused on....

~50million uninsured
almost half can afford to be insured but choose not to be (but go bankrupt when they need it)
almost half are illegal immigrants
around 5-10million are actual legal residents/citizens that truely can not afford insurance

In summary, the system must be upturned to mostly pay health insurance for illegals, force the tightwads to get insurance, and maybe increase salaries for PCPs.... in the hopes of catching the 5-10million that fall through the cracks.

tort reform? no
competition? no (it's not designed or conceived as a instrument to promote competition).

 

[mercaptovizadeh]

Or that an otolaryngologist will decide to take out some kid's tonsils because he can "make more money doing that than treating him with medication?"

(A patient last week with a dead leg actually told me that he didn't want to be the guy who ended up paying for my BMW, so he refused an amputation... I've never been so insulted in my life, and for the first time I started hating my job...)

Excuse me, but let's just get this straight: tonsillectomies are performed by the pediatricians.

(and that's frightful)