Health Care reform from a Doctors perspective

[wabrams]

What the poster is saying is better worded as badgering, which most people se as the same thing as bullying. The meteorologist comment a few frames ago would be considdered badgering. You just know how to cover your tracks better than most, it doesn’t make you anymore incocent.

Pot meet kettle. I recall you have had some nasty comments yourself, including calling any doctor who gets sued (rightly or wrong) a quack.

 

[royal_archer]

Everyone in this thread gets flamed sooner or later. There is a lot of hostility here. I just want to point out that Pathia didn’t state anything about the Constitution. Pathia stated that he/she didn’t want his/her money going to defense contractors. I may have missed something stated earlier and if so I apologize. It’s hard to keep track in this thread. Usually I’m able to categorize posters as either “pro” or “anti” whatever position I have. But I have no position on national health care and I can’t figure out what most of the posters here believe. I can’t get past the anger. There is no OP to keep an eye on things.

Perhaps there should be an amendment to the Constitution. Maybe that would be part of the solution, or it might cause even more problems as it could be interpreted by the Supreme Court whichever way it chooses (which is unfortunate IMO). I guess that would best be discussed on another thread.

The Constitution does not allow the Federal Government to provide health care for citizens at large even medicare and medicaid are out of scope to the powers the states have given to the Federal government. If there were a constitutional ammendment passed that allowed the government to take over health care, many of the arguements against it would go away. Keep in mind the federal government is an artificial entity formed out of aliance of states in a manner similar to the formation of the UN, NATO, or the EU. This entity was given a limmited number of specific powers. How would you feel if NATO or the UN sudenly decided to give universal health care and started redistributing our resources to third world countries?

As another poster pointed out states do have more freedom to act and it would be better to see the states try something first and then try to nationalize it after the bugs are worked out and a consensus has been achieved.

 

[royal_archer]

The Church teaches the following:

"…An act or omission which, of itself or by **intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, ** his Creator. The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. (CCC 2277)

“Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted…” (CCC 2278)

If Pathia were a patient in a hospital and was maintaining life only because of machines which kept respiration going, etc. it would be acceptable to turn off the machines and allow death to occur. However, Pathia is here, on this forum, conscious and able to type comprehensible posts. He/she is obviously not covered under CCC 2278. Taking life-saving medication is not burdensome, dangerous, extraordinary, or disproportionate to the expected outcome. However, Pathia’s option of discontinuing life-saving medication is covered under CCC 2277 where it states that an omission which causes death constitutes a murder, even if it is done in order to eliminate suffering. If Pathia decides to stop life-saving medication in order to die, he/she is committing the grave sin of murder. Pathia would be murdering Pathia. It would be the same as if a diabetic stopped injecting insulin in order to die. It is suicide. It is absolutely forbidden by the Catholic Church.

As far as Pathia’s intentions of posting as he/she does, that is between Pathia and God. I’m not going to decide that Pathia is lying or playing the “sympathy card.” That burden is on Pathia. I can only go by what the posts say. Also, even if Pathia were lying, there are lurkers here who may very well be in the situation Pathia describes.

Pathia presented a medical condition to the board which is being advertised as having two options A: no medicine = pain, suffering, disability, death or B: Medicine = all problems go away and patient leads a normal life. Given this, I don’t see how any doctor would disagree with providing medicine. The aspect of recomending and implementing a treatment with the highest probability of a positive outcome is fully within a doctor’s area of expertise. A doctor is not qualified to make a judgement on the value of the treatment. Only a patient or perspective patient can provide a judgement of the value of their life as it relates to the cost of the treatment. For instance what if this medicine cost 5 million dollars per day? At some point the patient can no longer sustain the cost. And at some time society can no longer endure the cost. The average worker has a right to say enough is enough and decide that they would rather enjoy they life they have and accept the risk that they will not be able to deal with certain conditions.
The health care debate is pitting those who want access to unlimmited resources against those who want more say in how their resources are allocated. A doctors perspective is inclined to the side of the argument that will increase the money going to them. however they are not experts in the fundemental funding questions.

 

[LittleSoldier]

I have not threatened or bullied anyone here. I may have said some things others did not want to hear and I may be less than touchy feely in my wording but I would not stoop to threatening others. However, others here have said things I find as very insulting, offensive, and hateful. Part of being on a discussion of this type is that you get a variety of points of views, not just those you want to hear.

Could we please stay on topic, per the moderator’s warning?

 

[LittleSoldier]

Pot meet kettle. I recall you have had some nasty comments yourself, including calling any doctor who gets sued (rightly or wrong) a quack.

Could we please stay on topic per the moderator’s warning?

 

[royal_archer]

Could we please stay on topic, per the moderator’s warning?

then please read post 471 on this thread :dts:

or my 2506th post.

 

[LittleSoldier]

I’m not a doctor, but I work with them everyday as I am a X-ray & CT technologist. I here the genuine fear in their voice about nationalized healthcare. Several of them trained under doctors from Canada and the UK who immigrated here to get out from under those systems due to horrid practices. Many of them feel that tort reform would help greatly in reducing their costs (through malpractice insurance rates among other things). I had an MD tell me once that once you have to sit in front of an attorney who has no medical training and they second guess everything you did, you will never practice medicine the same way again.

I know medical imaging is one of the areas the government has said they want to scale back under a single payer system. What they don’t get is that CT cut back exploratory surgery by something like 80%. Do we want to go back to 1970’s/early 80’s medicine?

IMO that is a very good point. If the insurance companies or the government or whatever else that ends up in charge paid for preventive care money would be saved. It’s similar to when uninsured or under-insured people end up in the ER which costs so much more money than a simple visit to a physician and a prescription.

Do you think that if people had the option of seeing a physician early on, say if a person is coughing a lot and running a fever, they would do so instead of waiting until full blown pneumonia sets in? I would hope they would. I would!! Maybe part of the answer is education, which I know has been discussed before, but perhaps people need to not only have the option of seeking preventive care, they have to understand why they need it and that they need to really do it. And they need to know that if they show up at the ER with a fever of 99.6 degrees and coughing a little they will be turned away.

I thought that imaging was the way of the future and I’m disappointed that the government wants to cut back on such an important diagnostic tool. My father died of cancer of the pancreas. If scanning were available to detect such a thing he might be alive today. It just makes so much sense to prevent a problem than to try later on to fix it at a much higher cost, not to mention it’s just better overall for the health of the patient.

 

[LittleSoldier]

then please read post 471 on this thread :dts:

or my 2506th post.

I read it. Thank you. I never meant to imply that you have never, ever, ever made any significant point in this thread. My question was in response to Post #464, or your 2508th post.

Now can we please remain on topic?

 

[St_Francis]

I’m not a doctor, but I work with them everyday as I am a X-ray & CT technologist. I here the genuine fear in their voice about nationalized healthcare. Several of them trained under doctors from Canada and the UK who immigrated here to get out from under those systems due to horrid practices. Many of them feel that tort reform would help greatly in reducing their costs (through malpractice insurance rates among other things). I had an MD tell me once that once you have to sit in front of an attorney who has no medical training and they second guess everything you did, you will never practice medicine the same way again.

I know medical imaging is one of the areas the government has said they want to scale back under a single payer system. What they don’t get is that CT cut back exploratory surgery by something like 80%. Do we want to go back to 1970’s/early 80’s medicine?

I was talking with a doctor recently, and he told me he had been offered a part-time job in a clinic, but that the people running the clinic would not show him the business plan. He told me that all too often doctors get involved in these clinics only to be told that they have to see more patients in less time in order to make enough money to pay the bills of the clinic, and that, he told me, leads to bad medicine.

I am sure that there would be an overwhelming pressure on doctors to do this.

So, yes, I see a bad effect on doctors.

 

[LittleSoldier]

The health care debate is pitting those who want access to unlimmited resources against those who want more say in how their resources are allocated. A doctors perspective is inclined to the side of the argument that will increase the money going to them. however they are not experts in the fundemental funding questions.

I agree, partially, although I think it is much more complicated. But looking at what you’ve stated I would say that many “undeserving” (I don’t like that word but I don’t know what other word to use) people do want access to unlimited resources. I will agree that most people who have resources want more say in how their resources are allocated and they should have some choice. I don’t want to fund abortions. I will also agree that many doctors are inclined to choose whichever side increases the amount of money going to them, although I am also aware that free medical care is provided by some physicians.

But there is a segment of society that wants and needs basic health care and isn’t getting it. Many of these people are the “working poor.” I think another point to be made (which doesn’t mean I’m disagreeing with you here) is that physicians may order tests and screenings and scans and things like that without realizing how much the patient can afford. I guess it’s because they are removed from the financial problems that the patient may be facing.

If I were a physician (and that used to be my dream until I discovered lizards and rocks) I would want the best care for my patients. I would want to utilize every diagnostic tool I could and I would want to prescribe the absolute best medication, without any consideration as to cost. And that would really be my job. I think it would be. Like you’ve said, the physicians are not experts in the fundamental funding questions.

So here are physicians doing the best they can (I hope) and not understanding that many patients literally cannot afford to pay for the best. Somewhere there has to be some sort of compromise and I don’t see where it is.

Sometimes I cancel appointments with my physician because all he wants to do is check on me and I don’t think it’s worth $150 to tell him that the hot flashes are not so frequent and I am sleeping better. I’ve also told him that I could not afford an expensive medication, even if the pharmaceutical company has offered it to me at half price (it was still $70 a month). My physician then prescribed a medication that costs me $4 a month. It isn’t perfect - the other med is better but this one works just fine and I’m happy with the results of the med and with my savings of $66 a month.

If unlimited resources are offered I think you and I would agree that most patients would take advantage of them. That’s the way people are. And that, in itself, is going to be a problem because costs will skyrocket. And that will lead to more taxes for the people who have more resources, which really isn’t fair especially if they worked so hard to get those resources. The whole thing could spiral out of control.

There has to be a difference somewhere in what is “basic health care” and what is, wow, I don’t even know how to phrase it, “health care for people who can afford more.” I’m sorry. I know that is very poorly worded but I don’t know how to word it any better.

Shouldn’t everyone have access to “basic health care” - more than emergency visits to the ER but preventive care, help with medication that is necessary to maintain life (such as insulin or heart medication), that sort of thing? And then those who have more resources could pay for the more expensive procedures? I hate this idea but I can’t think of anything better.

I have two concerns: the first is that human beings are suffering needlessly and when they are treated it comes at a very high cost to both the patients and the tax payers; the second is that I don’t want the government funding abortion on demand.

 

[chichizola]

Money is nothing more than a mechanism for packaging effort. It is just an exchangeable token representingtime away from family, years of education, stressfull and dangerous work, and raw sweat. To take that money away from them with out their approval is in many ways a violation of them as a human and essentially retro active forced labor. Keep in mind we are all called to charity, not the forcefull redistribution of resources you are advocating.

Is it OK to take that money from them to pay for war and subsidize the same companies that are elevating Healthcare cost? If we would take just a little of it we could insure all US citizens.

Live Jesus!

May God bless you,

 

[royal_archer]

Is it OK to take that money from them to pay for war and subsidize the same companies that are elevating Healthcare cost? If we would take just a little of it we could insure all US citizens.

Live Jesus!

May God bless you,

It is not ok except as defined in the constitution for mutual defense.

 

[aspawloski4th]

Pot meet kettle. I recall you have had some nasty comments yourself, including calling any doctor who gets sued (rightly or wrong) a quack.

I’m what you call agitated. All my nasty comments, and I do not deny that I have made them, were in response to to comments that I percieve as nasty. I am a fight fire with fire type of person. When I see no concern about stripping humans of their humanity I get nasty very quick. In these threads I am actually be pragmatic, if you heard how I really feel many here would have their eyes pop out of their heads. With some of the business fanatics here it wouldn’t bother me one bit if an 8 foot 400 lb ogre picked them up hold them upsidedown and shook all their cash of their person and gave it to a mother of 5 dying of cancer who lost her house to medical bill. At the same time tickling the bottem of the foot of the person being shaken so he can only laugh aat whats happeneing to the money he hoarded. There thats how I really feel, but since that isn’t about to happen anytime soon, I settle for a healthcare system that put everyone on an equil plane so the rich , middle class and poor are treated exactly the same.

 

[royal_archer]

I agree, partially, although I think it is much more complicated. But looking at what you’ve stated I would say that many “undeserving” (I don’t like that word but I don’t know what other word to use) people do want access to unlimited resources. I will agree that most people who have resources want more say in how their resources are allocated and they should have some choice. I don’t want to fund abortions. I will also agree that many doctors are inclined to choose whichever side increases the amount of money going to them, although I am also aware that free medical care is provided by some physicians…

I presume dotors are interested in getting paid for these services that they occasionally provide for free.

But there is a segment of society that wants and needs basic health care and isn’t getting it. Many of these people are the “working poor.” I think another point to be made (which doesn’t mean I’m disagreeing with you here) is that physicians may order tests and screenings and scans and things like that without realizing how much the patient can afford. I guess it’s because they are removed from the financial problems that the patient may be facing.

They also can’t consider the quality of life issues of the people who can “afford it”. My doctor wanted me to spend a bunch of money on some heath improvement program but for me there are other things that are just more important than the marginal improvement in health that the program would have made.

If I were a physician (and that used to be my dream until I discovered lizards and rocks) I would want the best care for my patients. I would want to utilize every diagnostic tool I could and I would want to prescribe the absolute best medication, without any consideration as to cost. And that would really be my job. I think it would be. Like you’ve said, the physicians are not experts in the fundamental funding questions.

That is sometimes called turning something into a private “science project”. Technical people sometimes tend to do that, working things to the final point of knowledge instead of accepting close enough.

So here are physicians doing the best they can (I hope) and not understanding that many patients literally cannot afford to pay for the best. Somewhere there has to be some sort of compromise and I don’t see where it is.

That compromise needs to be within the person.

Sometimes I cancel appointments with my physician because all he wants to do is check on me and I don’t think it’s worth $150 to tell him that the hot flashes are not so frequent and I am sleeping better. I’ve also told him that I could not afford an expensive medication, even if the pharmaceutical company has offered it to me at half price (it was still $70 a month). My physician then prescribed a medication that costs me $4 a month. It isn’t perfect - the other med is better but this one works just fine and I’m happy with the results of the med and with my savings of $66 a month.

I have canceled several appointments insurance would have paid for just because I didn’t want to see anyone wasting money.

If unlimited resources are offered I think you and I would agree that most patients would take advantage of them. That’s the way people are. And that, in itself, is going to be a problem because costs will skyrocket. And that will lead to more taxes for the people who have more resources, which really isn’t fair especially if they worked so hard to get those resources. The whole thing could spiral out of control.

Some are inclined to be thrifty but those are the people who tend to need government assistance.

There has to be a difference somewhere in what is “basic health care” and what is, wow, I don’t even know how to phrase it, “health care for people who can afford more.” I’m sorry. I know that is very poorly worded but I don’t know how to word it any better.

unfortunately there is no such concept as basic health care. every new procedure no matter how exotic goes right to the “must provide” list.

Shouldn’t everyone have access to “basic health care” - more than emergency visits to the ER but preventive care, help with medication that is necessary to maintain life (such as insulin or heart medication), that sort of thing? And then those who have more resources could pay for the more expensive procedures? I hate this idea but I can’t think of anything better.

everyone would consider what they need to improve their health care to be basic health care. And as long as it is just the “evil rich” who are paying they don’t seem to care about the cost.

I have two concerns: the first is that human beings are suffering needlessly and when they are treated it comes at a very high cost to both the patients and the tax payers; the second is that I don’t want the government funding abortion on demand.

Humans are going to suffer regardless of what we do, thanks to Adam and Eve.

 

[LittleSoldier]

Humans are going to suffer regardless of what we do, thanks to Adam and Eve.

Not if I can help it.

 

[St_Francis]

I agree, partially, although I think it is much more complicated. But looking at what you’ve stated I would say that many “undeserving” (I don’t like that word but I don’t know what other word to use) people do want access to unlimited resources. I will agree that most people who have resources want more say in how their resources are allocated and they should have some choice. I don’t want to fund abortions. I will also agree that many doctors are inclined to choose whichever side increases the amount of money going to them, although I am also aware that free medical care is provided by some physicians.

But there is a segment of society that wants and needs basic health care and isn’t getting it. Many of these people are the “working poor.” I think another point to be made (which doesn’t mean I’m disagreeing with you here) is that physicians may order tests and screenings and scans and things like that without realizing how much the patient can afford. I guess it’s because they are removed from the financial problems that the patient may be facing.

A lot of extra tests are performed because doctors need to protect themselves from malpractice suits.

An example from long ago (33 years ago)—I hit my head really hard at work one day, and “saw stars.” It was a very hard knock on the head. I had a friend whose brother had died some time after a knock on the head due to its having been more serious than anyone had thought who persuaded me to see a doctor, so I went.

The doctor checked me out and then said, knowing I had very little money, that he could say with 99% accuracy that I was all right, but that I could get X-rays and all that in order to be 100% sure. He gave me the choice, and I chose to not spend the money I didn’t have. But he said, even back then, that he wouldn’t even mention the X-rays except for fear of malpractice.

…Shouldn’t everyone have access to “basic health care” - more than emergency visits to the ER but preventive care, help with medication that is necessary to maintain life (such as insulin or heart medication), that sort of thing? And then those who have more resources could pay for the more expensive procedures? I hate this idea but I can’t think of anything better.

Alternatives are springing up. There are 24-hour clinics for when you are sick but not ER sick, and there are in-store (Wal-Mart and CVS for example) offices which offer the most basic care—checking on things like ear infections and the like for which a prescription might be necessary—since they are staffed by a PA or RN, they charge only a little.

Also, given what I have noticed, check out the overhead of where you are going. Sometimes a small doctor’s office will charge less than a large clinic staffed mostly by PA’s because the overhead is that much smaller. Also, if it’s new, they have to charge more to pay off the equipment, but if it’s older, then they’ve paid off their equipment and so keep their rates lower. I have seen big differences.

 

[St_Francis]

I have canceled several appointments insurance would have paid for just because I didn’t want to see anyone wasting money.

I have heard people with good insurance programs say that they go to the doctor because the insurance will pay for the visit and the medicine and so they save by not buying OTC medicine.

Some are inclined to be thrifty but those are the people who tend to need government assistance.

Not necessarily. Some of those on government assistance get everything they can.

 

[royal_archer]

Not necessarily. Some of those on government assistance get everything they can.

OOPs, got distracted while typing.

I meant to say that those who are thrifty are the ones who are morel likely to NOT need assistance.

 

[wabrams]

IMO that is a very good point. If the insurance companies or the government or whatever else that ends up in charge paid for preventive care money would be saved. It’s similar to when uninsured or under-insured people end up in the ER which costs so much more money than a simple visit to a physician and a prescription.
Do you think that if people had the option of seeing a physician early on, say if a person is coughing a lot and running a fever, they would do so instead of waiting until full blown pneumonia sets in? I would hope they would. I would!! Maybe part of the answer is education, which I know has been discussed before, but perhaps people need to not only have the option of seeking preventive care, they have to understand why they need it and that they need to really do it.

People seem to have forgotten how to take care of themselves. Having a cough and a mild fever is not cause to run to the doctor; simple OTC medicines can usually fix that.

With regards to preventative care, annual physicals average around $90 to $125 around here. You don’t need insurance for that. Many offices will negotiate lower for those paying cash.

And they need to know that if they show up at the ER with a fever of 99.6 degrees and coughing a little they will be turned away.

No one is ever turned away from the ER.

I thought that imaging was the way of the future and I’m disappointed that the government wants to cut back on such an important diagnostic tool. My father died of cancer of the pancreas. If scanning were available to detect such a thing he might be alive today. It just makes so much sense to prevent a problem than to try later on to fix it at a much higher cost, not to mention it’s just better overall for the health of the patient.

I’m sorry to say pancreatic cancer is something you just don’t recover from unless you are that 3% of the victims that are caught early and by accident.

 

[wabrams]

I’m what you call agitated. All my nasty comments, and I do not deny that I have made them, were in response to to comments that I percieve as nasty. I am a fight fire with fire type of person. When I see no concern about stripping humans of their humanity I get nasty very quick. In these threads I am actually be pragmatic, if you heard how I really feel many here would have their eyes pop out of their heads. With some of the business fanatics here it wouldn’t bother me one bit if an 8 foot 400 lb ogre picked them up hold them upsidedown and shook all their cash of their person and gave it to a mother of 5 dying of cancer who lost her house to medical bill. At the same time tickling the bottem of the foot of the person being shaken so he can only laugh aat whats happeneing to the money he hoarded. There thats how I really feel, but since that isn’t about to happen anytime soon, I settle for a healthcare system that put everyone on an equil plane so the rich , middle class and poor are treated exactly the same.

You know where I stand on the issue, but let me tell you something about myself: our family owes the hospital over $2600 from when my daughter was born (3 mos ago today!) b/c that is what our insurance didn’t cover. Money is too tight for comfort right now, but it’s better than having socialized medicine and me paying more in taxes to have no bill.