Survey: US Doctors Fear Healthcare Reform

[ProVobis]

Of course, they will fear it. They get paid from the insurance companies and if premiums are forced to come down by competition of the exchanges or if public option prevails, their paychecks might get smaller. And if they make it easier for foreign doctors to enter the market, that would really hurt the US doctors. The AMA is the most powerful union in the country; which doctor wants to see the breakup of that?

 

[mary_bobo]

Of course, they will fear it. They get paid from the insurance companies and if premiums are forced to come down by competition of the exchanges or if public option prevails, their paychecks might get smaller. And if they make it easier for foreign doctors to enter the market, that would really hurt the US doctors. The AMA is the most powerful union in the country; which doctor wants to see the breakup of that?

With respect, I question that the AMA is powerful. Less than 50% of physicians belong to that group. The most powerful unions are the SEIU and the NEA.

 

[mary_bobo]

And to add insult to injury, the quality of care received at an ER is pretty far down the scale.

And your proof is…?

 

[Monte_RCMS]

Health care won’t get worse for folks without health care.

Presumably you have had an opportunity to think about this.

Define health care.

Define health insurance.

What are the differences.

What are the similarities.

 

[Ridgerunner]

And to add insult to injury, the quality of care received at an ER is pretty far down the scale.

Like anything else, that depends on where you go. I am aware of ERs that are not very good, and ERs that could not possibly be better.

 

[Ridgerunner]

Of course, they will fear it. They get paid from the insurance companies and if premiums are forced to come down by competition of the exchanges or if public option prevails, their paychecks might get smaller. And if they make it easier for foreign doctors to enter the market, that would really hurt the US doctors. The AMA is the most powerful union in the country; which doctor wants to see the breakup of that?

The “public option” is not “competition”. It’s just a government takeover of healthcare, nothing more or less, because the government can always lose money in its operation, then print more. No private organization can compete with that advantage.

It’s not competition physicians are concerned about, it’s socialized medicine they don’t want.

If the AMA is trying to keep foreign doctors out of the country, they’re not doing a very good job of it. Long ago I worked some with H1 visas for healthcare workers of all kinds, and if their educations are relatively equivalent and they can speak English well enough to take the exam, they’re in. They’re the easiest visas to get, bar none.

The real choke point in production of American doctors is the limited number of med school applicants accepted. There are lots and lots of people who would enter medical school; well qualified ones too, if they could. Part, but not all, of that problem is that medical schools lose money for the universities of which they are a part. As high as med school tuition is, it still doesn’t pay the freight. Universities make up for the shortfall by overcharging other students, the ones for which only a “professor with a chalkboard” needs to be provided. Law schools are an excellent example of a “profit center” for universities, which is one of the reasons why law graduates so massively outnumber medical graduates.

 

[mark_a]

And your proof is…?

It’s my personal experience and knowledge of the experience of others who have had to come to grips with being uninsured. I never claimed to prove anything.

None of anything I’ve said is meant to be a blanket statement against anyone who works in health care or an ER. I’m sure they do their best.

 

[Brendan]

AND, decades ago, they had what they used to call “clinics” … basically, they took everyone who presented themselves. Regardless of ability to pay…

They still do, my father is a physician who volunteers at one run by the Archdiocese. He works there two days a week.

He is also firmly against Obamacare.

 

[TheTrueCentrist]

The “public option” is not “competition”. It’s just a government takeover of healthcare, nothing more or less, because the government can always lose money in its operation, then print more. No private organization can compete with that advantage.

It’s not competition physicians are concerned about, it’s socialized medicine they don’t want.

No. The proposals that were discussed during the debate over health care do not resemble your claims at all. If the government option were adopted, the government would have used a one-time expenditure to establish its own insurance program which would have subsequently relied on paying customers for its upkeep. In other words, the only difference between the organization which administrated the “government option” and private insurers would be that the government organization would be non-profit and its plans likely subject to more political scrutiny.

 

[TheTrueCentrist]

A caller to a radio talk show, today:

Its nice that the ER staff is working hard to save lives, but that has little bearing on the economics and politics of the issue. While they don’t refuse treatment, the cost of the treatment does not magically disappear just because the hospital staff works hard. Should ER treat everyone regardless of their ability to pay? Of course. If that criterion is satisfied, does that mean the system is working? Of course not. Hospitals which treat people who are unable to pay must recoup the loss somewhere. That “somewhere” is increased medical costs to everyone else.

 

[AugustV]

So, here is the real tell: Our ruling elite in Congress and their aides, who conceived this bill, are not moving over to this “plan.” Not good enough for the barons and baronesses that “rule” us little people.

For years now, doctors have been under government control. No other industry is regulated, at the costs of billions, as medicine is. This is just one more layer of regulation that will drive costs up and quality down. Oh, and be prepared for even more rationing and abortions. Sadly, the AMA and the AARP supported this legislation. Sadder still is the support the NCCB gave this bill.

 

[Monte_RCMS]

And to add insult to injury, the quality of care received at an ER is pretty far down the scale.

Mark, you haven’t answered any of our questions, except to joust or play with words or to be picky.

You have made assertions or statements which are incorrect. But you won’t answer questions.

What is health care?

What is health insurance?

Additional question: how does insurance work?

 

[Monte_RCMS]

Its nice that the ER staff is working hard to save lives, but that has little bearing on the economics and politics of the issue. While they don’t refuse treatment, the cost of the treatment does not magically disappear just because the hospital staff works hard. Should ER treat everyone regardless of their ability to pay? Of course. If that criterion is satisfied, does that mean the system is working? Of course not. Hospitals which treat people who are unable to pay must recoup the loss somewhere. That “somewhere” is increased medical costs to everyone else.

The issue stated was that 15% or so of the people do not have health care.

We have demonstrated that that statement is false.

Now you are changing the question to: should the ER treat everyone regardless of ability to pay.

That is a totally different question.

The issue of how to pay for health care is a separate issue.

There is a third issue: how to deal with decisions of elective health care versus essential health care.

YOU are the person responsible for YOUR health care.

YOU do not have the right to demand that other people provide YOUR health care.

Those other people do have a responsibility to treat you … up to a point.

Some people demand instant access to a doctor at all times for any reason.

The real issue is … what is elective medical treatment and what is essential medical treatment.

I know people who virtually live at their doctor’s office … always coming up with one medical complaint or another. And the tests show nothing abnormal.

And that gets into the area of psychosomatic illness.

And then there are the people who demand cosmetic surgery to such an extent that their faces no longer look human. There is a radical big difference between reconstruction of burn injuries or repair of a hair lip and wanting the bump on your nose that you were born with to be made smooth or getting age wrinkles removed.

What you CAN to is to shop around and purchase a medical insurance policy that will cover the things that are important to you. Essential medical treatment versus elective medical treatment … and the terms and conditions can go on for 50 pages.

 

[ProVobis]

The “public option” is not “competition”. It’s just a government takeover of healthcare, nothing more or less, because the government can always lose money in its operation, then print more. No private organization can compete with that advantage.

No private organization has been able to run the flood insurance program either. Why? Because they can’t handle catastrophic events either. And private health insurance fails in that environment, unless you think bankrupting insurance companies is the greatest solution. Plain and simple, the free market has not come up with any ways of making profits on treating very sick patients within the United States. And since companies are finding it more and more costly to cover their employees, more and more are forced to buy their own individual insurance if they can get it at all.

The way I see it, the chances of them setting up an exchange program by 2014 is low and it will ultimately come down with state governments running the insurance industry. They already regulate all insurance companies, not only health insurance so that would make most sense. I belong to an ICHIP program, premiums are hefty but becoming less expensive as more are drawn into the pool.

 

[Suudy]

No private organization has been able to run the flood insurance program either. Why? Because they can’t handle catastrophic events either.

I’m not sure that is true. The reason private organizations didn’t do it (not that they weren’t able to to it) is that nobody bought it. Nobody considered that a flood or disaster would hit them. And when it did, there wasn’t a sufficient number of people in the insurance pool. It wasn’t that they weren’t able to handle it, there just weren’t enough customers. Only those with the highest risk purchased the insurance.

So, instead, the government formed NFIP to force people to buy it when federal dollars were involved. You get an FHA loan? You must buy flood insurance if in a flood plain.

And guess what? The federal government couldn’t do it either! They had a goal to be self-sufficient by 1988. The achieved it in 1986, but then Agnes, Isabel, Katrina, and the 1993 flood broke the bank of the plan requiring it to borrow from Uncle Sam. They had to borrow $16 billion for Katrina alone! And to keep it from completely bankrupting the government, there were plenty of denials of coverage for things like illegal structures. Further, adjusters were undervaluing properties and not paying real replacement value. Even with Uncle Sam running the program, it did a horrible job and could not stay in the black.

So, your analogy to flood insurance does nothing to bolster an argument for federally run health care.

And private health insurance fails in that environment, unless you think bankrupting insurance companies is the greatest solution. Plain and simple, the free market has not come up with any ways of making profits on treating very sick patients within the United States. And since companies are finding it more and more costly to cover their employees, more and more are forced to buy their own individual insurance if they can get it at all.

Which is why the only way it would possible work is with the insurance mandate. But even the flood insurance program doesn’t have a mandate, unless one has received federal funds. Flood insurance is not required of all citizens, regardless of risk, which is what the federal government is trying to do with Obamacare. Because that is the only way it will keep from going bankrupt.

And I think Obama/Reid/Pelosi knew this. They want the program to fail miserably to pave the way for a single payer, universal coverage system.

 

[Monte_RCMS]

If you move to New Orleans, and you are looking at houses, and if you see a ship driving by above you … you have to look up to see the ship … , then there is a clue that the property you are looking at is below sea level.

Look somewhere else.

Don’t buy that property.

OR, if you really like the location, build your house on stilts … piers and pilings to raise the building above the ocean level. AND, make sure that if your new building is a hospital … that the generator is not below sea level, so that when it floods, you lose your emergency power supply … to quote some cartoon character, “D’oh”.

In the recent floods in California and in Brisbane Australia, it turned out that a lot of people built or bought houses that were in dry river beds.

DO NOT BUILD OR BUY A HOUSE IN A DRY RIVER BED.

And, if you do, then don’t expect someone who built on high ground to buy you a new house when your house gets washed away, which it will inevitably do.

When you get a home inspection, ask for a flood susceptability determination. There even may be a flood plain map. Ask. Look.

Insurance is when people voluntarily pool their money so that they can share risks. It probably started with ship owners in the 1600’s [you can look up the precise date, I’m sure] and gradually spread to cover other risks such as house fires, car wrecks, and such. They even sell “life insurance”, so that if you die [and you will at some point], you will get paid for dying … well, not YOU, personally, but someone you designate as a beneficiary.

And there are escape clauses … there are age limits, sometimes. And war risk exceptions, sometimes. Etc. You can set the terms and conditions. And there are people who get paid to calculate the “odds” … the risks … and to set a premium. These people have the title of “actuary” … and they get paid very well … because they know how to do math. If you study math in school, then you might also understand the concept of risk analysis.

And if you hire your own agent, then maybe they can come up with some creative sets of terms and conditions to meet your own personal needs.

They have things like “umbrella” policies; and layered policies with high deductibles. The insurance companies WANT to please you so that you will buy insurance from them. And they have re-insurance to protect themselves.

They even have beneficial societies that will bury you … you just join in. Or you can take your chances, make no provisions, die totally broke … and the town will bury you for free in the “potter’s field.”.

Same thing applies to flood “insurance”. If you travel to some countries where people live on the coast, even in third and fourth world countries, people live in houses up on stilts.

They don’t have insurance. They plan ahead. And they don’t expect that if they make really bad decisions, that other people will bail them out.

If you move to Florida and live near the water, odds are that at some point, you will experience a hurricane. They invented hurricanes a few hundred years ago. Not some thing new. If you build a house on a beach on the ocean, then watch out.

Don’t expect me to pay for when your house on the ocean beach washes away.

Because I’m telling you right now, it WILL definitely happen. Not a maybe.

Same thing applies to medical insurance to pay for your health care.

You can use an HSA and catastrophic coverages. You can join a community that has its own hospitals that people voluntarily pay for.

What we have done in the United States is create bureaucratic obstacles that make it all but impossible for voluntary communities to run their own hospitals and then when the obstacles are utterly overwhelming, the government bureaucracy says, “SEE! We told you it wouldn’t work”.

 

[mark_a]

Mark, you haven’t answered any of our questions, except to joust or play with words or to be picky.

You have made assertions or statements which are incorrect. But you won’t answer questions.

What is health care?

What is health insurance?

Additional question: how does insurance work?

I’m not much of a debater and said I’m speaking from my personal experience and the experience of friends and family of mine (see post 27). I’ve been on both sides of the fence and I prefer the other side.

Jumping through you hoops won’t improve my situation.

 

[TheTrueCentrist]

The issue stated was that 15% or so of the people do not have health care.

We have demonstrated that that statement is false.

Now you are changing the question to: should the ER treat everyone regardless of ability to pay.

That is a totally different question.

I disagree. What people face is a choice between physical ruin and economic ruin. While it is true that people will be given the lifesaving care they need regardless of their ability to pay, that doesn’t mean everything is fine. The person who’s life is saved will most likely face financial ruin as a result. Therefore, people who cannot afford treatment are at all times forced to choose between bankruptcy or the inconvenience of an untreated illness/injury.

 

[mary_bobo]

I’m not much of a debater and said I’m speaking from my personal experience and the experience of friends and family of mine (see post 27). I’ve been on both sides of the fence and I prefer the other side.

Jumping through you hoops won’t improve my situation.

With all due respect, your experience and those of your family and friends does not transfer to a blanket statement of how things are. Hospitals write off bills all the time and those who present at an ER are treated. Of course those true emergencies do take preference and those that are deemed not an emergency may have to wait, sometimes for a long period of time. I am sorry for your bad experiences, but there are many others on this forum that have had the opposite experience. We just can’t make sweeping statements.

 

[mark_a]

We just can’t make sweeping statements.

If you’ll check my post #27, I addressed this.

My position, better articulated by many other posters on this thread, is that even when the ER does it’s job perfectly, it is many times far less than ideal, especially for the uninsured / uninsurable patient, who have even fewer health care options.