[HSF] double negatives

Wed Jul 4 12:35:55 EDT 2007

Mike:
I share your pain.  However, I think this is a prelude for even more  
to come.  I am convinced that we will have a democratic president and  
democratic congress in the US in 2009.  I also think that the  
Clintons and Barak Obama have broken the code when it comes to  
universal health care (thanks to Hiliary's missteps in the 1990's).   
The key to putting through universal healthcare (ie, a medicare  
program for the entire population), is to go through the insurance  
companies.  Existing companies will administer the plans, there will  
be set stoplosses funded by the federal and state governments to  
protect the insurance companies, and that funding will be through  
increased taxation on the wealthiest of the population.  The initial  
setup for these programs will be via a RETROACTIVE tax increase  
(styled after the one in 1992 when Bill Clinton was elected).  In  
this way, this potentially risky insurance sector will have  
guaranteed profits, and will be alleviated of a majority of financial  
risk.
It has always seemed to me that it did not matter what party was in  
power regarding physician income/lifestyle.  It seems that when  
republicans were in power, money flowed away from entitlement  
programs (ie, less reimbursement) but taxes decreased.  When  
democrats were in power, money flowed into entitlements (ie, more  
reimbursement or decreased rate of decline) but taxes were raised.   
Therefore, overall standard of living was awash (in general).  This  
may change in 2009 to 20012.  How good or bad remains to be seen.  If  
we can be relieved of a lot of this tort negligence, it may be worth  
it, but I'm not holding my breath.  Just get ready for more  
regulation.  The tendency will be to resist or fight it, but maybe we  
should all re-read the book, 1984, to get a flavor for how futile  
resistance will be.

Signed,
Big Brother

not really

Ed Bender, MD

On Jul 4, 2007, at 10:41 AM, Michael Firstenberg wrote:

> The short answer is that we are easy targets.  We keep taking it on  
> the chin
> and coming back for more.  Everyone complains that we make too much  
> money
> and yet (at least in the US and probably everywhere else) they want  
> instant
> access to top doctors, top health care, top everything 24 hrs a  
> day.  Here,
> in the US - July 4th - national holiday, took me an hour to drive  
> to work
> (usually 15 minutes) to meet with a family about an upcoming  
> operation - at
> their convenience.  Try calling your lawyer today (even if it is a  
> crisis)
> or your stock broken, insurance agent, real estate agent, plumber,  
> etc.
> Sure, you may get ahold of them (at their vacation homes, on the golf
> course, trout fishing) - but just wait for the bill for that 15  
> minute phone
> conversation.  Besides, they dont even have to pay for their health  
> care -
> again, people do not appreciate or even understand the value of the  
> services
> that they require/want.  Then, on the other side we work our butts  
> off and a
> fluke accident happens or something out of the ordinary (so what if  
> the
> patient is a non-compliant overweight poorly controlled diabetic  
> smoker) and
> everyone wants to place blame.  Now CMS (medicare/Medicaid) is  
> publishing
> AMI/CHF 30 mortality statistics, patient satisfaction results, and  
> I guess
> the latest is that patients must sign a form agreeing 2 days in  
> advance to
> getting discharged - and if they disagree then it goes to a unbiased
> moderator (hmm - who is going to pay for that???)  We take a stand on
> something and we get marked for abandoning our patients, our  
> hospitals, or
> oaths.  And, yet here on this National Holiday - just try to get  
> ahold of an
> administrator or supervisor if you have a problem.  I am not  
> complaining,
> that is the way things are and that is why we chose this field.  My
> patient's families hug and thank me for saving their loved ones in  
> their
> time of need - that I why I do this.  We are expected to be perfect  
> - at
> times I dont mind that reputation as I strive for it and families  
> at times
> recognize that is not the case when the see how hard we work and  
> how much we
> do care.  It sure beats the alternative - people expect their  
> lawyers to
> be...... (fill in the blanks).  If people are satisfied in life being
> mediocre and having other expect that of them and expect to live  
> and die by
> a timecard/hourly rate/billable hours then fine.  I am looking to  
> buy a new
> condo to live and the developer "does not negotiate on price" -  
> fine, when
> he comes in the hospital and needs "my" services then he can pay  
> full price
> also.  OK, enough rambling.....We are not the bad guys in all of  
> this - the
> system is - yes there are bad, greedy, apathetic doctors (and  
> probably a few
> that can be classified as "terrorists") - but in the end, are we  
> not all
> passionate zealots - if not martyrs for our causes?
>
>
> -michael
>
>
> On 7/4/07, Tea Acuff <tacuff at swbell.net> wrote:
>>
>> Speaking of double negatives has anyone noted the sense of  
>> incredulity in
>> the reports on the Muslim doctors in the UK who played a part in the
>> terrorist attacks. This is from the same media sources that  
>> usually talk of
>> our (as physicians) failures, negligence, and greed. The concept  
>> of killing
>> healers is really a contradiction deep in the psyche of the West  
>> despite its
>> mouth piece preference for jaded pseudo sophistication.
>>
>> tea
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