There’s lot’s of discussion going on about health care lately– very little of substance from our politicians (is anyone surprised?), who are more interested in ramming through a massive government “solution” than actually figuring out what a good solution might be.
Here’s some articles worth looking through to get yourself better informed:
♦ TennCare’s troubling history: Tennessee tried universal coverage with a public option in 1994, similar to what is planned for Obamacare. The result? Employers dumped patients onto the public option; massive cost overruns; doctors ran for the exits due to gawdawful reimbursements; rationing; activists endlessly demanding even more money be poured into the abyss. Hey, let’s try this at the national level!
♦ Health Reform \'s Hidden Victims. The Prez was asked at his presser which patients would need to sacrifice, and how much, in order to get health care reform done. He didn’t answer, but John Fund does. The victims who aren’t now paying attention are in for a very rude shock.
♦ Peggy Noonan has some good insights on why common sense may sink Obamacare. Here’s one in particular which I haven’t seen mentioned before, but which is definitely true:
The first [reason for Americans’ hesitance about government health care] has to do with the doctors throughout the country who give patients a break, who quietly underbill someone they know is in trouble, or don \'t charge for their services. Also the emergency rooms that provide excellent service for the uninsured in medical crisis. People don \'t talk about this much because they \'re afraid if they do they \'ll lose it, that some government genius will come along and make it illegal for a doctor not to charge or a hospital to fudge around, with mercy, in its billing. People are afraid of losing the parts of the system that sometimes work — the unquantifiable parts, the human parts.
Note to Peggy: its already illegal for your doctor not to charge the patient under Federal health care programs: Federal programs consider it fraud if you do not balance bill a poor patient for their Medicare./Medicaid copay and deductible, and your doctor can be fined or excluded from Medicare if he does this.
No joke.
That having been said, there’s a huge, undocumented financial pillar to the current system, which is charity & unreimbursed care by ERs and physicians. The former has been talked about a fair amount; the latter not at all. This charity care will disappear with universal coverage, and will be a large — and unanticipated — additional cost burden to be picked up by the taxpayer.
“I think AMA has become part of the whole government-medical complex.†[Vuckovic] argues that the AMA has complacently accepted the transformation of the medical profession into a “service-delivery model, with both physician-providers and patient-customers slowly but surely becoming servants of the same paymasters: the private and public insurers.†The idea of returning medicine to a fee-for-service model has been all but abandoned in Washington, where AMA lobbyists spend most of their time.
Spot-on — the AMA is a bunch of elitist fools who are only interested in schmoozing with the politicians and pretending they are the voice of medicine. They are not, which is why their membership rolls look like the New York Times readership stats. Worthless traitors, as dangerous as they are ineffective.
Update: This from the AAPS:
In December 2008 the AMA had 236,153 members, of whom 20% were students and 13% residents; thus about 157,000 were practicing physicians — about 17% of some 900,000 eligible practitioners, compared with 22% in 2004. … in a recent online survey, 75% of some 4000 respondents said they were not AMA members; 89% said they did not believe the AMA speaks for them; 91% said the AMA does not accurately reflect their opinion as physicians.
Also noted: more than 85% of its $282 million annual revenue comes from sources other than membership dues.
See also this: The AMA Has Sold Out Physicians for a Few Bucks.
Stay informed, folks — and keep the phone lines to your senators and representatives singin’. Trust me, you do not want this monstrosity they are trying to shove down our throats.
Dr Bob,
Fellow physician here (radiology), thanks for the links. The AMA is indeed foolish, they may be pretty smart as a group but they’re lousy poker players. Their imprimatur has been purchased in part with revocation of the “Sustainable Growth Rate” provision of the Medicare payment formula. Were I sarcastic, I would say this suggests that they support an Unsustainable Growth Rate for Medicare payment.
The problem is that the endorsement having been made, it cannot be unmade should the Sausage Factory at Capitol Hill introduce other silly things into the bill, including things that violate the AMA’s own policy. I believe the vernacular for this is “getting played”.
At one point I was pretty involved in the AMA, even becoming the Resident Section chairman. I was discouraged by not only by the silliness of the policy system (rounding off the sharp corners of life in matters only tenuously connected to medicine) but by my observation that the loudest voices in the room were also the most liberal. Finally, I really felt stabbed in the back at one point by the very fellow who is now the AMA President. Yet another example of history not repeating, but rhyming, at least in my own personal case.
A former legislative director for the Texas Medical Association referred to organized medicine as “Boys’ State for Doctors”, and that really did stick with me. I see this as an example of pretend politicians getting devoured by real politicians. While I am a proud TMA member, I have no interest left in the AMA.