A Cardiac Intensive Care Practitioner's Opinion * Vanity

Email Correspondence | 9-15-2009 | From A Frustrated Practitioner

[TruthBeforeAll]

I already agreed waste, fraud and transparency should be addressed first. I mean you have to do that just to save Medicare. How does that help the uninsured. I mean do you really think the private insurance industry is going to lower premiums, or stop canceling people for no reason, or start covering people with preexisting conditions unless somebody makes them...

[TruthBeforeAll]

These are 2 emails I received from my brother with regards to the current health debate. He is a cardiac intensive care practitioner who is very good at what he does. But politically he and I just don't see eye-to-eye on much. I'm posting this so you can read the opinion of somebody who is not a politician or a liar. I would be very interested in reading your reactions to it.

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I am for waste reduction and system transparency... I would rather not do the public option, but we already recognized along time ago that private business (both insurance co's and hospitals) aren't interested in taking care of old sick people past the point of profitability. It doesn't take long to rack up a several $100,000 dollar charge in the hospital. Private insurance doesn't want to pay it and hospitals don't want to eat it....i.e., Medicare was born. The same businesses don't want to pay for the poor either... i.e., Medicaid was born.

Many people can afford health insurance, but would rather buy a carton of smokes every week and then come to the ER when they have a heart attack. Of course, other than bonus stamps off their empty packs of smokes, there's no way they can pay for it (they've already maxed out their home equity loan on the two new cars in the driveway). So we pay for it with higher insurance premiums to cover the additional deadbeat costs hospitals add to every payers bill. These are probably some of the same dumb f#cks standing in the street screaming "No public option" "Give me liberty or give me death". I say lock the doors to the ER and give them death.

P.S. I don't disagree with anything I read in the Barack Obama exchange. Healthcare is rationed everyday. Private insurance companies decide who gets what therapy everyday. People die everyday because their insurance company decides the treatment they are seeking is "experimental" or "unproven". How do the insurance companies decide which therapies they will pay for or medications they will let you have? PANELS!!! Panels of experts. Panels who review a particular intervention or medicine and advise the insurance company whether or not there's enough "evidence" to support them paying for it. They don't want to pay for anything they can get out of... so they spend A LOT of time and resources trying to find ways NOT to pay for (i.e. ration) something... Death panels... panels of experts who advise insurance company A, B, or C NOT to pay for something. Something that may save the patient's life. There are tens of thousands of lawsuits every year brought against private insurance companies over their refusal to pay for a particular treatment or medicine.

"Rationing", "Death Panels", "Public option" these are all bullsh#t buzzwords. They're bullshit because they already exist!... and have since the beginning of organized healthcare (well, Medicare came a little later). While I am somewhat frightened by the fact these "words" already exist in practice... and are practiced in healthcare in the US every minute of every day... I am ten times more frightened of the dumb f#cks that don't know they ALREADY EXIST!

BTW:Thank you for at least acknowledging Barack Obama can say one thing you agree with... even if you believe everything he says or does is ultimately aimed at turning the US into a socialist/fascist state. :)

I already agreed waste, fraud and transparency should be addressed first. I mean you have to do that just to save Medicare. How does that help the uninsured. I mean do you really think the private insurance industry is going to lower premiums, or stop canceling people for no reason, or start covering people with preexisting conditions unless somebody makes them. I mean did the Republican Party wake up one day and say "Hey , the cost of health insurance is rising at twice the rate of inflation and there are more people uninsured every year... we should do something about that". Maybe even though I understand healthcare better than most, read literature to keep my practice current and have almost every piece of healthcare legislation forwarded to me through an APN list serve I belong to... I just missed the Republican solution... Oh wait... I guess they presented a solution. Thanks to Barack Obama they could no longer ignore an issue that is destined to bankrupt the country.

[jessduntno]

Privatization + Inter-State Sales + Individual Policies + Tort Reform = Healthcare Reform

Step one: do NOTHING until there is true Tort reform and remove BILLIONS from HC by removing unneccessary expenses and procedures.

I can't imagine another way out that will not draw us into the disastrous slippery slope that will be co-ops or "expanded medicaid" or other euthamisms...we need to privatize, make portable and drive down costs by opening a free market.

Performance based outcomes will propel the better providers to the top and the market will sort out the lesser programs. 25% of the "uninsured" are "the invincibles" (the 18-25 year olds) that feel no need to buy insurance...if they do not buy insurance they can contract with private fee for service firms that will compete and possibly make loans or give them credit for procedures.

The higher risk 50-65 uninsured (uneligible for medicare, but struggle with no coverage, low income, job loss or pre-existing conditions) get assigned to a "risk pool" that better performing insurers will ultimately compete for, because they are able compete for them at reduced rates, giving them good coverage and reasonable rates.

Elderly Americans will be covered by medicare.

The indigent will be treated pro-bono by participating hospitals. I would like to see THAT pool covered by University Hospitals, many of whom have billion dollar grants behind the universties and should make use of the interns and younger doctors to keep the indigent covered, much as many law firms do.

[hinckley buzzard]

Well, first, your brother has cause and effect backward. Medicare and Medicaid were not responses to soaring costs--history is clear, they stimulated a sudden acceleration in the rise in costs.

Elementary economics 101: stable supply and soaring demand = rising prices.

[hinckley buzzard]

probably some of the same dumb f#cks standing in the street screaming "No public option" "Give me liberty or give me death". I say lock the doors to the ER and give them death.,

Your brother has a faulty "dumbf&ck detector." It goes off when the wrong people are around. The ones who deny the death panels and feed off the free ER, and the ones who have been protesting, have been two different groups. The "dumbf*cks" are the ones who apparently agree with him, and who he has been treating for free; which doesn't say much for him and his extreme confusion..

[outofstyle]

Well, first, your brother has cause and effect backward

Amen! Like the poster's brother, I also provide care to critically ill patients. Because of 3rd payers, doctors do not feel responsible to provide value & patients have no motivation to seek value. The worst cases involve Medicare.

[HiTech RedNeck]

Sarah Palin was 1000% correct to point out how “death panels” would be expanded to government scale.

[TruthBeforeAll]

Your brother has a faulty "dumbf&ck detector." It goes off when the wrong people are around. The ones who deny the death panels and feed off the free ER, and the ones who have been protesting, have been two different groups.

I did let him have it for that comment. His idea of freedom is one that ends when you do something detrimental to yourself. i.e. smoke. It's funny how much he hates smoking, yet he still supports Obama. I bust him on it regularly.

[Waryone]

He may not be a politician or a liar but he is very naive. Hospitals don't eat anything -- they just pass on the cost. The Federal govt does not care about taking care of old people either. As he should know, payments for Medicare and Medicaid patients have been reduced and will continue to be reduced by the govt whenever they decide they need to look like they care about saving the taxpayer money. Your brother's pay will also be reduced by the govt. when they take over. Plus the fact that politics will now be a part of healthcare. No coverage for whomever depending on what the governing political power says. Shut down this hospital and open one in so and so's district. We've already seen the result of politics and govt service in ACORN.

I can't say I disagree with lock the doors to the ER, especially for people who use the services and decide they don't have to pay the bills. But most of us screaming "no public option" are the insured ones who are picking up the bill for the deadbeats and people with reduced govt payments from Medicare and Medicaid.

Right now private insurance panels do make decisions, but if I don't agree with them I can sue them. I can't sue the govt. Once the govt decides it won't be covered, it is over. I won't be able to go anywhere to get it covered. Not even if I want to pay for it myself. Show your brother the story about the woman from Europe whose mother was killed by their system because they needed the bed she was in. There was no place for this woman to go for help. The govt wanted her dead and that was that. If the govt rules here, the same thing will happen. You can sue the insurance or nursing home now, you won't be able to do it with this govt healthcare in place.

Here's her story:

http://www.youtube.com/watch?v=pylorJ-AEJc

Rationing and death panels may already exist, but I'll take my chances with them and a jury of my peers. I know the thought of legal system involvement might scare a doctor, but when it comes to the unscrupulous in the industry, sometimes it is the only thing that keeps them honest. It's not that we don't know rationing and panels already exist. It's just that we can handle private industry not massive govt control.

Remind him that you can't always believe everything the MSM tells you. We are not against real healthcare reform. We are against govt take over. Tort reform, portability of insurance, ability to purchase across state lines, catastrophic coverage only, and other ideas are better than Obamacare. There is no reason for the govt to take control. And the only reason he hasn't heard what republicans have put on the table is that 0bama and his cohorts in the media don't want 0bama to be upstaged. But republicans have been screaming to be heard for months.

[Citizen Tom Paine]

I know nothing (on a professional level) about how health care is delivered in the US. I do understand big numbers very well. The big numbers say many things to me. One is that this present generation cannot AFFORD for the Federal Government to operate the health care system without burdening our GRANDCHILDREN with enormous debts which we incurred.

The other thing which catches one’s eye is the amount of GRAFT which occurs in the present government administered Medicare and Medicaid system together with the major inefficiencies that are apparent to the most casual observer.

Those two reasons alone mitigate against a Federally operated system.

But STAND BY FOR A RAM readers, they are going to open Pandora’s box if they can.