Skip to comments.ObamaCare's Lost Tribe: Doctors
Posted on 07/05/2012 2:23:02 PM PDT by SeekAndFind
Back at the at the dawn of ObamaCare in June 2009, speaking to the American Medical Association's annual meeting, President Obama said: "No matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period."
But will your doctor be able to keep you? Or will your doctor even want to keep you, rather than quit medicine?
For the longest time now, since day one of the Affordable Care Act, we have been having arguments over the mandate to purchase health-care insurance, requirements that insurance companies accept policyholders regardless of health, and price discrimination in insurance policies.
And of course, the Supreme Courtor something resembling the Supreme Courtoutputted a decision on the tax status of the insurance-purchase mandate, the states' obligation to pay for Medicaid and as a bonus, the Commerce Clause.
Have you noticed what got lost in this historic rumble? Doctors. Remember them?
ObamaCare has been a war over the processing of insurance claims. It has been fought by institutional interests representing insurance, hospital and pharmaceutical firms. The doctor-patient relationship, or what used to be called "the practice of medicine," has sunk beneath these waves.
Barack Obama, a savvy pol, understood from the start that rationalizing payments claims through the maw of these private and public bureaucracies was not what the average person thinks of as "health care." To any normal person, health care means that when you or yours get really sick, the doctors and nurses who attend to you will push all else aside to give you medical help.
Thus, the constant Obama chorus that you can "keep your own doctor." No one knows better than Barack Obama that his law sends the nation's doctors on a voyage into an uncharted health-care world
(Excerpt) Read more at online.wsj.com ...
Doctors will seek out states that don’t expand Medicaid because the reimbursement rate for Medicaid will be maybe 10%.
Don’t worry. There will soon be plenty of government educated and salaried doctors. They’ll be every bit as proficient as those in Cuba.
“If you like your doctor, you will be able to keep your doctor. Period.”
“But will your doctor be able to keep you? Or will your doctor even want to keep you, rather than quit medicine?”
Obama is going to say, “I never said anything about your doctor keeping you.”
Don’t be so sure that Zero won’t declare a national emergency.
Force retired doctors to return to work. And send doctors
anywhere in the country Obama wants them to work.
Physicians will be the second biggest losers from ObamaCare. Patients will be the biggest losers. I hope and pray that we will be able to repeal this horrible bill before the damage is inflicted on our country.
It’s going to be a good time to learn pioneer and homeopathic medicine. It might not be a bad thing to start collecting books on the subject before they are outlawed.
He can't quite do that. He can just tax them if they don't follow his orders and return to work where he commands them to go.
Wrong..Doctors will NOT be the biggest losers under Obamacare. The biggest loser will be the cardiac emergency who finds there is NO Cardiologist to keep him alive. Or perhaps the auto accident casualty who discovers there is NO doctor in the now closed Emergency Room.
It may well be YOU, when your long term doctor has quit in disgust, and your new one (if you can find one) isn’t sharp enough to spot that little difference in you, so you now have 4 months to live.
OBAMACARE will make the actual practice of medicine not worth the financial cost, the time required and the not worth fighting the government.
And when the rest of the doctors stampede out of the country, then what?
He will create an “Exit Tax” to leave the country.
And it won’t be a small tax. It will like tens of thounands of dollars.
I am surprised CA hasn’t started an “Exit Tax”
USNS Mercy is a government hospital ship, one of the biggest and worst designed hospital ships in the history of the world. If ObamaCare is not repealed quickly, I imagine there will be a fleet of private hospital ships off the coasts of the USA, built for the task or modified from cruise ships, rather than converted from an unwanted supertanker. Hospital ships with a non-US flag will be immune from frivolous malpractice lawsuits, free of the unnecessary paperwork that doesn't improve care, and paid in cash by those with the financial means - probably costing far less for better care than we'll get for our tax dollars. I rather like the idea.
Obama will TAX the retired doctor everyday until he or she returns to the emergency room to work. It will be under the
coming NATIONAL HEALTH CARE EMERGENCY ACT.
And Roberts will be the swing vote to uphold the act.
Go out on a “vacation”, make your immigration arrangements in some country that welcomes skilled doctors, and don’t come back. Or just take your passport (or buy one from a country of convenience), get on your boat and sail away.
I wonder how soon the “coyotes” will stop smuggling Mexicans in and start smuggling Americans out?
The AMA made a deal with the devil and soon we’ll be hearing how hot it is in hell.
THAT is a terrific idea. Call them Liberty Ships.
Wife, an ER Nurse, and I, a shrink (MD), had a lengthy discussion last night about various ways to retire or semi-retire, or go do locum tenens work in New Zealand or some such, or go ex patriot and settle in Baguio - anything but continue the worsening grind of our thankless professions. And believe me, we are far from alone in this.
Thank you. Once rationing or delays reach their inevitable levels, I imagine the Liberty Ships (great name!) will be terrifically profitable too.
I suppose they could hire health care provider "extenders".
(Any citizen of the Obamanation would surely be happy to have some doofus in a white coat who couldn't pass HS chemistry making life-or-death medical decision for him or her! After all, it's for the Greater Glory of the Obamanation!)
On a more serious note, this train wreck is going to be "interesting" to watch. I hope I don't get seriously sick before Obamacare explodes. And explode, it will.
Will they wear hoodies?
Come on. They can maybe force me to show up. They CAN’T force me actually practice medicine.
I’m in training to be a nurse practitioner — and all the liberal gobbeldy-gook in my textbooks about the ACA tell me that NP’s are going to SAVE THE DAY!! They have gathered all of their so-called evidenced-based research that NP’s provide care on the same level as docs in primary care, and thus, have pronounced it so.
The problem is, there are NOT enough of them to handle all the new patients that will be streaming in. Not by a longshot.
And I personally DO NOT want to be expected to take the place of a doc to save costs. I didn’t go to medical school, I have not been trained like an MD, and I do NOT want that incredible responsibility! NP’s can only do so much, before a person needs a qualified, trained physician. But you watch — this government is going to try to get by with it.
zactly. My Dr. bailed about 4 weeks ago. 22 yr relationship...poof !
Who knows. Maybe there will be a brown-shirt watching every
I mean if the recent court opinion says we all have to buy
Government insurance, who’s to say a brown-shirt will be in
every doctors office?
Here’s what I want to know. If the AMA represents only 15% of the doctors, where the @#$ were the other 85% of them who were getting screwed when this went down? I heard NOTHING from doctors: not in the doc’s office, not on blogs, not in emails circulating. You would have thought doctors loved Obamacare. I believe if they had spoken out en masse, the public would have been much encouraged to fight even harder, and more voices would have joined the fray?
I remember the days before Tenncare in our state and the ones that came after. The then Dem governor New McWherter was screaming Medicaid was failing and broke. All it needed was a few cuts mainly to ones who should have never been on it to start with namely welfare Mom's having babies for checks.
One national private insurer began taking out full page adds in the Knoxville paper to the affect call our congressman and support Tenncare. But it didn't stop there. That same private insurer was the majority holder of new Tenncare patients. The company basically told the doctors if you don't sign on to Tenncare as a provided we will not give you our private insured business.
After Tenncare was pushed through with the help of the VP Al and first co-POTUS Hillary even more things showed up. The ones who were too have supposed to been managing Medicaid in Tennessee under Ned Ray suddenly were HMO CEO's.
Under Tenncare patients who were on Medicaid because as workers they had become disabled and could no longer worked were threatened with being dis-enrolled from Tenncare which was what the HMO wanted. But it got worse. Ones who were disabled after two years were also Medicare qualified. So Tenncare then decided to drop the traditional Medicaid payment to the doctors for service. They did this and by law the doctors could not bill the patients for the difference. The disabled had a very hard time obtaining doctors.
Under medicaid the program was overseen by the Tennessee Inspector Generals Office. If you became disabled and met the fiscal qualifications you were on Medicaid. That rule as well was cut from Tenncare. There was no accountability, no way a disabled person could reasonably resolve any issues, and much like OBAMACARE the Tennessee general Assembly was clueless as too how it ran. The end result under Governor Don Sundquist nearly bankrupted the state. Corruption in Tenncare was rampant and it wasn't the doctors but rather the HMO's running it.
The so called Editorial Board at www.knoxnews.com gives the impression that Obamacare is the best thing to ever happen in this nation. They like most Liberals refuse to do articles on the down side of Obamacare. The only doctor in Knoxville I've heard cheering is one who runs a government funded clinic.
May I ask you and your wife, then? What were you (and your colleagues) thinking when this bill was being written/ passed? Not to blame, right? But I watched and listened carefully to see who was on my side, hating this bill. I saw that the AMA was PRO Obamacare, but I did not observe medical folks in any field speaking out. I think it would help the public. We love our docs and we respect you. Speak out/ lend a voice/ tell us why YOU hate it. Make a big noise. Take out ads. Rent billboards. Let the Truth come out.
And don’t just bail and leave us with crummy third-world educated doctors, please. It might seem right to you, but what about We the Patients?
The Fed’s will try and have PA’s, and NP’s diagnose and treat, because of cost. It won’t be pretty.................
And extremely liberal group that has hijacked those that pay dues.
Ha! Doctors about the most intractable group you will ever come across.
More like Obama will push most out of business and replace them with compliant foreign medical grads.
My subspecialty organization, the American Gastroenterologic Association, are major donors to Harry Reid and Patty Murray. It’s like union dues being given away to pro union Democrats.
Already happened to me. Our ER went to an electronic medical record system which is horrible. The old paper system took about three minutes to record the medical record giving me ample time to contemplate the testing and treatments for my ER patients. Now it is all I can do to click all the data into the EMR and my mind is not where it should be.
Believe it or not one must be thinking to be a good physician.
Trying to be a physician in a busy ER with a horrible EMR system is like trying to land a Lear jet and text your mistress and talk to your wife at the same time, while having a drink of Bourbon, and smoking a fine Cuban cigar.
With all that going on something is going to fall through the cracks.
How about putting doctors and hospitals on Indian reservations. It’s a long way to International waters here in Iowa, but we do have Indian casinos. I wonder how far their sovereignty could be stretched.
And eventually have the same access to medicines and machines.
They can already diagnose and treat. In many states, they can do it independently. But they can’t do surgeries. They can’t diagnose complex conditions or manage a critical condition usually ... and in many states, they can’t prescribe or treat without being under the supervision of a physician.
Of course, they’re pushing to eliminate that supervision ...all over. A lot of NP’s want this ...and I think they are insane.
nobama care: Stay healthy or die.
Going into the field of medicine is really a bad decision now. Soon the only doctors will be the self-loathing and incompetent or both.
It's been my experience that many advanced degree'd nurses think they can do it all. I'm here to say....they can't.
I know some NP's, and PA's that I would trust...with my life. But not many........
Funny thing....I know some Doc's that I wouldn't have treat my dog.
Coming soon - doctor shortages - incompetent replacements, and large looming death rates...
Back in the 1960s,70s 80S and up to the mid 1990s, the smartest kids were going to college to become medical doctors. They saw it as a career that allowed one to make a lot of money on their own terms.
Since then, it has changed and our smart kids want to be in finance and investment banking for similar reasons. They saw early that government was on the way to over-control health care and ultimately, absorb it.
We patients will be the ones getting lower levels of care and those who remain good caring doctors will be few.
Oh, pack it, buddy. I made plenty of noise to many movers and shakers. Like most docs, I don’t belong to the AMA.
As for “we the Patients,” very few really value what doctors have to offer. The majority - and “The Greatest Generation” is as bad as every other - believe free health care, and my participation in it, is their inalienable right. Self absorption and entitlement rule in this country. In my current private practice, for instance, a great many have vacation homes, and very nice recent model cars, and go on a cruise or two each year, or a few weekends or weeks at Vail each winter, or a week at Disneyland with their kids every summer - and yet, they don’t want to pay co-pays for my services or their meds; they demand not only that I prescribe meds for them but that I am obligated to get them an endless supply of free samples; they demand that I not only diagnose and treat, but once I get them well they still demand that I have to write letters and fill out endless forms for free to get them time off work, some special companion animal, disability, or forgiveness of student loans, etc, etc, etc.
Did I mention “etc”?
In other, less affluent settings, I might treat, for instance, someone’s severely suicidal depression, but they don’t want to take life-saving meds because of some very minor side effect, or because - unlike the cocaine or marijuana or alcohol they pay significantly for and consume in sizable quantity - the meds are not “natural” and a $9 co-pay is a pharmaceutical company rip off.
My wife, working in the ER, is even more burned out with the population she sees now, even though it’s better than some other ones she’s worked with. Ungrateful, entitled, demanding. She’s constantly fearful of complaints and threats to her job and license should she not give in their demands, and the patients know it, and treat her accordingly. I know it too. Both she and I practice good medicine with all comers, and both she and I have had formal complaints against our licenses with our state boards - frivolous stuff, and neither of us have had any complaints that stuck, but there’s the hell of a several year investigation, and the need to hire attorneys, and the fact that the complaint, even if found totally groundless and dismissed, becomes a permanent part of our record which we then have to defend when we change jobs or get a license in a new state.
“Let the Truth come out.” You want the truth? You can’t handle the truth. My wife grew up in Third World poverty, idealizing the people of this country - she’s appalled by them. I went through my Rat Year at VMI, boot camp, and combat - yet my rotations in medical school, and especially my internal medicine internship, were many times more brutal and scarring than any of that. And for what? So people can demand I prescribe some Xanax to cushion the crashes after each ecstasy-filled Rave they attend, or so I can listen to threats against my license from parents incensed that I won’t fill out a four page form so their juvenile 28 year old borderline can have a ferret “companion animal” accompany her to her parole hearings, or so some sociopath, who scammed the system in order to serve his eighteen year prison term instead on a cushy forensic unit, could badly assault me, then file a complaint against my license via his patient advocate, saying I deserved the assault?
I think not. “You the People” can probably become doctors in a few weeks training under the new Federal healthcare system, and then YOU can erect billboards, and then YOU can put up with the entitlement society. YOU do it, buddy. Not me.
“If ObamaCare is not repealed quickly, I imagine there will be a fleet of private hospital ships off the coasts of the USA, built for the task or modified from cruise ships, rather than converted from an unwanted supertanker. Hospital ships with a non-US flag will be immune from frivolous malpractice lawsuits, free of the unnecessary paperwork that doesn’t improve care, and paid in cash by those with the financial means - probably costing far less for better care than we’ll get for our tax dollars.”
An almost prophetic vision... :)
Sounds like something out of Ayn Rand. A business proposition that Midas Mulligan would invest in!
I wouldn’t be surprised if the U.S. Military would be ordered by a future Obama-like leader to shoot these out of the water.....
“If doctors salaries will be cut to the bone, who will pay for their medical school expenses? Will the taxpayers pay for students to choose medical school? Because, if the doctors aren’t going to make a good salary in the profession, how will they ever be able to pay back their exorbitant medical school loans?”
They won’t have to pay for medical school.
The -government- will pay. The medical education will be low-cost or free.
There’s a catch, however....
The medical education will come free, but the students will be told what specialties in the medical field they will learn.
Once these new young doctors graduate from medical school, they will become employees of the feds, and told where and what kind of medicine to practice.
For life, or at least for a lengthly fixed period of time.
(Aside: how much do military officers pay for -their- educations at the military acadamies?)
Obama-like? Maybe Obama himself.I think Chavez is the model.
That said, we are stuck with it now and I hope many of our physicians and specialists are already making arrangements to set up offshore in the Caribbean where they will find a welcoming environment. I do not hope that they will stay to take căre of us here.
If all the best doctors in the world practice in an American socialized system it won't make much difference to the patients. The Medical Professionals, will have to practice government medicine and their diagnoses will be second guessed by Party functionaries. I would rather know that if I can get offshore and if I can afford it, I can be treated than know that I can go to my local doctor for "free" and be better off talking to the Haitian voodoo who has quietly set up shop next to the Projects