AMA Joins the Gimme Queue - But What do Doctors Say?
By LisaB on September 17, 2009 at 3:01 PM in Current Affairs
Listening to NPR recently, I heard that the AMA is supporting Obama’s attempt to change healthcare. That’s new. The AMA rejected all other attempts at reform before now. So what gives? The Chicago Tribune looked at this question.
And among the many reasons for the AMA’s historic shift is one practical consideration: Obama’s plan promises to provide millions of government dollars to help millions of patients pay their doctor bills.
Moreover, in a deal cut with Obama’s congressional allies that has made it into one of the principal health care bills pending on Capitol Hill, the government will rescind scheduled cuts in Medicare payments to doctors amounting to $228 billion over the next 10 years.
Critics denounce the deal as a fiscally irresponsible effort to buy the doctors’ support, while the organization and leading Democrats defend it as necessary to safeguard the stability of the medical system. But whatever the merits of the deal, it stands as the most costly concession to any single interest group made so far.
The AMA’s new position on the government’s role in health care reflects changes in both the organization and the economics of American medicine. With AMA membership in decline, what was once considered the capital’s most powerful single lobby was beginning to slip.
In the past, the AMA saw the government as endangering doctors’ incomes and independence. Now, with the advent of Medicare and other federal programs — which the organization originally opposed — the government has become a vital source of revenue and stability for doctors.
True enough. As private health insurance becomes more complicated, costly and patchwork, I can see where Medicare is at the very least, a known quantity for providers.
Doctors have become discouraged that more and more people are losing healthcare. I believe this; I’ve had many conversations with doctor friends about how they see the problems. Back when Bill Clinton took a swing at healthcare, the AMA did not support his effort, but clearly have changed their position. According to health insurance people though, the AMA’s change of heart is more quid pro quo than a prescription for a healthier public.
In the view of health industry analyst Robert Laszewski, a former insurance company executive who tracks health policy in Washington, AMA support is really explained by the deals the organization cut with congressional Democrats.
“They were bought off,” he says of the doctors’ organization. “And the price tag was $228 billion.”
Laszewski thinks that all of the major interests that once opposed reform, including insurance and drug companies, have received sweetheart deals in exchange for their support. But he thinks none is as sweet as the deal scored by the AMA, which many still regard as the nation’s premier lobbying force.
Laszewski and other critics focus their ire on a little-known section of the House Energy and Commerce Committee health bill that will relieve the doctors of scheduled cuts in Medicare reimbursement rates.
The scheduled cuts — called the sustainable growth rate, or SGR, cuts — were written into law in 1997. The idea was to prod the medical community into holding down health care costs by cutting back reimbursements to doctors under the mammoth Medicare program whenever Medicare spending outpaced the growth of the overall economy.
For the most part, the cuts were never imposed because doctors and other medical providers convinced Congress to override the SGR — with a catch: Each year that Congress blocked the SGR cutbacks, it made the following year’s scheduled cuts larger.
In 2010, the cumulative cut would be a whopping 21 percent.
From the beginning, eliminating the SGR was a top priority for the AMA, which has spent $30 million on lobbying since the beginning of 2008. Over the past decade, no other interest group or trade association has had a bigger lobbying budget, except the Chamber of Commerce.
There is argument about whether these rollbacks are fair or not, with Henry Waxman saying criticism of the deal isn’t fair. But it does seem to just push costs forward.
Still, says Lawrence Jacobs, a University of Minnesota specialist in health policy, “This was a big concession to doctors. Waxman, like any good reformer, is pushing costs into the future and emphasizing benefits in the near term. The magic of reform in America is to get stakeholders to focus on wins in the present and delay the cost as much as you can.”
Like much of the healthcare discussion, this little piece is more complex than it appears. I’ve got no problem with paying doctors well. After all, medical school is hugely expensive and it takes years to become a proficient doctor while others are already making money. And I’ve heard horror stories about what doctors actually get paid for their services, notwithstanding the bill the patient receives. Personally, I’d rather just pay the doctor directly. Paying someone for services is, aside from a monetary transaction, a way of thanking them for that service. But, that’s not the way it works and I understand the reasons why, having needed the services of a highly trained surgeon myself.
And according to IBD, even some doctors don’t agree with the AMA.
Two of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.
The poll contradicts the claims of not only the White House, but also doctors’ own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.
———-More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered “no” when asked if they believed “the government can cover 47 million more people and that it will cost less money and the quality of care will be better.”
———-Recent population growth has been 1% a year. Patients, in short, are already being added faster than physicians, creating a medical bottleneck.
The great concern is that, with increased mandates, lower pay and less freedom to practice, doctors could abandon medicine in droves, as the IBD/TIPP Poll suggests. Under the proposed medical overhaul, an additional 47 million people would have to be cared for — an 18% increase in patient loads, without an equivalent increase in doctors. The actual effect could be somewhat less because a significant share of the uninsured already get care.
Even so, the government vows to cut hundreds of billions of dollars from health care spending to pay for reform, which would encourage a flight from the profession.
The U.S. today has just 2.4 physicians per 1,000 population — below the median of 3.1 for members of the Organization for Economic Cooperation and Development, the official club of wealthy nations.
This might explain why those concessions to the AMA were made. Perhaps the hope is that since the effects of the bill are not good for physicians, removing the Medicare cap will seem like they are not entirely getting messed over.
Like I said, it’s always more complicated. So, doctors lose on one hand and, hopefully, gain on the other. How’s that going to work out?
The article also says states that have tried an overhaul, such as Massachusetts, Tennessee, Maine and Hawaii, have run into problems with most having to cut back services to patients. Britain has to import doctors every year.
In Britain, a lack of practicing physicians means the country has had to import thousands of foreign doctors to care for patients in the National Health Service.
“A third of (British) primary care trusts are flying in (general practitioners) from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland” because of a doctor shortage, a recent story in the British Daily Mail noted.
British doctors, demoralized by long hours and burdensome rules, simply refuse to see patients at nights and weekends.
Likewise, Canadian physicians who have to deal with the stringent rules and income limits imposed by that country’s national health plan have emigrated in droves to other countries, including the U.S.
So, what to make of all this? Well, it certainly seems as if the AMA is pushing hard to remove the cap on Medicare, not necessarily out of greed but because they see bigger problems coming their way. The point is arguable, I know. Even as this makes some sense, instead of rethinking the problem, the AMA simply joined the gimme queue thinking that what is likely to be pennies on the dollar will appease its membership.
A couple of doctor friends have nearly $100,000 in medical school student loans to pay off. Even at low interest rates, that’s a second mortgage payment each month. They’ve got to be asking what the reimbursement rates for patients will be under any national plan.
Will they make out like bandits in this plan? I just don’t see it. The money must be elsewhere. But what did doctors actually say? IBD asked for comments. And they got them.
Our poll also invited those taking part to tell us the reasons why they didn’t like the health care reforms — or, in the minority of cases, why they did. The outpouring of written responses IBD received — about 1,300 in all — was stunning.
—–In combing through the responses, we identified no fewer than 21 separate issues doctors felt either weren’t addressed or weren’t solved by proposed reforms. The issues are many, but boil down to three big categories: costs, controls and courts.
IBD reports that responding doctors worry about: socialism, lack of tort reform, government running medical protocols, paperwork with low reimbursement rates (Medicare and Medicaid), the disappearance of private insurance, and other issues quite familiar to town hall “racists.”
“Between the government and insurance companies, I now only collect 28% to 30% of billed charges. No other business can function at that rate,” this doctor added.
As many noted, all of the plans now being discussed would require massive tax hikes — and debt.
——–
Many of those who opposed the plan had a unique perspective: They had practiced or lived under national health care systems in other countries.
———-“It will take away consumer choice, drive up health care costs, and drive down health care quality,” said one. “It will sharply increase the demand for health care providers and sharply decrease the supply as doctors like me will retire early and students will avoid the field.”
IBD will have comments from doctors supporting the plans in Friday’s edition. However, it notes those represent a minority of the doctors responding to their poll.
So, what do you think? Any doctor readers out there?
(Release: November 13)
on sale for only $16.95.
has a spatula.)
8% Off at $11.95, with a rare five-star ranking by 294 customers: 
And check out these: 
("This crazy redhead is on to something. Her pink Rambler story alone is worth the price of the book," writes 
- “Richard Sale’s reportage on Washington, the CIA, the American armed forces, and foreign intrigue has created a perfect background for this account of the steady growth of President Clinton as a master of the game of nations.”--W. Patrick Lang, former head of Middle East Operations, DIA
"Anne C. Heller's stunning biography of Ayn Rand" uses a "plethora of newly unearthed research and fresh insight."
Yes…Medicare for all..The doctors got the short end of the stick…a paltry $228 billion. Obama’s deal with the Drug companies, “no negotiation of price and no re-import” will allow the Drug Co. revenues to essentially double over the next ten years. That will be worth $3-4 trillion and the hospital associations also cut a huge deal with Obama. Whatever deal was made with the Insurance lobby is also worth trillions.
Health Insurance Reform is a huge corporate pay day and a total rip off for the American People. It is not just coincidence that the Drug Industry, Hospital Industry, the AMA and probably the Insurance Industry support Obama’s “Health Insurance Reform” and the reason is $$$$$$$.
My sister works for a big name drug companies. The things she tells me would make your hair stand up. Profits profits profits is all they care about.
Just in case no one saw this, a new party is forming. I find it really interesting. I hope it TAKES OFF! We all need to come together under one umbrella and fight!
birthofaparty.com The UNITED PATRIOTS PARTY
Yes, some greedy Canadian doctors have emigrated to the U.S. for the big bucks. I went to one for a checkup which he managed to turn into two billed appointments - the first one only to fill out the paperwork before he would examine me! And both times I waited for hours while the doctor and staff saw drug salesmen.
Fortunately, I replaced him with an older, better American doctor.
I wondered how long it would take the AMA to figure that out. In Canada all doctors are private (not like the NHS). They have a choice of billing patients privately or joining the government plan. For most doctors, the fact that they can operate an office with one person and are guaranteed payment for their services trumps the fact that they have to agree to a negotiated rate (like Blue Cross does here).
BTW - Canada offers free Medical School to anyone who agrees to serve in a rural area for some period after Medical School. Seems OK to me.
I believe less than 20% of doctors belong to the AMA and most of that 20% are either young doctors first trying to get established and retirees.
I was surprised that 65% of doctors were opposed to Obamacare - I thought it was closer to 90% - certainly all of the doctors I have spoken to are completely opposed to it. They also do not have kind things to say about Obama who found ways of disparaging physicians (I’ll leave out the more colorful remarks since this is a PG site).
Did anyone see the doctors march on Washington?
Apparently it made Nancy cry: So are doctors against the plan inciting violence as well? Get this she is likening the protest to the murder of Harvey Milk-STOP IT NANCY!
(BARF BAG ALERT FOR THIS STORY)
http://www.examiner.com/x-19823-PostPartisan-Examiner~y2009m9d17-VIDEO-Nancy-Pelosi-cries-implies-rightwing-inciting-violence
Never mind the fact that Dan “Twinkie Defense” White was a Democrat who ran on supporting the common man.
Oh and never mind her nazi sign comments and ‘un- American’ op-ed, astroturfed, bused in and paid for town hall bodies, or the finger biter are all on the left. It is the rest of us who is causing the probelms. You Lie Nancy!
And to fill out the truth more. White used to like Milk and invited him to his kid’s birthday party. Who does that if they hate the guy?
He just seem to get increasingly jealous that Milk’s comments on the evening news seemed to frame the subjects much better. It wasn’t that White was saying anything wrong, it was standard Democratic, for the common man comments. He said them like he meant it and had a command of the subjects.
It was just Milk and Rev Jim Jones were also on the news every night. So White’s comments seemed to be less than by comparison and his segments seemed to get shorter and shorter.
We watched this all play out on the evening news every night. Oh and get this Rev Jim Jones was loved by the SF politicians because he would bus in church members as protestors or supporters for them for the nightly news to show. Kabuki theater.
Sound familiar?
should be….who ‘are’ causing the probelms.
Oops again…it was his child’s baptism not birthday party. Which frankly is more personal than a b-day party.
Yes, it set me off. I wasn’t sure about posting here, my apologies for possible bad placement.
It set me off too.
And my apologies to LisaB for adding to a possible bad placement.
After seeing the video my fingers couldn’t type fast enough. That hypocrite Pelosi…ugh…is such a disappointment. Really, I don’t think Newt in his day upset me as much.
I truly believe that this Pelosi has issues - and not political ones.
65%? The old adage. If you can’t justify the numbers use percentages. Obamacare? Lets see this so-call reform legislation has 5 Bills with some 164 amendments. And everyone is getting upset with what? Bull-sheet-rock…
Wait a while longer before we throw a gasket. Lets see what really washes here. If its a bad deal then kill the bill but lets not kill the process.Getting your panties in a tightwad right now is just silly…
Don’t you think this plan of giving us information and then backing off and saying, “This is not the final plan” has been the strategy all along. If we all wait to, as you put it, get our “panties in a tightwad,” it may be too late to do just that?
I saw that after the Messiah’s command performance (at least he commanded that they attend) to Congress. He tells what the bill will and will not contain, as if there were a set bill to be voted on. Then when people and Congress members call him out as a liar, he gets to say, “Well, excuuuuse me, that is not the final bill so what are you so upset about?” They’re hoping everyone is so tired of this issue, they can pass what they damn well please.
So………I think I’ll keep on getting my “panties in a tightwad” as long as it takes.
Only if you think that the constitutional process of how a bill becomes a law is a conspiracy…
It’s a conspiracy as long as the Dems are totally in charge right now, since the MSM is also in their pockets. They are playing the game and setting the rules and keeping any other voices muted all the while pretending the opposition is not coming up with ideas.
They were hoping, I think, that there would be no push back at all so they could quietly say, we followed the constitutional process (while pushing through a mess) since, after all, we won the election!
This getting our “panties in a tightwad” is keeping the heat on them. Does, by the way, arranging deals with the AMA, meeting 27 times with insurance execs (and then having to be forced to let us knowthat happened), and arranging deals with Pharma go along with the constitutional process?
Well, getting our “panties in a tightwad” is also part of the American way and the constitutionally founded American system. I’m sorry, too many things have gone wrong as people sat by and allowed things to move ahead because they were waiting to see how it worked out. They scream afterwards, when it is too late.
So all of you who want to, I want to hear your rants and concerns before the damn thing is put to a vote.
Yes it always your Constitutional Right to jump the gun based on your political preferences wihtout any bases in fact. And that is all American…
But let me put it this way to you. If this was a baseball game we would only be in the second inning. We still have a long way to go before anyone gets excited.
Lets see what washes out before we kill anything.
“Lets see what washes out before we kill anything.”
Isn’t that what Quint said just before the shark ate him?
Yeah, well, to use another sports cliche, you’ve gotta be in the game, not standing on the sidelines just waiting to see what happens.
Unless, of course, you’d be fine with whatever other people decide on your behalf.
A process can’t be a conspiracy, so your question is truly irrelevant and only serves to demonstrate your ignorance. Moreover, you are the only one to even mention conspiracy, which means one of three things: you’re a troll; you can’t read; or you don’t understand what you can read.
Stop putting unused words into people’s comments, Chester. Better yet, go find another website to pollute with your banal comments.
JM is not here to spread knowledge. It is here to spread natural fertilizer.
jwrjr,
After reading some of your posts all I can say is that if Bull-sheet was a form of energy, you would be a nuclear power plant.
Ferd
My comment went over your head wish is no surprise. What I was saying was the issue in front of us is going through the legislative process. Unless you believe the legislative process is nothing more than a conspiracy. Meaning your a wingnut.
We have a long road ahead before it truly matters on this bill with much that needs to be worked out.
Once again there are 5 Bill not one like folk think and I will add none from the mighty republicans. Some 146 amendments that have to be decided on before it goes to conference and or mark up. Like I told the lady, if this was a baseball game we are only in the second inning..
As far as your insults are concerned your proving yourself nothing more than the brother of the town idiot.
[...] Read the rest of this great post here [...]
my Dr. is against it.and the hini vaccine too
Olympia Snowe was just interviewed on CNBC & she thinks Obama is more of a moderate on the issue of Health Care Reform than a liberal. Snowe is emerging as a major player in the debate. If I understand this process, even if they pass a bill, it won’t go into effect for 4 years.
You are correct about when it goes into effect in 2013 well after the 2012 election. This means that if the bill fails in its promise to deliver quality health care to all at a lower price, Obama, if reelected in 2012 will not have to bear he consequences of a bad bill. As an AA that is another reason why I don’t trust the slick dude from Chicago.
As someone upthread posted, the AMA represents only about 20% of the physicians in the US. Many doctors don’t support the currently circulating versions of “reform” because they focus on insurance companies and doctors are sick, sick, sick of having to plead with insurance companies to approve treatment for their patients, another reason why doctors leave the profession. A large number of doctors support a single payer system. We need to design a great one for our country and stop fiddling around with trying to “improve” a doomed system built around greed.
so now, not only are anti-obamacare people racist and auditioning for the kkk..they are potentional assassins.
if this wasn’t real, it would be hysterically funny.
so now, not only are anti-obamacare people racist and auditioning for the kkk..they are potential assassins.
if this wasn’t real, it would be hysterically funny.
I’m not a doctor but my husband is, as are his father and brother. They all agree that while healthcare reform is needed, it should be well though out and not rushed into. They do not support the bill as it stands.
And they also agree that if it comes to it, they will reconsider their career choices. My FIL is ready to retire and my husband says he’ll just work fewer hours. If you think waiting-romm time is too long now, wait til there are fewer doctors and more patients to see.
The AMA represents less than a third of all doctors and of those who are members, they are almost all primary care physicians and as mentioned above, medical students. Once a doctor chooses a specialty, he or she quickly learns the AMA does not represent their interests. My husband is no longer a member. The AMA has proven itself to be increasingly irrelevant to the medical profession as a whole.
I’ve long maintained that if the government buys the support of the Rx companies, the AMA, etc. then those organizations become de facto branches of the government at that point. To claim that we’re not nationalizing healthcare just because the AMA and the Rx companies still maintain a nominally indepedent existence is enough to make Joe Wilson jump up and shout out all over again. Men to pigs, pigs to men, getting harder and harder to tell the difference.
One thing I’m honestly confused about, maybe somebody could help me understand. I thought this blog consisted predominantly of Hillary Clinton fans. And Hillary was all in favor of single payer - I remember her system quite well because I work in the business and attended a number of seminars on it - it was a hodgepodge of bureaucracies, acronyms, all very well thought out admittedly, but BIG government nonetheless. Don’t understand why you all think Hillary would have given us any less of a big government headache to deal with now than Obama is. Is it that you’re all so bitter that you’re hoping for Obama to fail, even if his policies aren’t that different from what Hillary might have pushed through? Please don’t accuse me of being an Obamabot, I am not (I’m a libertarian, BTW … both houses of Congress and the White House could be swallowed into a yawning, steaming hole in the ground once and for all and I’d consider it an improvement.) So I dislike Obama as much as I dislike any other pol. But, please help me by explaining why you think Hillary would have fared any better?
“Is it that you’re all so bitter”
I read your old comments, and this is the same kind of stuff you posted last year, which is why you got a cold reception.
This blog is a mixture of liberals, former Dems, independents, conservatives and Republicans.
We are HRC fans, but would gladly have criticized her plan if we didn’t like it. Overall, we though she was more likely to make informed decisions.
We weren’t worshippers though. And since she got pummeled early, I don’t think her plan for healthcare was particularly fleshed out.
Governing is a lot different than campaigning. HRC is a wonk and would have worked harder.
Ah! I’ve located an intelligent, well-spoken liberal. I will take advantage of this stroke of good fortune to venture a second question: Why the )(#* do we have to completely scrap the current system and start over from scratch and have the government become even more involved? What would be so bad about just giving the 30 million uninsured nonrefundable tax credits of up to, say, $10,000 a year towards the purchase of insurance, force insurance companies to cover pre-existing conditions, and raise everyone’s taxes proportionally to cover the cost of the credits? Uninsureds win, status quo wins, we end up paying more taxes but looks like we’re going to have to anyway. As a conservative, I’d just as soon say, do whatever you want to cover the uninsureds, send me the bill, but apart from that just leave my system the hell alone. What would be wrong with that?
Hey, if it would work, NQ would be all for it. Of course, we’d pick it apart first to see what we think. But isn’t that the point?
You’re calling me a “liberal” but I think you’ll find NQ is full of people who departed the Democratic Party months ago.
Many of us are fiscally conservative and probably to the left of you somewhat. But perhaps not as much as you think.
Go ahead, search through NQ posts going back to whenever and see for yourself.
And we loathe Keith Olbermann. That’s gotta count for something, right?
Basically, if you’ve come to NQ thinking we’re a “typically liberal” blog, you’ve been misinformed.
I first found out about this sight because I heard Larry as a regular on the John Batchelor Show, which is my bread and butter. I thought Larry was right about 90% of the time, maybe a bit weaker on financial stuff than on foreign policy, his true forte, but overall, a very refreshing voice. So I came over here and posted a few times and ran into a hornet’s nest in the person of SusanUnPC and her supporters. I was told to get lost. And, I’m sure I will be told to get lost again if I stick around long enough. Still, you all have your heads on a lot straighter than most websites. Without trying to be a kiss-ass, I’d say you’re all about 30-40 IQ points higher than most of the other “non-conservative” (I won’t say liberal) sites.
I’m sure you’d say that would still put us somewhere below an IQ of 100, but I’ll choose to be optimistic.
HAH! Good one. Nope, so far you all seem like you’re right on top of things.
Stick it out this time. Even the regulars don’t always agree with eachother. And to be fair to Susan they might have thought you were an Obot troll which can be rough sailing on NQ.
However, most of the people here enjoy a geniune discussion with someone even if they don’t agree. There are very few wallflowers here….lol. And the more opinions or eyes on these subjects can help strengthen or change our own views.
As far as the financial stuff. Larry Doyle, instead of Johnson takes over that part and keeps us informed on that front. But Johnson was one of the first I’ve seen to report on the commercial real estate markets being the next big issue and that was last year. Now I see it everywhere.
To be fair to Susan, I can be a sarcastic S.O.B. sometimes when provoked, so I contributed to it. My big sin that started the ball rolling was being critical of Hillary. I know now that criticizing Hillary on this blog is like shouting “Fire” in a crowded theatre .. won’t make that mistake again.
Still, think each issue should be judged on its own merits rather than getting into ad hominems. If I believe that, in general, our policy is wrong but on a specific issue, Obama did the right thing, I should be free to say it without worry of being called names. If I believe, as I do, that George W. Bush did some things right, and that he was basically a good man who was eventually destroyed by his political enemies, then I should be free to say it without being called names. If not, where’s the freedom? See, I was raised by liberal parents, I’d love to be a liberal, but it’s the close-mindedness of today’s average liberal blogger that is a big turn-off. Convince me I’m wrong, don’t call me a troll (or worse) and 86 me.
Medicare only reimburses 80 percent from their own rate scale. It doesn’t matter what you charge Medicare for a procedure. They have a scale set up and pay 80 percent of it. The rest either comes from the patient or if the patient has secondary health insurance.
Many of the state run systems such in TN ran out of money because they were covering only those who could not get insurance otherwise. In other words, those who already had pre-existing conditions and were ill and mostly poor. These people take up the most health care dollar and without healthier people contributing into the system of coverage it went belly up
Whatever the reimbursements schedule, it’s still all about money. And I’m saying, whatever the cost of covering the uninsureds, including the additional shock to the system of the increased morbidity associated with those who previously went without treatment, send the taxpayer the bill for it. I’m just saying the cost is $X. You’re saying, no wait, the cost is really $X + $Z. So stipulated, send me a bill for the $X + $Z, just leave the system alone for those of us who are happy with it. Regardless of what anyone says, this is all about money, plain and simple. It’s a wealth transfer scheme; I don’t like them, but it looks like we’re stuck with them for my lifetime at least, so let’s call it for what it is, put the cost out in the light of day, pay for it, and move on to the next thing. No need for all this government intrusion.
Except to say that government is going to add x to medicare funding doesn’t really say too much either. Don’t really know what that money is going to do. Does it represent the needed money to cover more retirees, or does it reflect an increase in reimbursement rates?
As more people become eligible for Medicare it will take more money. As our seniors are living longer..it will still take more money to cover that. As we can manage more chronic diseases, that too will take more money.
The year Medicare was enacted the life expectancy was 70.2 years. So insurance on average covered someone from age 65 to around age 70. Today life expectancy is 78.1 That is 8 more years of health care coverage on even more people who are eligible. That is allot of money.
So, how does it being “a lot of money” make it any less desirable to figure out exactly how much money, and then figure out who’s going to pay for it, rather than continuing to obfuscate the issue through all these roundabout subsidies?
I’m a health actuary, by the way (independent consultant, not an insurance company employee) and the biggest mistake I see being made in this whole debate is the continued obfuscation of the true cost of healthcare delivery by arguing over who pays it. The first question should be, how much will it cost? Then once you know that, step 2 is to figure out how to finance it and then step 3 is to start to whittle away at the input costs of it.
The greater the cost, the more important it is to run the numbers first.
I’m told that TN also had to contend with an influx of people moving in to get TennCare. True?
Now who was elect to go shopping on our behest???
Behold the prophetic vision foretold!
((no dump-shit,speaking to the wind); it didn’t take a prophet to see this coming!) Many saw this coming like the 5:30 to Hauppauge on the Ronkonkoma branch.
“Pay to Play” in IMAX seen with 3D spectacles is what we have here, ladies and gents.
The “eventual economics” as postulated by Prime Obot are fraught with predictable uncertainties, yet the level of honest blunt conversation regarding them, will not be had.
When people tell me that employment is a lagging indicator, all it means to me is that the worker was the first one screwed.
If for no other reason that a person does not want our Federal Government to have a bigger role than it does now, I can respect the position.
What really puts rosin on my bow is when BO Industries Inc. sees the American citizen as live stock to be used a collateral for a loan they can’t afford to finance.
LisaB, I very much admire your writing. Thanks
Why thank you Teak!
Follow the money. Most of the revenue the AMA derives is not from member dues but from licensing agreements for the Current Procedural Terminology (CPT) codes. Swithcing to the Medicare alternative Healthcare Common Procedure Coding System (HCPCS) coding would wipe out the AMA’s funding. The only way to understand anything is to follow the money.
http://www.fivethirtyeight.com/2009/09/ibdtipp-doctors-poll-is-not-trustworthy.html
http://www.rwjf.org/healthreform/quality/product.jsp?id=48408
We’ve got one hell offa, conundrum then…
Whom to believe…
The NEJM or the IBD/TIPP…?
FoxNews had this info (below) a few weeks ago. One of their contributors who was also a Doctor said that only 15% of Physicians in the US belong to the AMA.
http://www.examiner.com/examiner/
A group of 100,000 U. S. physicians, members of Sermo, say that the American Medical Association (AMA) endorsement of government-run healthcare does not reflect the views of practicing physicians. Sermo doctors belong to an online community which is used to collaborate on difficult cases, share clinical observations and work together to achieve better patient outcomes than each could do individually
Dr. Daniel Palestrant, Sermo CE, says that Physicians are the only true advocates for their patients and this bill fails to meet what physicians need to improve the quality care they deliver….By endorsing a bill that does not adequately address concerns of physicians in this country, AMA shows again that it is out of touch with physicians and is conflicted by its own business model. He continued Physicians have voted with their feet with AMA membership now estimated at only 15-20% of U.S. physicians.
To learn more about Who Speaks for Physicians, go to:
http://industry.bnet.com/healthcare/1000913/who-speaks-for-physicians/?tag=content;col1o
–