Comments on: Obama Health Care, etc.

By: Erin

Erin — Fri, 11 Sep 2009 17:51:24 +0000

I just saw Obama's address to the Nurse Association he did yesterday via Scrubsmag.com. I must say, was there a point, other than to schmooze and find another venue to address his blurry speech?

By: Thomas Sears

Thomas Sears — Fri, 11 Sep 2009 09:20:49 +0000

Thank you for the plaudit. Makes me want to have a cocktail. But….I’m on call tonite….all nite….so I’ll have to forgo the pleasantries until tomorrow. Have one for me….I prefer Dr. Daniel’s….I think his name was Jack…with coke or water on ice. That’s my ‘southern’ side taking over.

TDS

By: Thomas Sears

Thomas Sears — Fri, 11 Sep 2009 09:10:29 +0000

From my vantage point, the problem of defensive medicine is from the group we refer to as ‘primary care’ physicians. The often do not understand the indications for tests of various sorts, and as a specialist, I daily encounter inappropriate testing requests. My perception is not a specific number of particular specialty or sub-specialty docs but rather a damper on the fear of involvement in lawsuits. The most common test in ED’s across the country today is a blood test to determine if there has been any cardiac damage…a serum Troponin test. This test is usually ordered in triplicate and unfortunately is ordered on anyone with a chest….irrespective of the history. It is the most over-utilized test in the country now by a factor of almost three-fold. Other examples of over-utilized tests are echocardiograms for the diagnosis of endocarditis and the repeated performance of the same test in persons who mistakenly have acquired ‘Heart failure’ as part of their diagnostic summary list. Improved education of the docs should be implemented country-wide to have an impact on waste, redundancy, and defensive medicine. Tort reform would have to figure in this equation. When our president accuses us of fraud, however, my neck-hairs stand up. I have not observed fraud except in a couple of instances of over thirty years in practice in a highly acute and complex sub-specialty. Doctors don’t have enough time for fraud unless they are incompetent. And only a few are. So, Obama’s comments along this line are simply dishonest and uninformed….a seeming trademark for his presidency to date.

TDS

By: Thomas Sears

Thomas Sears — Fri, 11 Sep 2009 08:35:50 +0000

Barbara…..they won’t read it, but you have my permission. I believe, perhaps, that someone who hasn’t actually been dealing with the problems really won’t understand anyway. I have little faith in most elected officials..after all there is a reason they were elected and the story is not ordinarily pleasant. Most of our elected officials have made too many compromises…and have come to a point of being to beholden to ‘interest groups’. I apologize for seeming cynical.

TDS

By: Thomas Sears

Thomas Sears — Fri, 11 Sep 2009 08:28:14 +0000

Larry is ruled by my sister, the true autority in the clan. Actually, Larry did subscribe to a couple of my suggestions ( a nightly cigar and a couple of scotches). Otherwise, he’s like a border collie…nobody really owns him and if he doesn’t have something to do he becomes psychotic. I love him. It’s my sister who is the lucky one.

TDS

By: wbboei

wbboei — Fri, 11 Sep 2009 06:05:08 +0000

a CRITICAL point you and Clara make. Well said both of you.

By: wbboei

wbboei — Fri, 11 Sep 2009 06:01:23 +0000

Larry–I have been canvassing the internet for reactions to Mr. Obama’s maunderings last night and this one is far and away the best.

By: whoframedrudy

whoframedrudy — Fri, 11 Sep 2009 05:00:18 +0000

“in other words, there would be an incentive for just paying the fine and dodging the health care coverage entirely.”

It’s amazing that a Law Review Editor, from Chicago no less, chooses to ignore this. It’s basically the University of Chicago theory of torts, and the rationale for punitive damages. ‘Corporation A will pay the costs of accidental death lawsuits rather than pay the higher costs of preventing accidental deaths in the first place.’ Under the Chicago theory, that’s the result they want — it’s called ‘allocative efficiency.’

Setting the fine so low reveals an allocative agenda to kill off employee-based health insurance. In the private sector, we’d call this predatory pricing.

One key I see is the culture of employment. Will the talent pool take jobs that don’t provide health benefits? Young people are already getting used to the idea of jobs without benefits. If health benefits aren’t needed to compete for talent, then say hello to single payor.

By: What’s Popular? » Blog Archive » Functional Rant; Obama , You’re Going To Far | Teamtuxedo

Fri, 11 Sep 2009 02:42:16 +0000

[...] Obama Health Care, etc. : NO QUARTER [...]

By: Portia Elizabeth

Portia Elizabeth — Fri, 11 Sep 2009 01:02:58 +0000

Dr. Sears, thank you for taking the time to express your thoughtful opinions on the health care issue. My husband is also a physician (radiologist), and has been talking about the points you made. He agrees that the focus should be on (1)deregulating insurance to promote competition similar to when telephone coverage became competitive, (2) tort reform (3) renegotiating what prices drug companies can charge. He’s very concerned about the number of healthcare professionals who will be expected to provide for additional patients.

It seems obvious that the people who designed this monster of a plan have done little to assess feedback from the ones who will be most affected by its implementation.

By: Peggy Sue

Peggy Sue — Fri, 11 Sep 2009 00:39:38 +0000

PS: the endorsement was from the American Nurses Association.

By: Peggy Sue

Peggy Sue — Fri, 11 Sep 2009 00:35:54 +0000

That’s my point, Clara. The vast majority of people listening to these endorsements think: Oh, if “all” the doctors and nurses agree to this craziness, it must be a good idea.

I think statements from Dr. Sears and other medical professionals are incredibly important. Unfortunately, I haven’t seen enough statements of this sort to turn the tide of opinion.

By: Clara

Clara — Fri, 11 Sep 2009 00:04:06 +0000

Peggy Sue, Do you know if Obamapalooza has been endorsed by the American Nurses Association or just the California Nurses? Even so, the ANA is to nurses what the AMA is to doctors. It’s not those guys and gals in the trenches.

By: Clara

Clara — Fri, 11 Sep 2009 00:01:54 +0000

Thank you for sharing your very real perspective of the issue at hand. I’ve been astounded that more doctors and nurses are not sought out for their input. It’s disturbing to hear Obama repeatedly say that “he’s got all the doctors and he’s got all the nurses on board”. That’s a lie.

As a nurse for 30 years, I’ve been tuned in to the nursing shortage for a long time. There is currently a shortage, critical in some regions, and only due to become dire as we oldsters retire. A recent article by the President of the Virginia Nurses Association painted yet another disturbing picture when she wrote that, as the economy begins to improve and finances stabilize, there will likely be a wave of retirements. She feels that many nurses who may have otherwise retired are staying on a little longer to have a job in a “safe” profession. This would coincide with the implementation of any new health care bill. I know there are doctor shortages, but I’m not as familiar with which specialties are in need except for primary care docs.

By: jangles

jangles — Thu, 10 Sep 2009 23:56:20 +0000

Obamacare is a bailout of the insurance industry and pharma who conjointly created a failed market system. They are now to be rewarded by millions of new customers and mandates to individuals and employers who must participate or be fined/taxed. To say that medicare “reforms” will produce the savings to pay for this is hysterical. Dems will get a long lease on insurance and pharma corporate pockets while retaining all the benefits they already have from labor, Wall St. corporate America.

Get ready for a long hard expensive ride.

Thank you Dr. Sears for confirming through your experience and expertise what we already knew and believed—we are being screwed.