Monday, March 22, 2010

Healthcare Reform Finale

Well it finally comes to an end. If your a follower of this blog, you know where I stand on the issue of health care reform (I am for it). That does not necessarily represent my co-writers (wish they would write more) on this blog. It's my personal opinion. I know one of them is a conservative and I can't remember how the other feels.

I'm not afraid to say I wish there was more in this bill. I wish there was a public option, or at least Co-Ops. I wish there was sweeping tort reform. I wish there were greater restrictions on the insurance companies.

Now for the sarcasm:
  • Anyways, I see why so many people are upset. I mean...the stuff on this bill is soooo liberal. They had to leave out the public option b/c I guess that would be too communist. But telling insurance companies they can't deny people with pre-existing conditions is so far left. How are these companies going to make money if they have to do their jobs and COVER HEALTH CARE . How dare the Democrats put that in the bill! All the kids being born TODAY with pre-existing conditions have to be covered, not denied, now. That's got to be bad for business. And after all, health care should be a business, not a right, right?
  • Now insurance companies cannot place a cap on how much they can cover in a lifetime? I bet that hurts. I mean hell....if a healthy 27 year old gets devastating injuries from being hit from a drunk driver...the companies aren't going to have as much ground to drop their coverage! And how are they going to drop all the people who develop cancer? How can they do business anymore! Damn Democrats!
  • The new bill also helps out seniors who fall into the Medicare Coverage Part D plan. It will basically help them pay for their out of pocket expenses on medications. Who do they think they are!? Shouldn't these seniors have to pay like the rest of us?! Get a job! Just because you are old, have way more illnesses b/c you are old, and already retired from working your whole life doesn't mean that the Democrats should pick up the bill, right? Leave our health care alone! Helping others....that's so Un-American.
  • Kudos to you, Rep. Randy Neugebauer of Texas, for shouting "Baby Killer" last night. That's right. Even though the abortion clause is being taken out of the bill...I am sure the Democrats will be planning to kill babies somehow.
  • Dow at 18 month High today, with health care stocks leading the way. I'm sure this is liberal propaganda. There is no way health reform is already helping the economy right? If so, let's not give the Democrats any credit. Keep it a secret from them. We don't want to get their heads any bigger.
Now in all seriousness:
  • Today while moonlighting in a private hospital, I had a nice gentleman who came in with chest pain. His white blood cell count was strikingly high, over 75,000. This generally means cancer. I went to break the news to him, but he already knew. He was diagnosed with CML a year ago. He can't afford to see a Oncologist, and his health insurance dropped him. His treatment....waiting another year until he is eligible for Medicare to get treatment. He will be dead by then. But today he got admitted for the pulmonary embolisms his cancer caused. Then again, there were previous comments from older posts stating anyone can just go to a county hospital when the get cancer and get taken care of. Guess that wasn't true for this guy, or the other 50 cases I have seen just like this.
-ER Doc. "Leave our health care alone," cried the people. I say suck it


Eric Atkinson said...

No, I beleive it will be you "sucking it."

Anonymous said...

I believe health insurance companies should be not-for-profit, they should not discriminate against pre-existing conditions, we need more primary care physicians, we need tort reform, and we need to change how physicians are paid. This bill, however, is not the answer and it's a disguise for expanded government interference in our daily practices. Rather than include a public option, they essentially expanded the existing government health plan without reforming the current flawed Medicare and Medicaid system. It doesn't make since to expand a program that's currently broken. Already, more and more physicians cannot accept Medicaid and Medicare because they lose money when seeing them. So now we are going to expand a broken program that includes a shortage of primary care doctors who will no longer accept their insurance? Where will these newly insured go for their government mandated "free preventative checkups"? The government will now tell doctors what they can and cannot order, not the insurance companies? To me, we've exchanged one evil for an even greater evil. In addition, Obama is raising the top income brackets and now taxing that bracket an additional 2.5%. This will add up to close to a 50% tax rate. Is this fair to the hardworking people who sacrificed and found ways to become successful to bear the brunt of society's social programs? Especially when these social programs are benefiting some individuals who made poor choices in life. We are a society and social welfare programs should be shared amongst all citizens, no matter if you make 1 grand a year and have to pay 1 cent in taxes. When you provide anything for free, economics shows that people take advantage and abuse it. The bill doesn't include provisions that prevent people from abusing the system, and we all know that this will occur. Even the poorest of the poor should be required to pay something, either monetary or via labor. Without this, it creates a society where we are all helpless victims blaiming others for his or her social ills. This is one fundamental difference between Republicans and Democrats. Republicans believe in providing the means to better yourself that requires action, personal responsibility, and hardwork. Democrats, however, provide handouts that require no personal responsibility or hardwork. They are and have already created a society of victims. This bill will further advance this ideal, and I find this apsect more disturbing then any of the other provisions in the bill. Yes, I do believe patients should have health insurance, but the philosophy of how is where bleeding liberals like youself and me respectfully disagree.

Doc Sensitive

Elizabeth said...

I know that our Canadian Health care system has it's problems but NO ONE will loose their home or go bankrupt trying to find the money to get treatment. No one dies because they cannot afford the medical care they need. We get to choose our own doctors and the hospitals we go too.. I will keep this system.

Trust us....we're doctors said...

Doc Sensitive just outted himself. I think too its not a great idea to expand coverage in medicaire/medicaid. But supposedly they have ways to pay for it. But other good options were brought to the table by the Right. All I heard was tax breaks. The reason Im excited is b/c its a start. Maybe from this start we can fix some shit. Sometimes you have to start things to get them fixed. We haven't started anything in 40 years.

What's funny, Doc Sensitive, is that we are both going to work in the hood when we are done with residency. So....conservatives and liberals alike will be working together in this mess. We didn't choose the private world with high paying insurances.

Why...bc we want to be able to have shit to write on this blog I guess

Anonymous said...

Yes, this new health care system will be great!

I work my @$$ off to pay for my health care so why shouldn't I pay for everyone else's?

That's right... who do you think will end up footing the bill for this?

That's OK ER... You'll be right there with me paying the whole time...

I'm guessing somewhere in the back of your mind when you choose to go to med school and make that sacrifice that somewhere along the line you wanted to be able to put food on the table, provide a few comforts for yourself/loved ones, and maybe even pay off those student loans...

That party's over... within the next 10 years you'll be nothing more that a factory worker putting together widgets for minimum wage wishing for the bygone days of yore when docs were paid "in-kind" because even a chicken or a dozen eggs would be more than the pittance you get for an otitis media...

Yup read between the lines... you're a self-righteous idiot...

Liz said...

Health care for all is a wonderful idea.

Anyone who thinks the government can do this efficiently
is smokin' sumthin'. (Think Social Security, Medicare, Amtrak, Postal Service, all near bankruptcy)....

"The definition of insanity is doin the same thing over and over and expecting a different result"'s called Socialism and it has been tried and failed throughout history. I can't believe we have to actually make this mistake again.

Soon, anyone can be a doctor. That's because the best and the brightest will stop becoming doctors, choosing a better life for themselves and their families. Smart people won't go into a field that pays less and threatens much (too bad no tort reform). This means in our desperation for MD's, medical schools will start taking just about anybody.

On the bright side, nurse practitioners will likely do well, since they'll be taking the place of PCP's...Likewise hospice will probably not go away, being so cheap and all.

And another thing, more people will stop giving to private charities.....why should they give when Big Gov't is already taking care of everyone? This makes sense to me, except I know so many will continue to fall through the cracks.....

You can be a good person and want more for others without drinking the Socialist Kool-Aid.

Anonymous said...

Come on guys. Relax a Lil. You have to admit everyones kind of freaking out. There isn't much in this bill that is socialist or government takeover. It will either work or fail. Neither of which will be drastic or quick. Deep breaths everyone.

Liz said...

EVERYTHING is Socialist about it.

It takes away freedom of choice (read closely, it does)....

It takes from those who work and gives to those who don't (don't, as in won't, as opposed to cannot).

It kills jobs (and if you don't think so, you haven't been paying attention).

It does create some new gov't jobs.... in the IRS of all places. Why oh why would it ever occur to anyone to involve the IRS in our health care? Unless it's less about health and more about keeping track of our money.

Nothing much will change immediately. It will be hoped that many will just shrug it off as it comes on down the pike later.

The government CANNOT make us happy nor solve our human problems. But if we think it can, well then we don't have to lift a finger as individuals to help a neighbor, nope just call Big Brother. That's just awfully convenient.

Anonymous said...

I'm a self-employed veterinarian.

This means that though I'm well-educated and make a decent living, I pay for my own individual health insurance policy. So does my significant other, also self-employed in another well-paid field. In my state, I have two choices: one company I've never heard of (rated "B"), and the one I have, which sucks. This policy's premium increased by 33% last year (2008 vs. 2009). The policy has a $2M lifetime cap. Let's hope I don't require anything expensive, like a new organ or chemotherapy. May I also say it's SO much fun to appeal denied claims when one has an individual policy. The insurance company simply stonewalls. Why should they pay? It's just little me, individual policy holder.

I am the citizen the insurance companies fear would have switched to a public option: young, healthy, educated. I'm very disappointed this option isn't available. I lived in Canada for a number of years and received very good care while I was there, even though I'm not a Canadian citizen.

Liz said...

What's really wrong with the bill:

The underhanded way in which is was put together and passed.

That it is 2700 pages long and NOBODY could possibly have known exactly what they were voting for.

That it includes everything and then some, like student loans.

That the IRS will be in charge of it. This one just boggles my mind.
It's why I don't think this was about health care at all.

That the President and Congress are exempt from the policies that we will have to choose from. This is outrageous.

The lies! The incessant lies from Obama and know, like when he said jobs were the most important issue for 2010? Transparency, C-SPAN? When all the while his main focus is on ramming through legislation that 73% of Americans did not want but that will assure him a place in the history books, whether as hero or villain, he doesn't seem to care.

Mr. Vet, how will this bill lower your insurance costs? Do you have employees? Will you now be able to pay less for their policies? As you get older, do you think you will (under this bill) be eligible for cardiac bypass surgery, chemotherapy? There's only one way for costs to be contained, and that is to offer less care.

I would not have been against true health care reform. This is just a massive power grab.

Anonymous said...

It didn't work in Massachusetts, why will it work for the rest of the country? What's so hard to understand about that. Maybe it has nothing to do with helpng the uninsured and more to do with a President who wants to the the first in everything. Is this just all about his Legacy? I certainly hope not.

Anonymous said...

>>Mr. Vet

I'm female. You can call me "Dr." Vet, though.

>>how will this bill lower your insurance costs?>>

I'm not convinced it will, and I'm not convinced it should, though I may eventually find myself uninsured if the 33% increase becomes an annual event. Health care is expensive. I would, however, like to feel confident that my health insurance will cover my expenses should I need to utilize it at some point. At the moment, insurance companies operate with virtual impunity when denying claims for the individually insured. That's scary, considering about 10% of the population has an individual insurance policy.

>>Do you have employees? Will you now be able to pay less for their policies?>>

Yes. They're part-time employees. I don't provide them with health insurance and have no plans to change this in the future.

>>As you get older, do you think you will (under this bill) be eligible for cardiac bypass surgery, chemotherapy? There's only one way for costs to be contained, and that is to offer less care.>>

Actually, both cardiac bypass and chemotherapy are currently inappropriately overutilized in human medicine. A major fault of fee-for-service, and one I can criticize with full knowledge because I work in a fee-for-service model myself.

The system we have currently is rife with waste and greed. The new legislation will not solve this basic problem.

For ideas toward a solution more realistic and constructive than maintaining status quo, I suggest you visit the PBS/Frontline webpage and watch "Sick Around the World", in particular the segment on Switzerland. Almost 20 years ago, Switzerland's system was like ours. Now they have a system to which we should aspire.

Oh, and as for the best and the brightest... many of us went to veterinary school. Call us crazy, because we'll never earn physicians' salaries. ;-)

Anonymous said...

Well Vet, most physicians are paid as much as yourself when you subtract Obamas new tax rate with this new Medicaid tax then subtract loan payments(250k). It works out to net 90-75 grand a year or less for most primary care doctors.

DreamingTree said...

It's clear from the comments that those who are opposing this bill haven't read it. It's also clear that you are drinking the Glenn Beck (or Rush Limbaugh) kool-aid. Little is based on reality, much is based on feelings or emotions (or conspiracy theories).

Maybe if the Republicans had been willing to cooperate we'd have more of a bipartisan bill. Instead, they chose to stand back & spread lies, in hopes that this would be his Waterloo. Who are they protecting/helping by acting in this manner?

You don't want to pay for others to have health care? What do you think you are doing right now?

Oh, and Liz, I'm not sure I understand your comment about hospice. Should we not be providing end of life care to the dying?

Anonymous said...

Amen Dreaming Tree:

The tax stuff people are saying is ridiculous. Current rates are around 33%. At the HIGHEST, this could go up to 39%, and that wont be for a few years and gradual. 39% is closer to Clinton days, but sure isn't 50%

Even countries with socialized medicine have bright doctors. Your an idiot if you think doctors will be poor peasants and med schools will just take anybody.

This bill has a lot of Repubilican ideals. The liberal ideas never made it in. Right now this is just Republicans vs Democrats. Honestly, they should be happy and thankful that the bill is the way it is. It is NO WHERE NEAR a government takeover or socialized medicine.

Stop drinking cool aide and start thinking on your own.

Anonymous said...

Yes but add in the additional 2.5% Medicaid tax, and it won't be long before he proposes an additional tax increase. Right now, as long as you don't have capital gains, the top tax rate will be around 42% + capital gains tax.

Anonymous said...

>>most physicians are paid as much as yourself when you subtract Obamas new tax rate with this new Medicaid tax...>>

I don't recall disclosing my salary.

>>...then subtract loan payments(250k)>>

Average medical school debt for 2009 graduates was the same as average veterinary school debt for 2009: $130K.

If we're going to discuss my income after I subtract my student loans, well, then, I'm really depressed now. Do you really think physicians are the only people with large student loans?

>>It works out to net 90-75 grand a year or less for most primary care doctors.>>

Primary care physicians are the poorest-paid specialty. Most physicians are not primary care physicians and thus are better-paid.

Your point?

Anonymous said...

>>Even countries with socialized medicine have bright doctors. Your an idiot if you think doctors will be poor peasants and med schools will just take anybody.>>

I liked my Canadian physicians just fine when I lived there. Most of Europe seems to muddle along nicely, too. Is any system perfect? No, but that's probably because humans are required to staff and manage any health care system, and humans are imperfect.

Dreaming Tree:

>>You don't want to pay for others to have health care? What do you think you are doing right now?>>

If it were possible to tease out the total amount spent by each individual towards health care on an annual basis, including all taxes and insurance premiums, people would be stunned at how expensive and inefficient this system actually is. But I'm not sure this degree of transparency is possible. It would be a sobering exercise, though.

Anonymous said...

Thank goodness, for a while there I was worried I'd have to hold down a job and work to make sure I got my medicine for my chronic illness. Now I know they'll get paid for whether I work or not.


Anonymous said...

My point is that everyone should share the burden of social welfare programs, not just the one that happens to make more money.

Anonymous said...

@DrVet-in some states, if you set up a company with two employees (you and your spouse), you can go to Costco and buy health insurance for your small business for much less than an individual policy costs. Not available in all states, but it's an option for some.

@DocSensitive-Nicely said.

Rachael said...

I couldn't be happier about the health care bill, although I don't think it goes far enough. And also, what the hell took so damn long? (that's rhetorical - I know the answer - conservative propaganda)

Kat said...

Canada's Health Care System was set up to be self sustaining, and it still would be if not for American pressure to get Bryan Mulroney to sell off Air Canada and Petro Canada to American interests and so that our health care system would fail and the American Government can proudly proclaim that Government subsidized health care doesn't work.
That's why Canada's health care is going down the tubes, well that and also because the insurance companies are fighting for a two tier health care system so that they can get their fingers into the pie.
American should look at what Pierre Elliot Trudeau did in Canada to ensure that our health care would be able to be sustained, andt then copy, just don't sell if off because some idiot tells you too.

Liz said...

Dear Dreaming Tree:

Liz here. I'm a hospice nurse and believe in it whole heartedly. But it is cheap and so will probably fare well.

What Liberals and Progressives don't understand is that it isn't health care for all that we object to. What we object to is:

Government intrusion into all aspects of our private lives.

Excessive taxation.

Dependence on Big Governement.

Loss of personal freedom.

That's what you all don't seem to grasp. I'd love to have a Pollyanna outlook, Government's in charge and all's well with the world. That's naive and foolish.

12 million Americans won't be helped by this giant bill. Once tax rates go through the roof (speculation is a federal sales tax is coming)...who's going to want to help those in need? After all, government is supposed to be doing it.

Why are insurance company stocks going up NOW? Drug company stocks are as well. Interesting.

I'm sort of a hybrid, too. I believe in rationing.....I just don't want the government making the decisions.

Why are Congress and the President exempt from the insurance that will be available to us? It's not good enough for them? This thing they've forced on us? I do not believe for an instant this was about health was about Power pure and simple.

You're not going to change my mind, so you don't have to respond.

Anonymous said...

Give me a break. How is this bill intruding and taking over our personal lives? And how congress "exempt" from the new health plan? Theres nothing to be exempt from. There isn't a new insurance plan or a public option. All it is is subsidies and expanding medicare and medicaid. And an insurance exchange system. So what exactly did fox news tell you they are exempt from.

Glad to see some rationale people for the improvement of health care speaking up on here.

Liz said...

Actually, the Republicans proposed three times on Sunday (watched it live, dude) that Congress (including themselves) and the President have the same policies as the people. The Democrats rejected the proposal each time. Go read page 158 of the new law, it's there in black and white.

According to the new law, we will be able to choose from four different policies, based on how much we want to spend. That is the full extent of our ability to choose. There will be no choice as to what is in each policy. There will be no difference in policies no matter which insurance company you purchase it from.

Who will be enforcing this law? The IRS. The government will be hiring 16,000 new IRS employees to go over our incomes and "tax" us if we fail to purchase one of the four policies available. This is ALL a massive government intrusion into our personal healthcare decisions. The IRS? Really? Yep. Oh, and that cost alone will be $10 billion.

Those with the lowest incomes will be able to get healthcare from Medicaid, but not until 2014.

Medicare is just about a done deal. Bankrupt by 2020 give or take. Were you even paying attention on Sunday?


Note, that's from MSNBC and it give a nice summary of the new Law of the Land.

Anonymous said...

>>Not available in all states, but it's an option for some.>>

Not in mine, and given that my SO and I are geographically tied to our clients, it's not likely we'll be moving anytime soon.

Anonymous said...

Liz is exactly right. The bill is more than health care- it's about an intrusive big government creating a society of non personal responsibility. Giving people something for free makes them ungrateful and causes them to abuse the system. Why not make them pay a min co pay or make them work cutting grass for the city? Take my hard earned money, then I expect people to work.

Anonymous said...

If the new health care system was so great, Congress, the President and the rest of the government establishment would be covered by it. But they exempted themselves. Proof positive they understand the abomination they have foisted on the rest of us.

ERP said...

Why so many anonymous posters?
Register yourselves for crying out loud.
I will out myself as in favour of the bill. Even if I have to pay some more taxes.

Liz said...

ERP: just know that I do love you!

It's NOT health care for all that anyone hates....

It's that we KNOW a government takeover when we see it.

It's that we KNOW government bankrupts ALL of it's entitlement programs.

It's that we KNOW there will be many who fall through the cracks.

It's that we KNOW Britian's NHS is falling apart at the seams.

It's that we KNOW to spend the money you have to actually have the money.

It's that (apparently only some of us) who KNOW that Utopia is a fantasy.

Anonymous said...


Are you apart of the coffee shop party? I see you as the type that loves to talk and talk and bitch about everything, drinks too much coolaide, and dont have any solutions to the problems.

Knowing the problem is the easy part. You can pick away anything to death. Knowing the answer is the hard part. At least obama is trying something. Hes not sitting on the bench like you