Battling ObamaCare: The Health Care Industry Starts to Awaken
Somewhere between the election of President Obama and the raging battle to repeal ObamaCare, the health care industry has woken up — sort of.
Part of why President Obama was able to gain early momentum for ObamaCare’s passage was that he had the health insurance lobby, Big Pharma, the AMA, and the hospital lobby all eating out of his hand — or, more exactly, all feeding him and his party, in the form of donations and political support. In May of 2009, President Obama posed for a photograph at the White House with health industry leaders, and along the road to ObamaCare’s passage, the president and his congressional allies encountered very little opposition from the health care industry — the very people who arguably had the most to lose.
Thankfully, the Democratic White House and Congress have encountered plenty of opposition from other quarters: namely, from citizens who don’t relish the thought of government control over health care, or the thought of government intrusion into the uniquely private relationship between patient and doctor. Americans also don’t support the thought of launching a massive new entitlement program, or of largely paying for it by siphoning money out of an existing already-barely-solvent entitlement program (Medicare) — a practice commonly known as robbing Peter to pay Paul.
Americans don’t want higher taxes, greater debt, rationed care, reduced liberty, or any of the other unpleasant consequences that would result from funneling enough wealth and power to Washington to give it control of what will soon be one-fifth of our economy. All of this, of course, is why we are now very much in the midst of a nation-defining fight for repeal.
Some good news in that fight is that the alliance between the Obama administration and the health care industry appears to have largely broken down. The first group to break ranks was the doctors. Across America, they began to be among the leaders, and the leading funders, of the Tea Party movement. Groups like Docs4PatientCare — an organization of doctors who believe that the health care system should be controlled by patients and physicians, not by insurers and especially not by the government — sprang up and quickly expanded. New chapters of the Benjamin Rush Society (of which I was recently the director and am now a member of the Board of Advisors) began to form on the campuses of American medical schools. Taking their name from a doctor who signed the Declaration of Independence, they unite medical students who believe that doctors are called to serve their patients, not the government.
Such Tocquevillian civil associations can do a great deal of good, but USA Today reports that doctors haven’t stopped there. As of April, 47 doctors were running for the House or Senate — nearly three times the number of doctors (16) currently serving in Congress. Of these 47, 41 are Republicans and six are Democrats, a split that says something about how well the AMA — a high-visibility supporter of ObamaCare whose membership includes only about one-sixth of all physicians — represents doctors and their views.
Sadly, I perceive mostly narrow special interests driving great policy issues. Hospitals, doctors, insurers, all left, then right, then left again depending on which political entity is promising to squeeze blood out of the rest of the economy for them.
What nobody seems to be addressing is, what happens if more and more doctors REFUSE to accept the government-run insurance policies, especially Medicare? More and more doctors around the country, especially the really good ones, are dropping Medicare because they actually lose money on Medicare patients. Think about that. The very people Obamacare is supposed to help may not be able to find doctors who accept the insurance the government gives them! And it’s only going to get worse. As more mandated government insurance policies go into effect, doctors will have to decide whether or not it’s even worth staying in business. There could be a massive doctor shortage in a few years thanks to Obamacare. We could be heading into an era where more and more doctors may simply accept cash rather than any government patients. The Government insurance policies would be used only for diagnostic tests and if you’re admitted into a hospital, but even hospitals may balk at this if they lose millions on Government patients. And, with more and more corporations dumping their workers into the Federal program rather than providing their workers with private insurance coverage, you will end up with most Americans having government insurance but with no place to use it. Sounds really good, dosn’t it?
November. Start changing all of this in November.
Simple solution. Chavez care: free clinics and hospitals, bring over cuban doctors to hand out sugar pills. Obamacare the next generation.
I have long contended that this is a crisis in the making… a manufactured crisis. They want Dr.s to drop medicare and medicaid in order to declare a crisis and take over the entire system.
If it’s not repealed, and I have little hope it will be, just watch.
Based on what you posted, do you think it’s implausible?
There may be doctors who refuse to treat patients with the new Health Care Bill. But those doctors will be dinosaurs and will prove to be short sighted. As we workers have had to re-invent ourselves so goes the world. Medical expenses are bankrupting Americans. Each of the 59,000,0000 people quoted without healthcare are real people. I think this is a fact that has been lost. A Canadian nephew watches CNN-Buffalo for entertainment, says “Pop the popcorn”. He laughs at our… what? Misery? No,we are a spectacle in the eyes of the world. Canadian doctors have suggested my sister-in-law who has lupus, ginger and additional natural products. Yes, Canadians, still have that “fix me doc” attitude. This too shall pass.
Be aware that the AMA does not represent the majority of practicing physicians in the United States. As the group become politicized, it steadily lost support among practicioners trying to cope with the avalanche of regulations emanating from the federal bureaucracy, and trying to stay afloat as mandated fees were repeatedly cut despite steadily escalating overhead costs. If you’ve had trouble finding a doctor, now you know why.
These medical organizations remind me of Winston Smith in the novel 1984. Winston actually believed the head of his propaganda organization would help him in fighting “Big Brother”. Amazing how some organizations (and people) are so gullible.
So doctors are fighting back. I’m not at all convinced they are against Obama’s plan for the reasons you state. For many, it’s actually the other way around. If there is dissent, it is because the Obama plan doesn’t go far enough towards a single payer system. What makes you think that doctors are helping to “steer us toward” more market based insanity. Where is your evidence for such an absurd claim?
A Gallup poll of what people think. Oh, that’s trustworthy. People trust their doctors’ right? Must be because of that “special” doctor patient relationship. What nonsense.
What we need is a true single payer system of socialized medicine in this country. Most of the Western democracies have it. The United States is way behind in this regard. It is high time the “health industry” and insurance special interests go away.
Many doctors are for single payer. http://madashelldoctors.com/
Wow Nate, what a great idea – socialized medicine. Yay – free healthcare for all. And how about free luxury housing and free food and free cars. And we can pay for it all (not that we have to ’cause it’s FREE)by just taxing the rich.
What a pantload – aren’t you due at HuffPo for your daily indoctrination session?
This actually deserves a response, and not just brushing off.
Nate, you are operating from the assumption that we “are behind” in this area. You are assuming that this other system is superior. In what way? That folks do not have to pay for it? Just because the cost is diffused, doesn’t mean you are not paying for it. They make the taxes invisible, so you think it is free. It is not.
“It is high time the “health industry” and insurance special interests go away.”? Really? You really think they have no right to pursue their self-interests like everyone else? Would you enslave them then? Either you are a person, with unalienable human rights, or you are a slave, where someone else dictates your life.
Do you have any idea what it takes to become a doctor? First he has to have a genius IQ or greater. He has to go to college and study pre-med. Then he has to get accepted to Med School. He has to assume hundreds of thousands of dollars in tuition debt. Then he has to absorb 5,000 pages of dry material per week! They get very little sleep throughout med school.
Then they become interns for 2 years, at low wages for the massive number of hours they are required to work. If they specialize, well, that’s even more schooling and internship.
After all this, somewhere in their 30′s(!), they can then hire out to someone for long hours, or go into private practice. They have to open shop, hire staff, learn how to run a business, and see no money for awhile, because it takes so long to get reimbursed. They get to pay 50k per year in malpractice insurance. The lawyers get their cut.
Having somehow achieved all this, they are considered rich, and so get taxed more.After 20-25 years of practice, they can finally pay off their school loans and really start to save for retirement in a few years.
Yet, you think their selfish concerns are of no matter. You want your health care, and you want it to be free. The government should pay (government being other taxpayers). With a single-payer system, they are the only game in town. They will pay the doctors when they like, and however much they like, and the doctors will take it and like it!
So, you want to force others to pay for your care. You want the doctors, these tremendously gifted people, to work for peanuts, with no option to pursue their own dreams. They will be forced to become government employees. Their wages and hours will be set by government.
If you were genius enough to become a doctor, would you see this as a career option for yourself? Where will you get the doctors? Who is genius enough to become a doctor, but stupid enough to accept this deal? In Cuba, the doctor and the janitor make the same wage: peanuts. In every country with “free” health care, there are not enough doctors. They come to the USA to pursue their dreams.
This is why Communists insist on worldwide revolution, because as long as there is somewhere to escape to, the people can reject the servitude being forced upon them.
You Leftists never think about how you would make it work. You never think it all the way through. The revolution is all… but then what? What does it look like in actual practice? It is always tyranny.
But hey, the proles get cared for, like the sheep they are supposed to be. And their masters live in splendor. Utopia.
Well put Marc. However, from my experience, you are wasting your time trying to convince a liberal like Nate.
While everything you say is true, progressives are impervious to facts and logic. Socialism is a well travelled road that leads to economic stagnation, social upheaval and finally brutality and death to keep the little nobodies (i.e. citizens)in line with the workers paradise, such as it is. But if one ignores facts, history and honest discourse, as lefties all seem to do, then socialism is a great idea.
Anyway, great post. But I doubt that you have made a dent in the fog that surrounds liberal minds like poor Nate
Very well thought out and said.
Most of the western democracies are dumping it ‘cuz it doesn’t work..i.e. Canada and England.
So yeah, keep pushing it.
Um, Nate, FYI, most doctors are not in favor of a single payer system. The liberal MSM is, and slants who it quotes and what it reports accordingly. Just thought I’d let you know. PS: if you put your dentures under your pillow, the tooth fairy will not stop by. Sorry.
You don’t have to be a genius to know where this is going or the outcome. Look north to Canada and see what has taken place since our Obama, Pierre Elliot Trudeau, wreaked his academic socialist vengeance on our society. Something that looks good from a distance and sounds great but in reality does not work very well and is falling apart at its unionized government seams.
In the past docs were by far in solo or small group practices where it was their business. All of the regs, rules, and piles of cr*p foisted upon them has caused a record amount of them selling or leaving their practices, either retiring or back being an employee. As Medicare only pays about half the true cost of a service and is half of the market, everyone else gets to pay 1.5 to 2x the true cost. As an employee the doctor doesn’t have the risk of being the last one paid.
O’Care just added a lot of regulatory termites into the already shaky structure, accelerating its demise which had already been eaten up by Medicare and its poor sister Medicaid.
Real reform requires tort reform and putting the patient back into the cost equation. As a Tea Party supporter I find it strange that I recommend that the Medicaid portion be run as a single payer with Gov’t clinics that MUST include prompt care services that divert the huge stream of people going to the ER for Colds and Flu. The ER should be primarily for those sick enough to require an Ambulance.
The public is already paying for much of the ER walk in services so a Prompt care setup could halve that cost, helping to support the balance of the clinic.
As a doctor, I do not care who pays me as long as I get paid. Private insurance companies are no friends of collections and government payors are worse. We could reserve a whole new chapter about the negative effects of lawyers. The simple reason is that both like to challenge fees and control costs regardless of medical decisions. All three (insurers, gov.s and lawyers) like to project enormous paper work requirements that diminish the quality and time spend on patient care. I would estimate a minimum of three times the billing. That is 15 minutes of service results in 45 minutes of codifications, billings, committee approvals, and payment instrumentation. At least 10 functionaries handle my simple bills. What I most disapprove and a waiting reason to reject Medicare, Medicaid, insurance companies, is that they want to set my fee/cost schedule. In submitting the paper work, I also have to work for them for free (negative income).
The biggest and most objectional lie in Obama Care is that it is health care. It is not. It is sick care.
The headaches of insurance are a pain for patients, I get so tired of trying to figure out insurance, just to have the rules change again. The phone calls, approvals, just what you need when you’re sick. Add a layer of government to that, the perplexities will quadruple.
Wonder if doctors could have a rate for people who just pay cash? Probably against the law for being to simple.
Great comments all, but I wonder about things a bit farther off and much less certain. Particularly, what will the pool of doctors AND med-school students look like in a decade or so? Let’s speculate that the financial return from being a doctor will shrink further, and doctors largely will become minions of legislators and bureaucrats.
I propose that this will diminish the number of doctors, because the Feds certainly will devise a new law to compel doctors to participate in the Obamacare insurance mechanism. I also foresee that a mandate to participate will be tied to medical-school loans. Now that the Feds own the student-loan business, this should require no more than the stroke of a pen. In the face of all this, many prospective doctors will opt for another profession. Or, like many current doctors, they’ll move into elective specialties, such as cosmetic surgery or the new “medi-spas” popping up all over the nation. The bottom line is fewer doctors for necessary care.
To motivate more med students, the Feds will dangle ever more generous loan-forgiveness arrangements. This may ease somewhat the supply problem, but what of the quality of care? What sort of care will you expect from a doctor whose career logic went something like “I won’t get rich as a doctor, it’s not a prestigious profession any more, the bureaucrats will be breathing down my neck, but hey — becoming a doctor doesn’t cost anything!”
Yes, it still will require lots of time and motivation to become a doctor, and some will do it just because they love the profession. It’s unrealistic to believe that such doctors will form the majority, however.
Look at Canada. New docs are literally indentured servants–they have to work for the state for a certain amount of time before they can hang their own shingle. And as soon as they’re free, they…make haste for the U.S.
A little too much wishful thinking and a little too late? I sat through Medicine Grand Rounds on Wednesday at which the Medical School’s premiere cancer doc presented the voluminous data showing that at least 40% of all future cancers can be prevented if basically, you know, we fat-ass Americans eat what they tell us to and get more exercise. No mention of the many biological issues that contribute to why people do not eat what they tell us to and get more exercise.
In the follow-up discussion with the former Chief of Medicine, cancer doc seemed to lament that we do not have a system like Singapore – where students are caned for not exercising or even better yet, like North Korea (!) whose use of force could guarantee we reach the utopia of 40% cancer reduction.
Folks, these are some of the best and brightest docs in the country and they seem to have no trouble in embracing the tyranny of Obamacare and Obamunism.
One of the best attended and well received Grand Rounds (attended by faculty, physicians, and medical students) in mid 2008 was a proponent of government run (Medicare) for all, no exceptions.
Don’t overlook that Medical Schools and physicians more broadly are being bought off by the politicians through carrots in Obamacre. Omerta for all.
The current medical students and frankly ones I have known for the last 10 years are frightening to me in their embrace of infanticide, geronticide, and their elitism.
That kind of attitude is coming from the “god” doctors–the top ones, as you said, at your institution. They have no patience for inferiors (which is everyone), so it’s no wonder they’re OK with the idea of punishing patients who don’t obey. Simple arrogance and laziness (and maybe some misanthropy). The most competent doctors have more than surgical skill or diagnostic prowess. They understand human behavior is difficult to change, that it’s time-consuming and messy and not fixable with a pill or a scalpel or a barked command.
Never thought I would need to ask if my Dr. is a liberal or a conservative!
Good article. Keep fighting against the nationalization of health care. However, I would like to make one comment. Quoting from the piece:
“Taking their name from a doctor who signed the Declaration of Independence, they unite medical students who believe that doctors are called to serve their patients, not the government.”
I understand the sentiment being expressed here regarding the relationship between a doctor and patient. However, in making this statement, I believe the author commits the very error that has made the entire health care debacle possible in the first place.
Other than in a euphemistic sense, doctors should never be thought of as “serving” their patients. Doctors study and then practice medicine in order to further the personal goals of their own lives. Through hard work, they acquire skills, and then offer those skills, in a free market, to others who have a need for their services. Just as with any other exchange in an open market, the doctor and the patient voluntarily enter into a relationship which they individually judge is mutually beneficial for both parties. The doctor chooses to exchange time and knowledge for the patient’s funds, and the patient chooses to exchange their funds for valuable health care. The doctor no more “serves” the patient than the patient “serves” the doctor. Each one engages in the exchange in order to serve their own ends. The beauty of the free market is that this is a win-win situation for both parties.
But when we say that a “doctor serves their patient”, we either consciously or unconsciously introduce the altruistic concept that a doctor, in some way, owes a moral duty to their patient, and that a patient’s health care needs are somehow a claim upon the doctor or society. In a free society based upon individual rights, each person is an end in themselves and no one may properly lay a moral claim upon any aspect of their life or property. If you wish to successfully overturn Obamacare, then this is position that must be articulated. In this battle, we are not simply fighting for the rights of the medical profession, or the rights of patients. Instead, we are fighting for the rights of every individual in this country to retain control over the purpose and course of their own lives — rights recognized by both the Declaration of independence and our Constitution. Let’s be crystal clear about this, and not muddy the intellectual waters by using terms that allow the opposition’s philosophy to sneak in the back door and undermine our efforts.
When we rail against nationalized healthcare, what we are fighting one small skirmish in the battle FOR individual rights and personal freedom.
Regards,
–
C. Jeffery Small
Serving the patient IS the product C.J.Small.
Always has been.
Spindok
Thank you for bringing attention to the grass-root physician’s group Doc4PatentCare. After spending this week with several leaders from this group, working at the scientific conference of the American College of Surgeons, I am impressed by the level of passion and integrity these physician have for preserving independent medical decision-making for doctors and patients. The desire to preserve the sanctity of this relationship drives them to spend their time and money fighting government intrusion into their practices, knowing only too well that quality medical care is impossible when individual patients are sacrificed to the “needs of the masses.”
Additionally, D4PC supports realistic, freedom-respecting alternatives to the top-down central planning of ObamaCare. These recommendations include equal tax treatment for medical expenditures, competition across state lines for insurance companies, lowering of healthcare price inflation by removing government obstructions to market competition in both medical insurance and medical care, as well as the need for serious tort reform.
It’s great to have an alternative to the majority of medical organizations who are currently cooperating with — if not outright supportive of– the government take-over of medicine.
The Left is always saying that we on the Right shill for Big Business but it disgusts me when business sells out American citizens in misguided attempts to protect themselves. CEO’s and other executives come and go but they will always be American citizens subject to the same legislation as their lowliest employees after they leave their employers so why do they support policies that are bad for all Americans including themselves, their employees, their families, and their shareholders? I will ALWAYS place my personal interests above those of my employer no matter how high I may rise inn the food chain because I know that one day I won’t be CEO and that my kids and grandkids probably won’t be the CEO of my company.
The ONLY way to make corporate America act in the best interests of America is to reform the tax code. For all the demagoguery against “special interests” in Washington there would be a lot less lobbying if we could dramatically change the tax code. Companies only lobby to protect themselves from taxation or legislation. And that protection costs money and that money goes to members of Congress who revel in their tax code created power.
If the federal government’s power to meddle were severely curtailed then the support for Democrats would dry up overnight.
If you REALLY want to reform DC the place to start is with the tax code.
Many are predicting that if Obamacare proceeds without being repealed the result will be fewer doctors. That scenario makes the optimistic assumption that in the future we will require doctors to be competent.
I can imagine a different scenario. The intelligent and the competent will be driven out of the medical profession, as others have said. The government takes over the health care system lock, stock, and barrel. But they need more doctors, and the smart, competent people are not applying to med schools in sufficient numbers. So the government forces the med schools to loosen their requirements for admission and for granting of degrees. This fits hand in glove with another trend in higher education these days, namely putting pressure on universities to admit students not based on merit, but rather on “diversity”, i.e. quotas based on race, sexual identity, etc. Moreover, real science is given a back seat in favor of politically correct diktats. It will be like the old Soviet Union. So in this scenario we will have plenty of doctors, all with shiny government approved degrees, but they will be illiterate, incompetent, ill-paid, and dangerous. People will weigh the alternative of seeking medical advice from their veterinarians rather than their government run clinics.
When I was walking into a high school gym to vote for Governor last November (Virginia’s Bob McDonnell steamrolled opponent Creigh Deeds), a senior citizen with an Obama shirt and wearing a Deeds button asked if I’d like a sample ballot for Deeds.
I stopped and looked at this friendly yet frail man and asked, ‘How can you wear that shirt and button and KNOWINGLY consent to those 2 removing health insurance options from you and me’, all the mean while RAISING our rates in the near future for less health benefit?
Sadly, deer in the headlights was his response.
The biggest oxymorons and foot-in-mouth comments IMO as of recent is ‘Progressive thought’ ‘..the stimulus is working’ ‘..most transparent administration..’ ‘We will spend our way out of debt’ ‘..pass the Bill to see what’s in it’ ‘..Nevada’s unemployment and nation’s economic woes aren’t my fault (paraphrased)’ ‘I’m not an ideologue’ ‘I don’t believe affirmative action is being abused..’ ‘I’m for small businesses and the private sector’ etc etc.,
Maybe a government option looks pretty good to a lot of docs. What choices do you have?
You can sign on as a hospital employee, maybe in a big mega corp such as Mayo clinic. You are limited in that you need a baseline productivity output set by contract. You get bonus if you see more patients faster or generate RVU revenue by doing more procedures. If you sign on well you have some security.
You can go with the ever shrinking number of traditional private practices. Then you deal with the really rough seas. Hospital can cancel you at any time. Your partners may have different interest than your own. You need to deal with the business of negotiating insurance contracts and a Hospital management which may not invest in the new equipment or facilities you need to develop to stay on top.
You can go with a government job. Right now there are not many of those except some County hospitals or VA type jobs. These can offer some benefits such as good retirement plans and generally smaller quotas. Good job security and benefits and most often better lifestyle at the expense of some income. Teaching type University equivalents are hard to come by as those places must generate enough revenue to be self sustaining or profit centers.
I think medical economics is a part of the larger economic picture. Demand is unlimited so when times are good there is more to spend.
What is missing from this discussion is medical science and art. Medicine itself cannot ignore the contradictory pull of economics and the desire to attend to the patient irrespective of cost or income. Economics I can deal with. Politics is another matter. Politics are fickle and emotional. The last thing you want to think about when Mrs. W., age 42 asks “well how often should I get a mammogram? I have been reading a lot about it in the news”.
People talk about “shiny government approved degrees” Yet every Nurse, PA, Physical Therapist, MD, whatever, many others in the field, has exactly that right now as their basic trade. Nothing new in the fact that government grants the license and good luck without one.
I think the government missed chances on political considerations. Medicine can survive and people in it can do what they started out to do, by sticking to science and art. Economics and politics will take care of themselves.
Spindok
Explained below is why America has the Party of Food Stamps:
http://canadafreepress.com/index.php/article/28467
Isn’t the combining of big industry and government called FASCISM?