Re: An Open Letter To All USCHO Crackpots and Knuckledraggers - by Rover
I think if 1/2 of your family grew up under the tyranny that our current president is inspired by (castro, guevara, chavez, et al) you'd be singing a different song instead of making jokes about it.
And you'd be just as worried about our future now as some of the other posters here. Today was a significant step away from the representative republic and toward the world of marx.
I can tell you with 150% certainty there are 1/10th of every person born in Cuba living here now, and of those people you're going to see at least 80% of them vehemently expressing their opposition to this, and calling it for what it is
While I now understand what you base your viewpoint on, it still is sadly out the other side of reality. I am glad that I don't have the angst in my heart that you do. What I have is a little less frustration knowing there is a possibility that before I retire I may not have to spend at least 50% of my day trying to figure out whether the patient in front of me can a) afford the most basic treatment or testing that will prevent them from having serious sequelae b) eventually will not have to strategize what medication my senior patients can most safetly discontinue when they hit the donut hole or afford even when they have coverage, c) can do an an health maintenance exam on the medicare patient without having the practice eat the cost because the pt can't afford it, d) see patients that have not had treatment for chronic illness because of insurance issues and then come in symptomatic, with permanent damage because they couldn't afford said insurance, e) spend more than half my visit helping the patient figure out logistics and cost rather than diagnose and treat what is wrong with them.
And before you start on how they will tell us how to practice medicine and direct care- the insurance companies do this in a very arbitrary way with no recourse and many times are requiring us to change perfectly good treatment plans simply because they have a deal with pharm companies for a different medication. So even if they do that (which I can't see anywhere in the bill) there would be no change.
Do I like the whole bill- no. It is going to cause a CF of major proportions because we don't have enough primary care providers to care for the population. When Mass started the insurance requirement we had an instant shortage. There are a ton of other potential problems that Mass makes a great audiovisual aid for. It certainly isn't perfect.
Access/ability to pay for care is the worst I have seen it in the 30yrs since I started school. The amount of people undertreated and underdiagnosed due to financial issues is mindnumbing. The percentage of working people that can't afford the most basic care used to be low enough that it was an anomaly that I had to discuss what they could afford, etc. Now I would say that greater than 50% of my patients part of the visit is discussing what they can afford. These are people who have worked their whole lives. They don't have the plasma TV and the big car.
I would love to see someone do a projection of cost if we kept things as a status quo. I didn't ever see that. Doing nothing would have bankrupted the system. We have a critical mass of people aging up, undertreated, undiagnosed who are a trainwreck waiting to happen. It costs a hell of a lot less to treat someone's diabetes, blood pressure than treat their heart attack, kidney failure, stroke and resultant incapacities to the tune of a few hundred thousand (on the cheap side).
This isn't socialism, it is a much more cost effective way to run things in the long run. Socialism would be providing for everyone. We certainly don't and won't. The biggest problem with the system is that you can't link profit to good medical care. There is no way to make good money without an effect on good healthcare. If you look at the best health systems in the world
for the population as a whole, profit is not part of the picture.