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Forced collectivization of the health care kulaks via single payer is inevitable under Obamacare

Forced collectivization of the health care kulaks via single payer is inevitable under Obamacare

The Revolt of the Kulaks Has Begun, February 22, 2009, just over a month after Obama’s first inauguration:

In the end, as must all economic redistributors, Obama either will have to resort to repressive measures, or he will have to abandon his redistributive plans.

The great Obamacare reform is turning into the great thrust of tens of millions of people onto Medicaid.

The problem is, fewer and fewer doctors are willing to take Medicaid patients because the reimbursements are so low.

I have met numerous doctors who tell me they either refuse Medicaid patients or restrict them because the reimbursements do not cover their costs.  They also double and triple book, because so many Medicaid patients who make appointments don’t show up.  As to Medicare the payments currently are bearable, but only because private insurance payments for other patients make up the shortfall.

Increasingly, doctors are abandoning the government payment train wreck, and going all cash or some hybrid.  This all was foreseeable and was foreseen.

The millions of new Medicaid patients will have insurance, just no doctors to see them.   That is a feature, not a glitch, to those who want single payer.  Obamacare is proceeding accordingly to plan.

So this report (via @SissyWillis) is no surprise, Virginia Democrat Calls For Forcing Doctors To Accept Medicare And Medicaid Patients:

…. here is Kathleen Murphy, Democrat running for the House of Delegates against Barbara Comstock, telling a forum in Great Falls that she believes it should law to force doctors to accept Medicare and Medicaid patients. Forced by government decree, mind you. A birdie sent me this:

FYI last night at the Great Falls Grange debate, Democrat delegate candidate Kathleen Murphy said that since many doctors are not accepting medicaid and medicare patients, she advocates making it a legal requirement for those people to be accepted.

She did not recognize that the payments are inadequate to cover the doctors’ costs. She also did not recognize there is a shortage of over 45,000 physicians now and that it is forecast to be 90,000 in a few years.

Kerry Picket at Breitbart.com notes:

… according to the National Center for Policy Analysis, there are simply not enough doctors in Virginia to accommodate such an expansion under Obamacare:

Effect of the ACA on Virginia’s Physician Supply.

As in other states, Virginia’s physician supply is relatively “inelastic,” meaning the number of physicians cannot increase quickly to accommodate the rising demand for medical services an influx of newly insured Medicaid enrollees would create. Virginia physicians have little if any capacity to expand the number of patients they treat. Currently, there are about 29,472 physicians in Virginia, of whom an estimated 22,215 are actively involved in patient care.12 About 85 percent of Virginia’s active doctors work full time – so there is little excess capacity.

According to the Virginia Department of Health Professions Healthcare Workforce Data Center, two-thirds of Virginia’s active physicians are more than 44 years of age, while 20.1 percent are 60 or older.13 Thus, many of these physicians will retire in the next few years. A number of economic studies indicate the newly insured will nearly double their consumption of medical care.14 Yet the demand for health care will continue to rise. Furthermore, an aging population will require more medical care. Across the U.S. 78 million baby boomers are either retired or headed that way in the next decade.

There really is only one way out of this mess for the government.

If there is only one payer, physicians must submit or quit.

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Comments

Dark days, indeed. Make your plans, people.

I’m all for the direct to doctor pay system, cutting out insurance altogether.

I’m sure most doctors would reasonably support a long or short term loan to cover the costs, with patients being able to pay catastrophic costs through a monthly payment plan that would be about the same as insurance premiums, but unlike premiums, would eventually end when the loan was paid off. Alternatively a cash up front payment option would be about as much as most current (obamacare) deductibles, so it simply save the payment of monthly premiums altogether.

Here’s an example of a cash only surgery center:

http://www.surgerycenterok.com/

I hope they are able to sustain their business via this means, because the other option “Gingle payer” will destroy the quality of healthcare ever after.

Even if we decide to go to a single payer, which I don’t think will ever happen because the insurance has a heavily entrenched lobby, then doctors will still have a choice. That choice will be to stop being a doctor. The government can never take away choice, as much as it might like to.

    Rick in reply to Shane. | November 3, 2013 at 11:19 am

    But how diminished America would be.
    I don’t love doctors, but I love their meaningful choice to become doctors and for those who can to excel.

    JOHN B in reply to Shane. | November 4, 2013 at 7:44 am

    I tend to remember the Soviets testing school children and sending them to various school to become whatever the Soviets decided.

    Do you really believe that those currently in power wouldn’t want to do the same thing?

    They will order people to become doctors – or else. We will get Soviet-quality doctors.

      Henry Hawkins in reply to JOHN B. | November 4, 2013 at 12:04 pm

      They already test and steer children academically and vocationally, it’s just not on the basis of applicable merit. It’s based on ‘diversity’, aka identity politics.

Who says democrats don’t believe in slavery?

I saw that on Drudge this morning and came to see if you were addressing it, and was glad to see you are.

I also read this morning about Bond vs US, I hope is next on your agenda to discuss:

The Obama administration is arguing that if the United States enters into a treaty, the federal government can enact laws to implement the treaty that would otherwise be unconstitutional.

So the question in this case is whether the Treaty Clause of the Constitution somehow empowers the federal government to escape the Constitution’s limits on federal lawmaking authority. It is a very important case on the scope of reach of federal power, with implicating for proposed treaties on gun control, limits on parental authority, and state sovereignty.

    Musson in reply to betty. | November 3, 2013 at 11:00 am

    Betty,

    Because the US is signatory to agreements that implement treaties after they have been signed (and before they are ratified by the Senate) the Feds can begin implementing treaties as if they were the law of the land almost immediately. These treaties are legally binding until they are rejected by the Senate or repudiated by the President.

Under their licensing authority – States can require this – just like the State of Vermont has chosen to implement single payer. The Federal Govt cannot.

    It’s a tax.

    –Andrew, @LawSelfDefense

      The three letter word no one in LSM will say. The so-called penalty is a TAX! I hope everyone on this blog clarifies this in all conversations!

      “According to Chief Justice Roberts, the penalty is merely a tax on not owning health insurance, no different from “buying gasoline or earning income,” and it thus complies with the Constitution. This a large loophole. The result is that Washington has unlimited power to impose new purchase mandates and the courts will find them constitutional if Congress calls them taxes, or even if it calls them something else and judges call them taxes.”

      http://online.wsj.com/news/articles/SB10001424052702304058404577494400059173634

      All states have to do is make acceptance of certain groups of patients a requirement to hold a medical license. They can already do that. I expect you will see several states making this a requirement before too long.

Even in “single-payer” systems, there remain other options for both providers and patients.

Those include “black market” (which is to say “free market”) providers, alongside private providers who simply do not work in the system the government supports.

I have lived a long life, raised a large family, and never had insurance at all. I currently pay cash to my (same aged, non-conformist) doctor, who will not submit to ObamaDoggle, and will not be sending my records to the ObamaDoggle maw.

The day will come when I cannot afford treatment for some malady. It isn’t anywhere on the horizon just now, but “nobody gets out of here alive”.

Before that happens, I hope to see the day when a free market in general health care is allowed to bring people the same innovative care that we see in areas that are NOT much subjected to third-party payer distortions, such as Lasik and other kinds of eye surgery, plastic surgery, and veterinary care. These provide models of how our entire system could work, if market forces were allowed to flourish again in health care.

    But wouldn’t that be UNFAIR!?! as you can (presumably) afford to buy yourself ‘better’ healthcare than the other good comrades can afford?

      Ragspierre in reply to Paul. | November 3, 2013 at 1:34 pm

      I guess “unfair” in the sense that my health has been remarkably good, as was my family’s. Not that we had no crisis times.

      But my income and needs are both quite modest (by design in both areas…some Galtish tendencies). I lack for very little, smoke good cigars and drink good booze. I eat what I want, which is a pretty “paleo” diet, and I shop like the Scotsman I am by heredity.

      PLUS I do contribute to the many little ad hoc charities one finds in my ruralish area, where a child has a liver disease, or a teenager has leukemia. Just like millions of other Americans. IF we were left more by our governmentssss, we could and would do more.

      I have no concept of “retirement”. I will never take Social Security (as a very small bequest to my children and grandchildren). My ‘estate’ consists mostly of tools and whatever example I have set and whatever truth I have taught.

    Carol Herman in reply to Ragspierre. | November 3, 2013 at 7:16 pm

    Maybe, because I live in Southern California, I’ve known dentistry is a thriving business “south of the border.” American trained English speaking dentists and doctors. As long as it’s elective, you can choose another route, not just your local hospitals with their inflated prices. And, tests you don’t need.

    Now, 10 years ago I heard that people would fly into LAX. With their medical records. And, head for Harbor Hospital. Because hospitals must treat you. They weren’t asking for payment, first.

    It’s one of the reasons moms take their babies to emergency rooms. The downside? No medical records. So often-times vaccinations are given again and again. And, hospitals didn’t complain … because they started charging astronomical fees!

    There was what to fix. ObamaCare doesn’t even come close! No other country does it as expensively as us. And, no other country expects your record to be the size of a telephone book. (Of course, first came the lawyers. And, the fears that if you didn’t run tests … the lawsuits just came flying in the door!)

    Ever hear of “slap suits?” Every single professional name in a case that was brought to lawyers … got sued. Even if they were nowhere near the patient when whatever “went wrong” went awry. Yours was just a signature. And, the lawyers came loaded for bear.)

    I don’t think its in any politician’s blood to solve this one.

We started selling our Commie Obama hats back in 2008. They were meant as a joke. It is amazing what has come in just 5 years.

I had several Obamao teeshirts made. They will come in handy,

I’m not a professional politician and I don’t play one on TV. So how come I knew this five years ago and 90% of the GOP still doesn’t know it today?

    JohnG in reply to raven. | November 3, 2013 at 1:30 pm

    The establishment GOP knows it – they’re part of the problem.

    Carol Herman in reply to raven. | November 3, 2013 at 7:22 pm

    Mitt Romney was a terrible candidate! Yesterday, Drudge ran with a book, I think it’s called “Double Down.” And, it doesn’t portray Romney in a good light.

    It seems he set up an office (super duper secret. Except now it’s in a hardcover book). Telling how Romney had 10 to choose from. And, that he “played” with Chris Christie.” But ended up choosing Ryan. Who brought him NO votes!)

    The GOP has some good people. Some were among the ten Romney considered. Before choosing Ryan. Which only goes to show ya … when the GOP contendah couldn’t even figure out the playing field!

    Chris Christie would have cleaned Obama’s clock!

Remember, too…

There were multiple BIG LIES that presaged all this ObamaDoggle.

Like…”our health-care system is broken, and MUST be fixed”.

Or, one of my favs…”X0,000 Americans die every year because they cannot access health-care”. (Which means that Obama killed x0,000 times 4 years by ObamaDoggle design.)

Or (some price-controlled) health “insurance” = health care (as noted above, it doesn’t).

The crisis…to the extent there was one…came as a result from market distortions starting with FDR wage and price controls during WWII. THAT saw the beginning of employer-provided health insurance as a perk to being in employees that could not be lured with good wages.

Remember HMOs (since a bogey man failure)? Ted Kennedy was their author, I seem to recall with wage-and-price control Progressive Nixon.

And, it bears repeating, YOU can stop ObamaDoggle by joining me and millions of others.

Do. Not. COMPLY.

Huckabee had three doctors on his show last night; one chose to stop her sole practice altogether, feeling she had lost the quality doctor-patient time; one doctor said she doesn’t accept Medicaid or Medicare, and the third, while now taking both, said the reimbursements are so low she sees nothing but more doctors refusing to take Medicaid and Medicare. All agreed that the new coding for ACA is so convoluted and cumbersome it requires as much as 25-30% of their time to do paperwork, or pay someone full time to handle it. It’s a segment worth seeing. I’d link to it here but it’s not up on Huck’s site yet.

http://www.powerlineblog.com/archives/2013/11/ny-times-editorial-board-hacked-by-the-onion.php

Yes. Obama “misspoke” like the murder defendant who claims his victim accidentally ran into the knife.

Twenty-four times.

In the back.

The left loves indentured servants. Notice how ‘mad’ Obama really is about all the healthcare.gov woes? How ‘hard’ he’s working to ‘fix’ them?

I became a physician for two reasons: 1) the intellectual challenge of learning medicine, and 2) a desire to help people. The melding of the two in applying acquired knowledge and judgement in the care of patients was a source of immense joy and satisfaction for a while. My time is now split about evenly between the practice of Medicine and the practice of Bureaucrat Satisfaction. What’s really sad, from my in-the-trenches point of view, is that so much of the immensely expensive bureaucracy already in place contributes absolutely nothing to the well-being of patients.

    PersonFromPorlock in reply to Daiwa. | November 3, 2013 at 12:48 pm

    So why don’t you doctors do something about it? Tell the bureaucrats to stuff the paperwork and if they don’t like it they can doctor themselves?

    You do have a powerful threat at hand if you’re ruthless enough to use it – as ruthless as the government otherwise will be in breaking you to harness.

      *sigh* The doctors I know are not politically involved, and they do not contribute to political parties.

      JackRussellTerrierist in reply to PersonFromPorlock. | November 3, 2013 at 1:47 pm

      You make a good point. If doctors wanted to exercise their power, they could do so through non-compliance. They would have to find ways to raise revenue due to the absence of government payments, but, through attrition, that could be done.

      Just say no.

        Not really. I’m a doc at a University practice. My ability to practice non-conformance is virtually zero — I and my colleagues at the university all do in the end what the Dean and Department Chairs say we have to do. Don’t like it? There’s the door. And there’s always someone to take my place. Always.

        What I do at the university I truly enjoy (patient care, teaching, translational research) so I’m more likely to grind my teeth and do as I’m told.

        Sorry, I guess I’m not that strong. You may choose to scorn me.

        Some docs, particularly in solo practice, will walk away. With regard to the numbers of docs in Virginia: first I’m amazed that 25% of docs with an MD don’t practice at all, and that of the remaining ones, 15% are part-time. So indeed, if a relatively modest number of community MDs practice non-conformance (or quit, or go part-time) there’s no way all the patients can be seen.

        How might the State (fed and local) respond?

        1) allow more foreign MDs in. I work with and have trained foreign MDs. They’re good people and they’ll work hard. A practice on the south side of Chicago beats a practice (and the risk of being killed) in Peshawar.

        2) allow more NPs and PAs. They’ll work under the new guidelines; life won’t change much for them. And truth be told a LOT of what family practice and general internal medicine docs do in community medicine can be done by NPs. You’ve seen the drug-store NP kiosks, right? There’s the future of medicine under ObamaCare. For a lot of routine health care, if the ACA uses NPs and PAs as a safety valve they’ll get away with a lot of nonsense.

        3) mandate service in return for a medical license. The feds can ram that through ObamaCare/Medicaid funding to the states and the states will go along — they always do. You want a license, you agree to their terms. That’s the power of a state license, be it for medicine or for barbering.

        4) aggregate medical care into larger entities. See above how I’m required to do as I’m told. Get more docs into larger corporations/practices/accountable health organizations, etc., whatever, and you have power over docs. It works.

        Obama, Axelrod, ValJar, Emanuel and the rest couldn’t possibly have a better plan to wreck American medical care and rebuild it in a socialist, soviet model than the one they have now.

          InEssence in reply to stevewhitemd. | November 3, 2013 at 7:59 pm

          You could add deregulation to your list. Doctors don’t need to be filling out paperwork all the time, and more people should be allowed to practice medicine. Many people are going into health care, and we should make it easy for them to become a doctor. We could cut 90% of government regulation and achieve a better health care system. For a perspective, I have designed a couple of medical devices that were received well.

          snopercod in reply to stevewhitemd. | November 3, 2013 at 8:11 pm

          “mandate service in return for a medical license.”

          So your plan is to turn doctors into indentured servants of the federal government? Sorry, but I’m strongly imposed to that on moral grounds. Allow me to quote a passage from Atlas Shrugged:

          “I quit when medicine was placed under State control some years ago,” said Dr. Hendricks. “Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I could not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything—except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, but ‘to serve.’ That a man’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards—never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness at which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind—yet what is it they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”

          PersonFromPorlock in reply to stevewhitemd. | November 4, 2013 at 8:16 am

          Mea Culpa, I wasn’t clear: by “doctor themselves” I didn’t mean ‘stop treating everyone’, I meant ‘stop treating federal employees’, specifically federal employees above a certain pay grade. This is do-able with some coordination and courage, and the moral justification is preserving the quality of care for everyone else. If state boards interfere, the “doctors’ strike” can be extended to state functionaries, too.

          You do have the power if you’re willing to use it.

          Clinics in my county have stopped accepting new patients. Period. I think they are doing that to avoid the Medicaid influx.

          When you think you are not strong enough to do what is right for fear of thuggery, look to Chick Filet and Hobby Lobby as an example. They risk it all to do what is right.

          Phillep Harding in reply to stevewhitemd. | November 4, 2013 at 12:32 pm

          25% of the MDs don’t practice? What do they do?

          (This would help explain the number of Dr’s who support Obamacare, though.)

      So why don’t you doctors do something about it? Tell the bureaucrats to stuff the paperwork and if they don’t like it they can doctor themselves?

      A group of doctors from New Jersey tried that back in the early sixties when Medicare was crammed down their throats. The government threatened them with prosecution. Does anybody believe that won’t eventually happen to doctors who refuse to take Medicaid patients? Oh wait, it already has…

        PersonFromPorlock in reply to snopercod. | November 4, 2013 at 10:03 am

        A group of African-Americans got thrown in jail for occupying segregated lunch counters back in the early Sixties, too.

      There is a very simple answer to that question, one that entirely explains why/how we got to where we are and why we have no leverage: we care too much about our patients. True to our ideals, we won’t sacrifice their needs. It’s why all of this was inevitable the minute direct third-party payment became acceptable. The third parties, especially the feds, have all the power and they know it.

Humphreys Executor | November 3, 2013 at 12:38 pm

A family practice doctor I know says the new electronic records keeping system imposed on him means he has to take more time with each patient, meaning he can see fewer patients each day — yet another hit on his bottom line. Say good bye to your small practice family MD. Its death by a thousand cuts.

My mom worked a lot of years in Patient Affairs for the US Air Force, so she is accustomed to reading and interpreting medical forms. My dad is retired Air Force, she’s retired civil service, so they have good coverage through a combination of Medicade, VA benefits, and their own medical policies.

They’re both in their low 80s, and have medical conditions that are being treated by specialists. She’s seen what specialists are being paid for sophisticated treatment, and she wonders why anybody would bother to to work for Medicade reimbursement.

This is a separate issue from how to deal with this mess. Both of my parents are Democrats, who think that Obama hung the moon and that those mean ol’ Republicans are responsible for most of the ills in this country. No kidding.

The Repub message is not getting through, probably because what they have been saying for the last 4 years simply hasn’t been reported, except through the distorted lenses of their political enemies. This is a HUGE problem.

So, in addition to my comments, here is an outline for one of the many Republican market-based proposals that is more likely to expand insurance coverage to the currently-uninsured in this country, without the seismic effects of Obamacare:

http://www.washingtontimes.com/news/2013/oct/22/carson-a-better-alternative-to-obamacare/

If you listen to Democrats say what they like about Obamacare, this proposal includes those points Democrats really say they want.

“It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.” Adam Smith

What is proposed is forced benevolence of doctors for politicians own interest.

In four years, Obama will be free to play golf, jet around and give speeches (his first love) for hundreds of thousands of dollars each. He will have a security detail, lifetime healthcare and a fancy new library that rich donors will run to fund. He’ll definitely live the good life. He doesn’t care about a poor presidential rating, he doesn’t care about the American experiment. He’s running his own experiment.

These politicians are non-empathetic ultruists, they disregard that the use of force is a moral issue, and that it takes precedence over their self proclaimed moral good intentions. If I am forced to do something for you against my better judgement I probably won’t do a very good job.

The government will solve the doctor shortage the same it it “solves” all sorts of other problems. It will create subsidies for people who want to study medicine. When this doesn’t work (because med school is hard) it will simply lower standards so that people who would not normally be considered doctor material will be able to do doctor stuff for lower wages. (California is already on this road).

Everyone will then have ready access to medical professionals of all kinds – except the competent kind.

Yet, congress will still want good doctors for themselves. So they will set up a special system where those who are actually skillful at medicine will be treated well and paid well and their (few, well-connected) patients will get excellent care.

Welcome to the Union of Soviet Socialist Republics circa 1972.

Midwest Rhino | November 3, 2013 at 1:01 pm

Just spoke to my nephew doc, who said Medicaid pays one fourth what Blue Cross pays. They have a few at his group, but I’m guessing they may even lose money on them.

So what lowered standards will be required to fill the doctor needs? Doctor assistants can help, but they like to make good money too.

Fraud and abuse of the system doesn’t get addressed, which perhaps lobbyists consider a feature, not a bug. They needed some oversight, but insurance companies have been turned into tax collectors, forcing large tax payments commingled with “New Improved” insurance bills.

Concierge medicine may expand, but they will need hospitals from which to operate. And surely Obamacare will look to make that illegal next, claiming it’s another capitalist scheme of “the rich”.

“Your electricity rates will NECESSARILY skyrocket”
Your health care costs will skyrocket
Government control will skyrocket
Lobbyist control of DC has skyrocketed

Obama is only good at tearing things apart with his language of hate, redistributing to his clan, and making golden promises of rainbow unicorns in some future commie nirvana … after the destruction and fundamental transformation destruction of America the Beautiful. But the Democrat history indicates we will instead become a giant Detroit.

We are reaching a breaking point in the advancement of Communism. “They came for the doctors, but I wasn’t a doctor …” Rest assured that Hussein welcomes this. He needs to purge the doctors who refuse to go along, who refuse to just give grandma a pill, or refuse to finish her off. It’s similar to the anti-intellectual purge of the Soviets.

I suspect this is where the illegals come in. They will be granted free tuition to medical schools and will eventually replace the doctors we’re losing now (h/t Irv’s comment). They will do as the gov’t commands.

Will there be enough outcry about what Obama is doing to the doctors? It is the end of health care, of course. But it is the first systematic purge of intellectuals who refuse to go along. Who will be next?

    JackRussellTerrierist in reply to JerryB. | November 3, 2013 at 1:56 pm

    If we remain on our knees, which is where we are now, we deserve whatever we get. It is time for the brave to stand up and each drag a few cowards along with him to the front lines, if for no purpose other than to be used as cannon fodder while the brave and those of us who will, do.

    And when will you man up and fight back? refuse to comply? Or will you hang your head in shame when others win this thing without you and you realize you did nothing to advance freedom?

“… going all cash or some hybrid.”

I’ve gone hybrid. Recently my empoyer-provided insurance was changed (received a letter with the lovely reassurance our new plan was in compliance with the new Obamacare law) and now all UCLA affiliated medical groups are excluded.

I lost my doctor of 12 years located just a few blocks away and my children lost their pediatrician of 12 years, also a few blocks away … as both doctors are in UCLA medical groups.

Now, after visiting a couple of doctors we came to have little (almost zilch) confidence in, we finally found a sufficient one in the greatly reduced network of providers now available to us … but it is almost an hour drive to see her.

For simple things we now visit my parents’ old doctor—an elderly doctor here in town (who, of course, does not accept our insurance) and, as an old friend of my parents, he charges us “just” $100 for an office visit to write a prescription for antibiotics for an infected throat or an earache, etc.

I’d rather pay the $100 out of pocket and drive to his office in five minutes instead of spending two hours round trip driving to the other doctor with the $15 copay.

Setting aside the financial aspects of this train wreck … wait until people try to find a new doctor in whom they have the confidence of a doctor they’ve forcibly lost.

ObamaCare assumes a doctor is a doctor is a doctor.

Doctors aren’t like roses.

ObamaLaw, the next big project, will assume that a recent graduate of Martinique Medical School’s new long-distance-learning, web-based Law School is a lawyer is a lawyer is a lawyer just as Harvard Law graduate and Cornell Law Professor William Jacobson is a lawyer is a lawyer is a lawyer.

The GOP has to keep harping on the debacles of ObamaCare. But they have to, even more importantly, publicize their own piecemeal, focussed reforms to save our healthcare system.

Good grief, is there anything else in Americans’ lives where 85% of the people are happy with what they have which the government can throw out the baby with the bathwater … and then demolish the bathtub itself for good measure … because whatever it is isn’t completely perfect?

Why not start with something the vast majority of Americans hate and want to change?

LHC (who knows that our healtcare system isn’t perfect, but who’d remind Obama that no human endeavor is … and that sometimes the best approach to a problem is to improve it incrementally with focussed reforms pinpointed upon isolated shortcomings … especially when the imperfect thing you’re trying to improve is already the best and most advanced in the world)

[…] Was the plan all along by Obama and the Democrats to so systematically destroy our health care system via ObamaCare that they only option to “fix” the crisis they created would by single payer? I have already wondered about this, because we know that is exactly the goal of Obama. If so, the consequences could be even more dangerous for those of us who oppose such Totalitarian aspirations. The American people are being forced to comply with the government take over, that one Party rammed down our throats, of our health care system. Doctors may soon be forced to take on patients that cannot afford to pay for their services even with government aid. […]

Zelsdorf Ragshaft III | November 3, 2013 at 3:28 pm

What next after forcing Doctors to accept Medicare? What if the cotton needs picking? I hear the distanct sound of revolution. We need to throw off the tyrant.

Takeittothelimit | November 3, 2013 at 7:01 pm

What was astounding was watching a professional class, lawyers, vote to enslave another professional class which was medical doctors without nary a peep from the doctors.
Obamacare has made the building of doctor owned hospitals illegal, the equivalent of making a large legal firm against the law. That there is a war between doctors and their parasitic pests lawyers has been known for years. What is most amusing is that the lawyers have killed off their most productive and lucrative source of blood to suck. I wonder if the legal eagles have thought through the consequences of single payer. Lol no more get rich John Edwards types.
Americans need to refuse to comply, doctors need to hurry up and get politically savvy, and care needs to be for cash, with as an earlier poster suggested a loan system for catastrophic care.
The populace in general needs to be educated that what they had was never insurance to begin with. True insurance pays by the incident until you are made whole for the incident. Much like auto insurance or home insurance works. If your house burnt down and your policy was cancelled the day after, the insurance company still makes you whole, because you were insured when the incident occurred. Medical insurance has never functioned to make you whole after an incident. Just try having a heart attack losing your job and not being able to continue your policy. The “insurance” stops paying for your heart attack incident the day you can’t pay the monthly fee you are never made whole unless you can find some way to continue paying the monthly membership in what is essentially an exorbitant monthly bill paying club.
I am hopeful that when the whole house of cards crashes something akin to what auto or house insurance is arises, basically catastrophic coverage, and we do away with the public con that a fifteen dollar copayment and a ten dollar prescription are cheap because the little sheep or their employers pay hundreds of dollars a month to a protection racket. Doctors lawyers hospitals have all made a lot of money convincing the sheep that unless they pay thousands yearly they might have to pay the real cost of an office (what 75 to 100 dollars even if you went ten times a year thats what 1000 dollars vs 4-5 thousand you pay so you can visit ” free”) visit which the dear little sheep think is “free” because they have a policy costing thousands annually. Stupid never sleeps.

    Carol Herman in reply to Takeittothelimit. | November 3, 2013 at 7:54 pm

    This works until a kid breaks his arm. Or needs braces. Or an old lady trips at home and suddenly needs a new hip. And, perhaps, even elder care.

    Like a frog in water, supposedly not feeling anything as the heat rises; we’re watching a very long journey into this expensive hole. Today, $1000 doesn’t even cover your first night’s stay in a hospital!

    Back in the 1970’s? A room at the Ritz was about $50 a night. (Forget about Motel $6.) Hospitals charged more. (About $135 a night for a private room.) And, no matter what you want to factor in for the passage of time … You can’t explain today’s hospital bills to any sane person.

    Guess the going rate of two aspirin tablets? Now, take two every 8 hours.

    In days long ago a doctor could work with a nurse, and a receptionist. And, a bookkeeper, who sent out bills once a month to patients who owed the doctor money. (Oh. And, insurance companies used to send the money to patients. Who sometimes went out to buy stuff, like carpeting. Because they never saw a check for $1,500 all at once.)

    Today’s bookkeepers, working in medical practices, are driven crazy by the way Medicaid and Medicare reimburse! It’s like 1975 prices!

    Then you hear about the malpractice policies! An obstetrician can face a $100,000 bill (or more) for coverage. Why? Babies aren’t perfect. And, women SUE!

First, there’s real life.

When Blue Cross/Blue Shield began issuing insurance coverage for doctors visits … (Circa 1976) … A visit to a gynecologist cost $15. (And, women expected the office staff to fill out the form.)

You couldn’t write in “annual visit” because the patient would complain “I won’t be reimbursed.” So, staff would write in “yeast infection.” This was before the “age of computers.” Patients walked away happy. Doctors never saw the forms.

Yes, it’s important to factor in “co-pay” now. Because, among other things, it keeps people from over-utilizing the system. I learned this long ago. When a co-pay for a new pair of glasses was $5. People opted to keep what they had.

The one thing the politicians (both parties) want right now is INFLATION! They want wages UP. And, prices UP.

Sure, Adam Smith gave you all the reasons you need to know about why pricing something WRONG hurts your business.

Gas at $4 a gallon. Which it is in Pasadena. Keeps people off the roads in DROVES!

Take Halloween. There used to be a time people would drive to my area, towing along all their kids. Ringing doorbells. This year, like last year, no one came by.

My son says at work he heard a lot of people who bought candy. Yet no kids came by.

Sometimes, economically lousy times shows up where you’d least expect it.

Takeittothelimit | November 3, 2013 at 10:07 pm

Sigh…. Please see above poster’s Oklahoma hospital website check their prices. People don’t seem to understand that insurance as it is currently structured has completely distorted the true costs. Some of which are greater and some much less than current conditions. That combined with cost shifting for deadbeats have taken capitalism out of the marketplace. We have already some clinics here in Texas that are cash only pay upfront fix a simple broken arm for 5-8 hundred dollars xrays included.
What gets me is folks will happily pay 35,000-45,000 dollars for a new car and then carp because a kids broken arm cost a couple of thou.
You are supposed to have savings and live within your means and provide for emergencies. You have house insurance and car insurance to provide for catastrophic stuff.
Back in the fifties my sister was born very very premature she had an amazing doctor and hospital that kept her alive. My parents didn’t have health insurance (lol unlike today’s perpetual children my dad was 25 and my mom was 22 they were considered adults) anyway the medical bills were astronomical for the era. My dad quit college for a year and went to work the hospital arranged a pmt plan which they paid for several years and eventually the bill was paid off. Life went on it was amazing.
Another problem we have nowadays is people don’t pay their bills. They feel entitled to medical care. I had an employee recently take her boyfriend to the ER for a backache because like you know it’s free, they have to take you. These kids certainly could pay but weren’t going to.
Somehow we now have the idea that every couch pumpkin in the world is entitled to the services of someone who unlike the couch pumpkin spent years in school, interning, not to mention the cost, and of whom it is demanded that they provide their services to all at less than a night at the bar, but that same couch pumpkin thinks nothing of blowing thousands on a new car, or a Vacation at disneyland or maybe just a really fun party!
Medical services are just like every other commodity and if we had less regulation in some areas, allowing price advertising for example, while enforcing pmt for services rendered, a robust charitable tradition (thanks to the government almost all charitable hospitals have now been shut down, that religion thing you know) as well as modernizing a creaky system that prevents people from taking advantage of health innovations like getting your own lab work or MRI and did I mention true catastrophic coverage, cost would come down for everyone.
But…. And it’s a big but…… It won’t be fair. Some will save and be prudent some will live lives of poor choices, and some will be stricken by fate. It is called life in a free country.

theduchessofkitty | November 3, 2013 at 11:40 pm

This comment in response to an opinion article that showed up in the Wall Street Journal brings it into severe focus.

The article: You Also Can’t Keep Your Doctor, written by a cancer patient who has successfully fought it so far with good doctors of her trust, only to have them taken away by Obamacare. And now,as she says, “this luck may have just run out.”

The comment:

“”What happened to the US?”

An old man, a good friend of mine name Victor, from the old Soviet Union asked me that two days ago. He said Americans think that Socialism and Communism works now. He said, “I came here in the US because it doesn’t work. It’s oppressive and it suffocates the reality of individual thought from birth to death. He said he doesn’t want to see this system here in America before he dies.

He had tears in his eyes and continued to speak: “I have light by which my feet are guided; and that is the light of experience. I know of no way of judging of the future but by the past. And judging by my past life in Mother Russia, America is going down the same road to Siberian hell.“”

One point the doctor said stood out for me: “They also double and triple book, because so many Medicaid patients who make appointments don’t show up.” Medicaid is insurance for people “in poverty.” Any correlation between being “in poverty” and not being responsible enough to show up for (or cancel in advance) an appointment with the doctor? Yes, I know that not everyone on Medicaid lacks responsibility, but I suspect that a lot of the “poor” out there aren’t poor because of circumstances beyond their control, or because the man is keeping them down.

[…] Forced collectivization of the health care kulaks via single payer is inevitable under Obamacare (legalinsurrection.com) […]

I have a niece who entered med school before Obamacare was passed, finds herself looking at a playing field enduring earthquakes and tremors. She is consulting with a two-doctor GP practice that went cash-only four years ago and is doing fine. No insurance paperwork opens up a lot of space in the appt book, all of it cash-only. Office labor smaller, cheaper. No weeks or months long waits for payments from, priv insurers, federal, or state plans. She’s seriously considering it.

Watching Dr. Emanuel interviewed by Chris Wallace gave me the creeps. This guy is a Provost at a medical school, no less. Holy crap.

More Mengele than Osler if you ask me. Which is especially bizarre considering his ethnic heritage. But he’s been in the Ivory Tower ever since finishing his training in medicine so I suspect he has little if any understanding of the real world informing his ‘research’ in ‘bioethics’. Hard for me to comprehend how a Jew could embrace a medical philosophy placing the ‘good of the state’ above the needs of the individual.

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