Comments on: How President Obama can fix health care immediately

By: Dr. K

Dr. K — Fri, 07 Nov 2008 15:02:00 +0000

Driving down the costs of healthcare is paramount to increasing healthcare accessibility and providing quality healthcare to every American. As long as the healthcare industry remains “for profit” this will not take place. We have the most expensive healthcare system in the world and we pay more for prescription medications than any country in the world. The healthcare industry survives by showing a profit to its investors and in order to do so they must deny care or increase the number of unneccessary procedure. I believe we are on the verge of a collapse of the healthcare system similar to what we have just seen with the financial system. For more discussions on similar topics, please visit my blog at http://www.takingcontrolofyourhealthcare.com.

By: BloggerPal

BloggerPal — Fri, 07 Nov 2008 08:14:00 +0000

Obama’s victory was very momentous yet very challenging. He has to inherit a country at its great depression. Healthcare is one of the challenges Obama shall be facing come January 20. We should do every way possible to uplift the healthcare services in this country.

By: Anonymous

Anonymous — Thu, 06 Nov 2008 20:41:00 +0000

Doc99…evidently you don’t know how the SGR works. I recommend a little google time.

The short answer to your question is this: All of them.

By: Doc99

Doc99 — Thu, 06 Nov 2008 18:01:00 +0000

Sorry Anon … but 20% increase?! I’m seriously laughing at that one. And which imaging procedures will be cut 20% to make up for this? Covering Mammograms only every three or four years?

By: Matt

Matt — Thu, 06 Nov 2008 16:01:00 +0000

As a brand new Pediatrician, starting out this past July, I have to say my gut tells me to watch out. I think Anonymous at 8:02pm is right on the money: why do we as a profession seem to enjoy being martyrs to a cause? Why do we have to accept that ‘we’re not in it for the money?’ Why can’t we fight and vote appropriately and demand that as elite, well educated, hard working professionals we deserve to be paid well? And I agree with Dr. Johnson: loan repayment is not an incentive. A bright future for the business side of primary care IS. It is an incentive for me. It is an incentive for the young people at the top of their college classes right now considering the question, ‘do I want to go into medicine?’
I am particularly worried, as a pediatrician, that there will soon be a government run coverage system that will undercut the private insurers who are, right now, what keeps the incomes of my collegues reasonable. If reimbursement shifts toward the medicaid model, there will be a lot of pediatricians pulling their hair out worrying over the payment on their stinking toyota corollas. Not me, I’ll just go back and subspecialize because I still can. Or maybe I’ll just go to law school. Or maybe, just maybe, we as a profession will draw a line in the sand and refused to be devalued any more then we already have been. The politicians, the rest of society, they wouldn’t mind one bit if it was all just free. I wouldn’t mind if law advice was free but it isn’t. Obama is a democratically elected president and by definition he is interested in pleasing the largest number of people. In case anyone forgot, physicians are an elite minority. Nobody out there is really interested in our well being. I think its time we take the valuable assets we offer and demand decent wages for them like every other businessperson and professional in America insteading of crossing our fingers and hoping for the best, as we lay our heads down after another 40 patient day.

By: Anonymous

Anonymous — Thu, 06 Nov 2008 15:16:00 +0000

Disagree with Doc99…the fundamental misconception you have is that upping 99211-15 will increase the costs to taxpayers. With the SGR, this is false. Increased funds for cognitive services will be paid for by decreased payments for procedures and imaging…a much-overdue payment reduction which is, in my opinion, even more important to the future of primary care.

Remember, procedurists and imagers have a great political motive for keeping cognates relatively poor…it’s the cognates who can’t accept Medicare beneficiaries if the annual SGR override doesn’t pass. Without this threat, there’s nothing to stop SGR cuts from actually kicking in. No way in hell a gastroenterologist is going to stop colonoscopizing 70-year-olds, even with a 20% pay cut…the money is still too good.

By: Doc99

Doc99 — Thu, 06 Nov 2008 13:18:00 +0000

Sorry to burst your bubble, Kevin, but no way is CMS upping reimbursements 20% for anything. If you think this will happen, I humbly suggest you give up smoking rope. Moreover, IT will not end medical errors and will undoubtedly result in yet more unfunded mandates for American docs. We are so screwed.

By: Kevin

Kevin — Thu, 06 Nov 2008 04:33:00 +0000

Deron,
Medicare doesn't cover routine physicals, so the 99394-99397 codes are not applicable to any type of government action.

Unless they start covering physicals of course.

Kevin

By: DR. MARY JOHNSON

DR. MARY JOHNSON — Thu, 06 Nov 2008 02:42:00 +0000

Deron, respectfully, my "personal situation" is ten years old and began on the Democrat's watch (Bill Clinton/Jim Hunt).

I've worked nearly 40 assignments since what was done to me in my own hometown. Believe me when I tell you that the problems I speak of are UNIVERSAL. I have watched different people/groups/institutions make the same sad/sorry mistakes over and over again - most of them devaluing the doctor - some of them endangering the patient.

In that same time period, I've heard countless speeches by well-meaning types like Barack Obama on "change" and "ethics" and "reform" . . . and I simply do not see it happening . . . especially in North Carolina.

Talk is cheap.

Here, Kevin suggests that loan-repayment-for-primary-care (or public service) is some kind of magical answer . . . or a new idea . . . and it is NOT on either count. These programs traditionally treat the doctor as if he/she is an indentured servant. They are also a revolving door.

The campaign is over and it's time to leave the "we can't be negative" act at the Oval Office door. Obama is not going to get anywhere if the only people he listens to are "yes" men and women.

It's time to get real.

In terms of "developing solutions" it also seems to me that it would be very "productive" for some of the young guns of medicine (many of whom, like Kevin, probably voted for Obama) to listen some of us who have been burned (in my case, very badly) . . . and learn from those experiences. Moreover, in order to work together, I believe that the businessmen now in the equation of medicine MUST learn how to respect the doctors that they have for so long treated like pawns on their personal chessboards to profit.

Unless this happens, and happens soon, Anon 8:02 is right on the MONEY about the practice model Kevin voted for.

By: Anonymous

Anonymous — Thu, 06 Nov 2008 01:02:00 +0000

You should be ashamed of yourself Kevin. All you have to do is surf the internet a little to see what democrats actually think about us rich, overpaid doctors (this includes ALL doctors). There is no need to increase payment to primary care physicians when there is already a flood of nurse practioners, nurse doctors, and pa s coming into practice each day.

Mark my words. You may be rewarded in the short term marginally, but in the long term you will be replaced. 5 nurse practioners with one physician overseeing them. That is the practice model you have voted for.

PS: michelle obama has been a health care ceo already. you don't hear about many bold steps she took to help out physicians do you?

I just regret that I am in the only profession in the country that repeatedly shoots themself in the foot. I don't know what more to say, except when the law of unintended consequences comes to roost I want you to write a big opinion piece about how you were warned over and over. This will not be Obama's fault, this will be on you. As a previous poster mentioned, Obama has already broken his word on campaign finance reform that he made in national debates. What will stop him from not fulfilling these promises (most of which you seem to infer that maybe he will due out of the goodness of his heart) that are written in journals that no one reads except a small percentage of doctors.