Monthly Archives: September 2013

Freedom’s Just Another Word For Everything To Lose

September 27, 2013

Ted Cruz’s phony filibuster on September 24, 2013, was ostensibly about “freedom.” Tony Perkins of the Family Research Council said, “… the greatest threat to our faith, our families and our freedom is Obamacare”  And one internet troll complained, “Thanks to Obamacare, I’m losing all my choices?

Oh, really? And what freedoms are you losing?

The freedom to let other people absorb that $79 billion a year in uncompensated care for the uninsured?

The freedom to wait several hours in someone’s emergency room for routine care because you are uninsured and none of the doctors in town will see you?

The freedom to go bankrupt because the cost of the care for your catastrophic illness exceeded your insurance policy’s lifetime cap?

The freedom to be uninsurable because you developed cancer, lost your job and then lost your insurance?

The freedom to put a pickle jar on the local convenience store counter asking for donations for your child’s surgery because you make too much to qualify for Medicaid but can’t afford insurance on the individual market?

The freedom to stay in a soul-crushing job under a boss you hate and you would leave in a heartbeat if it wasn’t for the the health insurance benefits you desperately need?

If you are fortunate enough to have heavily subsidized health insurance through the generosity of your employer you can keep it. Thanks to Obamacare, you have additional proctections – insurance companies can’t drop you because you actually needed your insurance. So stop complaining that 30 million people will now get something you’ve taken for granted.

The Sky Is Falling! Obamacare is Coming!

A physician shortage is one of the many catastrophes conservatives claim will befall the country if Obamacare isn’t repealed.  Alyene Senger, in a Heritage Foundation Issue Brief, thinks declining Medicare and Medicaid reimbursement rates combined with obnoxious bureaucratic oversight will cause already dissatisfied physicians to retire in droves and dissuade younger people from becoming doctors. Jeff Tangney, CEO of the physician social media site Doximity, Inc., predicts we’ll be short 90,000 to 150,000 physicians by 2025 as 30 million people obtain health insurance.  The unstated implication is “You’re screwed because some undeserving, lazy moocher is getting the health care you worked so hard for, and YOU’RE paying for it.”

This is wrong on so many levels I’m not sure where to start.

 Overwhelming the system?

The uninsured have always been there but now they will have health insurance. Barring an unexpected pandemic, thirty million people aren’t going to become sick on October 1, 2014. People won’t be trampling each other in a Black Friday-like rush to the doctor’s office. More may now seek preventative care, but not necessarily.  My well-insured sister-in-law hasn’t had a Pap smear in 24 years.

 The scourge of Medicare and Medicaid?

Physicians were predicting disaster before Medicare was enacted in 1965. Ronald Reagan railed against “socialized medicine” in 1961. Now, they love it because it pays them for taking care of old people. My late father-in-law’s internist got a hundred bucks for each five minute visit.

More people on insurance means more revenue for physicians and hospitals instead of bad debt write-offs.  The same holds for Medicaid. Many physicians refuse to see Medicaid patients; those that do accept those patients out of necessity or a sense of moral obligation. More people will be eligible for Medicaid but the Feds will be throwing more money into the pot, so what’s not to like?

 Doctors leaving in droves?  I don’t think so.

The independent, solo practitioner is almost extinct. More than half of all physicians are employed by a hospital or a healthcare system and don’t have to worry about the bureaucratic headaches of private practice. Younger physicians find this attractive because they want a life outside of practice.  Employers like them because their young minds can be molded into the corporate way. Established physicians like the idea of a guaranteed salary and potential productivity bonuses.  And many, if not most, physicians will shut up and endure for the right price. Those of us nearing retirement may get out early because we’re tired, but Obamacare provides a convenient excuse for the complainers.

For the past thirty years I’ve heard physicians complain that “the practice of medicine isn’t fun anymore.” But they are also bound by the golden handcuffs. The average physician income is $259,000/year and even primary care physicians average a healthy $189,000/year.  It’s hard to walk away from all that money. Trust me; I still see a lot of luxury cars in doctors’ parking lots, including one Tesla Model S.

You will still get the medical care you need.  Everyone should.