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View Diary: Healthcare Reform: What a Week (236 comments)

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  •  Can't help but have an opinion (1+ / 0-)
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    since I've been soaking in this mess for 15 years of practice.  I truly can see both sides of the issue, but I KNOW free market has fatal flaws.

    I come from the point of view that health adds value to the society, and I take issue with the CBO estimate of what the House plan would cost, mainly because they fail to add in all the efficiencies: early detection of disease, healthy workforce, etc...

    The ONLY plan out there that has any provision for cutting costs is Medicare which is run as a trust fund.  This is subverted every year by Congress, but the mandate is to cut costs.  Such a single-payer is a nonstarter.

    It's not about my salary, dude.  I make a fair living and I have no qualms about it.  I do work for a salary, not fee-for-service.  I have other blogs on my website that cover physician contributions for your info... and you are free to look at them.  My commitment is to the community and I won't apologize to people like you for the living I make.

    "Hope and fear chase each other's tails." --Buddha

    by Grodge on Mon Aug 10, 2009 at 08:47:05 AM PDT

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    •  My mention of your salary (0+ / 0-)

      was to highlight costs.  Your profit (or salary) is a cost that goes into the total costs of healthcare.

      Proponents of healthcare bills floating thru Congresss always talk about the insurance company profits.  How about your profits?

      Worse, how about the profits of many physicians who have ownership stake in clinics that do the tests they order?  Do you not find even a hint of conflict of interest in that?  Would you agree to outlaw that type of arrangement in any and all healthcare "reform" bills going through Congress?

      We can agree that single-payer is the only real solution to cutting costs.  But short of that, I think physicians and other service providers have to be willing to cut their fees in order for any plan to be a success.  Otherwise, I believe, they are doomed to fail.

      "Those are my principles, and if you don't like them... well, I have others." - G. Marx

      by Skeptical Bastard on Mon Aug 10, 2009 at 09:03:40 AM PDT

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      •  I agree and there are laws (0+ / 0-)

        governing clinic assn's owned by doctors, with self-referrals being limited or prohibited.  These are called Stark laws, after Rep Pete Stark from CA and have been on the books and revised for over ten years.

        There are large numbers of physicians who are in favor of single payer, see Physicians for a National Health Plan and other groups.  Physicians are actually an extremely eclectic group that have the complete spectrum of points of view.  Trying to pigeonhole doctors is very hard to do.

        "Hope and fear chase each other's tails." --Buddha

        by Grodge on Mon Aug 10, 2009 at 09:31:20 AM PDT

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      •  There are many ways to cut costs (0+ / 0-)

        on the delivery side:

        - Ditch fee for service payments to doctors and pay them a set amount per patient - Reduce the payment for tests, particularly high tech tests (MRI, CAT scans, etc).  The rest of the world pays a fraction of what the U.S. pays for these tests.  An MRI is $10 in Japan. - Mandate that hospitals enact patient safety regulations.  More deaths were attributable to lax safety standards in U.S. hospitals last year than were attributable to auto accidents.  (See the current investigation of patient safety by Hearst Newspapers.)  Enforceable safety regulations would also reduce infections and mistakes in drug distribution occuring in hospitals - Negotiate down prices of prescription drugs with drug companies.  U.S. patients shouldn't have to pay more for their prescriptions than anyone else in the industrialized world.

        "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

        by SueDe on Mon Aug 10, 2009 at 10:53:28 AM PDT

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