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rxwine
rxwine
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June 30th, 2012 at 6:08:03 PM permalink
Quote: EvenBob

I'll say it again, in case some of you weren't paying
attention.



It will be government intervention distorting the market no matter who does anything.

Romney created a mandate with a penalty (call it a tax, whatever). Same thing as we have.
There's no secret. Just know what you're talking about before you open your mouth.
weaselman
weaselman
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June 30th, 2012 at 6:37:49 PM permalink
Quote: SanchoPanza

Which doctors (other than residents, interns and the like) "have to treat" uninsured patients without pay?


Well, whoever those doctors are, they will just end up being paid for their work. If you are saying noone is doing it now (residents don't count, of course, the fact that they are paid more than an average engineer doesn't matter ... they are just slaves), that just means that nothing is going to change with Obamacare.
"When two people always agree one of them is unnecessary"
weaselman
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June 30th, 2012 at 6:40:12 PM permalink
Quote: SOOPOO

You must treat the patient regardless of their ability to pay. If you are a surgeon on call at that hospital you are likely to do the surgery for free. ... Obamacare greatly increases the Medicaid rolls, which is perhaps the main reason practicing physicians are against Obamacare.


So, you guys prefer to work for free?
"When two people always agree one of them is unnecessary"
SOOPOO
SOOPOO
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June 30th, 2012 at 7:06:21 PM permalink
Quote: weaselman

So, you guys prefer to work for free?



Nope- as I've posted many times before, places that have a disproportionate Medicaid or uninsured population would have no doctors if there wasn't some sort of subsidy. The community pays the cost for their uninsured. As the Meicaid rolls increase the subsidy must increase, or doctors will not work there. Obamacare vastly increases the Medicaid rolls. Medicaid patients have far better access to elective healthcare than the truly uninsured, thus there will be increased utilization without compensatory increased payments. I can assure you, with full implementation of Obamacare, there will be a severe shortage in my specialty. There are many reasons for this, which I have listed in other threads. Those that can afford to retire but would prefer to work at the present pay scale, will retire.
s2dbaker
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July 2nd, 2012 at 4:38:36 PM permalink
There's Always Somalia
Someday, joor goin' to see the name of Googie Gomez in lights and joor goin' to say to joorself, "Was that her?" and then joor goin' to answer to joorself, "That was her!" But you know somethin' mister? I was always her yuss nobody knows it! - Googie Gomez
weaselman
weaselman
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July 2nd, 2012 at 4:57:14 PM permalink
Quote: SOOPOO

Nope- as I've posted many times before, places that have a disproportionate Medicaid or uninsured population would have no doctors if there wasn't some sort of subsidy. The community pays the cost for their uninsured. As the Meicaid rolls increase the subsidy must increase, or doctors will not work there. Obamacare vastly increases the Medicaid rolls.



Actually, what you said before is exactly:
Quote: SOOPOO

If you are a surgeon on call at that hospital you are likely to do the surgery for free.


So, you claim you don't like to work for free, yet argue against Medicaid being extended to cover those people you have to treat anyway. It does not make any sense.

There will be fewer uninsured people, yet the subsidy must increase? That logic seems backwards.

Quote:

Medicaid patients have far better access to elective healthcare than the truly uninsured,


"elective healthcare"? What exactly do you mean by that?
What kind of "elective health care" do Medicaid patients have access too? Flu shots?

I think a more commonly used term for what you are referring to is "preventive care", and the whole idea is that it is cheaper to provide that rather than wait for a major problem to develop, that will take hundreds of thousands to treat, or a chronic disease, requiring a lifetime worth of care.

Quote:

Those that can afford to retire but would prefer to work at the present pay scale, will retire.


I really don't think it is a problem. With all due respect, there is nothing special about doctors compared to all other professionals. Yes, they are highly trained and educated, but so are nuclear physicists, and so are the docs in most other civilized countries, making several times less money. After the technology bubble, there was a large drop in computer programmer compensation, but there never was any shortage of programmers (and if a company needed a specialist in a particular area, that was not available immediately, there was never a problem to bring one over from abroad). In Massachusetts, the "dooms day" has already happened, but there is no shortage of doctors (in fact, if what I heard is true, young doctors consider it a big success to get a position in one of the larger MA hospitals).
If a bunch of rich old whales decide to retire, so be it. There are plenty of young eager kids ready to take their place.
And if there is not enough in US, there is always Canada, India, Eastern Europe ... I know what you are thinking, but there are pretty good doctors there, and yes, they will not mind working for half of your current income, probably, even a quarter will do.

And one more thing. I think one of the major problems with our healthcare actually is that we ... have too many doctors. Yes, too many. My wife has to go and see a doctor every time she gets a herpes attack to get her prescription. To say that it is unnecessary, is to say nothing. In many other countries, you can just buy common antibiotics over the counter. Even if we think our people are too stupid to allow that, why not let a nurse write the damn script? I went for a physical yesterday. The MD took my blood pressure. Really? At $500/hour?

I think, if there is suddenly a little bit fewer doctors available, it might actually be a start of some changes to the better.
"When two people always agree one of them is unnecessary"
EvenBob
EvenBob
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July 2nd, 2012 at 5:11:24 PM permalink
Quote: weaselman

And if there is not enough in US, there is always Canada, India, Eastern Europe ... I know what you are thinking, but there are pretty good doctors there



Its that what we're going for now, 'pretty good'? Forget
exceptional, forget excellent, with Obamacare, 'pretty
good' is good enough. Even my car mechanic is better
than 'pretty good'.
"It's not called gambling if the math is on your side."
weaselman
weaselman
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July 2nd, 2012 at 5:13:17 PM permalink
Quote: EvenBob

Its that what we're going for now, 'pretty good'?


I just did not want to hurt anyone's feelings. But when I said "pretty good", I meant "way better than many you find here".

Quote: EvenBob

Forget exceptional, forget excellent


Yeah ... I am afraid, that train has departed long time ago, probably, even before Obama was born.
"When two people always agree one of them is unnecessary"
EvenBob
EvenBob
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July 2nd, 2012 at 5:20:36 PM permalink
Quote: weaselman

I just did not want to hurt anyone's feelings. But when I said "pretty good", I meant "way better than many you find here".
.



99.9% of doctors are in the profession because of the money.
They make more money here than anywhere, far more. The
best come here, the rest stay where they are.
"It's not called gambling if the math is on your side."
weaselman
weaselman
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July 2nd, 2012 at 5:27:51 PM permalink
Quote: EvenBob

99.9% of doctors are in the profession because of the money.
They make more money here than anywhere, far more. The
best come here, the rest stay where they are.


This is just a baseless and unreasonable speculation on your part, I am afraid.
"When two people always agree one of them is unnecessary"
EvenBob
EvenBob
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July 2nd, 2012 at 5:33:03 PM permalink
Quote: weaselman

This is just a baseless and unreasonable speculation on your part, I am afraid.



You think there in it for humanitarian reasons? They spend
$400,000 on schooling because they love mankind? They
may be great people, but its money first. Take away the money
and they will find something else to do for a living.
"It's not called gambling if the math is on your side."
weaselman
weaselman
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July 2nd, 2012 at 6:00:03 PM permalink
Quote: EvenBob

You think there in it for humanitarian reasons?


Some are, some aren't. The best ones - more likely than not.
But that's not even the point.

You seem to think, that anyone who wants to come to the US, just packs their bags, buys a plane ticket and goes. That's not how it works. It is too damn hard to immigrate into the US, harder even then to become a doctor. You need an employer to sponsor you to get a visa - a complicated, and expensive process. Without a shortage of doctors in the US, why would the hospitals bother? When the old and rich guys retire as they threaten us, and if there will really not be enough of young and talented kids to replace them (hard to believe btw), the hospitals will start looking for good candidates abroad, and sponsoring them to come over. The H1 quota will probably need to be increased too, but that's just a technicality.

Your statement about US doctors being the best because they make the most money is also logically flawed. US doctors work in the US, because they were born and/or raised here, that fact does not mean that they are good or bad (in fact, given the recent education quality discussions, it may be reasonable to assume that it is more of a disadvantage to be raised in the US, compared to, say, China or Eastern Europe). There is no way to make that conclusion from the value of their current salary.

Once again, there are lots of very good doctors abroad, who would be willing to come here and work for a quarter of SOOPOO's income if only we let them. The reason they are still there, and not here is not that they want more money, it's just that we have not invited them. And the reason we haven't is not that they are bad doctors, it's just that we have too many doctors here already, and we don't mind paying their outrageously high salaries. If it changes, and we start looking abroad, we'll just save some money, that's all, nothing to be afraid of.
"When two people always agree one of them is unnecessary"
SanchoPanza
SanchoPanza
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July 2nd, 2012 at 7:00:25 PM permalink
Quote: EvenBob

Forget exceptional, forget excellent

Quote: weaselman

Yeah ... I am afraid, that train has departed long time ago, probably, even before Obama was born.


We were still pioneering in aerospace, information technology and tons more fields for at least a few decades after Obama's historic birth.
weaselman
weaselman
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July 2nd, 2012 at 7:16:59 PM permalink
Quote: SanchoPanza

We were still pioneering in aerospace, information technology and tons more fields for at least a few decades after Obama's historic birth.


Yes, we were. I am talking about medicine specifically. It started deteriorating earlier than other fields (but they are catching up now).
But, perhaps, "before Obama was born" was indeed an exaggeration. I would say, US health care was one of the best in the world back in the sixties, and, maybe even early seventies.
"When two people always agree one of them is unnecessary"
EvenBob
EvenBob
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July 2nd, 2012 at 7:27:36 PM permalink
Quote: weaselman

Some are, some aren't. The best ones - more likely than not.
But that's not even the point.
.



Sure its the point. The rest of what you posted is either speculation or
just not true. Godd doctors find it easy to get sponsors here and they
come in droves. Its amazing what you can do with money and the
right connections.
"It's not called gambling if the math is on your side."
weaselman
weaselman
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July 2nd, 2012 at 7:40:13 PM permalink
Quote: EvenBob


Sure its the point. The rest of what you posted is either speculation or
just not true.


Oh, I am sorry Bob for having misled you. This argument is simply irrefutable. Now I see the light.
"When two people always agree one of them is unnecessary"
EvenBob
EvenBob
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July 7th, 2012 at 7:57:59 PM permalink
This is interesting:

"The Supreme Court, in its 5-4 ruling, upheld the mandate that most Americans get health insurance. The majority said Congress has the power to enforce the mandate under its taxing authority. The decision labeled the penalties a tax, noting that they will be collected by the IRS...
The law, however, severely limits the ability of the IRS to collect the penalties. There are no civil or criminal penalties for refusing to pay it and the IRS cannot seize bank accounts or dock wages to collect it. No interest accumulates for unpaid penalties."

So if they can't collect it, and can't make you pay it, why would you?
The more this goes forward, the more moronic it sounds. The biggest
cluster-frick in modern history. The federal gov't at work.
"It's not called gambling if the math is on your side."
rdw4potus
rdw4potus
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July 7th, 2012 at 8:20:42 PM permalink
Quote: EvenBob


So if they can't collect it, and can't make you pay it, why would you?
The more this goes forward, the more moronic it sounds. The biggest
cluster-frick in modern history. The federal gov't at work.



Yep, plus, the "tax" only applies if you're receiving a refund. So if you just lower your withholdings enough to require you to pay in on 4/15, then you never have to pay the "tax". Unless you like loaning money to the government, you should already have your withholdings that low...

The idea of the non-payments is interesting. I'm quite sure that they did that so that it couldn't be construed as a tax since it's effectively an optional payment. I think they counted on the commerce clause validating the law, and the optionality of payment would keep it from being an illegally biased tax. Turns out the court made the exact opposite ruling.
"So as the clock ticked and the day passed, opportunity met preparation, and luck happened." - Maurice Clarett
Pokeraddict
Pokeraddict
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July 7th, 2012 at 8:45:52 PM permalink
You can also claim that for religious reasons you will not participate. The code says that you must be a recognized religious group but that clause is easily unconstitutional to even the most liberal judge. If you worship a rock that tells you not to buy health insurance the government cannot legally tell you that your religion is illegitimate.
EvenBob
EvenBob
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July 7th, 2012 at 8:53:00 PM permalink
Quote: Pokeraddict

You can also claim that for religious reasons you will not participate.



There are lots of ways to weasel out of this thing, apparently.
It'll never be enacted, its unworkable as written. It would
bankrupt the country before the kinks were ever ironed out.
"It's not called gambling if the math is on your side."
QuadDeuces
QuadDeuces
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July 7th, 2012 at 10:26:34 PM permalink
Quote:

It would bankrupt the country before the kinks were ever ironed out.



Already bankrupt. The loan just hasn't been called yet.
EvenBob
EvenBob
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July 9th, 2012 at 5:39:07 PM permalink
Quote: s2dbaker

I think it's more likely that the doctor is a figment of his imagination since most Doctors support the law.



Really? My imagination? Read this:


"Eighty-three percent of American physicians have considered
leaving their practices over President Barack Obama’s health
care reform law, according to a survey released by the Doctor
Patient Medical Association."

Maybe you can post a survey that shows most doctors
love the new law.
"It's not called gambling if the math is on your side."
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