We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
From a piece at Junk Science, The Vision of our Healthcare. These are the correct rates for docs as determined by the geniuses at the Center for Medicare and Medicaid:
Emergency medicine is valued at $38.36/hour, while chiropractors are at $65.33/hour (even 31% higher than previously) and osteopathic manipulative therapy is valued at $53.93/hour. Endocrinology (think especially diabetes and obesity) was valued by the PPIS at nearly twice what the CMS had been using to determine physician payments, and is now at $84.39/hour. Family medicine saw a similar increase and is now valued at $90.15/hour. In contrast, for example, Cardiologists’ value was cut nearly in half to $88.04/hour. Allergy and Immunology care was increased to $162.68/hour and Dermatology was increased to $184.62/hour.
When you’re injured or have a real medical emergency, or actually develop a disease, which of the best doctors will you hope are available to care for you: emergency medical physician, cardiologist, family medicine doctor, chiropractor or dermatologist?
News to me that chiropractors are covered by government insurance but, for all I know, they may cover massage too. Anyway, are these numbers insane? No doc could pay his school debt and his malpractice insurance on those fees, plus office and staff overhead.
This is valuing ER docs lower than what I pay my part-time secretary. But my real comparisons are my excellent plumber ($125/hr) and the local electronics repairman ($175/hr).
Read the whole piece. Another interesting bit he has in there is about the quackery of "Lifestyle Medicine." He has it right:
The popular belief, rigorously spread by the growing lifestyle medicine movement, is that chronic diseases of aging; such as cancers, heart disease and diabetes; can be prevented and are to blame on unhealthy diets and lifestyles and failing to control health risk factors. The actual fact is that the best randomized controlled trials (the gold standards of medical evidence) continue to fail to support such premises behind lifestyle medicine, as we’ve seen time and again. The 64 percent drop in age-related deaths from heart disease over the past 50 years, for example, is largely attributed to our modern, advanced medical care and coupled with the survival advantage of a better fed, immunized and overall healthier population. Even mainstream medicine is finally realizing lifestyle medicine is more pseudoscience and ideology than sound, evidence-based science.
Fads and quackery have always abounded in Medicine. Who would expect government to be able to tell the difference?
I remember a doctor telling my students, "The death rate, in the long run, is one per person." Lifestyle may promote vigor and enjoyment longer than for those who don't take care of themselves, but I've seen enough of life to wonder seriously. I've also seen enough of COPD to keep me from smoking.
Healthy living may postpone when you spend most of your healthcare dollars but it isn't likely to stop you from spending them. Most people have a dying process involving a diagnosis and a deteriorating health status. They seek relief and even a cure. That will cost -- and by what right will anyone deny them the chance to seek it?