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Monday, November 4. 2013
Just imagine federally-managed and controlled legal insurance. After all, legal access and justice is a real right. At Jacobson:
Socialism requires government force. A key tactic is to break and disrupt things, and then to jump in with a forced plan to fix it.
It's interesting that, in most of the discussion of medical care, the source of the heavy costs are neglected: expensive procedures and hospital care at the end of life. An office visit to an internist or family practitioner is still inexpensive.
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"in most of the discussion of medical care, the source of the heavy costs are neglected: expensive procedures and hospital care at the end of life"
I agree with you there. For me, this is the single most frustrating aspect of the entire fiasco of nationalized health insurance, from Day 1. When the high costs of Obamacare eventually begin to sink in, this indisputable fact about end-of-life medicine will make government "Death Panels" inevitable. Among our political overlords, only that "dummy" Sarah Palin was honest enough (and farsighted enough) to realize how big governments "fix" their mistakes: they bury them. Her efforts to deal with it openly and frankly came at great political cost to her. The media mocked her incessantly for this. Down the road, when it eventually turns out she was right--and this will be the case---the media will be certain to ignore how prescient she was and how wrong they were; because when it comes to media amnesia, the media never have any regrets.
Obamacare: Turning America into one big E.R. waiting room.
Before the ACA there was a demographic that didn't have insurance and thus couldn't get treatment. After the ACA, a different demographic will have insurance but be denied treatment due to govt rationing/death panels.
Anyone besides me see some irony in that?
From the WSJ:
"Obama's Health Rationer-in-Chief White House health-care adviser Ezekiel Emanuel blames the Hippocratic Oath for the 'overuse' of medical care."
"As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs."
There has been a lot of talk about Dr.s refusing to treat Obamacare Patients or Medicare Patients. I could easily envision that these practitioners will be forced to take these patients or lose their license to practice medicine. What the government gives, the government can take away.
Also, a few years ago Michelle O was pushing the idea of healthcare access - not enough practitioners in the inner city. Could we reach a point where the government tells you where to practice - that you have to leave your nice suburban office for an inner city location? I don't see why not. Stranger things have happened.
Right now the doctors have leverage because many can retire and cause a shortage of physicians. But, the government can easily build additional medical schools and many universities would stand in line for a chance to open a new government-paid school of medicine. The entire field can be very different in ten years.
The lack of doctors offering help to medicaid patients is easy to solve, and this is how it will be done (and has been done in other countries with similar systems):
Force doctors to accept them as a condition for keeping their license to practice medicine.
And change doctors from self employed small businessmen into salaried employees of a local "health care center" where 5-6 of them share 1-2 nurses, a few offices and a treatment room, and a pool of 50.000 or so patients.
Of course for the patients that means they no longer have their own doctor, they call the center and get assigned a slot at the next available doctor depending on the severity of their complaints (the nurse on the phone effectively doing triage, deciding who gets to see a doctor today and who has to wait 2-3-4 days to get primary healthcare).
"many universities would stand in line for a chance to open a new government-paid school of medicine"
But how many students would stand in line, even for a free education, if they knew every aspect of their working lives would be dictated by an arbitrary, whimsical government? That kind of dedication to public service is found among our military personnel, at least until now, but even there morale sinks further each time the Obama administration decides to purge another general officer from the service.
When you say the entire medical field can be different in 10 years, I agree with you, but for a different reason. Ten years ago, the law profession looked mighty inviting to prospective law school students. Today, not so much. The law profession is on course for a significant downward spiral. The same "correction" can occur in medicine if an overbearing government decides it, like our current President, is infinitely "smarter than any guy in the room."
In that case, doctors and nurses across the country will realize they need to unionize so they can bring the health care system to its knees whenever they choose, for whatever reason they want. If the recent pseudo government shutdown caused nationwide angst, can you imagine what would happen if all of the doctors and nurses in the country went out on strike? No government administration could to survive a job action by the entire medical profession of the country. Smart politicians will intuit it is not in their own best interest to hand the medical profession a good reason to unionize.
There is a simple fix for all of the bad effects of Obamacare. Two simple amendments:
1. Make Obamacare optional for individuals and companies.
2. Make Obamacare self supporting. That is everyone who chooses it pays a premium calculated to keep the system in the black.
We can not get a medicaid patient to sign up for morning appointments. Only the hard working people paying their bills wake up before noon.
I do think students would stand in line as well. Remember - this is not our grandfather's medical practice anymore. It is government work - strictly nine-to-five with a one hour lunch and scheduled coffee breaks, just like the TSA employees at airports who go on break while 1,000 people stand in a security queue. Physician productivity will plummet and these new-age physicians won't care because they know the government will make more of them if needed. No one is going to kill themselves.
And, the new-age medical schools will have very different admissions policies based on race/ethnicity/sexual orientation/political connections first and maybe academic quality second.
Also, the medical malpractice industry goes away since you can't sue government employees so I think we will have a ready supply of med school applicants coming out of the legal profession.
That would be anti-socialist, anti-fascist, anti-collectivist, anti-hispanic, anti-black and anti-islamic, therefore un-American.
It would become a woman and foreign born dominated profession which like other professions where woman and foreign born became dominant would drive salaries down. Most woman would likely prefer the security and reduced stress of working for a clinic versus running a small business.
An ever better fix would be an ammendment that all government workers, particularly federal, would be subject to the same obamacare terms as everyone else...no exceptions.
As far as quality of care goes, in your nightmarish vision of the future of health care it would be a race to the bottom. The practice of medicine is both art and science; it takes talent and brains to do the job right. With the wrong people wielding stethoscopes, patient death rates would soar. Oh wait, that's the point of Obamacare, isn't it? Never mind.