A talk with a physician about Obamacare
Yesterday in the company of many fine fellows and a few feminine companions history was made. Maybe. We small group of erstwhile Quixotes have formed a chapter of a 527 organization with the intention of informing and energizing voters. I am hopeful that within a couple of months we can have a small impact and by 2012 we will help to focus grassroots efforts and perhaps even have a convention for Tea Party types to pre-qualify a people's candidate to run against the RINO that the dunderheads up the ladder drop down on our heads. You will know us when we have the html code ready for the badge to display on blogger.
In Indiana, many grassroots candidates lost to party hacks because the hacks had some name recognition and big money. We can't help with the money part. But we can inform voters so they don't just vote for a name they vaguely remember. Sadly, with some voters any recognition at all gets their vote. John Gacy? I heard of him, guess I should vote for him as Sheriff!
While working as a poll judge I was asked to tell people who the incumbent was and how to vote a straight ticket (primaries? Nothing but straight tickets) or who to vote for (which I could not do) and a few folks who were asking other voters who to vote for...shouldn't people KNOW something about candidates in advance? Well, we want to fix that!
While starting up the chapter with charter memberships and doing the officer thing (both by acclamation) and so on and so forth, I had the chance to have good conversations with some of the more honest local politicians and a few bloggers I had not met in person before and one exceedingly interesting wife of a blogger buddy who had a lot of eye-opening things to say about Obamacare.
My doctor and the people at my clinic are very concerned about what will happen once Obamacare really takes hold. I wondered what Dr. A would say and here is a close-to-verbatim recounting of the conversation. Keep in mind that I was holding a conversation with her about this and with two colleagues about two other topics so I was going back and forth between three people. Keep in mind that Dr. A was born and raised in Romania and remembers the communist years, is also fluent in Spanish and English is her third language! Makes me feel kind of dorky, but here we go.
R = Radar
A = Dr. A
R - So what kind of medicine do you practice?
A - I am, I do internal medicine, yes.
R - Where do you work? A hospital around here?
A - A clinic. I used to work in ******** Hospital but it was a consortium of physicians who were more concerned about money than caring for people and I grew tired of that, so I went out on my own. Hospitals are either going to focus on money or go broke and close.
R - Yes! My daughter had interupted aortic arch with ASD and VSD at birth and they rushed her to Michael Reese Hospital, which was a top class pediatric surgical hospital and her life was saved. Now the place is closed and abandoned...I saw some pictures of the place on Flickr and it was awful, a bunch of trash and junk now.
A - So now I work in Illinois.
R - Nearby? Can I go there?
A - (She then describes the area so I know what part of Illinois her clinic is in) I had to work in Illinois because I signed a non-compete in the state so I could not work in Indiana.
R- What do you think of Obamacare? Would it be a disaster?
A - No, I don't think so at first. But I think it is a lie. It really isn't free healthcare but it would lead to rationing. It would be hard to tell at first.
R - You think it would work at first?
A - Yes, at first it will not make so much difference. But it will go bad later on.
R - My doctor is worried he will go out of business. You know, I get a discount for paying cash? And I have gone to the same clinic since 1984 and they know me and what is going on with me. I am afraid I will lose them. Plus I can afford cash better than buying insurance.
A - Yes, well in Germany they have a system like this. It works but if you have a very difficult or expensive condition you must be politically connected or have money. Romania really did have free care but that was very bad.
R - Romania was free?
A - Yes, but the government would give a hospital a certain amount for the year and that was that. So they would get a million dollars and what do they buy? Soap, toilet paper, gloves, basic medicines, things like that. Then they have a few hundred thousand dollars and they pay for the most common medicines and then that is that. So if you come in with a broken hip and you need a special orthopedic device, you cannot have it...unless you pay for it and also pay a tip. In Romania people would tip doctors to get faster service or anything. If you had something that was not common and you had no money, you could not get help.
R - So it was actually a disaster?
A - Yes, for most people it was very bad if they were badly hurt or had a bad disease. It was a kind of rationing and it was about bribes and tips.
R - The underground cash only economy?
A - Yes. In this country a homeless bum can be rushed into the emergency room with broken bones and get xrays and everything he needs and then if he is ready to leave and has no money the hospital just pays. But someone who just wants to be checked for non emergency needs to show ID and maybe a visa card to get treatment. So the Obamacare is not about giving care to emergency patients who are poor.
R - But if it is free, then people will just come in with a headache and ask for all sorts of tests?
A - Okay. If my patient has a headache and we look at her condition and tell her there is a chance of brain cancer and she is a cash patient or has very poor insurance I know getting tested will cost her at least three hundred dollars. If she asks me the chances she has a tumor versus something common and I say one per cent then she can decide maybe she doesn't want the test. But if it will not cost her anything she will get it, you see? I get no money for the test, I will tell her the odds and let her decide. Under this Obamacare maybe everyone will want the test?
R - Sure. Again, I am a cash patient and everyone gives me a discount for cash so I would hate mandatory insurance.
A - I give thirty per cent for cash. If I have a Medicare patient and the charge is 63 dollars I probably only get 45 dollars back for that or maybe less and there is a lot of delay and paperwork. Some insurance only pays part of what is charged. I like cash payers. So many things are...
(At this point another guy interjects) There will be people who will be required to do operations they believe violates their Hypocratic oath and they will leave medicine!
R - Right, what if all physicians are required to do abortions? Some of them will not do it, believing the Hypocratic oath means they don't take innocent lives. What do you think?
A - I didn't take the oath.
R - No?
A - The room was crowded and a lot of the people did not smell good when they gave the oath so I just walked out and got my license anyway.
R - Wow. Romania was another world. Were there Trabants there?
A - No, but some other car like that, yes. But there is no bank loan at that time, you had to have the money to buy a house or buy a car so not many people owned cars. I was very privileged and so I was better off than most people. My grandfather was rich and had much land and money. When the communists took everything they took land but did not take the house, so my grandfather sold it and got a smaller house where we lived and we still had some money. My parents were professionals. My mother was a professor of economics and I loved math but she warned me not to be a teacher.
R - Why is that? A university professor is a good job!
A - No, not in Romania. The pay is not good. The students are not good, they are not respectful. My mother warned me to either be an accountant or maybe four other ideas and I decided to try medicine. When we finally were free from communism in 1989 I began thinking about how to go away from Romania. Before we had no visa, no passports.
R - This is off the subject, but what if doctors did pro bono work maybe one-two days a month to help give care to the poor? Couldn't we do okay with the present system and throw away Obamacare if maybe doctors with tort reform could pay less in insurance and maybe help out pro bono like a lot of lawyers do?
A - I wanted to do this. At my church, which is in Cook County I was going to give three hours in the afternoon after church on Sundays to help out people who needed care, but I can't do it because if I practice medicine in Cook instead of Will County I have to pay an extra ten thousand dollars insurance. To give free care. So I could not do it.
R - That is so stupid. Lawyers!
A - So at first here it will not be bad but soon there will be rationing because all national healthcare plans become rationing. Only the rich and connected people will get everything they need. The poor will die.
R - So the poor and elderly people will get minimal care and then they die faster and oh, well?
A - That is what will happen, yes. It will be harder for me to work. It will be hard on people.
R - But couldn't we just allow insurance plans crossing state lines and business consortium plans and make insurance more affordable? We really aren't doing this the right way?
A - Yes, this is better. Make insurance better. My husband and I pay six hundred dollars a month for disaster insurance, if we have something very bad that puts us in the hospital but otherwise we just pay cash. Imagine when Obamacare happens, insurance companies cannot keep out anyone with preexisting conditions and so cancer patients and people who are going to need a lot of care so all insurance will be expensive.
R - So paying the no-insurance penalty is probably what I need to do.
A - In the end it will hurt the poor and people who are older and have bad conditions so rationing will happen and people will die I think. The poor.
~
So someone more accomplished and smarter than me who works in the industry and has experience with socialized medicine AND totalitarian governments is completely against it but her manner was quite stoic. She seemed to expect to get dumped on and was ready to slog on through. I hope for her and her husband that Obamacare will be stopped and repealed before it ruins the greatest medical system in the world. Yes, there are flaws in the system and jerk lawyers like John Edwards have helped insurance costs for doctors shoot up precipitously (ten thousand dollars EXTRA a year to give free care in Cook County?!) but we have the best system anyway. You find plenty of people fleeing national medicine nations coming here to get special care. Once the government takes over health care, that will change and I think it will change faster than Dr. A. believes.
Her husband is a talented writer and an IT guy. I am a writer and an IT guy. They have been married twelve years and met on Thanksgiving in New York City and were married in February. I asked if it was love on first sight and A said "maybe third" but her husband said he proposed on their fifth date. Great couple! I met my wife in late July and we were married before Christmas. Sometimes you just know. It will be fun to introduce my wife to M and to A. I am keeping them anonymous for now. Their names do not matter right now. The problems and issues remain.
And a note from Robert Sumner of the Biblical Evangelist:
In Indiana, many grassroots candidates lost to party hacks because the hacks had some name recognition and big money. We can't help with the money part. But we can inform voters so they don't just vote for a name they vaguely remember. Sadly, with some voters any recognition at all gets their vote. John Gacy? I heard of him, guess I should vote for him as Sheriff!
While working as a poll judge I was asked to tell people who the incumbent was and how to vote a straight ticket (primaries? Nothing but straight tickets) or who to vote for (which I could not do) and a few folks who were asking other voters who to vote for...shouldn't people KNOW something about candidates in advance? Well, we want to fix that!
While starting up the chapter with charter memberships and doing the officer thing (both by acclamation) and so on and so forth, I had the chance to have good conversations with some of the more honest local politicians and a few bloggers I had not met in person before and one exceedingly interesting wife of a blogger buddy who had a lot of eye-opening things to say about Obamacare.
My doctor and the people at my clinic are very concerned about what will happen once Obamacare really takes hold. I wondered what Dr. A would say and here is a close-to-verbatim recounting of the conversation. Keep in mind that I was holding a conversation with her about this and with two colleagues about two other topics so I was going back and forth between three people. Keep in mind that Dr. A was born and raised in Romania and remembers the communist years, is also fluent in Spanish and English is her third language! Makes me feel kind of dorky, but here we go.
R = Radar
A = Dr. A
R - So what kind of medicine do you practice?
A - I am, I do internal medicine, yes.
R - Where do you work? A hospital around here?
A - A clinic. I used to work in ******** Hospital but it was a consortium of physicians who were more concerned about money than caring for people and I grew tired of that, so I went out on my own. Hospitals are either going to focus on money or go broke and close.
R - Yes! My daughter had interupted aortic arch with ASD and VSD at birth and they rushed her to Michael Reese Hospital, which was a top class pediatric surgical hospital and her life was saved. Now the place is closed and abandoned...I saw some pictures of the place on Flickr and it was awful, a bunch of trash and junk now.
A - So now I work in Illinois.
R - Nearby? Can I go there?
A - (She then describes the area so I know what part of Illinois her clinic is in) I had to work in Illinois because I signed a non-compete in the state so I could not work in Indiana.
R- What do you think of Obamacare? Would it be a disaster?
A - No, I don't think so at first. But I think it is a lie. It really isn't free healthcare but it would lead to rationing. It would be hard to tell at first.
R - You think it would work at first?
A - Yes, at first it will not make so much difference. But it will go bad later on.
R - My doctor is worried he will go out of business. You know, I get a discount for paying cash? And I have gone to the same clinic since 1984 and they know me and what is going on with me. I am afraid I will lose them. Plus I can afford cash better than buying insurance.
A - Yes, well in Germany they have a system like this. It works but if you have a very difficult or expensive condition you must be politically connected or have money. Romania really did have free care but that was very bad.
R - Romania was free?
A - Yes, but the government would give a hospital a certain amount for the year and that was that. So they would get a million dollars and what do they buy? Soap, toilet paper, gloves, basic medicines, things like that. Then they have a few hundred thousand dollars and they pay for the most common medicines and then that is that. So if you come in with a broken hip and you need a special orthopedic device, you cannot have it...unless you pay for it and also pay a tip. In Romania people would tip doctors to get faster service or anything. If you had something that was not common and you had no money, you could not get help.
R - So it was actually a disaster?
A - Yes, for most people it was very bad if they were badly hurt or had a bad disease. It was a kind of rationing and it was about bribes and tips.
R - The underground cash only economy?
A - Yes. In this country a homeless bum can be rushed into the emergency room with broken bones and get xrays and everything he needs and then if he is ready to leave and has no money the hospital just pays. But someone who just wants to be checked for non emergency needs to show ID and maybe a visa card to get treatment. So the Obamacare is not about giving care to emergency patients who are poor.
R - But if it is free, then people will just come in with a headache and ask for all sorts of tests?
A - Okay. If my patient has a headache and we look at her condition and tell her there is a chance of brain cancer and she is a cash patient or has very poor insurance I know getting tested will cost her at least three hundred dollars. If she asks me the chances she has a tumor versus something common and I say one per cent then she can decide maybe she doesn't want the test. But if it will not cost her anything she will get it, you see? I get no money for the test, I will tell her the odds and let her decide. Under this Obamacare maybe everyone will want the test?
R - Sure. Again, I am a cash patient and everyone gives me a discount for cash so I would hate mandatory insurance.
A - I give thirty per cent for cash. If I have a Medicare patient and the charge is 63 dollars I probably only get 45 dollars back for that or maybe less and there is a lot of delay and paperwork. Some insurance only pays part of what is charged. I like cash payers. So many things are...
(At this point another guy interjects) There will be people who will be required to do operations they believe violates their Hypocratic oath and they will leave medicine!
R - Right, what if all physicians are required to do abortions? Some of them will not do it, believing the Hypocratic oath means they don't take innocent lives. What do you think?
A - I didn't take the oath.
R - No?
A - The room was crowded and a lot of the people did not smell good when they gave the oath so I just walked out and got my license anyway.
R - Wow. Romania was another world. Were there Trabants there?
A - No, but some other car like that, yes. But there is no bank loan at that time, you had to have the money to buy a house or buy a car so not many people owned cars. I was very privileged and so I was better off than most people. My grandfather was rich and had much land and money. When the communists took everything they took land but did not take the house, so my grandfather sold it and got a smaller house where we lived and we still had some money. My parents were professionals. My mother was a professor of economics and I loved math but she warned me not to be a teacher.
R - Why is that? A university professor is a good job!
A - No, not in Romania. The pay is not good. The students are not good, they are not respectful. My mother warned me to either be an accountant or maybe four other ideas and I decided to try medicine. When we finally were free from communism in 1989 I began thinking about how to go away from Romania. Before we had no visa, no passports.
R - This is off the subject, but what if doctors did pro bono work maybe one-two days a month to help give care to the poor? Couldn't we do okay with the present system and throw away Obamacare if maybe doctors with tort reform could pay less in insurance and maybe help out pro bono like a lot of lawyers do?
A - I wanted to do this. At my church, which is in Cook County I was going to give three hours in the afternoon after church on Sundays to help out people who needed care, but I can't do it because if I practice medicine in Cook instead of Will County I have to pay an extra ten thousand dollars insurance. To give free care. So I could not do it.
R - That is so stupid. Lawyers!
A - So at first here it will not be bad but soon there will be rationing because all national healthcare plans become rationing. Only the rich and connected people will get everything they need. The poor will die.
R - So the poor and elderly people will get minimal care and then they die faster and oh, well?
A - That is what will happen, yes. It will be harder for me to work. It will be hard on people.
R - But couldn't we just allow insurance plans crossing state lines and business consortium plans and make insurance more affordable? We really aren't doing this the right way?
A - Yes, this is better. Make insurance better. My husband and I pay six hundred dollars a month for disaster insurance, if we have something very bad that puts us in the hospital but otherwise we just pay cash. Imagine when Obamacare happens, insurance companies cannot keep out anyone with preexisting conditions and so cancer patients and people who are going to need a lot of care so all insurance will be expensive.
R - So paying the no-insurance penalty is probably what I need to do.
A - In the end it will hurt the poor and people who are older and have bad conditions so rationing will happen and people will die I think. The poor.
~
So someone more accomplished and smarter than me who works in the industry and has experience with socialized medicine AND totalitarian governments is completely against it but her manner was quite stoic. She seemed to expect to get dumped on and was ready to slog on through. I hope for her and her husband that Obamacare will be stopped and repealed before it ruins the greatest medical system in the world. Yes, there are flaws in the system and jerk lawyers like John Edwards have helped insurance costs for doctors shoot up precipitously (ten thousand dollars EXTRA a year to give free care in Cook County?!) but we have the best system anyway. You find plenty of people fleeing national medicine nations coming here to get special care. Once the government takes over health care, that will change and I think it will change faster than Dr. A. believes.
Her husband is a talented writer and an IT guy. I am a writer and an IT guy. They have been married twelve years and met on Thanksgiving in New York City and were married in February. I asked if it was love on first sight and A said "maybe third" but her husband said he proposed on their fifth date. Great couple! I met my wife in late July and we were married before Christmas. Sometimes you just know. It will be fun to introduce my wife to M and to A. I am keeping them anonymous for now. Their names do not matter right now. The problems and issues remain.
And a note from Robert Sumner of the Biblical Evangelist:
THE “FIRST LADY’S” STAFF: Information provided by Columnist Dan Kennedy: "In lecturing us about blowing our money, The Great Ozbama displays breathtaking gall. Given that he is blowing trillions of our money, not his, and burying us in debt as no president in history, silence on the subject would seem more reasonable. To be nit-picky about it, since he is in citing trips to Vegas as particularly objectionable, I hold in my casino chip-calloused fingers a list procured from CanadaFreePress.com of Mrs. Obama's staff and their salaries.
“She reportedly has a staff of 22 assistants. Yes, I said twenty-two. (Previous First Ladies' dedicated staffs were in the single digits). Michelle's little army includes a Chief of Staff costing $172,000 a year; a Deputy Chief of Staff at $90,000; a Director of Policy and Projects at $140,000; a Director of Communications at $102,000; a Deputy Director of Scheduling at $62,000; two Social Secretaries – mysteriously, one at $65,000, one at $64,000; an Associate Director of Correspondence at $45,000, an Assistant to the Social Secretary at $36,000, and more, in total consuming $6.3-million annually – thus $25-million during her 4-year term. Not to mention a make-up artist and hair stylist.
“I have one assistant. Answer my own correspondence. Keep my own calendar ... Mr. President, sir, if you are going to lecture me about blowing my money in Vegas or turning down my thermostat or inflating my tires, do you think you could reign in your wife's blowing of my money just a teeny bit?"