Friday, July 27, 2012

Hark! Some Doctors admit they might be for Obamacare. Oh, Right. Shhhh.

 
Lately I've been hearing from certain friends that Obamacare is EVIL.  They're hearing it, they say, from their doctors, and I have to believe they're telling me the truth.  I don't understand why any doctor would favor health care profiteers over a plan--watered down as it may be--that at least makes an attempt to bring some relief to health care abuses, but my own dentist seems to be one of them.  He objects to Obamacare for reasons he didn't make entirely clear, but since he was railing against it while puttering around with a drill deep inside my tooth, I wasn't much for talking about it, anyway.

When I asked my own primary care physician (a sweetheart of a small town doctor who gives hugs and makes house calls) what he thought about it, he said there were pros and cons and the jury was still out and oh, wait!  Is that a cyst?

So I'm left with the internet for some insight into the thinking of those in the medical profession who have to deal with insurance companies and with the Affordable Care Act known as Obamacare.  (You'll notice almost immediately that I'm only choosing the pieces that mostly favor ACA.  If you want to find articles against it there are multitudes from which to pluck.  I don't want them here.)

A while back I came across a site that led me to White Coat Underground.  It's written by a physician who prefers to remain anonymous for obvious reasons. He has a knack for keeping his readers  interested by combining medical ethics with common sense and a friendly bedside manner.  He writes on "Health Care Reform:  Who Speaks for Doctors?"  And in this article called "Thoughts on Obamacare", he says:
For now, I’m sticking to my guns. I’m calling the Supreme Court ruling on Obamacare a victory for Americans, and I’m proud to call it “Obamacare” (rather than Romneycare, which would better reflect history). But it’s not entirely clear how ACA’s implementation will ultimately affect us all. Here’s some potential pitfalls:
  • As insurance reform, rather than healthcare reform, it continues to fund the bloated, cash-sucking US private health insurance industry.
  • It’s going to cost us all something. Whether that “something” is more than we’re pumping into health care now, or simply a shifting around of costs isn’t clear.
  • A lot more people will have access to preventative care, but there are not nearly enough primary care physicians available to take care of them due to perverse financial incentives.
  • That’s really about it. That’s the worst I can come up with.
Here are some potential benefits:
  • As insurance reform rather than healthcare reform, it should unify conservatives and liberals. More coverage, but reliance on the public sector. Still waiting for that Kumaya thing, though.
  • It’s going to cost something, but nothing we’re not already paying for. You think paying for insurance for people is expensive? We already tried not paying for it, and we pay anyway, every time someone wanders into an ER, every time an uninsured diabetic gets another leg chopped off.
  • A lot more people will have access to preventative care. This may give us the incentive to reform medical education and practice to encourage more primary care docs.
  • It’s a moral victory. It’s not a single payer, and still allows the insurance industry to steal our money, but it makes a statement that as a nation, we believe that the health of our citizens is as important as fighting fires and keeping criminals off the streets.
  • We get to make people buy broccoli. And Brussels sprouts.

Dave Weigel exposes the poll that says 83 percent of doctors oppose Obamacare so much they might quit:
If a story leads the Drudge Report for most of the day, you're eventually going to hear about it. So, here you go: "Report: 83 percent of doctors have considered quitting over Obamacare," by Sally Nelson.

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.
Intriguing. What's the Doctor Patient Medical Association? Nelson refers to it as "a non-partisan association of doctors and patients." But lots of organizations claim to be "non-partisan." The DPMA's co-founder, quoted here, is Kathryn Serkes. She's "non-partisan" in the sense that she worked for a conservative Republican in the 2010 Washington state race for U.S. Senate, and appeared alongside Republican members of Congress at Tea Party rallies against the Affordable Care Act. Her partner at the top is Mark Schiller, M.D., who's also a fellow at the Pacific Research Institute, and the author of a classic 2009 column about how "Obamacare" would succeed by helping to kill sick people.
(Ed. note: Media Matters calls the same survey "comically awful".)

Making a house call

 Here on Buzzfeed doctors react to the survival of Obamacare (partial snip below):
What it really means. Health care professionals, from an OB/GYN to a therapist to a pharmacist, share their feelings on the law and how they foresee it affecting their practices and patients.

The OB/GYN
With the law upheld, I will see fewer patients who lose their insurance, don't get birth control, and then come to me with unplanned pregnancies. And a planned pregnancy is a healthier pregnancy, so fewer unplanned pregnancies would also mean fewer infant deaths.

The Dermatologist
I don't take any insurance. I have a fee for service practice. In the past, a patient would be reimbursed about 80 percent of the bill by their insurance carrier. Now they will only get 140 percent of what Medicare pays. Since that is very little, I believe many of my patients will be forced to switch to an in-network provider. As a result, I could lose a huge patient base. While I truly believe that health care is too expensive, it is still unclear how mandating that everyone is covered will decrease the cost of healthcare.
 The Internist
My practice treats largely geriatric patients and is almost 100 percent Medicare. We have already seen some benefit from Obamacare. Specifically, our patients have better coverage for their prescription drugs, and they are very happy about it, especially our significant percentage of limited-income patients. From our side, as primary care doctors, we have seen a bonus to our pay which was enacted with this law. If it had been struck down completely, that would have affected our patients because of their drugs, and us because of our bonus. It is urgent to get more doctors attracted to primary care, and keeping this bonus is a help.
We are still seeing a lot of people who still can't find insurance and even if they do it is so costly that people cannot afford it, because the provisions for uninsured people will not be effective until 2014.
We need to get the insurance companies to lose total control of healthcare in this country, but whether increasing government control is the answer remains to be seen! The Canadian system would be a good model if we could afford it.

I don't know. Whenever I hear the opposition demand the repeal of Obamacare--recognizing, of course, that they're the ones most likely to benefit from a repeal, I can't help but think of that old Emo Phillips joke:
I used to think the brain was the most wonderful organ in the body.  Then I realized who was telling me this.

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