How is the world’s medical establishment supposed to handle that? The problems of being prepared for a pandemic capable flu are much greater than payment source and require much anticipatory planning with international cooperation.
Cynicism re motivations are noted.
Well, we do have the Centers for Disease Control, which I’m sure at least has plans on file for such a contingency. Presumably a lot of private doctors would find themselves drafted (by pressure, not force) into fighting the epidemic, billing and payment problems to be resolved after it’s contained.
I agree that doctors and nurses would rise to the challenge, and that the majority got into medicine out of a sincere desire to help people. But wouldn’t it make sense to build a system that could handle nationwide medical problems before the epidemic is underway? I don’t know the full extent of the CDC’s power during a crisis, but I suspect it is far less than the power of a National Health Service.
I’m not a doctor, but it would seem that a flu pandemic would be battled by tracking the spread, identifying the strain and developing a response. The CDC is equipped to do that job as well as or better than any other entity in the world. The problem is getting the solution to every American. As far as I can tell, the CDC doesn’t have any way of ensuring everyone gets treated.
Maybe this should have it’s own thread.
So, to be clear, you have no basis for believing that a majority of doctors would benefit financially from UHC. Now, according to you, inner-city doctors have a financial interest. Can we get a cite for that?
(I assume you understand that if inner-city doctors support UHC because they were in favor of UHC prior to working in the inner-city, that does nothing to affect BG’s point in this thread.)
Ok. So we’re back to point one, needing a cite that UHC is in doctor’s self-interest.
In the world of informal message board persuasion, the persuader has the burden of proof. You’re trying to persuade me not to take this cite seriously. It is your burden to back up your claims. Otherwise you fail to persuade.
(bolding mine)
You make a decent point, but I don’t think it’s fair to imply that doctors don’t have enough distance. The fact of the matter is that I, as a medical consumer (well, with no health care, I haven’t used any medical services of any kind since maybe 2002, but I digress), am equally in the thick of things as a doctor. I’ve just got a different perspective.
If I’m going to insist that doctors aren’t distanced enough to be objective, I’m going to find it hard to find anyone who is.
Again, I think you’re right in suggesting that doctors might have a perspective unique to their profession which can be shaped from within medical ‘culture’. I just think that you can apply that criticism to anyone who has any opinion on the issue.
Well, I distinctly remember several prior threads on this subject when polls showing that most docs (at the time) opposed UHC were cited as compelling evidence against it. Now apparently our opinions don’t matter as much!
(I am a doctor who strongly supports single-payer health care (and also a patient who has spent many hours over the last few months trying to persuade my private insurance company that, yes, I really did send in my payment and the check was cashed, regardless of what the computer says…)). I wonder how the folks who attribute this poll result to greedy physician self-interest explain the recent dramatic shift in public opinion among physicians?
In general, the experience of countries which have moved to single-payer systems is that physician incomes have not changed significantly. I think docs are fed up with (a) having to lose patients because the patients change or lose their insurance and (b) having to deal with a whole bunch of different bureaucracies which all have slightly different requirements, resulting in mountains of paperwork. I know eliminating these problems would go a long way toward improving my job satisfaction, even if my income didn’t change much. Certainly a system where it was assumed that everyone had a basic right to health care would eliminate the sort of huge, stressful hassle that I allude to in the paragraph above.
Renob said:
Because the level of political support to adequately fund programs that serve the entire population is generally higher than that for programs which the majority of the voters derive no direct benefit from.
I, too, remember when most physicians were vehemently opposed to UHC of any sort. I think this survey demonstrates the vast change in public opinion (in many sectors) about UHC since the early 90s, if nothing else.
I also remember when those physician opinions counted as very important in explaining why UHC couldn’t happen. I guess they’re only important when the docs agree with the anti-UHC crowd.
Most doctors would benefit from UHC because their overhead would drop. If you don’t work in healthcare billing, you have absolutely no idea how much money is spent trying to keep up with the gazillion different rules created by thousands of insurance companies, each with hundreds of different plans, policies, benefit levels, copays, coinsurances, deductibles, coverages, etc.
Not to mention the thousands of dollars a physician loses each year because the insurance companies either can’t or won’t pay properly according to their own plans/policies/rules/etc.
Somehow, I don’t see that “benefit to physicians” as being at all detrimental to anyone else. Except the insurance companies, of course. And people in my line of work, i.e., medical billing.
I’m for UHC, despite the fact that it could conceivably cost my job. Does that mean my opinion doesn’t count, because I would benefit from UHC? Or that it would count because I don’t? Or wouldn’t count, simply because I support UHC? (I’m a bit confused about whose opinions count and why, according to brazil84 and Renob.)
First things first: do you deny that UHC would benefit some doctors? Do you deny that UHC would benefit those doctors that rely mainly on government payments for their services?
Because if you don’t deny these things, I’m not going to waste time debating them.
I’m a little late to the party, but you’re saying that you wouldn’t hold some extra weight to the people that work with/in the system every day as a chosen profession?
I don’t see how that possibly works. Would it be too much to say that an “expert” in any field has no more pull than your Average Joe?
I have no idea. UHC is a vast and complicated policy that, as envisioned by Obama and Clinton, involves both myriad cost-reduction measures and government subsidized insurance. I find it very likely that some doctors would benefit and others would suffer, but I have no idea what the proportion looks like or whether it would disproportionately help those who rely mainly on government payments.
That you take what you said as an article of faith beyond debate makes me think the prospects of a rational debate are slim.
The majority of this( not all of course) is due to the vast labyrinth of existing government regulations, both state and Federal, that both providers and insurers have to comply with. Ask your billing manager how much paperwork s/he has to do just to comply with HIPPA, and that’s just one law. Now you want to put the people responsible for the mess that you do have in charge of everything in the belief that things will get simpler somehow? That’s…nuts.
Can you give me one reason that you believe that government sponsored health coverage won’t regularly not “pay properly according to their own plans/policies/rules/etc.”? Medicare doesn’t. UHC in other countries doesn’t. I can’t think of one single government agency (seriously, not one) that isn’t a mess of paperwork, conflicting rules and bureaucratic inefficiency. You’re going to rely on that to pay you promptly, on time and in full? Are you nuts? Why the blind faith that somehow UHC will be different from every other government run program?
As far as I can tell, the main change in public health care since the 90s is the rise of the HMOs. Everything the insurance industry’s “Harry and Louise” fear campaign to defeat the original Clinton health care plan threatened has since been delivered by the HMOs.
It’s like Churchill’s famous quote:
“We seem to be very near the bleak choice between War and Shame. My feeling is that we shall choose Shame, and then have War thrown in a little later on even more adverse terms than at present.”
The HMOs have delivered us all the ruthlessness that the insurance industry claimed we’d get from the government, but at a much higher cost due to the profit margin of the insurance companies. Depending on the source, Medicare administrative costs are from 2% to 5% (the higher number is including costs of the IRS collecting the taxes), compared to 20% to 25% for the insurance companies.
Exactly. My dentist accepts Medicare and Medicaid. He does this for two reasons:
One, he can actually effect positive changes in the lives of his patients, rather than spend his time trying to make some vain person’s smile even whiter
Two, he did the numbers and found that - even with the lower Medicare/Medicaid fees - he wound up making more money because he didn’t have office staff constantly fighting insurance companies to get paid.
It’s a article of faith that the government can do nothing right. But somehow, they manage to do an excellent job of collecting taxes, and they get every Social Security recipient’s check to them on the third of every month.
Cite?
I have never heard of a Canadian physician complaining in that regard.
Considering that many insurance companies are non-profit, such as Kaiser Permanente and many of the Blues, this criticism doesn’t hold much water.
One, it’s difficult to compare the administrative costs of Medicare and private insurance companies because they don’t do comparable work.
Two, when one actually tries to compare similar costs it seems that Medicare’s administrative costs are around 5% and private plans are around 8.9%. If commissions, profits, and premium taxes are included, then that rises to over 16%. One of the reasons that Medicare does well in this category, though, is that the amount of money it has been paying out has increased dramatically while its administrative costs have remained relatively flat. With “free” care for people, they use more of it. That is hardly a sustainable model.
I’m not sure how I could have been clearer:
Again, I don’t see how I could have been clearer:
To sum up, yes, doctors have an informed opinion on health care policy. However, their opinion may be tainted by their own interest as well as the biases which arise from being so closely associated with the subject. They may not, in the parlance of our times, “think outside the box.” Their opinion should not be given greater weight than someone else who has an informed opinion on health care policy. So if your Average Joe has some sort of decent knowledge about health care (which most probably do not, considering the level of knowledge that the self-proclaimed “above average Joes” on here demonstrate), then they should be listened to, too.
Having been a client of the Kaiser, I think I’ll take my chances with an expanded version of Medicare.
In what way? The deck would seem to be stacked against Medicare; they don’t get to cherry-pick their clients like private insurers do.
Data from an insurance industry front group is unlikely to be unbiased.
One could also read that as praise for Medicare. They are serving an aging population and have managed to hold their administrative costs to the same level? That sounds like excellent administration.
The inefficiencies in health care for the poor and aged are due mostly to lack of preventative care. Few doctors would disagree that it is far cheaper to keep someone healthy than to try to repair damage later on. And the lack of UHC keeps them from seeking that preventative care.
My argument is based on this point. Since we can be pretty confident that some doctors would directly benefit from UHC and other doctors would directly suffer from UHC, the fact that 60% of a self-selected group of doctors think that UHC is a good idea, and 30% think it’s a bad idea is not very persuasive that UHC in general is a good idea.
The contrary argument seems to be that those doctors in the 60% group are going against their own interests, but I haven’t been given any proof on this point. Instead you keep demanding that I supply proof going the other way.
Sorry, but that’s not how it works. There’s no a priori reason to assume that doctors in the 60% group are all going against their own interests. Given human nature, and given your admission that some doctors will benefit from UHC, it’s reasonable to assume that self-interest may be informing the opinions of some subset of the 60%. Which undermines the OP’s argument.
The OP was arguing that since 60% of a self-selected group of doctors favor UHC, we should be persuaded that UHC is a good idea. (Actually he seems to have given up on that argument and argue instead that the opinions of doctors should be listened to).
In any event, I’ve raised a reasonable objection and he bears the burden of proof on his claim.
Again, I agree 100%.
What is so amusing is that years ago, the drumbeat against UHC was that the majority of doctors opposed UHC. Now that the tides are changing, we’re hearing, “Can’t listen to them…they have a vested interest.”
I can’t speak for others, but I certainly never made that argument. In fact, I don’t recall hearing about any doctor surveys during the 90s UHC debate. I don’t doubt that such surveys were done, just that they were at the forefront. Are you positive that this argument was the “drumbeat against UHC”? I’m a little skeptical.
I do agree that there are many partisans against UHC who spin the facts to support their position.
Pro-UHC people would never do such a thing, however. If the next UHC legislation is opposed by a majority of doctors, they will simply withdraw any support for such legislation. They will trumpet any survey results regardless of whether the results support their position.