Thursday, November 06, 2008
THIS Time It's Gonna' Work
Gosh dangit. This time it's gonna' work!
Because oppressive taxation has worked so well in the past.
XOXO, Lofty
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Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.
my wife and i just ran the numbers on taxes. conclusion? we are both going to work part time and spend more time with the kids. interesting, as 'cat points out, that the traditional wall street 'honeymoon' with the new president is, well, more like a nightmare. and for all of you cheering this on because you don't have money invested, the people who write your paycheck are going to have to make some cutbacks. you know, fire some people. hope welfare under the miraculous one is good for ya. turns out there's always a need for someone with our skills so we will be fine. toodles.
ReplyDeleteAs I watched that YouTube clip of those naive kids at the BHO victory celebration dancing with the Soviet flag, I was struck by the fact that they were still in diapers at the time the Soviet Union fell.
ReplyDeleteTheir historical education is so grossly inadequate that they have no idea what the Eastern Block was like under Soviet Rule (DrX could enlighten them if they chose to listen).
They likely have no idea what happened at Tiananmen Square in China in 1989, or why. They probably never witnessed the jubilation of the people rushing through the holes that they created in the Berlin wall, and they almost certainly never thought to consider what that moment meant with respect to the overthrow of a super-power by a people yearning for freedom.
It is an oft repeated expression from George Santayana (not the guitar player), but it bears remembering: "Those who cannot remember the past are condemned to repeat it".
One final thought, the hammer and sickle didn't get much coverage in the MSM (no surprise) but imagine if McCain had won and one of his supporters had waved the Stars and Bars, or the Cross of the KKK. That would have had the left screaming for weeks (and rightly so...I merely point out the double standard).
Точно, камрад. Но, мы все должны обхватывать вниз к большому социалистическому Obama для пользы масс. Все окличут смерть зажиточности.
ReplyDeleteP.S. I think my messages lately come across better in Russian than they do English....because that's where we're heading, right?
ReplyDelete911& Mrs.911: I made that same choice years ago. I get money back every year and life is good. Best of luck!
ReplyDeleteThe little darlings grow up so fast anyway. Before you know it they're falling off cliffs and igniting their beards while "breathing fire" with lighter fluid....Wait! It's probably because I didn't work ENOUGH that they're morons.
ReplyDeleteThe ER docs actually hide when they see us. We had. A French doc recently and he said,"Well, I guess you won't do ZAT again..."
I remember.
ReplyDeleteThe double standard makes me crazy too! It is so blatant! How do they get away with it?
ReplyDeleteWhy is everyone so hard with conservatives and expect perfection and yet they seemingly can do anything?
I remember being in 1st or 2nd grade having to crouch in the school hallway to practice in case we got bombed during the Cuban missile crisis.
And my girlfriend's father built a bomb shelter right in the middle of their back yard.
Had a toilet and lots of shelves with canned food. Partly above ground and mostly under ground.
One of my uncles bought a ranch in the 80s that had a bomb shelter, with toilet at the other end of the garage.
Can you imagine being that scared here?
I think the history books are sanitized and students aren't taught conservative perspectives as with someone who lived through these things.
Seriously... I can deal with the rest as long as he keeps a safe with a strong military presence and a good foreign policy. I always say this so I'm sorry for the repetition but if we don't have that then nothing else will matter.
Devo, if your gettin money back, you paid too much, and just made an interest free loan to Uncle Sam. I learned that at age 14, one of the benefits of havin a Paper Route. Even if you like the Idea of loanin the IRS a little extra, just imagine that they're spending your refund shooting baby seals with 20mm depleted Uranium rounds from a polluting FA-18. Uncle Sam doesn't get my money till midnite April 15, who knows? maybe Jesus's comin back April 14.
ReplyDeleteWhile I was paying for a prescription for my son, a lady wearing an Obama button stood at the next register - I came so close to asking her for a dollar so she could begin spreading the wealth.
ReplyDeletefrank: I know-I never get it right.
ReplyDeleteOne of the closet "O" supporters at my husband's office came in so ticked off yesterday after hearing O's "victory" speech. She was "shocked" to hear him say that we would see change happen, but that it may not be in his presidency or our lifetimes. Her thought was - but he said he was going to effect immediate change. My thought was: how the hell am I going to see change if it isn't in my lifetime? Difference between libs and conservs I guess........
ReplyDeleteIronically my word veri is: lyracti
This is the greatest song ever. Period. http://www.youtube.com/watch?v=zY3spl48_0Y&feature=related
ReplyDeleteI got a call from my daughter this afternoon. She's a freshman pre-med major, and she wants to change (her major).
ReplyDeleteShe says that she is scared about the future of medicine and the future of our country. She argues that she has studied hard over the past 3 months, and can't even imagine what is ahead of her over the next 10 1/2 to 12 1/2 years.
She reasons that if our country values spreading the wealth more than it values education and work ethic, why should she bother to put forth the effort?
I told her that if she chose medicine only for the money, she chose it for the wrong reasons (we have had that discussion before, the money ain't worth it). She assured me that it wasn't the money issue driving her decision, it was the fear of government control, red tape, and health care rationing on the horizon.
In addition, she rightly observed that if she was going to sacrifice the next decade of her life to studying and training, she didn't expect to be rewarded with a salary equivalent to that of a lawn chair mechanic.
I tried to reassure her, but I can't say that I don't have the same concerns for her future.
Of her group of pre-med friends, she told me that every one changed their major yesterday or today. She is the only one that has not.
So this begs the question...where are all of these docs coming from that are gonna fulfill the universal healthcare dream?
Doctor's offices are full now, and if some cut back hours to avoid the spreading of the wealth, and others retire to avoid governmental encroachment into their practices, and still others follow the trend of the past several years and chose not to go into medicine altogether, I don't see how a fix is on the horizon.
We'll outsource the medical field like we do everything else.
ReplyDeleteThe reason I am mentioning this is that a friend just told me about the growing field of medical tourism, and apparently, it's not only the Canadians and the Europeans that use it...
I am shocked.
Oppressive taxation?
ReplyDeleteYou mean like under Reagan? Or Clinton?
You guys'll dig this. I think East Germany would be proud.
ReplyDeleteDoctors in countries with universal healthcare do NOT get paid badly-in fact- they make MORE than you guys for the most part. Salaries for UK GPs are above 100K sterling and they don't do any out of hours. Salaries for Irish consultants start at 250K euro and if you add in private practice can almost double.
ReplyDeleteProviding healthcare for all citizens does not mean you have to do away with private medicine. It is possible to have a two tier system.
I would agree that basic decent quality healthcare should be provided for all regardless of ability to pay. If people want top up care, or quicker access to things, or things like cosmetic surgery, sex changes etc, then go private. Anyone who has insurance can go private also.
Docs can choose whether to work in private or public systems, with specific, higher salary incentives to work in public systems.
What you are really afraid of is that you will have to pay more taxes, or have to compete with other doctors for jobs instead of enjoying the closed shop that you have until now. It's not about the patients, no matter what you say.
It's about money.
And thank FUCK that semi literate, gun totin', moose huntin', redneck with her unborn superarmy didn't have a shot at becoming President in the likely event of that old guy slipping in the shower and breaking his hip. The whole world is breathing a sigh of relief.
aaaahhhhhh
Al
ReplyDeleteI believe basic decent car care and high speed internet access should be provided regardless of ability to pay. If it is a two-tiered system, I can get a T1 line if I am willing to pay for it, (when you can't get porn fast enough) or a mechanic that will actually work quickly on my car and fix it right. And I believe I am entitled to whatever goods or services you provide (unless you are a male prostitute) regardless of my ability to pay.
Al, CONGRATULATIONS on the most illogical post in the history of left wing bilge!
ReplyDeleteYou begin by extolling the virtues of UHC. Doctors make more money and even work fewer hours. That sounds GREAT to me.
Then, you say that REAL reason we oppose it is money. WOW! With those superior debate skills, you must have been the head of the Irish Special Olympic Debate Team the year they took the Silver Medal (the Albanian Anencephalic team won Gold).
So, I'll make more money and work fewer hours...but I might pay a little more in taxes? That sounds like a net plus to me. So why would I oppose it?
I have talked to numerous doctors, nurses, and patients who have been through or worked in the British system. It's pretty good if you're healthy (as is much of UHC). But if you get sick, you've got problems. I want no part of health care and resource rationing. You see, it IS about patient care. You inadvertently made the argument yourself.
Before you try to say that health care services in the UK aren't limited compared to the US, let's play a little game. In my town of 100,000 people, there are 9 CT scanners, 6 MRI machines (4 closed mag, 2 open mag), and one PET scanner. How many are in the whole of the UK (pop about 61 million) and what is the per capita distribution of each compared to my area? Now try and convince me that health care availability is no different. The issue IS patient care and access to care.
Your next inane statement is that we are scared that we will have to compete with other doctors and will lose our "closed shop". There is already a shortage of doctors in this country, and by all estimates, the shortage will reach a critical level in the next 15 years (an even bigger problem if UHC brings about greater hassles to the practice of medicine). So just exactly WHO are we going to be competing with? Besides, most of the docs on this blog are ER docs, we don't compete with other docs...we're glad to see some of our workload taken by someone else. There's always PLENTY of business for everyone, so I don't know what website you cut and pasted this "idea" from, but it's ultra-stupid and just exactly the kind of argument I would expect from someone who doesn't know what the hell they are talking about.
I will make one parenthetical point before I take you to task for your final half-witted remarks. I am not willing to work harder for the same amount of or less money. Are you? Is anyone? I am also not willing to pay higher taxes when I can avoid doing so knowing full well that much of those taxes become a subsidy to people who make poor choices in life and have become experts at scamming a system that was put in place to help the truly needy (a concept with which I have no problem).
One example from yesterday was the two women who pulled up next to me at the pharmacy in a new Chrysler PT Cruiser (God those are ugly cars). Both women were well dressed, both crushed out cigarettes before entering the pharmacy. The conversation before entering the store involved which of their Medicaid cards they were going to use to pay for the Rx. I see this behavior ALL DAY LONG in the ER.
In fact, I'm convinced that a new Medicaid card comes with a cell phone, a pack of cigs, a case of Zig-Zag Papers, manicured nails, a fancy hairdo, and a pair of Air Jordan Colleziones. If I'm heartless for not wanting to pay for this, then you're naive for thinking it isn't a rampant problem.
Now, to your final ill-considered remarks. You refer to Governor Palin as semi-literate. I would like for you to compare her campaign gaffes to those of Joe Biden, then putting partisanship aside consider where and how long each has been in public service and think about who is really scarier.
As for your next tirade, I guess I'd have to say that I'd rather be governed by a gun totin', moose huntin', redneck than either a hot-headed, hair-plugged, pube hunting Borker or a fox huntin', tea sippin', euro-bastard.
Finally, you sadly made one valid point. The whole world IS happy about our election results. But, I didn't go to the polls to elect the President of the World, nor did I sit and look at the issues and think: "now who would be better for the world"? As a responsible voter, it was my job to select the person that I thought would take the best care of OUR Republic.
So, you were able to accidently make one valid point. Not bad for your first attempt at thought. Maybe by the time that Governor Palin's daughter delivers the "unborn superarmy" you so witlessly tried to lampoon, you will have been able to muster a real honest to goodness idea.
BRAVO 85!! Well said.
ReplyDeleteHere's a little "spread the wealth around" socialism story going around:
ReplyDeleteToday on my way to lunch I passed a homeless guy with a sign the read "Vote Obama, I need the money." I laughed.
Once in the restaurant my server had on a "Obama 08" tie, again I laughed--just imagine the coincidence.
When the bill came I decided not to tip the server and explained to him that I was exploring the Obama redistribution of wealth concept. He stood there in disbelief while I told him that I was going to redistribute his tip to someone who I deemed more in need--the homeless guy outside. The server angrily stormed from my sight.
I went outside, gave the homeless guy $10 and told him to thank the server inside as I decided he could use the money more. The homeless guy was grateful.
At the end of my rather unscientific redistribution experiment I realized the homeless guy was grateful for the money he did not earn, but the waiter was pretty angry that I gave away the money he did earn even though the actual recipient deserved money more.
I guess redistribution of wealth is an easier thing to swallow in concept than in practical application.
Good luck to all those who voted for the Obama. You will need it to defend your vote; possibly, you will have to defend it to even yourself. I've had to live with the guilt for years of voting for Carter. Twice. It has caused me a great deal of shame, but perhaps the education was worth it. I have been helping my country ever since by making much better choices when I vote for President.
erdoc85: The conclusion I come to is that the shortage will be alleviated by trucking in foreign doctors and loosening licensing requirements, as well as rationing care. I believe the quality will deteriorate as fewer people opt to become physicians.
ReplyDeleteMy father was in a private practice (only physician in a town of about 800) in the midwest in the 1970's. He decided he wanted to pick up and move west, but had a terrible time attracting someone to fill his vacancy. His conscience wouldn't let him leave the community without tying up loose ends. Ultimately two Korean doctors were hired to staff the clinic. For many years afterward he received letters from patients asking him to return. In my view, ironically, the little midwestern town was light-years ahead of the rest of the country in the evolution of American health care.
Doctors where I live seem to be anxious to embrace universal single-payor health care. It surprises me, as my image of physicians is that they are individualistic and conservative as a rule. I think my father would probably turn in his grave if he could see what is happening. He always liked Canada, but this is the one thing that kept him from moving us there.
Peggy, you are absolutely correct. In order to get enough doctors, we'll have to get FMG's (foreign medical grads) and less competant trainees from our own schools. As we keep saying, quality WILL suffer.
ReplyDeleteHere's a dirty little "secret" to illustrate a point.
In 1997, the Clinton Administration decided that there were "too many" medical specialists. This decision was based on two primary factors. One was that fewer and fewer med school grads were entering primary care. Second, Medicare was seeing progressively increasing costs that they could trace directly to higher expenditures to specialists.
So, they devised a way to limit this. Not to get too technical, but the Government (via Medicare) pays for most of the Resident education in the US. So, in 1997, the Clinton Administration changed the rules by which Medicare would reimburse hospitals for resident training.
Essentially, they would only pay for the INITIAL chosen training up to 5 years. In addition, they capped the number of residents that a hospital could train at the 1996 level unless a waiver was requested and granted.
Consider that general surgery alone is a 5 year residency. So, the total cost of any surgical sub-specialty training was immediately borne by the training institution. Now do you wonder why there is a critical shortage of neurosurgeons in the US? I have worked in hospitals where I watched people die because of the lack of a neurosurgeon.
Here is more proof that we do not need MORE government involved in the affairs of medicine.
By the way, the Clinton brilliance did not result in any net increase in the number of primary care physicians.
Businesses are going to have to cut a lot of jobs and you folks with the logest job time will probably be the first out the door with more vacation time and larger salary when the bean counters go to management with the numbers you can say goodbye to all those long years of service.
ReplyDelete