ObamaCare and me By Zane F Pollard, MD

[jazzgeek]

Dale, I never stated I was a spokesperson for ALL health care professionals opinions on health care. What I am is someone who is around health care professionals....

Define your terms. By "health care professional", are you saying you're directly involved with the delivery of health care, as in diagnosing and/or treating patients, such as an MD or RN? Are you in a support role, such as running diagnostic tests or imaging? Physical/occupational/speech therapy, perhaps?

Or would you be more on the administration side of the very broad and general term of "health care professional"? Do you work for an insurance company or other care management firm? Are you in medical billing? Do you review and audit health care information systems to see if they're HL7 and/or HIPAA compliant?

In the early to mid-90s, I used to write software for a company that is now under the umbrella of McKesson. Would I have been considered a "health care professional" in your perspective?

...all day and have yet to find one excited about this program though I did say I am sure their are supporters.

So, let me see if I understand this....

You want to know of the "distribution" of the doctors sampled in the poll to make sure there's no bias (and you've stated in the quote below), and yet, your claim of "yet to find one excited about this program" is murky and obfuscated because your use of the term "health care professional" could include anyone from a hospital janitor to a radiologist to a VP of marketing for an insurance company.

Noted.

Onto your statistics.

You give me too much credit. They're from the foundation, I merely repeated them.

63% of 2,130 physicians polled said they support this bill in "some" fashion. You understand statistics so knowing the type of physician, where they practice, and specifically what kind of practices do they run is essential here. Are they doctors working in not for profit orgnizations or highly indigent environments where they are already feeling the pressure of taking medicaid payments on services that in reality cost twice as much?

This is as good of a confession of "I didn't click to the article you linked" as I'll get, I guess....because the methodology was explained within it.

Oh, and nicely loaded question, there. You may as well have added to it by asking if the physicians still beat their spouses.

I still really want one of you to look at this bill and see whats being "proposed", than think about how providers are reimbursed, and seriously tell me this is a great idea.

I'm not following you here; are you asking that I look at the bill and consider what is being proposed over considering how providers will be reimbursed, or it that a typo, and you meant to say "then" instead of "than"?

Oh yeah and for the third time where is the government going to get these funds?

As I understand it, the direct mechanism is still being negotiated - this is why Olympia Snowe has yet to be "on board" with it - but obviously, it'll be through a reduction of other budgetary items, an increase in taxes, an increase in efficiency thereby generating cost savings, or (and my money is on this, so to speak) a combination of the above. Any HS sophomore who has taken a civics class could have told you this....unless you're aware of some new means of revenue enhancement.


Dale

 

[jazzgeek]

Remember health care IS A BUSINESS.

And did you happen to see the article this past June in New Yorker magazine about the exorbitant costs of health care in McAllen, TX, wherein the patient is viewed as a "profit center"?

Would you agree or disagree that controlling costs is a vital and necessary part of keeping health care affordable and profitable?

Just wondering......



Dale

 

[Drizzt80]

To debate the validity of a bill based on how it will work, whena final bill has yet to be written, and presume all this positive response is very, VERY bold.

:shrugs:
D80

 

[tyflier]

To debate the validity of a bill based on how it will work, whena final bill has yet to be written, and presume all this positive response is very, VERY bold.

:shrugs:
D80

Hmm...it would be very bold, wouldn't it? Pray tell...who, exactly, has ever predicted a positive outcome for this bill in this topic?

The only predictions I see being made are of doom and gloom. Still incredibly presumptuous, very bold, and wrong to do. But I haven't seen any positive predictions being made. Just people that are willing to try something, ANYthing, that might change the garbage that has BEEN going on...

 

[snakemom1961]

TAXES, TAXES, TAXES.

 

[tyflier]

LOL Chris, I am a person of knowledge from my immediate arena and thats what I said on opinions on this plan. Twisting words in a defense makes it appear you have nothing valid to add to your point.

As for me sounding like an insurance company because I ask about the backgrounds of the polled doctors thats also a poor attempt at deflecting a valuable question. The hospitalist is very different than the single practice or partnered physician. Remember health care IS A BUSINESS.

Now on your last "you sound like an insurance company statement where am I backpedaller? I said look at the bill, how their planning on reimbursing providers, and still tell me understanding that HEALTH CARE IS A BUSINESS why this is a good idea. I am asking you to do what I did and base your argument for a national health plan on fact. How and where is our government going to get this money to fuel the health care INDUSTRY?

When one can not defend their stance with fact or even an explanation of the simplest questions about payment it would seem that one in all reality knows NOTHING about the subject. You my friend are the backpedaller support your claim!!

You backpedaled from your second post, trying to say you never predicted, and now further trying to say you are not a "spokesperson" when your first post was very plainly and obviously written as someone in a position of knowledge. Now you are changing your tune. That's backpedalling.

I haven't backpedaled one bit. I have always maintained that there is no way of knowing...and there isn't, until someone actually writes the bill.

So would you care to explain to me how I am unable to support that stance?

 

[Pruddock]

Hmm...it would be very bold, wouldn't it? Pray tell...who, exactly, has ever predicted a positive outcome for this bill in this topic?

The only predictions I see being made are of doom and gloom. Still incredibly presumptuous, very bold, and wrong to do. But I haven't seen any positive predictions being made. Just people that are willing to try something, ANYthing, that might change the garbage that has BEEN going on...

That in itself is a presumptuous statement considering the majority of the population is against the bill thus far. So if the majority are ok with the current "garbage" when it is compared to the tax hike needed for any nation wide reform, why is it only those who are for the bill are the good guys as your statement seems to elude to?

 

[tyflier]

That in itself is a presumptuous statement considering the majority of the population is against the bill thus far. So if the majority are ok with the current "garbage" when it is compared to the tax hike needed for any nation wide reform, why is it only those who are for the bill are the good guys as your statement seems to elude to?

Really? Sources?

The last poll I saw regarding this bill, from, again, msnbc a couple nights ago, showed a distinct majority of the population polled was in support of the bill, either with or without a Public Option. Now, I don't remeber the exact numbers, and it certainly wasn't the landslide of polled physicians Dale and I both mentioned(and which you still haven't cited any sources for your contradictory poll results)...but it was a distinct majority. Something in the neighborhood of 57% in favor of medical reform.

So again...sources? That is, of course, unless you meant to say a "majority of your friends", in which case...I believe you...

And...since when do my statements elude to only those in support of the bill being the "good guys"? I haven't made ANY statements or elusions to such an effect. I called the current state of medical insurance garbage. This much is true. But that very simple statement does not in any way, shape, or form elude to a presumption about the people in support of or against the bill. Sorry, but those assumptions are all in your head. I'm sure there are just as many blind good guys as there are bad guys against the bill..:nyahThat last statement is a sarcastic attempt at levity, not an actual debate technique...just so you know...)

I don't debate the person, I debate the topic. So if you'd like to rephrase your accusation to state that I called the current system garbage, you're welcome to. Otherwise...don't put words in my mouth, because I never stated, assumed, nor eluded to any such nonsense...And I think you know that...

 

[tyflier]

I'd also like to say one thing...

I would be willing to bet that if medical reform could be satisfactorily accomplished without changing the current tax structure...you "majority" against the bill would very quickly turn tail and support it. You can assume anything you want from that statement, but to me, it seems to boil down to personal greed.

Now...before you twist this in some way to mean something I never intended...that is NOT to imply that these people are "bad" or that personal greed is "bad". It's ONLY to say that it is, in my opinion, a very classic case of NIMBY. That stands for "Not in my backyard", and is a VERY typical response from people that want something done...but don't want to pay for it, see it, or have to deal with it. It first became popular when people were screaming for more prisons to be built in the mid-80's, but nobody at the town and/or state level were willing to allow those prisons to be built in their "backyard".

This, at least from my point of view, seems to very much be the case, where the majority of anti-reform protestors seem to me mostly concerned with how it will effect their tax schedule, rather than how it will actually change the country.

And yes...this is based entirely on conjecture and opinion. Do with it what you will...

 

[Pruddock]

http://rasmussenreports.getmobile.com/site?t=4jWKt8g4CNXMypZKvruHLw&sid=rassenreports-feblzqlu

http://messageboards.ivillage.com/n/mb/message.asp?webtag=iv-elpoliticsto&msg=20104.1&ctx=0

I've refrained from doing thisbecause I'm on my iPhone and it's a pain in the butt, but here you go. I saw the doctor poll on hannity last night as I was flipping by (not much of a fan) so that's where I saw it. I would look more if I had access to a pc, but those will work. And you can accuse me all you want of assuming, but we both know that you make assumptions as much as anybody. I'm guilty as well, but fingerpointing really does nothingso I guess I'm just being a hypocrit again.

 

[Pruddock]

I'd also like to say one thing...

I would be willing to bet that if medical reform could be satisfactorily accomplished without changing the current tax structure...you "majority" against the bill would very quickly turn tail and support it. You can assume anything you want from that statement, but to me, it seems to boil down to personal greed.

Now...before you twist this in some way to mean something I never intended...that is NOT to imply that these people are "bad" or that personal greed is "bad". It's ONLY to say that it is, in my opinion, a very classic case of NIMBY. That stands for "Not in my backyard", and is a VERY typical response from people that want something done...but don't want to pay for it, see it, or have to deal with it. It first became popular when people were screaming for more prisons to be built in the mid-80's, but nobody at the town and/or state level were willing to allow those prisons to be built in their "backyard".

This, at least from my point of view, seems to very much be the case, where the majority of anti-reform protestors seem to me mostly concerned with how it will effect their tax schedule, rather than how it will actually change the country.

And yes...this is based entirely on conjecture and opinion. Do with it what you will...

Chris, I don't know if greed is the correct term I would use for my own personal feelings, but rather a distrust of the goverent and a greed that I feel it has come to stand for.

I will definitely agree with most of your statement though. If the government were to cut other extraneous spendig from the budget, of which there is SO much, and redistribute it to clean up current bureaucracies and work on reform, I would completely support that. My fear is that the government will do what it has become infamous for, and thatis creating a bill, spending the money, and showing little or no effort to monitor the funding afterwards and letting it get out of control. My fear for what has been proposed so far is that the bill is extremely vague and large from what I've read. It seems like an entity that could become a serious detriment to our tax dollars and our healthcare system if history proves true.

 

[jazzgeek]

http://messageboards.ivillage.com/n/mb/message.asp?webtag=iv-elpoliticsto&msg=20104.1&ctx=0

Ah, the Investor's Business Daily Poll.

Nate Silver, the statistician (for all you baseball rotisserie league geeks, he invented the PECOTA ranking system) and pollster (he runs the website fivethirtyeight.com) who correctly predicted 49 of the 50 states in the 2008 Presidential election - and given that, who probably knows a bit more about methodology and accurate sampling than anyone on this forum - doesn't find the IBD poll to be credible.

His reasons?

1. The survey was conducted by mail, which is unusual. The only other mail-based poll that I'm aware of is that conducted by the Columbus Dispatch, which was associated with an average error of about 7 percentage points -- the highest of any pollster that we tested.

2. At least one of the questions is blatantly biased: "Do you believe the government can cover 47 million more people and it will cost less money and th quality of care will be better?". Holy run-on-sentence, Batman? A pollster who asks a question like this one is not intending to be objective.

3. As we learned during the Presidntial campaign -- when, among other things, they had John McCain winning the youth vote 74-22 -- the IBD/TIPP polling operation has literally no idea what they're doing. I mean, literally none. For example, I don't trust IBD/TIPP to have competently selected anything resembling a random panel, which is harder to do than you'd think.

4. They say, somewhat ambiguously: "Responses are still coming in." This is also highly unorthodox. Professional pollsters generally do not report results before the survey period is compete.

5. There is virtually no disclosure about methodology. For example, IBD doesn't bother to define the term "practicing physician", which could mean almost anything. Nor do they explain how their randomization procedure worked, provide the entire question battery, or anything like that.

His advice?

My advice would be to completely ignore this poll. There are pollsters out there that have an agenda but are highly competent, and there are pollsters that are nonpartisan but not particularly skilled. Rarely, however, do you find the whole package: that special pollster which is both biased and inept. IBD/TIPP is one of the few exceptions.

Dale

 

[jazzgeek]

As an aside, Investor's Business Daily is also the publication that opined that scientist and cosmologist Stephen Hawking, who suffers from ALS ("Lou Gehrig Disease") would not have a chance of survival if he lived in the United Kingdom, given their National Healthcare System.

Um, Hawking DOES live in the UK, and was born there; he's a professor at Cambridge.

In response, Hawking said, "I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."

I just wish that we could accurately list this as his response. :grin01:

EPIC fail on the part of IBD. Oops.


Dale

 

[tyflier]

Chris, I don't know if greed is the correct term I would use for my own personal feelings, but rather a distrust of the goverent and a greed that I feel it has come to stand for.

I will definitely agree with most of your statement though. If the government were to cut other extraneous spendig from the budget, of which there is SO much, and redistribute it to clean up current bureaucracies and work on reform, I would completely support that. My fear is that the government will do what it has become infamous for, and thatis creating a bill, spending the money, and showing little or no effort to monitor the funding afterwards and letting it get out of control. My fear for what has been proposed so far is that the bill is extremely vague and large from what I've read. It seems like an entity that could become a serious detriment to our tax dollars and our healthcare system if history proves true.

I can't argue with this...which is why it offends me to have assumptions made about my "position". The truth is...I don't HAVE a position. I WON'T have a position, until I have access to a finalized bill that will be going up to vote that I can peruse. Problem is...that may not help most people because these things are specifically written to be barely understandbale by "layman", and I am as lay as they come...

My ONLY position is...we don't know. Don't know what's in it. Don't know how it will work. Don't know what it will change. Don't know what it will cost. Don't know ANYTHING other presuppositions, scare tactics about socialism, and biased opinions coming from one side or the other.

 

[Drizzt80]

As an aside, Investor's Business Daily is also the publication that opined that scientist and cosmologist Stephen Hawking, who suffers from ALS ("Lou Gehrig Disease") would not have a chance of survival if he lived in the United Kingdom, given their National Healthcare System.

Um, Hawking DOES live in the UK, and was born there; he's a professor at Cambridge.

In response, Hawking said, "I wouldn't be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived."

EPIC fail on the part of IBD. Oops.


Dale

Just for a fair level of comparison, what type of care do non-Stephen Hawking British ALS sufferers receive?

D80

 

[KJUN]

Just people that are willing to try something, ANYthing, that might change the garbage that has BEEN going on...

That's right. Lazy people who don't get MORE than someone that actually works and improves themselves (i.e., can get those higher paying jobs or work harder and make more money) ARE willing to try anything....especially communism, socialism, and anythign else that takes from the rich and gives to the poor. I guess they've read Robin Hood a few too many times....

 

[Pruddock]

http://www.foxnews.com/politics/2009/09/16/obama-used-faulty-anecdote-speech-congress/

Oops... I guess the insurance companies aren't the only one's who construe stories to support their claims... Maybe liar was the right term, just not the right time.

 

[Nova_C]

That's right. Lazy people who don't get MORE than someone that actually works and improves themselves (i.e., can get those higher paying jobs or work harder and make more money) ARE willing to try anything....especially communism, socialism, and anythign else that takes from the rich and gives to the poor. I guess they've read Robin Hood a few too many times....

Well, the US is the only first world nation without some form of UHC. Are you claiming that all supporters of said UHC systems are lazy? How does one support such a bold claim?

And even if you aren't, why don't you back up the claim that supporters of socialized medicine are any more lazy than people who do not support it?

 

[Drizzt80]

Well, the US is the only first world nation without some form of UHC.

Do you think before you type? What is medicaid and medicare if not some form of UHC??

That's the point of the """paranoia""". The government can't even run medicaid and medicare adequately and yet we're supposed to blindly accept the fact that they will be able to run a health care program to help everyone.

D80

 

[jazzgeek]

Just for a fair level of comparison, what type of care do non-Stephen Hawking British ALS sufferers receive?

D80

Are you suggesting that a health care delivery system derided by critics here in the US as SOCIALIST just might have some capitalist aspects to it? Or are you suggesting that people of celebrity and fame may get preferential treatment, regardless of the means of delivery? :shrugs:

As it is, so far I can't find anything on the webz for a comparison of mortality rates among those diagnosed with ALS within the UK, or compared to the mortality rates of those with ALS here in the US....without paying an abstract fee.

That said, how does your well-raised point/question refute my prior point that the Investor's Business Daily editorial was an epic fail because of its lack of fact checking, Mr. Hawking's endorsement notwithstanding?


Dale