You might think that the American Medical Association, which today came out in opposition to a "public option" on comprehensive health care reform, is just a bunch of doctors trying to do what's best for their patients, and that their opposition to the public option is a mere disagreement over details.
And you'd be wrong. The AMA is not just a bunch of doctors, but among other things an extremely lucrative lobbying organization that has given more than $12 million in campaign contributions to federal candidates since 1998. And since 1998, according to the nonpartisan OpenSecrets.org, some 64 percent of the AMA's donations to federal candidates have been to Republicans -- although 2008, in which the AMA gave 56 percent of its contributions to Democrats, was a notable exception.
The disparity is especially noteworthy on the Senate side, which arguably has a greater role in passing health care reform. Since 1998, almost four-fifths of the AMA's donation to Senate candidates have been to Republicans (including 64 percent in 2008). They have been a bit more equitable on the House side.
These aren't particularly moderate Republicans the AMA is donating to either. The leading Senate-side recipient of its campaign contributions since 1998 has been John Ensign of Nevada, to whom the AMA has given $30,000. Ensign is the chairman of the Senate Republican Policy Committee. And Minority Leader Mitch McConnell, with $20,000 in donations, is in a tie with six other Republicans for second place. By contrast, the AMA has given just $3,000 to Ted Kennedy over this period, $4,000 to former Senator Hillary Clinton, and nothing to Majority Leader Harry Reid. Nor did President Obama or Vice President Biden receive any contributions from the AMA before departing for the White House. The AMA has, however, has given more generously to some other Democrats who are key players in health care reform, like Ron Wyden of Oregon ($12,800) and Max Baucus of Montana ($15,000; Baucus is the leading Senate Democratic recipient of AMA funds).
The AMA has given, since 1998, a total of $280,485 to the 66 Senators who voted in January to pass the Children's Health Insurance Program (SCHIP). That is $4,250 per vote. By contrast, it has given $374,745, or $11,711 per vote, to the 32 Senators who opposed SCHIP. All but one Senator who voted in opposition to SCHIP, the newly-elected Jim Risch of Idaho, has received at least some contributions from the AMA over this period. By contrast, 30 of the 66 yea votes on SCHIP have not received a donation from the AMA since at least 1998, although we should note that a relatively high number of Democrats have joined the Senate chamber since 2006 and have not had as much opportunity to receive contributions.
6.11.2009
American Medical Association Has Long Donated to Opponents of Health Care Reform
@ 4:10 PM
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But... why?
Is this disparity *about* health-care? Or is it that doctor's often make in excess of 250k, and are looking for some tax relief? Or something else? Any guesses?
I wish I could see response to this post from the AMA.
This is a generation thing.
Older doctors tend to have been moderate Republicans.
My generation of doctors was in love with Reagan in many of cases. There was a lot of propaganda fed to those who grew up in the US about the horrors of the Canadian medical system (during the cold war, it was easy to falsely analogize democratic universal systems to the Soviet system), and there was a general stereotype that hard-working, ambitious people should be Republican.
The younger doctors graduating from medical school today are much more likely to be Democrats and in favor of universal health care, however.
The younger doctors graduating from medical school today are much more likely to be Democrats and in favor of universal health care, however.
Any proof whatsoever to back that statement up...or are we just supposed to believe you...well, just because, right?
Through reading your numerous posts I've come to one inexorable opinion:
You are a pompous jackass!
I don't like the title...It's a bit misleading...No one opposes Health Care, at least not that I know of, some do oppose public health care in many different forms...Possibly semantics, but i think it does mislead
My doctor hates insurance companies - all the paperwork, and especially their trying to tell him how to practice medicine when they are just paper-pushers trying to save money by denying care - and he thinks the AMA is disgusting and refuses to belong to them. Does anyone have a figure on what percentage of licensed or practicing physicians are members of the AMA?
The thing is that the AMA does not represent the majority of American physicians. The AMA represents only about 1/3 of doctors, and 90% of doctors over the age of 70, but less than 30% of doctors under 50.
59% of American physicians support a public option.
I'm sorry, but what is a "health care opponent"? That statement is nonsense.
That's an interesting tidbit. My guess, based purely on my assessment of the situation, is that doctors are well aware that our present system is buckling under its own fatness and figure a public option, while hardly perfect, is like choosing between getting hit with a baseball bat or being slowly burned to death.
@CasualObserver: You forgot to say "liberals"
The AMA is all about doctors getting paid more money. It tries to restrict the number of doctors (which is a main reason why there aren't more med school slots) to keep doctors wages high. As others have pointed out not all doctors belong to the AMA and many doctors disagree with the AMA politics. Doctors as a whole are in favor of a public option because it works and because the hodge podge multiple insurance mess that we currently have is a huge problem. Way too many resources go to insurance paperwork, insurance marketing, insurance overhead, and insurance profits. When you need 2 people for bookings and billings and paperwork for each primary care doctor you have a very inefficient system.
The AMA is a professional lobby. They represent the financial interests of their members: physicians. They have no patient advocacy function. I wish people would spend more time listening to CMS or the WHO; you know, groups that actually focus on outcomes.
I'm a pharmacist (PharmD), so while I don't have direct experience with the AMA, I do have direct experience with the (much less powerful) pharmacy professional organizations, and from my conversations with MDs I can say that they operate in a very similar fashion.
You need to weight your donations to reflect that there were more republican house members and senators on a year-weighted basis from 1998 to the present.
Can someone cite a source on the majority of doctors supporting a public health care system? I dont dispute it, Id just like something to post on Fuckbook and to shove in drive by conservatard faces.
Shouldn't the real story be that donating a paltry $12 million over a decade gives you major influence on policy for one of the largest sectors of the economy? It never surprises me that legislators are for sale. But the pittance that is their going rate is shocking. Government is the single best investment that any corporation or organization can make.
If there was a law that said you needed certificate x to be a pilot, firefighter, EMT, etc. and a group like the AMA that severely limited the number of people who could get certificate X, then all those types of people would also make starting salaries in the 200-600k range. Some primary care doctors really don't get paid enough, but many specialists who don't actually do anything that skilled are obscenely overpaid (anesthesiologists would never have starting salaries of 500k in an open market, but the AMA makes sure they don’t compete in an open market). Also, consider the % of people that are kicked out of med school versus say law school, mba programs, etc... I was quite surprised to learn how low the number was.
The thing that I find most shocking about the AMA is how successful they've been while providing no value to patients, only more cash to doctors (who should be well paid and have to deal with a lot of crap to be sure), yet somehow public opinion doesn’t just level the AMA. If Obama wants to do something big to get healthcare costs under control he can simply say FU to the AMA and change the system. Make everyone start like a nurse, those who pass a test can advance to the next level. Anyone with the skill can have the job. Also, pay interns and residents something like 100k so it’s less intimidating for people to pursue some 7 year program. I floated this idea to some of my friends who are in residency at the moment and got like 3 minutes of diatribe about how much they had in medschool debt... only since it only takes them about 6 months to pay off 200k, I didn’t feel very bad for them.
@juvanya,
You're a know-nothing, son-of-a-bitch asshole, that's what you are.
I literally laugh out loud at how you pompous jerks on the left talk about all of the "angry and bitter conservatives" but you come on here and fill the comments section of every post, day after day, with invective and insults of everything under the sun.
The AMA is now walking back their opposition, saying that they oppose Medicare rates in a public option, not a public option per se. So they are caving in.
Casual Observer -
Any proof whatsoever to back that statement up...or are we just supposed to believe you...well, just because, right?text
No definitive proof, just my own impressions and the impressions of long time professors at my old medical alma mater, for now.
By the way, you posts here are typically among the angriest and bitterest I see in any site. Usually for no obvious reason.
I mean, let's say that younger doctors are more liberal. Or let's say that I'm wrong. Either way, why should either of those things make you so angry?
Realist, to be fair, malpractice insurance is also a heavy expense for doctors. If the power of the AMA to shield the small number of doctors responsible for the huge majority of malpractices is broken, it would make sense under a system of guaranteed health insurance to more or less eliminate compensatory awards for health care payments and possibly lower punitive awards - but only in exchange for easier revocation of the licenses of incompetent doctors.
No definitive proof, just my own impressions and the impressions of long time professors at my old medical alma mater, for now.
Ah, pulling stuff out of your ass based on anecdotal evidence, I see. That's a statistically sound way of generalizing across the entire population./sarcasm
By the way, you posts here are typically among the angriest and bitterest I see in any site. Usually for no obvious reason.
I just dole out what I see. But I think you exaggerate with your superlatives. I've hardly been that angry or bitter, and if I have dropped a snark or two, it was in response to vitriol that a liberal had already hurled.
I mean, let's say that younger doctors are more liberal. Or let's say that I'm wrong. Either way, why should either of those things make you so angry?
I'm not angry. But I do get very "to the point" and may drop a swear word or two when I see damn lies and false suppositions made by liberals or an otherwise negative and cynical tone about conservatives "for no obvious reason."
@casualobserver:
Your firm and masculine points have persuaded me to cease being such a darn wimp. Is there a way which I can cease bearing this taint of Cain of being a "liberal," or is it a mark beyond even the saving blood of Christ?
Please; I want to know! Is there any hope for us, or are we worse than Commu-Nazis?!
@harold: I think the definitions of "conservative" change over time, but I wouldn't be surprised if there's been more of it nowadays. There's kind of a cycle, and we seem to be in the liberalizing part of it.
@nirad: That is the sad truth; not that people sell themselves, but that the rates are so low.
Any chance you can add a "report abuse" function, so we can remove posts that add nothing to the discourse other than swearing and/or insulting others?
Thanks!!!
Casual Observer, you can say what you want, but there's no reason for you to have such a nasty tone. If you think they're pompous jackasses, be the bigger person and don't be a pompous jackass yourself.
That being said, I agree with most of what you've said. All of the doctors I know have been conservative, but I don't act like "doctors I know" is a random sample of all doctors in the country. Surely there has been some actual polling done about whether doctors favor public health care. My guess would be that doctors tend to be Republicans because they make so much money.
Remember that some congressmen were doctors as well: Bill Frist (retired), Tom Coburn, and Ron Paul immediately come to mind. All of them were fiscal conservatives.
The AMA also fought against Medicare in the 1960's.
The percentage of American doctors who are members dropped from around 70% in the 1960's to about 30% in 2000. It has taken increasingly conservative political positions that apparently do not appeal much to younger doctors, as they are not signing on as members. My husband and my brother are both doctors who will have nothing to do with the AMA. By the way, state medical associations used to require that their members also belong to the AMA, but that started to change in the 1970's, which is no doubt one of the reasons for the drop in AMA memberships.
Scott: JAMA actually put out a minor study on it in '04. There've been 23 physicians in House over the previous 40 years, and 2 in the Senate. At the time, 8 were serving.
Partisan breakdown, according to the abstract, was 60% Republicans, 45.1% Democrats. Significant, for sure, but not overwhelming, truth be told. (I assume some switched parties)
http://jama.ama-assn.org/cgi/content/full/292/17/2125
wv:winglysi- sorry, but no. It's just too easy.
Nate Silver is a hack.
What is good for the doctor is good for healthcare.
If we get government run healthcare than you can expect thousands of doctors to go Gait on America. They would rather retire early than deal with being told how to practice medicine and being told which of their patients is deserving of care. Government healthcare is a sick system, only a drone would support it. Human beings should never be subjected to plutocratic healthcare.
When Obama-care passes you can be assured the supply of doctors will rapidly decline and there is nothing government can do about that. We will all suffer.
Nate is such a tool!
Rush predicted this very sort of attack today. The WH is no doubt sending out its talking points to its minions (yes, Nate is a minion as well as a wanker).
The Obama administration like all leftists depends on Hate to get is agenda passed. It wants to create a wedge between the people and those who would oppose its policies.
Now we must demonize the opposition.
What bullcrap!
Doctors are about the only force left in medicine who care about you as a patient. They alone have taken a sacred oath to protect you. These are the practitioners of the healing arts.
But now in the age of envy and division they must become targets and vilified for fear that you, the public, might just listen to these people you have trusted so much that you would undress in front of them and let them cut you up! Obama alone wants your ear.
Imagine where the money from those who support Obama's brand of health care reform (it's called rationing -- it will work like Medicaid, which is to say, badly) goes? All saintly types, I am sure!
The President lies to you about his intentions on a daily basis and among his biggest lies is his vision of health care.
Obama, if permitted (and there are enuf sheep out there, he might just get the chance!), would impose a Cuban style health care system on us. Of course, he is Fidel so he will be kept alive quite nicely, thank you!
The rest of us will have to wait in line, sometimes for years, sometimes till death claims us.
The crisis in healthcare is like the crisis of Global Warming: It is more apparent than real.
If you all keep swallowing Oliar's crap without critical examination (and don't count on the media to help you -- they are in league with him as much as Nate), we are all doomed.
Next time you stop by an ER see who's there. You'll find out it is choked not with the uninsured, as the Liar in Chief will tell you, but by government insured patients, especially Medicaid ones. These are people who because of low government reimbursement cannot find a doctor to treat them in their offices.
Government run healthcare is already a scandal. They want you to start subsidizing it even more because they lack the will or the desire to fund it properly.
Mark me -- if this vision of hell comes to pass there will be no one left to treat you.
That's the way I see it.
petekent01 (on twitter)
I find the shift in donations in recent times interesting. I'd guess the major associations, AMA, PhRMA and others have realized fighting it is a losing cause so have decided to switch donations to some that may think donations might help to have a listening ear when law is being written that may put them in a better position had they not tried to get a voice at the table.
@BeanoCook: I hope you realize that the US is almost the only country without a government-run central healthcare system (if you don't count third world countries with no healthcare system to speak of at all).
And, guess what, the rest of the world is quite happy with what they've got, while the US "free market" system is dysfunctional.
Oh, and one more thing: do us a favor, do look up the word "plutocratic" in a dictionary before you use it again. It really says the exact opposite of what you meant.
What? The AMA is opposed to the public medical option? That's like asking, "Is the Pope Catholic?"
The fought Medicare for years and years. It's important to realize that they're like almost every professional association -- they support the economic interests of their members. And their economic interests are to maximize profits, not to reduce costs or to expand coverage if that doesn't lead to increased profits.
Sergely--virtually every one of those countries has a two-tiered system where the rich pay privately for what the government refuses to provide.
If something is free you have no means of controlling supply other than to ration it. That means the bureaucrats decide who gets treatment, not you.
Companies are building medical facilities in the Caribbean because of the coming boom in medical tourism.
Only the naive support government healthcare. With the exception of America most of the world is used to living in a class stratified society where things are naturally denied them.
This is America -- we don’t have to take that crap! We are better than you!
petekent01 (on twitter)
We already ration healthcare in the US. We just do it by income, not need.
Atul Gawande's latest article in the New Yorker for a better understanding of how our system is failing. It's the doctors who are treating patients as profit centers who are making out like bandits while sending the cost of health care soaring. Those doctors undoubtedly belong to the AMA.
Sergely--
The best you got is the rest of the world does it, so we should too?
You strike me as foolish.
America is the best country in the world, why should we do what Estonia does? Or what England or Canada does?
Democrats want to micromanage every aspect of my life, get the hell out of my life. I want to be able to get the healthcare I deserve and my family deserves and not have to ask permission from the government if I can get an MRI, especially if I can pay for one myself. Think of that insanity.
Your ideas suck. Nate doesn't have a PhD. These doctors do, they are smarter than he is, there is even a consensus that government healthcare will destroy people's lives in America. this matter is settled.
Smarter: Doctors>>>Silver
By and large, Doctors overwhelmingly oppose "socialized medicine".
It is very very easy to get them to rant about this at length.
The rants are usually focused on how Socialized medicine will be disastrous for their patients, who won't be able to get the care they need.
I'm rather shocked (and a tad envious) that Nate has somehow managed to go through life without hearing this rant.
But the fact remains that doctors (as a group) do hold beliefs that are consistent with their advocacy.
Obama's health care proposal can be read at snipurl.com/jucia.
The numbers don't come close to adding up and elements of the proposal contradict one another. For example, how would covering more people and doing more preventive care- that's treating more people more often- cut costs? We'r a lot more likely to see costs cut by denial of Jane's hip replacement or Joe's prostate cancer surgery. It will be cheaper for Jane to limp and Joe to die. There is absolutely no way that government run health care will reduce costs.
Does the average American really think the government can do a better job of running health care than the private sector?
The desired results should be freedom of choice, timely access to care, high quality of care, flexibility, innovation. Wait, that's what the vast majority of Americans enjoy today.
@BeanoCook
My doctor husband would think you are nuts. The current system is untenable. He just left a very successful private practice to practice in the VA system; now he can just give good medical care and doesn't have to worry about billing insurers who make a game of denying claims.
The MRIs I got 2 weeks ago cost over $13,000. Why would you want to pay for that yourself?
The AMA is a terrible organization that does not pay attention to the majority of physicians. It is run by an older generation that only cares about money. That may be why older physicians got into medicine, but it surely isn't why my generation went into medicine (there are much easier ways to get rich these days).
oh and to the commenter that calls Nate an idiot for not having a PhD... most doctors don't have PhDs either
Hey Nate -
Would it be possible for you to do similar analysis on a PAC like UAW and see if they in aggregate contributed more to Ds than Rs? If so, do you think that would raise questions about the stake they received in GM?
I'd love to see the analysis, instead of just making assumptions.
Thanks
Don't feed the trolls! They make these comments for the express purpose of elliciting a reaction. JUST IGNORE THEM.
NATE: If I've learned one thing this year it's that democracy has been circumvented by the legality of corporations donating millions to senators. Senators are corporate lawyers who write legistlation and have a veto power.
Nate - you're a smart guy - how do we go about changing the system? Does it have to be through the Supreme Court?
The MRIs I got 2 weeks ago cost over $13,000. Why would you want to pay for that yourself?
SOMEONE is paying for it, whether you realize it or not. If you have private insurance, everyone else who has your plan is paying for it through increased premiums (and in turn, you're paying for their medical costs). If your company gives you healthcare, they're either taking the money out of your salary or passing it along to the consumer. If you're on a government plan, the taxpayers are paying for it.
There is no such thing as free healthcare. You can cut costs all you want, but at the end of the day, someone has to pay for it. I think people should pay for their own medicine (with the exception of very poor children, who should be covered by the states). What happens if the government runs out of money to pay for healthcare? What if they tell you you can't HAVE an MRI?
Scott,
I think the underlying point is why in the world does a couple of MRI's cost 13,000 in the first place?
A friend of mine just had his appendix out... $56,000. $14,000 of that was for "surgical instruments".
I work in the defense industry, and even OUR procurement department would think that is nuts for a couple of knives and scissors.
I love how the right-wing here believes that insurance companies don't have bureaucrats, especially not bureaucrats devoted explicitly to denying people care.
And, of course, there's the fact that even the "reasonable" right-wingers are unaware that emergency room treatment costs often hundreds of times what preventative care would have cost, and that for people without insurance, they can get emergency room care (and the hospital has to eat the cost, because they can't deny emergency room care to people who can't pay, and people without insurance are, of course, entirely unable to pay it back ever, so declare bankruptcy instead.) while they can't get preventative care.
And then, of course, there's the fact that the wingers are unaware that Medicare has an approximately 2% administrative cost, versus the 20+% of private insurance.
But since they believe Reagan's lie, they have to assume that anything that says government would be an improvement over industry must inherently be wrong or a lie.
Michael, you raise a great point.
I really like your idea about making it so so doctors who did really dumb / bad things lose their licenses instead of having the insurance companies pay extreme $$$ from our pockets - why do we pay when they F up? Crazy system. The way the AMA protects some selected doctor jobs in terms of protection from being fired and above market wages is way above what the UAW or some teacher unions manage to pull off.
Your idea and making it so its easy for people to be specialists would really reduce the cost of healthcare.
Health care costs are seriously going to break this country if we don't get it under control.
Seriously, for all the people who think universal healthcare system is the devil, what's your plan? The percent of GDP we spend on healthcare is increasing every year. You just want to wait until your "free market" breaks us? I work in antitrust and I can assure you that the healthcare system is already nothing like a free market - go try and buy your own drugs... see if you can pay near the marginal cost for an MRI scan... try and open your own show providing medical services without managing to get through all the rules they've created to reduce supply. It's not a free market now. We might as well see if we can get a universal system to work because this clearly does not.
BeanoCook, PeteKent, etc...
What the hell are you talking about?
Your statements are completely disconnected from reality. I mean, I know you're just trolls and all, but it's not as funny when you diatribe flys in the face of facts that are readily apparent to anyone paying attention.
I expect a better quality of troll-ishness from you guys.
------------
Here's the absolute reality of Obamas plan:
GEICO. Anybody know what it stands for?
Government Employee Insurance COmpany.
They used to to all the insurance for the military, then they got spun out into a separate company.
Now imagine that GEICO was just the same as it is today with their gecko's and their stupid eye-ball cash things. Only difference is that they sell medical insurance instead of car insurance.
THAT'S THE WHOLE CHANGE! Rant that Obama's not really changing anything, but don't pretend like our car insurance options have been destroyed because GEICO is on the market. That's just not good trolling.
word verification: "brupsesc"
Just swap two letter pairs and you've got "burpsecs". PeteKent's erotic Rush Limbaugh fantasy come to life!
Quick question -- what is the hottest topic being debated in Congress this week?
I doubt one of you on the left will know it. Or wonder why so virtually no one is talking about it.
I'll reply on Twitter.
petekent01 (on twitter)
Jake--
A Hole!
GEICO is an effing public company and has been for years. You proved nothing.
Its all about rationing, my friends, rationing.
petekent01 (on twitter)
I'm a young, liberal doctor, married to a young liberal doctor. Of my medical school & residency classes, a clear majority expressed liberal inclinations and were supportive of universal healthcare. Anecdotal yes, but in my experience Ed is by and large correct. Unfortunately data is lacking on older physicians, but what little data exists suggests the same:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17372802
It would be nice to respond to some of the conservative-leaning posts here, but it's difficult to get past the lack of civility.
@Scott
Of course someone is paying for my MRIs. I have federal insurance, and I got a bill for over $600 of the total. Insurance pools risk and spreads the costs across the insureds. If everyone is covered, the risk pool is much larger and includes healthy as well as sick people, so that the average cost goes down. When everyone is covered and claims can no longer be denied, the administrative costs arising from the effort to deny every claim possible disappear. And insured people are entitled to doctor's office visits and don't have to show up at the emergency room when their condition is acute -- which is another way having everyone covered would save huge amounts of money. At least one study has suggested that if we just extended a single payer system like Medicare (yes, we already have "socialized" medicine in this country, and your grandparents are probably pretty happy with it) to everyone, the system would not cost any more than we are already paying, because the administrative costs are much lower (see the comments above) and the risk would be spread over a much larger pool -- not just the elderly who are more likely to use the medical system, which is one of the current problems with Medicare. Notice that with Medicare, patients generally get to choose their own doctors, and the doctors bill Medicare just like any other insurer. The most important difference would be that we would not be paying for insurers to profit from our ills. The current fee for service system actually encourages doctors/hospitals to treat patients as profit centers.
It seems only foreigners are populating medical schools. They tend to be married couples who are smart and see medicine as a way out of the poverty of their home countries.
Their instincts are much more mercantile than prior generations of physicians. Think about the Mayo brothers.
As importantly, this new class of doctors come from such deprived backgrounds and from the sorts of command and controlled/results-oriented economies in the third and developing world that they are quite content to be government employees.
For manyof them medicine is a stepping stone to the creation of a 7-11 franchise empire.
petekent01 (on twitter)
Beckee--
what the problem with Medicaid, then?
petekent01 (on twitter)
PeteKent
Which is it? Mercantile or government employees?
These would be very well paid government employees, we are not after all talking about teachers!
My other question(s)?
Medicaid?
This week's big Congressional debate that the media refuses to cover?
petekent01 (on twitter)
@PeteKent
I am not an expert on Medicaid, but I think one of the problems with Medicaid is that although we have decided to give some medical care to really poor people, we don't want to give them much. (They don't deserve it, you see. That they are poor is God's judgment.) So the reimbursement rates in many states are so low that doctors cannot afford or are not willing to take on Medicaid patients. They've each got a big "M" painted on their foreheads. If all patients were covered by the same level of insurance, there would be no stigma associated with Medicaid patients. I for one would like a world in which no American had to worry whether they could afford to go see a doctor when they really need to.
In a way, Nate's thesis is nothing new, as Howard Wolinsky and Tom Brune covered the same thesis in their 1994 book The Serpent on the Staff, of how the AMA more often puts self-interest above public health.
You can get an MRI in America for $10!!!
I’ve giving this secret away in honor of you Scott.
Here’s what you do: Go to your second hand store, buy the worst clothes you can find for $5 and put them on. Go to the liquor store, buy the worst wine you can find for $5. Give your keys and wallet to someone you trust. Now in an alley pour the wine all over your face and head – even drink a little. Now go to a busy corner and lie down.
Here’s what’s going to happen: An ambulance will come pick you up, letting you avoid traffic as you whiz with sirens to the hospital. They’ll take you straight into the emergency room, so unlike any other medical experience you won’t have to wait around for hours (the system wants to free up that ambulance and they can’t break continuity of care – so no waiting for you – you didn’t even have to find parking). The doctor will ask you what’s wrong. Act a little out of it and tell him whatever’s going on (if you want an MRI you can act like you’re mentally totally out of it and don’t respond well to questioning etc) – or maybe say you fell down and hit your head – ask a doctor friend what to say to get the treatment you need. Now you’ll get that treatment and then you’ll be discharged. The greatest part about this is not only did you get in and out fast, but you didn’t have to fill out any of that Fing paper work. Since you look indigent, the hospital won’t even try to charge you – just make sure you look homeless!!!
On a more general note, Medicare for everyone would be terrible because Medicare is setup so it’s really easy for doctors to charge a ton for a patient if they need to… a doctor who knows how to game the system can come in to a hospital and more than double the amount of money they earn from medicare for doing the exact same crap. We need to either get a socialized system like in Europe or get rid of all rules – anyone can prescribe medications, anyone can become a medical specialist, doctors not payors through insurance premiums get sued when doctors messup, and finally we need avoid the moral hazard of medical insurance… you smoke, eat too much, you pay more. Can’t pay for your bad behavior, then we let you die. Personally I prefer a European style of healthcare, but almost anything is better than what we have.
I noticed no one corrected or answered the idiot up top who asked how preventitive medicine cuts costs? Are you seriously that stupid? Preventative medicine cuts costs because the more things are pre treated and monitored, the less likely preventable afflications end up in long trreatment programs...Casual Observer, you're not angry, just a dangerous loon who should be institutionalized. I guess being such an intellectual lightweight with no accomplishments and no future must be tough...
Well, Beckee. I think you have that about right. Medicaid is totally underfunded as a way to control costs. Not very liberal is it? Let's see what Obama does about that. Probably as much as he'll do for the Gays. Nada.
When healthcare is "free" the only way to limit demand will be to either ration or keep reimbursement artifically low so that patients will get less treatment as they wait in line for care.
That's how they do it in much of the socialized world. Canada is a perfect example.
We import their drugs and they export their patients!
petekent01 (on twitter)
Realist...yeah, the current system is a fricken joke, and the current set up for health insurers is so silly...The CEO's of these firms make so much money based on denying current care with no regard for the future for the comapny...If the private insurance idiots could see past todays profits, they'd actually make more money long run
I don't know John, if they deny current care they make more more money later since preventitive care is usually more cost effective.
I have a great idea. Let's privitize the fire department, and then let them charge whatever they want when there's a fire!!! Wait, I can do better. Let's make it so that only a few people are allowed to fight fires and if anyone else tries to fight a fire they get put in jail for not having a licence - after all they could hurt somebody since they don't have training.. Wait, let's make it so the people who's house is burning don't actually pay the cost, that way they won't flinch when the firefighter demands 300k to save their house. Wait, let's change that setup so the only thing people have to pay for is preventitive measures like smoke detectors but still not the really expensive stuff... wait, let's make sure that no matter what people do, bonefires inside, whatever, that doesn't effect what they pay the insurance company for having coverage...I could go on and on, but sadly am still at work.
In light of what Michael said,
Michael said...
You need to weight your donations to reflect that there were more republican house members and senators on a year-weighted basis from 1998 to the present.
June 11, 2009 5:04 PM
It would be interesting to see donations going back at least 2 full political cycles, just as in finance we look at trends over at least 1 or 2 full economic cycles. From 1998-2006 (with the exception of 2000-2002 when Jim Jeffords defected to the Democrats and handed them control), Republicans controlled the chamber.
As I imagine that doctors are smart, they'd probably donate more to the ruling party for more results. I wouldn't be so quick to say that doctors are all knee-jerk Republicans. Is the data from say, 1986-1994 available? That would be when the Democrats last controlled the Senate.
@Realist
The irony of your post is that fire companies in this country were originally purely private and would only serve those who paid. Walk around Philadelphia and you can see the plaques that showed payments. The fire companies did not come to fires for those who had not paid. As we progressed, fire fighting became a community effort available to all and is now paid for largely through taxes. Perhaps now is the time when health care will follow suit.
As a medical student, I would agree that the overwhleming majority of medical students lean democratic and/or favor universal health care. This is just anecdotal evidence from my own school and from discussing the issue with friends in other medical schools around the country.
I would also agree that older physicians tend to be more conservative than younger doctors. Again, this is just anecdotal evidence, but is at least overwhelmingly true in the hospitals I train at.
Lastly, I think it's a little unfair to be callous towards doctors because they make "250,000 +" per year. First, for many, many doctors this isn't true. Secondly, by the time I graduate I will have $320000 in debt. Then I get to watch as interest accrues during residency for my particular specialty, which happens to be 7 years long. So, I don't think it's all that bad that doctors make good money. I am paying alot for my education, and I sure as hell am working my ass off to be a good doctor one day!
The MRIs I got 2 weeks ago cost over $13,000. Why would you want to pay for that yourself?
_________________________________
Well Beckee, to answer your (ignorant) question. Because getting a timely MRI to diagnose a lump on my grandma's body will become difficult, if not impossible.
Our only recourse would be to travel to a clinic that will do the MRI for cash.
This is how healthcare works in Canada, the rich come here to the US to get preventive healthcare like MRIs.
Saskatchewan, Canada has 2 MRI machines. The small town I grew up in has 7.
BeanoCook & co.:
Fun fact: fuming over "rationed" healthcare aside, which country has the highest number of MRI machines on a per capita basis? Alternatively, which nation has the shortest wait time for a kidney transplant?
Hint: Both are nations with actual healthcare systems, as opposed to the mess we have in the US, where we serve fewer, achieve inferior outcomes, and pay double for the privilege.
I love the hypocrisy of Nate Silver, crying about money doctors give to Washington to impact policy, yet we hear nothing about UNIONS and their payoff of Washington to get a sweet, if not illegal deal to secure GM's assets.
Nor do we hear a peep about the trial lawyers who motivated by profit, block tort reform in medicine, driving up the cost of medical insurance to levels that add $ billions of unnecessary expense to US medicine.
Let's not forget those "scientists" that claim climate research that shows man is responsible for all of the warming we have (not) had over the last 8 years, (especially this year losers).
Where are you stat boy on these issues? Stat boy lacking even a PhD. These AMA doctors have MDs, they are smarter.
THe politics of doctors is changing, and single payor is winning our hearts and minds. As Nate points out, however, it has not changed the AMA's mind- they are trying to screw us all again.
Data: Reunion poll at my Harvard Medical Reunion last year. When we graduated in 1983, 70% or so of the class of '83 favored single payer, but only 15% of the class of '58 did so. In 2008, more than 70% of both the class of '83 and the survivors of the class of '58 favored single payer plan.
Yes, I know it is Harvard; still we are coming around.
Insurance pools risk and spreads the costs across the insureds. If everyone is covered, the risk pool is much larger and includes healthy as well as sick people, so that the average cost goes down.
I'm a healthy 19 year old, so my medical costs would be dramatically higher than they should be under a public plan. I would much rather get a low-cost, high deductible plan that would cover me if, say, I got into a car accident or got cancer, but I wouldn't want to pay extra for regular doctor's visits and medication that I don't yet need. Should a situation ever arise where I would have to pay a lot more for my medical care (like, if I were diagnosed with diabetes), I would pay more.
When everyone is covered and claims can no longer be denied, the administrative costs arising from the effort to deny every claim possible disappear.
This is a straw man argument. I've heard of people being denied care before, but do you have any statistics that show it happens with any regularity? Insurance companies do have to fight back against fraud. If they never denied claims, they would lose a lot of money.
If you're suggesting the government will never have to deny claims, you are sadly mistaken.
And insured people are entitled to doctor's office visits and don't have to show up at the emergency room when their condition is acute -- which is another way having everyone covered would save huge amounts of money. At least one study has suggested that if we just extended a single payer system like Medicare (yes, we already have "socialized" medicine in this country, and your grandparents are probably pretty happy with it)
My grandmother is extremely UNHAPPY with Medicare. When you reach a certain age and are on a federal retirement plan, you are forced to use Medicare as your primary provider, even if you have a better private plan (like she does). Most doctors in her area won't take Medicare because of the paperwork involved.
The current fee for service system actually encourages doctors/hospitals to treat patients as profit centers.
What's wrong with that? Every other business in the country runs on a for-profit basis; why shouldn't the medical system? People who provide better care should be able to charge more, and people who receive care should be able to shop around and get the best care for the best price. What's unfortunate is that most people DON'T.
Beckee: that is pretty ironic and amusing about fire departments. Glad they don't still charge...
Patrick: I agree doctors should be well paid, but a specialist who starts at 500k will pay off that huge loan in <1 year... now a family doctor with that loan has it a lot worse. Clearly not all doctors are overpaid, and clearly it's a profession where I hope the salary attracts talent. I also think it's dumb we don't pay residents more - they do the work of doctors after all - if they were paid more, more people might go become doctors. Finally, if they limit doctor pay under some new system they should also limit the exploding cost of med-school imo.
BeanoCook: Before you jump all over Nate you should consider that this post is about the AMA which is basically a union - protects jobs and tries to raise wages over market rates. I do agree that tort reform would be a good subject as well as unions... but Nate I think also once said he thought ibankers deserve what they were paid, and they're probably the most overpaid people I know (most mergers lose shareholder value, maybe it's the complex derivatives that just sunk our economy we’re paying for? At least if your doctor is ripping you off you're getting something valuable – if over priced - in return).
Scott you said:
What's wrong with that? Every other business in the country runs on a for-profit basis; why shouldn't the medical system? People who provide better care
What's wrong with it is that it's going to break our country - no joke. Look at a graph of what we spend on healthcare as a percent of GDP and then see what's likely to happen in 2025.
Markets only work if they are free. Our healthcare market is not a free market - not anywhere close. So we can either remove ALL regulation or try something like the European system.
Here's a silly example. Let's pass laws that say that only people I give a licence to can sell water - if you sell water without one you go to jail. Guess how much water will cost? It'll be stupid and aweful for everyone and I'd be the richest man in the world. And, it'd still be more of a free market than our healthcare system is at the moment. Partially regulated markets aren't free markets and certainly don't give the benefits of free markets.
The reason so many things cost so damn much is that that's sort of the public cost, and insurers are really paying something substantially more reasonable. The thing is that if you aren't on the insurance rolls (I am not) you get to pay the full price.
I am also still waiting for instructions on how I can stop being a hateful liberal drone, since it sounds like it's really kind of a bad thing, to have like four people here screaming about how it's so nasty. :( Help a brother out here, buddies!
Uh last time I checked insurance companies and your income here chooses whether you can get health care.
Last time I went to the free market doctor, I waited.
Last time I tried to make an appointment, it wasnt the next day.
Last time I checked you couldnt just run in and get heart surgery at any time.
The conservatard myth machine continues to spew out propaganda and lies that you have to wait on lines in Socialist health care, but you dont have to here. The reality is, anywhere you have a number of people, you have lines to wait in.
What's up with all the drive-by conservatards here. PeteKent, CasualObserver, BeanoCook? If you dont like what we say here, why are you here. rushlimbaugh.com could use more goons.
Michael mentioned something that hasn't been brought up in any of the comments: malpractice. Democrats in general tend to favor legislation that makes it easier to sue for malpractice. I don't have the data to prove this, but all those endorsements from trial lawyers don't really help. I wonder how much of the contributions to Republican candidates are because of their efforts to limit malpractice suits and cap benefits. Regardless of whether or not such measures are the right thing to do, they may bias the results seen here. Nate, I love your work, and you usually use multivariate regression to correct for such codependent variables, but I think the data here are not enough to suggest that the AMA is against health care reform.
That said, as a medical student, I find the AMA extremely sketchy, and I will certainly not join when I graduate. For example, most pharmacies sell prescribing information to information distribution companies, who sell it to pharmaceutical companies. The AMA sells data that allows the pharmaceutical companies to match prescribing data with physician names so that they can target their marketing on a physician-by-physician basis. In 2005, database product sales provided more than $44 million to the AMA! (Steinbrook R (2006) For sale: Physicians' prescribing data. New Engl J Med 354: 2745–2747.)
Sorry, clearly I skimmed over the first few sentences which pretty much prove that the AMA is against the current public option. However, I maintain that AMA donations are not only motivated by an opposition to health care reform but also some other factors, which may bias towards Republican contributions even more.
I'm probably the only poster here that is actually on a universal health care single payer plan.That's right, I'm on Medicare.(And almost all of my friends are on it too.} So let me give you my summing up.
It is great.I know of no one on it that doesn't think so.
I see any doctor I want,including specialists.I need no one's permission to do so.I need no one's approval for any medical procedure.I wait no longer for any kind of appointment than a person with private insurance.I fill out absolutely no paper work.My providers get paid within a few weeks after submitting a bill via an office computer.
Any questions? Feel free to ask.(I have trolls on Greasemonkey so don't ask,you guys.(You know who you are!)
P.S.The only thing better than Medicare is the health coverage members of Congress,Supreme Court justices,the President ,Vice President,etc.get FOR LIFE.And that,by the way is true socialized medicine as,unlike Medicare, the providers are employees of the payer.(Did any member of Congress ever opt out because it's socialized medicine? Don't make me laugh.)
Opus, please send me a thank you note, for I am certainly paying for your health care.
What you don't seem able to understand is that once the entire nation is under socialized medicine, the system will break and there will never be enough money to go around to pay for what healthcare service is needed. Therefore we will be forced to ration care and you my friend will be the first to have basic care revoked, why? Because you will be deemed to be worthless and a poor investment.
That's right, the decision to save you will be a cold slap, based solely upon the return on investment, measured by your life expectancy from point of care/procedure.
Medicare sure works when 10 people are paying for 5, but soon, we will have 5 paying for 10......do you ever pick up the news paper? Social Security, Medicare, Medicade are all ponzi schemes, just like the GM/UAW benefits.
Stop micromanaging my life.
The AMA makes me damn sick.
@BeanoCook:
Hey, could you give me a note about paying for your roads and everything? It doesn't have to be much, but I've probably put a hundred bucks into the federal liquor excise tax since I turned 21, so I figure, you know, I'd like some thanks. Just whenever you have a moment, I know you're busy.
A brief comment about the AMA: it's largely dominated by specialists, because specialists have the most money and influence to donate to it. Therefore, it tends to support programs that line _specialists'_ pockets, which the current system does in droves. Meanwhile, organizations like the American Academy of Family Physicians tends to be in support of such reform; it wouldn't make them richer, probably, but it would more evenly distribute health care dollars where it could actually do some good. (Full disclosure: I'm married to an FP.)
How about some actual polling data, instead of screaming?
The Journal of General Internal Medicine reported in April 2009 on a study from Harvard Medical School that only 9% of the 1,675 doctors surveyed prefer the current employer-based system. A full 89 percent of physicians say that all Americans should get access to care, regardless of ability to pay. Close to one-fifth (19.3%) of the respondents (all of the respondents were doctors, remember, they deal with insurance companies everyday) believe that even those patients with insurance sometimes lack access to needed care.
The Journal went on to say, "CONCLUSIONS: The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians."
Before rightwingers scream "But Harvard is liberally biased!", a 2008 study from the Indiana University School of Medicine found that 59% of physicians support legislation to establish national health insurance; 28% "strongly" and 31% "generally". This was a 10 point increase in support since 2002, when the number was 49%. Support was highest among psychiatrists, pediatricans and emergency care physicians... I'm guessing these are specialties more likely to deal with the uninsured. Support was lowest among anesthesiologists and radiologists... I am not sure why. Maybe they wonder whether cost saving measures, like having online analysis of fractures and the use of nurse anesthetists will eat into their business?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2659157
http://www.pnhp.org/docsurvey/annals_physician_support.pdf (warning pdf file, but small one)
To all those who are bashing on Nate for not having an MD, let me tell you that despite what you may have heard, doctors are not the smartest people in the world. There are plenty of not-too-intelligent doctors out there. To get to (and through) medical school, all you need to be able to do is figure out a way to memorize a lot and kiss ass. It doesn't require any critical thinking skill, any in depth analysis or anything that people like Nate have to do.
@Michael"...malpractice insurance is also a heavy expense for doctors."
Agreed...But didn't those supporting malpractice legislation a few years ago say that malpractice insurance would drop and would thus reduce health care costs? Am I mis-remembering?
The National Association of Insurance Commissioners says that the total amount spent by physicians to pay their malpractice insurance premiums in this country was $9.6 billion dollars... a HUGE number, but only .62% of the total cost of healthcare.
That is to say, for every $100 spent on healthcare, 62 cents goes to pay malpractice insurance.
Now, that said, there may be other costs accrued in performing unnecessary tests and procedures in defensive medicine. (For example, a pt presents with a funny bump on their arm, thinking it is a new mole. The doctor looks at it and says, "That's not a mole, that's a mosquito bite!" But if cancer later coincidentally develops in that spot, the doctor may be in big trouble, so she schedules follow up visits, or biopsies or whatever to make sure it doesn't, therefore spending hundreds of dollars on a mosquito bite, even though she was 99.9999% sure it's not cancer at first glance.)
This is why we need a national board that monitors practices and health outcomes as part of the reform of healthcare. Then if that spot does develop into cancer, the doctor can simply say, "I followed the best practice guidelines for diagnosis and tratment as set out by the board. It showed all the signs of being a mosquito bite. If lightning later struck and it coincidentally developed into cancer, it's frankly not my fault."
Plus, one of the ways other countries keep down the cost of malpractice suits is by having a single-payer, univerrsal national healthcare system. In these countries, if a doctor or hospital makes a grievous mistake... let's say making a mistake which destroys your kidneys, putting you on dialysis for the rest of your life, there will no doubt be a lawsuit. The damages sought, though, will be lower, because the injured patient doesn't bear the cost of the medical treatment resulting from the mistake. Damages may include pain, suffering, loss of work, possibly even punitive damages, but the doctor's insurance company won't be paying for the patient's dialysis and associated medical treatment for life. That cost is already covered.
Good point about how with universal coverage the cost of a medical mistake lawsuit is less because the future medical coverage costs are not a problem the victim faces.
The other issue with medical malpractice insurance, in addition to it being such a small part of the health care costs (let's see 0.62% goes to malpractice insurance but 30+% of private medical insurance premiums goes to overhead, paperwork, and profits compared to <2% in the gov't run system) is that medical malpractice insurance rates do *NOT* track well with medical malpractice awards. The insurance rates instead track with market returns. When everyone is making money in investments then the insurance companies make money on their invested premiums. When the market is bad the insurance companies lose money on their premiums invested and need to bring in much more in premiums than they pay out in malpractice awards. There have been a number of studies that show this pattern. There are some subspecialties of doctors where malpractice issues are real, but they are the exception not the usual case.
Really, doctors folding under malpractice expenses implying a need to fix the legal system is similar to people wanting to shut down welfare because of cadillac driving welfare queens or wanting to end the estate tax because of all those family farms being destroyed by it. They are right wing memes that don't stand up to a reality based analysis.
I'm a medical student and I'm President of my medical school's AMA chapter. The reason why the AMA donated so much to the Republicans for the last decade is because the Republicans WERE IN POWER during that time.
Notice that after the Democrats took over both houses, the AMA significantly increases its donations to the Democratic Party. Just take a look at the 2008 cycle.
Furthermore, Republican senators got a lot of support from the AMA in 2008. Well, it was mainly three moderate, centrist Republicans: Susan Collins, Gordon Smith, and Norm Coleman. These three Senators were unequivocally against Medicare reimbursement cuts that were going to take into effect in 2008. The AMA supported them because they stood up against cuts that would have devastated thousands of physician practices.
This analysis' claims are patently false and warrants a better investigation of the facts. It is entirely disingenuous.
Also, the analysis talks about how the AMA gave more money to Senators who oppose SCHIP.
AGAIN: The SCHIP vote was after the 2006 cycle. Nate Silver assesses how AMA money has been given to politicians since 1998 by using a vote that takes place a decade later as his benchmark. Just brilliant... just brilliant (note: I am exuding sarcasm right now)
I wrote to the AMA:
"Can it be true that the AMA wants to continue the lunacy of health insurance instead of directly-funded national health care free from profiteers?
Are the leaders of your 250K members invested in the insurance companies, pharmaceuticals, and HMOs that are stressing and bankrupting your patients? I am inclined to think there must be some truth to that.
How can it be that a doctors' association would not be objecting strenuously to the double whammy of the insurance companies: the false claim of rising malpractice that excused the bilking of physicians and the totally useless shakedown by gatekeepers whose sole purpose is to skim 30% off every health care dollar?
Single payer eliminates the middlemen who get paid via premiums and co-pays and taxes and property insurance. Single payer means every patient swipes a card and gets quality health service. Single payer means doctors spend time tending to patients, not negotiating deals with insurance companies.
You don't need a specialist to diagnose this ailment. The AMA has an acute crisis of morality."
Anonymous 2,
How do you intend to pay for single-payer? We already have single-payer: it's called Medicare and Medicaid. They are going broke. Those two programs will account for 13% of GDP in 2040, and to sustain Medicare outlays in 2030, America would need an ACROSS-THE-BOARD 36% income tax hike.
You also mentioned that Medicare provides better quality insurance than private insurance. That is completely false. In 30 clinical categories which account for
half of the reasons people seek care, only 55% of proven-effective therapies are administered to patients who need them. Health care providers did not perform the other procedures and failed to meet the rest of the evidence-based medical benchmarks. Medicare insures the recommended treatments, yet adherence to these quality indicators did not significantly vary between Medicare and non-Medicare patients (RAND Corporation, McGlynn et al. 2003).
Anonymous 2, before you indulge in partisan hackery maybe you should first read some health economics.
npunwani:
"How do you intend to pay for single-payer? We already have single-payer: it's called Medicare and Medicaid. They are going broke. Those two programs will account for 13% of GDP in 2040, and to sustain Medicare outlays in 2030, America would need an ACROSS-THE-BOARD 36% income tax hike."
I'm gonna lay some difficult math on you here, so try to keep up.
Right now, we're paying for both systems (social and private). All of us. In addition to private insurance, the average American is paying $750 out of pocket for medical services. Moving to a single payer system means that all that money that's currently being taken directly out of my paycheck and given to a private entity will... be taken out of my paycheck and given to a public entity instead.
Is that difficult to understand? I mean, there are the same number of players in the system, with the same amounts of money. If a single-payer system is doomed to insolvency, why isn't a private system, where the additional overhead of profit has to be accounted for? People such as yourself keep pointing to the insolvency of Medicare as if it's inherent to any socialized system. They ignore the fact that Medicare covers a relatively smaller, relatively poorer pool of higher risk. It's the perfect storm of badness, which is why private insurers won't touch the folks covered by Medicare. If it were privatized, the costs would be staggering.
To put it in perspective for you, 1.45% of an average person's income goes to pay for Medicare, but 4.5% goes to pay for private insurance. Medicare is a system that was virtually set up to fail, and yet it continues to chug along, despite years of neglect from the government and vitriol from the public (who hate where "their taxes" go, until they have cause to use the system).
Adding a larger risk pool (with lower risk and more capacity to pay) to the Medicare system would dramatically reduce average costs, as would giving more bargaining power to a single payer.
Are you sure you're not the one in need of an education in health economics?
Slobodan Dragorabinikočević,
Actually I don't need an education in health economics because I was a health economics major and I've written health care policy papers for Brookings Institution think tank in Washington DC.
If we restructure the private market for health insurance as U.S. Senator Ron Wyden (D-OR) wants to do we could save $1 trillion over 10 years once his bill is fully implemented. His Healthy Americans Act would mandate community rating (insurers can't cherry pick only the healthy patients and would have to charge the same rate to all), an individual mandate that all people buy insurance, and tax subsidies so everyone can buy the private health insurance of their own choice.
The Dutch back in 2007 abandoned their single payer system to embrace universal health care thru private insurance. Guess what happened.. cost growth is projected to fell to about 3% after inflation from 4.5% in 2006. This happened because private insurance could no longer compete like they do now thru cherrypicking healthy clients, they had to compete by avoiding unnecessary utilization (this is whats bankrupting America, something like 30% of Medicare spending is waste and doesnt result in better outcomes)
If health care costs grew at 3% a year, America's health care system would be solvent. Instead of Medicare for all, lets adopt some managed competition as the Dutch, the Germans, and the Swiss have done.
Slobodan Dragorabinikočević,
Also, better bargaining power isn't actually going to control health care costs. Whenever Medicare cuts reimbursement rates to providers, providers respond by doing more procedures. In the 90s, when Medicare cut payments to cardiothoracic surgeons by 25%, the surgeons responded by doing more surgeries so their gross incomes fell by only 10% or so. The study was done at Duke University.
American physicians are the highest paid in the world. The AMA has opposed universal health care since the 1930s and is the primary reason we are the only developed nation that doesn't have it. It is a morally corrupt organization with blood on its hands.
travelingwriter1,
American physicians also have the highest costs in the world! Most physicians go into debt over $250k after completing medical school. We also have the highest malpractice expenses too. You need high incomes if you're gonna make sure that the physician population stays constant. Only 10% of health care spending actually goes in the doctor's pocket.
There is no blood on anyone's hands. The AMA has proposed a plan for universal health care. You should mind your language.
The AMA’s healthcare reform plan calls for government to subsidize insurance premiums.
The AMA wants the government to spend more money so the insurance companies make more money while they continue to take 30% of the health care dollar for paperwork and otherwise keep business as usual with the broken system we currently have? No thanks.
The healthcare system needs a complete overhaul, not a bandaid applied to an arterial spurt. I only hope President Obama holds out for true reform and doesn’t accept a half-baked gift to the insurance companies like the AMA’s plan.
DermottTrellis,
That 30% you speak of is because of underwriting. That's why the AMA proposes community rating. If there was community rating insurers would not be spending 30% of their revenues on underwriting and trying to price sick people out of the market.
Health insurance companies have already proven that they are not to be trusted with our health so I don’t see why we should continue to pay them $$$$$ to screw us over. Sure, they can tinker with the underwriting, but they will still be the same profit-seeking entities out to deny health services to enhance their bottom lines.
Other countries that care about their citizens’ health don’t have people with ‘good’ medical coverage declaring bankruptcy. Nor health insurance companies who routinely deny covered claims, hoping that the claimant will just pay out of pocket rather than appeal the denial. Nor insurance companies that encourage, no, demand! that OBGYNs induce labor rather than allow natural childbirth because natural takes too long and we need that bed turned over! And hey, the OBGYNs can play the system and make a lot more money with a Caesarean anyway (gee, too bad for the woman, oh well). I’ve got personal horror stories, and as it turns out so do a lot of other people. President Obama is wrong when he says that most people will choose to keep their current coverage rather than choose a nonprofit public option. Most people I talk to will run-don’t-walk to a public option that doesn’t have the demeaning, time-consuming, and soul-crushing hoops we all currently jump through.
Oh yeah, give the insurance companies another chance, they’ll do better... And Lucy won’t pull the football from Charlie Brown either. Our system is broken and our trust is broken. Enough with the foxes guarding the henhouse. My representatives know I want single payer/public option and want insurance companies cut out of the process. My fervent hope is that President Obama truly reforms healthcare and doesn’t settle for a bandaid.
Nothing in obama"s plan to curb defensive medicine ie malpractice reform.So lets restrict access lower payment and do nothing to reform malpractice in this country. What a great recipe for disaster. am all for reform what is the rush Do you let the mechanic hastily start pulling parts out of the engine instead of taking his time to diagnose the problem.Novel idea he might take a lesson from the group he is destroying.Some say we need to move fast because people are losing there jobs because of the recession ie the banking crisis not healthcare as the main problem.So think twice act once.
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