With the enticing promise that Obamacare can improve access while reducing costs why the emotional town hall meetings and slipping polls?
As a father of three doctors and a nurse practitioner (a son, a daughter and two son-in-laws), this issue feels pretty personal to me.
Here’s the rest of the story:
I felt compelled to write after two of my kids emailed this quote today from the American College of Surgeons:
Tuesday, during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation, plus patient follow-up care that is provided 90 days after the operation.
So why is Obama overstating doctor’s pay? Without his projected 40% national health care savings from dramatically reduced Medicare payments, his plan is dead.
So why is there reason for concern?
The typical med student graduates 
with $2oo,ooo in school debt. After 8 years of education and 6 years of residency (with inhuman 80-90 hour work weeks leaving them looking very much like this) they finally begin to generate a real income as a 31 year old. That’s 10 years after a typical college graduate.
The next decade, with Obamacare, they will work almost 6 months of each year to pay off school debt and their $20,000 annual malpractice insurance premium. Almost six months before they bring home a dime for themselves or recoup any of those ten years of lost income.
With these odds stack against them, young aspiring doctors will simply pass for another career. Obamacare will be shrinking our supply of doctors while dumping 46 million new customers on the system.
Big demand with shrinking supply always equals long waits and eventually increasing costs. This dog simply doesn’t hunt.
The only power any leader possesses is the permission of those that follow them. No matter how important a cause, they must lead with complete integrity…or risk that permission.
[...] Care Failure as of August 13, 2009 August 13, 2009 Health Care Reform (Deform) No Comments Obamacare: The Rest of the Story – edbahler.com 08/13/2009 Can Obamacare actually improve access while reducing costs? As a father [...]
Ed,
The following is an excellent article on the structural deficiencies of our current health care system, and the authors suggestions on how to fix it. As someone outside of the health care system, but interested in our nations policies and alarmed by the shift toward more gov’t intrusion, I found the article to be extremely thought-provoking.
I’d love to hear an “insiders” take on it.
http://www.theatlantic.com/doc/200909/health-care
Luke,
That’s an interesting story. I’ve had similar frustrations with my recent heart cath. operation.
Give me a few days. I’ll be with all three guys this week end and I’ll get everyone’s take on it and come back with a follow up post.
Ed
[...] Health Care Failure as of August 13, 2009 August 13, 2009 Health Care Reform (Deform) 1 Comment Obamacare: The Rest of the Story – edbahler.com 08/13/2009 Can Obamacare actually improve access while reducing costs? As a father [...]
hey all,
I asked Luke about the issue Luke Knapp brought to the table here. Apparently the hospitals that my Luke works in have people sitting around in chairs watching whether hand sterilization and disease prevention measures are being taken seriously day in and day out. They call them Nazis because they make such a big deal about it.
The biggest motivator backing compliance is money. If compliance grades fall below a certain level, the hospital receives less money from Medicare/Medicaid making everyone pretty willing to measure up.
I don’t know how smaller hospitals do it, but the ones here in Indy seem to rigidly follow the basic guidelines mentioned in the article. The stats given in the article would need to be looked at with a critical eye too…it would be critical to assess what kind of patient base was present at the hospitals. Bigger hospitals have the sicker patients brought in from the smaller ones. They are more immune compromised and more susceptible to secondary infection.
An
Ann,
Thanks for bringing up the statistics issue. There are definitely a lot of stats thrown around in that article. The lack of citations is probably that articles biggest weakness. The biggest draw for me, regarding that article, was his apparent embrace of free-market ideas to fix the system. My agreement with those principles may have biased me towards the article a bit.
Luke
Luke,
I do believe the free market system is the only solution. Unfortunately, Obamacare did little to address the dysfunctional incentives driving costs up. I sense that along with the overall $1 trillion cost may be the reason for the big push back nationwide.
It appears the plan in congress was ideologically versus practically driven. The system dysfunctions are real but largely ignored. But they are dwarfed by the biggest dysfunction. That being the misunderstanding and lack of incentives to a healthy lifestyle and choices associated with it. This is the white elephant nobody wants to talk about.
Yes we need to correct the disincentives to good medical choices within the system. But the only real solution is to address the lifestyle issues.
Ed
See my post today for more detail.
Ed
Ann,
Thanks for sharing the insight. It was helpful. Those Nazi’s show up everywhere.
I took the conversation further in my post today. Would welcome your thoughts.
Ed