# Is this Indicative of the Future? OR Sour Grapes?



## Wolf mom (Mar 8, 2005)

This was in today's paper...under the heading _*Heartfelt Goodby*_

My dear friends and patients,

I am grieved to announce the closure of my office. Sadly, due to the insurance situation in this country today, it appears that it is now impossible for primary care physicians to make a living as free-standing practitioners. Our hard work and our long hours in service to you our patients, as you yourselves know, are no longer considered of wortht o the the powers that be and "they" have decided that we are not worthy of payment.

It is for this reason, with a heavy heart that I must close my doors.

This open letter goes on to talk about Dr referrals and that the office will be open for 2 weeks for record transfer. 

Thankfully, living in a rural area, we still have doctors here BUT......

I wonder if this letter is indicative of the future of solo practitioners. Thankfully my Doc is part of a group that also has an after hours clinic attached.


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## texican (Oct 4, 2003)

All part of the plan... In a socialist paradise, there's little room for private doctors.

Have a 2nd cousin, who's a doc and has her own practice in central Tx... talked last month about the upcoming storm... she's not hopeful. She struggles to break even, carrying medicare patients. If it weren't for her 92 year old mother who runs the clinic, she'd not take any medi patients (most of my Aunt's friends are on medicare).


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## Bearfootfarm (Jul 13, 2006)

Even the Drs in groups are turning down new Medicare/Medicaid patients
If they don't feel they are making enough money, why should they continue?


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## Spinner (Jul 19, 2003)

My doctor said he was going to quit too. I've read that we will lose a lot of doctors over this. Hopefully "the Bill" will be eradicated by the next congress.


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## mountainlaurel (Mar 5, 2010)

A guy I know had a medical clinic in the most unpopulated county in Virginia. He has now sold it and is going to teach at college. His wife told me that most of the patients are on Medicare and in June when it was frozen, they didn't make hardly any money and they knew they couldn't keep the clinic going.


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## ChristyACB (Apr 10, 2008)

It isn't just medicare now, a lot of them aren't taking Tricare anymore either due to the very low payments. Military retirement just got a lot less valuable.


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## seedspreader (Oct 18, 2004)

I fully expect laws REQUIRING doctors to take Medicare. 

Actually if the "health care industry" is considered "too big to fail" now the Fed has the right to step in and make those big guys take payments, etc.

It's one of the great benefits of the recent "finance reform". You can make any company do what the government wants!


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## Tricky Grama (Oct 7, 2006)

Spinner said:


> My doctor said he was going to quit too. I've read that we will lose a lot of doctors over this. Hopefully "the Bill" will be eradicated by the next congress.


Probably will be one of the issues candidates run on, since nearly 2/3rds of the country want it repealed.


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## Prismseed (Sep 14, 2009)

Nevermind the fact insurance companies were greedy to start with that wanted to cut the amount doctors receive.

Ask doctors, it isn't just 'socialist government' some insurance companies are just to much BS to deal with, which is why doctors only accept certain health insurance companies.


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## wwubben (Oct 13, 2004)

Most of the local hospitals around here quit delivering babies years ago because of high insurance premiums.This has nothing to do with the new bill.Private insurance priced them out of business several years ago.


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## watcher (Sep 4, 2006)

Its a problem in all countries with socialized health care. Do a google search on the shortage of doctors in Canada and the UK and you will see our future.


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## georger (Sep 15, 2003)

I think it's sour grapes since there are doctors in every country around the world (and they're not shutting down and leaving their patients without their services), and in most medically advanced countries doctors are still aware of of the Hippocratic Oath.

http://www.medterms.com/script/main/art.asp?articlekey=20909

_Classic Version of the Hippocratic Oath

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant: 

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else. 

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. 

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. 

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. 

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. 

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about. 

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.


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A Modern Version of the Hippocratic Oath

I swear to fulfill, to the best of my ability and judgment, this covenant: 

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. 

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. 

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. 

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. 

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. 

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. 

I will prevent disease whenever I can, for prevention is preferable to cure. 

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. 

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help._


Nothing in these oaths mention a doctor having high wages. So it sounds like sour grapes to me.


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## Windy in Kansas (Jun 16, 2002)

It's not just sour grapes. I have read of several medical facilities closing rather than selling out to others because of the tax advantage of doing so. Another advantage is doing so now rather than waiting for the new government law (Obama Care) to go into the mix.

Several doctors locally have also announced the closing of their practice and are simply retiring a number of years earlier than they had planned to.

I think we are just seeing the tip of the iceberg for what will be coming.


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## 7thswan (Nov 18, 2008)

Yes, right arround the bill being voted on there were a number of storys about Dr.s announcing they would be quiting, one poll said 45%. One dr. I remember taped a note to his door.


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## mnn2501 (Apr 2, 2008)

Its sour grapes, I have found many doctors may know what they are doing as doctors but are poor business managers.


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## naturelover (Jun 6, 2006)

watcher said:


> Its a problem in all countries with socialized health care. Do a google search on the shortage of doctors in Canada and the UK and you will see our future.


No, I think it has nothing to do with socialized health care. I did as you suggested and did a search but I took it one step further, I did a search on *global* shortages of physicians. I discovered there is a world-wide crisis, a shortage of physicians and other medical personnel on a global scale and that compared to the rest of the world, the United States has 10 times more doctors and medical personnel per capita.

Here is just one example of what you can find if you do a similar search:

http://www.hhnmag.com/hhnmag_app/js...cember/061219HHN_Online_Pittman&domain=HHNMAG



> ........ With a world population of over 6.5 billion and, according to the World Health Organization (WHO), 59.2 million full-time paid health care workers, *there are only 0.11 health care workers per 1,000 people across the world. Contrast that with the United States, where there are roughly 10 employed physicians and registered nurses per 1,000 people.*
> 
> Also consider that a threshold of 2.5 health care professionals (counting only doctors, nurses and midwives) per 1,000 population is considered the minimum to achieve 80 percent coverage for deliveries by skilled birth attendants or for measles immunizations. One can quickly infer the magnitude of the developing world&#8217;s shortage. &#8220;There are currently 57 countries with critical shortages equivalent to a global deficit of nearly 2.4 million doctors, nurses and midwives&#8221; [WHO&#8217;s _World Health Report 2006_]_._ This number continues to grow.​
> Migrating Health Care Workers​
> Improvements in communication and transportation have brought increasing globalization to the health care workforce. The worldwide shortage and maldistribution of the health workforce have highlighted the problem of international migration of health care workers...........​


I suspect the situation with some American doctors threatening to close up shop is a case of sour grapes and wanting to continue to manipulate the 'easy street easy money' system. American physicians already get paid more than physicians in all other countries whether there is socialized health care or not. If some American doctors quit their jobs it will be a case of "cutting off the nose to spite the face" and it will backfire on them since they will simply be replaced by other migrant doctors from other countries. That will further decrease the available medical personnel in other countries.

A bit more searching found that there is only one other country in the world where there is not a shortage of physicians, and that is North Korea. The reason for that is because they are not allowed to migrate away from their country.


.


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## Aintlifegrand (Jun 3, 2005)

ChristyACB said:


> It isn't just medicare now, a lot of them aren't taking Tricare anymore either due to the very low payments. Military retirement just got a lot less valuable.


Yes.. the base here stopped taking patients recently so my DH had to find a Doc on the outside.. it was so hard to find one that would accept his Tricare prime... I was going to put him on my insurance (BC/BS) and cancel his tricare, but we had such a big increase this year that I didn't...he found a doc _for now_.


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## big rockpile (Feb 24, 2003)

Because I started seeing an Independent Doctor instead of Contract Doctors I'm alive.But with the New Health Care System I believe the Goverment dosn't want this.

big rockpile


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## Windy in Kansas (Jun 16, 2002)

naturelover said:


> American physicians already get paid more than physicians in all other countries whether there is socialized health care or not.


One has to wonder though if the lawsuit threat is the same in the other countries where doctors earn less? Perhaps much is about purchasing liability insurance here in the U.S.


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## Nevada (Sep 9, 2004)

From the looks of this clip, maybe our doctors would look forward to single-payer health care.

[ame]http://www.youtube.com/watch?v=GOZmvaFfjtk[/ame]


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## Bearfootfarm (Jul 13, 2006)

> I discovered there is a world-wide crisis, a *shortage *of physicians and other medical personnel *on a global scale *and that compared to the rest of the world, the *United States has 10 times more doctors and medical personnel per capita*.


And yet there are those who insist we CHANGE *our* system so we will be more like the rest of the world


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## naturelover (Jun 6, 2006)

Bearfootfarm said:


> And yet there are those who insist we CHANGE *our* system so we will be more like the rest of the world


If you mean change it so the doctors and insurance companies become less capitalistic and more devoted to patient well-being, then I guess you're probably right about that. It does kind of sound as though the doctors threatening to quit are not dedicated about their patient's well being if they're willing to abandon them. Evidently those doctors can already afford to quit and go for early retirement. That's okay if they quit though, they'll still be replaced by new doctors and the new doctors will still get paid more there than they would elsewhere. Migrant doctors especially will leap at the increased opportunity to come to America.

.


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> And yet there are those who insist we CHANGE *our* system so we will be more like the rest of the world


Well, certainly being more like Japan's medical system would be an improvement.


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## Sonshine (Jul 27, 2007)

Sour grapes or not, my MIL was just told by her doctor that she's going to be closing her doors.


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## watcher (Sep 4, 2006)

Nevada said:


> From the looks of this clip, maybe our doctors would look forward to single-payer health care.
> 
> http://www.youtube.com/watch?v=GOZmvaFfjtk


Seems like the docs in Canada and the UK aren't really happy with their system.


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## Aintlifegrand (Jun 3, 2005)

I am in the medical field and we ( as hospital admin) lost three primary docs last week *due to closing offices*.. we lose docs and gain docs all the time..but not to office closures....usually due to competition..fortunately this area is still a big regional area so we (as patients) still have choices.. but for how long.


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## fishhead (Jul 19, 2006)

I remember Mom telling me that my stepfathers surgeon told her that he just couldn't afford to do $14,000 hip replacements any longer and was going to stop taking Medicare patients. That was back in the 80's.


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## Lyra (Sep 15, 2009)

Indicative of the Future

We have had at least 3 community hospitals in the region close in the last two years. Thousands of jobs lost.


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## Bearfootfarm (Jul 13, 2006)

> Evidently those doctors can already afford to quit and go for early retirement


They aren't all retiring.
They can just STOP taking Medicare/Medicaid patients.
Or they can go into other things such as teaching or specialty practices

The end result will be fewer PRIMARY care physicians just when BO's policies will put MILLIONS more people on the DEMAND side of "supply and demand".


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## Bearfootfarm (Jul 13, 2006)

> If you mean change it so the *doctors and insurance companies become less capitalistic*


Everyone says that, and yet no one has ever been able to *show *they make UNREASONABLE profits.

The demand for CHEAPER goods and services is what drove industries (and jobs) out of this country
Does anyone REALLY want to do the same woth medical professionals?


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> The demand for CHEAPER goods and services is what drove industries (and jobs) out of this country
> Does anyone REALLY want to do the same woth medical professionals?


I would like to see it. I think it's inevitable. Prices can only get ridiculous to a certain level before customers flee. Can it get any more absurd? $70,000 hip replacements and $250,000 cardiac bypass procedures are over the top.

I think it's high time we took their $250,000 heart attacks away from them by sending them overseas. You'll see changes then.


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## edcopp (Oct 9, 2004)

My doctor just stopped practicing. He was in a contract situation with a medical group. He is the coroner in the county where he lives. Perhaps he expects less liability problem from dead people.


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## Dandish (Feb 8, 2007)

Prismseed said:


> Nevermind the fact insurance companies were greedy to start with that wanted to cut the amount doctors receive.
> 
> Ask doctors, it isn't just 'socialist government' some insurance companies are just to much BS to deal with, which is why doctors only accept certain health insurance companies.


That's correct. If this guy is closing his doors already, then he's only been working under the current system (he uses he word "current") so you can't say it's because of any new healthcare policies, and more than likely the ins co hassles. They make the rules and have doctors' hands tied to a large extent, and doctors are having to contrast for less and less.


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## TheMartianChick (May 26, 2009)

I guess that I don't see any issues in my area, so far. We have a Catholic hospital, a teaching hospital and two private hospitals in our city alone. I don't see medical facilities shutting down or doctors printing love notes in the newspaper to their patients or anything else.

Twenty years ago, the teaching hospital stopped delivering babies. The other three still do the brunt of that.


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## naturelover (Jun 6, 2006)

watcher said:


> Seems like the docs in Canada and the UK aren't really happy with their system.


I think you just get that impression because of all the negative propaganda and lies that are being spread through media by the American insurance companies who are against it.

_*Universal Health Care Message to Americans From Canadian Doctors & Health Care Experts*_ 
[ame]http://www.youtube.com/watch?v=DXXBCFnhsUc[/ame]


Some further facts:
http://www.ehow.com/about_5065500_canadas-universal-health-care.html


.


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## rkintn (Dec 12, 2002)

naturelover said:


> If you mean change it so the doctors and insurance companies become less capitalistic and more devoted to patient well-being, then I guess you're probably right about that. It does kind of sound as though the doctors threatening to quit are not dedicated about their patient's well being if they're willing to abandon them. Evidently those doctors can already afford to quit and go for early retirement. That's okay if they quit though, they'll still be replaced by new doctors and the new doctors will still get paid more there than they would elsewhere. Migrant doctors especially will leap at the increased opportunity to come to America.
> 
> .


So, the way to make a doctor more caring for the patient is to take away or reduce his income? That sounds pretty ridiculous to me, especially considering the high price (not only financially) of becoming a doctor. Personally, I avoid the doctor as much as possible but when I do go, I don't want a migrant doctor. My experience has been that they are not as caring and less likely to listen to the patient.

I don't agree with the new healthcare bill or system and I think it's going to get much much worse before anything gets better.


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## Bearfootfarm (Jul 13, 2006)

> I think it's high time we took their $250,000 heart attacks away from them by sending them overseas. You'll see changes then.


Fine. 
If you feel chest pains, book a flight instead of calling 911.
If you want state of the art treatment in *minutes*, pay the price

It's your choice


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## Bearfootfarm (Jul 13, 2006)

> $70,000 hip replacements and $250,000 cardiac bypass procedures are over the top.


Lets see your sources that verify those claims.

Here's one that says you've inflated it by about two to three times:



> For patients without health insurance, a total hip replacement usually will cost between $31,839 and $44,816, with an average cost of $39,299, according to Blue Cross Blue Shield of North Carolina. However, some medical facilities offer uninsured discounts. At the Kapiolani Medical Center in Aiea, Hawaii, where the full price is about $33,000, an uninsured patient would pay a discounted rate of $20,212 to $23,581.


http://www.costhelper.com/cost/health/hip-replacement.html


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## Bearfootfarm (Jul 13, 2006)

> I think you just get that impression because of all the negative *propaganda and lies *that are being spread through media by the American insurance companies who are against it.


What "lies"?
YOUR people say the same thing:



> SASKATOON &#8212; The incoming *president of the Canadian Medical Association *says this country&#8217;s health-care system is sick and doctors need to develop a plan to cure it.
> 
> Dr. Anne Doig says patients are getting *less than optimal care *and she adds that physicians from across the country &#8211; who will gather in Saskatoon on Sunday for their annual meeting &#8211; recognize that changes must be made.
> 
> ...


http://bejohngalt.com/2009/08/is-canadas-health-care-plan-in-trouble/


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## watcher (Sep 4, 2006)

naturelover said:


> I think you just get that impression because of all the negative propaganda and lies that are being spread through media by the American insurance companies who are against it.
> 
> _*Universal Health Care Message to Americans From Canadian Doctors & Health Care Experts*_
> http://www.youtube.com/watch?v=DXXBCFnhsUc
> ...


Actually most of my information about other nations comes from sources in those countries. Its easily available via the internet. One source for it is news.google.com. You can read the news from almost any nation in the world.

My favorite source is the Canadian government. I like the site where it tract how long you will have to wait before you can get treatment. Another is where the government is bragging how the average wait time for treatment is down to ONLY 14 weeks.

BTW, if you do your own research you WILL find out Canada and the UK are in a fairly acute doctor shortage.


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> Fine.
> If you feel chest pains, book a flight instead of calling 911.
> If you want state of the art treatment in *minutes*, pay the price
> 
> It's your choice


You have to do emergency procedures here in the USA, but definitive corrective procedures can wait. In the case of heart attacks it's preferable to wait until the patient is stable to fix trouble spots anyway. Most of the time these things can be done later.


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> For patients without health insurance, a total hip replacement usually will cost between $31,839 and $44,816, with an average cost of $39,299, according to Blue Cross Blue Shield of North Carolina.


My friend's hip was $70K, including hospital & rehab. I know, since I'm the one who forced the hospital to eat it.


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## Bearfootfarm (Jul 13, 2006)

> My friend's hip was $70K, *including hospital & rehab*


Then it *wasn't *a "$70,000 hip replacement", as you claimed. She was already IN the hospital 
*Hype *doesn't help your credibility


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## naturelover (Jun 6, 2006)

Bearfootfarm said:


> What "lies"?
> YOUR people say the same thing:
> 
> http://bejohngalt.com/2009/08/is-canadas-health-care-plan-in-trouble/


Ahh, no, sorry but you got misled by that right-wing propagandist blogger. He got that false information from Canada Free Press, but CFP never had any interview with Dr. Doig as they claimed. No self-respecting Canadian would ever do an interview with that CFP rag. Didn't you know that CFP is actually owned and operated by American extreme right-wingers pretending to be a Canadian publisher, who do nothing but try to dig up dirt about Canada and then twist the truth to suit their own American political agenda? :shocked: 

CFP took bits and pieces from the real interview about Canadian Medicine that was published by the editors of *Parkhurst Exchange* and then CFP twisted it all around and filled in imaginary bits to make it sound like that's what she said, and then that false information from CFP got spread around to a whole bunch of other right-wing bloggers the same day and now that's what people like yourself believe she really said. CFP got caught out in their falsification, they were threatened with legal action and had to remove their false information about Dr. Doig from their blog 

You need to read the real article about the real interview with Dr. Doig and understand fully what she actually said. Not only did she talk about the Canadian system, she also talked about the American system and said it was imploding. So for your edification and elucidation, here is the real interview with Dr. Doig. (Don't forget to check the date of publishing, you'll see it's the same day). Facts and truthfulness are important, remember? Oh, and don't forget to read some of the readers comments too.

http://www.canadianmedicinenews.com/2009/08/new-cma-president-anne-doig-urges.html 

.


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## naturelover (Jun 6, 2006)

watcher said:


> Actually most of my information about other nations comes from sources in those countries. Its easily available via the internet. One source for it is news.google.com. You can read the news from almost any nation in the world.
> 
> My favorite source is the Canadian government. I like the site where it tract how long you will have to wait before you can get treatment. Another is where the government is bragging how the average wait time for treatment is down to ONLY 14 weeks.
> 
> BTW, if you do your own research you WILL find out Canada and the UK are in a fairly acute doctor shortage.


I would like to see some links to these sites you're talking about. As I mentioned above, I already did do the research you previously suggested be done, and I already posted back about it. Didn't you read my post? Yes, it's true that Canada and the UK have a shortage of doctors as does the rest of the world. There are only 2 countries that do not have a shortage of doctors, namely America which has 2 times more than it really needs because of its' head-hunter recruiting practices that promise big $$$$ to migrant physicians, and North Korea which won't permit it's doctors to migrate out of North Korea.

.


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## brosil (Dec 15, 2003)

I asked a proctologist friend once if he'd work for $25 per hour. He said he'd jump at the chance since he only averages about $12.50 per hour in his specialty. I make more than he does. I suspect it may have something to do with the $300k he spends on malpractice insurance. So, how much further can you cut his take home pay before he quits and starts flipping burgers for a living? Remember, you can do a lot of things to a person but you can't make them work.


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## watcher (Sep 4, 2006)

naturelover said:


> I would like to see some links to these sites you're talking about. As I mentioned above, I already did do the research you previously suggested be done, and I already posted back about it. Didn't you read my post? Yes, it's true that Canada and the UK have a shortage of doctors as does the rest of the world. There are only 2 countries that do not have a shortage of doctors, namely America which has 2 times more than it really needs because of its' head-hunter recruiting practices that promise big $$$$ to migrant physicians, and North Korea which won't permit it's doctors to migrate out of North Korea.
> 
> .


Here's a site with links to different government sites where you can find out how long you will be waiting for different medical treatments. http://canadaonline.about.com/od/healthcarewaittimes/Wait_Times_for_Health_Care_in_Canada.htm

A quick google search will give you several links to Canadian government reports on the wait time.


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## sirquack (Feb 18, 2009)

I love how medical insurance companies have been demonized in the current health care scam. The largest contributing factor for the cost of health care is MALPRACTICE insurance. And why is that, because patients expect too much of their providers. I am all for a doctor paying if they cut off the wrong limb, or take out the wrong organ, but how much are these things worth. The average cost of a settlement can easily reach into the MILLIONS of dollars. If a weak patient dies on the table, even if it is not the doctors fault, the living family members usually sue the doctor, hospital, city, state, cab driver and every one else for loss of the family member. And in many cases, even against the will of the doctor, the insurance company settles. It is all about risk mitigation.
The insurance companies know if the case were to go to a jury, who are not experts gets sympathetic with the family will award ungodly amounts of money to the family. Then the cost of insurance goes up to the doctor.
Does anyone wonder why doctors have stopped delivering babies? A big part of the reason is the age of mothers has increased with fertility drugs and treatments. People are not taking their pre-natal care as seriously as they once did. Mothers are working harder, longer and under more stress than ever before. And guess what happens when the baby does not come out perfect? You guessed it, the doctor gets sued and in most cases even if it is not their fault, they lose. The cost of malpractice insurance is more costly for OB's than it is for plastic surgeons. I know because I am friends with doctors. And most of the ones I have talked to personally are very scared of the health care scam that has been approved by a group of politicians who specifically excluded themselves from the provisions they hold the rest of us too. 
Sorry if this is too honest, but I am tired of seeing all the hyperbole about this topic.


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## Nevada (Sep 9, 2004)

sirquack said:


> The largest contributing factor for the cost of health care is MALPRACTICE insurance.


I notice that you neglected to provide a link to back your statement, so I'll provide one for you. Consumer Reports should be agreeable to most of us as being factual.

******
_"Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office."_
http://www.consumerreports.org/heal...for-high-costs/health-care-security-costs.htm


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## mnn2501 (Apr 2, 2008)

mnn2501 said:


> Its sour grapes, I have found many doctors may know what they are doing as doctors but are poor business managers.


 Their "god complex" makes the blame everyone but themselves for their own lack of business management capabilities.


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## mnn2501 (Apr 2, 2008)

Bearfootfarm said:


> Lets see your sources that verify those claims.
> 
> Here's one that says you've inflated it by about two to three times:
> 
> ...


Yeah, your prices are for the hip replacement ONLY -- now add in the anesthialigest (sp) the hospital stay, the drugs, the testings, the rehab and you're back up to the higher cost.


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## sirquack (Feb 18, 2009)

Nevada said:


> I notice that you neglected to provide a link to back your statement, so I'll provide one for you. Consumer Reports should be agreeable to most of us as being factual.
> 
> ******
> _"Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office."_
> http://www.consumerreports.org/heal...for-high-costs/health-care-security-costs.htm


Nevada, I would normally agree with you except I know my friends have told me what they pay in malpractice insurance premiums per month. And if that is 2% of their income, I am definitely in the wrong business.


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## EasyDay (Aug 28, 2004)

Nevada said:


> You have to do emergency procedures here in the USA, but definitive corrective procedures can wait. In the case of heart attacks *it's preferable to wait until the patient is stable to fix trouble spots anyway*. Most of the time these things can be done later.


Stable, as in physically able to undergo major surgery.

Not stable, as in... book a flight, fly to another country. In fact, after major heart surgery, flying is not recommended for 8-10 weeks until the sternum and any ribs are healed.

Let's expand your thoughts on this:

So, costs now include (but not limited to) flight to another country, medical bills, place to rent (hotel, or whatever) for 8 - 10 weeks recovery, flight home. And I'm leaving out all the little stuff like food, meds, someone to care for you at the start... and if you take your own "home care" person, you can double the airfare, hotel, food, etc.
Now add the risk factor: Risks include (but not limited to) surgery by a doc in a country who may have very different rules/standards than we do, possibly no means of retribution if they mess up (especially if it meets their standards), and then issues with follow-up when you return to the US. Many doctors don't want to take on a patient who's surgery was performed in another state, much less than another country.


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## watcher (Sep 4, 2006)

Nevada said:


> I notice that you neglected to provide a link to back your statement, so I'll provide one for you. Consumer Reports should be agreeable to most of us as being factual.
> 
> ******
> _"Malpractice-insurance premiums and liability awards account for less than 2 percent of overall health-care spending, according to a 2004 study by the Congressional Budget Office."_
> http://www.consumerreports.org/heal...for-high-costs/health-care-security-costs.htm


About 10 years ago I was talking to an OGGYN. He told me he was paying around $125,000 per year for malpractice insurance. About 8 years ago my SiL was an OB nurse and she told me the hospital was paying around that same amount for EACH OB nurse on staff. I shutter to think of what OBs are paying today.

This does not include the extra cost added to each case by unnecessary test required by the insurance companies for evidence the doctor did everything possible when the MD is sued.

Before we moved there was not an OB in the county where we lived. The closest was an hour drive away.

Do a google search for 'obgyn crisis', read a few links and then tell us that medical liability isn't a problem in the medical field.


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## Nevada (Sep 9, 2004)

EasyDay said:


> Stable, as in physically able to undergo major surgery.
> 
> Not stable, as in... book a flight, fly to another country. In fact, after major heart surgery, flying is not recommended for 8-10 weeks until the sternum and any ribs are healed.
> 
> ...


But let's not stop expanding on that. I have a friend who needed an artificial patella (kneecap). They needed $25,000 to do it here. He got it done in Thailand for $900. Why don't you run the economics on that one for us.


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## Bearfootfarm (Jul 13, 2006)

> Yeah, your prices are for the hip replacement ONLY


And Nevada's claim was for hip replacement only


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## EasyDay (Aug 28, 2004)

Nevada said:


> But let's not stop expanding on that. I have a friend who needed an artificial patella (kneecap). They needed $25,000 to do it here. He got it done in Thailand for $900. Why don't you run the economics on that one for us.


You sound as if you already have, so how much did he pay out of pocket for ALL involved expenses, not just the kneecap? Also, how did you put a dollar amount on the risks involved? (I did realize, though, that you quickly switched from heart surgery to a kneecap replacement. Nice.)

And while you're doing that, I'll try to keep my money here at home.
Your idea is precisely what initially put US into this economic woe... now you'll "off-shore" your medical treatments.


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> And Nevada's claim was for hip replacement only


What I'm seeing here is protectionism at its worst. With capitalism you have survival of the fittest. What we see in the medical industry is a financial parasite system which is killing its host. As a capitalistic industry it's a failure, yet you can't stand the thought that they go the way of other failed industries.

The medical industry has profited from our misfortune, placing life & limb for common Americans on the line. They are the worst kind of people. Those people will kill for money, and they do it every day. They don't care about us, yet you suggest that we care about them. Why is that?


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## Tracy Rimmer (May 9, 2002)

Windy in Kansas said:


> One has to wonder though if the lawsuit threat is the same in the other countries where doctors earn less? Perhaps much is about purchasing liability insurance here in the U.S.


DING DING DING!! We have a WINNER!

The sue-happy culture is destroying your doctors, and discouraging young people from training to be doctors. Why would anyone do something that risks their entire future on a patient whose main aim MIGHT be to acquire a lifelong annuity from someone they perceive to be "wealthy"? I sure wouldn't.


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## Nevada (Sep 9, 2004)

Tracy Rimmer said:


> Why would anyone do something that risks their entire future on a patient whose main aim MIGHT be to acquire a lifelong annuity from someone they perceive to be "wealthy"? I sure wouldn't.


Take it one step farther. What if they could go to prison for a mistake that hurt someone. The fact is that engineers have that kind of liability. If I was held accountable for my mistakes then why not the same for doctors?


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## dahliaqueen (Nov 9, 2005)

watcher said:


> Its a problem in all countries with socialized health care.


I WISH we had socialized medicine.

What we have is PRIVATIZED medicine holding hands with another ruthless corporate entity, the profit-at-any-cost insurance companies.

And, yes, we are screwed.


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## mnn2501 (Apr 2, 2008)

dahliaqueen said:


> I WISH we had socialized medicine.
> 
> What we have is PRIVATIZED medicine holding hands with another ruthless corporate entity, the profit-at-any-cost insurance companies.
> 
> And, yes, we are screwed.


Amen!!


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## watcher (Sep 4, 2006)

Anyone who has ever had to deal with large government agencies can tell you the last thing they want is to have the government running our health care system.


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## EasyDay (Aug 28, 2004)

watcher said:


> Anyone who has ever had to deal with large government agencies can tell you the last thing they want is to have the government running our health care system.


Amen!!


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## Jenn (Nov 9, 2004)

sirquack said:


> Nevada, I would normally agree with you except I know my friends have told me what they pay in malpractice insurance premiums per month. And if that is 2% of their income, I am definitely in the wrong business.


Sir, Nevada is right. To ME (I'm a doc) malpractice is huge- it was about 5% of my gross income and I am in a cheap specialty- but to those paying for our health care- all of us, our employers, and the government- there are two bigger costs: 

-Continuing improvement in medical advances and technology and the expectation that if it can be done, it should be paid for. 

-Admin costs for health insurance which does nothing but take money from the folks paying for it, take their expenses including huge salaries to executives which makes physician pay look like chicken feed, and then ensure their profit by stalling and whenever possible refusing to pay the docs and hospitals actually providing the service.


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## EasyDay (Aug 28, 2004)

Nevada said:


> Take it one step farther. What if they could go to prison for a mistake that hurt someone. The fact is that engineers have that kind of liability. If I was held accountable for my mistakes then why not the same for doctors?


Now, THIS I agree with. (That's like 3 times in as many years, Nevada! Woo Hoo!)

The AMA (and their string of attys) protect the doc, whether the lawsuit is ligit or not. Maybe they go on the defensive right away due to so many frivolous lawsuits, but I think it's wrong when there is proof.
I was told by several attorneys that I'd never get a doc to testify against another in court because of the fraternity or brotherhood, or whatever they call it. They would lose their credibility in the medical arena if they testified against another. One atty said that those docs who DO testify against another, well that's what they do... they're paid to do it, and don't have much respect in the med. community.

Don't know how true this is, but this was 3 attorneys in 2 different states.


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## Roadking (Oct 8, 2009)

dahliaqueen said:


> And, yes, we are screwed.


Yup, unless it gets unfunded. BUT, remember when HIPPA came into being? Lots of folks went mad on it...
Afraid it's a long jump up the stairs, but there will be more to come. 
Heck, I'm retired, formerly self employed, medicare and medicade are nil for me, and my monthly premiums for my family, between several companies, rally from 3 digits to high 4 digits...it's not even close to where TPTB want it. Luckily, it may be on shakey groung around November. Hold on, the roller coaster is about to run again.
Matt


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## Stann (Jan 2, 2005)

Bearfootfarm said:


> Everyone says that, and yet no one has ever been able to *show *they make UNREASONABLE profits.
> 
> *The demand for CHEAPER goods and services is what drove industries (and jobs) out of this country
> Does anyone REALLY want to do the same woth medical professionals?*


Attention WALMART shoppers. Todays special is heart transplants. Visit Dr. Bombay, on aisle 39, to get your free evaluation.


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## Nevada (Sep 9, 2004)

Stann said:


> Attention WALMART shoppers. Todays special is heart transplants. Visit Dr. Bombay, on aisle 39, to get your free evaluation.


It could be in our future, and it may not be a bad thing. It would be a giant step towards the cash & carry medical system many of us grew up with.

The problem with medical care in this country is that you can't afford to get sick without medical insurance. It's one thing to need insurance to pay for a broken leg, but quite another to need insurance to pay for a sore throat. That's where we are today. It's a system that's stretched to the breaking point. We all know that something has to give sooner or later.


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## EasyDay (Aug 28, 2004)

Some people are raised running to the doc for every little thing. I wasn't, and still don't. 

Part of the problem with going is, you go for one thing, and they always seem to find something else. cha-ching!


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## watcher (Sep 4, 2006)

Nevada said:


> It could be in our future, and it may not be a bad thing. It would be a giant step towards the cash & carry medical system many of us grew up with.
> 
> The problem with medical care in this country is that you can't afford to get sick without medical insurance. It's one thing to need insurance to pay for a broken leg, but quite another to need insurance to pay for a sore throat. That's where we are today. It's a system that's stretched to the breaking point. We all know that something has to give sooner or later.


You don't NEED insurance to pay for a sore throat the problem is people DEMAND insurance pay for a sore throat. Its the very fact that people demand and use medical insurance for the least little problem which has helped drive the cost up.

If you don't have insurance here's what happens. You go the the doc, he may or may not run a few test (depends on what his malpractice insurance requires), he writes you a script for antibiotics. You pay the person at the desk and go on your way. Latter that day someone from the doc's office goes to the bank and deposits the money. End of story.

But if you have insurance and use it here's what happens:

You go to the doc. Due to medical liability the insurance company/companies requires him to take a complete medical history and run a full battery of test to make sure your sore throat isn't an early stage of cancer or a system of another disease. After all the necessary fluids and tissue samples are gathered and you life history has been recorded you are given a script for antibiotics. You then go back into the office where you may or may not pay a co-pay and leave. Back in the doc's office. . .the doc must now sit down and fill out the paperwork the insurance company demands it receives before he gets paid. When he's done with it the person whose only job is dealing with insurance claims takes it and sends a copy to the insurance company and files a copy. Switch scenes to the insurance company. . . the forms the doc's office sent in arrive where they must be opened, sorted and sent to the proper office. In that office a rep checks to make sure the person treated really was insured by the company and the treatment was covered by the policy. After that they then see if the treatment which was given was one of the treatments allowed under either company policy or the individual insurance policy. If all the T's are crossed correctly and all the I's have the proper dots in the proper places that rep sends it to a rep in the accounting office. There the accounting rep checks the amount the doctor charged the insured against the amount the company authorizes for payment for that treatment. If the charges line up the rep then checks to see how much that doc is to be paid for the specific treatment he gave to the insured. After finding that amount the rep authorizes payment of the account and sends out the check. Switch scenes back to the doctor's office. . . The person in the office who is responsible for insurance claims goes through the mail, finds the letter from the insurance company and removes the check. They compare the amount paid to the amount charged to the insured's account. If they match up great, if not well we won't go there. So finally, weeks after the insured has been treated, the doctor is paid.

Now can you see how having insurance which covers every little sneeze and sniffle has driven the price of medical care up?


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## EasyDay (Aug 28, 2004)

And many go to the ER for their sniffles or sore throat!


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## Sonshine (Jul 27, 2007)

I see so many people complaining about the cost of medical care. One of the main reasons it's so expensive is because there are so many people who don't pay their bills, which means everyone else has to pick up the tab. Also, we live in such a sue happy society that the doctors, nurses and medical facilities have to pay high costs for insurance to protect themselves. What this new health care bill is is the final straw for many in the medical field. It's not that they want to abandon their patients, but they have their own families and bills and all that goes with it they have to think about.


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## Tricky Grama (Oct 7, 2006)

Sonshine said:


> I see so many people complaining about the cost of medical care. One of the main reasons it's so expensive is because there are so many people who don't pay their bills, which means everyone else has to pick up the tab. Also, we live in such a sue happy society that the doctors, nurses and medical facilities have to pay high costs for insurance to protect themselves. What this new health care bill is is the final straw for many in the medical field. It's not that they want to abandon their patients, but they have their own families and bills and all that goes with it they have to think about.


Post of the day award.


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## HOTW (Jul 3, 2007)

I have a client whose DH is a surgeon. He has considered getting out because of the absolutley crazy cost of malpractice insurance. That si one of the major issues plus the factt hat patients will sue a DR for something he didn't do he's just a tagalong in a suit then the Ins.Co. pay s out and the insurance goes up! He has doena lot of pro bono work int he past and won't do it anymore because they sue everyone! That has been his experience and out town will lose a good Dr if he quits but who can blaim them? When a bill is 120 and they get 58 but others will overcharge say 300 and get 200 can we see why the honest Drs are leaving?


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## Cornhusker (Mar 20, 2003)

Amazing
All the people who (along with the "administration") who pretended this HC scam was about better more available and more affordable health care are in favor of running doctors out of business.
Shows their real concerns are giving their dictator power, and breaking the back of the middle class not giving people medical care (per Obama's agenda).
Hypocrites.


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## Cornhusker (Mar 20, 2003)

Sonshine said:


> I see so many people complaining about the cost of medical care. One of the main reasons it's so expensive is because there are so many people who don't pay their bills, which means everyone else has to pick up the tab. Also, we live in such a sue happy society that the doctors, nurses and medical facilities have to pay high costs for insurance to protect themselves. What this new health care bill is is the final straw for many in the medical field. It's not that they want to abandon their patients, but they have their own families and bills and all that goes with it they have to think about.


Too bad Obamaco wasted the opportunity to actually fix the system, choosing instead to grab power over our lives.
What we'd expect from the most corrupt "administration" in the history of this country.


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## Nevada (Sep 9, 2004)

watcher said:


> You don't NEED insurance to pay for a sore throat the problem is people DEMAND insurance pay for a sore throat. Its the very fact that people demand and use medical insurance for the least little problem which has helped drive the cost up.
> 
> If you don't have insurance here's what happens. You go the the doc, he may or may not run a few test (depends on what his malpractice insurance requires), he writes you a script for antibiotics. You pay the person at the desk and go on your way. Latter that day someone from the doc's office goes to the bank and deposits the money. End of story.
> 
> ...


So your fix for that is to keep things the same?


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## JeffreyD (Dec 27, 2006)

Nevada said:


> So your fix for that is to keep things the same?


We have great coverage right now! Why do you want me to lose it? My entire family is covered. The HR dept told me that they would pay the fine and we could fend for our selves. Why would you want that for my family? Were happy the way things are.


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## Bearfootfarm (Jul 13, 2006)

> So your fix for that is to *keep things the same*?


That would be preferable to BO's *extortion*, which really won't solve any problems or save any money


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## Cornhusker (Mar 20, 2003)

Nevada said:


> So your fix for that is to keep things the same?


So your fix (and Obamaco's fix) is to make it 100 times worse?
We are losing health care, we will be paying way more than we are now, and medical care will be almost nonexistent for people not living in cities.
Is that what your dear leader wants for this country?
Is that what you want?
Or are you just following dear leader?


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## Nevada (Sep 9, 2004)

Cornhusker said:


> So your fix (and Obamaco's fix) is to make it 100 times worse?
> We are losing health care, we will be paying way more than we are now, and medical care will be almost nonexistent for people not living in cities.
> Is that what your dear leader wants for this country?
> Is that what you want?
> Or are you just following dear leader?


You're speculating. Besides, your arguments are two-fold. On the one hand you believe that they will be giving too much health care away, while on the other hand you think it will be too expensive for Americans. I'm suspecting that it will strike an acceptable balance.


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## Cornhusker (Mar 20, 2003)

Nevada said:


> You're speculating. Besides, your arguments are two-fold. On the one hand you believe that they will be giving too much health care away, while on the other hand you think it will be too expensive for Americans. I'm suspecting that it will strike an acceptable balance.


No
Obamacare will drive away medical care from rural communities.
You know, those fly over states that Obama turns his nose up at?
He will give the inner cities, his voting base, the dregs of society more freebies while breaking the backs of the working class and therefore America.
He's either evil or stupid, no other possibility fits.
Why do you support his agenda of destruction?
Are you that blindly partisan that you'll turn your back on your country to support your corrupt ruler?


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## Sonshine (Jul 27, 2007)

Cornhusker said:


> No
> Obamacare will drive away medical care from rural communities.
> You know, those fly over states that Obama turns his nose up at?
> He will give the inner cities, his voting base, the dregs of society more freebies while breaking the backs of the working class and therefore America.
> ...


I vote evil. I don't think he's stupid at all, but that he has his own agenda to break the back of America in order to become one happy global community.


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## EasyDay (Aug 28, 2004)

Nevada said:


> You're speculating. Besides, your arguments are two-fold. On the one hand you believe that they will be giving too much health care away, while on the other hand you think it will be too expensive for Americans. I'm suspecting that it will strike an acceptable balance.


I'm glad to see you've moved from "predicting" to just "suspecting".
Not such a good track record with your predictions.


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## Tricky Grama (Oct 7, 2006)

JeffreyD said:


> We have great coverage right now! Why do you want me to lose it? My entire family is covered. The HR dept told me that they would pay the fine and we could fend for our selves. Why would you want that for my family? Were happy the way things are.


And wasn't this the way it was for nearly 4/5ths of the country??? We ALL will suffer now b/c they had to "pass something". What an argument. No wonder their approval is 11%!

Get this congress outta there!


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## Tricky Grama (Oct 7, 2006)

Nevada said:


> You're speculating. Besides, your arguments are two-fold. On the one hand you believe that they will be giving too much health care away, while on the other hand you think it will be too expensive for Americans. I'm suspecting that it will strike an acceptable balance.


You cant take these 2 examples: 'giving too much away & not doing enuf' and just average it into "an acceptable balance". Geesh.


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## halfpint (Jan 24, 2005)

Our doctor told us it was tempting to go to a no insurance accepted practice. For the first 10 or so years that he was in practice, he had only a nurse and a clerk. Now he still has the nurse, but has 4 full time clerks and 2 part time just to keep up with all the paperwork - most of it insurance related. 
Dawn


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## Sonshine (Jul 27, 2007)

watcher said:


> Anyone who has ever had to deal with large government agencies can tell you the last thing they want is to have the government running our health care system.


That's the truth! Just look at military medical care, or the VA hospitals.


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## watcher (Sep 4, 2006)

Nevada said:


> So your fix for that is to keep things the same?


And where did you see that in my post? You will see I clearly stated that insurance was one of the reasons medical cost were rising.

If you happened to read between the lines you could have gathered I'm for two things.

One, getting the government out of the medical (and all other) industry as much as possible. It should do what only government can do, make sure the industry operates safely and w/o fraud.

Two, making people responsible for their own lives. Do you not think if people went to the doctor and paid their own bills for 'regular' health care the cost of that care would actually go down? Think about how much just the reduction in man hours used at the doctor's office would probably save.

People would think it crazy if you tried to sale them auto insurance which covered routine maintenance and general up keep but they think they should have their body's routine maintenance and general up keep covered and covered for next to nothing.


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## Stephen in SOKY (Jun 6, 2006)

It isn't just malpractice insurance that's causing physicians to consider retiring/closing their practice. It's also the elevated cost of keeping a practice open compared to only a few years ago. Biohazard waste disposal, EMR, document shredding, higher cost of health insurance for themselves and their employees, building maintenance, and the list of cost increases/new mandates just keeps getting longer. It has become increasingly dificult to accept medicare patients because reimbursement hasn't kept pace with the increasing cost of running a practice.


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