Abusing doctors
Like Megan, this gave me a chuckle:
At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor’s reimbursement is between “$30,000” and “$50,000” for such amputations! (Actually, such surgery costs only about $1,500.)
Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine. …
Et cetera. As Megan notes,
most lawyers could readily explain why trying to pay every lawyer in the country on a flat-fee basis based on what some bureaucrat thinks it should cost to take a case would probably not result in optimal outcomes. Indeed, most every professional, from engineers to journalists, would reject such a scheme for their own profession in short order. So why do these things sound so sensible when the target is wearing a white coat?
I’ve been thinking about this a lot myself, in part because something like half of my friends on Facebook posted the same asinine status update declaring no one should have financial difficulties because they get sick, or some such. And I thought to myself: “Well, why not?”
No, seriously. Let’s say you get some sort of horrible disease, chose to spend disposable income on ancillary items instead of getting health insurance (as many in my cohort have done), and head into the hospital. Why should we expect the hospital to dispense expensive lifesaving treatments for things like cancer if you have no way to pay them back? Hospitals have expenses — doctors train exceptionally long and exceptionally hard to get to where they are in life and should be compensated accordingly; MRI/CT machines aren’t cheap to purchase, maintain, or operate; medicine doesn’t grow on trees. Why should we expect the hospital to cover these things with no hope of reimbursement? Why shouldn’t you endure financial hardship if it means saving your life?
I think it’s because we think we can abuse doctors. For reasons that utterly escape me, liberals think we can impress them into service at pay rates they determine. And we think we can do this with no consequences whatsoever, which boggles the mind. Look at the shortage of geriatricians we have, in no small part because of the pay schedules Medicare employs:
Experts see little hope that the geriatrician shortage will be resolved any time soon, largely because so few doctors elect elder care as a specialty. Geriatrics fellowships produce only about 300 new practitioners a year nationwide—a problem partly blamed on Medicare.
“Almost all of the reimbursement for geriatricians is defined by very specific payments under Medicare,” says Sutter’s Phillips. “Geriatrics is probably the only area in medicine where the physician can spend a year or two in additional training and end up making less than if they had never done so.”
Medicine is a good and a service, just like anything else. To expect to receive that good/service without paying for it strikes me as insane. But here we are.