doctors making money: the problem

I'm going to be a doctor. It is an incredibly difficult road. I became a doctor because I know it will be a rewarding and interesting career. However, I also became a doctor because I knew it would be a great way to support my future family. In fact I became a doctor because I expected it to support my family quite well actually. Sure, I wouldn't be making as much as the guy who works a successful pyramid scheme or the successful business owner, or the investment banker, or the dentist... in fact this list could go on. But I became a doctor because it's not about the money... but it is just a little bit.

Then I read THIS ARTICLE in the New York Times. It talks about how part of health reform ultimately must control... gulp... physician salaries.

But I can't help but agree with the author. The author is taking from an article written by Dr. Howard Brody, professor of family medicine and director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston wrote for the New England Journal of Medicine. He talks about the way physicians can quickly run up the cost for medical care by utilizing expensive technology like diagnostic imaging.

This reminded me of a conversation I had with a pediatrician yesterday. I asked her "So, how difficult is it to sub-specialize in pediatrics?"

She responded, "It is a little bit competitive for some specialties. But I would advise against it for you. The field of primary care is where the demand is, and specialties are getting too overcrowded."

This was really interesting. Could this be true? Could medicine in the United States turn its back on expensive frivolous treatments and diagnostics?

I don't know. Most people I meet in the United States seem to think it is appalling that people in Canada have a waiting list for elective surgeries and the fact that access to an MRI sometimes is not as simple as showing up to the primary physician with a complaint of dementia.

As much as people complain about medical costs in America... maybe they complain about them the same they complain about Baseball players: many think it is ridiculous that players make that much, but they continue to buy the merchandise and pay $100 for a mid-level seat.

So what's my opinion? I don't want people to pay for unnecessary treatment. It is dishonest. It is like a dentist I had who performed several unnecessary procedures on my family (ie. "I have good news and bad news. The good news is that you didn't need a root canal. The bad news is that I did a root canal."). I didn't go into medicine to be a businessman. But do I think ultimately greedy doctors are the reason medical costs are up?

No. A big no. I think it is what people expect. It is the lawyers who sue doctors who don't do the MRI of the brain. It is the way insurance pays for CT scans and refuses to pay for physiotherapy. It is the way people expect to be lazy and eat high fructose corn syrup while taking insulin. It is the way drug companies are able to advertise direct to consumer just like a breakfast cereal does to kids.

Ultimately, I think it is the desperation we all have to be healthy, pain free, and to extend life as long as possible that allows capitalist structures to ultimately take everything we have monetarily (and then some) to fulfill these lofty promises.

Holy smokes. We need health reform in America.

Health Care Quote

I read a fantastic article about Medicare on NPR. It is basically about how Medicare actually succeeds. This frames my opinion about the Healthcare debate so awesomely well:

"Bernfield says she's not at all worried about claims that the bills now under consideration in Congress might cut back on her Medicare benefits. In fact, she thinks the country would be better off if everyone could have the same Medicare benefits she enjoys.

"I think people don't understand that instead of government in their business, they have health insurance companies in their business," she says. "Somebody is overseeing your health care no matter what your status is. Whether it's to tell you you can have it or you can't have it, somebody is there checking off a box."

I know that insurance has to examine claims to stop fraud. But the profit incentive to deny claims... it sickens me. I hope congress really starts to change things about health care in the United States. Mandated coverage and a public option... it just makes me excited to think about this.

I'm excited about a mandate because it may prevent costly visits to the ER that are paid for by those who actually pay bills / have insurance. Because of a mandate, hopefully we will see more visits to the primary physician to prevent illness and treat disease before it becomes an emergency.

I'm excited about a public option because of its lack of profit incentive and the proven low overhead of government administered health care. That means I'm getting bang for my buck. Plus, Medicare is portable and actually affords extensive coverage. What a dream that a poor student like me can have access to that kind of care... it just makes me happy. And all the people working day after day without health benefits for big companies like WalMart, Target, or small companies like Downeast Outfitters, Cafe Rio, or Yogurt Land -- YOU WILL HAVE GOOD HEALTH CARE IN YOUR REACH!

It just makes me excited! So come on congress! Work together! Bring the great Republican ideas about malpractice, and trimming wasteful government spending (ie. subsidizing drugs at a RIDICULOUS COST). Bring the great Democrat ideas about mandates and a public option! Let's do it!

And to all you lousy, lying, and filthy lobbies, right-wing radio idiots, self-serving politicians, and liberal snobs... stop stirring the pot of contention. Do something useful and actually present both sides of the problem we face in health care! Or better, just go away.

Obama's Speech

I wish I graduated BYU when Dick Cheney spoke at the commencement. Unfortunately, I needed the following Fall semester to wrap up and finish all my needed classes. Anyways, I bring this up to pose this question to my fellow cougars: Remember the protests?

I remember when I heard Dick Cheney was coming, I though "Really? That is so cool. The vice president." And at the same time I very much enjoyed the protests and the alternative commencement. By the way, I totally went to the alternative commencement and it was awesome (like in a funny and serious way).

So, really, the behaviour that took place happens on BOTH sides. But at the same time, I became really frustrated over the reaction that students had about the president.

I mean, who cares about politics. It is the PRESIDENT. The Commander in Chief. The leader of your country. Doesn't that position alone make him someone worth supporting to some degree. I mean, even if it is just to hear him out. JFK, FDR, and Reagan all belonged to political parties... but they were also something greater.

Obama may not gel with every political belief you may hold... but his motivation is the same as yours. He wants to make this country better. So ya vote him out at the next elections. But when he wants to tell your kid to stay in school, why don't we let them listen to this important historical figure.

Your thoughts?

Thank you Palin...

... for leaving.

I have debated on what I should write about Palin for the past day. A big part of me said, "You know what, she's a human being. And if you're going to write about her, you should treat her with respect." But another part of me said, "She's a public figure. Public figures should be treated differently. You are allowed to be hyper critical."

The second part of me won.

Now you should know something about me. I am not a dyed in blue liberal. I don't listen to how celebrities tell me how to vote. In fact, I hate it when celebrities act like we should listen to them. I hate Fox News along with CNN and MSNBC.

What I'm trying to say is that, although I LOVE Obama... it's not like I have dug in my heels within the Democratic Party. If Eisenhower were to run, I'd vote for him.

But back to the main point. I am so glad she's leaving. She just irked me. She wasn't very intelligent. Not very politically savvy. It seemed like she just loved the spotlight.

I have to tell you. The Republican Party in general is taking a beating. How can anyone still be Republican? The party of the religious right is scandalized with adultery, kickbacks, corruption, and lies. In a way I want to Republican again, but how can I. The party is so far away from representing my values.

Also, the Republican Party is not even conservative. Under Bush, we saw incredible fiscal irresponsibility. And the moral standing of the party is in jeopardy.

So I will keep voting democrat, but I welcome the return of an actual Conservative (capital C, like William F. Buckley) party.

Obama & Health Care

The New York times ran an interesting editorial on health care that got me thinking about health care reform again.

First of all, Obama spoke to the AMA today. The reaction was chilly. Obama's proposed changes to malpractice, electronic health records, and anti-smoking legistlation were met warmly. However, the push for health cost savings was met with ice cold stares. So why the resistance from the AMA?

Fortunately, the NY Times expanded on this and provided an explanation. Essentially, health cuts really hurt physician salaries because they get less money for doing the same thing. Does this idea need to be expanded? Probably not.

So what is the solution? I think we need to simplify the system. I think materials and procedures should have a consistent cost and a clear system of billing. Is this possible? If so, it would provide a clearer picture as to how Obama's plan would change things. Because I think right now, everything is just speculation. We don't know how physician compensation would change. We don't know how our costs will change. Everything is a step in the dark.

Hopefully, President Obama will continue to make more steps to inform us about his proposed changes. I will be listening carefully for any numbers that he reports. So if you're interested tune in June 24th for Obama's "Health Care Town Hall" on ABC.

President Obama "CNN...MSNBC... It is like watching the WWF"

Brilliant! Absolutely brilliant. I think he says something like, "You know, all these guys have roles to play. It's like watching the WWF."

You know what... how correct. How useless is Cable News? Well, maybe they are not so useless when they do something like this... [edit] I don't like the look of the video here so I am just putting the text of the transaction I'm talking about:

During the first part of NBC's "Inside the Obama White House," Brian Williams asked Obama if he watches cable news debates about him. (TVNewser caught the exchange).

I generally don't. Mainly because I don't find most of the cable chatter very persuasive. I've used this analogy before, it feels like WWF wrestling. Everybody's got their role to play. I know a lot of these guys. And if Pat Buchanan is having a conversation with Chris Matthews or talking to Keith Olbermann, everybody's got their set pieces and, so, I don't feel as if I'm learning anything from the debate.

The Supreme Court Nomination

I remember an interesting conversation I had with friend's family. It took place before the 2008 presidential election. The father expressed his view that he would be voting Republican mostly because he wanted conservative judges to be appointed to the supreme court.

I thought this was interesting. I guess I had never really factored that into my vote for president. Maybe it is because I wear these rose colored glasses that believes the supreme court acts impartially and makes it judgments based on precedent and what's in the constitution.

However, maybe this view is not so rose colored. Now I am not an expert on the Supreme Court, but I feel like there is an incredible respect for the constitution among the judges. In addition, I feel like it is extremely, exorbitantly, and remarkably rare that the Supreme Court drastically changes moral or social values.

So how much does the Supreme Court nomination's political affiliation matter to me? I guess it ranks low, unless I had reason for concern.

On a second note, I am actually pretty excited about Sotomayor mostly because President Obama picked her. Why? Because of this introductory paragraph from a NY times article about the Sotomayor nomination:

When talking about the Supreme Court, Barack Obama has resisted the familiar ideological categories that have defined our judicial battles for the past several decades. He has made clear that despite his progressive inclinations, he is not a 1960s-style, Warren Court liberal — someone who believes that the justices should boldly define constitutional rights in an effort to bring about social change. It’s true that Obama has cited Chief Justice Earl Warren as a judicial ideal, emphasizing that Warren, a former governor of California, had a sensitive understanding of the real-world effects of Supreme Court decisions. But at the same time, Obama has suggested that liberals in the Warren Court mold may have placed too much trust in the courts and not enough in political activism. “I wondered,” he writes in his book “The Audacity of Hope,” alluding to Senate battles over George W. Bush’s court appointments, “if in our reliance on the courts to vindicate not only our rights but also our values, progressives had lost too much faith in democracy.”

President Obama has an excellent grasp on what the court's role should be. Let's not forget that before his presidential career he taught constitutional law! So I'm excited for who ever he nominates. I know this sounds dumb but... President Obama is awesome.

I do not heart Huckabee

Romney was the ONLY hope the Republican Party had for me to even consider me voting conservative this year. Why? First, although Romney is pandering to America's cursed Religious Right, his presence on the ticket would be their worst fear: I quite enjoy that thought. Second, although Romney was pinned as a political flip flopper, his real life reflected what family-oriented Americans wanted in a politician. Basically, Romney to me was a genuine character and if elected would be like a John F. Kennedy, minus the philandering, in that he would have a lot to prove and thus introduce careful and calculated policy.

However, I believe what we saw in Iowa is the future of the 2008 U.S. Elections. We will have Obama and Huckabee on the ticket. But you know what, I am not that disappointed. Why? I love Obama. I think he shares many of the characteristics that Romney possesses. He is a young, charismatic, and handsome politician who would have a lot to prove in office. Obama will do wonders for America's perception abroad. For domestic issues I would have preferred Clinton, but overall Obama has some good ideas for important issues such as health care and his pledge to start cutting into the pockets of CEOs.

Something I would really like to see happen in the 2008 elections (if it does turn out that Obama will take on Huckabee) is for Utah to become a blue state. I think the odds have never been better: wake up Mormons, the Republican Party hates you. REAL conservatives need to take back their party from intolerant religious bigots and fear-mongering neoconservatives.

President 2008: It's a win-win situation!

The presidential race has never been so exciting. However, I will not humor the overdone the woman/black/mormon reason as a reason for doing so. It is exciting because I believe there are candidates within both parties that could be great presidents.

Top of my list for the Democrats is Obama. I make this choice despite the fact that I hate feeling like I'm jumping on the bandwagon along with likes of so many inept high school students on facebook who "support" Obama (see this article for an explanation of what I mean). However, I think he'll be a great face for a new America which can hopefully resolve the horrible situation of America's foreign policy.

Top of my list for Republicans is Romney. I make this choice with a little hesitancy also because he is quickly becoming the choice for my church, the LDS church, and is almost assuming an essential part of a member's testimony: "I know that Mitt Romney is a true candidate." However, as much as that bugs me, Mitt Romney, faith ignored, is the best candidate hands down for, wait for it, non-abraod American issues. Mitt Romney and the Iraq war has me a little concerned. But Mitt Romney's ability to improve health care, taxes, poverty, and education is actually believable. With Mitt Romney I feel like these issues will not just be empty promises. Not convinced, please read the linked Economist issue.

Romney Popular?

Romney Criticizes Bush War 'Errors' - washingtonpost.com

The article linked above shows that Romney matters. The question is: how much? Popular polls say not very much. He has a small amount of support. But do these polls really represent real opinion? My guess is that they're probably not far off. However, I think Romney is getting stronger every month!

Stop, hammer time! I dislike that he has changed his stances on abortion and homosexual marriage just for the mere fact that he gave into the lousy far right Republican agenda. I like many of the Republican Party stances but I believe religious issues get involved far too much.

So why do I like Romney? His business sense. I think he has a great track record and would like to see how he does in office. Plus, I would like to see if his ideas towards medical care work (Romney's Health Plan).

So, I feel really optimistic for Romney's chances! As far as the democrat ticket, I actually think they have a lot of great candidates. Hillary, Obama, or Edwards would be great