Arizona doctor goes Galt
posted at 10:12 am on April 14, 2010 by Ed Morrissey
Last month, a urologist in Florida told patients that he’d prefer ObamaCare supporters go elsewhere for treatment. Today, a dermatologist in Arizona warns that he’ll be elsewhere if ObamaCare comes fully into law. Joseph Scherzer says the penalties for dealing with Medicare patients, along with more top-down government control of health care, will drive him to close his doors:
While it may be years before most Americans feel the impact of President Obama’s health-care bill, a few patients in Scottsdale, Ariz., got a small taste of life under Obamacare last week when they arrived at their Dermatologist’s office only to see a sign with the following taped to the front door:
“If you voted for Obamacare, be aware these doors will close before it goes into effect.” The note is signed Joseph M. Scherzer M.D. and includes the following addendum: “****Unless Congress or the Courts repeal the BILL.”
Scherzer, who attended Albert Einstein College of Medicine in New York, has been a practicing Dermatologist in Scottsdale, Ariz., since 1976. Reached yesterday at his office, Dr. Scherzer, 63, said he plans to stop practicing before 2014 when the bill’s full impact will be felt because he refuses to deal with the headache of increased government involvement in health care. …
Scherzer said the bill’s emphasis on punitive measures for physicians not following government-prescribed treatment methods under Medicare would increase his anxiety level to the point he would no longer be able to practice medicine. The maximum fine was previously $10,000; under the bill it will now be capped at $50,000. Scherzer said the fine system makes seeing a Medicare patients a difficult and stressful exercise.
“Doctors have actually committed suicide over these things. There’s no insurance to cover it,” Scherzer said, calling the fine system “tremendously complicated and Frankensteinian.” “It’s absolutely impossible to be certain you’ve complied. I feel like when I see a Medicare patient I have the Sword of Damocles hanging over my head.”
Frankenstein isn’t a bad analogy for ObamaCare. Its piecemeal approach to overhauling health care has already had some frightening and unintended consequences, the most humorous and ironic of which was stripping Congress of its health insurance. The hidden tax for the middle class, which will cost people in the middle $3.9 billion in 2019 alone, is another.
Scherzer is near the normal retirement age anyway, but many specialists continue working in their practices past that time. What matters here are the incentives and disincentives in play. If Congress quintupled the penalty cap that the HHS Department can levy on Medicare issues, that provides a disincentive for providers to accept Medicare patients altogether. In fact, the arbitrary nature of these fines probably accounts for at least some of the existing difficulties that Medicare patients have in finding providers, which is why 25% of Medicare patients purchase Medicare Advantage plans in order to get wider access to providers.
Except, of course, that ObamaCare makes deep cuts in the Medicare Advantage plans to pay for Medicaid expansion. Oopsie!
Under these circumstances, as well as other disincentives to providers in ObamaCare, we can expect to see large number of doctors in all fields following Scherzer’s example, primarily the most experienced who see early retirement as a much better option than dealing with Uncle Obama’s medical-care directives. What will that leave? A less experienced and smaller cadre of providers with increased wait times and miles of red tape for everyone. Scherzer may be one of the lucky ones, at least until he gets sick himself.
Blowback
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Which won’t meet the new government guidelines.
mwdiver on April 14, 2010 at 12:08 PM
And who determines which tests? What you have been saying above makes no practical sense. Expertise is needed as every step of the way. Perhaps you’ve never been seriously ill?
jeanie on April 14, 2010 at 12:09 PM
Go ahead and make fun all you want, but this is exactly the same way all unemployable libtards see the world.
Brain surgery, schmain surgery… EVERY job is “easy” to the people who believe that productive work isn’t as important as sitting on your ass and caring deeply about the world.
logis on April 14, 2010 at 12:13 PM
You’re arguing a cultural reaction to a professional specialty. One has absolutely no bearing on the other. You can use a cultural fix for some health care prevention, but not once you’re beyond the prevention stage.
Professionals do know best. You need to learn to dissect and understand a problem so you can understand how to resolve it.
Medicine is something that is very specific with great consequences, so specialization is vital.
ButterflyDragon on April 14, 2010 at 12:15 PM
logis on April 14, 2010 at 12:13 PM
Nothing is impossible for the man (or woman) who doesn’t have to do it himself.
NoDonkey on April 14, 2010 at 12:17 PM
…and Obamacare is gonna make it better?
jbh45 on April 14, 2010 at 12:18 PM
Related parody: Obama Says Lawyers and Union Workers Stand Ready to Fill Health Care Gap Left by Doctors Who Leave Medicine Over ObamaCare http://optoons.blogspot.com/2010/03/obama-says-lawyers-and-union-workers.html
Mervis Winter on April 14, 2010 at 12:20 PM
Definitely – a Government employee will hold your place in the unemployment line, while you’re waiting in line to see the licensed practical nurse.
NoDonkey on April 14, 2010 at 12:20 PM
He’s a dermatologist. Many of his treatments are (from my experience) not covered by insurance, anyways.
Sorta like a plastic surgeon saying he’s going to quit because of ObamaCare.
Jimbo3 on April 14, 2010 at 12:22 PM
Yes, it’s that extra something that immersing yourself wholly and for a long time gives you. There is no substitute for this in any line of work, not just professions. Nurse practitioners, while very well educated and competent, are no substitute. Their perspective, while valuable, is just not the same.
jeanie on April 14, 2010 at 12:22 PM
–Sorry about your mom, but I’m very happy with the nurse practitioners down in Texas. Maybe the nurse practitioner wasn’t supervised properly in your mom’s case.
Jimbo3 on April 14, 2010 at 12:24 PM
Jimbo3 on April 14, 2010 at 12:22 PM
Skin cancer is covered by health insurance and if you have a mole that could be cancerous, you see a dermatologist.
Although perhaps Doctor Obama has determined a tree surgeon will be good enough for government work.
NoDonkey on April 14, 2010 at 12:25 PM
Link to obligatory seinfeld clip.
lorien1973 on April 14, 2010 at 12:26 PM
Every once in a while, you just have to remind us how much of an
idiotObama voter you really are. You are the target demagogues aim at when they want to whip up outrage against “Big Insurance” and “Doctors who just want to make money.”You want the doctors to sacrifice to give you what you want without having to pay for it. A doctor declines, and you dismiss him as “just in it for the money.”
Do you go out and work for free? Would you be content if the government decided to add burdensome laws and fines to you? I suspect you’d be a little upset if the government made laws that made it virtually impossible to hold a decent job. That day may be coming sooner than you think.
tom on April 14, 2010 at 12:26 PM
A
-Cardiolgists, brain surgeons, etc. are not general practitioners. They only come into play once your GP decides you need to go to a specalist. And nurse practitioners (in my experience) do a good job in screening patients and handling basic problems.
Jimbo3 on April 14, 2010 at 12:27 PM
And who are you to make that determination for me? What if I’ve had the “sniffle” for weeks and it’s only a symptom of something much more serious?
BacaDog on April 14, 2010 at 12:27 PM
Better hope so, cuz your overlords will punish doctors who send people to specialists once Obamacare comes into full swing.
Enjoy!
lorien1973 on April 14, 2010 at 12:28 PM
–True, and I went to see one in AZ for that reason. But acne treatments and many of the other stuff that dermatologists handle aren’t usually covered by insurance.
Jimbo3 on April 14, 2010 at 12:28 PM
Can confirm that from personal experience…PTL that awful condition goes away by itself after awhile.
Dark-Star on April 14, 2010 at 12:29 PM
Jimbo3 on April 14, 2010 at 12:27 PM
How about we transport this idea to the legal profession?
Why see a lawyer when you can go to a pick pocket, a con artist or a mugger and get the same outcome for less money?
Seems practical to me.
NoDonkey on April 14, 2010 at 12:29 PM
But you repeat yourself.
lorien1973 on April 14, 2010 at 12:31 PM
Jimbo3 on April 14, 2010 at 12:28 PM
I have a sure cure for acne but most teenagers don’t want to look at a photograph of Janet Napolitano before they go to bed.
NoDonkey on April 14, 2010 at 12:31 PM
–We have already transported this idea to the legal system. It’s called “paralegals”. And, BTW, one of the bigger problems with primary care doctors is that the US requires foreign-trained doctors to complete a US residency before they can practice in the US. Why not eliminate or significantly change that requirement?
Jimbo3 on April 14, 2010 at 12:33 PM
Okay!! I’m sufficiently discouraged and put off about the future of health care in this country–soooooo–where do I go? Where can any of us go? Certainly not to either of our neighboring countries or Cuba?
jeanie on April 14, 2010 at 12:33 PM
Cuz you can’t guarantee the same education level in foreign schooled doctors. Lots of countries are notorious of handing out doctor degrees like candy.
lorien1973 on April 14, 2010 at 12:35 PM
Australia or Japan, perhaps?
Europe will be Israel writ large once we run out of money for shielding them from Russia, China is not a nice place to live if you’re a Christian, and England is just going 1984-style crazy.
Dark-Star on April 14, 2010 at 12:35 PM
No, paralegals can NOT practice law. NP’s and PA’s can practice medicine.
And why would I want to eliminate the need for foreign doctors complete a US residency program?
cibolo on April 14, 2010 at 12:36 PM
The changes in direction of her arguments made me realize I felt like BHO reading from Totus. Right, left, right, left, right…
Yoop on April 14, 2010 at 12:37 PM
And while we’re at it (since assuring quality care isn’t apparently a concern here), let’s adopt the new Brit NHS policy of allowing muslim doctors and nurses to only scrub up to the wrists rather than the elbow.
I mean goodness – even veterinarians will scrub up to the elbows because (here’s the kicker) – it works and actually helps ensure the health of the patient.
But again, once you abandon the notion that *quality care* is what’s important, then you can quickly move on to adopting other policies like reduced sanitation/scrubbing, reduced requirements on training to ensure competency, etc.
Hell, we could reduce homelessness and doctor shortages at the same time – let’s do a federal stimulus program to buy a few million lab jackets, give them to homeless folks, let them wash their hands a bit, and they can step in and fill the empty physician positions.
You know, I could get the hang of this leftist thinking after awhile perhaps.
Midas on April 14, 2010 at 12:38 PM
Really? Just a simple geico a caveman can do it test? That’s all there is to it? Really?
/rolleyes
I went to the doctor for what I thought was just a chest cold. Certainly that’s all that the signs pointed to. The nurse did a quick check and made a few notes. My doctor, an amazing woman, spent time with me and asked several dozen questions while giving me an increasingly serious set of tests.
Finally , she called for her nurse and told her to get a wheelchair, and get me straight to the (attached) hospital. The nurse looked as confused as I was. The doctor made a call to the emergency room and off I went for a battery of tests and treatments I was sure were a waste of time.
Sometimes the body can’t recognize an infection, gives up fighting an infection, or simply doesn’t know how to do so. You’ve probably heard of similar things, though often described incorrectly with such terms as “walking pneumonia”, etc
Hours later in the ICU, oxygen on high and a mix of powerful IV antibiotics and steroids pumping into my arms, I found out how close I had come to dieing. I still have some scarring and reduced lung function, and take medication to this day.
My doctor saved my life, the nurse would have given me a z pack and sent me home. That is why you use a GP. They can find that 1 out of 100 case. Sure, a nurse might get 99 right, but what if it’s your turn to be the outlier? Maybe your son, or daughter? Will you still feel that doctors aren’t really neccesary?
I, through experience, disagree.
Irritable Pundit on April 14, 2010 at 12:39 PM
Amen
ucantbserious on April 14, 2010 at 12:39 PM
–So why not some sort of written test for competency instead of (I think) a 2 or 3 year residency requirement? Or a reduced 6 month residency program for foreign doctors?
Jimbo3 on April 14, 2010 at 12:40 PM
I remember a line in Agnes of God in which nun Anne Bancroft says to
reporter Jane Fonda “When did you stop practicing your religion? I can smell you ex-Catholics with a grudge miles away.”
AnninCa with her continuous doctor bashing (but Obama good) makes me think everytime of a jilted something or other every post she writes. Haven’t you ever been to a good doctor, Dear? Or does every one remind you of ___________?
Marcus on April 14, 2010 at 12:42 PM
-Cardiolgists, brain surgeons, etc. are not general practitioners. They only come into play once your GP decides you need to go to a specalist. And nurse practitioners (in my experience) do a good job in screening patients and handling basic problems.
Jimbo3 on April 14, 2010 at 12:27 PM
The problem is that your chances of seeing a specialist are being taken away by Obamacare; probably why the good doctor above is leaving his practice.
(Pajamas Media)
Dr. Milton Wolf warns of other methods that ObamaCare would use to cut Medicare costs:
If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently — no matter how valid the reasons — he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list. Many doctors will try to avoid the sickest patients, and others will simply refuse to accept Medicare.
TN Mom on April 14, 2010 at 12:42 PM
–All three must be supervised by a doctor or lawyer, as applicable:
Supervision
It is the responsibility of the supervising physician to direct and review the work, records, and practice of the NPP on a continuous basis to ensure that appropriate directions are given and understood and that appropriate treatment is rendered consistent with applicable state law. Supervision includes, but is not limited to: (1) the continuous availability of direct communication either in person or by electronic communications between the NPP and supervising physician; (2) the personal review of the NPP’s practice at regular intervals including an assessment of referrals made or consultations requested by the NPP with other health professionals; (3) regular chart review; (4) the delineation of a plan for emergencies; (5) the designation of an alternate physician in the absence of the supervisor; and (6) review plan for narcotic/controlled substance prescribing and formulary compliance. The circumstance of each practice determines the exact means by which responsible supervision is accomplished.
–Because you could pay only $25 for a visit if you had a sniffle rather than $100+.
Jimbo3 on April 14, 2010 at 12:43 PM
–TN Mom, I’ve searched on Medicare, 10% referral, 5% reduction, etc. and can’t find the specifics. Do you have a link?
Jimbo3 on April 14, 2010 at 12:48 PM
+eleventy
I don’t think CannedAnn gets the difference between a health savings account and health insurance.
Ann – an HSA is a person’s own money put aside just for medical expenses. In the past, we’ve been able to use it for doctor visits, hospital bills, prescriptions, OTC drugs, eyeglasses, and many other small and large expenses related to health. These accounts could be used in conjunction with insurance or as a replacement. I love mine.
Laura in Maryland on April 14, 2010 at 12:48 PM
http://pajamasmedia.com/blog/the-real-obamacare-fraud/?singlepage=true
TN Mom on April 14, 2010 at 12:52 PM
The man is in Arizona, skin cancer capital of the US and home to lots and lots of elderly people; he’s been in practice since the 70s; he’s talking about Medicare patients.
One Arizona retirement community can provide (or could previously provide) enough Medicare customers to keep several dermatologists in business.
He’s not making his living off of teen acne problems.
notropis on April 14, 2010 at 12:53 PM
Jimbo3 on April 14, 2010 at 12:43 PM-
Paralegals cannot practice law, they cannot give legal advice, they cannot represent a client. Heck, they cannot even set rates.
NP’s and PA’s are supposed to be supervised, but they can diagnose and prescribe medicines (other than narcotics).
cibolo on April 14, 2010 at 12:58 PM
You prove the good docotrs point – you think these items are not covered now, just wait!
humdinger on April 14, 2010 at 1:00 PM
It never ceases to amaze me how stupid people can be…. and the congress is a microcosm of that malady. Both the house and the senate, and both parties. These people are legends in their own minds…………
ultracon on April 14, 2010 at 1:02 PM
Jimbo3 on April 14, 2010 at 12:43 PM-
–
-Paralegals can draft documents, draft pleadings, do legal research, etc. so long as they are supervised by a lawyer. NPs and PAs can diagnose, prescribe medicines, etc. so long as they are supervised by a doctor. Don’t see any real difference.
Jimbo3 on April 14, 2010 at 1:06 PM
Exactly! There is nothing unique about the medical profession, except that it provides a bit more melodrama for liberals to latch onto.
Once you get past all the “I care more than you do” BS, Communists see EVERY industry in exactly the same way: Why hire all those “expensive” managers and let owners have “free” yachts to waterski behind? They aren’t actually DOING anything.
Why not just get rid of all the “worthless” professionals and let the manual labor handle everything? Whatever insignificant ministerial tasks highly-paid professionals did can be replaced by a handful of government drones. To people who don’t have a clue how anything in the world works, it all makes absolutely perfect sense.
Collectivism stopped being a stupid idea about a hundred years ago. Today, it’s insane.
logis on April 14, 2010 at 1:09 PM
What will the Democrat National Socialists parties’ reaction to this event be when it is multiplied a few thousand times?
Will they try to force doctors to keep on practicing?
Chip on April 14, 2010 at 1:10 PM
No – we can’t. Do they have Pathologists in your alternate universe? I can tell you whether or not you have a fungus, but not melanoma.
labrat on April 14, 2010 at 1:11 PM
Really, you cannot see the difference between being able to get DX’d by a NP or a PA and not being able to get legal advice from a Para?
I mean you go to see a lawyer for representation or advice and you go to a doctor because you are ill. If you see a paralegal, you get told- sorry you have to see an attorney. If you see a PA or NP they can tell you what is wrong and prescribe medicine.
Seems like a very big difference to me.
cibolo on April 14, 2010 at 1:11 PM
I bet there is an army of lawyers just waiting to step into the nurse practitioner malpractice business. I bet a lowly nurse practitioner will be able to afford the malpractice insurance the doctors cannot.
Keep in mind that here in Canada, doctor’s income is capped, which limits the number of patients they can see in a day. The GM workers here can negotiate pay raises, doctors can’t.
caygeon on April 14, 2010 at 1:16 PM
And thats why I am going to jut go down to home depot and hire from the parking lot for all my needs, they work cheap. All my medical needs, computer repairs, automotive work….. better yet, maybe I will just treat myself, I know how to google. Hey, I think I just solved the entire medical crises here! Proffesionals schemisonals, who needs em, Ill just handle all my own medical needs.
Koa on April 14, 2010 at 1:17 PM
They will have to. In fact, if I had to guess, it would be along the lines of huge subsidies to get people in medical school.
Having a government that grants “rights” based off another person’s labor always ends up in slavery.
ButterflyDragon on April 14, 2010 at 1:18 PM
Which is why the Statists keep on changing their names – yesterday it was Socialism or Communism, today it’s progressivism, tomorrow it’ll be…. ?
Vomit goes by many different names – puke, throw up,.. but it’s still not a good idea and it makes a heck of a mess.
Chip on April 14, 2010 at 1:20 PM
LOL. Can you use a cardboard cutout to hold your place in the bread and cheese line?
jbh45 on April 14, 2010 at 1:23 PM
–Not in practice. Paralegals talk to clients all the time to finalize documents and court filings. They also can file documents with the court (so can runners).
Jimbo3 on April 14, 2010 at 1:24 PM
Watching this thread, I see the same old pattern among the usual suspects. They start with mockery (‘crybaby’ doctor), go next to trying at other points barely related (everything AnninCA has posted in her 30+ times by another’s count), to finally just nitpicking select terms, scenarios, what-have-you.
Liberals just need to defend this whole disaster the way gun owners need to defend their homes against a break-in of their homes. I guess libs feel the same ‘threat’ to this O-Control debacle the same way a Conservative man sees risk of rape to his wife and daughters during an invasion of his home. Except the guy with the gun isn’t F-ing insane.
O-Control, as passed, doesn’t achieve Obow’s stated intentions at all, and it was passed by a Party through questionable means. All it does is spend money the USA no longer has, and crimps people’s options. We Cons and libs don’t argue something has long needed to be done, but libs are steadfast in believing this law is the ultimate Panacea. That’s all they seem to care about, as evidenced by–among other things–Obow going about weeks after signing the bill into law to continue ‘selling’ it. And, of the thing itself, why is it so flawed it still needs to be ‘adjusted’ and tweaked? Yet, liberals pull out all stops, even the most extreme, to defend it. Really, you libs: if this bill was so great from its inception, why does it need ‘fixing’?
Liberals ignore all what’s in it; they got their wish that we need to pass it to see what’s in it–like Pinata and we Citizens are all supposed to be blindfolded. But, unlike with a Pinata, the ones who pack thing don’t even know what’s in it themselves.
Who in his right mind would enter a game of Poker, expecting a straight deck, only to find the cards are for Pinochle?
It’s a bad law, full of all kinds of things including taxes. Worse, the law is full of things of a tactic used by school districts: Terminology so vague that the schools can run parents around a tree until they turn to butter.
All I can say, which pisses off libs to no end, is Welcome to our nightmare, that is also now yours.
Tell us all, five years hence, how much you like all you’re facing the same as us. The same way some of you liberals thought you were somehow spiting us. You got what you wanted weighting on us, and it weighs on you, too.
This doctor has made his statement. Many others have not, but that doesn’t guarantee so terribly many more won’t be following after him. Some, maybe, will be ahead of him though they may not have made public statement.
See, you libs–you just don’t know any more surely than do we Cons.
Liam on April 14, 2010 at 1:28 PM
Which is one of the reasons Statism can never work in a modern society.
Think of it this way – as skill levels go up, it is more and more difficult to force people to work.
Some could use a whip to have some make bricks or haul stone, but brain surgery ?
Our society needs a countless numbers of complex tasks to be done in order to function – tasks that people cannot be compelled to perform.
Chip on April 14, 2010 at 1:28 PM
I guess the bottom line is that you feel okay to go to a nurse or other general practitioner for your needs. And that’s okay, your choice only affects you so that’s great.
But if I choose to go to a specialist and you have decided for me they are not needed, then my choice is being overridden by another person without my input whatsoever.
That in a nutshell is the problem with liberalism. You decide for others what you think is best for them regardless of how they feel. Whereas the libertarian approach (which many conservatives adopt) will not encroach on another person’s choices.
ButterflyDragon on April 14, 2010 at 1:29 PM
What happen when the lower level functionaries start “Going Galt”?
Chip on April 14, 2010 at 1:31 PM
What does that have to do with anything? They are still not representing clients. They are still not giving legal advice.
cibolo on April 14, 2010 at 1:36 PM
You realize specialists exists for a good reason, right? Do you believe doctors were sitting around figuring out a way to make more money and just happened upon this grand scheme of specializing everything?
Or do you think it’s possible the human body is so complex that to properly treat the innumerable amount of inflictions that can occur would need to be broken down?
Why do you think a general practitioner refers someone to a specialist? Because they make a few bucks off of it? Or the fact they know they do not have the expertise in that particular field?
Every profession has it’s own specialists. And it’s to achieve maximum results via the most efficient manner possible. The only difference for the medical industry is that efficiency is relegated (many times) to a life or death decision or a quality of life decision. Those are things you don’t want to experiment with trying to find the right resolution in the process.
ButterflyDragon on April 14, 2010 at 1:38 PM
$#%@$
Chip on April 14, 2010 at 1:38 PM
I see this O-Control thing like that Halloween urban legend to never take an apple. It might be loaded with razor blades.
Liam on April 14, 2010 at 1:40 PM
….”..yes we can!”
Hold up…thats what they use today.
BobMbx on April 14, 2010 at 1:41 PM
I’m thinking there are people right now exploring how to get around the rules and make a black market healthcare market for the richer people. I just don’t believe Americans are going to stand for this, we are too indenpendent.
Maybe we will have to have Speak Easy doctors where you have to have a password to get in.
petunia on April 14, 2010 at 1:45 PM
Yes, but sadly for US, it’s not an urban legend.
Chip on April 14, 2010 at 1:47 PM
There is no underground for the rich; they don’t need one.
But there will be an underground economy. Already is, with pot and other drugs. Expansion will come.
Not to preach here, but I’m a Bible-thumper. Those who trust will be saved at all times. All is needed is a little faith; I believe the Lord provides. I’ve also seen it, experienced it.
Just an idea.
Liam on April 14, 2010 at 1:49 PM
Let the ignorant bite into such apples, at their own risk. The wise cut up that apple.
Funny, really–I’m called all sorts of name by libs who want this O-thing when I mock them for their having to live under it the same way they hunger for me to do. I’m ‘evil’ in their eyes for telling them they’re as F’d as I am.
The best way to disarm a spiteful person is to remind they, too, will live according to their own spite.
Liam on April 14, 2010 at 1:53 PM
People smart enough to be physicians AND PA’s are smart enough to do other, more lucrative things. Consider the education costs, responsibilities, and increasing bureaucratic red tape, balanced against declining income – how many intelligent people are going to go into medicine?
It sounds more and more like a nightmare job.
(And re acne as a minor piddling complaint, we all know people with horrible acne, leads to major scarring and disfigurement, not to mention emotional impact. Dermatologists are important, the skin is the biggest organ of the body.)
jodetoad on April 14, 2010 at 1:56 PM
My point: The Federal Government, with the passage of the Fugitive Slave Act, became the guarantor of the rights of slaveholders to keep their property even in so-called free states. Many citizens wanted that policy to fail, to the extent that some slaves captured under that law were rescued from the Feds by bands of citizens opposed to the Government’s policy. They certainly wanted that policy to fail.
This is certainly not an argument from ignorance — it is an argument rooted in historical observation.
unclesmrgol on April 14, 2010 at 1:58 PM
Noted. Thank you for clarifying.
Dark-Star on April 14, 2010 at 1:59 PM
jbh45 on April 14, 2010 at 1:23 PM
Better yet, because it’s Obamacare, just let an empty suit hold your place in line.
NoDonkey on April 14, 2010 at 2:01 PM
I am another primary care physician that will retire before I’ll practice under the rules enacted by Obama, Pelosis, et al.
Under Obamacare physicians will be required under penalty of stiff fines, loss of license or even prison to put other considerations before what is best for their patients. This is contrary to our Oath, pertinent parts of which include:
“I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and my arts.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing…
All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.
Under Obamacare I would be required to relinquish my judgement to that of the Sec’y of HHS. I would also be required to provide what should be confidential information to unseen and unnamed bureaucrats for whatever nefarious purposes they may devise.
I have already informed family, friends and some loyal patients that I will continue to care for them outside the government system for as long as I can, which probably won’t be long because the IRS will likely seize assets and my license when they discover what I am doing.
Sadly, even some conservatives don’t fully grasp the deadly consequences of Obamacare. We are all in great jeopardy.
drewas on April 14, 2010 at 2:12 PM
Jimbo3 on April 14, 2010 at 1:06 PM
NPs effectively act as a physician, dispensing medical advice and prescriptions, whereas Paralegals are prohibited from giving legal advice.
I got a $1,000 quote for a will and did it using LegalZoom for a small fraction of that price. So now lawyers are suing LegalZoom, go figure.
Greed.
NoDonkey on April 14, 2010 at 2:12 PM
drewas on April 14, 2010 at 2:12 PM
Kathleen Sebelius has a Master’s in Public Administration, is there anything she doesn’t know about medical practice?
At least I know she has the D&X procedure down pat, she could probably perform one herself with a spork.
NoDonkey on April 14, 2010 at 2:18 PM
I wonder if liberals would be okay with a law that allows the Attorney General to dictate what sort of procedures lawyers could provide, and how much they could charge for it.
Unlike healthcare, legal representation is a Right enumerated in the Constitution. Why doesn’t the government provide me with a lawyer?
BobMbx on April 14, 2010 at 2:19 PM
Notice how Drywall pops in & spews meaningless drivel, trying to be cool & clever, & then exits without providing any meaningful reply rooted in facts & reason.
The troll is a POS. I have often questioned as to why he thinks his foreign opinion of our affairs is of any value.
He’s like diarrhea-he often comes back when you least expect it (sometimes by surprise) & leaves just as mysteriously.
Ann I see is still trying to make her meaningless drivel fashionable.
I’ve read all her posts here & it’s all full of class envy & crappy nonsense.
And Jimbo-dear God man-how can you equate a paralegal to an NP?!
I have experience w/ BOTH.
Use of a paralegal frees up the lawyer to do other more important thing, like argue cases & stuff, without having to do annoying paperwork, which YES, the lawyer can read through & make sure it’s on the up & up.
A NP is also supervised, but this is my LIFE we are talking about here.
I only have access to a Dr a few days/week here in the stix.
So for a while, I was seeing the NP for an allergy problem.
I finally decided she wasn’t worth my time since her inexperienced diagnoses were not working & only wasting my time & $$$.
My husband went to see her to get his health card renewed (for driving truck).
His blood pressure was within the legal limits but the NP refused to issue him the card bcs he was taking blood pressure meds, even though he was legally entitled to the renewal of the health card.
My husband had to make ANOTHER appt to see the REAL Dr & she issued him the card, bewildered at the stupidity of the NP for refusing to do so.
I have other experiences w/ both professions, but suffice to say that when I needed legal representation, I went to the BEST lawyer I could afford bcs the custody of my child depended upon it-NOT a paralegal (who couldn’t help me anyway).
And even though I have researched the area of child custody, as well as various medical problems for myself, there is no way in HELL that I would EVER depend upon the inexperience & sub-par education of a paralegal or an ‘almost-a-doctor’ NP for my regular needs.
Badger40 on April 14, 2010 at 2:20 PM
You know passes for a will? Take a piece of toilet paper and in pink crayon write whatever you want. “I give all my crap to so-and-so, and nothing to so-and-so.
Take that to a notary public with some witnesses (you don’t even have to know the witnesses, btw), sign it and have it notarized. A valid will.
But, for $1,000.00, a lawyer will construct a document that does the same thing. Only, the lawyered document will not be understandable by anyone except him. So why frickin bother? I bought a program (WillMaker, by NoloPress) something like 15 years ago. I’ve modified my will several times over the period since, at my computer while enjoying a cup of coffee and a doghnut. Total cost of 3-4 wills (2x for spouse): $~50 + notary fees.
Shazam.
BobMbx on April 14, 2010 at 2:28 PM
In Canada, this very discussion is considered hate speech.
BobMbx on April 14, 2010 at 2:29 PM
For stuff like that, I agree.
But when I was fighting for custody, I wanted an experienced lawyer.
And if I was charged w/ murder, I sure as hell wouldn’t be relying upon a computer program, self-knowledge or an ‘almost-a-lawyer person to get my a$$ out of the fire.
Badger40 on April 14, 2010 at 2:37 PM
Forgot.
Maybe someone should turn Drywall in to Canadian authorities for his hate speech he loves to spew on HA.
Badger40 on April 14, 2010 at 2:38 PM
BobMbx on April 14, 2010 at 2:28 PM
So if I want to make my loved ones hire more lawyers after I buy the farm, it’s best to hire a lawyer to do my Will, is that what you’re telling me?
Whereas if I actually like them, I’ll put one together that an actual person can understand.
NoDonkey on April 14, 2010 at 2:48 PM
Why do you consistently post with authority about issues in medicine when you don’t know anything about it?
There are already programs that expedite foreign doctors. In areas of shortage they can file for a PERM Labor Certification Application, or if they are specialist (as most are) their PERM application might be expedited. Further if they are already recognised as an expert in their field they can file as “extraordinary ability” – which a lot do and are approved much faster.
Almost 25% of our physician labor force is foreign born. In some cities the residency programs are almost entirely foreign born and foreign taught med students.
Our medical system is superior to any in the world and it requires more teaching & training than you understand to turn a foreign born med student or doctor into an American doctor. You only see them at the end of that exercise, because I doubt you ever have been cared for at an county hospital or been to a free clinic.
Foreign born doctors & nurses come here for the freedom. Freedom to practice in an area they choose, Freedom to earn as much as they can, Freedom to practice safely and without bureaucrats dictating … You think we have a Doctor & nurse shortage now? Wait until the foreign born doctors don’t want to come here, after all under obamacare what’s the difference between here & their home country?
batterup on April 14, 2010 at 3:02 PM
I know a weekend pilot who soloed in a Cessna 180 last month. Would you ride with him from LAX to ORD with him flying your 757? Or would you consider that a job for an experienced professional, since it’s your body you’re putting on that flight?
Now, about professionals, your body and your health…
Yoop on April 14, 2010 at 3:12 PM
HPV?
DarkCurrent on April 14, 2010 at 3:34 PM
HPV?DarkCurrent on April 14, 2010 at 3:34 PM
If you’re confused about the acronym, PTL = Praise The Lord.
If you meant the disease, wrongo.
Dark-Star on April 14, 2010 at 3:39 PM
You got it. When the probate judge reads the will (which happens when everyone dies), he’ll say..”Looks like everything goes to his mistress, and spouse takes nothing….seems pretty clear to me, does anyone contest the will?”.
BobMbx on April 14, 2010 at 3:39 PM
$&%#! Meant to quote, not strike! Can we get an ‘edit’ button already?
Dark-Star on April 14, 2010 at 3:39 PM
BobMbx on April 14, 2010 at 3:39 PM
Q: What’s the penalty for bigamy?
A: Two wives!
NoDonkey on April 14, 2010 at 3:44 PM
Time to re-consider that move to Utah…..may have to put it off…….never thought of that….
BobMbx on April 14, 2010 at 3:45 PM
–
–You know that many current insurance plans won’t pay for you to go to a specialist unless you’ve been referred by your primary doctor.
Jimbo3 on April 14, 2010 at 3:51 PM
BobMbx on April 14, 2010 at 3:45 PM
Brigham old, Brigham Young, just bring ‘em.
NoDonkey on April 14, 2010 at 3:52 PM
From yesterday’s WSJ: http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html?mod=WSJ_hps_sections_careerjournal
While doctors trained in other countries could theoretically help the primary-care shortage, they hit the same bottleneck with resident slots, because they must still complete a U.S. residency in order to get a license to practice medicine independently in the U.S. In the 2010 class of residents, some 13% of slots are filled by non-U.S. citizens who completed medical school outside the U.S.
One provision in the law attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary-care or general-surgery residencies. The slot redistribution, in effect, will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services.
Jimbo3 on April 14, 2010 at 3:55 PM
–Those are fine for simple wills.
Jimbo3 on April 14, 2010 at 3:56 PM
–Hi, Badger. I’ve got experience with both, too. But I don’t have a problem relying on a NP for most of my medical stuff as long as s/he is checking with the doctor before I receive my diagnosis and prescriptions. Looks like your NP wasn’t really being supervised on-site by a doctor?
Jimbo3 on April 14, 2010 at 3:59 PM
I fail to see the problem with that.
ButterflyDragon on April 14, 2010 at 3:59 PM
But I still get to keep my high premiums right?
ronsfi on April 14, 2010 at 4:01 PM
Jimbo3 on April 14, 2010 at 3:56 PM
And an NP is fine for a simple diagnosis, but if it’s complicated, she might miss it.
It’s a lot less complicated and more clear cut for a lawyer to tell you that your finances need more than a paralegal or a software program, I would think.
NoDonkey on April 14, 2010 at 4:04 PM
NPs do not need to be supervised on-site by a doctor. PAs do, NPs operate independantly. They need a collaborating physician, and need a very small percentage of their charts reviewed yearly by that physcian. Part of the agreement is that they have access to discuss questions they have about diagnosis with their collaborating physician, but they do not need one in the building with them, nor do they need “supervision.”
In other words, they act/operate independantly from physicians and only are subject to a chart review periodically. And that’s fine with a good one with a lot experience who knows when to contact their collaborator and most importantly knows when they’re in over their head.
But with plans like this, they will be stretched to the limit. Fewer and fewer physicians will be available to be collaborators, stretching the whole system.
As was mentioned in an earlier similar thread about NPs being utilized more often, I don’t have issues with NPs (I’m a collaborating physician with 3 of them, only one is in the building I work in, and she’s here when I’m not) I have BIG issues with them (and me) being stretched beyond our capabilities to act safely.
DrAllecon on April 14, 2010 at 4:11 PM
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