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Reading
an article in the newspaper on the table in the Staff Lounge:
"President Obama has appointed a commission on the federal
debt (National Commission on Fiscal Responsibility and Reform),
mainly focused on Social Security, Medicare and Medicaid. To
signal his seriousness about this venture, the president has even
gone so far as to put the newly passed health reform bill on the
negotiating table - although the ink on the new law is barely
dry."
Dr.
Rosen: Is there really Ice on the Ground in DC in July?
Dr.
Sam: I'll believe that when DC really freezes over in July.
Dr.
Edwards: Hey, let me go out and catch a falcon.
Dr.
Dave: We are living in a world of fiction.
Dr.
Edwards: Maybe the kid in the big White House is growing up
and realizing that he can't spend greenbacks as if they were green
paper issues.
Dr.
Rosen: It truly is a fictitious world. The county is going
broke and laying off health care workers and eliminating critical
jobs. The cities are going broke and laying off police,
firefighters and other safety workers. The states are going broke
and closing clinics, cutting university salaries, laying off
professors, and limiting the number of students that can enroll.
Those that are able to enroll are facing increased tuition and
fees.
Dr.
Edwards: You don't really think Obama's monstrous health care
bill, that will double taxes for our children and triple taxes for
our grandchildren, will really be pulled back?
Dr.
Paul: I certainly hope not. Everyone is exaggerating the
effects.
Dr.
Edwards: How can you say that, Paul? Even Obama's own finance
director has stated that taxes will have to go up even though they
were allegedly supposed to go down.
Dr.
Paul: How else though are you going to cover the poor?
Dr.
Dave: Well, don't we have the huge Medicaid program for all
poor people?
Dr.
Paul: Why am I seeing so many children whose parents have a
difficult time paying their bills?
Dr.
Dave: Don't most of your patients already have Medicaid?
Dr.
Paul: There are more Medicaid patients standing in line
waiting to be seen.
Dr.
Dave: If you have a waiting list for Medicaid patients
already, what's going to happen when the president puts another 35
million people into the program?
Dr.
Paul: At least
they will be covered and have an even chance of being seen.
Dr.
Sam: Isn't that what the lawsuit that went to the Canadian
Supreme Court a couple of years ago was all about?
Dr.
Paul: How's that?
Dr.
Sam: The patient was in severe pain and after waiting two
years for a hip arthroplasty was still not able to obtain care, so
he took his case all the way to the Canadian Supreme Court.
Dr.
Rosen: Yes, wasn't that interesting. The patient and his
doctor knew they had the court exactly where they couldn't move in
another direction. After completing all the arguments, the Supreme
Court waited a full year to give its report: Canadian Medicare
does not give access to health care; it only gives access to a
waiting list. *
Dr.
Sam: And if Obama is successful in implementing his outrageous
plan, which doubles the number in Medicaid, all the new Medicaid
patients, plus all the current Medicaid patients, will no longer
have any better access to health care, similar to Canadian
Medicare. So we've gone the disastrous way of Canada through the
back door. The 30 million or so current Medicaid recipients have
moved from access to care to access to the waiting list, and the
35 million or so new Medicaid recipients will now have access to a
waiting list. They will probably be worse off than they are now in
receiving care.
Dr.
Rosen: Getting back to Paul's statement of how his Medicaid
patients have difficulty with their finances, have you had
informal discussions with them before or after your appointments?
Or escorted them to their cars?
Dr.
Paul: I'm too rushed to have that kind of talk.
Dr.
Rosen: My Medicaid patients frequently have two cars and live
in upscale locales.
Dr.
Edwards: It looks like a matter of priorities. If you sit at
home most of the time watching TV, wouldn't you want a 60-inch
flat screen?
Dr.
Sam: Sometimes it's enlightening to escort patients to their
car to see what they are driving. I'd say the most expensive cars
in our doctor's lot are about equally divided between the Medicaid
and so-called middle class patients.
Dr.
Rosen: I once tried to accompany a patient to the car and he
stopped in the hallway and asked what I was doing. He invited me
to return to my office. So I turned to go back to my office and a
minute later followed from a distance as I watched him get into a
late model Jaguar and drive off.
Dr.
Sam: So you were seeing him for half your usual fee and he's
driving a car twice as expensive as you are driving.
Dr.
Edwards: It helps when you have several sources of income and
the government doesn't know about two of them.
Dr.
Rosen: It also explains a doctor's perception of welfare and
government largess while getting blamed for insensitivity or
greed.
*
--Canadian Supreme Court Decision 2005
SCC 35, [2005] 1 S.C.R. 791 http://scc.lexum.umontreal.ca/en/2005/2005scc35/2005scc35.html
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