Re: America's Primary Care About to Collapse

Joe S. wrote:
> "Igor The Terrible" <igor_the_terrible@xxxxxxxxxxxxxxxxx> wrote in message
> news:1138704630.265943.303010@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
> >I have been harping on this for a while....   Did anyone listen?  No.
> > Guess what? It couldn't have timed out better...right at the time when
> > boomers are getting ready to retire.  Another thing, don't expect money
> > to buy you out of this one; it's a little late to be thinking about
> > that.  This is one (of many) fucked up situation that has festered for
> > years because nobody felt like doing anything about it.  Not to
> > worry...the exceedingly brilliant, Yale alumni-Skull and Bones George
> > Dubya Bush will save the day...he will have our health care system
> > running like a well-oiled machine before you know it, right?  In the
> > meantime, enjoy your future physicals....in Jamaica, Mexico, Denmark,
> > Canada, Germany, etc....  Or maybe you will actually get that
> > just-in-time e-mail reply from a first year med student advising you of
> > your quadruple bypass options.
> >
> > This country sure does a fine, outstanding job in managing its
> > priorities, eh?  ...BTW, anyone know what is on American Idol or ESPN
> > tonite???
> >
> >
> > Igor sez.......I told ya so!!!
> >
> >
> > +++   ---   +++  ---   +++   ---   +++   ---   +++   ---   +++
> >
> >
> > Primary care about to collapse, physicians warn
> > Group proposes solutions for changing reimbursement policies for
> > doctors
> >
> >
> > Updated: 3:14 p.m. ET Jan. 30, 2006
> > WASHINGTON - Primary care - the basic medical care that people get
> > when they visit their doctors for routine physicals and minor problems
> > - could fall apart in the United States without immediate reforms,
> > the American College of Physicians said Monday.
> >
> > "Primary care is on the verge of collapse," said the organization, a
> > professional group which certifies internists, in a statement. "Very
> > few young physicians are going into primary care and those already in
> > practice are under such stress that they are looking for an exit
> > strategy."
> >
> > Dropping incomes coupled with difficulties in juggling patients,
> > soaring bills and policies from insurers that encourage rushed office
> > visits all mean that more primary care doctors are retiring than are
> > graduating from medical school, the ACP said in its report.
> >
> > The group has proposed a solution - calling on federal policymakers
> > to approve new ways of paying doctors that would put primary care
> > doctors in charge of organizing a patient's care and giving patients
> > more responsibility for monitoring their own health and scheduling
> > regular visits.
> >
> > U.S. doctors have long complained that reimbursement policies of both
> > Medicare and private insurers reward a "just-in-time" approach, instead
> > of preventive care that would save money and keep patients healthier.
> >
> > "Medicare will pay tens of thousands of dollars ... for a limb
> > amputation on a diabetic patient, but virtually nothing to the primary
> > care physician for keeping the patient's diabetes under control," said
> > Bob Doherty, senior vice president for the ACP.
> >
> > The ACP plan called for innovations such as using e-mail to consult on
> > minor and routine matters, freeing up expensive office visit time for
> > when it is needed. Doctors would be compensated for an e-mail
> > consultation.
> >
> > The proposals include incentives for doctors to work more efficiently
> > and to provide better care, ACP President Dr. C. Anderson Hedberg told
> > a news conference. "ACP proposals would provide patients with access to
> > care that is coordinated by their own personal physician," Hedberg
> > said.
> >
> > Young doctors avoiding primary care
> > The ACP cited an American Medical Association survey that found 35
> > percent of all physicians nationwide are over the age of 55 and will
> > soon retire.
> >
> > In 2003, only 27 percent of third year internal medicine residents
> > actually planned to practice internal medicine, the group said, with
> > others planning to go into more lucrative specialty jobs.
> >
> > "Primary care physicians - the bedrock of medical care for today and
> > the future - are at the bottom of the list of all medical specialties
> > in median income compensation," the ACP said.
> >
> > The group, which represents 119,000 doctors and medical students in
> > general internal medicine and subspecialties, joins others that warn
> > the U.S. health care system is untenable.
> >
> > "If these reforms do not take place, within a few years there will not
> > be enough primary care physicians to take care of an aging population
> > with increasing incidences of chronic diseases," said Dr. Vineet Arora,
> > chair of the College's Council of Associates.
> >
> > Dr. Sara Walker, a Missouri physician, said she believed doctors were
> > leaving general practice because of drops in Medicare reimbursement to
> > doctors.
> >
> > "A drop in Medicare payments will not only force me to stop taking
> > Medicare patients but could force me out of business," agreed Dr. Kevin
> > Lutz, a solo practitioner in Denver.
> >
>
> It'll never work.  The medical industry DOES NOT WANT YOU TO BE HEALTHY.
>
> I am 61, 6-ft 1-in, 180; I bench press 225, curl 125, run 5 miles a day, and
> TAKE NO MEDICATION OF ANY KIND (Well, maybe I do take a bit of Dr. Jack
> Daniels's elixir now and then).  BP is 120/60; resting heart rate is 46;
> cholesterol count is so low I don't remember.  I visit a doctor about once
> every 3-4 years when my wife won't shutthefuckup about it.  And every time I
> go, they tell me I need:
> -- colonoscopy
> -- PSA test
> -- this test and that test and another test.
>
> I refuse.
>
> Finally, I raised hell with a young physician a couple of years ago and
> asked him why, with the state of my health and physical condition, does he
> tell me to undergo these expensive, invasive tests?  After all, I have no
> indications of anything but excellent health.  He finally admitted that his
> "practice group" collects a referral fee from the specialists for everyone
> they send over for tests.  I have not been back.
>
> The medical industry DOES NOT WANT YOU TO BE HEALTHY.  If you are healthy,
> they can't sell to you pills, tests, more office visits, surgery, tests,
> more pills, more office visits, more tests, and on and on and on.
>
> Piss on 'em -- stop smoking, get up off your lard ass, exercise and stop
> stuffing your face with all that fat ***.  Your medical expenses will
> disappear.


I don't drink (except for an occasional glass of wine during dinner),
smoke or do drugs, I eat right and I am in good physical shape.  I work
in the trades so I still have maintained my strength.  I do run and
swim; but don't bother lifting...I can still clear and jerk 400+ lbs
without too much trouble.  You do, however, have 11 years on me.  :D

My argument is not about me or people like you.  We were fortunate to
have been born with good genes.  It's those who are less fortunate that
concern me.  Wouldn't it just make your day if you and your family were
driving down the road and the next thing you know someone plows into
you head on at 70+ mph?  Naturally the individual was in his mid 50s,
uninsured, been suffering from chest pains but ignored them because he
couldn't afford the expense of seeking care.  Something similar
happened to me almost 4 years ago on I-95 in the state of Florida,
except the person driving the pickup had fallen asleep and hit a bridge
piling before he got to me or others around me.

With the boomers getting to retire and a lot of them are not exactly a
picture of health, that should give most people something to think
about.  To me having access to health care is an option; but, for
nearly 20% of this country's population it isn't.  Those numbers do not
still well with me.  In a way, I am like you...I loath seeing doctors
and pretty much for the same reasons as you.  Not to mention the
principle of knowing what they are made of and the goddamned hypocrites
they are.

So if you are healthy, be happy and count your blessings.  But, don't
condemn other for ailments or injuries they have little or no control
over.  Finally, keep in mind that being smug or ignoring the problem
will not make it go away.  Perhaps if there are enough health related
accident on the job, highways, etc... and someone with sufficient
prominence gets killed, then maybe the wheels will start turning and
something will get done.  Remember, you, or anyone else, are never too
old or too young to die.

.
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