A friend of mine on facebook wrote a status message of "I'm debating my political choices". She is a Physician. So I said to her
what's there to debate? on one hand you have an old fart who insults women and has put a dumb bimbo a 72-year-old-4-time-melanoma heart beat away from the Presidency, and on the other hand you have a young vibrant intelligent person who has the potential to unite the world and inspire a new generation. Quite an easy choice I think :)
Unless you are wondering which Judges to vote yes/no for. I never know what to do on those either...
Another friend of hers, who is also a Physician, said to her...
Hmm your a physician and you think you have an option. How about this, on one hand you have someone who will ensure that as a physician you will make a living wage and that the quality of healthcare in this country will stay superior and on the other hand you have someone who will make sure you won't be able to pay off your loans and everyone will... Read More be under the VA healthcare system or the Medicare system. Don't vote on looks and popularity vote on the issues. Remember you are voting for a president not homecoming king. this is not a popularity contest. Any doctor who votes for Obama really hasn't read his health plan policies.
that started a debate between me and my friend's friend...
I said:
what's wrong with this picture: http://bigpicture.typepad.com/...
McCain wants to privatize everything, kinda like how he removed all regulations over the banking industry. Look what disaster that has caused!
The AMA has its own plans:
http://news.medill.northwestern.edu/...
Obama's plan: http://www.barackobama.com/...
Some of many reasons to vote for Obama: http://www.dailykos.com/...
As medical doctors, do you really want to put into power people who have absolutely no regard (let alone understanding) of science?
http://thinkprogress.org/...
and he said
The AMA's plan is very similar to what McCain is advocating. I should know my mentor wrote the AMA plan. www.voicefortheuninsured.com Again if you want socialized medicine that hasn't worked any where in the world and brings the quality of healthcare down (like the british system, the VA or Medicare) then vote Obama but as physicians we should care about the quality of healthcare we can deliver and so we should vote McCain. I might not agree with some of his views but as a doctor I would be cheating my patients if I chose Obama.
I said:
hasn't worked anywhere in the world..."
ya, i can see people dying left and right on the streets of London and Toronto, and they're all coming to the US in droves. In the meantime we have 50 million uninsured in the US.
As a physician you should also care about the future of medical science, and we've seen how republicans have impeded that progress by interjecting their religious views into public policy (blocked stem cell research as one example). Good luck getting any funding for research using Drosophila, Aplysia, or any other weird creature that "has nothing to do with the public good", according to Palin. You want to put tounge-talking witch-hunting spirit-invoking Pentecostal nut-jobs in charge of our medical and scientific policies?
http://www.talk2action.org/...
And good luck getting an abortion in this country under McPalin. I'm sure that will greatly benefit your patients! Where is that wire hanger?
he said:
Actually I worked in Syracuse NY and yes people from Canada were coming over in Droves for medical care. My friend's grandfather had a stroke in toronto and couldn't get an MRI because well that's nationalized healthcare for you. They transferred him to Buffalo and he got the MRI and treatment within hours. Sorry but when you are wrong, you are wrong. And the AMA method would insure those who are uninsured but not at the cost of destroying the quality of healthcare. I don't agree with everything republican's do but ultimatley for the future of healthcare in the United States the Democratic method is just wrong "Dead Wrong".
I said:
just because a few people in Canada could afford to come to the US to get treatment doesn't mean that the US system is good for everybody. There are 50 million uninsured in the US. There is no social justice in such a system. What good is the "quality" of the US healthcare if 17% of the population can't even access it, and those of us who are lucky to have insurance through our employers keep having to pay higher and higher premiums every year?
Saying "you are wrong" is not the way to debate. Give me facts, not hyperbolic statements like "you won't be able to pay off your student loans".
Obama's healthcare plan is not law yet, there is lots of time and room to debate it and come up with a good system.
Healthcare is only one of many issues. It would be unwise and blind to vote for McPalin, when we know what a disaster they would be for so many aspects of our society and the globe.
he said:
Fact is that in Canada average wait time for cardiac catheterization is in months but in the US it is a matter of Days. You can look up this article about the wait time in Canada.
The risks of waiting for cardiac catheterization: a prospective study
Madhu K. Natarajan,* Shamir R. Mehta,* Douglas H. Holder,* David R. Goodhart,* Amiram Gafni,† Donald Shilton,* Rizwan Afzal,* Koon Teo,* and Salim Yusuf
The issue is even if I don't agree with most of the stuff republicans do I can see from history that once you change Healthcare (Such as Medicare) then it is nearly impossible to adjust it or make it better. So you should start off with a great plan and not a terrible one that Obama has. Other things such as taxes, economic plans, even abortion rights and stem cell research can be changed by one bill, one legistlation. Not healthcare. This should be the most important issue in this election because once this plan is instituted there is no turning back.
I said:
In thinking about public health and health policy, specialized procedures like MRI and cardiac catheterization are not very important. I know as a specialist you don't like to hear that, but the fact is that basic and preventive medical care are much more important to public health than specialized procedures. What has had the greatest impact on longevity have been sanitation, immunization, and basic preventive care. A society's priorities, therefore, should be to make those available to all citizens. Access to MRIs and catheterization should be at the bottom of the priorities list, after those other 3 things.
The myth that in Europe and Canada people are suffering cause they have to wait for MRIs, is something that greedy insurance companies have promoted. People in Europe and Canada are not suffering, and they are not dieing en-mass. But in the US millions of people, including millions of children, don't have access even to basic preventive health care.
Lack of basic preventive care to millions of people ends up putting a higher cost burden on society, because people will get sick more often, and end up going to the ER and needing specialized procedures more often.
If you don't like Obama's health policy, you can work with the AMA to try to influence the policy when it is debated in congress. Obviously you are in the position, with your mentor, to affect the policy. But you shouldn't vote for McCain only on this one issue. You are too smart and educated than to be a single-issue voter. "pro-life" abortion-clinic-bombing nutjobs are single-issue voters. You have to use your education and intelligence to impact all issues affecting our country and the world, not just one which is close to you because of your field of work. We are not voting for the secretary of health here. We are voting for the president, who will determine all sorts of policies.
McCain and Palin are dangerous freeks and thieves. Their anti-regulation policies have bankrupted the country (if not the world). They will ban abortions and make children study "creationism" in science classes. How is that for the future of science and medicine?
he said:
In that article that I showed you they found that people were dying while waiting. The fact is immunization, sanitation and basic preventive care is currently available to anyone who wants it. EVERY child in this country receives health care for free (this is a federal law) and with that immunization. Sanitation is not really part of health care... Read More unless it is sanitation in health care. that is observed by all organizations as it is needed for accreditation. Prevention is a public health policy not Health care, very similar to tobacco cessation programs or HIV prevention. To say that access to MRI and catherization is not important is exactly the point I was arguing against. Basically, the democrats want to decrease the QUALITY of care for QUANTITY. What is the point of giving everyone sub-par health care. And it is not a myth but reality that countries such as England don't like their healthcare but can no longer do anything about it.
http://www.burtonreport.com/...
The fact is the democrats have it wrong on Health Care. I say this as a registered democrat. I am afraid with a democrat in the presidency and congress we will not have any time to convince them otherwise. Again once this happens you won't be able to change it if you don't like it The democratic plan will create a two tiered healthcare that currently exists in Europe. One for the rich and the other for the poor. This is a bad thing especially since we won't be able to change it after it happens. Again I point to Europe.
I said:
1. voting based on only one issue is neither smart nor socially responsible. If you're a registered democrat, then I don't have to convince you that 4 more years of republican presidency will be a disaster. We're not voting for Secretary of Health, but for President.
- The next president will appoint 2 or 3 supreme court justices. If McPalin are in power, you can bet that they will stack the court with ultraconservative nut jobs like themselves. All the issues that you care about as a democrat will be shot to hell.
- Europe is not the third world, and t hey don't have a third-world health care system. You say "i point to Europe" as if you are saying "i point to sub-saharan Africa". Even if we "get stuck" with what they have, it is not the end of the world, and it is not worth having McPalin ruin our society on so many different levels to avoid "getting stuck" with Europe's health system.
- Look again at this picture. UK is slightly, and Canada much higher than the US in life expectancy. So obviously Canadians are much better off as a whole, that Americans, even though Americans pay a much higher price as a society, for their health system. http://bigpicture.typepad.com/...
- From that web page that you posted: "In the United States in 1996 26,200 patients were treated with defibrillators as a life-saving device. " That's 0.01% of the US population in 1996. Even if all those people had died due to lack of defibrillators, there wouldn't have been a major public health disaster. I'm not belittling the lives of people, I'm just trying to look at the big picture. The page also said that "only 100" people in Japan got treatment with defibrillators. Ok, so what? Average life expectancy in Japan is much higher than the US, so they are better off than Americans as a whole.
- The article by Natarajan et al states that "[o]verall, 109 patients (1.4% [of the sample in the study]) had a major cardiac event, namely, death, myocardial infarction or congestive heart failure." 109 patients in a hospital that serves 2.2 million people. Again, not a major public health disaster. So from looking at the big picture, I would say that access to specialized health procedures is not a big deal. It is not wise to base public health policy based on access to such procedures. It is much more important to ensure basic preventive health care for all citizens. The payback to society is much higher.
- You said every child in the US gets free health care and immunization. That's news to me, cause I have to pay for my baby's doctor visits. If I lose my job and insurance, I won't be able to pay for her basic medical care. That's the position that thousands of American families are in. That puts a much higher cost on our society than a few people having to wait for MRIs.
- by sanitation i meant public sanitation, like sewage systems and clean running water, and garbage collection. I didn't mean only sanitation in hospitals, although that also had a major impact once Pasteur proved the germ theory. My point was that a society's health priorities should first be sanitation (look back at Plague and Cholera epidemics), then it should be immunization, then it should be basic preventive care, and then lastly, it should be access to specialized medical procedures. Places like sub-Saharan Africa should worry about sanitation and immunization. They should also worry about preventive measures like using condoms to prevent spread of HIV. They shouldn't even worry about MRIs at this point! In the US, UK, CA, etc. we are way past the point of worrying about sanitation and immunization. So to further improve our general health, we have to concentrate on giving access to preventive care to all citizens. Having 17% of the population uninsured is not acceptable.
- A responsible citizen, especially a liberal and progressive democrat, would base their vote for President of the US, on those issues starting from the most critical (#1, and #2), and considering all issues affecting our society, including but not limited to healthcare. Single issues should not deter such citizens from voting for the best candidate for Presid
ent as a whole. Single issues can be dealt with by working with Congress.
He said:
Medicaid laws provide healthcare to every child that can not have one any other way. in fact recently there was controversey because congress wanted to increase the age of eligibility to 25. I don't know if you remember that about 2 years ago. I think this issue is more important than any other facing us purely because once done it can not be undone. Now to say that we don't need MRIs or Caths because only 1.4% of patients died or what have you, as a physician I think 1.4% is too many to die while waiting for a life saving procedure. I can not in any good conscious support that type of a system. The hypocratic oath that I took means that patient's come before politics. And the democratic system puts patient's lives in danger even if it is 1.4% of them waiting for a cath. Is our system broken right now? yes. Does Obama have the solution? No.
I said:
The Hippocratic oath tells you not to do any harm to your patients that you treat, it doesn't tell you how to vote in a political election. 0.01% of Americans not having access to cath procedure is less harm than 17% not having any medical care at all. By voting for McCain you will do more damage to society than the 0.01% who can't access cath procedure. By stacking the supreme court with nut case judges, McCain will do tremendous harm! Please don't let that happen! Women will lose the right to choose, and children will have to pray and study creationism in school. Please vote based on all issues,not just one. We can't afford to have our intelligentsia become one-issue voters! Please!!!
actually, i made a mistake. if 26000 people got the cath procedure in one year, that's 0.009% of the population. If 1.4% of them die from having to wait, that's 364 people! Let's say there are 10 other specialized procedures like cath, with similar statistics. That would mean 3640 people would die a year from having to wait for specialized procedures. That is not a public health disaster! More people die from car accidents in a year (20,000) !!! If Obama totally screws up and we end up with the healthcare system of UK and CA that you dread so much, there will not be a major public health disaster as you are trying to make it sound!
That is NOT worth voting for McCain for, and letting him stack the court with conservative judges!!!
any feedback from the KOS community would be appreciated. Thanks!
[Update] My friend is a female doctor. Her friend, with whom I had the discussion, is a male doctor, and his specialty is plastic surgery. Thanks for all the feedback!
[Update2] I changed the title to Physician singular, in place of physicians plural, after a few people pointed out that many Physicians Dem or Rep are in favor of Obama's plan.