Cohen's piece strikes a cord:
'In America ... There is endless worry that one’s neighbor may be getting more than his or her “fair” share.” ... (Americans) mythologize their rugged (always rugged) individualism as the bulwark against initiative-sapping entitlements.'
Cohen points out that, 'We’re not talking about health here. We’re talking about national narratives and mythologies — as well as money. These are things not much susceptible to logic.'
But he strays from his point, and loses my support when he provides as the second reason to support a public option; '... to provide competition to private insurers and so force waste, excess and cozy arrangements out of the American system. Behind all the socialized medicine babble lurks a hard-headed calculation about money — all the profits skimmed from that waste and the big doctors’ salaries that go with it.'
So, despite a decent appraisal of how the cultural differences between europeans and americans are shaping the discourse on health care, Cohen's (incorrect) assumptions about doctor's salaries, and their relation to waste and skimmed profits reinforce the important viewpoint of those skeptics within our profession.
Is Cohen unaware that doctors groups were among the early and vocal supporters of health care reform?
ReplyDeleteHe certainly presents yet another hurdle in the path toward physician support of the public option
cr
from anonymous:
ReplyDelete... indeed there are doctors who have big salaries associated with big waste ... (they are quite visible in contrast to the relatively less visible) physicians with (much lower) salaries. (could this) create the illusion that Cohen reports?
... as I look at the high earners in my community, it is evident to the rest of physicians that these individuals are raping the system. Everyone knows it is impossible for them to be making their high salaries without carrying out excessive and unnecessary procedures and tests. Since none of us knows how they commit their fraud, we fail to report them.
Everyone sees them in the community. They often engage in philanthropic activities and make themselves highly visible. Their success is looked upon as the standard (for our profession) and often, their philanthropic activities make the rest of us seem like tight wads. Meanwhile, the rest of the physician community keeps silent.
Those (high visibility) high earners actually promote a false image of physicians - that ... of ALL physicians in the community as high earners even when they are not.
Those folks, rape the system and in the process, prevent the rest of us from getting what justly belongs to us namely, better reimbursement rates. (Because) they learned how to game the system, other physicians (are prevented) from getting adequate rates for appropriate care.
Perhaps it time we stood up and said IT IS IMPOSSIBLE FOR THESE PHYSICIANS TO BE MAKING THE MONEY THEY MAKE IN AN HONEST, MANNER!!! Ah! there! Ive had my catharsis for the day!
Doctors have big salaries? Compared to whom? Class warfare/envy won't win the argument and certainly will win fewer friends.
ReplyDelete