Doctor Fate wrote:Doctors? Not too much love either:

Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law, according to a survey released by the Doctor Patient Medical Association.

The DPMA, a non-partisan association of doctors and patients, surveyed a random selection of 699 doctors nationwide. The survey found that the majority have thought about bailing out of they're careers over the legislation, which was upheld last month by the Supreme Court.

When I google the DPMA the line under the hit says: "We believe that the battle for medical freedom is about more than just repealing the Patient Protection and Affordable Care Act..." To me, this hints that while they may technically be "non-partisan", in that they're not officially associated with either party, they are not unbiased when it comes to the ACA. As for the survey: I looked into the methodology. Unfortunately, they don't provide a sample of the survey form. They faxed the form to 16,227 doctors. They got a response rate of 4.3%. Now think: how might the appearance and wording of the first part of that faxed form influence who (among busy docs) took the time to respond? They call their 699 respondents a "random selection" but the only thing that was random was the 16,227. The 699 were very possibly HEAVILY selected. We can't say exactly how the selection might have been biased because the DPMA doesn't show us the form. But what if right at the top of that form, just as is the case right at the top of their google listing, it says, "We believe that the battle for medical freedom is about more than just repealing the Patient Protection and Affordable Care Act..."???

In my humble opinion I have cast some doubt on the credibility of the data: "Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law." That's one of those statistics that just doesn't pass the smell test, which is why I went to the trouble of accessing the following links.

http://www.doctorsandpatients.org/image ... esults.pdf
http://www.dpmafoundation.org/physician ... icine.html

BTW, the DPMA may be "non-partisan" but it is a member of the National Tea Party Federation. Source: http://www.sourcewatch.org/index.php?title=DPMA

What do you think, Dr. Fate? Is there at least some doubt that 83% of ALL doctors have considered leaving their practices over the ACA?

Wow, that survey makes a poll of 'adults' look pretty rigorous. Well checked, Purple.

rj

They may have health insurance, but their plan may not satisfy the ACA requirements

Whats the point of the ACA standard? I presume its the same as the requirement for minimum liability coverage in order to get a drivers permit?
http://www.dmv.ny.gov/insurance.htm

If someone had liability coverage for driving but it was only for a limit of $5,000 it wouldn't serve as adequate to the purpose . So states set a requirement for adequate insurance. Same principle with health insurance....

Similarly if someone has health insurance but it is so poor that his family is basically self insured after only a small amount is covered..... then that person isn't really insured.
Its really about being responsible enough to have enough coverage to ensure that others don't have to cover medical expenses incurred by your family.
As long as the state doesn't allow hospitals to send those unable to pay for coverage away, the state ends up covering the expenses for which you chose not to insure. Itsreasonable that for those of means, that they make health insurance a priority expense then.
That many have chosen to be un or under insured (there's little difference) is simply a failure on their part to be personnally responsible.
I'm sure that means some who are currently under insured will have to forego the premium cable package or a dinner out, but isn't the financial security from an expensive medical emergency both worth it, and the person's individual responsibility anyway?

By the way, the underlying problem is the high cost of medical care.... Insurance costs only reflect that.... The uninsured and underinsured are gambling that they won't get sick or injured, and that if they do someone else will end up paying if they can't. Why should you not resent that action on their part?

Ricky, you just don't know what you are talking about, again. Why don't you Google the minimum insurance requirements in the Federal and Mass law?

Ricky:

By the way, the underlying problem is the high cost of medical care.... Insurance costs only reflect that

We agree on this sentence. You also need to factor in the extent to which state mandates drive up those insurance and care costs.

Purple wrote:

Doctor Fate wrote:Doctors? Not too much love either:

Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law, according to a survey released by the Doctor Patient Medical Association.

The DPMA, a non-partisan association of doctors and patients, surveyed a random selection of 699 doctors nationwide. The survey found that the majority have thought about bailing out of they're careers over the legislation, which was upheld last month by the Supreme Court.

When I google the DPMA the line under the hit says: "We believe that the battle for medical freedom is about more than just repealing the Patient Protection and Affordable Care Act..." To me, this hints that while they may technically be "non-partisan", in that their not officially associated with either party, they are not unbiased when it comes to the ACA. As for the survey: I looked into the methodology. Unfortunately, they don't provide a sample of the survey form. They faxed the form to 16,227 doctors. They got a response rate of 4.3%. Now think: how might the appearance and wording of the first part of that faxed form influence who (among busy docs) took the time to respond? They call their 699 respondents a "random selection" but the only thing that was random was the 16,227. The 699 were very possibly HEAVILY selected. We can't say exactly how the selection might have been biased because the DPMA doesn't show us the form. But what if right at the top of that form, just as is the case right at the top of their google listing, it says, "We believe that the battle for medical freedom is about more than just repealing the Patient Protection and Affordable Care Act..."???

In my humble opinion I have cast some doubt on the credibility of the data: "Eighty-three percent of American physicians have considered leaving their practices over President Barack Obama’s health care reform law." That's one of those statistics that just doesn't pass the smell test, which is why I went to the trouble of accessing the following links.

http://www.doctorsandpatients.org/image ... esults.pdf
http://www.dpmafoundation.org/physician ... icine.html

BTW, the DPMA may be "non-partisan" but it is a member of the National Tea Party Federation. Source: http://www.sourcewatch.org/index.php?title=DPMA

What do you think, Dr. Fate? Is there at least some doubt that 83% of ALL doctors have considered leaving their practices over the ACA?

What? All of the sudden source matters? How odd for you fellows of the Left!

It did not say they "would" leave.

However, suppose 3% or 5% do decide to retire early. Suppose more decide that taking insurance isn't worth the hassle. Then what?

And, if you think I'm just popping off, do you believe NO doctors will react negatively to a pay decrease and a paperwork increase?

Doc, Purple did not simply dismiss it because of the source (he questioned your assertion of it being non-partisan based on what they say and what they are a member of, but that is not the same as dismissal). It only 'matters' as a function of you bringing them up as if they are independent and open-minded.

The meat of the post was to show that the study was not something that could be used to state that it was representative. The methodology relies on self-selection, it is based on under 700 doctors. The form used is not shown, so it's not hugely clear what exactly was asked and in what context.

And still, it's not dismissed out of hand (as you do for any poll of 'adults'), but instead Purple asks to consider doubt of it.

I bet at least 5% of doctors consider leaving their practice at any one time, for all kinds of reasons. A fair proportion of those will (they retire, take up a new career - I hear GOP congressman is popular - or a new specialty, they move to a new part of the country, they have a career break (such as for motherhood, or because they get a better office at a new practice/their current practice sucks).

By the way, how do you know Purple is 'of the Left'? Because he doesn't agree with everything you say?

danivon wrote:And still, it's not dismissed out of hand (as you do for any poll of 'adults'), but instead Purple asks to consider doubt of it.

I'm fine with viewing it with a grain of salt. However, that number is pretty big.

I bet at least 5% of doctors consider leaving their practice at any one time, for all kinds of reasons. A fair proportion of those will (they retire, take up a new career - I hear GOP congressman is popular - or a new specialty, they move to a new part of the country, they have a career break (such as for motherhood, or because they get a better office at a new practice/their current practice sucks).

Right, but given that doctors were not major contributors to this law in terms of writing it, is it completely illogical to think they might think it is really bad law--and bad for the practice of medicine? Again, even if it is a fraction of that large number, it is significant. I'd be willing to look at other polls on the matter, if you find any.

By the way, how do you know Purple is 'of the Left'? Because he doesn't agree with everything you say?

No, because I read what HE says. He's not a super-liberal OWS-type, say like freeman2, but there is no doubt he tilts left.

Doctor Fate wrote:

By the way, how do you know Purple is 'of the Left'? Because he doesn't agree with everything you say?

No, because I read what HE says. He's not a super-liberal OWS-type, say like freeman2, but there is no doubt he tilts left.

I tilt, huh?

Dr. Fate: I've pretty much determined who I will vote for in the upcoming election, both for Prez and the US Senate from my state. Would you like me, simply because you ask, to change my votes - go the other way? If you think I'm voting Dem, you should certainly take me up on this - I live in a swing state. But would I make this offer if I wasn't planning to vote GOP?

Maybe I don't tilt - maybe you're looking at me c-o-c-k-e-y-e-d.

ray

Ricky, you just don't know what you are talking about, again. Why don't you Google the minimum insurance requirements in the Federal and Mass law

I did. And the point of the law is to ensure that the insurance mandated is adequate to actually provide coverage. You agree on that point?
Without a standard of coverage, any person could claim"I'm insured" even though the coverage might be of little real value.
What standard do you think is appropriate?
And why do you have a problem with people of means being responsible for being required to provide for their own security of health care?

Doctor Fate wrote:

danivon wrote:And still, it's not dismissed out of hand (as you do for any poll of 'adults'), but instead Purple asks to consider doubt of it.

I'm fine with viewing it with a grain of salt. However, that number is pretty big.

Yes, but the margin for error is simply huge. It was a self-selecting survey. In reality all it tells you is that 83% of the 4.3% of respondents said that they would consider leaving. or about 3.5%, which is a much smaller figure, and is still a self-selection and we don't know if the questions were leading (a common issue with 'push polls' like this.

Right, but given that doctors were not major contributors to this law in terms of writing it, is it completely illogical to think they might think it is really bad law--and bad for the practice of medicine? Again, even if it is a fraction of that large number, it is significant. I'd be willing to look at other polls on the matter, if you find any.

Well, perhaps some people are listening to the constant screeching telling them that it's a bad law as well. How can we tell who is coming to such a view with objectivity, or with their professional experience, and who is just led by the nose? A survey won't tell you.

By the way, how do you know Purple is 'of the Left'? Because he doesn't agree with everything you say?

No, because I read what HE says. He's not a super-liberal OWS-type, say like freeman2, but there is no doubt he tilts left.

Really? I'm not convinced. He's not a partisan republican, perhaps. He's not a Tea Partier it seems. Maybe he's not a rabid social conservative, either. But with what little we have, all I can really detect is disdain for both sides.

Which is fair enough. What I love, though, is that when someone comes along who might be a moderate, a centrist independent who is in that category that mighht decide the election, you respond to him by accusing him of being a 'Leftist'. I know ideological purity is like a thing in the GOP, but is it really a great idea to slur your potential supporters? Try winning the guy over, not beating his words to a pulp.

(or not. frankly I'd love it if the right annoyed so many people in the middle over the next few months that Obama slid back into the White House)

Purple wrote:

Doctor Fate wrote:

By the way, how do you know Purple is 'of the Left'? Because he doesn't agree with everything you say?

No, because I read what HE says. He's not a super-liberal OWS-type, say like freeman2, but there is no doubt he tilts left.

I tilt, huh?

Yup. As it dictionary.com

to incline in opinion, feeling, etc.; lean

Dr. Fate: I've pretty much determined who I will vote for in the upcoming election, both for Prez and the US Senate from my state. Would you like me, simply because you ask, to change my votes - go the other way? If you think I'm voting Dem, you should certainly take me up on this - I live in a swing state. But would I make this offer if I wasn't planning to vote GOP?

Never bet a Sicilian when death is on the line!

The offer itself shows me something, presuming, as I do, that it is genuine. Someone who tilted Right would have long ago soured on the President.

In any event, if politics is a continuum, I think you are slightly to the left of center. Now, I could be wrong, but that is based on what I read here.

Maybe I don't tilt - maybe you're looking at me c-o-c-k-e-y-e-d.

What? Dude, I'm a centrist!

danivon wrote:Which is fair enough. What I love, though, is that when someone comes along who might be a moderate, a centrist independent who is in that category that mighht decide the election, you respond to him by accusing him of being a 'Leftist'.

No, really, I think you need to read what I wrote instead of what you think I wrote.

I know ideological purity is like a thing in the GOP, but is it really a great idea to slur your potential supporters? Try winning the guy over, not beating his words to a pulp.

You have no idea how funny this is. "Ideological purity?"

GWB? McCain? Romney?

You're killin' it! You could do stand-up at a Tea Party rally.

"Your boy, Romney! What a right-wing ideologue! Just look at how he forced Obama to the right on healthcare . . . "

*chirp*

(or not. frankly I'd love it if the right annoyed so many people in the middle over the next few months that Obama slid back into the White House)

I'm afraid the President is his own worst enemy. He's determined to try and divide and conquer. In the long run, I don't think that will play well in the middle. We'll see. I think this is still an aspirational society, not one of envy. If I'm wrong, President Obama wins.

Doctor Fate wrote:

Dr. Fate: I've pretty much determined who I will vote for in the upcoming election, both for Prez and the US Senate from my state. Would you like me, simply because you ask, to change my votes - go the other way? If you think I'm voting Dem, you should certainly take me up on this - I live in a swing state. But would I make this offer if I wasn't planning to vote GOP?

Never bet a Sicilian when death is on the line!

Movie quotes instead of a real response? You must be a Reagan Republican. Where's the courage of your convictions?

Earlier in this thread I said that because the USSC had struck down that part of the ACA by which the administration could force states to adopt Medicaid expansion, "many" states would decline the federal $$$ and stay away from expansion. Later, I altered my prediction from "many" to "a few" (or something like that) based on Danivon pointing out some mitigating facts.

Medicaid expansion is an important part of ACA since it is responsible for a large part of the provision of coverage to those currently uninsured, a key goal of Obamacare.

Headline today in the Washington Post: Medicaid expansion a tough sell to governors of both parties. The news: "At least seven Democratic governors have been noncommittal about their willingness to go along with expanding their states’ Medicaid programs...The range of state leaders expressing unease suggests that implementing the law could be rough going, with divisions not always breaking along party lines."

http://www.washingtonpost.com/national/ ... story.html

The WSJ had an interesting lead editorial on this topic. They say the Governors should just say no, but I don't think that's going to be easy to do. The Feds pay for 100% of the cost of new Medicaid beneficiaries for the first 2 years, and 90% after that. (The current range for medicaid reimbursement is 56 to 85%.) Hospitals and others are agressively lobbying Governors to accept the federal money.

By the way, the editorial says that ACA prevents the states from experimenting with medicard with "maintenance of effort" rules. This will prevent much needed reforts of this expensive program.