I'm linking to The Daily Mail's coverage of this story because it's got some nice pictures showing the physical attractiveness of the physician Milton Wolf and his family and in spite of the British paper's inability to write clearly about whether this man is running for the Kansas state senate or the U.S. Senate. (It's the latter, but DM repeatedly writes "Kansas Senate.")
Where do we get this idea that a background in medicine is particularly apt for lawmakers? How many doctors are there in Congress anyway?
2012 was again a landmark election in terms of physician candidates, with 50 physicians running as challengers or in open seats for federal office at one point during the cycle. The 113th Congress will welcome two new physicians to the House of Representatives.I know some people are leaning toward assisting Wolf — here's Instapundit — but why empathize with a man who flaunts his lack of empathy? Here's the direction I lean: What is going on with this promotion of doctors in the American political scene? There's something odd and excessive about our respect for them. We must trust and depend on them when we have medical problems, but why are we bent on installing them in political office? Let's think more carefully about the sort of minds that go into medicine and whether we are not overvaluing them as political candidates.
Twenty physicians are currently serving in the 113th Congress which include three senators, 16 representatives and one delegate. Seven of these members of Congress are graduates of AMPAC’s Candidate Workshop and/or Campaign School.
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239 comments:
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"It was a weekend and the surgeon was out of town so I didn't have a lot of options"
And this would have been handled better under ACA?
"Emergency rooms have no knowledge of the health status or sophistication of the patient"
That is a good idea to save money - maybe under ACA sophisticated patients can diagnose themselves, write their own prescriptions, etc. I'll bet that's one of the parts of the law that nobody has read yet.
Pogo is Dead said...
Because most of them are lying.
Apparently a lots and lots of lying going on then if that is the sum total of your counter argument.
Michael K said...
One option you had was to call the on-call physician for your surgeon.
I don't want to interrupt your need to impose your lack actual knowledge of the situation on all of us, but I knew exactly what I needed and thought, foolishly as it turned out, that I could get it most quickly and with the least amount of fuss on a Sunday morning by going to the ER. I was wrong but I was also in a lot of pain at the time and not thinking entirely straight. Again, it was an appalling waste of resources.
HoodlumDoodlum said...
Ignorance is Bliss said...
Emergency room visits grow in Mass
Weren't we reassured repeatedly by your recent candidate for the presidency that RomneyCare was completely different to ObamaCare, so how is this relevant? Or maybe he was just lying.
"your need to impose your lack actual knowledge of the situation "
So, it was my lack of knowledge that led you to do a stupid thing like go to the ER instead of calling the on-call doc ?
Got it.
AReasonableMan said...
Weren't we reassured repeatedly by your recent candidate for the presidency that RomneyCare was completely different to ObamaCare, so how is this relevant? Or maybe he was just lying.
No, we were not, not even once. We were told it was different in significant ways, one such way being that it was constitutional.
It is relevant because, like the ACA, it reduces the cost to the user for both ER and primary care visits, and like the ACA it was predicted to reduce ER usage.
"but I knew exactly what I needed and thought, foolishly as it turned out, that I could get it most quickly and with the least amount of fuss on a Sunday morning by going to the ER"
Hilarious.
You actually thought that MDs who didn't know a damn thing about you would take legal and medical responsibility for your problems without verifying it to their satisfaction.
That they would take all the risk based on your diagnosis and say-so alone, especially when you were " in a lot of pain at the time and not thinking entirely straight"?
Is that your argument?
Who thinks that way?
Hey doc, I know you never met me before, and I am in great pain and not really thinking straight, so I came up with this great plan of care...."
Genius.
Pogo is Dead said...
Is that your argument?
Who thinks that way?
What impresses me here is that having no knowledge of any details you are so confident of your conclusions. It doesn't reflect well on anything else you might have to say.
Hell, then why did you post it as an example of something, if you left out important information?
Typical bullshit.
"AReasonableMan said...
**Ignorance is Bliss said...
Does anyone know why it costs more at an emergency room?**
There is endless stuff on this but I can give a personal anecdote."
After which followed bullshit, apparently, because he later says my comment based on his anecdote showed that I had "no knowledge of any details."
Does anyone understand this guy?
Bueller?
Bueller?
To tweak that famous aphorism, "Lawyers, like fire, make good servants but bad masters."
There's no reason at all why lawyers should be preferred over any other regular profession, when looking for people to be in strategic governing policy roles. Sure, hire any lawyers necessary to help draw up the laws and regulations, once policy is settled upon. But what essential quality does a group of lawyers bring to the table, when the subject is military strategic planning, or foreign trade relations, or farming, or water quality, or science research? Zip, in my opinion.
Pogo, ARM is an expert in almost everything so we lesser beings should avoid contradicting his brilliance. 50 years of medical practice experience is unnecessary in answering his example. After all, he knew "exactly what was wrong."
AReasonableMan said...
Weren't we reassured repeatedly by your recent candidate for the presidency that RomneyCare was completely different to ObamaCare, so how is this relevant? Or maybe he was just lying.
Objection; unresponsive. Do you, ARM, think the PPACA will increase or decrease emergency room utilization (both net and just for the previously-uninsured)? Do you have anything other than a just-so story/general economic theory (without knowing the relevant elasticities) to support your belief?
Any supported answer other than "it doesn't matter" is fine. If "I don't know" or "it doesn't matter" is the answer that's OK too but then we would have to stop using the cost and inefficiency of the current system vis a vis ER care/utilization in the argument.
First, the good news. Democrats want to save Medicare. Now, the bad news. Democrats have still not read the Obamacare tomb (some corpseman humor)... I mean tome. A $4 trillion operation and they still have to raise taxes.
Suppose you have an enlarged prostate and can't take a leak. You can go to the ER and get catheterized for relief of the problem. But don't you need to follow up with a urologist? Or do you just keep going to the ER every time you need to take a leak? That would be time consuming and expensive. There are lots of tractable diseases that cannot be resolved in an ER setting. Werner would be far better served being followed by a urologist than constantly going to the ER.
Engineers should design the laws. Lawyers should write the laws. Managers should oversee their execution. Accountants should audit the numbers. Community organizers should help form a consensus.
HoodlumDoodlum said...
Do you, ARM, think the PPACA will increase or decrease emergency room utilization (both net and just for the previously-uninsured)?
As you no doubt know there is a considerable effort to move people to primary care providers. If this works as hoped then it will decrease emergency room utilization. It is too early to tell whether it is going to work. My guess is that some combination of incentives will ultimately work.
Ignorance is Bliss said...
No, we were not, not even once. We were told it was different in significant ways, one such way being that it was constitutional.
So the Supreme Court was wrong in your considered opinion? Interesting solipsism.
Michael K said...
After all, he knew "exactly what was wrong."
Any proof that I didn't? You really are an arrogant piece of work. Your family must be so proud of you.
Well, whoops.
So much for cutting ER visits.
"Across Massachusetts, about half of primary care doctors aren’t taking new patients, according to the Massachusetts Medical Society’s 2013 Patient Access to Care Study. The rate for internal medicine specialists, or internists, who often also serve as primary care doctors, is 55 percent. If you’ve found a new doctor and want to schedule a routine visit, be prepared to wait. It takes an average of 39 days for new patients to get an appointment with a family physician and 50 days to see an internist. That’s better than last year, when the average wait was a whopping 45 days, but up from 29 days in 2010.
The wait could get longer. The Association of American Medical Colleges projects that nationwide 13,700 more doctors of all types were needed than were available in 2010, and that the gap will hit 130,600 by 2025, with about half of the shortfall in primary care"
The answer will be 'medical homes', meaning you don't get to see a doctor at all. You're triaged by phone/online.
Pogo, you make a lot of froth but you don't seem to have a point. Do you genuinely believe that the health care system was on a sustainable path before the ACA?
AReasonableMan said...
If this works as hoped then it will decrease emergency room utilization. It is too early to tell whether it is going to work. My guess is that some combination of incentives will ultimately work.
Thank you for the answer, and I quite agree it is "too early to tell." Is there a particular reason you believe the effort to move people to primary care providers will work, though? Some of the examinations of expanded Medicaid indicated that patients may increase utilization of primary care physicians without an offsetting decrease in ER utlization (and in fact with a statistically significant increase).
It would be possible to spin this as a good thing, perhaps, but one couldn't simultaneously argue that it saved money or increased efficiency. Also relevant are the time horizons involved -- if it takes 25 years to get to "ultimately" then that would have to count as a "no."
HoodlumDoodlum said...
Some of the examinations of expanded Medicaid indicated that patients may increase utilization of primary care physicians without an offsetting decrease in ER utlization (and in fact with a statistically significant increase).
It would be possible to spin this as a good thing, perhaps,
I don't think it would be a good thing. I have a lot of sympathy with the libertarian view of the world that it is too complex to effectively regulate without producing many unintended side effects. This is why the polarization on medical care is so damaging to the country. It is something that we will just have to experiment with until we figure out how to get our results within the norms of other developed countries. Otherwise we are just shooting ourselves in the foot when it comes to economic competitiveness.
AReasonableMan said...
It is something that we will just have to experiment with until we figure out how to get our results within the norms of other developed countries.
I largely agree, and this is one of the reasons I relfexively support small-government/federalism-based approaches, as they allow you to experiment with less lock-in or at least with lower chances of nationwide harm.
I can answer that easily. The MD is a proxy for intelligence. Heinlein wrote of the devaluation of academic credentials-PhDs in fly-fishing and such. For instance, I don't think you are terribly intelligent, Althouse, as defined in factors of intelligence besides verbal fluency. But I'm pretty well convinced that anyone licensed to practice medicine rates high in those. Most people are.
So, as the USA has been led these last decades to worship at the altar of smarties, and since the "intellectual" currency of soft academe and of the literati has been devalued like used matches, not to say toilet paper, next up is the medicoes. Now, will this post or does blogger eat me again?
"You really are an arrogant piece of work. Your family must be so proud of you."
Yes, they are actually.
Yours ?
Does disagreeing with you when you say something dumb count as arrogance ?
A joke from Sermo. Does this sound like physicians like Obamacare ?
How many health care team members does it take to screw in a light bulb? Seven
The doctor to diagnose the lighting problem.
The social worker who arranged to transport the light bulb to the office.
The medical assistant who prepares the light bulb for screwing.
The pharmacist who verifies that there are no contraindications to the use of that particular lightbulb.
The nurse who hands the prepared light bulb to the PA.
The PA who screws in the light bulb.
The hospital administrator who verifies that the proper light bulb screwing techniques were utilized and verifies that all parties have properly documented their actions.
I would assume a radiologist would have good visual association areas. Clausewitz said 'War is politics by other means' and in war someone with such brain skills would have the brain for being a sniper. You could look at the man and see what else was suggested in his presentation and background. Doctors, of which group radiologists are, can generally be assumed to have an IQ of 120 which is no great brilliance. He might, based on the intellectual stamina required of a physician be more expected to be able to read the 400+ page ACA for instance.
They should've fixed medical care in the V.A. - which was already under government control - and given us the results of their efforts.
Whoa whoa whoa. Mea culpa. Reading comprehension failure on my part. I missed this:
Ann Althouse, decrying the empathy of any other living being???
EEEEEEEHEEHEEHEEHEEHEEHEEHEEHEEHEE!!
BWAAAAAHAHAHAHAHAHAHAHAHAHAHAHAHA!!!
Lolololololololol!
Omfg that was funny. Pull the other one.
Wow - 232 prior comments.
Cool chart of the incoming 2013 by profession
Lots of lawyers. Plus one microbiologist, one carpenter and one physicist.
Hopefully Business Week will continue this charting yearly.
Polling Doctors about Obamacare is like polling WI state workers about Act 10 ... Given it is a pocketbook issue few will actually stand up for what is good as they personally suffer for it.
You can't trust their opinion on it. Not when it ties so directly to their bank account.
'Efficient' is a bullshit word, as well.
What do you mean by it mean exactly, when talking about human beings?
Probably not what HHS thinks it means (which actually means lower overall costs, regardless of outcome). What needs to be factored in, is outcomes. But, it can be, and is, done. You need to factor in outcomes and severity of the malady.
Mostly, what I consider inefficient is too many resources applied for too little result. I think that the reality is that some health care providers utilize too many resources, for what they provide. So, one way that this is calculated is comparing resources utilized for a given diagnosis code (or set of codes), controlling for severity and practice patterns. This then is compared across a specialty in an area. Not surprisingly, the results tend to fall on a bell curve, with some health care providers utilizing significantly more resources, and some less resources. Interestingly, you can find certain procedures, tests, etc, that predict, good or bad, whether the health care provider is efficient, normal, or inefficient, and often, the results are almost counter-intuitive - sometimes a high cost test, etc. actually saves money.
Not surprisingly, it is the insurance companies that are utilizing this technology. And, physicians are not always happy with the results. Ok, a lot tend to dislike it. Part of the reason to try so hard to control for severity and case mix is that rarely do two doctors, even in the same practice, have identical practices, when it comes to what they face, in terms of patient and maladies. And, merely looking to the total cost disadvantages the health care providers treating the worst off patients. One basic problem with single payers, such as governments, utilizing this technology is their tendency to look at the bottom line, and ignore that some health care providers in any specialty handle more difficult cases.
Polling Doctors about Obamacare is like polling WI state workers about Act 10 ... Given it is a pocketbook issue few will actually stand up for what is good as they personally suffer for it.
You seem to be presupposing that ObamaCare is a net positive for anyone besides bureaucrats, and maybe some of the insurance companies (and other insurance providers such as AARP).
The reality, so far it seems, is that more money is being spent on worse care, and the physicians are the ones getting shafted, along with a lot of people who dutifully paid their insurance premiums for years, just to be dumped out of their insurance plans because bureaucrats in HHS didn't like the fact that they didn't have pregnancy insurance, free contraceptives, etc. And, as a consequence, many are facing losing their doctors and hospitals (often in the midst of treatment), and paying much more money. It is a horrid mess, and pretending otherwise to score political points is plain silly.
But there is the awe of and deference toward doctors that I think we should become aware of.
Says someone whose guild members can put people in prison and take away their property.
We'd be a lot better off if we had more plumbers and programmers in Congress and fewer lawyers.
IMO, anyone but lawyers.
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