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  • Dr. Tom Price nominated for HHS Secretary

    Posted by antoni.bielazik_633 on November 29, 2016 at 6:52 pm

    [link=http://www.nytimes.com/2016/11/28/us/politics/tom-price-secretary-health-and-human-services.html]http://www.nytimes.com/20…nd-human-services.html[/link]
     
    I’m looking forward to this.

    khodadadi_babak89 replied 1 year, 4 months ago 36 Members · 245 Replies
  • 245 Replies
  • henriqueabreu

    Member
    November 29, 2016 at 7:29 pm

    This will be an interesting ride, that’s for sure.  I wonder what will remain of Medicare when it’s all said and done.

    • btomba_77

      Member
      November 29, 2016 at 7:47 pm

      Got a discussion running in OT already if you want to jump in 🙂

      • antoni.bielazik_633

        Member
        November 29, 2016 at 8:14 pm

        I hope he works on repealing Obamacare and privatizing Medicare.  This guy is definitely fiscally conservative, different from some of Trump’s other nominations.

        • Unknown Member

          Deleted User
          November 29, 2016 at 8:17 pm

          Hope he is not a radiology hater like so many others have been.

          • antoni.bielazik_633

            Member
            November 29, 2016 at 8:18 pm

            Expand the HSA system too.

            • aryfa_995

              Member
              November 29, 2016 at 9:09 pm

              I don’t see how an orthopod committed to cutting health care to the bone could be anything other than anti-radiology but I’m open to hearing how I’m wrong.

              • 100574

                Member
                November 29, 2016 at 9:16 pm

                favors move away from fee for service–get ready Trump rad voters–orthopods
                don’t play well in the sand box generally
                Aunt Minnie has article on looming MRI cuts for 2017
                don’t see a license on Georgia board
                we will see where he falls on malpractice reform for all docs –don’t know whether he had prior law suits
                -recall the Georgia mammography debacle–never heard any comment from him on that
                you guys have read the looming MRI cuts for 2017

                Quote from deadwing

                I don’t see how an orthopod committed to cutting health care to the bone could be anything other than anti-radiology but I’m open to hearing how I’m wrong.

              • antoni.bielazik_633

                Member
                November 29, 2016 at 9:30 pm

                Quote from deadwing

                I don’t see how an orthopod committed to cutting health care to the bone could be anything other than anti-radiology but I’m open to hearing how I’m wrong.

                 
                Because free market healthcare will be good for all.  Radiology is just another special interest that we happen to work in.

                • Unknown Member

                  Deleted User
                  November 30, 2016 at 6:47 am

                  Removed due to GDPR request

                  • jquinones8812_854

                    Member
                    November 30, 2016 at 8:06 am

                    AMA backed him last night. He is going to easily be confirmed. 

        • Unknown Member

          Deleted User
          July 11, 2017 at 10:20 pm

          Interesting how the radical fringe has managed to steal the respectable term – Conservative!
          Helps having Murdoch working to blind the population

  • antoni.bielazik_633

    Member
    November 30, 2016 at 10:50 am

    AMA also endorsed Obamacare, so they have 0 credibility with me.

    • Unknown Member

      Deleted User
      November 30, 2016 at 11:26 am

      I don’t trust that the lot of radiologists is going to be better simply because conservatives/Republicans have usually overspent on defense and other special interests, and end up scrimping on everything else, and if regular folks like teachers and firefighters are feeling the pinch they don’t pay their imaging bills. Plus, if they’re spending a boat load on infrastructure and a yet to be declared war, docs are going to take a back seat.

      The ACR and AMA and everyone else in medicine is going to send in their obligatory congratulations, that’s a given.

      • antoni.bielazik_633

        Member
        November 30, 2016 at 4:23 pm

        How about we let the free market decide how much radiologists are worth, instead of having the government set prices?

        • Unknown Member

          Deleted User
          November 30, 2016 at 5:41 pm

          Removed due to GDPR request

          • antoni.bielazik_633

            Member
            November 30, 2016 at 6:03 pm

            That’s when insurance comes in.  They are supposed to insure against catastrophic conditions, unlike our current system of prepaid health plans which is not insurance and continues to drive up the costs.
             
            We need real prices and real competition in healthcare for non-emergent situations.

            • Unknown Member

              Deleted User
              November 30, 2016 at 6:22 pm

              If you’re a radiologist you’re not going to like REAL competition in the radiology space, with regards to what happens to incomes. Be careful what you wish for.

              • radgre305

                Member
                November 30, 2016 at 6:27 pm

                If they repeal Medicaid expansion say hello to massive increase in no-pay patients as percentage of insured patients plummets.

                • antoni.bielazik_633

                  Member
                  November 30, 2016 at 6:32 pm

                  Like I said, Radiology is just another special interest that we happen to work in.  Our country got screwed up by subsidizing special interests.  I’m going to stay true to my libertarian values.

                  • antoni.bielazik_633

                    Member
                    November 30, 2016 at 6:34 pm

                    If they expand entitlements like Medicare, Medicaid, and Social Security, say hello to tax increases and good-bye to America’s future.

                    • btomba_77

                      Member
                      November 30, 2016 at 7:27 pm

                      Quote from radi2012

                      If they expand entitlements like Medicare, Medicaid, and Social Security, say hello to tax increases and good-bye to America’s future.

                      Yep. It’ll be a hellscape like Northern Europe.     Save us!!!

                    • antoni.bielazik_633

                      Member
                      November 30, 2016 at 8:34 pm

                      Quote from dergon

                      Quote from radi2012

                      If they expand entitlements like Medicare, Medicaid, and Social Security, say hello to tax increases and good-bye to America’s future.

                      Yep. It’ll be a hellscape like Northern Europe.     Save us!!!

                       
                      What about Spain and Greece?  Shout out to them and their economies.

                • ruszja

                  Member
                  December 1, 2016 at 5:47 am

                  Quote from DifferentialDx

                  If they repeal Medicaid expansion say hello to massive increase in no-pay patients as percentage of insured patients plummets.

                  I don’t think groups have seen a ‘massive decrease’ in self-pay patients over the past 4 years. It may be true for some selected hospitals in states that did expand MA, but across the board. As a result I wouldn’t expect a ‘massive increase’ if it was to go away.

                  • Unknown Member

                    Deleted User
                    December 1, 2016 at 7:12 pm

                    Many large states (like Texas and others) never took the medicaid expansion money. 

                    • antoni.bielazik_633

                      Member
                      December 1, 2016 at 7:15 pm

                      Good.

                    • tovayalda

                      Member
                      December 6, 2016 at 9:16 am

                      Some choice remarks from Dr. Tom Price (NYTIMES): “Mr. Price… has argued that the [b]government should get out of the way of doctors[/b] and give patients more control over their health care.”    
                       
                      “he said in the House in 2007, I know oh so well how the [b]intervention of the state and federal government [/b]into the practice of medicine [b]destroys[/b] the ability to take care of people.”                                                                                      
                       
                      “Mr. Price often reminds colleagues of a sentence in the original [link=http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier]Medicare[/link]law, passed in 1965: [b]Nothing[/b] in this title shall be construed to authorize any federal officer or employee to exercise any supervision or control over the practice of medicine.’
                       
                      This is certainly heartening to hear. I am curious to see how this will translate to the private practice world. Will this result in a swing away from hospital hostile take-overs?

                    • eyoab2011_711

                      Member
                      December 6, 2016 at 10:22 am

                      You can read his plan…enjoy the numerous occasions where he uses the federal govt to override state based initiatives that he doesn’t like and to take autonomy away from states…but yeah doctor’s will be free to do whatever they want and charge whatever they want…science optional…that will surely put a dent in health care costs

  • 100574

    Member
    November 30, 2016 at 7:36 pm

    but do they have the malpractice issue
    -being born is a special interest
    being a doc is a special interest –one that we spend multiple years slaving away to become

    Quote from dergon

    Quote from radi2012

    If they expand entitlements like Medicare, Medicaid, and Social Security, say hello to tax increases and good-bye to America’s future.

    Yep. It’ll be a hellscape like Northern Europe.     Save us!!!

    • obebwamivan_25

      Member
      November 30, 2016 at 8:36 pm

      I don’t know a lot about this specific representative, but his record is that of an extreme right wing conservative, who believes he has the right to dictate to women what they can and cannot do; has voted to defund Planned Parenthood, and has been opposed to the ACA without proposing anything as an alternative.
       
      This appointment makes sense in that he is a physician but it worries me as an American who believes that the government sticking their noses into our personal decisions is a bad thing. 

      • antoni.bielazik_633

        Member
        November 30, 2016 at 9:26 pm

        Tom Price has proposed an alternative to Obamacare every year since 2009.
         
        [link=https://en.wikipedia.org/wiki/Empowering_Patients_First_Act]https://en.wikipedia.org/…ing_Patients_First_Act[/link]
         
        If you believe that government getting into your personal decisions is a bad thing (as do I) then you would welcome the repeal of Obamacare, a huge government intrusion into our personal lives and finances.

        • aryfa_995

          Member
          December 1, 2016 at 3:13 am

          Everyone is in favor of government intrusion, just depends on the how and why. Unless you’re Somali and really like the homeland for some reason.

  • tovayalda

    Member
    December 6, 2016 at 10:36 am

    But has government hyper-regulation reigned healthcare costs? I am genuinely asking because I don’t know the answer, but I have heard anecdotally that healthcare costs and premiums are still rising. From discussions on these boards and speaking to community physicians, hasn’t government regulation (i.e EMR) have been so costly that many doctors have been driven to become employees of hospitals, where ADMINS have started to milk “us” for money while their salaries increase. While physician output (RVUs) is scrutinized, no one has instituted administrative RVUs (i.e. every hour of the admins day accounted for with direct correlation to revenue generation).  I am more optimistic (for medicine) with Price, at least, preliminarily. 

    • heenadevk1119_462

      Member
      December 6, 2016 at 12:40 pm

      ^ In the micro (Obamacare years) and the macro (post 1965) scale of medicine, the only conclusion (the fact, look at the graphs) is that intervention in and regulation of health care has resulted in increasing costs, never decreasing.
       
      We have the data, we have the obvious answer, but guys like Thor can’t even be a shred honest about the topic.
       
      I often wonder why guys like him even post. Not only can they  not predict anything, they gain nothing — just shill the status quo tribal political outlook — and what’s worse, add nothing to the understanding of other readers on the board.

      • antoni.bielazik_633

        Member
        December 6, 2016 at 1:53 pm

        Make Healthcare Great Again

        • tovayalda

          Member
          December 6, 2016 at 6:01 pm

          @Dr. Fager: Don’t you think we should have a more positive outlook on our profession with Price compared to the Obama administration? I certainly feel that way as of right now, but will wait until concrete steps truly diminish government control to justify my optimism.

      • Unknown Member

        Deleted User
        December 6, 2016 at 6:14 pm

        Removed due to GDPR request

        • antoni.bielazik_633

          Member
          December 6, 2016 at 6:26 pm

          Disagree.  Choice and competition amongst those groups that you mentioned will drive down cost.  The patient’s best friend is another doctor/hospital that is willing to treat them for less.

          • henriqueabreu

            Member
            December 6, 2016 at 6:33 pm

            Pharmaceutical companies and insurance companies are the 2 main sources of the high cost of the US healthcare system on a macro level.

            Fixing the high cost of medical care will probably not be in the best interests of individual physicians however. [we are easy targets without deep pockets]

            • 100574

              Member
              December 6, 2016 at 6:36 pm

              Huffpost
              Hospitals issue dire warnings about repealing Obamacare without a backup plan–unlike Goldman and Sachs–health care stock( not so great)

          • Unknown Member

            Deleted User
            December 6, 2016 at 6:37 pm

            10 -15 yrs ago the same argument was made for self referred imaging

            Price and competition….. the free market capitalism would drive down price and competition

            Grandma could go to her family docs office and have her MRI…. access would be greatly improved by this choice and competition would drive down costs

            How did that work out for everyone?

            costs escalated enormously

            Patients paid just as much and we all took huge pay cuts

            I’m not feeling your argument

            • Unknown Member

              Deleted User
              December 6, 2016 at 6:40 pm

              It’s amazing how little the younger generation of radiologist actually know about very recent history

              They fall for the same bull sheet arguments that we all saw fail just a decade ago

            • Unknown Member

              Deleted User
              December 22, 2016 at 11:16 pm

              The point about free market is that there have to be losers to give winners

              • btomba_77

                Member
                December 23, 2016 at 4:13 am

                Quote from RogerL

                The point about free market is that there have to be losers to give winners

                And let’s be clear:
                 
                If the ACA is dismantled the clear users will be the poor, the sick, … even worse if both poor & sick.
                 
                 
                 

              • antoni.bielazik_633

                Member
                December 23, 2016 at 7:01 am

                Quote from RogerL

                The point about free market is that there have to be losers to give winners

                 
                False.  You are describing socialism.  In free market capitalism, wealth is created.

  • Unknown Member

    Deleted User
    December 6, 2016 at 6:42 pm

    You wish for privatizing Medicare

    Hahahaha

    I will be laughing into retirement as you bend over and get a good reaming

    Be very careful what you wish for

    • antoni.bielazik_633

      Member
      December 6, 2016 at 6:58 pm

      We need to get insurance out of outpatient care so patients can pay you directly without the middle man taking away their automatic 20%.  That’s better for doctors (less administrative overhead) and patients (lower cost through direct payment).

      • Unknown Member

        Deleted User
        December 6, 2016 at 7:07 pm

        Sure that will work

        we also need to get paid for all of our curb side consults multiple meetings developing protocols editing our own reports answering unnecessary phone calls monitoring and teaching technologists and have an hour lunch break everyday

        You think we can swing that too

        • antoni.bielazik_633

          Member
          December 6, 2016 at 9:28 pm

          I want the private market to determine what we are worth.

          • Unknown Member

            Deleted User
            December 7, 2016 at 5:08 am

            so do you also favor repeal of starke laws?

            Decreasing credentials and licensing standards?

            Removal of MSQA

            Those are all unnecessary very evil regulations right?

          • btomba_77

            Member
            December 7, 2016 at 5:56 am

            Quote from radi2012

            I want the private market to determine what we are worth.

            Quote from radi2012

            We need to get insurance out of outpatient care so patients can pay you directly without the middle man taking away their automatic 20%.  That’s better for doctors (less administrative overhead) and patients (lower cost through direct payment).

             
            That would be catastrophic for radiology salaries and employment.  

            • antoni.bielazik_633

              Member
              December 7, 2016 at 6:05 am

              I disagree.  It’s countries with socialized medicine where doctors are paid lower wages.  Why do you think they want to come to the US to practice medicine?
               
              And even if what you say is true, the people’s interests should come before special interests.  Like I have said before, Radiology is just another special interest that we happen to work in.

              • Unknown Member

                Deleted User
                December 7, 2016 at 7:25 am

                Those who refuse to study and learn history are doomed to repeat it

                • antoni.bielazik_633

                  Member
                  December 7, 2016 at 8:27 am

                  Yeah socialism has failed. Let’s not run it back.

                  • Unknown Member

                    Deleted User
                    December 7, 2016 at 11:38 am

                    if you’re in pol sci class you can argue about socialism and how medicine is a giant special interest. if you’re a real life radiologist you see things quite differently, or not, i guess.
                     
                    of course we are a special interest. the only cohort in this country that is not a special interest is the homeless, is all who i can think of. maybe prisoners, but the constitution gives them guarantees of health coverage, for example. and my congressman made sure to tell us that many years ago when i participated in ACR’s AMCLC “walk on the hill” – that we’re a special interest group.
                     
                    you want free market capitalism in medicine, sorry you can’t have it. the plumber that fixed my toilet has it but i don’t. as long as the country pumps out NPs and PAs who are ordering all kinds of studies on patients who don’t have much say in the studies, and in the ER setting we have to read said studies, i don’t see how your dream will be realized.
                     
                    otherwise, i just pile up cash in them 529s and retirement and try to cash out.
                     
                    too bad you don’t see that although we’re special interests, some special interests are more special than others. think pharma, defense, and the list goes on and on. 

  • Unknown Member

    Deleted User
    December 7, 2016 at 12:17 pm

    Question

    If you get insurance out of outpatient care as had been stated then who would care for those who couldn’t afford to pay?

    Think about it….. There are 3 basic answers

    • btomba_77

      Member
      December 7, 2016 at 12:47 pm

      I am always surprised to see how many physicians who are free market advocates fail to see the enormous extent to which we suckle at the teet of government largess.
       
      If the support of massive government funding for healthcare was removed and people truly had to purchase market rate insurance and/or pay out-of-pocket we would see our pricing power drop dramatically as the number of paying customers for our services dropped precipitously.
       
       
       
       
       
      If that was coupled with other “free market” reforms  like eliminating licensing and board certification mandates, allowing offshore interpretation, and eliminating oversight for quality and safety in medical imaging …… (a libertarian’s dream, right>) …. that would cause an instant commoditization in a situation in which the consumer (patient) has virtually no ability to judge who was providing good versus poor service.
       
       

      • Unknown Member

        Deleted User
        December 7, 2016 at 2:29 pm

        Conviction is rigid and inflexible

        Reality is reality for a reason

        • farzadahmadimedrn710_43

          Member
          December 8, 2016 at 4:05 pm

          yeah, libertarianism will make us poor. rad2012 would be fine with indian radiologists reading our studies at ruppies on the dollar. his classmates need to give him a good talking to. you’re bad for the profession.
           
          it’s very strange your website is so focused on government sponsored paychecks of residents… who’s going to pay for your salary once you’re thrown to the free market wolves? 

          • Unknown Member

            Deleted User
            December 8, 2016 at 5:14 pm

            Medicine is not amenable to true free market as a high barrier to entry is needed and it involves the lives and well being of the population. I don’t see medicine ever becoming a true free market in the US.

            • farzadahmadimedrn710_43

              Member
              December 8, 2016 at 5:32 pm

              Libertarians don’t want any borders at all. You should be able to live anywhere. And an Indian medical license is good enough to read grandmas negative non con head ct. Keep rad2012 away from the cameras

      • Unknown Member

        Deleted User
        December 16, 2016 at 10:56 pm

        Quote from dergon

        I am always surprised to see how many physicians who are free market advocates fail to see the enormous extent to which we suckle at the teet of government largess.

        If the support of massive government funding for healthcare was removed and people truly had to purchase market rate insurance and/or pay out-of-pocket we would see our pricing power drop dramatically as the number of paying customers for our services dropped precipitously.

        If that was coupled with other “free market” reforms  like eliminating licensing and board certification mandates, allowing offshore interpretation, and eliminating oversight for quality and safety in medical imaging …… (a libertarian’s dream, right>) …. that would cause an instant commoditization in a situation in which the consumer (patient) has virtually no ability to judge who was providing good versus poor service.

         
        I suggest that you watch the following:
         
        [link]https://www.youtube.com/watch?v=8q71hrwUcu0[/link]
         
        Milton Friedman – Who Benefits From Licensing?[b] [/b][i] [/i][u][/u][strike][/strike]

        • jakub_s

          Member
          December 17, 2016 at 12:41 am

          I would be interested if there was any true free market in regard to any consumer service.  
           
          Any service that requires highly skilled individuals to perform it is going to necessitate some form of regulation.    A minimum standard to practice or participate.  There are laws and writs and rules that need to be followed in order to practice law, to be a doctor, to be a fireman or a police officer or even a business owner.  There are certain barriers to entry in everything.  I can’t just go build a house or sell tacos out of my office.  
           
          Free market doesn’t mean a free for all.   There will never be a scenario where there is complete and utter deregulation of anything.  Especially medicine.  Everyone has to know this.  There is going to continue to be licensing, credentialing, and certifying.  It’s going to include more favorable terms for the domestically inclined and a greater degree of difficulty for the nationally challenged.  
           
          So what are people talking about when they say they want a ‘free market’?  To me it means they want the opportunity to charge whatever they want for their services.  To not have the government set your price.  Are we jealous of attorney’s in that way?  Do we want to bill in six minute intervals?  
           
          What the government has inadvertently done by regulating healthcare as it has is to give every doctor the opportunity to receive a medal for for merely participating.  The arrogance in most of us fuels the notion that in an environment where we can charge whatever we want, I am going to be the cream that rises to the top.  But the economics behind how that system works will dictate that there will be a mean and standard deviations thereof.  The circumstances behind whether you are 1, 2 or even 3 deviations above or below the mean are likely to be much different than we could currently predict.  But in the end, it would likely be that the more money you have, the better chance you have of higher quality care.  
           
          There are already some ‘free market’ opportunities in medicine.  You, as a physician, are not forced to accept medicare patients.  A small conglomerate of doctors have become wildly successful by not doing so.  
           
          Would a ‘free market’ decrease the rate of consolidation or keep us from being commodities?  Or would it further enhance it by allowing non-physicians to recognize market inefficiencies and exploit them?  Would it propagate the notion that doctors are good at medicine and bad at business?  
           
          Whatever happens as a result of Price becoming secretary of HHS doesn’t change the game as much as it just reshuffles the deck.  An opportunity lost for some will be others gain.  But there isn’t a magical healthcare unicorn santa claus easter bunny where doctors make shit tons of money and every ‘merican gets the cheapest, high quality, accessible healthcare in the galaxy.  Maybe we should instead focus on something with better odds like a mathematical proof that God exists.  I guess anything is possible now that we’ve seen the Cubs win the world series.  
           
           

  • btomba_77

    Member
    December 16, 2016 at 3:53 pm

    [url=http://www.huffingtonpost.com/entry/doctors-against-trump-clinician-action-network_us_58409ab9e4b0c68e047fed0a]Backlash against the AMA’s endorsement of Tom Price for HHS; 5,000 doctors sign letter of opposition, form new organization[/url]
     
     

    … the [link=https://twitter.com/ClinicianAction]Clinician Action Network[/link], a nascent alternative organization that has grown in response to Trumps election. And their letter struck a chord. Before its publication, the initial group of CAN members included 60 health care providers. Network membership has since swelled to several hundred individuals, including physicians, nurse practitioners, physician assistants, pharmacists, social workers and community members. 
     
    When someone becomes sick in this country, whether theyre rich or poor, we want to ensure that we have a system thats able to take care of them in a particular way, Chhabra said. We dont think that thats a partisan thing.
     
    Instead, the group sees its role as a clearinghouse to connect clinicians to organizations that are already doing good work, and to coordinate support for patient-first, evidence-based health policies. They hope members will take a more public role in policy by writing op-eds for the public, policy briefs and background pieces to voice physician concerns. 
     
    Were going to be very responsive to legislation that is being introduced and voted on in Congress, both at the state level and the national level, Zhu said. This is the time for clinicians to take part actively in a process thats always been dominated by politicians.
     
     

     
     
     
    [url=https://medium.com/@ClinicianAction/the-ama-does-not-speak-for-us-d697511267d5#.estva6w73]An open letter: The AMA Does Not Speak For Us[/url]
     
     

    We are practicing physicians who deliver healthcare in hospitals and clinics, in cities and rural towns; we are specialists and generalists, and we care for the poor and the rich, the young and the elderly. We see firsthand the difficulties that Americans face daily in accessing affordable, quality healthcare. We believe that in issuing this statement of support for Dr. Price, the AMA has reneged on a fundamental pledge that we as physicians have takento protect and advance care for our patients.
     
    We support patient choice. But Dr. Prices proposed policies threaten to harm our most vulnerable patients and limit their access to healthcare. We cannot support the dismantling of Medicaid, which has helped 15 million Americans gain health coverage since 2014. We oppose Dr. Prices proposals to reduce funding for the Childrens Health Insurance Program, a critical mechanism by which poor children access preventative care. We wish to protect essential health benefits like treatment for opioid use disorder, prenatal care, and access to contraception.
     
    We see benefits in market-based solutions to some of our healthcare systems challenges. Like many others, we advocate for improvements in the way healthcare is delivered. But Dr. Price purports to care about efficiency, while opposing innovations by the Centers for Medicare and Medicaid to improve value and eliminate waste in healthcare. He supports plans to privatize Medicare, a critical program which covers 44 million of our elderly patients.
     
    As physicians, we challenge the AMAs position by affirming our commitment to our patients above all else. Americans ought to know that the AMA does not represent us, and that we do not ascribe to Dr. Prices views. We will continue to strive towards better health for all, regardless of the barriers ahead.
     
    Manik Chhabra, MD, Navin Vij, MD, Jane M. Zhu, MD, MPP

    [/i]
     
     
    [link=https://docs.google.com/forms/d/e/1FAIpQLSfMUMkP3CR0eNorVihYYPoqnJDP7TYD2eiXniLOhfSHMPYqJw/formResponse]https://docs.google.com/f…fSHMPYqJw/formResponse[/link][/i]

    [/i]
     

    • Unknown Member

      Deleted User
      December 16, 2016 at 4:19 pm

      Elections have consequences – if people don’t like it they will vote out Trump and his minions in 4 years.

    • tdetlie_105

      Member
      December 16, 2016 at 9:55 pm

      Quote from dergon

      [link=http://www.huffingtonpost.com/entry/doctors-against-trump-clinician-action-network_us_58409ab9e4b0c68e047fed0a]Backlash against the AMA’s endorsement of Tom Price for HHS; 5,000 doctors sign letter of opposition, form new organization[/link]

       
      AMA does not represent most physicians (maybe 20-25%?).  They supported the ACA and now they support Price, guess they sorta just go with the flow

  • Unknown Member

    Deleted User
    December 17, 2016 at 10:45 am

    I agree with much of what you say, however, generally I think when doctors talk about free market – what they really mean in the fee-for-service model and traditional PP model  vs.  single payer / capitation / ACOs etc.  
     
    There is no denying that the traditional fee-for-service model has bee very good for physicians and thus many hope Trump will slow down the fast march towards single payer / government run care that we were on and would have certainly gotten at the end for 8 years of HRC.
     
     
     

    • jakub_s

      Member
      December 17, 2016 at 4:27 pm

      Quote from macrophallus

      [b]I agree with much of what you say, however, generally I think when doctors talk about free market – what they really mean in the fee-for-service model and traditional PP model  vs.  single payer / capitation / ACOs etc. [/b] 

      There is no denying that the traditional fee-for-service model has bee very good for physicians and thus many hope Trump will slow down the fast march towards single payer / government run care that we were on and would have certainly gotten at the end for 8 years of HRC.

      Agree.  In fact, I inferred that when I mentioned the inadvertent effect the gov’t and CMS has had on medicine by giving everyone a participation trophy.  Which is essentially fee for service.  The minimum standard phenomena where a general radiologist reading a brain mr off a 20 yo scanner gets paid the same as a subspecialist neuro trained rad reading the same scan off a 3T.  We are incentivised to wear the minimum pieces of flair.  
       
      Regardless of the administration, I think they have recognized the above as a flawed way to compensate in that it doesn’t evolve quality at an administrative level.  Putting the impetus for such on the individual doctor and their conscience.  I am not saying that the way it currently works is bad.  I am just pointing out the flaws that I think they see as motivation for change.   It probably does need to be tweaked but I am not sure how to do it and that’s above my pay grade anyway.  
       
      But going forward I think we will see a shift away from fee for service irrespective of who’s in the big chair.  I have seen capitation work well in the outpatient environment with effective rates better than medicare so it’s not the devil people think it is.  You just have to be big enough to push back when the shoving starts and you’ve got to have some clout/cojones.  
       
      People also need to think about the intended paradigm shift and what that means for small to medium size private practices and the macro economics that govern their successes and failures.   I know many are against consolidation but as with capitation, it can actually a benefit to maintaining appropriate compensation as opposed to a detriment if it’s done right.  
       
      The aforementioned private practices are and will continue to be the most vulnerable of all facets withing raidology.  Not because they don’t do a good job, but because they have almost no punch.  If they’re in the room at all, they’re in a corner next to the pastry and coffee while others in charge of their fate are at the table and it’s unlikely they have their best interests in mind.  
       
      I won’t get on my soapbox about the myth of autonomy because I’ve been there and done that around these parts.  But every radiologist has to ask themselves whether they want to hitch their box car to a train or just sit on the tracks waiting to get run over.  We can wish for it to be different, but wish in one hand then crap in the other and see which fills up first.  

      • Unknown Member

        Deleted User
        December 17, 2016 at 5:16 pm

        I’m not convinced either political party gives a rats arse about physicians let alone radiologists in general

        In fact these politicians don’t know anything but numbers

        We all despise what the democrat Obama has done, but Bush with a republican congress gave first gutted the Starke laws then gave us DRA 1 and DRA 2 after imaging skyrocketed

        Duhhhhhhhj no sheet you let everyone put a cash register in there office and then get surprised when they all start ringing it up

        Then Obamacare meant to increase coverage and control costs definitely didn’t control costs

        I have no hope that Trump does anything constructive as per healthcare and in fact if you read his prior book he actually favors single payor.

        Hopefully I’m wrong and he will save us and give the people the wonderful health care that
        Everyone would love ….. just as he promised

        Anyone think he coed through?

        • Unknown Member

          Deleted User
          December 17, 2016 at 8:19 pm

          I truly believe he and his minions will try a totally different approach.  There is no way Obamacare survives and Trumpcare will be something totally different.  The problem is that who knows if it will be good for us or not.  His tax policies are certainly gonna be good for us, even more so if he drops the S-corp rate as he said he would. 
          However, he is a total wildcard and who knows that him and his minions will come up with for HC.  However, with HRC I think we knew what we were gonna get and at this point I will take my chances with Trumpcare.  Of course, gotta be careful what you wish for and we could get screwed.

          • 100574

            Member
            December 21, 2016 at 5:46 pm

            Health care is a very complex web that is integrated in all parts of society-the GOP will learn that not even wall street can tolerate an outright repeal with no replacement for 3 years–hospitals have stocks to

          • tdetlie_105

            Member
            December 21, 2016 at 6:07 pm

            Quote from macrophallus

            I truly believe he and his minions will try a totally different approach.  There is no way Obamacare survives and Trumpcare will be something totally different.  The problem is that who knows if it will be good for us or not.  His tax policies are certainly gonna be good for us, even more so if he drops the S-corp rate as he said he would. 
            However, he is a total wildcard and who knows that him and his minions will come up with for HC.  However, with HRC I think we knew what we were gonna get and at this point I will take my chances with Trumpcare.  Of course, gotta be careful what you wish for and we could get screwed.

            ACA had its pros/cons and winners/losers as will Trumpcare, just hard to predict where we all end up

            • 100574

              Member
              December 21, 2016 at 6:16 pm

              Rep Bill Hutzenga( R-Mich) says son fell and he( not a doctor) decided to wait a day to take him to the doc in order to avoid the cost–end of story the kids arm was broken
              now what is the long term cost if the bone does not heal properly because of delayed diagnosis;-what if the kid threw a fat emboli
              -no word from Michigan Children’s protective services on the Rep’s decision with respect to his son’s care

            • Riquelme10

              Member
              December 21, 2016 at 6:20 pm

              excellent points microphallus
              In my view, whatever Trump does will be a temporary pause to the progression towards single payer
              When this happens, and there is capitation for any particular admitting diagnosis, radiologists are competely and totally screwed

              • 100574

                Member
                December 21, 2016 at 6:34 pm

                6 mil signed up this year since Nov 2016

                • Riquelme10

                  Member
                  December 21, 2016 at 6:37 pm

                  Well you know what they say, smart like a horse, hung like Einstein

  • tdetlie_105

    Member
    December 21, 2016 at 7:08 pm

    Quote from k space invader

    excellent points microphallus
    In my view, whatever Trump does will be a temporary pause to the progression towards single payer
    When this happens, and there is capitation for any particular admitting diagnosis, radiologists are competely and totally screwed

    hopefully temporary pause can be 10-15 years

  • btomba_77

    Member
    January 16, 2017 at 3:41 pm

    CNN (your home for ‘fake news’ 😉 ) : [url=http://www.cnn.com/2017/01/16/politics/tom-price-bill-aiding-company/]
    Trump’s cabinet pick invested in company, then introduced a bill to help it[/url][/h1]  

    Rep. Tom Price last year purchased shares in a medical device manufacturer days before introducing legislation that would have directly benefited the company, raising new ethics concerns for President-elect Donald Trump’s nominee for Health and Human Services secretary.
     

    Price bought between $1,001 to $15,000 worth of shares last March in Zimmer Biomet, according to House records reviewed by CNN.

    Less than a week after the transaction, the Georgia Republican congressman introduced the HIP Act, legislation that would have delayed until 2018 a Center for Medicare and Medicaid Services regulation that industry analysts warned would significantly hurt Zimmer Biomet financially once fully implemented.

    • dzerangel_635

      Member
      January 16, 2017 at 3:50 pm

      Wow, the corruption over the next four years will be impressive me thinks.

      • Unknown Member

        Deleted User
        January 16, 2017 at 5:05 pm

        Hey if he was Martha Stewart he be in jail

        Criminal piece of garbage

      • Unknown Member

        Deleted User
        January 16, 2017 at 5:11 pm

        On the note of saving healthcare dollars, I would really like to see a study evaluating the cost effectiveness of healthcare administrators. Wouldn’t it be nice to turn the tables and have the target on their backs instead of physicians? 
         
        The more I think about have completely clueless healthcare administrators are (not to mention overpaid) the more I long for action- trim down all these clowns and watch the revenue go up. Who knows? Maybe the healthcare system would actually be more efficient if the decisions were mostly made between physicians and patients. 

        • irma.molina_675

          Member
          January 16, 2017 at 6:21 pm

          Another Trump Swamp Monster… 
           
          Orthopod that lines his pockets with Zimmer money – big surprise. 

        • g.giancaspro_108

          Member
          January 16, 2017 at 6:34 pm

          If they want you to wear 37 pieces of flair, they should make the minimum 37 pieces of flair.

          • afazio.uk_887

            Member
            January 16, 2017 at 7:39 pm

            That doesn’t make sense. If he were looking to make money he would have just shorted the stock with the inside info and not blocked the legislation. 

  • btomba_77

    Member
    January 16, 2017 at 8:19 pm

    Quote from neuro_image

    Another Trump Swamp Monster… 

    Orthopod that lines his pockets with Zimmer money – big surprise. 

    U.S. Rep. Tom Price, the Roswell doctor [link=http://www.ajc.com/news/georgia-rep-price-expected-join-trump-cabinet/wBn4tdvm2AjL0YbPsyE0JL/]tapped by President-elect Donald J. Trump to oversee Medicare, Medicaid and the dismantling of Obamacare,[/link] has advanced policies favorable to the health care industry throughout his two-decade political career.

    And the industry in kind has donated millions of dollars in campaign contributions to help fuel his political rise from state senator, to chairman of the powerful House Budget Committee in Congress, to pivotal cabinet appointee in Trumps administration, according to an Atlanta Journal-Constitution analysis of his record.
     
     
    But its his investments in the health care, insurance and pharmaceutical industries, including hundreds of thousands in stock trades during the past four years that has turned his confirmation process for Secretary of the U.S. Department of Health and Human Services into one of the most contested [link=http://politics.blog.ajc.com/2017/01/03/senate-panel-to-mull-tom-prices-cabinet-nomination-on-jan-18/]of the incoming administration. Hearings are scheduled to begin Jan. 18.[/link]
     
    [link=http://www.myajc.com/news/state–regional-govt–politics/senate-democrats-call-for-ethics-inquiry-into-tom-price-stock-trades/GV0ZxsR2gjgHqEI3rpXvkI/]Senior Senate Democrats have called for an ethics investigation and a delay to his nomination process[/link] because of revelations, [link=http://politics.blog.ajc.com/2016/12/22/report-tom-price-traded-health-related-stocks-while-in-congress/]first reported by The Wall Street Journal, that Price traded more than $300,000 of stock in about 40 health-sector companies since 2012.[/link] Critics have said legislative decisions made by Price could have affected those stock prices and created potential conflicts of interest. Prices influence in shaping health legislation includes more than 36 bills sponsored or co-sponsored during the last session.

    • antoni.bielazik_633

      Member
      January 16, 2017 at 8:26 pm

      He should just stick to index funds.

      • btomba_77

        Member
        January 17, 2017 at 11:00 am

        Senate Minority Leader Chuck Schumer (D-NY) told [link=http://www.cnn.com/2017/01/17/politics/chuck-schumer-tom-price-may-have-broken-the-law-in-stock-transaction/]CNN[/link] that Donald Trumps pick to quarterback the replacement of Obamacare, Tom Price, might have [link=https://politicalwire.com/2017/01/16/price-invested-company-introducing-bill-help/]broken the law[/link] with a questionable stock purchase.
         
         
        Said Schumer: If he knew about it, it could very well be a violation of the law. Now they say theres a broker, its kind of strange that this broker would pick this stock totally independently of him introducing legislation thats so narrow and specific to this company.
         

        • Unknown Member

          Deleted User
          January 17, 2017 at 2:14 pm

          He is a fng criminal

          If you or I did that we’d be in jail

          • antoni.bielazik_633

            Member
            January 17, 2017 at 2:37 pm

            Just like Hillary.

          • 100574

            Member
            January 17, 2017 at 2:55 pm

            the swamp and the pumpkin will drag down Radiology
            but after the downtown abbey guy –should we be surprised
            get ready for some real bad health care policy

            Quote from kpack123

            He is a fng criminal

            If you or I did that we’d be in jail

            • antoni.bielazik_633

              Member
              January 17, 2017 at 3:09 pm

              And Godwin’s law declares itself on post 89, thanks to sentinel lymph node.
               
              “As an online discussion grows longer, the probability of a comparison involving Hitler approaches 1”
               

            • Unknown Member

              Deleted User
              January 17, 2017 at 3:09 pm

              Hillary lost

              This guy is fng criminal who won

              • antoni.bielazik_633

                Member
                January 17, 2017 at 3:21 pm

                Damn right Hillary lost.  Nice to hear you accept the results of the election.

                • Unknown Member

                  Deleted User
                  January 17, 2017 at 3:33 pm

                  Since when didn’t I accept it

                  Do you want to show me an example you little wussy

                • Unknown Member

                  Deleted User
                  January 17, 2017 at 3:33 pm

                  Since when didn’t I accept it

                  Do you want to show me an example you little wussy

                  • 100574

                    Member
                    January 17, 2017 at 3:52 pm

                    single payer–can’t wait to see these red state rads get hit with that

                    • antoni.bielazik_633

                      Member
                      January 17, 2017 at 4:14 pm

                      There are conservatives in the north too.  You might notice when you look beyond your liberal bubble.

                    • Dr_Cocciolillo

                      Member
                      January 17, 2017 at 4:28 pm

                      Let’s hear your definition of conservative radi2012.

                      Anyone who is liberal please give me one as well.

                    • antoni.bielazik_633

                      Member
                      January 17, 2017 at 4:33 pm

                      Conservative = small government.  In the fiscal sense, lower taxes and less regulations.

                    • antoni.bielazik_633

                      Member
                      January 17, 2017 at 4:34 pm

                      FYI, Trump is not a conservative.

                    • Unknown Member

                      Deleted User
                      January 17, 2017 at 4:54 pm

                      Regardless of who Is what price is a criminal and they need to go after his arse

                    • Dr_Cocciolillo

                      Member
                      January 17, 2017 at 5:34 pm

                      I can somewhat live w that definition. But I can’t with the other 60% nonsense that gets lumped into being conservative. Less regulation sounds good however the devil is again in the details. What exactly to regulate less ? By default most here will agree w healthcare. But the rest ? Banking ? Derivatives? Education ? Environment ? Highly debatable for some though not for me.

                    • antoni.bielazik_633

                      Member
                      January 17, 2017 at 5:44 pm

                      For things that we as a country disagree with, it should be left to the states.  We are the United STATES of America.  If you don’t like NY, move somewhere else, etc.  Federal government overreach is beyond ridiculous.

  • Unknown Member

    Deleted User
    January 17, 2017 at 3:33 pm

    Since when didn’t I accept it

    Do you want to show me an example you little wussy

  • btomba_77

    Member
    January 31, 2017 at 9:35 am

    [url=http://www.politico.com/story/2017/01/steven-mnuchin-tom-price-democrats-boycott-234426]Democrats boycott votes on Tom Price (and Mnuchin) in protest over misleading Senate testimony[/url]

    • kaldridgewv2211

      Member
      February 7, 2017 at 12:14 pm

      Quote from dergon

      [link=http://www.politico.com/story/2017/01/steven-mnuchin-tom-price-democrats-boycott-234426]Democrats boycott votes on Tom Price (and Mnuchin) in protest over misleading Senate testimony[/link]

      This does not look like it will work out so well since Mike Pence appears like he’s ready to tie-break.  

      • nelson33.jn

        Member
        February 7, 2017 at 4:19 pm

        Tom Price will be confirmed within the week

  • 100574

    Member
    January 31, 2017 at 11:29 am

    have u heard of Aetna/ Cigna–they already cross states

    Quote from radi2012

    For things that we as a country disagree with, it should be left to the states.  We are the United STATES of America.  If you don’t like NY, move somewhere else, etc.  Federal government overreach is beyond ridiculous.

  • btomba_77

    Member
    February 10, 2017 at 4:48 am

    Tom Price confirmed for HHS on a party-line vote in the Senate.

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