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Sun Jul 26 19:05:16 BST 2009

--> Did not hear this myself. But I must say I am surprised. Can you send me the actual text?
Did he say this about DOCTORS? Or was it about "some doctors" or "a doctor"? Was it stated as a FACT or as a potential possibility? That it DOES happen or that it MAY?

The exact quote is:
"So if they're looking -- and you come in and you've got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid's tonsils out. Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies, maybe they have something else that would make a difference."

Whether it was "doctors", some doctors or one doctor in particular, it was said while giving reasons why all doctors are in the position of trying to figure out ways to make more money rather than do what is correct for the patient........

Personally, I think that every physician should take affront to that statement, as it was made in haste, out of ignorance, and to make a point at someone's expense.  In this case it was a helluvalot of someones!

 I believe he spoke "stupidly"!  Hmmmmmm, where did I hear THAT recently?

Ron
-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Doc Holiday
Sent: Sunday, July 26, 2009 1:30 PM
To: .Trauma List
Subject: RE: BRAVO to the ACS

From: KMATTOX at aol.com
> Don't bet on it

--> Well, as I did mention, I have NOT bet on it. I have "bet" against it. Although while making investments at the time I made them, I did not consider the dawn of universal health care as a factor, it will likely cause me losses if a more socialised system came through. And, regardless of whether I think it will be good for the USA or not (and I am not American, so I will not vote) I honestly really BELIEVE such a system will come and that it's only a matter of time.

This is what I believe. Please no-one shout at me - I am NOT CAUSING it to happen!

And I'd save people the time of trying to convince me that it's the wrong thing for the USA, 'cause y'all have better things to do - I will NOT be voting! Additionally, I tend to look at evidence in these issues, so it would be tough...

> ...have patients who look up to their  doctor much more than they look up to their politicians

--> Agreed! This is universal and is very much related to how we use evidence in making arguments (not politics), how we appear to care for the patient more than for our pocket, etc. (but see below)

> list servers... have had a tremendous influence on the Democratic Blue Dogs  in Congress, just the past 10 days

--> Welcome to politics, I guess...

> 1:1 audience with important persons...

--> But, to use our previous terminology, what is the OBJECTIVE of these important persons, be they blue dogs or indigo hyenas, what is the OBJECTIVE of each of these important people? Will their own PERSONAL OBJECTIVE actually be served by succeeding in defeating a democratic president so early in his tenure and "opening the door"? Or are they merely being polite?

No, I DON'T know better than you. I am 1000% certain I know less in these matters. Perhaps I'm merely playing a poor devil's advocate... If you're right then at least ONE cheerful thing will be proven and that is that there ARE ENOUGH politicians who put their true conscience ahead of their career's and their party's success. Still, if that costs the USA this chance at universal coverage, it will only be delayed...

BTW, I am not casting stones in complete ignorance of the glass around me. I also think that it is inevitable that the UK's nationalised system will be made MORE "capitalist" by successive governments for the same reason - perceived success in making change gets votes.

> a comment was made about doctors doing tonsillectomies just to make money...  insult...

--> Did not hear this myself. But I must say I am surprised. Can you send me the actual text?
Did he say this about DOCTORS? Or was it about "some doctors" or "a doctor"? Was it stated as a FACT or as a potential possibility? That it DOES happen or that it MAY?

In each of these examples, the latter version is how a politician would put it. I am sure you all know that you could run as many circles as you wish, but you still could not eliminate the fact that SOME doctors SOMETIMES do things for money (or fear of litigation, I.E. FOR MONEY) in advance of ethics/principles...

> Do not underestimate the power and influence of even one committed tenacious person

--> You misunderstood my meaning. I do not underestimate it, I am RELYING on it - I think Mr. Obama, if nothing else, is a man of immense power, influence, commitment & tenacity. Additionally, he is motivated by his career riding on this, while the majority of doctors (the majority which will remain 100% silent in this debate) do still know that even if they object to the change and lose, they new system will depend on their careers even more than the current one. Although some of them may well think they will make less money, they know that they will be able to continue in their chosen profession.

From: Gross, Ronald (Ronald.Gross at baystatehealth.org)  
> President Obama has focused the 'numbers' debate for the medical field on making money, not providing universal quality of care when he said (as best as I can remember and paraphrase) that a doctor would, for example, do a tonsillectomy rather then treat the tonsillitis because it pays more. That was as poor a choice of words

--> ... In the eyes of an intelligent medical professional it might be a poor choice. But in the eyes of a recently unemployed secretary?...

> the key here will now be for the AMA, the ACS and ALL OF US to become very politically active

--> Well, as I said above, welcome to politics!
Still, we must remember that the trust the public put in us may well be eroded towards the politician level if that is what we become...

> Just my 2 cents (a far cry from the trillion thing!)

--> In a funny way, I believe the way you signed your message is EXACTLY my point!!!

If levers may move the earth, it is still more likely to move in the direction of a lever that is a trillion-long, not a .02-long... In a capitalist system, that is...

> ...we need to adopt the "union mentality"

--> How socialist of you!

> QUALITY universal health care in an American capitalistic way...

--> Yes! Mold it - don't fight it!

No need to emulate a communist system. There are capitalist societies with universal healthcare alongside capitalist care - why is that beyond the capability of the American Nation?

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