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Re: Health CareFrom: Douglas Krell (dkrell@msn.com)Thu Jul 30 22:29:20 2009
I simply cannot believe that ALL the members of this list, or any group of physicians (or practioners of any stripe) would agree to settle wholesale for salaried positions in the employ of the US government! This is just simply a ridiculous proposition! There is an enormous difference between choosing a salaried position among other offers and being forced by congressional decree to accept employment as the only alternative for medical practice in the US. Under circumstances such as those, physicians would certainly be at risk for losing their status as the finest most well respected physicians in the world. It is only by knowing that a practitioner can take advantage of better alternatives, that employers offer the wages and benefits that closely approximate those found in the private sector. Imagine if state or federal health administrators knew that no matter what grievance or problem, you were stuck in a certain job. There is little you could do to make more money or seek advancement. There would be downward pressure on all incomes and those income ceilings would be determined by some bureaucrat. If there's a shortfall in the budget, doctor's "scheduled cost of living increases" would be easy to put off another year. Typically bribery and under the table payoffs would become the common practice. Just like in Mexico, Canada, the UK, the Czeck republic, or any other country with socialized medicine. Of course we all got into medicine to make things better, but everyone becoming an employee would not make things better! Simply put, we are NOT the problem! The GOVERNMENT is the problem! The regulations that favor the HMO's, the insurance companies, and the lawyers are the problem. As educated professionals we have always demanded independance. The importance of freedom of thought and practice are critical to the development of ideas and new techniques. We are not the sheep to be led around, we are the shepherds. And I doubt that we wish to known as the generation who "gave-up" the right of independant practice. All primary care MD's and pediatricians as employees ? Doesn't that still leave surgical specialties intact? Well it's a slippery slope. Any one who wants to lead the "unencumbered" life of the employed physician can certainly find a job today. So why would we want to make that mandatory? Is there a downside to single payor, single employer, single anything? In my opinion, if it's mandatory, Yes. Its ALL downside.
-- Douglas Krell MD
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