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Re: Health Care --> "everything free"From: RModugno@aol.comFri Jul 31 20:37:49 2009
Don't the salaried Docs at Kaiser do this kind of surgery? Robert Modugno MD MBA FACOG Sylva, NC In a message dated 7/31/2009 6:22:37 P.M. Eastern Daylight Time, rchudacoff@mylinuxisp.com writes: I just finished an LSH on a 2200gm uterus. I would never do that as a salaried, performance-free physician; especially if I wasn’t rounding that weekend. Wait, I wouldn’t be rounding on the weekend; I’d be a M-F nine-to-fiver. Okay boys, sharpen up those scalpels, I’m doing TAHs again…on Fridays Richard Chudacoff, MD, FACOG Las Vegas International Center for Advanced Gynecologic Care (Specializing in minimally and non-invasive surgery) TEL: 702-485-8893 FAX: 702-629-4628 _rchudacoff@lasvegasgyncenter.com_ (mailto:rchudacoff@lasvegasgyncenter.com) _www.lasvegasgyncenter.com_ (http://www.lasvegasgyncenter.com/) "The measure of a truly great man is the courtesy with which he treats lesser men.†-Anonymous The information in this e-mail may be confidential and/or privileged. If you are not the intended recipient or an authorized representative of the intended recipient, you are hereby notified that any review, dissemination or copying of this e-mail and its attachments, if any, or the information contained herein is prohibited. If you have received the e-mail in error, please immediately notify the sender by return e-mail or phone and delete this e-mail. Thank you. From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of GORDON M. GOLDMAN Sent: Friday, July 31, 2009 3:06 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Health Care --> "everything free" This gets really to the basics of much of the healthcare system today. The country has been convinced by government that health care is a 'right' or 'entitlement' which (IMHO) is should not be, except for the most basic of necessities. No one should be entitled to the labors of anyone else without expecting to pay for it. And if you want lobster insted of codfish, you expect to pay for it. If you go to the grocery store, you don't expect to get your food for free, simply because you have a basic right to be fed. If you need shelter, you do not have a basic right to a home. The government in attempting to resolve those issues offers subsidies (rent, food stamps, etc.) but allows the individual to make their own decisions as to how they spend it. Why is medical care different? Gordon --- On Fri, 7/31/09, DoctorJoe@aol.com <DoctorJoe@aol.com> wrote: From: DoctorJoe@aol.com <DoctorJoe@aol.com> Subject: Re: Health Care --> "everything free" To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net> Date: Friday, July 31, 2009, 4:49 PM I guess I should start a new direction and see where everyone stands on this. It's been discussed in a few places I've seen so far . . . Especially since Medicare/Medicaid have come into being, a significant portion of the population began to expect everything free. This was aggravated by the so-called HMOs. By "everything free" I mean each visit is free (except for maybe a miniscule co-pay), prescriptions are free or very cheap, and you basically don't "see" what you're spending (and with Medicare/Medicaid, YOU may NOT be spending anything -- some other taxpayers are paying for you). You don't pay anything at the site of care -- someone pays it in the background, basically transparently from your point of view. This is a dangerous set-up and it's caused the problems we're having now, IMHO. When I was a kid, we were in one of the first HMO-type organizations, certainly one of the first in Louisiana. It was a medical organization for employees of the Exxon refinery. I remember going there for everything -- glasses, medicine, doctor visits, shots, vaccinations, everything. And the cost was either nothing or very nominal. But SOMEONE paid for it -- the company did, in effect giving you less paycheck and providing you "free" medical care. It looked like a great perk. [As an aside, I ALSO remember that the doctors we saw in that system were some older doctors -- semi-retired? -- and some younger doctors who worked there for a while and then went out and opened a "real" practice. I also remember some scheduling issues, although I was young and I don't want to say anything about that and get it wrong.] The expectation that we have a "right not to pay" for doctor visits and medications and etc. is what is ruining the American system. We expect our "insurance" is going to pay for just about everything. The concept of insurance is a mechanism by which you INSURE against some catastrophic or rare expensive event -- like car insurance in case of a collision. You don't (usually) have auto insurance for routine maintenance. But in healthcare, that's what we have gotten used to. Basically, we want insurance for routine health maintenance. We need to reset the system so that "insurance" is for the big-ticket expenses that occur from time to time. The day-to-day maintenance should be paid for out of pocket by us. My thought is, if the system reset that way, day-to-day maintenance items (for us, how about Pap smears, urinalyses, vaginal cultures, etc.) should be cheap enough to afford. On the other hand, surgeries and hospitalizations are the big ticket items that insurance should cover. Otherwise, we can look at medical care as a giant entitlement. I don't even want to pay for aspirin. It's my health -- it should be free from the government. Joe P.
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