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The Right Prescription
Obama’s Medical Mystery Shoppers
Big Brother Obama and Big Sis Sebelius tighten the noose on America’s doctors.
On Tuesday evening, after being outed by the New York Times, the Obama Administration abandoned plans to have “mystery shoppers” call primary care physicians to determine how easy or difficult it is to get a doctor’s appointment and whether being part of a government health insurance program impacted that ease or difficulty.
The original proposal from the Department of Health and Human Services, dated April 28, 2011, specified that a division of HHS would contact 465 Primary Care Physicians (PCPs) in each of nine states: “Each PCP’s office will be contacted twice; once using a privately insured patient scenario, and once using a publicly insured patient scenario. The scenarios will simulate requests for an appointment with the sampled PCP from a new patient with both public or private insurance and either an urgent medical concern or routine exam appointment.”
HHS also planned to call 465 more PCPs (in total, not per state) who would “be informed about the study and asked directly if they are accepting new patients and how long it would take to obtain an appointment. The purpose of this additional data collection component is to evaluate the validity of the mystery shopper approach in generating accurate estimates of physician availability and timeliness of services.” Does anyone believe that a doctor really wants to tell a government questioner that he’s avoiding taking new government-funded patients?
As the Times noted, “the decision [to abandon the “mystery shopper” plan], after criticism from doctors and politicians, represents an abrupt turnabout. On Sunday night, officials at the health department and the White House staunchly defended the survey as a way to measure access to primary care, and insisted that it posed no threat to privacy.”
It’s a remarkable scoop for a newspaper which has operated as an arm of the Obama Administration’s press office (and recently has only seemed interested in breaking big stories when they can damage national security or the election chances of Republicans). Nevertheless, the Times’ article quotes four doctors opposed to the scheme and no doctors in favor of it. For example: “‘I don’t like the idea of the government snooping,’ said Dr. Raymond Scalettar, an internist in Washington. ‘It’s a pernicious practice — Big Brother tactics, which should be opposed.’”
One defense of the plan that has been made by liberal talking heads is that the use of “mystery shoppers” is a common practice by private businesses who want to make sure their products are being sold as much and as well as possible. But of course, government is not a business; government is power. A business is trying to maximize the chances that a consumer makes a decision to buy that business’s product rather than someone else’s. The government, especially this Administration, has the opposite aim: to take as much decision-making ability as possible away from both consumers and providers of health care. The voluntary aspects of consumer choice and doctors’ rights to run their own businesses versus the compulsion of government power makes the comparison ridiculous, though maybe not in the minds of liberals who believe that most people are too stupid to make their own decisions.
The most likely outcome of the “mystery shopper” program would have been heavy-handed federal regulations on how doctors must behave, such as how many patients of what type they must see. Furthermore, given this administration’s reputation for attacking anyone who gets in the way of its statist plans, one can only imagine the anti-doctor propaganda that would be used or at least threatened once HHS had data to prove what we already know: low reimbursement rates by government are causing more and more doctors to avoid taking Medicare and Medicaid patients.
The American Association of Medical Colleges estimates that “the United States will face a shortage of 124,000-159,000 physicians by 2025.” But despite the creation of four new medical schools in 2009, there has over the last few years been essentially no growth in the number of people applying to medical school. Let me put on my big surprise face. Would you want to spend the better part of a decade and take on $160,000 in debt (the 2010 median for new medical school graduates) just to be told by Kathleen Sebelius what to do, which patients to see, and how much you can charge?
To be sure, the sort of information the Administration is seeking to gather would be useful for informing public policy. But it should not be gathered by Big Brother operating undercover. Instead, a private organization or think tank, perhaps working with several physicians associations, should survey doctors in a way that guarantees respondents’ anonymity and that no individual data will get into the hands of government. (They’d have to be careful with the AMA since that group has already sold its soul, supporting Obamacare in return for keeping an arcane publishing monopoly and receiving sure-to-be-broken promises about Medicare reimbursement rates.)
The Obama Administration is all about blaming anyone but itself: blame the victim, blame an observer, blame anyone but The One!
• The top 1% of earners who pay nearly 40% of all federal income taxes (more than the bottom 90% of taxpayers combined, and despite earning only about 20% of total national income), nevertheless are the targets of Obama’s class warfare rhetoric and policy.
• Obama blamed “the 24-hour news cycle and cable television and blogs” for citizens’ anger against Obamacare as displayed at town hall meetings in 2009 when Americans suspected — as they now know — that we are victims of the most damaging piece of legislation in modern American history.
• Obama blamed ATMs for unemployment (shorthand for blaming technological progress generally) when the unemployed are victims of this government’s failed economic plans. (To be sure, the Bush Administration has plenty to answer for as well. But Obama’s economic team — what’s left of it anyway — is incapable of realizing that they’re in a deep hole and it’s time to stop digging.)
The doctors are the next victims to be blamed, and they know it. The Obama Administration now says, though it was not in what it submitted to the Federal Register, that data about the doctors’ responses would have been kept anonymous and aggregated, and that it would not have been used against any individual or group of doctors. If you believe that, I have a bridge to sell you.
When has this administration ever been able to keep a secret? Well, if it has then we wouldn’t know, by definition, but there are plenty of things we do know about which we shouldn’t:
About the Author
Ross Kaminsky is a self-employed trader and investor and is a senior fellow of the Heartland Institute. He is the host of The Ross Kaminsky Show on Denver’s NewsRadio 850 KOA at 11 AM on most Sundays. You can reach Ross by e-mail at rossputin(at)rossputin(dot)com.
Letter to the Editor View all comments (149) | Leave a comment
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Mattled| 6.30.11 @ 7:31AM
Abandoned? Yeah, right.
Inez Owens-Faulk| 6.30.11 @ 11:02AM
I was just wondering if any of you readers have ever been tempted to snack on Milk-Bone dog biscuits.
A few weeks ago I took a nibble, and to my surprise the biscuit tasted good. Since then I've developed an appetite for them.
Sitting beside my monitor right now is a little crystal bowl of the delicious biscuits, and I nibble on them as I read your posts.
Anyone else out their tried Milk-Bone? If not, you might want to give them a try. They're quite tasty.
NoLib| 6.30.11 @ 12:05PM
Do you wear a shock-collar, too?
Margie's Husband| 6.30.11 @ 12:08PM
Nope, never tried 'em. But I do have a hankering for Funions. They go down great with Blatz beer.
NoLib| 6.30.11 @ 12:13PM
That shock-collar could help you with your over-eating.
Margie's Cat| 6.30.11 @ 12:28PM
I like Milk Bone dog biscuits.
They make me Ruff.
NoLib| 6.30.11 @ 1:07PM
I hope they contain birth-control ingredients, too. You've already birthed enough litters.
Margie's Cat| 6.30.11 @ 1:19PM
I eat Milk Bone dog biscuits because I don't wanna be a Pussy.
NoLib| 6.30.11 @ 4:15PM
Freak.
Margie's Cat| 6.30.11 @ 8:00PM
Watch it.
I'm a Milk Bone eatin' Ruff Cat.
Soon you'll have to change your name to "Claude Balls".
Occam's Tool| 6.30.11 @ 10:43PM
My cats will eat anything. Neither Cassius nor Rocky are "pussies."
lydia | 6.30.11 @ 1:30PM
I am a 28 years old doctor, mature and beautiful.and now I am seeking a good man who can give me real love , so i got a username Andromeda2002 on--s'e'ek'c'ou'ga'r.c óm--.it is the first and best club for y'ounger women and old'er men, or older women and y'ounger men,to int'eract with each other. Maybe you wanna ch'eck 'it out or tell your friends!
The only thing to the left of Obummer is Fascism - so far right it meets the left in a full circle.
George True| 6.30.11 @ 3:22PM
Myself, I am partial to Snausages. They're every bit as tasty as Vienna sausages, but less than half the price.
NoLib| 6.30.11 @ 4:16PM
They're probably cheaper, too.
Occam's Tool| 6.30.11 @ 6:13PM
I actually knew a guy who once nibbled on a milk bone in my presence (my wife was also a witness---I refuse to give his name since he is an asshole). His wife said, "Don, don't do that! You know the dog always knows when you are nibbling on his doggie treats!"
He went off to practice medicine in Australia.
NoLib| 6.30.11 @ 7:04PM
He should have become a vet.
Bill Hussein O'Stalin| 6.30.11 @ 8:30AM
Since Obama can't be trusted on any issue doctors should offer coupons and other incentives to make themselves "shopworthy."
I would suspect that part of the plan was to have minorities (blacks) call in and see if they could get an appointment.
That would have justified the provisions in the health care bill that call for racial preferences as well as confirm Obama's training under Jeremiah Wright that white America needs to be taken down a notch, perhaps taken out all together. Here's a good synopsis of racial hatred buried in Obamacare:
http://michellemalkin.com/2010.....obamacare/
One provision states that programs with “a record of training individuals who are from underrepresented minority groups or from a rural or disadvantaged background” will be given priority for government money. This is only one of several such provisions. Programs and medical institutions that practice racial preferences will be moved further up the money queue than programs and medical institutions that disregard race.
The one who disregards skin color is penalized. Hopenchange in America!
By the way, the Civil Rights Act prohibits government racial discrimination and preferences. The U.S. Commission on Civil Rights called the provisions racially discriminatory and sent President Barack Obama and Congress letters warning them about the provisions. The politicians ignored the warning, naturally.
The Commission said the inclusion of the discriminatory provisions appeared to motivated by a crusade to narrow racial health care disparities and the belief that the disparities are caused by a shortage of medical professionals who are members of preferred minority groups. Seriously.
JF| 6.30.11 @ 7:34PM
The quota system for medical school admission has already been implemented at UC Berkeley (are we surprised?) This school discriminates against Asian students who have SATs that are stratospheric in order to admit less qualified "minorities" (read that blacks). I suspect that eventually these students go back to practice in the 'hood, meaning that once again, a liberal program that is supposed to help the poor instead offers them sketchy medical care - and opens the door for the likes of Obama to "fix" it with government controlled health care.
Occam's Tool| 6.30.11 @ 11:02PM
JF--one thing in which you are in error---they do NOT go to practice "in the hood." They practice in the rich upscale suburbs just like close to 93% of the MDs in Minnesota. (City rural split of psychiatrists in MN---93% City, 7% rural. Of course, one of the rural guys is Superman, but even so.)
DG in GA| 6.30.11 @ 11:13PM
I agree that if you did a study you would find that very few of the black med students who got preferential acceptance into med school ever go back to the 'hood to practice. I've noticed that we have a LOT of black AMERICAN docs in our upper middle class area of Hotlanta, but in the 'hood there seem to be more Indian/Paki docs - some Nigerian as well.
richard ryan| 7.1.11 @ 12:56PM
The landmark supreme court case for affirmative action involved a white medical school applicant (Bakke) who sued based on racial discrimination. His spot was given to a black applicant with much lower qualifications. I believe the black student later became a plastic surgeon and was so ignorant of physiology that many of his patients died from local anesthetic toxicity.
MAH| 7.7.11 @ 8:37PM
Mr. Ryan
I agreed with the Bakke v. UC decision. But your supposition here on the student who was admitted in lieu of Bakke is pure conjecture and divisive. You have no facts on your side as to the outcome of the student who was admitted in lieu of Bakke; are purely race baiting.
Johnny| 7.2.11 @ 7:35AM
Your comment is almost correct. The problem is that the students who eventually graduate will not return to the 'hood. They'll move to the better places that allow them to make more money and will refuse to treat those on the govt. programs. LOL!
Occam's Tool| 7.4.11 @ 11:57PM
Good point, JF. Myself, I have always held that if our public universities turn Asian that will make the pampered whites suburban kids wake up. FDR put a Jewish quota system in place at Harvard---Affirmative Action has put an Asian quota system in place today. I thought it was wrong to have restrictive quotas then and now. It's unAmerican.
MAH| 7.7.11 @ 8:33PM
UC Berkeley does NOT have a Medical School...so Yes, I am surprised, JF. There has never been a Med School at Cal. You may mean UCSF or UCLA or UC Irvine or UC Davis, but not UCB. I am a stickler for facts; yours are way off and do not add constructively to the conversation!
Jay Dee| 7.3.11 @ 7:35PM
Not to worry, Obamacare has the "Women and Minorities" designation in it, compliments of that brain trust Maxine Waters.
Do you know what else has the same provision in it - the Dodd-Frank Financial Regulation boondoggle, again, compliments of Maxine.
All financial institutions MUST have a Dept. of Women and Minorities or they do not receive anything, i.e. bailouts, from the Fed.
All of these are written to promote unequal opportunities for "women and minorites" regardless of capabilities.
JP| 6.30.11 @ 9:04AM
ObamaCare is one reason that I believe the President will not run for re-election. With each passing week some new bit of reality comes to light concerning ObamaCare. And as the President finally realizes what's in the bill he may figure that he doesn't want to be anywhere around when it fully becomes enacted.
PJ| 6.30.11 @ 9:21AM
I agree with your stated outcome: Obama will not run. Yet, I think delusional Obama will decide against running not because of Obamacare but because big-moneyed donors will support Hillary if she throws in her hat. As you well know, many of the Democrat donors were pissed in 2008 that Obama not Hillary got the nomination.
Ross Kaminsky | 6.30.11 @ 9:56AM
No chance Obama won't run. Stan said it right: Obama is a narcissist as well as a committed leftist who will not stop until the nation is "fundamentally transformed" or until he is stopped at the ballot box.
Occam's Tool| 6.30.11 @ 6:17PM
As an MD, I can tell you that with the exception of improved techniques (which Obama wants to limit), the "fun" aspect of medicine has gone nowhere but DOWN during the 18 years I've been in private practice (as of 7/12/2011).
More Managed Care MD authorizations, restrcitions of test, etc.
My solution is to have the patients have to get the procedures and meds approved INSTEAD of the MD. That would wake our Reps and Senators up toot sweet as to the crap that private insurance and, much worse, Medicare, put docs through.
An overwhelming majority of MDs would not recommend their children follow them into the profession. This was NOT the case in 1963.
Texas Granny| 7.1.11 @ 11:48AM
You are correct. My girlfriend in West Texas told me that her doctor told her that most of the Doctors in private practice are going to go to ER's because of this mess.
Steve A| 6.30.11 @ 9:25AM
JP, Nice pipe dream buddy.
PJ| 6.30.11 @ 9:37AM
Darling, it's not a pipe dream. Except for Soros & a few others, many were very much annoyed that Hillary, who they felt paid her dues, could have easily taken the presidency in 2008. How do I know this? I have a brother who use to work for 1 of these rich democrats. Aaannd as of now, according to the media, Obama is having some difficulty in raising money for his re-election.
Steve A| 6.30.11 @ 10:54AM
PJ, How does she run against Obama for the nomination & secure it? Is she against Obamacare? No. Is she against his tax policy on the rich? No. What does she offer in opposition? If she acts moderate, she loses. She can't go to the left of him. She has no shot, even if she wanted to.
SpiralArchitect| 6.30.11 @ 11:59AM
The only thing to the left of Obummer is Fascism - so far right it meets the left in a full circle.
NoLib| 6.30.11 @ 12:07PM
Obama's an Authoritarian--Fascist and Socialist both apply.
Johnny Paycheck| 6.30.11 @ 9:07PM
And Bush was none of these.
Right.
NoLib| 6.30.11 @ 9:37PM
What's GWB got to do with it, dummy? Try to stay on topic.
Occam's Tool| 6.30.11 @ 10:59PM
But Obama takes everything you dislike about Bush economically and stretches it like a Tex Avery cartoon. (Yes, finally worked in a reference to Tex.)
PJ| 6.30.11 @ 5:32PM
She's a far left radical feminist, she's a thug, she is smart compared to Obama, she's got Bill who's an expert at getting out of jams, & she's got Bill's advisors who are still living along with his donors.
We all know that progressives are bigots. They're going to drop Obama the second after they all realize he's not re-electable.
NoLib| 6.30.11 @ 6:37PM
Hillary is a Marxist like the Bamster. They both worship Alinsky.
DG in GA| 6.30.11 @ 11:18PM
PJ: Ya know, I was wondering why suddenly Billy Bob Clinton was getting all this press with his "Economic Solutions for America" crap. I would not put it past those two to get Billy Bob out front and center as the potential "Economic savior" and then put her up as a candidate in 2012. Bill, Hillary and Obama are ALL narcissists and Bill and Hill have always presented themselves as a 2-for 1 package. So those people who can't stand Hill - and there are a whole lot of them - might support her because she's not Obama and they get Bill in the package. We all know the Clintons never do ANYTHING that is not very carefully orchestrated for maximum political advantage. Well, except sexually harass women...
PJ| 6.30.11 @ 9:40AM
Opps! Sorry for the slight dissing. I'm a little "dyslexic."
Stan Redmond| 6.30.11 @ 9:51AM
He will run. Don't underestimate a narcisist. The world NEEDS him. HE is the won we've been waiting for. HE will transform America. Of course he will not campaign or debate. He will be chopped liver in a debate (as he was with pathetic McCain) because he will suddenly be too busy to concern himself with such trifling things. He has the world to save.
Drunken Sailor| 6.30.11 @ 11:06AM
"He has a world to save"
Bingo! I have been thinking that one of Obama's dreams it to go down in the history books. First black president, passed a national healthcare bill, secured peace in the middle ease, etc. It doesn't cross his mind that his ideas won't work, his brain can not see that he is wrong. Hell, he may not even care if the programs he passes work, as long as they get him in the history books. This man is all about himself, his ego, and his delusions of grandeur.
SpiralArchitect| 6.30.11 @ 12:02PM
Not in dissagreement but Obummer has a "people to save" & he is quite willing to destroy the world to save them...
NoLib| 6.30.11 @ 12:12PM
The Bamster's a true believer, an ideologue who will destroy anyone who gets in his way, or just your common, garden variety batsh!t crazy leftist.
Texas Granny| 7.1.11 @ 11:53AM
Drunken Sailor, and it is up to us Patriots to see that Obama goes down in the history books as the worse President in history and the man who tried to destroy America!
PJ| 6.30.11 @ 5:35PM
Stan,
The progressives want to transform America. They would be happy with either Obama or Hillary to do the job.
patrick henry| 6.30.11 @ 1:43PM
In my posting of March 17, 2011 on this TAS site I specifically detailed Obama's long-range master plan, which includes the possibility that he will resign near the end of this year. I posted the first version of that on TAS more than two years ago, and some respondents quickly dismissed the "theory" as unrealistic. But as time has gone on, it is increasingly evident that Obama has ambitions far beyond the White House. My "theory" is more relevant now than ever, and I have updated it a bit to reflect more recent events.
Here it is again, re-posted in its entirety from the Mar. 17 TAS site (sorry for the length, but it's necessary in order to address all the pertinent details):
patrick henry| 3.17.11 @ 3:17PM
"Obama’s Long-range Master Plan Unveiled"
What Republicans need to seriously consider as they plan their 2012 Presidential campaign is that Obama may not be the Democrat candidate again. Candidates who base their entire campaign on that assumption are risking being completely caught off-guard by an historic blind-side political bombshell. The 2010 election seriously damaged Obama, and his on-going indifference as multiple domestic and international issues piles up will cause many Dem candidates up for re-election in 2012 to be very open to a "Savior" who can step in and rescue their party from political oblivion.
Consider this:
"Obama's long-range master plan unveiled"
As Barack Obama and his closest staff raced through the first several months of his new administration goading Congress into adopting bills hundreds of pages long without reading them and approving trillions of dollars of new spending and debt, long-time Washington insiders scratched their heads profusely as they attempted to decipher the specter and rationale of it all. Aside from the astonishing spending and associated risk, politicos marveled at the ability of the new President to move his agenda with apparent little regard for the constitutionality of such measures as moving the census operations into the White House and appointing hoards of “czars” with staffs of thousands, budgets of billions, and no apparent accountability to anyone but the President.
In the meantime, the new President remained on the campaign trail, giving speeches, making appearances, and posturing as if the Presidential election had not already occurred. The long time Washington observers puzzled over this odd behavior. After all, wasn’t the election over? Hadn’t he already won? Why was he still traveling all over the globe and not sitting at his desk in the White House Oval Office attending to business?
Was there any real method to this madness, or was it just plain madness? Turns out there is, indeed, very specific rationale and logic behind this President’s mad rush to acquire as much authority and control as possible over the nation and its subjects.
After some detailed probing and pursuit of the subject, what we find is that Barack Obama, still just in his late 40’s, has much greater ambitions than just serving two terms as President of the United States. Barack Obama is positioning himself to become the next Secretary General of the United Nations, a post with no statutory limit of terms and control of the only organization with widespread authority over all points of the globe.
Researchers contemplating Obama’s long-range master plan find that all the necessary elements are in place, or soon will be, to give Obama the opportunity to literally rule the world- possibly for as long as he wants. A brief review of the United Nations charter and history provides the eye-opening details.
UN Secretary General
The United Nations Charter establishes the Secretary General as the head of the Secretariat, and, as such, as the chief administrative officer of the United Nations. The position of UN Secretary General is a five-year term recommended by the UN Security Council and appointed by the UN General Assembly. The Secretary General position is generally rotated by geographic region and is traditionally (but not constitutionally) limited to two consecutive five-year terms. Since the founding of the UN in 1945, the only exception to this was in 1996 when American President Bill Clinton’s administration exercised its authority as a permanent member of the UN Security Council to veto the re-appointment of Egyptian diplomat Boutros Boutros-Ghali to a second term as Secretary General. As he was from Africa, the UN then selected another African representative, Kofi Annan, of Ghana, to replace him.
Annan served his two terms as Secretary General, completing his service Dec. 31, 2006. Under the UN’s rotational system, the Security Council then looked to Asia for the next Secretary General, and nominated Ban Ki-moon of South Korea. The General Assembly quickly approved him as the new Secretary General. And here’s where it gets interesting.
The first term of Ban Ki-moon expires Dec. 31, 2011 and, according to UN tradition, if he is interested, he will almost certainly be reappointed to a second term, which will expire Dec. 31, 2016, three weeks prior to the end of Barack Obama’s presumed second term as President of the United States. Since the founding of the United Nations in 1945, only two geographic regions of the world have not had a representative serve as UN Secretary General: Oceana…. and North America. Barack Obama intends to be the first from North America.
This, of course, would explain virtually everything about Obama’s otherwise-unconventional behavior and his aggressiveness in acquiring as much control, authority and international goodwill as possible. The basic goals of the Obama Presidency are to weaken the United States as an international force in order to lessen its ability to exert influence and control over international affairs, while at the same time seek to subjugate the U.S. as much as possible to international agreements and UN control, authority, regulation and laws. This will curry favor with the international community, thus enhancing Obama’s chances at ascension to the Secretary General throne, and make the U.S. less significant vis-a-vis the UN in international affairs, so that he, as life-long UN Secretary General, will have unquestioned and unchallenged authority over the worldwide community and its affairs.
The procedural steps
To achieve these ends, during his time as President, the Obama administration has pursued policies that weaken American strength, power and influence in every conceivable political, economic and social way possible. For example, many economists have pointed out that the Obama economic plan, loaded with unsustainable spending and debt, may cause serious long-term damage to the American economy. No problem- if his plan does happen to somehow work, fine, but the Obama economic plan is not designed to heal the economy- in accordance with Obama’s long-range master plan, it’s designed to weaken the economy, and the nation. And how does the on-going Obama international “blame America / apology tour” strengthen America’s foreign policy? It doesn’t- it’s not supposed to- it’s designed to weaken our nation’s role in international affairs. Further, Obama’s administrative and judicial appointments and nominations are people infused with a strident anti-traditional and anti-constitutional ethos, because that nudges America further toward an eventual submission to “international” ethics, laws and constraints.
The more that Obama will be able to enact this agenda and master plan now, the easier it will be for him to later wield unquestioned power as UN Secretary General, because the United States will have been severely weakened and unable to exert significant influence on international (or even some domestic) affairs.
Possible scenarios
Speculators are envisioning several alternative scenarios. For example, one option being bantered about is that Obama’s unbridled ambition will not allow him to wait until Ban Ki-moon completes a second term as UN Secretary General. Mr. Ban’s first term will conclude Dec. 31, 2011, one year and three weeks prior to the end of Obama’s first term as President, and one popular scenario envisions that, if Obama feels he has sufficiently accomplished enough of his agenda by then, he will resign as President and seek to replace Mr. Ban in January of 2012. After all, why wait another four years and risk something going awry in the meantime that could pre-empt an Obama second Presidential term or even the larger Obama long-range master plan itself?
Under that scenario, it is thought that Vice President Joe Biden’s subsequent ascendancy to the White House in January of 2012 would assure a continued passive and subordinate American role in UN and international affairs while Obama then promotes his UN Secretary General agenda, and, at the same time, assure election of Biden as President later that November.
Another variation of that scenario is that the aftermath of the 2010 election and growing unhappiness with Obama's lack of leadership, including by members of his own party, will cause key Dems, especially those up for re-election in 2012, to seek an alternative to head the Dem ticket as Presidential candidate. Hillary would then offer herself up as the "Savior of the Party" as Biden fills out Obama's term and doesn't seek the nomination. As a narcissist, Obama must be concerned about the prospect of being defeated in a re-election campaign. So, as a political safety valve, Obama could resign in late 2011 for the UN job. Under that scenario variant, everybody would win- Obama would get his UN Secretary General-for-life job, Biden would get to serve one year as a U.S. President, and Hillary would get her shot at making history as the first female President, perhaps even for two terms.
However, some feel that this scenario would be too outrageously ambitious for even Obama. Their thought is that Obama would prefer to complete the second term as President and then move on to the UN. On the other hand, this scenario would explain the “mad rush” to enact as much of Obama’s agenda as soon as possible in his first term. And it would also explain why Obama was so insistent on running for President in 2008, rather than allowing Hillary Clinton to have her shot at the job in ’08 and running after her two terms.
Many Democrat leaders felt that Hillary had earned her shot at an open office in the 2008 Presidential election, as George Bush was completing his second term. After all, even after two Hillary terms as President, Obama would still only be 55 in 2016 and, presumably, politically bolstered by another eight years of service and experience as a U.S. Senator. With such additional maturity and experience, Obama in 2016 would have had formidable credentials to then become the first black American President.
All very logical, except for one very revealing factor. As previously mentioned, a new UN Secretary General will be scheduled for appointment in 2016, and eligible for two five-year terms. If Obama would have let that opportunity pass by and allow someone else to become UN Secretary General, that would mean that Obama’s next best shot at the UN Secretary General position may not occur until 2026. At that point Obama would be 65 years old, with far less time to rule the United Nations. And, in addition, that would leave far too much time for something unforeseen to disrupt Obama’s long-term master plan. No, it was felt that it was a far better approach to push Obama for the Presidency in 2008 even if that meant risking the wrath of Hillary and her Democrat Party operatives. With an Obama victory in the 2008 Presidential election, his plan of ascending to the open UN Secretary General seat in 2016 was assured, and he could serve as many as four five-year terms as UN Secretary General before finally retiring at a still-robust 75, or possibly even serving beyond that. That would provide Obama with a full twenty years or more of ruling the world- a heady opportunity indeed, one that would be very difficult for an intense narcissist to let pass by.
Another variant of that scenario involves the secret pact made between the Clintons and Obama when Hillary decided not to challenge Obama at the 2008 Democrat convention and, instead, endorsed Obama for President. The negotiations between the Clinton and Obama camps concluded with some major concessions to the Clintons, beginning with Hillary’s nomination and subsequent appointment as Secretary of State. Some have said that the Clinton-Obama deal also includes (among others) eventual nomination of Bill Clinton to the U.S. Supreme Court, and Obama’s endorsement of Hillary for the Democrat Presidential nomination in 2016.
And Hillary’s part of that deal would include acquiescence with UN Secretary General supremacy in the international arena during her Presidency.
Regardless, it is clear that the position of UN Secretary General will be open for appointment just as Obama’s presumed second term is about to expire. The Secretary General serves a five-year term and is traditionally (but not constitutionally) limited to two consecutive terms. But Barack Obama clearly sees himself as a being above and beyond traditional (if not even constitutional) constraint, and there is no provision in the UN Charter that would prevent him from seeking as many terms as he desired. By ingratiating himself to the international community during his service as American President, he could assure himself of unlimited service later as UN Secretary General. The only constraint to prevent Obama from additional terms as Secretary General would be a veto by one of the five permanent members of the UN Security Council. But the Obama team has very effectively considered that element as well. The five permanent Security Council members are the U.S., the United Kingdom, France, Russia and China. The U.S. is already (figuratively and literally) indebted to China, Russia is clearly pleased with Obama’s weakening of the U.S., and Obama has profusely sidled up to the European powers in his on-going “blame America / apology” tours. This should greatly diminish the prospects of one of those other four permanent Security Council nations vetoing additional Obama terms as Secretary General beyond his second term. And, with a submissive America ruled by the Democrat Party, the chances of a U.S. veto are virtually nil.
Following his act as the first black President of the United States, the Obama campaign for UN Secretary General would focus on the historic nature of him becoming the first person from North America to serve in that capacity. And, as a result of his weaken-America policies as President, the members of the United Nations would feel much more comfortable bestowing upon him the honor of serving as the first North American Secretary General. For his part, naturally, this would fit very nicely into Obama’s narcissistic persona. And, of course, the mainstream American and international media would play it to the hilt. Obama’s ascendancy to the throne of United Nations Secretary General would be virtually a coronation, not a selection or an election.
Now that the basic goals of Obama’s long-range master plan are clearly evident, his motivations and intentions are much easier to decipher. Clearly, the structure of the Obama Presidency is not about what is good for America or its citizens- it’s all about Obama. It’s all about what advances Obama’s personal agenda and objectives. If it appears that Obama is still campaigning, it’s because he is still campaigning. Obama viewed the 2008 American Presidential election as just another primary election in his broader campaign to become the UN Secretary General. During his Presidency, Obama’s policies are designed to control, not cure. The economy, the banking system, the auto industry, the health care system- the Obama administration’s energies are directed toward seizing control over all those sectors, not “curing” any real or perceived problems in them. The more that Obama can make America subservient, compliant and subordinate now, the easier it will be for him to rule later as the unchallenged United Nations Secretary General.
This fascinating insight gives us the opportunity to view Obama and his administration in a much different light. Other such alternative scenarios are being actively debated, and only his closest insiders are privy to the details of the actual plan. But one thing is very clear: the increasingly strange and unconventional behavior of Barack Obama and his administration and policies can now be seen through a much clearer lens, and it’s quite obvious that there is, indeed, a very specific method to the madness.
Purpleguy| 6.30.11 @ 4:49PM
Wow - this colloquy gives a whole new meaning to the word paranoia. You're just making this s* up, ain't you? Filled with factual mistakes - Bush added more to the debt than Obama has during recovery. Bush caused 9.3 % unemployment before Obama was even sworn in. And, good grief how many people have to exactly the right thing at the right time for all this to come to pass. Ridiculous, just delusional.
Occam's Tool| 6.30.11 @ 6:19PM
Bush did not cause 9.3 percent unemployment before Obama was sworn in--Obama said unemployment would not get above 8% if the stimulus went through, Purple.
Oceania has always been at war with Eurasia.
Purpleguy| 7.1.11 @ 9:13AM
You're right about the stimulus, except Obama didn't say it - his Council of Economics Head said it first ... but unemployment rate stood at 7.8% when Obama was sworn in, and the economy was shedding 780,000 jobs/ month. It did continue to go up for the first months of his presidency - surely you didn't expect a reversal the day he was sworn in, did you? But his policies stopped the slide and gained over 2million jobs back since the summer of '09.
http://www.google.com/publicda.....yment+rate
NoLib| 7.1.11 @ 2:01PM
Sorry, Purple, Obama owns this economy and he will pay the political price for his abject and utter failure on November 6, 2012.
You weenies look pathetic trying to blame the Bamster's incompetence on GWB. It's not working.
Purpleguy| 7.1.11 @ 8:47PM
Hmmm, check the polls, oh uninformed one - only 8% of the population blame Obama... while 25% still blame Bush and another 25% blame Wall Street... I don't recall the other %, but it isn't blamed on Obama. Kinda destroys your hope for change, huh?
NoLib| 7.2.11 @ 2:37AM
Take a look at the clown's tanking approvals and the fact that 70% of Americans believe our country is going in the WRONG direction, Kool Aid drinking doofus.
Kinda destroys your hope for the clown's re-election, huh?
NoLib| 6.30.11 @ 6:53PM
Hey Purple, unemployment was 4.6% in January 2007 and had skyrocketed to 9.8% in November 2010. Any guesses as to the REAL reasons? That's right: FOUR YEARS OF NANCY PELOUSY, HARRY REID AND A DEMOCRAT CONGRESS!!
Damned lying liberals.
C Smith| 6.30.11 @ 9:08AM
Saturday, March 20, 2010
A Sunday Circus
Pravda, Russia's oldest newspaper predicted, almost a year ago, what is culminating this Sunday. In American Capitalism Gone With a Whimper Stanislav Mishin writes:
"... the American decent (sic) into Marxism is happening with breath taking speed, against the back drop of a passive, hapless sheeple [people].... the population was dumbed down through a politicized and substandard education system based on pop culture, rather then (sic) the classics. Americans know more about their favorite TV dramas then the drama in DC that directly affects their lives. They care more for their "right" to choke down a McDonalds burger or a BurgerKing (sic)burger than for their constitutional rights.... So, should it be any surprise to discover that the Democratically controlled Congress of America is working on passing a new regulation that would give the American Treasury department the power to set "fair" maximum salaries, evaluate performance and control how private companies give out pay raises and bonuses? Senator Barney Franks, a social pervert basking in his homosexuality (of course, amongst the modern, enlightened American societal norm, as well as that of the general West, homosexuality is not only not a looked down upon life choice, but is often praised as a virtue) and his Marxist enlightenment, has led this effort.... Prime Minister Putin, less then two months ago, warned Obama and UK's Blair, not to follow the path to Marxism, it only leads to disaster. Apparently, even though we suffered 70 years of this Western sponsored horror show, we know nothing, as foolish, drunken Russians, so let our "wise" Anglo-Saxon fools find out the folly of their own pride.... The proud American will go down into his slavery with out a fight, beating his chest and proclaiming to the world, how free he really is. The world will only snicker."
But why?
"... their faith in God was destroyed... their churches, all tens of thousands of different "branches and denominations" were for the most part little more then (sic) Sunday circuses and their televangelists and top protestant mega preachers were more then (sic) happy to sell out their souls and flocks to be on the "winning" side of one pseudo Marxist politician or another. Their flocks may complain, but when explained that they would be on the "winning" side, their flocks were ever so quick to reject Christ in hopes for earthly power."
Why do I feel more at peace with my enemy then with those now gathering in the once hallowed halls of Washington? Gathering to deliver our Constitution the final coup de grâce. A formality previously administered to our nation now convulsed with a death rattle confused with talking points, argumentum ad nauseam.
But why?
The church has forgotten her witness and her Lord. She has become like the world, giving the world her blessing. Like Esau, who would have inherited, but for a morsel sold his birthright and found no place of repentance, though he sought it with tears (c.f. Heb 12:17).
And as the abominable assembly gathers for their Sunday circus in the once hallowed halls of our forefathers, halls sanctified by their witness and their blood, we are rendered slaves not free "For the time is come that judgment must begin at the house of God: and if it first begin at us, what shall the end be of them that obey not the gospel of God? " (1Pe 4:17).
http://popularapostasy.blogspo.....ircus.html
Delta Zelda| 6.30.11 @ 11:52AM
C Smith, Thanks for posting! The writer hit the nail on the head.
darcy| 6.30.11 @ 12:57PM
You are quite right. The Church has lost her salt, has abandoned the gospel, and largely proclaims a man-centered social gospel/justice message, trying to fit in with the popular culture around it instead of doing its job, which is to preach Christ crucified for the sins of the world. Today's apostate churches deny sin, hell, and heaven, deny the Bible's inerrancy and make of themselves useful idiots for Marxist/fascist agendas.
Our country's moral decline and rapidly disappearing freedoms, as brought to us by the likes of the totalitarian in the oval, are the logical and natural result of a culture whose soul has been hollowed out. They are also the price we pay for abandoning our Christian heritage. We don't have a Christian heritage, you say?
How's this: "Providence has given to our people the choice of their rulers, and it is the duty, as well as the privilege and interest of our Christian nation to select and prefer Christians for their rulers," John Jay penned (1797) in a private letter to clergyman Jedidah Morse.
It's interesting to note that as Americans increasingly become libertines in their private morals, amassing to themselves a perceived maximum freedom to behave as they wish, that their political and economic freedoms are diminishing by the hour. Religious freedoms are next, as they are incompatible with the homosexual agenda (itself a tool of Marxist-globalists).
hardcard| 6.30.11 @ 9:11AM
big brother /sis report: recently (6-27) I had a check-up at my urologist, I go every 6 months to this doctor for the last 5 years I have private insuance. When I checked out and paid the co-pay, the receptionist took my photo from a hand held device from her computer station,when I asked her why she took a photo of me she replied,"We have to have a photo of you in your file" ????
PJ| 6.30.11 @ 9:27AM
Hardcard,
One reason, they took your photo was to prevent fraud. As of now, your PRIVATE insurance card is worth gold to those who receive lesser quality medical service because they are either on the dole or they have no insurance.
loulou| 6.30.11 @ 10:20AM
Illegal aliens are exempt for showing ID at doctors offices.
Ed| 6.30.11 @ 11:41AM
When I started seeing my doctor five years ago, I had to show a driver's licence. Medical fraud is rampant and a lot of patients go "doctor shopping" to get opiate painkillers.
teaghan| 6.30.11 @ 12:22PM
And exempt from showing ID when voting. Horrors! We wouldn't want someone to have to have ID!
Occam's Tool| 6.30.11 @ 6:21PM
Hardcard: would you like to receive the wrong medication? Picture IDs are used to reduce error in medications and chart match up with patients.
Redundancy is our avenue of survival. In addition, it is a defensive measure to protect against lawsuits.
Doctor Right| 6.30.11 @ 9:26AM
I was at the HUGE Tea Party rally in DC in September, 2009, and I clearly remember a woman debating the merits of ObamaCare with a young lady dressed in a white Doctor's jacket who belonged to an organization called "Physicians for National Healthcare", or something like that.
THe Tea Party lady was trying to be courteous, but her frustration was evident. This young Doctor, for all the brains it took to get her into medical school, was absolutely clueless on economics and the importance of a free market system, ESPECIALLY for healthcare.
Her replies consisted of the standard liberal drivel..."Health care is a right"..."Don't you want poor people to have healthcare?", etc, etc, etc...
Just goes to show...like Stalin said, there will always be "useful idiots" on our side that further his side.
Stan Redmond| 6.30.11 @ 9:55AM
As a young doc she probably had 200,000 dollars in unpaid debt to the med school. Uncle Obama will sweep her off her feet, pay her bill for 1 year of working in Chicago, and ensure her a safe $50k per year salary for life.
Occam's Tool| 6.30.11 @ 6:22PM
Much more than 50 K, but the stifling of individualized treatments under NHS is appalling, especially in this era of potential genetically tailored care.
NoLib| 6.30.11 @ 7:02PM
Obama and his Marxist minions are medical Luddites. Meatheads.
Skippy| 7.1.11 @ 4:23PM
Staff MDs around here(N. Cal. Bay Area)get paid 10k/mo.
On that they have to pay for everything; student loans, car pmt., mtge., kids, Insurance, etc.
After the 40% tax bite, of course.
In Wine Country that doesn't go far.
No longer are MD's respected members of the community with a new Buick every 2 years.
And that's before Obamaramacare even kicks in!
NoLib| 7.2.11 @ 2:39AM
Bet they're respected a whole hell of a lot when the local wine sniffers get deathly ill.
Occam's Tool| 7.4.11 @ 11:48PM
You get paid much more working for the prisons in CA, if you're not paid in IOUs.
I graduated from UCLA's psychiatry department in 1993. I had done some private practice moonlighting and seen how psych MDs were being screwed. I high tailed it OUT of CA.
If you're willing to work in rural areas you will work much longer hours than in the city, but you will make more money and have more autonomy. I'm glad I left LA and don't live in a big city.
What a lot of MDs don't realize is that the majority of their time will be spent in and around the hospital, so it really doesn't matter if they live in a big city, anyway. (This is if they don't marry rich, or go into Medicine already wealthy)
Just Joe| 6.30.11 @ 11:13AM
Useful idiots. Like those damn Catholics.
Just Joe| 6.30.11 @ 11:13AM
Useful idiots. Like those damn Catholics.
NoLib| 6.30.11 @ 12:17PM
Margie, your religious bigotry is unattractive.
victor| 7.1.11 @ 3:03AM
NoLib:
"Margie, your religious bigotry is unattractive."
Lying will only get you into Hell, N/L.
She wasn't on at that time and speaking of Religious Bigotry, you need some splainin' to do:
The Medieval Inquisition is a series of Inquisitions (Catholic Church bodies charged with suppressing heresy) from around 1184, including the Episcopal Inquisition (1184-1230s) and later the Papal Inquisition (1230s). The Medieval Inquisition was in response to large popular movements throughout Europe considered apostate or heretical to Christianity, in particular Catharism and Waldensians in southern France and northern Italy. These were the first inquisition movements of many that would follow.
The Tribunal of the Holy Office of the Inquisition (Spanish: Tribunal del Santo Oficio de la Inquisición), commonly known as the Spanish Inquisition (Inquisición española), was a tribunal established in 1480 by Catholic Monarchs Ferdinand II of Aragon and Isabella I of Castile. It was intended to maintain Catholic orthodoxy in their kingdoms, and to replace the Medieval Inquisition which was under Papal control. The Inquisition was originally intended in large part to ensure the orthodoxy of those who converted from Judaism and Islam. This regulation of the faith of the newly converted was intensified after the royal decrees issued in 1492 and 1501 ordering Jews and Muslims to convert or leave.
The Portuguese Inquisition was formally established in Portugal in 1536 at the request of the King of Portugal, João III. Manuel I had asked for the installation of the Inquisition in 1515 to fulfill the commitment of marriage with Maria of Aragon, but it was only after his death that the Pope acquiesced. This inquisition was a Portuguese analogue of the more famous Spanish Inquisition.
The Roman Inquisition was a system of tribunals developed by the Holy See during the second half of the 16th century, responsible for prosecuting individuals accused of a wide array of crimes related to heresy, including sorcery, immorality, blasphemy, Judaizing and witchcraft, as well for censorship of printed literature. The tribunals covered most of the Italian peninsula as well as Malta and also existed in isolated pockets of papal jurisdiction in other parts of Europe, including Avignon, in France. The Congregation of the Holy Office, one of the original 15 congregations of the Roman Curia created by Pope Sixtus V in 1588, presided over the activity of the local tribunals. While the Roman Inquisition was originally designed to combat the spread of Protestantism in Italy, the institution outlived its original purpose, and the system of tribunals lasted until the mid 18th century, when the Italian states began to suppress the local inquisitions, effectively eliminating the power of the church to prosecute heretical crimes.
Read Foxes Book of Martyrs
http://www.ccel.org/f/foxe/martyrs/home.html
and
Martyrs Mirror
http://www.homecomers.org/mirror/
Tells you who the REAL religious bigots are, eh?
NoLib| 7.1.11 @ 11:58AM
You're crazier than ever, Margie. Stop living in ancient history, nitwit.
Occam's Tool| 6.30.11 @ 10:57PM
Yes, I do want poor people to have jealthcare. Tell her to go to the New Zealand Herald website (a VERY LIberal Paper), punch in "District Health Boards" and start reading. Tell her it's actually worse than that.
Occam's Tool| 6.30.11 @ 10:58PM
Sorry, j is next to H. Healthcare. Sheesh.
Steve A| 6.30.11 @ 9:49AM
Ross, You need to cut Obama some slack here. How else is he going to find out if these Doctors are removing tonsils or amputating limbs needlessly in order to run up the bill?
Stan Redmond| 6.30.11 @ 10:00AM
I wonder if they found any inhilators and breathalyzers. Or if they had any "Pills" for grandma.
Louis Jenkins| 6.30.11 @ 10:00AM
Well, mother in law is back in the hospital. This time she has a bed sore on one of her feet.
A really bad bed sore, so much, if a doctor had been wise enough, he would have amputated it right then and there. Instead he cleaned it out, put a suction unit on it, and send her to teritary care. Now let's think about it for a moment, the wise thing would have been to amputate the foot. It would have saved money as it may still have to be removed. So, was it a wise move or not? Obama doesn't know what he is talking about. A pain pill for an AMI?
Occam's Tool| 6.30.11 @ 6:25PM
Louis---not necessarily amputate---reduced mobility to that would increase the risk of pneumonia and embolism. One should try to maintain maximum mobility if possible, and reduce abrasions as much as possible.
There are secondary complications to this, in addition to the risk of surgical complications if vascularity is compromised. Did you discuss this with the Doc?
In short, sometimes what may seem obvious is wrong long-term.
Occam's Tool| 6.30.11 @ 6:26PM
Sorry---"Reduced mobility due to that..."
Dave | 6.30.11 @ 10:32AM
For those just now arising, Big Brother isn't coming ... he's already here. However, in this latest caper, he tried slithering inside another legitimate business activity while disguised as The Green Hornet, with Kato wearing a skirt.
Too over the top? Paranoid? Perhaps. But take a look at the partial agenda list Barry's been following, then get back to me.
- Red Light Cameras.
- Mandatory Light Bulb Conversions.
- Government subsidies for the production of
(costly to produce) ethanol while watching the
price of corn drive up the real cost of food and
the transportation to deliver same in the name
converting us to a cleaner, happier planet.
And of course there's this ...
- Socialized Medicine via Obamacare and its
economy crushing (and unconstitutional)
mandates.
Meanwhile ...
- Among the many strangling EPA rulings are
potential restrictions on private property usage:
Is it a simple post-rain backyard puddle or (now)
a federally protected ... wetlands?
There's more, but the list is long, ever encroaching and yours may vary. The only questions remaining are (a) will B.O. and his army of EPA troopers be trading in their green shirts for brown ones, and (b) by next year will the nearly 40% of American drones who think the little Community Organizer is still 'da man be punching his chad, or will the iron fist of Barry's Big Government finally land in THEIR backyard puddles? Having observed how the Illinois con man operates, he'll no doubt just grant his political posse a few special waivers to get him over the hump. At least until the election's is in the bag.
Ain't that how Al, Nitty and Goti done it?
Betsy | 6.30.11 @ 10:33AM
So if Hillary runs and wins, does Obama buy, er, I mean, get a seat in the cabinet?
Steve A| 6.30.11 @ 11:01AM
Betsy, No. She pardons Blago & makes him Sec Of Treasury. Maybe Obama gets Minister Of Propaganda. Weiner gets nod for FCC chair. Bill comes back as Minister Of Ethics or perhaps Supreme Court Justice.
Have you considered| 6.30.11 @ 11:15AM
I believe that MA, under Romneycare, has conditioned the issuance of the needed medical license to practice, if doctors do not agree to take Medicaid or Commenwealth care.
This to my mind is involuntary servitude.
I have not stumbled upon any studies that show that doctors are leaving the state, but if I were a doctor, I would not stay in MA.
Occam's Tool| 6.30.11 @ 6:27PM
They are leaving. Unless you are a Harvard, BU, or Tufts researcher, why stay?
Pete| 6.30.11 @ 11:17AM
Glad to finally see this in print, as I think this is the scariest "unintended consequence" of all.
"Would you want to spend the better part of a decade and take on $160,000 in debt (the 2010 median for new medical school graduates) just to be told by Kathleen Sebelius what to do, which patients to see, and how much you can charge?"
So, as more and more decide not to become doctors, what are we left with? Government medical care administered in DMV fashion, by mindless, rule following drones. Terrifying. Start saving up now to fly to wherever the last few good doctors relocate, and hope you don't outlive them.
Oldefarte| 6.30.11 @ 11:20AM
Ross' article is typically brilliant and informative! No doubt, this is possibly examples of what's known as THE CHICAGO WAY? These thuggish goons attempting to kneecapping people/groups for strictly political purposes should be locked and the key thrown away. It's outrageous that this sleezy behavior is allowed to occur, and it is most probably illegal in some fashion [but of course, since he's a minority president, we simply cannot think of bringing legal charges against him/them, as that would be considered POLITICALLY INCORRECT, now wouldn't it?]. What a CROC of excrement!!!!!!!!!
SpiralArchitect| 6.30.11 @ 12:19PM
Obummer's agenda is personal, a crusade for the people that America has impovrished & punnished only because they are of a certain ethnic group.
Oldefarte| 6.30.11 @ 11:24AM
PS: maybe he/they should alternatively develop some kind of sting operation against TRIAL LAWYERS/AMBULANCE CHASERS, maybe huh? Oh wait, they can't do that since that group provides a substantial majority of his/their political contribution funding, right??????????
hardcard| 6.30.11 @ 11:27AM
Thanks PJ ! I suspect it's the regime documenting personal info for their data bases, all healthcare providors are compiling and computerizing for HHS and other governmental agencies easy access.
You do the math !!!
G. Field| 6.30.11 @ 12:09PM
Finding out whether it's difficult for Medicaid and Medicare patients to find doctors should have been done BEFORE the congress considered the health care bill, but no, they were so anxious to pass the bill they didn't allow anyone to read it.
If they had done the study first, they wouldn't have been able to pass the bill because it is next to impossible to find a doctor. I'm on Medicare and know that first hand after calling every doctor in the phone book,37 of them, and getting turned down by every single one.
Occam's Tool| 6.30.11 @ 6:47PM
Dear G;
Here's the problem---Medicare demands incredible paperwork trails if you want to bill for any complicated consultation. Further, Medicare forces you to be at odds with your patient because you are FORBIDDEN NOT TO BALANCE BILL, lest you be accused of fraud by the government, even if you know a patient can't pay the balance. Further, there is always a risk of an OIG inspection at any time on your Medicare patients, with potential jail time; if you make an agreement with an elderly patient for services outside of Medicare and bill for it privately you will be denied the ability to bill Medicare for two years, and finally, the pay is worse than private insurance.
Would you accept it if your practice was full with non-Medicare patients? There's a shortage of Doctors.
Let's look, for a moment, at the difference in training between a Psychiatrist and Vermin T Maggot, Esq.
Both the MD and Vermin do undergrad, the MD taking hard science classes while the Maggot takes easy Poli-sci classes. This is followed by Medical School for the Doc---4 years; while the Lawyer takes 3 years in Law School. Then the Lawyer leaves his formal intensive schooling. The MD has already completed 1 extra year of schooling.
Residency for the Psychiatrist is 80-100 hours a week for 4 years. Toatal schooling time: 12 years. Now, Psychiatrists have a longer (but less intense timewise) residency than do internists and pediatricians (3 years), but a great many of them do subspecialty training, which will add a year or 2. Psychiatrists have several subspecialties which will do that, too.
However, surgeons have the most intensive residency (100 plus hours a week of work), lasting, for General Surgeons, 6 years after Medical school, and, for, say Plastics, going up to NINE years. Most of the other Surgical subspecialties are coming in at 7 to 9.
That's a lot of years and very hard work. I, myself, am on call 136 hours of every two week period as a rural psychiatrist. Small town or rural surgeons and other specialists have it quite hard, as well.
My debt was 80,000 coming out of Medical School in 1988. The tuition cost per year of University of Minnesota Medical School is 33,000 yearly. That's the State school. We are a very high taxed State.
My medical school's in-state tuition (I was accepted as an out of State student, which is much harder), UTMB, is about $6600 dollars a year. But that is dirt cheap. Its out of state tuition is $10,000 dollars a year cheaper than Minnesota. free advice: if you want to go to Medical school, move to Texas and work a year or two there without going to school, preferrably as a nurse's aide. The Texas schools have FANTASTIC campuses, and are the least expensive schools in the Country.
But, even so, you're going to end up in a lot of debt, especially as you must pay back student loans starting in Residency.
And that's why your MDs don't take Medicare, and I work for the State for a guaranteed income after paying off my debts in Private Practice in the early 90s. The hassle factor is insane. Doctor Right, any comments?
And Paul, the survey could be benign in benign hands. Obama is ANYTHING but benign.
Occam's Tool| 6.30.11 @ 8:54PM
By the way---note that Texas, with no State income tax, has multiple State medical schools which have instate tuition 20% that of Minnesota, which is a high taxed State. Why would this be?
The University Of Texas Medical Center at Houston is part of the Texas Medical center, which is simply superb, especially in Cancer treatment/research. Galveston can do extremely high virulence infectious disease research. Southwestern is a superb Nobel prize winning Research school. Among Private schools, Baylor is home to one of the top Neuropsychiatrists in the Country, as well as Menninger Institute.
Couldn't be that a lower percentage of a greater per capita Gross State Product is greater than a higher percentage of a lower per capita Gross State product?
NoLib| 6.30.11 @ 9:39PM
Gonna move to Texas, it's the only remaining bastion of freedom.
Occam's Tool| 6.30.11 @ 10:55PM
NoLib:
May you prosper and stay healthy.
NoLib| 7.1.11 @ 12:08PM
You too, Doc, God bless you.
Paul| 6.30.11 @ 12:42PM
Honestly, I see nothing wrong with the survey, which seeks to answer the question of how patients are treated with private insurance vs public insurance. It is a fair question.
What would they have done with the answer? What is anyone else going to do with the issue and the data? I doubt anything good.
For all the griping about "Obama care," it remains that we mostly have "Corporate care" now, and it favors the Insurance companies over the patients. Anyone that has had cancer (like I have) comes to realize that one's affordable coverage hangs by the thread of one's excellent health and a good job. Break that thread with diabetes, or cancer, or a severe car accident, or a job loss, or any one of a large number of possible events breaking one's health or job status, and BOOM! Before you know it, your savings are gone, your retirement is gone, your health is gone, and you are now "scum that wants freebies from the government".
The system is broken, and it is getting worse. Obama really didn't do much to fix anything. It is fine to talk about how bad Obama Care is, but frankly cutting the costs of healthcare is going to hurt *SOMEBODY* in the current system. Any proposal that doesn't make Insurance, Hospitals, Lawyers, Pharma, or Doctors scream isn't a solution. Because any fix is going to cut the money (or cap the money) flowing to somebody.
The idea that we can both serve the people and the fat cat corporate interests in Healthcare is a pipe dream.
John Navratil| 6.30.11 @ 1:36PM
Paul,
We are very wealthy compared to previous generations. Whereas we might have had to worry about food, clothing and shelter, before, today it's obesity, fancy shoes and homelessness is more a mental issue than a housing issue.
So what does one spend money on? Health and entertainment! The problem is that 1/6th of the economy is being co-opted to provide a "right".
Insurance IS a problem. It's a problem that you cannot buy the coverage you want to buy. States, in their wisdom, have mandated all sorts of thing, from mental health care (abused appallingly) to mammograms. Routine care (called wellness care) is now part of the package. Why or earth should I expect insurance to cover a "sure thing"? All it does is make a profit for the company which is added to the cost.
What doctor, spending someone else's money, won't prescribe that test or drug in defence against being called for malpractice?
If we do not return to fee-for-service for all routine care and use insurance to spread the risk of the unexpected (the exact opposite of Obamacase), this problem will continue to worsen.
Ross Kaminsky | 6.30.11 @ 2:23PM
The idea that a solution which makes doctors (actual doctors, not the AMA) scream might be a good idea is the sort of thinking that got us into this mess. Doctors are not utilities to be used at the whim of government and at prices set by government.
Occam's Tool| 6.30.11 @ 6:50PM
Thanks, Ross.
In addition, as an MD, Paul, I'm probably smarter than you. Certainly about the health care system. Things that make me scream will make you die, as I make my living being your advocate for proper care. Lovely attitude you have toward the guy that holds a sharp knife on you while you are unconscious.
Occam's Tool| 6.30.11 @ 6:50PM
Thanks, Ross.
In addition, as an MD, Paul, I'm probably smarter than you. Certainly about the health care system. Things that make me scream will make you die, as I make my living being your advocate for proper care. Lovely attitude you have toward the guy that holds a sharp knife on you while you are unconscious.
NoLib| 6.30.11 @ 6:58PM
Just remember OT--most of us DON'T feel the same way toward doctors as Paul the moron does.
My life has been saved twice by good doctors--and I will never forget them. Those two men will always be my heroes.
Occam's Tool| 6.30.11 @ 7:11PM
NoLib---thanks.
Look, I have an excellent life and make good money. But there's a lot of hours I don't charge the State for, and my excellent income is caused by the fact that my base pay is $98.64/hr (40 hours/wk) plus 8 days of call (16 hours Mon-thru Fri, 24 hrs/day Sat and Sunday, billed at 1/4 time for being available and being called quite frequently) out of every two weeks (4 weeks of Vacation allow for 4 weeks of 7 day call per two weeks---half of the holiday days I'm on call and thus, if I work, I get essentially double normal time for being called in for the two or 3 hours--otherwise, it's 8 hours vacation pay at normal day rates and 1/4 time for 24 hours of call minus on-site time, same as a weekend day).
I had 12 years of training (actually 13--I did an internship in Peds 2 decades ago and have not kept up with that at all). $98.64/hr is not excessive for that. I also treat opioid addicts for the Local Indian tribe at a straight rate of $36,000/yr.
That's it, folks. I make my money by Being There. I do not drink or party; I take care of my wife and kids and patients. And I'm far from unusual. In fact, I live a pampered life compared to most of my colleagues in Medicine and Surgery in a rural area. Now those guys are MY Heroes. For vacation many of them go to 3rd World countries on Medical Missionary trips.
When my children (8 and 7) are older I think I will start so they can volunteer as aides and get a feeling for what life is like in Countries that aren't as blessed as ours.
Thank you SO much for the kind words, No Lib.
Occam's Tool| 6.30.11 @ 7:14PM
Sorry, the weekend days are 24 hours of 1/4 time minus full normal time for the time I am on site. I get essentially extra pay ONLY for holidays that I'm called in and ONLY for the on-site time.
I don't mind discussing these things. I don't play golf.
NoLib| 6.30.11 @ 9:10PM
These people are Marxists/Progressives and they are collapsing our system to replace it with theirs. We're just the grist to their mill, the collateral damage that results from their machinations.
It's quite simple really--and evil. They are the destroyers.
Both of the doctors who tended to me were wealthy. Why would I want it to be any other way? They were brilliant, courageous and hard working; and all the money in the world couldn't thank them enough for their skilled efforts on my behalf.
Occam's Tool| 6.30.11 @ 10:55PM
I'm fine with Lawyers being gored. 90% of all malpractice lawsuits are won by the docs.
NoLib| 7.1.11 @ 12:20PM
There are a lot of good and decent attorneys, too, who haven't been co-opted by greed and corruption. I know, because I have several in my own family.
There are times when a brilliant attorney is all that stands between you and the juggernaut of the State.
Oldefarte| 7.2.11 @ 9:53PM
This is mostly bullexcrement, since the average lawyer [ambulance chaser] will not consider a case if same is not connected to an insurance company. No doubt, according to them, the fight for justice is necessarily linked to the pot-of-gold represented by insurance companies' reserves. Try consulting an attorney over your case that does not have an insurance company connection, and see how fast same attorney will legally explain to you that you simply do not have a case. Alternatively, doctors are being threatened with below cost fee payments by our government, they're usually saving lives at a financial cost to themselves!!!!!!
NoLib| 7.3.11 @ 8:42PM
Screw you, stupid, you don't know squat. Everytime you open your damn mouth you say something asinine and it's usually misspelled to boot.
I know a lot of good attorneys--your ignorant generalizations are corroboration of your lazy mind.
Occam's Tool| 7.4.11 @ 11:51PM
That is very true about some decent attorneys, NoLib, and much fairer than me. However, those guys aren't medical malpractice attorneys, who tend to be John Edwards types.
figusja| 6.30.11 @ 1:03PM
I said it once and I will say it again. Pres. Hussein is a clueless lap dog. He is being told his ideas are gold. He is being spoon fed the results of his programs. They make him take countless days off to play golf? (I thought he loved basketball? Well that alone shows you how he was raised). Others than him are setting policy. K. Sebelious, E. Holder, C. Sunstein have more power than Hussein could ever hope to hold. Look at the chaos in the cities with flash mobs of black youth causing violence and destruction. New regulations and presidential mandates coming every other day. White house going against rulings made by judges. Moratorium on oil drilling in the gulf. I could go on and on. He is sitting on the throne and clueless of the consequences of his actions. It WILL get worse before he is done!
Douglas Marsh | 6.30.11 @ 1:15PM
Dear Mr. President: I am a family physician and am happy to participate in your survey. Here is my answer. I do not accept Medicaid, and I'm happy to tell you why. About six years ago, the person doing my billing came to me and told me I had to quit Medicaid. I listened to her argument. She said I was losing money hand over fist. I asked her how much they paid me for an office visit. She said that it had been so long since I was paid that she didn't know how much they pay me. Does anyone hear me when I say this? Money does not fall out of the sky to cover their care. Most of the money that comes into my office pays my overhead. I had to treat other patients who paid for their visits to cover the costs of the Medicaid patients. This is not discrimination. When a private insurance plan fails to pay, I eventually quit them, too. I have no choice. In family practice, you don't make much. I could make more being a manager at a McDonald's. Government intervention has done nothing to improve medical care. On the patient charts, it looks good. In reality, patients are suffering. If you want to reduce the cost of health care, get the government out of the way. Then I could provide better care at half the cost. In addition to being certified in Family Practice, I am also certified by the American Board of Quality Assurance and Utilization Review Physicians, Certified in Health Care Quality Management, and a Fellow of the American Institute of Healthcare Quality. Thus, I understand what the government is doing to health care. It doesn't work. Period. Thank you for your time.
Ross Kaminsky | 6.30.11 @ 2:20PM
Thanks, Dr. Marsh, for offering that excellent piece of first-hand knowledge of government impact on health care quality and availability.
darcy| 6.30.11 @ 5:34PM
Yes. Good insight into how government interference worsens -- rather than improves -- health-care delivery. But do we honestly believe for one second that the Marxists give a damn? No. They're cheering from the sidelines over the fact that their propaganda has yielded such delicious fruit: insurance stakeholders happy as clams to have taxpayer-funded (redistribution of income) health insurance (unloading their liabilities unto the producers/taxpayer) for the masses who are pleased as punch to vote for the party most eager to provide free services. Thieves. One and all.
Ron Edge| 6.30.11 @ 5:43PM
Douglas:
Right. You GROSS $30,000 a year.
That's in the ballpark for the higher paid store Managers for McD's.
AND, that's LESS than your nurses.
Geeze.
Occam's Tool| 6.30.11 @ 7:00PM
Actually, Ron, if you take Medi/Medi you will gross like that for a private clinic. Who pays for the needles, cotton balls, slides, test tubes, etc in the office. The patient gowns and sheets? The vaccines, etc.
Psychiatrists have very easy offices to maintain in comparison, and I DON'T DO Private work anymore for a reason.
Occam's Tool| 6.30.11 @ 6:57PM
Indeed, Dr. Marsh. A few things you forgot to mention, which I'm sure you will agree with. Medicaid patients tend to be your sickest, most complex patients. Thus, not only will they pay poorly, they will take up more time than other patients who are also sick but have better insurance. As a rural physician in Alabama in private practice, I did NO hand-holding. I saw one patient in therapy to keep my skills in that reasonably sharp. But I stopped working with Medicaid outside of inpatient hospitalization because I didn't want poorly paying, highly litigious, non-compliant, very sick patients on my outpatient caseload. I could fill it with much better patients. eventually I tired of the grind of that and have my current situation with no more than a max of 16 patients under my care at any given time and guarnteed payment. It's lower than what I could charge in private practice, but it's guaranteed, and there is no overhead, which even for a psychiatrist comes at a minimum of 25% of total receipts, and can go up to 40% or more.
Medi/Medi makes NO sense in private practice. It should be considered legal pro bono equivalent, although a lawyer has a much easier time getting rid of a client than an MD does a patient.
Cybercorrespondent | 6.30.11 @ 1:30PM
That’s how it was in the Soviet Union. Friends spied on friends, at restaurants you had to be careful what you say in fear of the table being bugged and pretty much everyone had to live pretentious secret lives. Those who did the spying were rewarded with better jobs and those who were caught expressing their dissatisfaction had a hard time surviving.
Cybercorrespondent
http://facebook.com/ccybercorrespondent
DaveS| 6.30.11 @ 1:38PM
I have come upon the only usable part of Roe v. Wade: let's keep the government from getting between a doctor and patient - after all, is it or is it not a privacy matter?
NoLib| 6.30.11 @ 4:19PM
Privacy only applies when you want to kill your baby--the penumbra said so. Sorry.
Occam's Tool| 6.30.11 @ 7:17PM
Dear Dave: your privacy ends where you might kill someone else or yourself, or where you are suspected of abusing old people, vulnerable people (Mentally Retarded, for example), or Old folks. Also, I reserve the right to get consultation on your case with a specialist or an attorney.
Psychiatric records are held to a higher level than general medical records, and substance abuse records (someone released Ted's wife's chemical dependency records to a newspaper) are held to the highest standards. There are also standards involving HIV. Dr Marsh, any other examples of right to breach you can think of?
Occam's Tool| 6.30.11 @ 7:19PM
Or to consult a colleague on your case, although to send written records out I need to get consent. I can also talk to the Emergency Room if the situation is dire. The general rule is that it is better to keep the patient alive to sue you for breach than it is to defend a wrongful death by claiming attempt to protect privacy.
Dan| 6.30.11 @ 4:34PM
Next Obama's Brown Shirts will come knocking.
NoLib| 6.30.11 @ 7:00PM
I think it's still a little premature because they haven't figured out how to get rid of the 2nd Amendment yet.
Strider| 6.30.11 @ 7:45PM
As long as they wear some kind of uniform. Then we'll know who to shoot. We still have the 2nd Amendment on our side. Could it be that Claire Wolfe's "awkward stage" is ending?
NoLib| 6.30.11 @ 9:17PM
ATF's Operation Gun Walker was meant to tarnish the gun industry and undermine the 2nd Amendment, but it backfired on the bastards. I remember Hillary whining about all of the American guns in Mexico--yeah, from YOU, Hillary! They're also trying to use the UN to go after the 2nd Amendment. Dangerous times.
NJK| 6.30.11 @ 7:28PM
I don't think I'll ever feel safe in this country again.
I'll always wonder if they're telling the truth. I'll always wonder if they're spying. I'll never trust another government agency again.
I'll never trust them because they allowed all of this to happen.
NoLib| 6.30.11 @ 9:12PM
I haven't trusted the bastards for a long time. I have a little problem with authority. lol
Occam's Tool| 6.30.11 @ 8:47PM
By the way, Dr Marsh:
Thank you for doing your work. Let me tell you, as a specialist: good FPs are the best Docs in Medicine. I am privileged to work with a good Physiatrist (rehab medicine) who also does primary care---he is worth 10 times his weight in Titanium---screw gold.
NoLib| 6.30.11 @ 9:13PM
But gold is so beautiful to wear. It's warm like the golden sun but cool to the touch. Gold is glorious.
Apen| 6.30.11 @ 9:27PM
The feds are already heavy handed with doctors. I have a long term pain condition that my doctor can't control because of prescription limits. Obviously the feds know how long you will need pain control. Right now I have zero pain control and no access to another doc for 30 days. During these next weeks I'll be picturing a federal DEA agent with broken knee caps sitting outside the ER waiting to get pain relief. When I get up to go in I accidentally bump his legs, happily on my way.
Occam's Tool| 6.30.11 @ 10:53PM
But you are right---the Feds do intimidate MDs on pain control.
Occam's Tool| 6.30.11 @ 10:52PM
Apen: Might I suggest that you get seen by a pain clinic at your local medical school? Have your MD make a referral.
Gold is glorious---but I did make a mistake--it is Platinum, which is priced higher than Gold. And I am so glad you ran into two Platinum docs. I can't understand why people wouldn't want to make the Medical profession as desirable to get into as possible, to increase the competition to get in as much as possible.
NoLib| 7.1.11 @ 12:03PM
You're right about Platinum--but IMO it pales in comparison to gold as far as beauty is concerned.
POST American| 6.30.11 @ 11:54PM
----The Tavistock Institute/RIIA/CFR vetted
and approved, son of CIA-linked Ann Dunham
'wild card outsider' Barack Obama further
promoting the capstone insurance designed
national health plan.
NOTE, we live, or recently lived, in the
wealthiest nation on earth with the highest
taxes anywhere on cigarettes and liquor.
NO ONE has ever asked where THAT money
has gone.
And DON'T expect ANY relief from our
Tavistock 'Republicans' ---a la FREEMASON
(?) and 'Banker Bailout' supporter ---the
CON-job serving father of 'Romney-care'.
(BTW---one and all, check out Tavistock
/John C Coleman online. Esp. pts 3, 4 and 5. --WOW!)
June| 7.1.11 @ 1:15AM
If you think Obama gave up on the snooping you are mistaken. I got a call, supposedly from a university doing a " survey" that asked all of these questions. Don't believe anything Obama says , he will just find another way to do the same thing.
NoLib| 7.1.11 @ 12:01PM
They will not stop unless and until we stop them.
It's on us, folks.
Tenn Slim| 7.2.11 @ 7:55AM
Nothing new here, we need to keep a list tho.
These type of releases, spot news, will make good graffiti for the 2012 election.
end
weddingdress | 7.5.11 @ 4:16AM
Gold is glorious---but I did make a mistake--it is Platinum, which is priced higher than Gold. And I am so glad you ran into two Platinum docs. I can't understand why people wouldn't want to make the Medical profession as desirable to get into as possible, to increase the competition to get in as much as possible.