Bioethics

A Nexus Between Academic Medicine and Government

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The Wall Street Journal has one more article on the effect of Obamacare on doctors. A couple of interesting statements bring up some comments on an excellent medical blog I read.

First the WSJ points about Obamacare.

The act will reinforce the worst features of existing third-party payment arrangements in both the private and public sectors — arrangements that already compromise the professional independence and integrity of the medical profession.

Doctors will find themselves subject to more, not less, government regulation and oversight. Moreover, they will become increasingly dependent on unreliable government reimbursement for medical services. Medicare and Medicaid payment, including irrational government payment updates, are preserved (though shaved) and expanded to larger portions of the population.

The Act creates even more bureaucracies with authority over the kinds of health benefits, medical treatments and procedures that Americans get through public and private health insurance. The new law provides no serious relief for tort liability. Not surprisingly, various surveys reveal deep dissatisfaction and demoralization among medical professionals.

I’ve been posting about this for a couple of years and it is no surprise.

Now here is where it gets interesting.

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Medicare optouts

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I subscribe to a physician only web site that has a lot of political items in the mix. It has over 100,000 members, well over, I believe. The subject of dropping out of Medicare, and sometimes from all insurance, is a frequent subject. I thought it might be interesting to see the comments (some of them) to one such post.

I am opting out of Medicare

Last week I stopped seeing new Medicare patients. Today, I decided to opt-out completely. The sign in my waiting area reads:

Dear patients,

As of October 1, 2010, I will no longer accept Medicare insurance due to the harassment and cuts in payments by the federal government. My fees are very reasonable – please feel free to discuss them with me personally. I would love to continue to care for my Medicare patients, just without the federal government telling me how do my job or how much to get paid.

This is just the beginning of the healthcare reform. Please thank your elected representatives and think carefully how you vote in November.

Yours,

EndocrineMD

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Personal Plug: The Victorians, Darwin & Lit Crit

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The first review of my husband’s book, Masculinity in Four Victorian Epics is out. He’s published a lot on Matthew Arnold, Victorian autobiographies, the Czechs, but this is his first full-length critical work using Darwinian criticism. This isn’t exactly a literary blog, but Tod Williams (who, in good peer review fashion we don’t know, but appers friendly to this methodology) reminds me of the way literature used to be approached.

My husband was attracted to this method: he argues it was growing up on a farm and reading Tennyson in the truck on the way to the feed store that made it natural. On another plane, of course, as the reviewer notes: “It should come as no surprise that an established Matthew Arnold scholar would approach literature with a concern for universal human truths or that one with such interests would turn to literary Darwinism for a methodology.” He examines that popular (but now seldom read) Victorian genre – the “long poem.” “Machann maintains in his introduction that the issue of masculinity is not only central to the four long poems he treats but to ‘our understanding of Victorian literature: its major themes, its idealism and social criticism, its perplexities and uncertainties’” (1) The Victorians restrained masculine violence in many ways, but the ideal of chivalry and “manliness” was also expressed in adventuring (both geographically and intellectually).

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