tag:blogger.com,1999:blog-5883634615775822475.post7871456771889890894..comments2024-03-18T09:00:31.992-04:00Comments on Doctor Grumpy in the House: Dear Medicare Patients,Grumpy, M.D.http://www.blogger.com/profile/09858110332436246760noreply@blogger.comBlogger71125tag:blogger.com,1999:blog-5883634615775822475.post-39022794677167232852012-06-01T10:37:12.515-04:002012-06-01T10:37:12.515-04:00Well I understand Dr. Grumpy, but what happened to...Well I understand Dr. Grumpy, but what happened to that Hypocratic Oath? You know the one where its the patient and helping others over money? Seems to me that the rate of medical care and the hospital care are going up faster than the rate of inflation in America. If you and other doctors really wanted to make a difference you could certainly do a sliding scale fee for those patients in most need. I honestly think doctors now a days are less educated and more greedy than in the long ago past. You say you are not in this to get rich? Well Mr. Grump Doctor the doctors I see drive expensive sports cars and live in houses that look like mansions. You could do more to lobby for the changes needed to help the poor and elderly on medicare but you don't. Instead you lobby for other things that gives you and your medical associates advantage over others and sets up an elitist system designed to leave the poor sick and dying out of luck and on their own. You don't give a rats ass about your patients and I am truly not buying your BS blog here.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-11053757182990326982010-05-29T00:22:38.392-04:002010-05-29T00:22:38.392-04:00As a Medicare patient who is young and disabled, I...As a Medicare patient who is young and disabled, I have a different perception of the situation. Yes our government (those with wealth and power) are consumed with making more money and maintaining power. Anytime you do not have TRUE representation in oversight, corruption occurs and decisions which require real life experience are mangled. So our government and its’ people are both responsible for this mess. To clarify, the government needs to listen to the true needs and pleas of the doctors and the people need to rally to force the government to actually create a long term plan that is realistic.<br />On the other hand, doctors need to think hard about why they became healers. If it was for money alone, in my book you should have been a lawyer. I know the sacrifice and many years of school you attended were difficult. In return, you should be compensated for your dedication and skill; however, I hear of a lot of doctors making 250,000 who are bitching because they are not getting what they think they deserve. Now back in the old days a doctor was paid via many avenues, from cash to livestock. He did the best he could depending on the community he lived within. Doctors were also given respect and a high social status (perks), not much different than today. Yes, please don’t think I am not sympathetic to the government’s nose being poked within your practice and treatment/testing plans. However, let me pose this question. If while attending medical school your teacher informed you that you would not be paid well but, your services would save countless people from the suffering of injury and disease; would you still have become a doctor? Or is this more a business venture than an act of great compassion and calling?<br />In closing, both sides need to give a little and reflect on what their true motivations are. I am tired of being in the middle of it and suffering the “blow off” from doctors. Are the doctors on the blog aware we (Medicare patients) are not stupid? We see right through the shallow exam and the token attempts to diagnose and/or treat. What has happened to the Hippocratic Oath? I guess easing the suffering of others has a price tag just like everything else in this land of capitalism.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-27469092772282790582010-03-03T14:48:50.833-05:002010-03-03T14:48:50.833-05:00Another Canadian here.
Our healthcare isn't p...Another Canadian here.<br /><br />Our healthcare isn't perfect, but as was said for urgent care you get it promptly. It is mainly the more elective stuff that people may try to get done in the US (i.e. knee surgery)<br /><br />When I see a doctor, I don't have to fill out endless forms, my doctor doesn't have to get approval from my insurance before doing a test or procedure. He or she just does what he feels is the best method to resolve the problem. I've had a couple CT scans, a few x-rays, and lithotripsy to break up a kidney stone...cost $0<br /><br />Talking to my American friend, hospital ERs there sometimes require you to wait a few hours to see a doctor just like here. I'm also told that what you have to pay for private insurance is often close to what we pay in taxes if not more. Actually going by many numbers I see including those in this thread it is SIGNIFICANTLY more.<br /><br />As far as paying taxes, nobody likes to do it but that is how you as a citizen contribute to SOCIETY. In return you get the benefits of living in a society which I feel includes fundamental human rights (and I'm not talking about your constitution but I'm sure the US founders would have rather seen everyone healthy than leaving poor people to die). I can appreciate rich people having problems paying more than the poor but maybe consider it as giving back to the society that enabled you to become wealthy!Robnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-14952552645404020502010-02-22T22:04:28.318-05:002010-02-22T22:04:28.318-05:00The people who are boasting about Canada and UK an...The people who are boasting about Canada and UK and Aust do not get it. Medicare *is* our national health care system. And it's cutting doctors (and the patients in the long run)to save money. And Cdn, UK, and other nations with socialized health care are dealing with humongous costs. Sweden now outsources 90% of their primary care to non-govt docs. There are long waits for care in Canada and Europe as well as limitations to such things as cancer medicines. Dr. Grumpy has to stop taking "socialized" medicine because it is breaking his bank.<br /> So stop boasting about how good your health care is. Medicare *is* a national health care system and it's abusing our physicians.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-25868161320456580872010-02-21T21:16:17.671-05:002010-02-21T21:16:17.671-05:00I'm not sure how many of the responses here ar...I'm not sure how many of the responses here are from those in the field of Pharmacy, but I thought that I would put in my 2 cents (this is a hot topic with many educated, interesting responses)! <br /><br />I worked in a pharmacy in a small town, with many people on Medicaid (many not citizens) and was very disturbed by my time at this pharmacy. I had many older low income medicare patients that could not afford to pay for their important medications (cardiovascular drugs, antibiotics, hormones etc). Sometimes they would leave without them, which really broke my heart. Then I would get Medicaid patients with overrides on their PPI's (i.e. Protonix) that cost (at that time) hundreds of dollars, or very expensive versions of drugs that have the same effect as less expensive alternatives. If the medicaid patients didn't have the dollar co-pay then they received the drug for free! I'm not sure what the solution to this is... Sometimes the medications prescribed to these patients were the latest and greatest, touted by pharmaceutical reps, when a less expensive (generic) medication would have been better for both types of patients. <br /><br />I believe that samples sometimes encourage a doctor to prescribe something very expensive and then the doctors get non-compliance when the patient can't/won't return for more, or they realize that the medication costs more than they can afford monthly. Many times the doctor has no idea what the medication costs are (they are rightly busy keeping up with the new advances in their fields).<br /><br />In addition to this, the hospital in this town was always flooded with patients with little cold viruses and strained ankles; Thus causing a huge delay for people with severe injuries. It is a tough situation. To some of the Medicaid patients it makes no difference to them, whether they go to the hospital and pay nothing, or go to a doctor and pay nothing. Why wait out the weekend when you want cough or pain medicine now and it's free from the hospital? If you have to go to the drug store for Tylenol or Advil it costs money.<br /><br />One thing I do NOT want people to read into this is that I am suggesting that doctors not be able to prescribe more expensive medications for those people that need them. Sometimes the less expensive, older drug really does not work as well or it does not work for that particular patient. I just hate seeing our elderly patients not get important medications. When I could, I would call the doctor for the elderly patients who were unable to afford their medication. Most of the doctors were grateful for the call and more than willing to switch out the drug, especially with a well thought out alternative. Without this interference many doctors never know that their patient can't afford their prescription. Many patients (especially proud elderly patients) will not even tell their doctor that they are not taking what they were prescribed or will not tell the doctor WHY they didn't buy it. With retail pharmacists most often being in such a stressful and chaotic job situation the doctors rarely get this important phone call.<br /><br />I think it is becoming more and more understood that an ounce of prevention is worth a pound of cure. The lack of an inexpensive antibiotic may lead to an expensive stay at the hospital. A patient that can't afford a physical may lose the critical time frame to stop a preventable disease that ends up costing a fortune in care.<br /><br />Insurance is a really complicated topic, other health care systems are very interesting and I think there is a lot to be learned from them. It can be hard for the pharmacists to understand the M.D.'s perspective (and the other way of course). It's even more difficult to make non medically trained politicians understand the complexity of different medical situations.MelKnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-71582551789431822232010-02-19T13:00:17.874-05:002010-02-19T13:00:17.874-05:001. Depends on the medi-gap plan.
2. No idea. But ...1. Depends on the medi-gap plan.<br /><br />2. No idea. But that's likely not what they are really getting reimbursed.Grumpy, M.D.https://www.blogger.com/profile/09858110332436246760noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-45342629502316393362010-02-19T12:48:40.819-05:002010-02-19T12:48:40.819-05:00So, Dr. Grumpy, are you going to refuse to see pat...So, Dr. Grumpy, are you going to refuse to see patients with Medicare plus Medi-Gap plans? I am not yet 65 but getting close and I want to know what's happening.<br /><br />Also, I want to know why it costs $45,000 for my sister to get ONE IV chemotherapy treatment for a drug that is not experimental, that she gets as an outpatient. Of course my sister doesn't pay that because she has insurance, but isn't that just a bit outrageous?I Travel for JOOLShttps://www.blogger.com/profile/07348834982890831188noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-86901481262192093242010-02-19T00:08:11.800-05:002010-02-19T00:08:11.800-05:00Wow. This thread is fascinating. Although at times...Wow. This thread is fascinating. Although at times a few individuals have lapsed into stale and foolish arguments (along the lines of "you're socialist!" and it's counterpart "well, you're EVIL") it's on the right track. <br /><br />I especially like Anonymous February 17, 2010 7:47 AM's comment comparing CAN vs US health based on experience. It's enlightening, and seems accurate. (I too hate when people try comparing taxes across borders...since it doesn't really work.)<br /><br />I would like to tell February 18, 2010 2:09 PM that Sicko probably overplays its hand. It's not all a bed of roses up here in Canada. There are many, many good things, and some not so good things. But we're doing pretty well.<br /><br />Finally, it seems to me that you all (yes ALL Americans) need to really make yourselves heard this coming midterm election cycle. Governments should be concerned about what their constituents think. Make them care. Although you all seemed to be somewhat on the right track (though potentially too expensive without as much benefit), reform may have already been blown off track (weak, spineless Dems, as usual, and 41 cynical, filibustering, power hungry Republicans in Senate). So as I said before... make them care.niknoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-72199433693512394132010-02-18T22:15:12.839-05:002010-02-18T22:15:12.839-05:00I wouldn't recommend anything by Michael Moore...I wouldn't recommend anything by Michael Moore, to be honest. But I would recommend a nice documentary named "Sick Around the World" which shows the public healthcare systems around the world. I learned SO much from this and it really changed how I thought about the whole subject - not by scare tactics or any such, but by factual knowledge. Anyone who really wants to weigh in on the healthcare reform issue should ACTUALLY know what they are talking about.<br />Most don't.Leahnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-11839878297291638842010-02-18T16:09:58.279-05:002010-02-18T16:09:58.279-05:00A really good movie I saw helped put all this in p...A really good movie I saw helped put all this in perspective for me. It was called Sicko by (Michael Moore). Although it was made in 2007, I don't think much about the health insurance system has really changed since then. I highly recommend it for those interested.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-71770356910193448442010-02-18T14:20:32.140-05:002010-02-18T14:20:32.140-05:00Apparently Ed doesn't know much about rights. ...Apparently Ed doesn't know much about rights. One has rights by virtue of being alive.<br /><br />I suspect that is the difference between liberals and conservatives; conservatives think you only have the rights they feel like giving you, whereas us liberals are aware that all, regardless of location, have certain rights by virtue of their humanity.Katharinenoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-24444417211496139732010-02-18T08:53:32.437-05:002010-02-18T08:53:32.437-05:00I am an American, and DO NOT believe in Socialism....I am an American, and DO NOT believe in Socialism.<br /><br />But I do believe in socialized medicine. Because the health of it's citizens is a key part of EVERY country's economy.<br /><br />I don't believe the govt should bail out car companies and banks, when the same money could be used to support the health care system, with far more dividends in the long run.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-68414238357403997472010-02-18T08:49:22.883-05:002010-02-18T08:49:22.883-05:00I am an American who strongly believes
that having...I am an American who strongly believes<br />that having Socialized medicine Does<br />Not make us socialists! In fact, it<br />makes us smart, willing to make sure<br />that people don't without Rx's because of the cost, or emergent care<br />because of cost. By emergent care I am not speaking of E.D visits but cancer treatment, surgury, etc. People are dying every day because they cannot afford treatment and meds.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-56172484029287332922010-02-18T07:44:57.951-05:002010-02-18T07:44:57.951-05:00I am a doc in private practice who has been active...I am a doc in private practice who has been actively engaged in lobbying legislators since 2003 to fix this problem. I had reason to hope earlier in the year when the health care bill, which contained a Medicare payment fix, was on the verge of passing. Regardless of one's views on the overall health care legislation, it at least addressed this looming problem.<br /><br />Now that hope has been replaced by utter frustration. As already mentioned in this blog, Medicare payments to physicians has remained essentially unchanged for the last decade, despite the fact that the cost of doing business has increased about 20 percent of the same time period. In under two weeks payments may be cut an additional 21%.<br /><br />I still believe congress will step in at the last minute to prevent this cut. However, the word on the Hill is that the most physicians can hope for is a five year freeze on payments. Another five years of payments that don't increase commensurate with the cost of doing business is not a sustainable way to run a business.<br /><br />I came across this blog because I was looking for any organized movement by physicians to stop accepting Medicare patients. I have not found one, but believe such an organization may have a role. After years of pleading, begging with legislators to fix this problem, I wonder if it will only be solved when seniors and military personnel lose access to care and in turn apply the type of pressure to legislators that forces them to act.privatepracticedocnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-32704275447845053532010-02-18T07:36:24.528-05:002010-02-18T07:36:24.528-05:00I'm on TN's "enhanced" medicare ...I'm on TN's "enhanced" medicare called TennCare.<br />Some of us don't have other options. I just turned 21 in November...and have recently been diagnosed with Multiple Sclerosis. PPMS. It sucks...a lot. And I would have lost the medicare when I turned 21 had I not shed a bunch of crocodile tears to the right people.<br />Without TennCare, I would be unable to see a doctor or get any treatment at all. I'm a college student - poor by default - and physically unable to work a job that requires a lot of physical activity (I.E. every minimum wage job in my area). <br />So not everyone on Medicare is a lazy SOB just working the system.<br /><br />That being said, I totally understand why Dr. Grumpy has to do what he's doing. Medicare simply DOES NOT pay what they should. They're cutting from places they shouldn't be in order to delay an already sinking ship.<br /><br />I'll just say to all you healthcare reform nay-sayers...it's scary when, suddenly, you find out you're about to have no healthcare coverage. You're poor and sick, through no fault of your own, and cannot afford to see a doctor...much less pay for medication. You research your options, only to find that there are none. And that was just after I was told that some nodules on my thyroid might be cancerous. It's TERRIFYING to be facing illness and know that there is no way for you to receive treatment....meaning you just have to live with it till you are killed by it.<br />And I'm just 21 years old. I can't say I don't feel a little cheated.Leahnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-87085239083705550012010-02-18T04:42:36.679-05:002010-02-18T04:42:36.679-05:00First of all healthcare is NOT a right. Rights are...First of all healthcare is NOT a right. Rights are granted in the constitution and, free healthcare aint there. Secondly, Americans dont want socialized healthcare because we aren't socialists!!!<br /><br />ED RNAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-45063053229806275322010-02-18T01:36:30.273-05:002010-02-18T01:36:30.273-05:00I live in BC. My husband and I are middle class. ...I live in BC. My husband and I are middle class. We have two kids. We pay taxes- but it really isn't much of a burden. <br /><br />I pay $114 a month for the Medical Services Plan (gov't healthcare)for our entire family. MSP premiums are based on your income and if you make below a certain amount (poor, student, etc...) you don't pay anything. With MSP you never pay for doctors visits, vaccines, health unit visits, hospitalization or ER visits. You DO pay for all perscriptions unless you qualify for a seperate plan to subsidize drugs (fair pharmacare). Each province is different. I believe that in Ontario you don't pay monthly it is incorporated into your income tax.<br /><br />I also have an extended medical plan through work for which I pay about $100 a month for the entire family. This covers life insurance, 80% of Dental visits, and 80% of Prescriptions. <br /><br />I gave birth in our local hospital twice. I received excellent care. I had several complications with each pregnancy and always received prompt diagnostics and treatment.<br /><br />Without our current healthcare our two pregnancies alone would have left us bankrupt, I never could have planned for all the blood tests, ultrasounds (OB and Cardiac), specialists, V/Q scans etc... <br /><br />What I don't understand about the reluctance of Americans to change is that they fear this type of system will encourage abuse. People are ALREADY abusing your system! But perhaps your current system doesn't seem to plan for this? And wouldn't the rest of Americans like to recieve the services that the losers are abusing? Without sacrificing their financial security?meghttps://www.blogger.com/profile/08910764572453422710noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-28614620398348131612010-02-17T21:30:54.751-05:002010-02-17T21:30:54.751-05:00What I don't understand is why "common&qu...What I don't understand is why "common" people like us don't stand up and demand that Congress DO something about our health care system. How many presidents have tried and failed? From what I understand it's almost always the insurance lobbies that stop things cold. When are we going to get fed up enough and desperate enough to get off our obese American asses and work to make things better????belovedparrothttps://www.blogger.com/profile/15821854533670618073noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-41462527272023416462010-02-17T20:41:35.985-05:002010-02-17T20:41:35.985-05:00just have a look at the australian healthcare syst...just have a look at the australian healthcare system...not perfect but it generally works. in a simplistic summary....<br />public system cost? paid for by 1.5% levy on taxable income collected thru the tax system. for those who can afford private health insurance and dont take it out ($146k annual family income) add another 1%.<br />cost of a doctor = 20% of a scheduled fee.<br />drug cost? max $23 with all sorts of support for low income earners.<br />emergency treatment? free hospitalization in the public sector for elective surgery? free.<br />private health insurance? minimum cost of around $100/month per person for a private room in a private hospital. your own doctor. a $500 once off per year co payment. other more expensive plans available to cover every need including dentistry, optical, physio etc. and copay waiver. but around $3500 a year for top of the line for a family is normal<br />if that is socialism at work then that's ok by me.<br />i think when it comes to health care, a lot of americans need to get their heads out of............um, the sand.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-48978857164804750492010-02-17T20:20:06.344-05:002010-02-17T20:20:06.344-05:00We have a very expensive war to pay for, MsLaurie....We have a very expensive war to pay for, MsLaurie. I'm not "seriously" ill but have a couple of chronic illnesses. I pretty much work to pay for my meds (even with a prescription plan, it adds up) and have gone without some things because I just can't figure out how to pay for the procedure.hekateshttps://www.blogger.com/profile/05248476836969662392noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-60478305927554956192010-02-17T19:35:25.058-05:002010-02-17T19:35:25.058-05:00I'm American, and a social worker, and I do be...I'm American, and a social worker, and I do believe healthcare is a right. I mean, thinking about it, not everyone is priveledged to have a body that works. It makes me sad that I have to worry about my insurence every time I switch jobs, as a young adult with a health condition. I don't have the luxary to wait until I get medicaid, and really the system is so mucked up right now that I'm not even sure it will exist in another thirty years.<br /><br />I don't understand either why Americans are so opposed to socialized medicine. I wonder, do these people ever have to use our medical system? I pay thousands of dollars a year in medical costs. I don't mind paying co-pays, but it's awful to think what would happen if I lost a job in our economy.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-46902847106744736462010-02-17T19:17:21.545-05:002010-02-17T19:17:21.545-05:00Australian here, also utterly befuddled by the US ...Australian here, also utterly befuddled by the US system, and why 'socialised' medicine is thought so awful. <br /><br />No one here fears medical debt - it just doesn't happen. Sometimes in the public system you can wait for ages, but if its urgent, you go straight to the front of the line. My uncle, for example, had a horrible farm accident a few years ago, which involved stablisation at the local hospital, helicopter to the major city hospital, and treatment in the burns unit for around 8 weeks with skin grafts and multiple operations, and it cost him and his family NOTHING up front. <br /><br />Really, why are people paying taxes if not to have the basics in life provided for?MsLauriehttps://www.blogger.com/profile/14865393664244155193noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-87968402365891846322010-02-17T18:04:17.885-05:002010-02-17T18:04:17.885-05:00In response to Anonymous at 8:40:
Geez, I wasn...In response to Anonymous at 8:40:<br /><br />Geez, I wasn't judging you, I don't even know you!<br /><br />I was judging my in-laws!!!Cherylhttps://www.blogger.com/profile/14756045431717118627noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-46682779915976988052010-02-17T17:58:08.268-05:002010-02-17T17:58:08.268-05:00It really does depend on where you live in Canada....It really does depend on where you live in Canada... In Ontario, if you make over a certain amount, the government charges you an additional health tax, on top of the already annoying PST and GST, soon (if not already) to be HST, which shows up on your paycheck as a deduction... It's tiered, so the more you make the more you pay, but it is capped at a certain point... The provincial government there made their campaign promises that they wouldn't charge a health tax, and then about a month into term announced they were going to do just that... More then a term later and they're still in power... People are mooks... *shakes head*...<br /><br />Meanwhile, here in good ol' Newfoundland, only seniors who 'earn' less then a certain amount get the NLPDP seniors drug plan supplement... Watching a somewhat poor 99 year old pay $100 for a 30 day supply of Plavix without complaining breaks my heart... :(<br /><br />Verification Word: winty...Alanda Jacobshttps://www.blogger.com/profile/02998343751856403466noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-87786003856677575172010-02-17T17:26:46.394-05:002010-02-17T17:26:46.394-05:00I don't understand why Americans are so agains...I don't understand why Americans are so against looking at what works in other countries. I live in Germany and don't pay anything at the doctors. Sure I pay higher taxes, but I worked it out once, and with the free healthcare and free college education factored in, the overall costs are lower in Germany. This is why a lot of young Europeans go to the US after college (I did and racked up enough for a down payment on my house here). They pay lower taxes and have more $$ in their pockets, but once you have a family and start thinking about paying health insurance for the kids and funding their college educations, Europe starts looking REALLY good.<br /><br />It's sad that Americans would rather put on patriotic blinders than push for a better system, one where doctors don't have to choose between feeding their families and helping patients. <br /><br />But of course, whether two guys can get married has much more affect on their lives than whether or not they have health insurance does.Max Krautnoreply@blogger.com