The Doctor will see you STAT*

There is an article in the New Atlantis Times that Matt Drudge linked to the other day. Dr. J. didn’t pick this up before Matt because he doesn’t get the daily New Atlantis Times, and because he was winging his way to Atlanta to conspire with Big Pharma. He would share with you the details of the conspiracy but then it wouldn’t a conspiracy now would it?

BlueCross&BlueShield of Tennessee, who happens to be the good doctor’s insurer, funded a study how Obamacare would affect access to healthcare state wide. Their analysis suggests that in 2014, 700,000 Tennesseans will become insured, many of whom are younger men eligible for Medicaid, and the rest will be able to purchase subsidized policies through state run exchanges.

This is, of course, if the Supreme Court doesn’t strike down Obamacare (John, Antonin, Clarence, Sam, and especially you Tony, you will find the law wholly unconstitutional (Jedi fingers waving towards DC)).

There are consequences of this influx of insured patients on to the insurance rolls. First, utilization will go up. When one has a low co-pay (or no copay in the case of women receiving womens’ health services in the post Sibelius era), they are more likely to use a service that they otherwise might not. Preventative services may be good medicine, but they’re not necessarily cost effective. As a consequence costs will go up for individuals paying for their premiums.

Second, the wait for said services will be longer because more people will be demanding services from a fixed number of physicians. As physicians are paid less than the cost of doing business caring for Medicare and Medicaid patients, they will be less than enthusiastic to take these patients into their already crowded clinics. Many private practice physicians are struggling to keep open and they are selling their practices to hospitals (who are relative winners with Obamacare) where there is safety and cost effectiveness in numbers due to lower per provider overhead.

Even at New Atlantis Ivory Tower Medical Center, one of the primary care groups has its own urgent care clinic so if you don’t feel good you see the doc of the day rather than your doctor. You only see your doctor for scheduled visits. Remember, you can keep your doctor, you just might not get to see him for every sore throat or tummyache. Fortunately the other primary care groups do not operate on this model. But make no mistake, as hospitals buy up private practice groups the scarcity of clinic visits will likely result in your urgent be managed in this model. In the interim when you feel unwell, you may be forced to go to Walgreen’s doc in the box.

Now Dr. Coulter, president of the BCBS think tank sums it up thus: “It will be a little longer line but everybody will be in line.” Well Kum-bay-fucking-ya, lets all hold hands, sing, dance and sacrifice unicorn glitter to the rainbow gods! What he’s not saying is the line will be longer, in part, because folks who may not need to go to the doctor are going to be gumming up the works. So if you have a pressing need, getting in with your generalist will take longer and then your referral to your specialist will take longer, as primary care providers that are pressed to see more people in less time tend to refer to specialists with less impunity, increasing costs to insurers and thus your premium. Do you detect a pattern here? Thought so, gentle reader.

Take solace in the fact that Dr. Coulter feels that the state exchanges will do a less shitty job than federal government run healthcare. He says, “I have a lot more confidence in their ability to run things than I do the federal government.” He clearly forgets about TennCare collapsing under the weight if it’s own promises as it ran out of other people’s money. And if he does take that into account, you WILL be waiting longer for your care.

Healthcare expert and film auteur Michael Moore profers that it’s patriotic for Americans to wait longer for the delivery of their healthcare because it we will all be in line together. He suggests that it’s only non-life-threatening issues that you will wait for and magically there will be no waits for urgent care despite the fact there more patients in the system without an increase in operating room slots will mean no additional wait time. Right? Wrong!

In Sweden, there was a study of ~5500 patients who were stratified as imperative (2 weeks), urgent (12 weeks), and routine (6 months). The median waiting time was 55 days.  55% of patients were operated on within their allotted time, meaning 45% were not. The folks operated on within their window had a mortality of 6.2% while the unlucky 45% had a mortality of 8.0%. This translates to an excess of 44 patients who deaths potentially could be explained by going to the OR later than they should have. Now, when they correct for age, gender, anginal symptoms and operative risk, in other words the determinants of something bad happening to them, all is well and good. The thing is, they’re wrong. The authors cannot make that statistical adjustment in this scenario. In this scenario, patients were placed into 3 categories. 45% of the patients in each category couldn’t be operated on in the timeframe desired, and their death rate was higher. The statistical adjustment demonstrated that they put people in the wrong places in line, and they can use that information, perhaps, to reshuffle the lines in the future.

Dr. J. could pull more studies for you if you’d like, but you get the idea.

Mr. Moore, longer waits won’t be patriotic, they will be lethal, and better yet, you, the politically connected and medically connected will not have as long to wait because doctors are always willing to work in a colleague, a friend, a patient a colleague is sufficiently concerned about because of their acuity, or someone of import in as an overbook. Dr. J. does it all the time. It will continue in the future, but we can only do so much.

So how do we fix this? Simple. Repeal Obamacare. Leave medicaid for the truly needy and phase out medicare in a manner that empowers citizens to ensure themselves into their golden years (it can be done).  Implement incentives for individuals to insure themselves. Allow folks to roll over HSA money. Put people, rather than the government, in charge of controlling costs. Decrease, rather than increase, the regulations that are increasing costs in healthcare. With the increased costs of healthcare, private practice is going the way of the dodo. Doctors’ salaries are going down, as well, so insufficient numbers of people are going into the field. It’s all basic macro- and micro-economics. It’s all fixable by doing the opposite of what Washington is doing.

SHAME ON YOU, MR. MOORE, SHAME ON YOU! And anytime you got Dr. J. and the Gormogons against you, you’re time is up!

*SomeTime After Tomorrow

About Dr. J.

Dr. J. was born the son of a New Atlantean sharecropper who cornered the market on notoriously delicious seaweed Himanthalia elongata (popularly known as Thongweed). With his newly minted seaweed fortune, Mr. J. the Elder sent his son to attend the Academy of Sorcery, Alchemy and Surgery where the good doctor apprenticed with the finest sorcerer surgeons in New Atlantis.Dr. J.'s areas of expertise grew to include bleeding, cutting for stone, trephination, medical divination with outstanding spatial and temporal resolution, cybernetic sorcery and medicinal alchemy. When King Orin of Atlantis fell ill with the Ick, Dr. J. stepped in with an elixir he devised from a combination of minerals, herbs and saps. Curing the king, Dr. J. gained significant notoriety which afforded him the luxury of time to devote himself to his side hobbies which include porpoise racing, the study of supply-side economics, cooking and raising his lovely merchildren alongside his lovely bride the archconservative Mrs. Dr. J.


The Doctor will see you STAT* — 313 Comments

  1. Pingback: Google

  2. Pingback: sandık no öğrenme

  3. Pingback: cuckcold

  4. Pingback: Make Money Online

  5. Pingback: Whisky

  6. Pingback: Bristol

  7. Pingback: Silicone Toy

  8. Pingback: SAI PDR Training review

  9. Pingback: read review

  10. Pingback: sterownik canon

  11. Pingback: Nouveau Finance

  12. Pingback: Nouveau Finance

  13. Pingback: Nouveau Finance

  14. Pingback: Nouveau Finance

  15. Pingback: What is the Best Vibrator

  16. Pingback: Lables

  17. Pingback: Plath SIGINT

  18. Pingback: Hospitality Furniture

  19. Pingback: Shorty

  20. Pingback: Cloud Business Continuity

  21. Pingback: Commercial Real Estate

  22. Pingback: Avery distributor

  23. Pingback: irritable bowel

  24. Pingback: online speed dating

  25. Pingback: xadat

  26. Pingback: Jeremy Neo

  27. Pingback: tech news

  28. Pingback: Thomas Caufmann

  29. Pingback: gaelic to english translator

  30. Pingback: Australian Shepherd breeder Arizona

  31. Pingback: legal steroids

  32. Pingback: earthlite massage table

  33. Pingback: vashikaran for love

  34. Pingback: آنلاک سامسونگ بدون باکس

  35. Pingback: original site

  36. Pingback: see post

  37. Pingback: hop over to this site

  38. Pingback: Your Domain Name

  39. Pingback: over here

  40. Pingback: free slot games with bonus rounds no download

  41. Pingback: try this out

  42. Pingback: Ball Buzzer

  43. Pingback: laser vasectomy reversal

  44. Pingback: base rock

  45. Pingback: marriage sites

  46. Pingback: Pop Up Banners

  47. Pingback: HIRAM

  48. Pingback: pet micro chips

  49. Pingback: technology

  50. Pingback: BENJAMIN

  51. Pingback: Club ETA

  52. Pingback: エンビロン

  53. Pingback: 5 Bucks Online Traffic School

  54. Pingback: dental health insurance

  55. Pingback: pakistani dramas online

  56. Pingback: warehouse space Bloomington Minnesota

  57. Pingback: BOOKER

  58. Pingback: Remote sex toys

  59. Pingback: emotional support animal

  60. Pingback: wsp background check

  61. Pingback:

  62. Pingback: fantasy soccer league

  63. Pingback: term life insurance quotes

  64. Pingback: حبوب الاجهاض سايتوتك

  65. Pingback: Seattle Transport

  66. Pingback: cheap phone calls to jamaica

  67. Pingback: Lackawanna County

  68. Pingback: Realestate agent

  69. Pingback: hotel venice

  70. Pingback: Air conditioner repair Toronto

  71. Pingback: ephesus tours

  72. Pingback: Niagen reviews

  73. Pingback: website

  74. Pingback: Sports Girls

  75. Pingback: christmas coffee mug

  76. Pingback: fast turn-around CAD service maui residential design

  77. Pingback: crossbow

  78. Pingback: Gutter Cleaning

  79. Pingback: cheap phone calls to uk

  80. Pingback: Lie Detector (Polygraph)

  81. Pingback: گرافیک

  82. Pingback: Discounted Wheel Warehouse

  83. Pingback: Discounted Wheel Warehouse

  84. Pingback: Discounted Wheel Warehouse

  85. Pingback: Minneapolis commercial real estate for lease

  86. Pingback: kazım sipahi

  87. Pingback: how to make money online

  88. Pingback:

  89. Pingback: Web wind pro

  90. Pingback: watch background check

  91. Pingback: satellite tv for pc

  92. Pingback: Must Have Sex Toy

  93. Pingback: Hamburger

  94. Pingback: Huge Realistic Dildo

  95. Pingback: Bosna Hall in Tirol

  96. Pingback: curtain singapore

  97. Pingback: Top PTC sites

  98. Pingback: league of legends

  99. Pingback: Manhattan Beach

  100. Pingback: Girls

  101. Pingback: leather briefcase

  102. Pingback: you could check here

  103. Pingback: More hints

  104. Pingback: Worldwide Vacations

  105. Pingback: this content

  106. Pingback: vinyl windows and doors

  107. Pingback: Continued

  108. Pingback: 7m

  109. Pingback: search engine optimization for a new company

  110. Pingback: Best Internet radio

  111. Pingback: upvc windows & doors

  112. Pingback: triple stimulator

  113. Pingback: he has a good point

  114. Pingback: free slots online for free

  115. Pingback: free slots with bonus

  116. Pingback: Going Here

  117. Pingback: my site

  118. Pingback: i thought about this

  119. Pingback: backgrounds checks

  120. Pingback: Sex Toy Bullet

  121. Pingback: einmaleins im schlaf lernen

  122. Pingback: Face Lift Beauty Instrument

  123. Pingback: nauka włoskiego za darmo

  124. Pingback: coffee classics

  125. Pingback: coffee vs

  126. Pingback: MacBook data recovery

  127. Pingback: coffee flavors for water

  128. Pingback: flavored coffee beans

  129. Pingback: music lessons hollywood

  130. Pingback: additional reading

  131. Pingback: flavored coffee recipes

  132. Pingback: computer parts store

  133. Pingback: additional hints

  134. Pingback: polycarbonate skateboard deck

  135. Pingback: jeld-wen windows & doors

  136. Pingback: windows & doors

  137. Pingback: window for door

  138. Pingback: canada windows and doors

  139. Pingback: double hung window

  140. Pingback: have a peek at this web-site

  141. Pingback: el cajon dentist office

  142. Pingback: m88

  143. Pingback: dentist near

  144. Pingback: common insider

  145. Pingback: Stromanbieter

  146. Pingback: Runescape private server

  147. Pingback: iphone 6s plus tempered glass screen protector

  148. Pingback: knowing it

  149. Pingback: m88

  150. Pingback: Blog Berichte in Berlin schreiben

  151. Pingback: hochzeit dj nrw

  152. Pingback: przedszkole piaseczno

  153. Pingback: growth hacking

  154. Pingback: hog wild trappers

  155. Pingback: end time prophecies in the bible

  156. Pingback: Package Forwarding

  157. Pingback: propane fire pit table

  158. Pingback: Get the facts

  159. Pingback: أفضل جامعة في دبي

  160. Pingback: law of attraction relationships

  161. Pingback: Go Here

  162. Pingback: work from home careers

  163. Pingback: Fire Extinguisher Training classes Online

  164. Pingback: a knockout post

  165. Pingback: get rid of bed bugs

  166. Pingback: classic coffee

  167. Pingback: mountain spring coffee

  168. Pingback:

  169. Pingback: sick

  170. Pingback: M88

  171. Pingback: eleaf istick 40w wholesale

  172. Pingback: modern kitchen ideas bala cynwyd

  173. Pingback: Window cleaning

  174. Pingback: Asian Public Sex

  175. Pingback: Motorcycle parts

  176. Pingback: sprzedaż obrazów

  177. Pingback: WiYnE

  178. Pingback: ATT CELL PHONES

  179. Pingback: dentist book online

  180. Pingback: all in one system

  181. Pingback: stupid

  182. Pingback: sick

  183. Pingback: ristorante verona

  184. Pingback: luxury car rental miami florida

  185. Pingback: Exhibitions in London

  186. Pingback: classifieds

  187. Pingback: Find an apartment in Shanghai

  188. Pingback: flavored coffee

  189. Pingback: Fridley office space for lease

  190. Pingback: SAI Superior Auto Institute Review

  191. Pingback: Woodbury commercial real estate for lease

  192. Pingback: office space for lease Brooklyn Center MN

  193. Pingback: classic coffee

  194. Pingback: classic coffee

  195. Pingback: coffee menu

  196. Pingback: mountain coffee

  197. Pingback: coffee makers

  198. Pingback: breakfast coffee

  199. Pingback: coffee and tea

  200. Pingback: coffee bagel

  201. Pingback: coffee news

  202. Pingback: coffee classics

  203. Pingback: Nederland/Holland

  204. Pingback: first fitness

  205. Pingback: peaberry bean coffee sale

  206. Pingback: travel london

  207. Pingback: free poker slot machine games

  208. Pingback: Express delivery service.

  209. Pingback: coffee classics

  210. Pingback: high fashion home

  211. Pingback: harga borong

  212. Pingback: snow roof removal

  213. Pingback: coffee classics

  214. Pingback: animals connect

  215. Pingback: sohbet hattı

  216. Pingback: more helpful hints

  217. Pingback: Build in Flash

  218. Pingback: flavored coffee

  219. Pingback: v fashion logo

  220. Pingback: real estate listings maine

  221. Pingback: Shaft Drive

  222. Pingback: telefon sohbet

  223. Pingback: sohbet numaraları

  224. Pingback: compare automotive

  225. Pingback: Disease eradication

  226. Pingback: up fashion

  227. Pingback: business management accounting

  228. Pingback: Liberia

  229. Pingback: healthtex shoes toddler

  230. Pingback: advertising london

  231. Pingback: how to seduce him long distance

  232. Pingback: what diet

  233. Pingback: Cream

  234. Pingback: asian pornstars videos

  235. Pingback: healthplex

  236. Pingback: you can look here

  237. Pingback: Bath Soap

  238. Pingback: Health care in Canada

  239. Pingback: pets care a lot

  240. Pingback: Grenade

  241. Pingback: new york city travel packages

  242. Pingback: flavored coffee beans

  243. Pingback: coffee flavors

  244. Pingback: international marketing ppt

  245. Pingback: cabbage soup diet

  246. Pingback: Flame Retardant

  247. Pingback: small engine oil vs automotive oil

  248. Pingback: Revshare earning

  249. Pingback: business management clep

  250. Pingback: starting business checklist

  251. Pingback: automotive components holdings mi

  252. Pingback: product marketing plan template

  253. Pingback: Conditioning

  254. Pingback: Tools

  255. Pingback: Single Barrel

  256. Pingback: Overseas service center available

  257. Pingback: madrid travel puerto rico

  258. Pingback:

  259. Pingback: luxury car rental miami

  260. Pingback: sales marketing jobs raleigh nc

  261. Pingback: Brasil

  262. Pingback: criminal law 101

  263. Pingback: Μουσική

  264. Pingback: ppr direct marketing llc

  265. Pingback: Eastern Europe

  266. Pingback: highest paying jobs in marketing

  267. Pingback: product marketing

  268. Pingback: internet sportbook

  269. Pingback: Beauty Without Cruelty

  270. Pingback: automotive accessories

  271. Pingback: Nicaragua

  272. Pingback: Royel Corp WET

  273. Pingback: south bend hotel deals yahoo travel

  274. Pingback: Generic Viagra

  275. Pingback: internet browser on roku

  276. Pingback: Business directory

  277. Pingback: Generic Viagra

  278. Pingback: free internet tv channels

  279. Pingback: beauty plus

  280. Pingback: treadmill fitness

  281. Pingback: fashion dresses for cheap

  282. Pingback: Stegplatten

  283. Pingback: Link search directory

  284. Pingback: Pérou

  285. Pingback: find lost cell phone

  286. Pingback: education youtube video

  287. Pingback: dental office

  288. Pingback: education 2015

  289. Pingback: Ear Hook

  290. Pingback: Hot Stamping

  291. Pingback: Hosted Exchange

  292. Pingback: mesothelioma lawyers

  293. Pingback: More about the author

  294. Pingback: pdr training

  295. Pingback: award winning flavors

  296. Pingback: paintless dent repair training

  297. Pingback: what to eat when trying to lose weight

  298. Pingback: best rate in lima

  299. Pingback: russischer dj hochzeit

  300. Pingback: pdr training

  301. Pingback: pdr training

  302. Pingback: puffy pussy

  303. Pingback: Cheap La Coruna Soccer Jerseys

  304. Pingback: canada background check

  305. Pingback: pdr training

  306. Pingback: pdr training

  307. Pingback: Minnesota commercial real estate listings

  308. Pingback: locate Minnesota commercial real estate

  309. Pingback: find Minnesota commercial real estate

  310. Pingback: Pregnancy Miracle Free Download

  311. Pingback: Coronado Cays Bahama village

  312. Pingback: Porno

  313. Pingback: labradoodle