Healthcare - Classical Liberal - West Coast
Joined September 2022
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Richard Chance retweeted
I thought candidates were elected by the people from a group running for election. The Democrat presidential candidate selection process looks like the communists. The party selects one candidate for you to vote for. How “democratic” of the Democrat Party. #Dictator
Richard Chance retweeted
For all those women angry at me for saying women should learn self-defense, or carry pepper spray, or have a concealed carry… Great! Don’t do any of these things! Keep working toward a just society & in the meantime please feel free to do none of the above. Doing nothing is easy. It’s the default.
Richard Chance retweeted
ALT Equality is everyone getting a book. Diversity is everyone getting a different type of book. Equity is everyone getting a book that fits. Acceptance is understanding that we all read different kinds of books. Belonging is reading the book you want without fear of judgment.
Richard Chance retweeted
This post has been getting quite the attention.
Want to know why your office visit doesn't run on time?
Take a seat... this may take a while...
Healthcare consolidation means doctors are no longer owner/operators of their own small business, able to cater to their patients' needs.
They can't even set the prices they want.
With the physician fee schedule being imposed on us by CMS, we are beholden to the price assigned to our CPT codes. For your beloved pediatrician, those E&M CPT codes reimburse very very poorly. Sure, some clinics can negotiate better rates with insurance companies, but for the most part it's a fraction of what is needed to run a small business.
Econ 101 tells us that price caps cause shortages. Here it is in action.
The price cap set on E&M codes means that doctors can no longer generate enough revenue off of professional fees to run their E&M-based practice. Additionally, they have more and more regulatory burdens that increase the price of running a practice (mandated EHR uptake, quality metrics, etc) while reimbursement declines.
That's not all.
The large hospital conglomerates have rules written in their favor, giving a competitive advantage. They get to charge more for those E&M visits due to "facility fees." They get to be tax-exempt entities. They get massive discounts on drug purchases that they can resell for profit. They get "economies of scale" in operating EHR & quality metrics. They can absorb the cost of a financially underperforming clinic by ensuring they capture downstream revenue from referrals, imaging and labs.
It doesn't take a policy expert to see that the small, independent practice has no chance of surviving.
So they sell out. The physicians become employees of a system which tells them how many patients they must see. They say they can't see patients in that small of a time frame, but the corporation doesn't care. It plans on replacing them with NPs or PAs soon anyway.
The other option is they open a concierge clinic. They stop taking government funds and get away from the price caps. They charge what they feel is needed to give the patients the attention they deserve.
So, what can you, healthcare policy expert and consumer of healthcare goods, do for the situation?
Take your business to a practice which runs on time.
If you have to pay for it, pay for it. That's the beauty of the free market. You're free to take your business to a concierge practice or cash-pay clinic. Nobody is forcing you to go to the practice which is chronically late.
And if your answer is: "but healthcare is a RIGHT! It should be free!!"
Just remember, you'll get what you pay for.
@anish_koka @DrBrian4Health @cscla @DutchRojas @LighthouseDPC
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Richard Chance retweeted
Things that have gone down since ACA was passed:
1) physician ownership in hospitals
2) physician pay compared to inflation
3) access to care
Things that have gone up since ACA was passed:
1) insurance company profits
2) consolidation/vertical integration
3) insurance premiums
4) US healthcare spend
5) hospital profits (particularly nonprofit)
All of this being said, the ACA didn’t do everything wrong. The real problem is our inability to admit that the ACA needs reform. Let’s fix the issues with common sense solutions.
Richard Chance retweeted
Many of you are taking your anger out on the messenger. The truth is that the public system wasn’t built for current demands. The government controls the care you get and the access to testing and treatments. You can see it when they stopped putting the unvaccinated on transplant lists, when they offer MAID instead of treatment, when your surgery is scheduled months or years down the road, when your experimental chemo isn’t covered but gender reassignment is.. It’s not me you should be mad at but as usual the frontline takes the abuse and blame for what you voted for.
Richard Chance retweeted
In the past, I used to criticize such practices. But since haters have explained to me that I'm a bigot for having condemned this, I now know that it would be wrong of Western imperialists to criticize this Noble Norm. Grand Mufti @justintrudeau even claimed that it is barbaric to call such practices barbaric.
Richard Chance retweeted
Not food.
Not healthcare.
Not education.
Farmers, doctors, and teachers aren’t slaves. If you can’t demand their labor & set their wages, neither should the state.
Richard Chance retweeted
"Dear Professor Saad, I was wondering if you could advise me as to whether it is now wrong to state that only women menstruate. Looking forward to your reply." [I'm paraphrasing the gist of email.]
Imagine that in the 21st century, the eradication of common sense is so complete that it causes well-meaning people to question reality in this manner.
Another pretend expert bites the dust when their healthcare conspiracy theories fall flat. On to the next.
Richard Chance retweeted
South Park nails it again.
nitter.cf/JRobFromMN/status/1627…
Richard Chance retweeted
I am the face of #MAID (assisted-death) in Canada.
As a 42 year old woman with a rare complication of lupus + iatrogenic injuries I will only cost the 'system'. I want to live but can’t get the care I need + have been approved for MAID.
#IamthefaceofMAID #Iamthefaceofhumanity
