Saturday, June 30, 2012

The Real Obamacare

(The following was written by a friend of mine whom has just finished his residency and is about to take his first job as a doctor. He's given me permission to share it, enjoy)
The Real Obamacare

The reason that medicine costs so much is because many individuals do not pay for it. The uninsured and under-insured visit the ER because they will not get denied an ER doctor evaluation when they do not wish to pay for an office consultation. Lawyers have made it where if a non-emergency is not seen in the ER, then the doctor suffers in court, therefore extensive, expensive workups are ordered that the patient never intends to pay. Medicaid patients do not pay a dime for any medical service or medication, and many go to the ER whenever convenient and get a full workup free of charge that you and I as taxpayers pay for. Ever realize that you and I are paying for someone on Medicaid to get free Tylenol from the pharmacy?

The problem with the insurance companies is not that they are big, greedy monopolies, but they have been subject to so many forced legal requirements and increased costs from hospitals (the hospitals have to raise the price for everyone to balance out the people who don't pay any of their bill or don't even have an address to bill, ie. illegal alien, etc.) and thus have no other choice but to drop certain people or coverages or increase premiums; it is just business. Insurance companies are not increasing in number due to so many of these legal precedents and ramifications, so healthy competition is at a minimum, and vastly meddled with by the federal government. So the problem with our current healthcare system has been caused by the federal government. And the solution? To expand
the current failing system. That is Obamacare. The Affordable Care Act may sound pretty to the individual, but in reality it is designed to destroy private insurance.

The ACA cuts reimbursements to facilities and clinicians taking care of Medicare patients, so more doctors cannot afford to accept Medicare, or at least they must accept fewer patients. It penalizes doctors for not using electronic medical records (and to the exact intricate specifics they dictate, all of which are insanely expensive by the way), so older doctors are being forced to shut their doors rather than now lose Medicare money and go bankrupt or buy a $10,000 electronic medical record when they plan to practice for less than 5 more years. It expands Medicaid to cover an additional 15-30 million people, but it does nothing to further compensate clinicians for seeing these people. A private physician who sees only Medicaid patients goes bankrupt, because Medicaid pays 30 cents to the dollar; it costs more to see the patient than you get paid. So more Medicaid holders have less doctors and access; this does not fix the problem. And they go to the ER instead. Might as well take a free ambulance ride to the ER while they're at it so they don't have to pay for gas. And you and I pay for it.

So how about the government-issued insurance plans set to come out in 2014? They're designed to be cheaper, so more people can afford them. Sounds sweet. Problem is, people look at the cheaper thing and often not what it covers (or which providers will accept it, which may not be many, making it akin to Medicaid) and will cancel their private insurance. Now more people than ever are on a government insurance policy that doctors cannot afford to accept, because it does not (granted may not) pay enough to sustain a practice. Even less access to care. This does not fix the problem of getting people their health care access that they need.

The government is also about the least efficient manager of goods and services; they do not save money nor prevent waste; quite the opposite. From experience the VA system is about the biggest example of waste there is. The government also is very picky about who gets what and when (trust me on this; I have battled many a time to get my Medicare and Medicaid patients what they need when the government says no). So we get less patient-centered care and more dictation on what the government says is what's best for the patient instead of the doctor, and the patient gets fewer choices and options. And the ACA fails to address anything at all about the absolute biggest medical expense of all: nursing homes. The law does nothing to keep people out of nursing homes, but will not pay for a nurse to make a nice, quick, easy, inexpensive visit to someone with home health and prevent further health decline. Medicare and social security are set to go bankrupt before any of us younger folk get of age, by the way.

I'm sorry to say the Supreme Court ruling this week forcing insurance or taxation will not get insurance for everyone; the tax imposed is still significantly less than insurance premiums (private or proposed public insurance), so a very large number of people will still opt out, and small business owners, already under so much legal taxation, will (if not forced out of business) most likely resort to paying the tax instead of providing medical insurance to their employees.

The solution is not to expand a failing system the government helped to create; it is to get the government back out so we can have our own private insurance competition again.

A side note: the majority of doctors in this country are against Obamacare and are not members of the AMA.
(So there you have it, a doctor's perspective on Obamacare and the problems with the medical industry)

Wednesday, June 20, 2012


Forgive me for I am about to rant at you.

Its 1:40am and I am groaning. I am groaning because I have no AC, its texas and its currently 82 degrees in my apartment. I am groaning because I am awake and I really don't want to be. I am groaning because I hate our culture. I am groaning because I wish I had an uncle named Iroh (firebending optional). I am groaning because I hate how much control my body has over me.

I promise these things are all related by more than just sleep deprivation. Not that I will explain how here.

This world sucks, we all know it. How do we know that though? We want something better but how do we know to want that? We desire, we groan, for a better world, what makes us think there's a better world to be had? Hunger implies food, respiration implies oxygen, thirst implies drink. For every physical desire we have, there is some means of satisfying it. So what gives with this desire for a world that doesn't suck?

Things just aren't right. Bodies are broken, families are broken, cities are broken, nations are broken. Bigger than why are they broken is the question of how do we know they are broken? How is it that we are even capable of desiring something better? How do we know what better is?

All of that to quote this:
For the creation was subjected to futility, not willingly, but because of him who subjected it, in hope 21 that the creation itself will be set free from its bondage to corruption and obtain the freedom of the glory of the children of God. 22 For we know that the whole creation has been groaning together in the pains of childbirth until now. 23 And not only the creation, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for adoption as sons, the redemption of our bodies.
This is what I am feeling tonight. The groaning of Creation and of my body, subjected to futility. I know there is something better, and dangit, I want it now! To quoth the internet:

I really don't, which is incredibly selfish. Wait, why is that selfish? Because if Christ were to return today, a lot of people would be left out from that perfect world we're all groaning for:
The Lord is not slow to fulfill his promise as some count slowness, but is patient toward you, not wishing that any should perish, but that all should reach repentance. - 2 Peter 3:9
Still sucks waiting though. There is absolutely nothing here worth waiting for. Not air conditioning, not fancy guns or shiny computers. Not even sex (le gasp!). Heaven, I am sure, will be much better than all of those. So what's the hold up? Well apparently those people are worth waiting around for.

See, that's where the "in hope" part of Romans 8:20 comes into play. God didn't subject the Earth to worldsuck out of wrath or malice, He did so out of hope that people, who had rejected Him, would realize their desire could only be met in Him.

Worldsuck is the thing that tells us something is wrong and compels us to find out what. By God's grace we are saved, but only after we start asking the question "what's wrong with me?"

So I guess I should wrap this up in some semi-coherent fashion before I fall asleep on my keyboard (though that wouldn't be a bad thing, at least I would get sleep (I am going to be sooooooo productive tomorrow)). Things are wrong, but they won't always be. What man has broken God will make new, and I will endure every moment of worldsuck (especially my incredibly light American flavored worldsuck (newsflash, if you live in America the chances that your life actually sucks is pretty low (just ask anyone living in Sudan))) that comes my way, knowing that each moment God delays, someone else is accepting Christ as his or her's Lord and Savior.

I am certain I will regret posting this by Thursday at the lastest, but I don't care. I will leave it here unedited in all its sleep deprived glory as a reminder that sometimes even a broken air conditioner can give you a theology lesson. It did for me anyway, hope you got something useful out of this rant.

Wednesday, June 6, 2012

Can you defend Sola Scriptura?

My study of church history and doctrine has thus far led me to believe that Protestants, at least the more conservative denominations I am familiar with, while professing to believe in Sola Scriptura actually adhere to a form of Tradition (called "single source tradition" by McGrath). This type of Tradition is essentially just a specific way of interpreting scripture and doesn't allow for anything that can't be supported by scripture. However, it doesn't allow for the willy-nilly interpretation of scripture.

The churches I've been in have typically claimed that scripture must be interpreted in a certain way, and have condemned taking scripture out of context or twisting it to conform to novel ideas. This sounds a lot like "single source tradition" to me as I cannot think of a reference in scripture that speaks to how scripture is to be interpreted.

As this is only the beginning of my study on Church history and doctrine I could quite easily be mistaken. However I cannot assume Sola Scriptura anymore. I must be able to prove it to myself, especially seeing how it appears to me that most churches that profess Sola Scriptura do not actually practice it.

So, dear studied Protestant friends, if you have a defense of Sola Scriptura, I'd be happy to hear it in the comments below.

... Okay fine, Catholics can comment too. But only if you're nice.