“Dad, I have cancer”

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Non-Hodgkin-Lymphoma-2b

Obamacare is going to kill you. Or one of your kids. Or one of your parents. Someone in your family is going to die from Obamacare. You can bet on it. You can bet your life on it.

There are many things in medicine that are in a state of flux because of Obamacare. Obamacare is the name given to the most inappropriately termed “Affordable Care Act.” There is nothing about Obamacare that makes care affordable. Obamacare has made care much more unaffordable. What it has done is make healthcare appear to be affordable because of subsidized premiums. The problem is that liberals – and especially democrat voters- do not comprehend that coverage is not the same thing as care. People are forgoing medical care because they cannot afford the large deductibles needed to keep premiums at even marginally affordable rates. Deductibles are especially high for seniors:

Patricia Wanderlich got insurance through the Affordable Care Act this year, and with good reason: She suffered a brain hemorrhage in 2011, spending weeks in a hospital intensive care unit, and has a second, smaller aneurysm that needs monitoring.

But her new plan has a $6,000 annual deductible, meaning that Ms. Wanderlich, who works part time at a landscaping company outside Chicago, has to pay for most of her medical services up to that amount. She is skipping this year’s brain scan and hoping for the best.

Hospital emergency room utilization is up, not down as they promised. That means a strong possibility of delay should you ever be the one wheeled in.

Obamacare is not reducing costs as promised either. The notion that millions could be added to the rolls of health care and pre-existing condition restrictions done away with and see costs lowered was absurd.

Those who do seek care are discovering that it isn’t a simple matter to even obtain it. Rural hospitals are dying because of Obamacare:

Since the beginning of 2010, 43 rural hospitals — with a total of more than 1,500 beds — have closed, according to data from the North Carolina Rural Health Research Program. The pace of closures has quickened: from 3 in 2010 to 13 in 2013, and 12 already this year. Georgia alone has lost five rural hospitals since 2012, and at least six more are teetering on the brink of collapse. Each of the state’s closed hospitals served about 10,000 people — a lot for remaining area hospitals to absorb.

As they close, patients will see lengthened transport times for critical care:

Peanut and cotton farmer Buren “Bill” Jones, 52, died of a heart attack a month after Stewart-Webster closed. His family had to wait about 15 minutes for an ambulance to take him to a hospital 22 miles away, where doctors couldn’t revive him. The closed hospital was 9 miles from his house, a distance his wife or daughter — who performed CPR on him at home — might have driven.

The requirement for electronic records comes at a significant and sometimes, fatal cost:

But the $1 million or more it was going to cost to change over to electronic records was one of the last straws for Randy Stigleman, former owner of Stewart-Webster. Efforts to sell the hospital never panned out.

The anger residents feel toward Stigleman is palpable here in Richland. He appeared to shut the hospital down suddenly — giving them only a week’s notice. But Stigleman says he just couldn’t put any more money into the hospital.

And there’s one more unpleasant surprise you have coming. Ever see those websites that post all of your personal data and then demand you pay to have it removed? You’re going to see more of that- only this time with your personal medical records. Credit card companies and businesses are frequently hacked now as it is. Now that your private records have to go online they’ll be easy prey.

Insurers have already cut reimbursement rates for providers. This is leading to many clinicians questioning whether they would continue to see Obamacare patients. It’s hard to run a practice at a loss.

Things are even worse for Medicare and Medicaid. Doctors are looking at a big cut in Medicaid reimbursement:

Andy Pasternak, a family doctor in Reno, saw more than 100 new Medicaid patients last year after the state expanded the insurance program for the poor under the Affordable Care Act.

But he won’t be taking any new ones this year. That’s because the law’s two-year pay raise for primary care doctors like him who see Medicaid patients expired Wednesday, resulting in fee reductions of 43% on average across the country, according to the non-partisan Urban Institute.

“I don’t want to do this,” Pasternak said about his refusal to see additional Medicaid patients. But now that the temporary pay raise is gone, he and other Nevada doctors will see their fees drop from $75 on average to less than $50 for routine office visits.

“We will lose money when they come to the office,” he said.

The temporary raise in rates was another one of those mirages democrats threw into the air to mesmerize the public. Medicaid has been greatly expanded and democrats trumpet that (along with adding in dental coverage) as a measure of Obamacare success.

Americans are looking at higher deductibles and reduced access to care. Obama’s response to the increases in insurance rates is to obtain a lower degree of coverage to remain near the same premium. In many cases that will mean dropping from a silver to a bronze plan, and individual deductibles could run as high as $6000 and $12,000 for a family.

The solution that you’re likely to see addressing the expected shortage of doctors is the increased dependence on physician’s assistants and nurse practitioners, which leads me to why I wrote this post in the first place.

Never in one’s life does a day go instantly darker as it does when your child calls you and says

“Dad, I have cancer.”

My son (who was in his late 20s’s) made that call to me a few years ago. He usually calls his Mom to talk and I get the report on things. When he calls me, I know something’s up. I was sitting at my desk in my office when he called. Upon hearing his words I experienced an absolute emotional shock and to my surprise, tunnel vision. My first words to him were “I’ll get you through this.” He was diagnosed with non-Hodgkins lymphoma and actually made the self-diagnosis, finding a positive supraclavicular lymph node.

Months before he’d mentioned to me that he had an enlarged and hardened axillary lymph node. That instantly sets off alarms in my head and I begged him to see a physician ASAP. His insurance coverage had him seeing a PA (physician’s assistant) who suggested he might have cat scratch fever based on a chest x-ray and CBC. You want to believe this represents the truth but it bothered me and never stopped bothering me and the PA insisted it was nothing. Some months later he called when he found the second node.

We saw an oncologist and then my wife and I took him up to Dana Farber in Boston to see Arnold Freedman, the top lymphoma doc in the world. I remember Dr. Freedman rubbing his hands together and saying to my son “You had a 7 cm mass under your arm and they thought it was nothing.”

If you’re a doctor you know exactly what he was saying.

The chemo regimen that Dr. Freedman recommended was the same as the one the local oncologist recommended and we felt comfortable with it. My son underwent seven chemo sessions lasting as long as nine hours. I sat together with him for six of those sessions, canceling out my days so I could. It may sound odd, but really I enjoyed the time we shared.

He’s been cancer free for several years now and for that I am eternally grateful. We would have taken him anywhere on Earth to do whatever it took. Fortunately the answer was nearby. I could not be more proud of how he shouldered the treatment.

Since then, Obamacare has excluded many of the premier cancer treatment centers from it’s coverages. That means Obama’s kids, Pelosi’s kids and grandkids and Gruber’s kids will get the very best of treatments should they require it, but yours likely won’t.

If you’re tempted to think doctors are paid too much, imagine for a moment what you would pay to save the life of your child. Imagine what you’d think if your child’s life hangs on a cheaper doctor substitute. Health care costs what it costs because people want to live. They want their kids to live. Health care costs what it costs because people need and use health care. The only way around it is high deductibles, rationing and lower cost treatments. As we’ve seen recently, liberals mean all those things for you and not for them.

My son had the benefit of having the right Dad and for Dad having one of the best internist-diagnosticians around as a close friend. PA’s and NP’s are stopgap measures, but they aren’t doctors. Someone you know is going to die because of that. You can bet your life on it.

DrJohn has been a health care professional for more than 30 years. In addition to clinical practice he has done extensive research and has published widely with over 70 original articles and abstracts in the peer-reviewed literature. DrJohn is well known in his field and has lectured on every continent except for Antarctica. He has been married to the same wonderful lady for over 30 years and has three kids- two sons, both of whom are attorneys and one daughter on her way into the field of education. DrJohn was brought up with the concept that one can do well if one is prepared to work hard but nothing in life is guaranteed. Except for liberals being foolish.

76 Responses to ““Dad, I have cancer””

  1. 76

    Pete

    @Ronald J. Ward:

    I think you need to re-read what I wrote. Whittaker Chambers was ridiculed as unreliable for calling Algier Hiss a communist spy (until the evidence clearly showed Hiss was a communist spy) – in the same manner you are trying to ridicule Attkisson for calling out the problems of obamacare.

    And your pretension of calm rationalism is rather laughable, RJW, considering how you initiated these exchanges, dodge actual facts in lieu of petty leftist propaganda, and throw out irrelevant strawman arguments. I admit I am rather angry about what obamacare has done, is doing, and will continue to do to the American people while collectivist liars keep denying the clear truth right in front of us. That anger stems from actually caring about patients and not wanting to see them harmed by socialist insanity.

    And to your comrade-in-arms, rewinn, perhaps you may have seen this little gem from the ever lurking worm Ezekiel Emmanuel:

    http://www.nytimes.com/2015/01/09/opinion/skip-your-annual-physical.html?_r=0

    Around 45 million Americans are likely to have a routine physical this year — just as they have for many years running. A poke here, a listen there, a few tubes of blood, maybe an X-ray, a few reassuring words about diet, exercise and not smoking from the doctor, all just to be sure everything is in good working order. Most think of it as the human equivalent of a 15,000-mile checkup and fluid change, which can uncover hidden problems and ensure longer engine life.

    There is only one problem: From a health perspective, the annual physical exam is basically worthless.

    In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.

    The unequivocal conclusion: the appointments are unlikely to be beneficial. Regardless of which screenings and tests were administered, studies of annual health exams dating from 1963 to 1999 show that the annual physicals did not reduce mortality overall or for specific causes of death from cancer or heart disease. And the checkups consume billions, although no one is sure exactly how many billions because of the challenge of measuring the additional screenings and follow-up tests.

    Now RJW, I know you weren’t spewing the idiocy that rewinn was regarding Gruber’s commentary that preventive care doesn’t reduce costs. Due to my patient care duties this morning, I don’t have time to go back and search through the posts here to specifically add to my responses to his comments – so I am simply doing so here.

    So Ol’ Dr. Death, who has previously commented that after age 75 people should stop getting medical care, is now laying the ground work for denial of care by claiming there is no benefit to undergoing annual physicals vis a vis reduction in mortality. Now, anyone who is familiar with Cochrane reviews understands that they are not perfect (i.e. the moronic continued inclusion of the discredited 1980’s “Hi-Fi” study in the Cochrane review on high-frequency neonatal ventilation) and one might question why the studies reviewed are limited to the years 1963-1999, as if there have been no changes to the manner in which annual physicals are performed, but this is exactly the kind of data being pushed by the collectivists to justify denial of care – because they know that is the only way to decrease medical costs under the socialist medical system they want to force upon us.

    And with regard to my previous posts on the goal of obamacare effecting the end of private/employer-provided medical insurance, from ol’ Zeke again:

    http://pnhp.org/blog/2014/04/29/ezekiel-emanuel-reinventing-american-health-care/

    * End of insurance companies as we know them
    Insurance companies will either become purveyors of management analytics, and actuarial services, or integrated delivery systems actually employing (or contracting with) hospitals, physicians, and other providers to render patient care.

    * The emergence of digital medicine and closure of hospitals
    Over 1,000 acute-care hospitals will close. We will see a slew of new technologies for remote monitoring, testing, and treating patients in real time outside of the hospital and physicians’ offices.
    * End of employer-sponsored health insurance
    Fewer than 20% of workers in the private sector will receive traditional employer-sponsored health insurance.

    And the plan to deal with physician shortages from forcing everyone into “free” socialist healthcare? just cut the training and shove more people through, regardless of whether or not they actually know what they are doing.

    * Transformation of medical education
    Medical education will be transformed in 4 fundamental ways: (1) three-year medical schools and shorter residencies; (2) half of medical school clinical training will be outside of hospitals; (3) integration of nurses, pharmacists, social workers with medical students in multi-professional team training; and (4) formal incorporation of population health and management skills in training.

    Think this isn’t an accurate portrayal of the leftist mindset on doing away with private insurance?
    http://www.newrepublic.com/article/116752/ezekiel-emanuel-book-excerpt-end-health-insurance-companies

    The good news is you won’t have insurance companies to kick around much longer. The system is changing. As a result, insurance companies as they are now will be going away. Indeed, they are already evolving. For the next few years insurance companies will both continue to provide services to employers and, increasingly, compete against each other in the health insurance exchanges. In that role they will put together networks of physicians and hospitals and other services and set a premium. But because of health care reform, new actors will force insurance companies to evolve or become extinct.

    The dirty little secret, when slimy vermin like Emmanuel speak (besides the fact that every previous claim they made as to the wonders of obamacare have been demonstrably false) is how they try to make “cookie-cutter”, no-thinking-required medical care sound like a good thing, as if individual humans are completely interchangeable. All for the main goal, which is to reduce costs, not actually take care of the patient.

    They will have standardized, guideline-driven care plans for most major conditions and procedures to increase efficiency. They will have figured out how to harness their electronic medical records to better identify patients who will become sick and how to intervene early as well as how to care for the well-identified chronically ill so as to reduce costs.

    Still think the collapse of the private insurance system isn’t the goal of these socialist bastards? (From the same article)

    In January 2012 Jeffrey Liebman and I predicted in The New York Times the end of health insurance companies by 2020. We might have been a bit optimistic—or provocative. But it is certain they will end.

    The arrogance of these leftists in thinking that they know what is best for you is breathtaking in it’s shamelessness. From other columns by the bastard Emmanuel:

    http://www.nytimes.com/2014/03/06/opinion/in-health-care-choice-is-overrated.html

    http://www.nytimes.com/2013/12/05/opinion/no-there-wont-be-a-doctor-shortage.html

    He, and the ilk of leftist obamacare pushers, have already been caught lying (you can keep your doctor; you can keep your insurance plan; your insurance premium will decrease by $2500/year; abortion won’t be covered; illegal aliens won’t be covered; the mandate is not a tax increase…) and they continue to lie in their effort to destroy the US medical system and replace it with socialist medicine.

    So, yeah, RJW and rewinn, you bet I am angry. I don’t like liars. I despise liars who pretend to care about patients, while trying to force a system down our throats that explicitly will harm patients.

    As I have said before – which you leftists consistently will not acknowledge (much less refute) – if obamacare was going to be so damned good, why was it necessary for Obama, et al, to lie about everything it would do, whether or not it was a tax, and be passed solely on a party line vote via questionable legislative maneuvers (being “deemed” passed via reconciliation)?

    Gruber’s 2009 policy paper clearly shows the intent of the Obama administration to deceive the American people because they knew they could not be honest about obamacare and expect it to pass . Tell us, please, of a single example of blatant deception ever resulting in anything good for the party or parties that have been deceived.

    Obamacare is utterly, contemptibly evil. It is not concerned with improving access to care, nor in improving the quality of medical care to patients. Watering down medical training and destroying private medical insurance makes no sense if your true goal is to improve medical care and access to medical care. It only makes sense if your goal is to force the government takeover of medicine. Obamacare is solely an effort to increase leftist control over the lives of every citizen in the US.

    Now pardon me while I go take care of patients.

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