9.08.2015

Letter to my peers on unionizing

(I will kindly *not* include myself in this)

Doctors are stupid, because they have allowed this to happen.

Still living in an era of the rich, private practice mentality...not accepting the fact that most physicians today are employees in one way or another. And instead of turning up their noses to unionizing, perhaps they should realize that they are now more like the average worker. They've allowed the nursing union to be the be the sole legislative voice on healthcare policy, to their detriment, and to the detriment of their patients.

As the nursing union shouts "patient advocacy," they are trying to implement healthcare policy that actually hurts the poorest, sickest, neediest members of our society (I'll elaborate as needed). The whole while, the AMA/CMA (made up of mostly people who are completely out of touch with young physicians) asks for money, but does nothing to help their cause. Time after time, taking "no position" on matters that make a huge difference with regard to modern physician's issues. Case in point - the Governor's proposed tax on doctors and hospitals. The doctor's are getting fucked, and there is no unified voice advocating on their behalf. Therefore, patients are getting fucked, and healthcare is a complete mess. And where are the doctors? Where is their voice. What solutions are *they* offering?

Doctors need to change their thinking, hold the medical societies accountable, (or refuse to join), participate in the legislative process, and drop the arrogance against unionizing. Or we can all prepare for complete chaos as healthcare continues to fall apart, without a legitimate beacon of leadership. As the doctors bury their heads in their arrogant asses, allow everyone else to take control, and then wonder why they are (directly) paying for a shitty healthcare system, run by nurses/chiropractors/optometrists/herbalists/and the 'people at the healthfood store.'

Get a clue.

5 comments:

Anonymous said...

IN NZ we have junior doc's union called they RDA (resident doctor;s association) - they have negotiated us a multi-employee contract agreement ('MECA') which limits hours, enforces rules re cover, days off etc; we still get abused by management, but we have a big stick to beat them with if things are getting out of hand - our union guys (and girls) are a pretty militant bunch, god bless them. basically junior doc's have realized that they can weild a significant amount of power - especially collectively; Our MECA servs to protect both doc's and patients - why not something similar for the US?

ERnursey said...

You must live in California with the 'governator'. Personally I think we should tax the entertainment industry to cover healthcare. Sorry, but really what does a ballplayer contribute to society that means he has to make several million dollars a year? and what about the likes of Paris Hilton etc? All the money they spend partying and dressing themselves could support a small nation.

ERnursey said...

Sorry, forgot the rest....The ER doctors in this state already provide millions of dollars in free care, why the hell should they be taxed 2% of their income?

Daniel said...

Actually, I bet Arnie was trying to get *more* money for the doctors, via medicaid (sorry, medical out there in California.)

Here's how it works. Medicaid, the largest insurer in the U.S., is a joint state-federal program founded at the same time as Medicare to provide public assistance to extremely low income people, the blind, the disabled, and now pregnant ladies and young children.

Funding works like this--depending on per-capita income, the fed provides a percentage of the funds, from a minimum of 50% to a maximum of 83%. I'm not sure of California's percentage, my google fu is not strong enough. But it's usually higher than 50%. The important part--it's a percentage, so as the total amount increases, the fed chips in more than the states.

Since state governments are constitutionally forbidden from going into debt, when California is out of money, there's no way to increase funding to MediCal. So, in the late 80's, in a kind of dubious double-entry-bookkeeping kind of way, 350 hospitals decided to donate money to the state for use in MediCal, with the understanding that when federal dollars came in, the resulting (higher) amount would be allotted to them.

Now this is just speculation, but I'm thinking Arnie is doing the same kind of deal, only I'm not sure that the same previous deal applies, but it follows the same pattern only now it's out in the open.

To summarize, doctors are taxed 2% by the state. This money is then spent on Medical. Since the overall pie has increased by increased Medical spending, the fed matches the increase, and goes a little farther, too. The idea being that Medical will get MORE money from the federal gov't than the doctors' tax brought into state coffers, thus increasing Medical funding, which then increases physician salaries, resulting in more tax revenues for Medical, etc.

Holes in the analysis--I don't know if the proposed tax revenues from doctors goes into Medical. I don't know if proposal incorporates increased physician salaries. I don't know if the federal gov't has closed this loophole.

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