Monday, September 23, 2013

Pile of shit care.

I first saw this comparison at the Bookworm Room blog and it is the most accurate description of Obamacare. When you hear the words: "You have to pass it, before we can find out what's in it", that is not a bill. It may be a stool sample, it may be a kidney stone, it may be something you cough out or urinate into a medical container.  It is not a law fit for a constitutional republic.

Awakening and Nightmares.

Those within the conservative blogosphere have written countless posts about Obamacare being a stepping stone to total government takeover of our health care. Canada has such a system where you cannot see your doctor outside of a government office. Those who can afford to pay for care, go to see doctors and get timely medical care within the United States.

I have a friend who is a psychiatrist in NYC and we have had discussions on government health care. She is a liberal, and proudly explained her support of Obamacare because - people have a right to medical care and our country has a responsibility to care for all those residing within its borders.  How to pay for something like this didn't concern her because from her perspective, she imagined herself and her elderly mother going to see any internist they wanted and not be concerned with payment.

She has a very different perspective on psychiatry, especially her practice. In NYC, most private psychiatrists do not accept any insurance, and people in need, pay them in cash. Overhead price for a psychiatric office is low as you only need 2 chairs and a desk, and typical charge is over 300 dollars for 45 minutes - that's a psychiatric hour. Hey, these folks are crazy after all.

It's fascinating to see a psychiatrist explain how it is therapeutic for patients to balance their bills, having to decide between paying their psychiatric bill and having to seek out a roommate because they cannot afford their rent.  It should not be surprising that a large portion of psychiatric patients are on medicaid and other forms of government assistance. These folks see psychiatrists and pay for their services in cash, but need lots of help from the rest of us to afford such service.

A very reasonable question might be: why don't psychiatrists just bill medicaid so that their patients aren't forced to chose between an hour of therapy and paying rent? The answer from most psychiatrists will be that in order for a patient to get the most benefit out of that therapy, they must commit to it in a real financial and physical way.  The answer from most others is - when a psychiatrist signs up with an insurance network, that psychiatrist must accept the rates paid by that insurance company. With medicaid, the money isn't worth the time investment.

So, my obamacare supporting friend wasn't bothered by the prospect of my having to accept government rates and because you see, I am the sort of doctor who should sacrifice for the sake of their patients because having your diabetes, pneumonia, and angina treated is a right. COPD she's not sure about, because she doesn't care for smokers much.

But now, a new aspect of the health care law is threatening her well being.  Now, medicaid is going to refuse to pay for medications, when these medications are prescribed by out of network doctors.  Psychiatric medications are expensive and while patients might have come to terms to pay for their hour of chit-chat, they will not accept paying for their medications out of pocket too.  Psychiatrist also know, that without the ability to prescribe medications, they are no more effective than a counselor.  At the same time, they cannot afford to accept medicaid rates.

She stands posed to lose over half her patient base and consequently may be forced to lose the business she has built up over the years. She didn't see it coming, because such things are never discussed among liberals.

The obvious reason for this legal maneuver is to push everyone into one government run health care group. Perhaps some psychiatrists will now wake up and no longer support this nightmare. On the other hand, perhaps they will stay asleep and teach themselves to cope with this nightmare instead; they are immersed in a world of crazy.  How else can you explain liberalism?

Tuesday, September 17, 2013

False Claims about Navy Yard Shooter.

Information is starting to trickle in about this latest mass murderer. Yesterday I've read multiple claims, including claims by his parents, about him having PTSD after working at Ground Zero during the days after 9/11/2001. That claim is false.  I know this because I took part in the initial search and rescue effort.

Here is the timeline that can and should have been verified by any reporter working for a major firm. Immediately after the planes hit, lower Manhattan was cleared of the residents and the area was off limits to people who had no clear reason to be there. Armed men and women patrolled then streets and you needed to be associated with either NYPD, Fire Department, or part of the medical team to get in. Some contractors did come into the area, to be part of the cleanup crew working at Ground Zero, but that didn't happen until Bush visited the area on 9/14/11.

The claim about participation days after the attack is what convinced me this this was a lie.  During the initial several days, it was too hot for firefighters to approach the area. They had to stay back several blocks.  The emergency triage area, was moved back nearly 5 blocks from "the pile" during the first several days.  Is it possible he was somehow able to sneak in? Yes, but very doubtful. In 2001, I worked at a hospital in lower Manhattan and had to show my badge to numerous cops, and go through multiple check points to get to the area.

Since 9/11, I've met many many people who claim to have health issues related to WTC attack and a large majority of those claims are made by people who have problems and they found it useful to tag their problems on that event because most people will sympathize with them. Most of these claims are false.

I suspect this man has a long history of anger issues and impulse control problems, and sometime along the way he started claiming that his psychiatric problems are related to 9/11. This was a convenient thing to do and it no doubt helped him out of problematic situations due to the sympathy such claim generates.

It is puzzling why his father would put out this false narrative at this time.  Sometime over the next several weeks, this story will be shown to be false and then people will ask his father why he lied.  Eventually we will find out about all the times he should have been institutionalized and how many folks gave him a pass. This was a long road paved by irresponsible helpers.

Monday, September 9, 2013

Revisiting Orwell and why it feels like 1936.

Daniel Greenfield has an excellent post today on our current plan to war with Syria.  His post compares an old essay by Orwell titled "Shooting an Elephant" and Obama's approach to Syria. Personally, I believe he is too kind to Obama in this post, and I wouldn't be surprised at all if Obama suddenly declared himself to be a full member of the Muslim Brotherhood, but the comparison to Orwell's essay is brilliant.  Do yourself a favor and read both.

Foolish Western foreign policy was documented by Orwell in that insightful essay over 80 years ago, during Fall of 1936. Less than 5 years later, World War 2 began. It sure feels like we're now on the threshold of another world war.