Is the hippocratic oath dead because of the lack of universal health care?

[FormerRepublican]

I'm not all that old - I'm in my 40s. But I still see the difference between modern health care and the way things used to be. Yes, you can get fancy, expensive procedures done. But when you do, you're in the drive through hospital lane and you'd better have thousands in cash in your hands. IMO, patient care is pretty much extinct.

There was a time when the hippocratic oath meant something. Maybe it's just me, but now it seems like the only thing that matters in medicine is money. If you have the cash, fork it over for medical care that may or may not help you (and they pretty much don't care which one it is).

Is the change due to managed care? The lack of universal heath care? Or just the growing malaise in labor in America?

Personally, I don't like hospitals or doctors anymore, and I would prefer alternative and home treatment as a first resort. This is my personal response to the growing commoditization of medicine. More and more employers are refusing to offer health insurance to their employees, and more and more doctors are refusing to see patients without it. Try to find a doctor willing to see you if you don't have insurance or lots of $$$ - good luck. The spiraling result of this is that more and more Americans are finding ALL medical care completely out of reach.

And the clinics that I remember all over the place from my younger days are now gone. The few that still exist don't accept new patients. That puts the uninsured in quite a bind if they need medical care. Is it any surprise that alternative medicine is a huge and massively growing business?

The downside to this is that standard medicine will inevitably decline. Time is rolling back to the dark days of our forefathers, when women died in childbirth in droves, and children had "teething" listed as the cause of death. America has peaked, and we're seeing her slow decline back into primitive oblivion. What's happening in medicine is a sign of our reverse progress. Our children will live shorter lives than our parents did.

[TallahasseeGrannie]

1. You wrote...

"America has peaked, and we're seeing her slow decline back into primitive oblivion. What's happening in medicine is a sign of our reverse progress. Our children will live shorter lives than our parents did."


PRIMITIVE OBLIVION? You are expecting nuclear winter or something?

Okay, what the heck brought this level of angst to the forefront?

..maybe you are a Seminole fan watching the 'Noles get destroyed by the Gators?

[FormerRepublican]

6. Personal experience. We're headed in the wrong direction for progress.

And the future does not look good for our continuing development.

WRT looming crises that could really turn the clock back to primitive oblivion - a mismanaged flu pandemic with heavy casualties, a mismanaged war that goes out of control and goes global, global warming and economic damage in it's worst case scenario, total government economic collapse in the US due to continuing and growing budget deficits and tax cuts, peak oil with no comercialized alternatives, etc.

Our future is not as secure as we'd like to believe - especially when we do nothing to secure it.

[Midwest_Doc]

2. You are Correct!!

I have been practicing medicine for more than 20 years. I attribute the decline in U.S. health care to its takeover by corporate America.

Specifically:

In a managed care setting the corporate owners of health care (like Bill Frist and HealthSouth) make money by NOT providing care to patients. There are tremendous pressures placed upon practicing physicians by the corporate providers of medicine to provide minimalist care. It's just like any other prepaid service - take the money up front, and give back as little as you can get away with.

[Warpy]

3. The problem is a psychotic corporate paradigm

that insists that illness is always a consumer decision. Hence, their endless blathering about competition and marketplaces, things that are utterly meaningless when you've got a hot appendix. You don't care what hospital you're taken to or which general surgeon walks through the door as long as they get that thing out of you. You didn't choose your illness, and you don't have the time or the inclination to do research on which hospital may be a few bucks cheaper. Trust me on this one, I've been there.

Doctors have gone from independent professionals to mere employees within the past 25 years, and most of them aint real thrilled about it. Instead of running a private practice, they find themselves in group practices or working directly for HMOs, every decision questioned by accountants with no medical training and their income set by the companies, meaning most docs have had to see twice as many patients as they did 25 years ago to maintain the same income.

Insurance companies are in the business of showing a profit, which means they devote billions of dollars each year to develop strategies to deny care and to eliminate unprofitable people from their rolls. This is one of the major things driving the increasing administrative cost of health care. The other is the Byzantine paperwork these guys generate to do so.

This denial of care to increase profit is the main reason to reject the DLC/New Democrat health care initiative, the one that Kerry copied word for word from their site. Leaving the insurance companies in this mix will ony perpetuate the root of the problem. Only when they are eliminated can we start fixing the rest of the system.

[nadinbrzezinski]

4. yuo need to separatre the oath from the corporate structure

doctors still believe in it, but they can't practice the way they might want to... and here is where you and me come in, time to demand single payer, end of discusion. We need to take profit out of health care, period

[newswolf56]

5. The Hippocratic Oath became the hypocritic oath the moment...

doctors became capitalists: making profits -- often obscenely huge profits -- off sickness and suffering turns the oath into a meaningless travesty: Into as many houses as I may enter, I will go for the benefit of the ill -- "the benefit of the ill" surely and by any definition excluding medical bills so huge and greedy they force the patient into bankruptcy.

Moreover, FormerRepublican, your question is superb: one that should be at the forefront of our national debate over the fact we have the most expensive, most viciously discriminatory healthcare system in the industrial world (with the death rates to prove it) -- all because, once again, the business of America is the business of the most savagely tyrannosauric capitalism humanity has ever unleashed.

Thank you so much for raising this question -- especially in such a pointedly telling manner. Thanks again!

[Hippo_Tron]

9. It's not the doctors making the profit

Don't get me wrong, many of them make nice salaries and some of them certainly deserve it, being on call 24/7 and what not. But it's the insurance companies who are making the REAL money from the whole process. The doctors aren't exactly happy about it either. In order to get paid, they have to do exactly what the insurance companies tell them to do.

[newswolf56]

13. Yeah I know -- the doctors are only following orders.

(I have an MD among my distant relatives: he is obscenely wealthy -- an unabashed fascist -- and his children are all trust-fund hard-right activists.)

According to the U.S. Department of Labor, the annual median pay for MDs ranges, depending on specialty, from a low $150,000 to a high of $305,000: "real" (upper-class) income by any standard, or as the Department of labor itself says, "among the highest earnings of any occupation."

USDOL Link:

http://www.bls.gov/oco/ocos074.htm

(Scroll down for income medians.)

[Hippo_Tron]

14. I didn't say that doctors don't make a good salary

But compare that 300k salary to the profits that the insurance companies make and it's like pennies.

[Mojorabbit]

15. I would not paint with such a broad brush

My hubby is a family physician with his own practice and his poorest patients have payed him with a flat of celery from the fields ,collards from the garden, a smoked turkey,sweet potatoes, and even a flat of strawberries. There is an old woman who crochets pot scrubbers and pot holders for her office visits though he would not charge her but she is proud. Some have nothing and are treated for free. Most want to give something in return.
We'd go under if all of them did that but there are still docs out there who do it the old way.

[newswolf56]

16. My most sincere and heartfelt salute to your husband. He is...

the Albert Schweitzer exception to the Bill Frist rule.

So are the MDs who give up millions of private-practice dollars to work for medical co-operatives like the Puget Sound-area's Group Health: the ultimate model for non-profit, single-payer healthcare -- consumer-owned, too, just as taxpayers would own a nationwide version of the same superb system.

(But of course I'm hopelessly biased: been a Group Health member off-and-on -- mostly on -- since 1972.)

[NVMojo]

7. it's been dead since the "for-profit" healthcare corporations started

munching community hospitals nationwide in the 90s.

[Syncronaut Seven]

8. The issue has personal significance to me.

Having once been dragged out of a hospital e-room by security over my refusal to sign their "we'll sue you in a second" paperwork.

Only to be greeted in the parking lot by a sheriff who knew the law. My child was seen that day.

The experience left me with a sense of bitterness and rage that hasn't subsided in the years since.

FYI this was a Catholic hospital who has since been spanked TWICE by the AG for systematically failing to render aid to the poor. Wonder if my letters helped?

:evilgrin:

[leftofthedial]

10. the banks (insurance companies) own the health care system

they don't take any oaths.

health care in this country for 90% SUCKS. We don't get care; we get our costs managed.

I hate what this country is becoming.

[catmother]

11. fortunately i have a doctor who really cares. unfortunately he is

74 years old. he's trying to semi-retire -- he's only seeing his old established patients. i am lucky to be one of them. he practices regular medicine and alternative. actually the way i found him was 15 years ago i was new to phoenix -- i was being treated by a naturapathic doctor, but she didn't do inravenous vitamins. i asked her if she knew of anyone who did and a few days later she called me and gave me his name. i went to see him immediately. (i used to get IV vitamins in new york). he does IV vitamins, chelation therapy, IV hydrogen peroxide and many other alternative things. so i can see him if i have pneumonia or if i just need a boost of energy with IV vitamins. it is also widely known that he will treat people who can't pay. for years he was not part of my insurance -- they did pay after a deductible and 70% instead of 80%. in the meantime i saw a primary care doctor who was a bitch. i would make a 1:00 appointment -- right after her lunch and when i went there would be 3 or 4 other people with the same appointment time. one time while we were waiting i saw her crossing over to another building. i asked the receptionist what was going on and she said "the doctor had to run an errand" -- run a fucking errand she just came back from lunch and people were waiting. i hated her but she was the best i could find. i tried others and waited for hours. anyway about 4 years ago my alternative doctor became part of my insurance and now he's my primary doctor. when his office manager told me i said "thank god i never have to go to that bitch again".

let me tell you about the bitch. she knew how to get the most out of her help. when i moved i told the receptionist. i said "let me give you my new address" she said "call and leave it on the answering machine". the bitch did not take blood, she sent you to a lab. she did nothing to go out of her way to help anyone. she is a DO and does not do spinal manipulation.

well i guess i went off on a rant, didn't I? anyway i strongly believe that we need national health care. my sister lives in canada and she posts here too. she explained to us how it works in canada. the doctors make a good living, they live in nice houses and drive nice cars. no one has to wait for emergency treatment like they want us to believe. if it's not a serious problem there may be a wait. and best of all, my sister and her family never have to worry about losing their house and everything they own due to illness.

so i am all for national health care.

[KT2000]

12. Many players with

conflicting objectives. As just another commodity in the capitalist system, every level of the healthcare industry exists to make a profit. The sick person is the vehicle for all those layers to make money.
That is why illness INCREASES the GNP.
The goals of the payer, insurance companies, is to make a profit, but their goal is achieved by weeding out the sick who would make use of services and limiting services as much as they can.

The whole things does not make sense. The concept of having a healthy population barely enters into the equation, it is only about managing money and forcing the system to the breaking point.

You make the points critical to the health care debate and this is really what we all need to talk about.