Opinion Forum

Doctors On Strike?

November 5th, 2009

In an article in Investor’s Business Daily, 45% of doctors said in a national survey that they’d consider quitting under Obama’s health care plan. This translates to roughly 360,000 doctors out of 800,000. Seventy-two percent of doctors said that they disagree with the claim that Obama’s plan can cover 47 million more people (the supposed number of uninsured) with better care at lower cost, and 65% of physicians said that they oppose Obama’s plan.

All of this flies in the face of the claims of the Obama Administration, which states that both the AMA and a majority of the doctors in the country support the plan. And while it is true that Obama’s plan does have the AMA’s support, it is also worth noting that not only does the AMA represent a mere 18% of physicians, it has also been hit with a fair number of defects over the health care overhaul.

Some might think that this is ridiculous; that other countries have had socialized systems for decades and their doctors have never complained. However, for anyone willing to do a little digging, it soon becomes apparent that not only are foreign doctors not happy with their countries’ cavalier treatment of their skills, but they’ve been voting on these plans with their feet for decades. A quick survey:

The British NHS system has been subsisting on imported doctors since the 1960s, mostly from Pakistan, India, South Africa, and Australia. A third of their primary care trusts are flying in GPs from countries like Lithuania, Poland, Hungary, Italy, Germany and Switzerland to do evening and weekend work because of a shortage of British doctors willing to work those hours.
Despite graduating a surplus of doctors, only 7 out of 12 medical students in Germany actually complete their training, and the country suffers a doctor shortage due to a stagnating, corrupt medical bureaucracy that facilitates a brain drain in the directions of the UK, Ireland, Greece, France, and especially the United States.
Japan has such a severe shortage of doctors that some hospitals are forced to turn away even emergency cases. Where these patients go after being rejected is unknown. Doctors are often required to work 36 hour-long shifts, going until they are literally falling asleep on their feet, and ambulances are often forced to call multiple hospitals before finally finding one that has room for their patient.
Canada has one of the lowest physicians-per-capita ratios in the developed world, and in one particularly vicious case, a town that was forced to hold a “doctor lottery” in order to assign patients to a physician. The system loses doctors to the US in droves, with one out of nine graduating physicians eventually coming to practice south of the border. It’s waiting lines are also infamous, to the point where Chief Justice Beverly McLachlin, when ruling in favor of the legality of a private health care clinic in Quebec, stated in her decision that “Access to a waiting list is not access to health care.”
Ireland, France, Norway, Sweden, Australia are chronically short of doctors.
Denmark, despite its protestations that their national plan is wonderful, is also short of doctors. It is also worth noting that Danish doctors were forced to unionize on a national level and strike for three straight months in order to win their current cushy conditions.

Clearly, foreign doctors simply love their socialized plans. Incidentally, I would like to point out that each country mentioned above is also on the list of those repopulating at below replacement level. This means that the medical situations in each of them will be growing increasingly acute in the next few decades as their populations age and begin to require larger amounts of care, but the number of doctors and amount of funds present in the system begin to dwindle.

Now, just in case there’s still anyone reading this who’s thinking, “Who cares what doctors think of the plan, I have a right to health care,” well let’s just say that you’d better start caring. In the words of Dr. Thomas Hendricks from Ayn Rand’s Atlas Shrugged:

I quit when medicine was placed under State control, some years ago. Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun. I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything — except the desires of the doctors. Men considered only the ‘welfare’ of the patients, with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter, was regarded as irrelevant selfishness; his is not to choose, they said, only ‘to serve.’ That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards — never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind — yet what is it that they expect to depend on,when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well, that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospitals wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it — and still less safe, if he is the sort who doesn’t.

You do not have a right to health care in the name of your physical well-being, any more than a doctor has the right to force you to become his patient in the name of his economic well-being. Attempt to present your supposed claim anyway, and while it may take a decade or two you will eventually end up being told precisely where you can stick it. Doctors and other health care providers are not your milch cows, and this country would do well to remember it.

Articles written by Brianna Aubin
Tags: doctors, health care, socialized medicine, uninsured
Categories: Economics, News, Politics | Comments (10) | Home

10 Responses to “Doctors On Strike?”

sweetromance2 | November 5th, 2009 at 7:45 am

This is just one of many ways that lead to healthcare rationing.

justmy2_cents | November 5th, 2009 at 7:49 am

I remember when Beck stated this on his show. And it’s misleading at best. Politifact.com has more info here: http://www.politifact.com/truth-o-meter/statements/2009/oct/15/glenn-beck/beck-says-45-percent-physicians-would-quit-if-heal/

Clarissa | November 5th, 2009 at 8:28 am

“Canada has one of the lowest physicians-per-capita ratios in the developed world, and in one particularly vicious case, a town that was forced to hold a “doctor lottery” in order to assign patients to a physician. The system loses doctors to the US in droves, with one out of nine graduating physicians eventually coming to practice south of the border. It’s waiting lines are also infamous”

-I’m sorry, but as a Canadian I can tell you that this is simply not true. Medical care in Canada is swift, high quality and absolutely free. Only a millionaire in the US can afford the level of care that anybody gets in Canada.

And there is no healthcare rationing in Canada. While in the US of course there is. It’s sad that the American people allow themselves to be so brainwashed about other countries. Read a newspaper from Europe, get into a car and travel to Canada. But don’t construct your vision of the world on the silly myths fed to you by Fox News.

Brianna | November 5th, 2009 at 11:43 am

Clarissa – For a country where medical care is swift, high and free you certainly seem to have a lot of news articles that speak of long waiting lines, doctor shortages, and people crossing the border for MRI’s. Did you actually *read* the article I linked to where these things were stated? I’m not making this stuff up, you know.

justmy2_cents – the same goes for you; I’m not getting this from Glenn Beck, I’m getting this from the article(s) I linked to. Incidentally, do you deny any of the facts I pointed out about socialized health care in other countries?

Also, for *anyone* who doubts my claims I am happy to send you a list of the articles I have been reading about socialized health care in various countries. All you have to do is email me, provide me with your email, and I am happy to send you all the data I have. The list is somewhere between 50 and 100 articles long though, drawn from everything from Fox to CNN to BBC to blogs to NPR, so expect the perusal to take a while.

Brianna | November 5th, 2009 at 12:41 pm

justmy2_cents – on your link:

*Whatever Glenn Beck might have said, I did not misrepresent the information in the article (which btw, I quoted from THE ARTICLE ITSELF, not Fox). I stated “consider quitting”, not “would quit”; this point in your link therefore does not apply to me

*”‘If Congress passes their health care plan, will you … continue your practice, [or] consider leaving your practice or taking an early retirement?’ This wording leaves open the possibility that respondents are saying they might simply leave their current practice to join another practice, rather than quit.” – I disagree witht the article; I think this question makes it pretty clear that they are asking if you would consider leaving your practice, not if you would consider leaving it to join another

*If the Investors poll got 1,376 responses out of 25,600, and the New England Journal got a response rate that “exceeded 43%” out of 5,157 questionnaries, that means that the NEJ got 2,579 responses and the IBJ got a 5.3% response rate. So yes, the NEJ got 8 times the response rate, but when you compare the absolute number of doctors who answered each survey you realize that this number is extremely misleading. I also note that the IBD mailed out five times the number of questionnaires than the New England Journal did, which implies that whatever the response rates were, the IBD was probably making more effort to get an unbiased viewpoint than the NEJ was.

*The assertion that people with liberal leanings might not have answered the IBD survey because it was from a conservative publication is not only pure conjecture, but I personally think that it is bunk. If I had been a liberal-leaning doctor, I would probably have been more likely to answer the survey, not less, because I would have welcomed the chance to air my views and possibly foil the expectations of a publication that would prefer a response more in keeping with its ideological leanings. I would also like to point out that financial publications in general tend to be the least biased and most objective in their pursuit of facts; there’s a reason the WSJ is one of the only newspapers in the country right now that is not suffering a decline in readership.

*The article complains about the wording of the survey, for example: “Do you believe the government can cover 47 million more people and it will cost less money and the quality of care will be better?”. Well, since that was the exact same wording I used when I pointed out that 72% of doctors said no to this question, I again do not see what it has to do with my article. Incidentally, all of these questions have to be worded *somehow*. How would you do it, if you think the IBD survey did a bad job of it.

*If the IBD is a conservative-looking publication, then it is also worth noting that the poll in the NEJ was supported by a liberal-leaning institution. The very article you linked to admits that “It’s worth noting that the Keyhani-Federman poll received financial support from the Robert Wood Johnson Foundation, which favors health care reform. Also, National Public Radio has said that ‘Keyhani and Federman belong to … the National Physicians Alliance. It supports a public option, and Keyhani has spoken publicly about her own support for a public option.’ A campaign finance database search found that both researchers donated to the Obama campaign in 2008 — $500 from Keyhani and $300 from Federman.” For some strange reason though, the article doesn’t dissect the NEJ poll the same way it does the IBD poll. I don’t know about you, but that fact certainly raises a few red flags for me.

In short: your article does a fair amount of grasping at straws, the misleading statements and statistics, as well as the blatant conjectures made in the article tarnish it in my eyes. It also admits that the NEJ poll could easily be equally biased. So at the very least, I think the IBD data is about par with the NEJ data, which in the end would prove nothing about either side, but personally I am going to go on trusting the IBD data.

Tom | November 5th, 2009 at 4:11 pm

Good article, Brianna! Very well researched and sourced (nothing from Glenn Beck, of course).

Almost all liberals believe that the socialized medicine systems of Canada, the UK, and other European countries are better than the U.S. system. Meanwhile, almost all conservatives believe the opposite. I’ve read and listened to as much of the arguments as I can on both sides, and what I hear most often are anecdotes that have no real value in the discussion and statistics that are cherry-picked to support one side or the other.

On this one, I think the conservatives have the better case. It particularly irritates me to read liberals who quote stats, often from the UN, that say the U.S. is worse in this-or-that particular area of health care than other countries. In most cases, digging into the details — how was the data collected, are apples being compared to oranges, are large and complex systems being compared to much smaller and less complex systems, are all variables being accounted for — shows a very different reality.

The most fundamental point is that Americans are not Brits or Canadians. As much as we respect them and as similar as we are, we will never accept a health care system that looks like, walks like, and quacks like socialized medicine. If our Canadian and British cousins like their systems, warts and all, good for them. The majority of Americans would prefer to keep our system, warts and all, with improvements where we can make them.

Brianna | November 5th, 2009 at 5:23 pm

Tom – thank you.

Everybody who is in any doubt, I urge you to please, send me your email so I can send you the research I have done. It is rather disorganized, but it is all documented and the sources have been drawn from across the board (mostly through google searches). My email is public knowledge on this forum; I would be happy to oblige anyone who asks.

Brian Bagent | November 5th, 2009 at 5:46 pm

Here’s one nurse that will quit. I absolutely will not, under any circumstance, work under such a system, even under penalty of law. I would rather go to prison because in prison, at least I would not have to live under the pretense that I am free, nor would I have to be bored by the platitudes of those less than what I am, telling me how wonderful it is to “serve.” I swear, by my life and my love of it, that I will never live for the sake of another man, nor ask another man to live for mine.

My older sister is a pediatrician, and she’s already at wit’s end for all of the medicaid crap. Her husband is a pulmonologist, and he’s ready to jump ship, too.

Some background on what it takes to be a doctor. My sister graduated valedictorian of her high school class of about 600. She graduated with high honors with a bachelor’s degree in zoology. She graduated with about a 94 average from medical school. Her residency program was 3 years, and according to her, was 10 times more difficult than medical school.

My brother-in-law graduated high school near the top of his class. He, too, graduated college with high honors in civil engineering. His 3 year residency was in internal medicine (he was the chief resident in his 3rd year), after which he was selected for a 2 year fellowship to study pulmonology.

In high school, when most people were watching TV or talking on the phone or going to parties, they were studying. In college, which most people do not even bother to attend, they were studying on Friday night and Saturday when everyone else was playing intramural sports or out drinking with their frat bros or sorority sisters. While in medical school, when their friends were getting jobs and starting families, they were studying. While residents, when their friends were getting promoted and busy living their lives, they were studying. Do you detect a pattern here?

It does not take an IQ of 180 to be a doctor. What it does take is a strong commitment to learning, to working hard. Nobody – not me, not Obama, not even “the masses” – has a right to compel a doctor (or nurse, or anyone else, for that matter) to do anything.

When my sister has call at the hospital, if an indigent case comes up, she is required to take it, and to provide free follow-up care for as long as it takes to recover the child back to the highest state of health that can be achieved.

And who is it that writes these laws? Well, lawyers, of course. However, I am not aware of any such law that requires lawyers to provide that sort of service for non-paying clients.

Health care is about quality of life. But if you think about it, so is eating, and a great many other things as well. Must you eat hamburger, or can you afford steaks as often as you like? Do you drive what you want to drive, or what you can afford to drive? If you live where I do, do you set your thermostat on 78 or 80 in the summer, or do you turn it down and don’t worry about the electric bill? Do you vacation at a relative’s house, or do you travel to Europe or South America?

I know, I can hear it…but…but…but…health care is diiiiferent. No, it is not. You may wish with all of your might that it were, but it is still a service provided by people with extensive education and commitment to making people’s lives better. But in that, the doctor is no different than a cattle rancher. The cattleman is committed to having people buy steaks off of his steers. Eating steak makes most people feel better, too. Most of us would feel better if we drove a new Mercedes or Lexus rather than a 10 year old minivan. Most of us would feel better if we got our feet wet in the Mediterranean on some Greek or Italian island rather than just looking at brochure pictures of those islands.

My brother-in-law and sister just got back from Dublin, where he ran a marathon. Why? Because he could. Because he made choices at 15, at 20, at 25, at 30 that I did not make, that most of us did not make.

If you do not like your current circumstance, then change it. No one has a right to FORCE anyone else to change theirs. If universal health care is what you seek, then you are ~~asking~~ demanding that another person live for your sake. It is the role of master and slave, for which there is no place in civilized society.

I part with this thought: the most powerful force for “social justice” is freedom. You are free to make good choices or poor, to fail or succeed, and to live with the consequences of such decisions. “The ultimate result of shielding men from the effects of folly, is to fill the world with fools.”

Kevin | November 8th, 2009 at 6:55 pm

I also note that the IBD mailed out five times the number of questionnaires than the New England Journal did, which implies that whatever the response rates were, the IBD was probably making more effort to get an unbiased viewpoint than the NEJ was.

Regardless of your opinion of the IBD’s intentions, the germane fact remains that they had far fewer responses. One needn’t be a trained statistician to understand that the relative value of a survey’s findings aren’t in how many surveys were sent out but rather in how many were filled out and sent back. Otherwise a survey which sent out 10,000 questionaires and received back only 10 would have more relevant conclussions than a survey which sent out 1000 questionaires and got all 1000 of them back.

More to the point of this post, the NEJ survey’s findings appear to indirectly debunk the IBJ’s claim of 45% would quit.

IBJ: 65% of 1,376 doctors opposed the “government’s proposed health care plan”.

NEJ: 63% of 2,579 doctors favored giving patients a choice between public and private insurance. Another 10% favored single-payer, which is to the left of what Congress has been working on.

Virtually polar opposite findings.

BUT… one is based on nearly twice as many doctors as the other.

Simple math: 63% + another 10% = 73%

The remainder of which is, of course, only 27% who (presumably) oppose the government being involved in health care insurance.

ASS-U-ming that every single one of those 27% doubters would consider quitting if they don’t get their way… leaves us with…

Survey A’s 27% of 2,579 doctors might consider quitting.

versus

Survey B’s 45% of 1,376 doctors definitely would consider quitting.

I think it perfectly reasonable and perfectly rational to be DEEPLY skeptical of your quoted stats based on the available information.

Brianna | November 8th, 2009 at 8:07 pm

This is the link to the Keyhani and Federman poll. Some highlights:

In the poll, it states that 63% of doctors favor a private/public mix and 10% favor a public option, whereas only 27% favor a private option only. Here is how these options are defined by the poll:

1. Public and Private Options: Provide people under
age 65 the choice of enrolling in a new public health
insurance plan (like Medicare) or in private plans.
2. Private Options Only: Provide people with tax credits
or low income subsidies to buy private insurance
coverage (without creating a public plan option).
3. Public Option Only: Eliminate private insurance and
cover everyone in a single public plan like Medicare.

In short, when they ask doctors what they prefer, they are not asking the doctors whether or not the government should be involved in health care, but how the government should be involved. It also makes no specific mention to Obamacare at all, which makes comparing this question to IBD’s specifc question on Obamacare like comparing apples and oranges. Asking people whether they would support some kind of public option coexisting with private ones is a lot different than asking someone if they support a specific bill going through the legislature.

On an unrelated note, when the survey compares private insurance to traditional medicare, not only does private insurance rank better overall by a wide margin (46% of the doctors surveyed had an overall better experience with private insurance, as opposed to 22% with medicare, the rest were “same” or “no opinion”), but in no category of this particular portion of the survey does medicare compare favorably with private insurance. It ranks equally in the categories of “autonomy of decision making” and “ease in obtaining services”, but that’s it.

Finally, as for the response rates, the IBD survey was conducted between Aug. 28, 2009, and Sept. 15, 2009. The NEJ survey was conducted between June 25, 2009 and Sept. 4, 2009. Doubtless if the IBD had waited another 2 months to publish their findings, they would have had more responses too. OTOH, there would have been much less point to publishing the survey if the health care bill had already been passed.