Free Markets, Free People

pessimism


Young physicians pessimistic about US health care system under ObamaCare

We already have a physician shortage in this country.  And with the passage of ObamaCare, it is likely to get worse.  

According to a survey, young physicians (below the age of 40) are pessimistic about the future due to the increased “involvement of government” that ObamaCare promises.

An overview of young physicians in the survey revealed:

- The typical younger physician in this survey is 37 years of age and is an employee of a medical group; with the largest single segment being employees of small groups (6 or fewer physicians):  58% are employees of medical groups, and almost half of those (48%) are with the smaller groups.  In contrast, 26% are with mid-sized groups (with 7 to 12 physicians), and 26%
are with larger groups (13-plus physicians).

- These physicians are markedly pessimistic regarding the future of the U.S. healthcare system, with the “new healthcare legislation” ranking as a strong #1 reason for the pessimism.  Many voice considerable cynicism with (what several call) “government’ involvement.”

- Financial-related considerations play a key role in the choice of practice/ arrangement.  Most cite “income/cash flow” and “employment security” as factors influencing their current arrangement.  And among the 27% who changed (or considered changing) their practice/arrangement in the past year, the leading reason given related to “financial issues.”

- The vast majority express satisfaction with their current practice /arrangement (with 35% saying they are “highly satisfied,” and another 45% saying they are “somewhat satisfied”); and most expect to stay with the current practice/ arrangement for 8 years or more.  Many (39%) aspire to some form of ownership position in the future (as either sole owner or partner).

There’s a reason for the marked pessimism.  They’ve already had to deal with government involvement at the level it now exists and their experience with doing so gives them no confidence that further involvement will lead to any sort of improvement.  Quite the contrary they apparently feel it will lead to a degradation in the quality of medicine practiced and an increase in the bureaucratic meddling they’ll have to endure.

Note the satisfaction index with the current system (80% highly or somewhat satisfied).  And note also the fact that many aspire to some form of ownership position in the future.  I’d put forth a guess that the 39% so aspiring see such a dream as threatened by further government involvement.

As to their pessimism about ObamaCare, the survey says:

These young physicians exhibit considerable pessimism regarding the future of the U.S. healthcare system:

-  When it comes to the Affordable Care Act, 49% believe the impact on their practice will be negative, vs. only 23% who believe it will be positive.  Among the three practice-types, the Primary Care physicians exhibited somewhat less pessimism vs. the other two segments:  They were a bit more likely to be “positive” or “neutral,” a bit less likely to be negative. 

-  And well over half (57%) are pessimistic about the future of the U.S. healthcare system (with over 30% saying they’re “highly pessimistic”).  In contrast, only 4% are “highly optimistic,” and 18% who are “somewhat optimistic”.  When asked (open-ended) reasons for their pessimism, responses covered a wide spectrum of negatives – with the “new healthcare legislation” leading the way.  Indeed, as one peruses the responses to the question, the cynicism voiced by so many – with most of it directed at “government” – stands out.

Of course it does.  And some of their specific comments tell you why:

“Government controlled healthcare will be the downfall.  Anyone who has worked in government environment such as VA would know this – ask any vet who receives their care through VA how good the system is!”

“The current administration is only concerned with money and maintaining their power and socialism.”

“Government regulation has too many strings attached.  (It) has not been well thought out.  (It) will bankrupt the country.  (We are) pushing toward socialist medicine.”

“I do not feel optimistic because of all the increased regulatory burdens on physicians.  There will be an increased shortage of physicians to provide primary care and decreased access to care.”

“The very reasons why people come to the U.S. to obtain care (research, quality, availability, cutting edge, good physicians, etc) is being taken away one at a time.  The changes that are being made are not made with the patient in mind, but with the ‘bottom line’ economically in mind.  Not once is the patient mentioned in all these changes.”

“I think the government is destroying healthcare.”

If you read the survey, you’ll find that even the more “optimistic” comments certainly are only relatively optimistic in comparison to the above.

The comment about the reasons people come to the US is the most telling of the group.  It pretty well describes what critics of the law have been saying since its passage.  You can’t have the best medical care available if the focus is cutting cost.  It’s a lie.  And pretending that you can do both is the biggest lie of all.  That’s precisely the snake oil sales job that has been used to justify the law.  But poll after poll has said the American people have rejected the sales job. 

It should also be clear that most young physicians have as well.  They are not optimistic about the future of US health care.

And if they’re not optimistic, why in the world should patients who will suffer through it hold any optimism either?

~McQ

Twitter: @McQandO


Does the economy doom Obama’s re-election hopes?

I’m beginning to wonder if the Republicans can run just about anyone for President (note the qualifier – “just about” – not everyone, even among the declared candidates) and win given this economy and this president:

Americans’ disapproval of how President Barack Obama is handling the economy and its growing budget deficit has reached new highs amid broad frustration over the slow pace of economic recovery, according to a Washington Post-ABC New poll released on Tuesday.

The ratings boost Obama received after the killing of Osama bin Laden has dissipated with his job approval rating back to 47 percent. Forty-nine percent disapprove of his performance.

Obama’s approval rating bounced to 56 immediately after bin Laden was killed last month.

But it went back to a plurality very quickly.  On the key issue, however, it hasn’t returned to a particular percentage – it’s gotten worse.  Much worse:

Fifty-nine percent, a new high, gave Obama negative marks for his handling of the economy, up from 55 percent a month earlier.

Obama’s approval rating on the deficit issue hit a new low of 33 percent, down 6 points since April.

Anyone who doesn’t understand that is where the election will be decided hasn’t been paying attention to politics very long.  Bill Clinton knew it when he rode to victory on his “It’s the economy, stupid”.   Ronald Reagan knew it when he continually asked, “are you better off now than you were 4 years ago”?   And Barack Obama would probably kill to have the economic problems Jimmy Carter faced – not that he’d do any better than Carter.

The point is, in bad economic times, incumbents have a tough road ahead of them at election time.  That’s because economic issues, joblessness, insecurity and fear are felt and understood by everyone.   Pocketbook issues are personal issues.   And the public has always voted those issues in general elections – much to the disadvantage of incumbent politicians, especially presidents.  There’s a number going around out there which claims that no president  since FDR has been re-elected with unemployment over 7.2% .  Of course keep in mind only a some of them since then have run for re-election and not all of them had bad unemployment numbers at the time.   The point, however, is that this sort of issue is critical to re-election chances.

The survey reflects a broadly pessimistic public mood as high gasoline prices, sliding home values and high unemployment numbers raised concerns about the pace of the U.S. economic recovery, The Washington Post said.

Eighty-nine percent of Americans say the economy is in bad shape; 57 percent say the recovery has not started and 66 percent said the United States was seriously on the wrong track.

Forty-five percent said they trust congressional Republicans over Obama to handle the economy, up 11 points since March.

If much of what is listed in the first paragraph isn’t improving fairly dramatically when 2012 arrives, Obama is in for a long year and, just guessing here, an “upset” loss.  The shine has worn off.  The cache of electing a black president has run its course.  History has been made.  And now the results part of the show come to bear.   Having been a moment in history won’t save Obama if the economy still sucks as badly as it does now.

My dad used to always tell us boys, “you live between your ears”, meaning attitude was critical to how you approached life and overcame obstacles.  Attitude is also critical in economies.  Pessimism isn’t the predominant mood one wants within the citizenry when they’re hoping to see it turn around.   And it certainly isn’t the mood a president wants through out the lane when he’s running for re-election.

Yeah, this is going to be an interesting year and a half until election day 2012.  I’m betting it’s not better economically and, again depending on who the GOP eventually nominates, Republicans stand to win the election.  Or, and you heard it here first with all the caveats – it is most likely the Republican’s election to lose.

Of course, knowing them, I have little doubt they can manage to do that.

~McQ

Twitter: @McQandO


Dear GOP – don’t get too froggy thinking you’re the “solution”

Because most Americans don’t share your evaluation of yourself.  In fact, because of the dismal performance of the Democrats, you’re only slightly more “acceptable” than they are:

Americans are growing more pessimistic about the economy and the war in Afghanistan, and are losing faith that Democrats have better solutions than Republicans, according to a new Wall Street Journal/NBC News poll.

Underpinning the gloom: Nearly two-thirds of Americans believe the economy has yet to hit bottom, a sharply higher percentage than the 53% who felt that way in January.

The sour national mood appears all-encompassing and is dragging down ratings for the GOP too, suggesting voters above all are disenchanted with the political establishment in Washington.

In fact, just 24% have positive feelings about the GOP, which according to the WSJ, is a new low in the 21 year history of the poll.  In fact, the only reason you’re under any sort of consideration at all is because we’re stuck with a two-party system –something you and the Democrats have been careful to manage – and you’re the only other choice.

If you’re thinking “mandate” in November, I’d change my thinking.  I think it may be better described as “your last chance” … or maybe your “next to last chance”, the last chance coming on the heels of the 2012 presidential elections.

"The Republicans don’t have a message as to why people should vote for them, but it’s pretty clear why you shouldn’t vote for the Democrats," said poll respondent Tim Krsak, 33, a lawyer from Indianapolis and independent who has been unemployed since January. "So by default, you have to vote for the other guy."

Great reason to vote, isn’t it?

You guys better buy a clue (and if you do, use your own money).

~McQ

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