The fate of our medical system in the future lies in the hands of medical students being trained today. Unfortunately, there is cause for alarm when examining the training and medical ethics of our current batch of medical students.

The evidence for this concern comes from many sources I have written about in the past.     (See Woke Medical Education, Woke Medical Education Update, Woke Medical Education Update 2024.) These posts mostly concerned training and speculated on the impact of such training. But now we have a real-life example of how this trend is influencing our world today.

Dr. Travis J. Morrell is an Ob-Gyn physician practicing in Grand Junction, Colorado. In an Op-ed entitled Ideology in Medical School Threatens Everyone’s Health, he tells us what happened in his state when he tried to protect children from radical transgender ideology. Here is his story: “Beware the rising generation of physicians. In June, an army of medical students defeated my attempt to protect children from radical transgender ideology. My fellow physicians in the Colorado Medical Society overwhelmingly stood with me in defense of basic medical ethics and evidence, yet students from Colorado’s premier medical school overruled us. Americans should worry that when today’s trainees become tomorrow’s doctors, they’ll put political activism ahead of patient health.”

Dr. Morrell filed a resolution with the Colorado Medical Society in March which was intended to protect children from transgender medical interventions that can ruin healthy sexual function and damage reproductive ability, potentially leading to a lifetime of physical and mental ailments. He built his resolution around the Colorado Medical Society’s existing policy on female genital mutilation. Passed in 1998 and reaffirmed in 2014, that policy opposes the practice, which is also a federal crime. Yet transgender surgeries often involve mutilation, which activists deem medically necessary. Earlier treatments, such as puberty blockers and cross-sex hormones, are typically prescribed in preparation for mutilating surgeries on teenagers.

Dr, Morrel tells us what happened: “Under Colorado Medical Society rules, my resolution came before the general membership in mid-May. My fellow physicians were given four weeks to vote, and within days passage looked likely. After more than three weeks, more than 60% of participating physicians supported the resolution. But by June 12—the day before voting ended—the tide had dramatically turned, thanks to a sudden influx of votes by medical students.

At first, I didn’t understand why so many medical students chimed in, but a website called the Publica has since reported that Frank Merritt, an assistant professor at the University of Colorado School of Medicine, emailed the student body shortly before the vote ended. “I don’t usually use this position for things like this,” Dr. Merritt’s email began. He then asked the medical students to vote against my resolution. He told the students that all of them are “automatically members of the Colorado Medical Society, though I imagine most of you have not registered accounts.” He provided instructions for registering and implored them to act fast as voting was closing soon.

The army of medical students swung into action. More than 150 voted against my resolution, with the final vote being about 75% opposed. Six medical students voted in favor—an act of bravery considering their names were made visible to other society members, including fellow students, during the voting process. Following the vote, on June 14, the Colorado Medical Society’s board formally rejected my resolution. It’s possible the board would have made the same move had the resolution passed, but it would have been much harder to justify.”

This real-world example of the impact of woke medical education has frightening ramifications for our country’s medical future. Combine this with the increasing call for socialized medicine like Medicare for All and our medical future is indeed alarming.

 

This blog is not intended as a political commentary. But it is intended as a healthcare information site and one that will inform you on healthcare issues being debated by our politicians.

Now that it appears Vice President Kamala Harris is the intended nominee of the Democratic Party for President, her views on healthcare should be known. Harris is a supporter of Senator Bernie Sanders’ views on socialized medicine. When Sanders promoted changes in our healthcare system he called Medicare for All, Harris supported his bill in the Senate. She has called for the elimination of private health insurance in favor of a socialized system where government controls all healthcare. What would that mean?

When Senator Sanders promoted Medicare for All, in 2018, I wrote a two-part series on the subject. Since this subject is sure to be discussed in the election campaign soon, In Part I of this series I re-published Understanding Medicare for All – Part I. Today I am re-publishing Part II.

Understanding Medicare For All – Part II

Robert S. Roberts, M.D.

9/10/18

Today we continue an explanation of the proposed legislation of socialist Senator Bernie Sanders entitled Medicare For All. Healthcare economist John C. Goodman gives us ten fundamentals you need to understand about Medicare and what it means if it were the only healthcare system available to everyone, as Senator Sanders promotes. Last post we looked at the first seven and today we pick up again with number eight.

8. The real cost of Medicare includes hidden costs imposed on doctors and taxpayers.

In number seven, we learned that Medicare For All would be costly. Charles Blahous of the Mercatus Center has estimated the cost at $32.6 Trillion over the first ten years – and probably more thereafter. Blahous also estimates that the administrative cost of private insurance is 13%, more than twice the 6% it costs to administer Medicare.

Single-payer advocates often use this administrative cost comparison to argue that universal Medicare would reduce healthcare costs. But this estimate ignores the hidden costs Medicare shifts to the providers of care, doctors and hospitals, including the enormous amount of paperwork required in order to get paid.

The Obama administration forced doctors and hospitals to implement electronic medical record system – a costly change that appears to have failed to deliver promised increases in quality or reduction in costs or medical errors. In fact, it has made it easier for doctors to “up code” and bill the government for more money. Also to be considered are the costs of collecting more taxes to fund Medicare. Some estimates put these costs as high as 25 cents on every dollar.

A Milliman  & Robertson study estimates that when all these costs are included, Medicare and Medicaid spend two-thirds more on administration than private insurance spends. Using the most conservative estimate of the social cost of collecting taxes, economist Benjamin Zycher calculates that the excess burden of a universal Medicare program would be twice as high as the administrative costs of universal private coverage.

9. Not a single problem in ObamaCare would go away under Medicare For All.

All of the difficult questions posed by ObamaCare would remain. Who would pay what? Would the premiums be actuarially fair? Would there be subsidies? Would the premiums vary by age? By health status? By income level? By health living choices?

How would employers be affected? Economists tell us that employee benefits are substitutes for wages and are therefore “paid for” by the employees. Under Medicare For All, would employers get off scot free?

Would there be an exchange? There is one now for Medicare – that’s how people enroll in Medicare Advantage plans. Like the ObamaCare exchanges, the Medicare Advantage exchange has subsidies for private insurance, mandated benefits, annual open enrollment and no discrimination based on health status.

The ObamaCare exchanges, by contrast, have been a disaster. Premiums and deductibles are skyrocketing, there are higher charges for chronic patients who need specialty drugs, and plans exclude more and more of the best doctors and hospitals. Expect more of the same with Medicare For All.

10. Medicare is already on a path to healthcare rationing.

Medicare is already in trouble. It is already on an unsustainable path with future promises made that far exceed expected revenues. When the Affordable Care Act (ObamaCare) was passed in 2010, the Medicare Trustees estimated the unfunded liability at $89 Trillion! Yet at the next trustees’ report that figure had dropped to $37 Trillion. How could that happen?

Passage of the ACA theoretically put the government’s healthcare spending on a budget. Goodman says that for the past 40 years, per capita healthcare spending has been growing at twice the rate of growth of real per capita income. At that rate it won’t take long to run out of money.

The Obama administration tried to “solve” this problem by creating an enforcement mechanism to control spending It was called the Independent Payment Advisory Board (IPAB). It was to be tasked with reducing fees for doctors and hospitals to cap spending. This unelected and unaccountable board would be able to restrict what treatments your doctor could provide with the stroke of a pen! Fortunately, IPAB was abolished this year in a bipartisan budget deal.

Goodman says expect Medicare fees to providers to continue to fall behind private sector fees in the future. This means one of two things must happen:

• Providers will respond to lower fees by providing less care to seniors
• Providers will shift costs to non-seniors in the form of higher fees, higher insurance premiums and higher state and local taxes.

The first of these options means Medicare will become more like Medicaid. Doctors will restrict access by offering fewer appointment options for Medicare patients just like they currently do for Medicaid patients. Hospitals may respond by reverting to the use of open wards instead of providing private rooms. Expensive treatments will be unavailable as cost-reducing takes precedence over patient care.

Medicare For All is socialized medicine and similar healthcare systems in other parts of the world, including Canada, Great Britain and Sweden always are plagued by restricted access and declining quality of care. Expect the same in this country.

 

This blog is not intended as a political commentary. But it is intended as a healthcare information site and one that will inform you on healthcare issues being debated by our politicians.

Now that it appears Vice President Kamala Harris is the intended nominee of the Democratic Party for President, her views on healthcare should be known. Harris is a supporter of Senator Bernie Sanders’ views on socialized medicine. When Sanders promoted changes in our healthcare system he called Medicare for All, Harris supported his bill in the Senate. She has called for the elimination of private health insurance in favor of a socialized system where government controls all healthcare. What would that mean?

When Senator Sanders promoted Medicare for All, in 2018, I wrote a two-part series on the subject. Since this subject is sure to be discussed in the election campaign soon, I am re-publishing that two-part series here:

Understanding Medicare For All – Part I

Robert S. Roberts, M.D.

9/10/18

It is the duty of every American voter to be educated on the issues. As we rapidly approach another election day in November, many Democratic candidates are touting “Medicare For All” as a solution to our failing healthcare system.

Vermont Senator and avowed socialist Bernie Sanders introduced his version of healthcare reform in 2016 when he campaigned for the presidency touting a new single-payer system he calls Medicare For All. Other Democratic candidates have jumped on Bernie’s bandwagon as a growing number of mostly young Americans favor socialism over capitalism.

Today I begin a series of posts to help readers understand what Medicare For All really means to the healthcare of Americans. To assist me in this analysis I will be relying on the excellent work of healthcare economist John C. Goodman.

Ten Things You Need to Know

Goodman gives us ten fundamentals you need to understand about Medicare and what it mean if it were the only healthcare system available to everyone, as Senator Sanders promotes.

1. Medicare is not really government insurance.

Although Medicare is mostly funded by taxpayers, it is not strictly a government system. It was formed originally by providing a standard benefit package offered by Blue Cross in 1965. It has always been privately administered, mostly by Blue Cross, that continues to provide private insurance to non-seniors. In recent years, one third of all seniors are enrolled in plans offered by private insurers such as Cigna, Humana, and United Healthcare under a cooperative program called Medicare Advantage.

2. The most successful part of Medicare is run by private insurance.

This refers to the above-mentioned Medicare Advantage program. Studies have found this program delivers higher quality care at less cost than traditional Medicare. (Choice of doctors, however, is more limited.)

3. Medicare is often the last insurer to adopt innovations that work.

Medicare started prescription drug coverage only after all the private insurers had been doing that for years. It still doesn’t pay for doctor consultations by phone, email, or Skype. It won’t pay for house calls at night or on weekends, even though the cost and the wait times are far below those of emergency rooms.

4. Medicare has wasted enormous sums on innovations that don’t work.

Medicare has spent billions on pilot programs and demonstration projects trying to find ways of lowering costs and raising the quality of care. Yet instead of finding places in the healthcare system where these techniques work (private Medicare Advantage plans), Medicare set out instead to reinvent the wheel. Medicare frequently has regulations that are counter-intuitive and wasteful, such as requiring patients to be hospitalized before they can receive home physical therapy.

5. Most seniors in conventional Medicare are participating in stealth privatization, even though they are unaware of it.

There are over 32.7 million patients enrolled in a managed care program called Accountable Care Organizations (ACOs). The Obama administration started this practice without telling seniors they were participating in a grand experiment. Not only that, but it is illegal for an ACO to tell a senior they are enrolled! Furthermore, ACOs are not achieving their intended purpose – they are neither saving money nor are they improving the quality of care.

6. There is nothing Medicare can do that employers and private insurers can’t do.

For many years the Physicians for a National Health Program argued that a single-payer health insurer would be a single buyer in the market for physicians’ services. They reasoned this would give the government the power to bargain down the fees paid to physicians. Reality, however, is that Medicare doesn’t bargain with anyone. They simply put out a price for services and doctors can either accept or reject it. Private insurers have been doing the same thing for years. This is currently bringing doctor fees down in the ObamaCare exchange market – which is why the best doctors and hospitals avoid these plans.

7. Medicare For all would be costly.

There is no such thing as a free lunch. This is one of the first lessons of adulthood. Even Bernie Sanders admits this, but only when pressed. A study by Charles Blahous of the Mercatus Center has estimated the cost at $32.6 Trillion over the first ten years. This would necessitate a minimum of a 25% payroll tax – but only if it is assume doctors and hospitals provide the same amount of care they provide today. Since Medicare rates are 40% or more below private rates, a realistic assumption is that doctors and hospitals would increase the amount of care to make up the difference. This would then require at least a 30% payroll tax.

(This post will be continued next time.)