Mr. Sowell could not be more correct in his assessment of the consequences of great government itrusiion into the lives of doctors. For some reason, Washington thinks that doctors are stupid. Most that I know have long ago made plans for the coming government madated health care system. And it has been coming for 40 years. As for me, I have been practicing for 25 years. When a huge increase in patients with Medicare and Medicaid descend upon me and the government (CMS) cuts reibursement significantly, then I am done. I have two options. Either retire, which looks more and more appealing, or go to a fee for service practice. I have everything in place to make that conversion within several weeks. That would insure no more fights with insurance carriers, mo more waiting months to get paid from Medicare, and no need for at least two employees that deal with insurance issues. All I can say to the Democrats is "bring it on." The mass revolts by people who suddenly have insurance (government) benefits who can find no doctors to care for them will be an awakening call. And we will be repeating the history of all nations that have gone to a socialized form of health care.

I agree with you, Dr. Keane, that Americans will revolt when they will find out that they have to wait a long time for medical care they used to get "on demand." Or worse yet, they won't be able to find a qualified doctor to deliver proper medical care to them. We will be swamped with third world doctors and nurses who will be licensed hurriedly to try to fill the demand, flooding the market with malpractice and substandard care. Most of these doctors are two or three years behind American doctors in their training on western medicine and technology. I am not sure I would like to go see one of them unless it is a life and death situation and I have no choice. Compound that with a severe shortage of basic drugs and you have a recipe for disaster.

A lot of doctors in our area have already stopped accepting Medicare, Medicaid, and Tricare, all government run insurance groups, because of their small and slow re-imbursement rate for patient care. Patients have no choice but to either pay for care out of their own pockets, not go at all to the doctor, or visit the foreign-born, foreign-trained doctors who, in my opinion, deliver, most of the time, sub-standard care in less than sanitary conditions, and delapidated buildings with antiquated equipment.

Dr. Kane;

You stated that you have everything in place to create a fee for service practice. Am I incorrect in thinking that under O-Care such a practice will not be allowed?

Such has been my understanding that patients will basicaly not be allowed to purchase services, even if the can afford them. That is to say that they will be mandated BY LAW to have some form of health insurance.

If you or anyone else can shed some light on this I'd be most appreciative.

My 20 year experience with socialized medical care has been that doctors are not allowed to practice privately. However, some doctors, in order to supplement their meager incomes, would see patients at home at night or on weekends, illegally, under the threat of being discovered and arrested. That is not to say that there are not other types of socialized medicine, such as the U.K., where doctors may be allowed to see patients who are also allowed to purchase private insurance (which is incidentally quite expensive). I am not sure what type BO has in mind, but the type I have experienced, does NOT allow private practice (legally) and doctors' salaries are determined by the government as well as where they have to practice medicine (it may be in a city, the country area, or the slums). No matter what type, it is not a good situation for doctors or patients. The state also runs the ambulance service which usually runs hours behind and has no life-saving equipment on board nor medical personnel, just a driver.

The local government can not stop speeding, and the federal government cannot regulate illegal drug sales very well. What makes you think, Richard, that the federal government could stop "private fee for service" medical practice if only those who pay know the doctors location?

Maybe if we regulated politicians and lawyers instead of doctors we would be better off. BTW, we have too may of them anyway. My daughter graduates vet school May 1 (I brag about her). She could have gone to med school instead, but will be much better off as a vet. No insurance forms or socialized medicine to worry about.

This is one of the dirty little secrets of Obamacare. Telling doctors they must earn less for seeing more patients under stricter mandates can ONLY drive more doctors out of the profession. Mr Sowell describes the situation precisely, as more doctors in a position to retire will do so while more young people thinking of a medical career will choose something with a better chance of success. The result is fewer doctors at a time when "free" government health care jacks the demand up to unprecedented levels.

When have Liberals ever taken the real consequences of their policies into account? They pass well-intentioned mandates, such as Socialized medicine or rent control, and when their effects turn out to be exactly the opposite of their intentions, Liberals don't say "mea culpa, let's enact policies that reflect reality!" Instead they blame a scapegoat, in this case the insurance companies, doctors, free markets, whatever. Obamacare can have only negative consequences and Americans have realized it. That's why most people now oppose the bills.

My doctor told me that if the Health Care Bill is passed, he is retiring and I assume there are many more that feel the same. Currently, I feel sorry for him because every time he prescribes a medicine for my wife, He must take valuable time trying to

justify it with the insurance company and even then only a small amount of compensation is allowed under Medicare guidelines.

Heaven help us if the Health Care Bill goes through.

My doctor is Canadian and he came to the U.S. to get away from the great Canadian system. He doesn't want to see that system repeated here.

Dr. Keane, you might want to talk to Mr. Last's daughter about going into veterinary medicine. There are many advantages for a true professional and much less stress.

Duke

Duke and Dr. Keane, The major difference between human medicine and vet medicine is the variety of patients. Among others my daughter has treated cats, dogs, horses, cows, bulls, sheep goats, pigs, birds as well as exotics, ferrets, elk, deer, and a zebra (he made the network news two weeks ago when he got away from a circus and ran on the interstate around Atlanta). She also did necropsys, besides on the above on prarrie dogs and an elephant. I asked her if she used a chain saw.

If Obamacare passes, I'm going to talk to my cats' vet about treating me, too.