I got an earful this past week in the doctors’ lounge at the PookieMD hospital.  And shockingly, hold on to your seats!, doctors were in agreement about how to reform health care.  My lunch companions included fellow hospitalists, cardiologists and critical care specialists.

They all agreed, to a one, that health care reform must occur.

They all agreed that the following must be part of reform:

  • A single payor system.  Yup, I’m not chowing down with a bunch of socialists, but that’s what they said!  All were disgusted with the waste and bloat that goes along with the multi-payor system we have currently.  The caveat that everyone mentioned was that there should be a way people could buy more “fancy, bells and whistles” health insurance if they wanted it–a two tier system.
  • Physicians pay should NOT be linked to procedures.  (This from the interventional cardiologist!)  Rather, there should be a required number of  patients to be seen, by all physicians, and a pay scale would be linked to years required for specialty.  My lunch pals were divided on whether pay for performance should exist.
  • Physicians should STOP doing procedures on everyone that walks in the door, just because patients want it.  (The pulmonologist and cardiologist brought up performing procedures on 90 year old patients because of family request as an example of this type of waste.)
  • Physicians in the “thinking” specialties (non-procedure based) should be paid more, and most physician salaries should be some where in the $200,000 range, with specialists getting in the high $200,000s.

Topics of debate:

  • “Sin tax”–most of my lunch buddies were in favor of heavy taxes on tobacco and alcohol, but there were some dissenters that felt that this was unfair (?to who?).
  • Taxing the obese–some docs wanted to tax those that were over a certain bmi, while others felt that those that were “horizontally challenged” should pay more for health insurance.  Some extremists at the table wanted a “McDonalds tax.”  Many sited the recent decision by the airlines to require the obese to purchase two seats.
  • How to pay for reform.  Must felt getting rid of the multiple payor system, reducing procedures and taxing those that indulge in unhealthy behavior would pave the way to more dollars.

How do YOU feel?

Lunch in the doctors’ lounge: how we really feel about reform.

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