Painful Cuts Coming to Pain...Elections Have Consequences

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LMAO why do people care about whether others are getting high or having casual sex? Mind your own damn business and stfu. For being the party of limited government, Republicans sure do like to get up in everyones business.

Not really sure republicans are doing the math on abortion vs 18 years of raising a ward of the state.
Lol. To be fair, here's my original quote:

"I think it's abundantly clear after this election (as if it wasn't wasn't earlier) that voters as a bloc care much more about getting high, having casual sex, and punishing those who by some miracle makes more than them than they do about understanding how our government works, taking responsibility, or planning for the future."

I was just observing what voters seem to be prioritizing.

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ooooooh. good one.

i tear holes in peer-to-peers and probably double your productivity.

if you dont like my politics, thats one thing. but check that at the gate when it comes to medical matters.
Just saw this…“and probably double your productivity” says the socialist 😂 buahahaha
 
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LMAO why do people care about whether others are getting high or having casual sex? Mind your own damn business and stfu. For being the party of limited government, Republicans sure do like to get up in everyones business.

Not really sure republicans are doing the math on abortion vs 18 years of raising a ward of the state.
it is all about culture wars and generating outrage in their base, to encourage them to vote for them, even if it is not in the voter's best interest.
 
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it is all about culture wars and generating outrage in their base, to encourage them to vote for them, even if it is not in the voter's best interest.
the GOP is in a post-policy era.

not interested in nor have the know-how for legislation. just bitching
 
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the GOP is in a post-policy era.

not interested in nor have the know-how for legislation. just bitching
Legislation? I’m pretty sure the GOP isn’t for $5/gas, eggs, or milk. I’m pretty sure they aren’t for open borders with fentanyl flowing through. I’m pretty sure they aren’t for kids learning about LGBTQ in kindergarten and elementary. Try again.
 
Legislation? I’m pretty sure the GOP isn’t for $5/gas, eggs, or milk. I’m pretty sure they aren’t for open borders with fentanyl flowing through. I’m pretty sure they aren’t for kids learning about LGBTQ in kindergarten and elementary. Try again.
how would you know?

where are the bills? where are the laws?

mccarthy doesnt have the chops
 
3rd party please. PLEASE.

Moderates.
Fiscal conservatism.
Strong military.
Close the border.
Open legal immigration
Term limits. 12 years total in DC for any/all elected position.
Abortion until 18 weeks.
Energy independence. Oil for now, money for transition to renewables/infrastructure-20 year plan to get there.
Change tax policy. No taxes for first $100,000. 10% for all else above this. No deductions. No havens. Open to wealth tax on $50M plus crowd.
All of this open for negotiation.
 
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3rd party please. PLEASE.

Moderates.
Fiscal conservatism.
Strong military.
Close the border.
Open legal immigration
Term limits. 12 years total in DC for any/all elected position.
Abortion until 18 weeks.
Energy independence. Oil for now, money for transition to renewables/infrastructure-20 year plan to get there.
Change tax policy. No taxes for first $100,000. 10% for all else above this. No deductions. No havens. Open to wealth tax on $50M plus crowd.
All of this open for negotiation.
Careful or you might get labeled as a Radical Leftist with this platform!
 
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3rd party please. PLEASE.

Moderates.
Fiscal conservatism.
Strong military.
Close the border.
Open legal immigration
Term limits. 12 years total in DC for any/all elected position.
Abortion until 18 weeks.
Energy independence. Oil for now, money for transition to renewables/infrastructure-20 year plan to get there.
Change tax policy. No taxes for first $100,000. 10% for all else above this. No deductions. No havens. Open to wealth tax on $50M plus crowd.
All of this open for negotiation.
hate to say it, but you are a democrat, dude.
 
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You don't know half of it. I've had a few conversations with (Dr.) Steiner Hayward staffers and others, but they just don't get it. Even two of the idea's biggest proponents (physicians and one a physician and former Governor) backed it off.


"Making access to medical care a fundamental right, without effectively addressing equity and opportunity in accessing the social determinants of health, will undermine, rather than enhance the health of our society."


“It’s likely that the Supreme Court would consider that,” Metz said. “I don’t know what they’d decide. The language is clear that a single payer proposal would be in great danger if this were in the Constitution.” Like medicine administered to a patient, the benefits need to outweigh the risks, Metz said, adding that he doesn’t see any benefits with the amendment."

It's like deciding to cap health care costs at 3% when inflation and labor cost is more than twice that. It's crazy. That puts me out of business. Tell me again that there is no "vast left-wing conspiratory?"


"Oregon and Connecticut have already set their health care cost growth targets and are expanding their capacity to collect and analyze health care spending data. Oregon set a target of 3.4 percent for five years in 2020, while Connecticut recently set a target of 3.4 percent for calendar year 2021, 3.2 percent for 2022, and 2.9 percent for 2023 to 2025."

But ideology is a powerfully addictive drug. And hardcore D's and others on the Left (many of whom post here on this forum) will not stop until they can get everyone to stand in line and get prostate exams at the post-office.

Pain physicians should read the handwriting on the wall and remember the words of Pastor MARTIN NIEMÖLLER and his observations of how insidiously ideology seems into human affairs and, eventually, our fundamental rights.

First, they came for the Communists
And I did not speak out
Because I was not a Communist
Then they came for the Socialists
And I did not speak out
Because I was not a Socialist
Then they came for the trade unionists
And I did not speak out
Because I was not a trade unionist
Then they came for the Jews
And I did not speak out
Because I was not a Jew
Then they came for me
And there was no one left

To speak out for me
My god the hyperbole. To compare pay cuts to the events of the Holocaust should make you feel ashamed of yourself on some level. Just stop taking Medicare, it's that easy. They're not rounding you up in doctor camps and forcing you to do injections without pay, oh my god.
 
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The majority of the country are idiots.

The majority of the country thinks the decision overturning Roe was about the merits of abortion, which is was not. It was about what the constitution actually says. Dobbs was a good and accurate decision. Abortion is not a constitutional or substantive right. If the states or the federal government legislatures wish to permit abortion, they have the freedom to do so. If the country thinks abortion should be legal, then it should be legislated.

You obviously feel differently, but getting high and having casual sex are both decisions that show a lack of personal responsibility and foresight, so thus relevant to the discussion in my opinion.

Lol. To be fair, here's my original quote:

"I think it's abundantly clear after this election (as if it wasn't wasn't earlier) that voters as a bloc care much more about getting high, having casual sex, and punishing those who by some miracle makes more than them than they do about understanding how our government works, taking responsibility, or planning for the future."

I was just observing what voters seem to be prioritizing.
I was referring to your post above that I have also quoted. Not sure how having casual sex or getting high show a lack of foresight or personal responsibility, especially when you consider the number of people that smoke and/or consume alcohol. Or are you just referring to psychedelics and marijuana?
3rd party please. PLEASE. YEP

Moderates. YEP
Fiscal conservatism. SURE
Strong military. KIND OF CONFLICTS WITH FISCAL CONSERVATISM
Close the border. IF BORDER CLOSED, HOW LEGAL IMMIGRATION HAPPEN? THIS NO MAKE SENSE
Open legal immigration IS IT CLOSED RIGHT NOW?
Term limits. 12 years total in DC for any/all elected position. YEP
Abortion until 18 weeks. MEH FETUS ISNT VIABLE UNTIL 21 WEEKS BUT SURE.
Energy independence. Oil for now, money for transition to renewables/infrastructure-20 year plan to get there. SURE
Change tax policy. No taxes for first $100,000. 10% for all else above this. No deductions. No havens. Open to wealth tax on $50M plus crowd.
All of this open for negotiation. FLAT TAX ACROSS THE BOARD ON ALL FORMS OF INCOME TO PEOPLE AND CORPORATIONS.
 
I was referring to your post above that I have also quoted. Not sure how having casual sex or getting high show a lack of foresight or personal responsibility, especially when you consider the number of people that smoke and/or consume alcohol. Or are you just referring to psychedelics and marijuana?
See. Good enough. Deal. NOw pass the laws.

For immigration I meant that we need to correct the existing laws to allow more people in who can help our country or are truly seeking asylum.
 
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My god the hyperbole. To compare pay cuts to the events of the Holocaust should make you feel ashamed of yourself on some level. Just stop taking Medicare, it's that easy. They're not rounding you up in doctor camps and forcing you to do injections without pay, oh my god.

 
The NHS, again, is hyperbolic. There is almost no scenario within our working lifetimes that would see a NHS system come into place in the United States. There are dozens of different ways to run systems in Europe and elsewhere in the world, to treat the NHS as the likely outcome of any healthcare change shows a severe lack of knowledge in the area or willful negligence on the part of the author. Even looking at the NHS, it does not force fully-trained physicians to work for it, you can work privately in the UK and accept private insurance or cash only if you so choose. Given that physicians there generally have means yet remain there should tell you that it is not the nightmare you imagine. Anesthesiology and radiology even have reciprocal agreements, yet you don't see them fleeing for our shores. UK applicants for US practice are a rounding error they're so small.

Of course, I would expect nothing less of an insurance industry piece. Their job is to be hyperbolic and make anything but the status quo look like some grimdark hellscape. Everyone here is smart enough to, I would assume, understand all of this. But instead of talking rationally, they're acting like a cut from CMS is the literal introduction of communism to our shores, rather than the Republican-passed cost-containment measure it is. Both MACRA and its SGR predecessor that have led to fights over physician pay cuts for over 20 years were devised by a Republican-controlled House and Senate to reduce Medicare and Medicaid spending by directly cutting payouts.
 
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The NHS, again, is hyperbolic. There is almost no scenario within our working lifetimes that would see a NHS system come into place in the United States. There are dozens of different ways to run systems in Europe and elsewhere in the world, to treat the NHS as the likely outcome of any healthcare change shows a severe lack of knowledge in the area or willful negligence on the part of the author. Even looking at the NHS, it does not force fully-trained physicians to work for it, you can work privately in the UK and accept private insurance or cash only if you so choose. Given that physicians there generally have means yet remain there should tell you that it is not the nightmare you imagine. Anesthesiology and radiology even have reciprocal agreements, yet you don't see them fleeing for our shores. UK applicants for US practice are a rounding error they're so small.

Of course, I would expect nothing less of an insurance industry piece. Their job is to be hyperbolic and make anything but the status quo look like some grimdark hellscape. Everyone here is smart enough to, I would assume, understand all of this. But instead of talking rationally, they're acting like a cut from CMS is the literal introduction of communism to our shores, rather than the Republican-passed cost-containment measure it is. Both MACRA and its SGR predecessor that have led to fights over physician pay cuts for over 20 years were devised by a Republican-controlled House and Senate to reduce Medicare and Medicaid spending by directly cutting payouts.

Don't put your head in the sand and underestimate the incremental death-by-thousands-cuts approach of a "Progressive" agenda. Go back and start at the beginning. This plan has been unfolding for over 70 years...

 
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Don't put your head in the sand and underestimate the incremental death-by-thousands-cuts approach of a "Progressive" agenda. Go back and start at the beginning. This plan has been unfolding for over 70 years...


Drusso, sometimes it’s hard for people to see things clearly (over temporal time) when they are jaded and trying make an immediate argument/point … but yes you are correct about the nebulous healthcare and educational subterfuge by one party . Why not be honest and admit you want socialized healthcare , education , and possibly the economy (becomes communism then)….
 
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Don't put your head in the sand and underestimate the incremental death-by-thousands-cuts approach of a "Progressive" agenda. Go back and start at the beginning. This plan has been unfolding for over 70 years...


You realize the current reason for the state of Medicare funding literally is Reagan and the GOP, right? Starve the beast, SGR, and MACRA was all them
 
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The reason Democrat supermajorities didn't increase Medicare funding is... Reagan?
They've never had a supermajority large enough to allow for a Medicare tax increase, because that's the only way finding could increase. Hell, even the ACA required an enormous amount of compromise to get through the door and that was during a time when they could hurdle the filibuster without issue.

As to who ruined things, well, when was the Golden Era of medicine and who was in power?
Screenshot_20221120-083124_Samsung Internet.jpg

When did things start to get ugly? When Reaganites started demanding cuts to government services and taxes. Both of the systems that have led to you having lower pay over the last 20+ years were designed by Republicans and passed by Republican majorities to contain how much the government spends on you. Not that Democrats have any of us in mind either- they serve nursing unions and hospital systems. But to pretend it's some big conspiracy solely on the part of Democrats to socialize medicine in this country is nonsense. Republicans are the reason your salaries are being cut and Democrats are the reason private practice is dying due to administrative nonsense added by the ACA that were designed to serve hospital systems. One party is trying to take your money, the other your autonomy. Stop thinking either of them have your best interests in mind.

It is always amusing for me to see conservatives complain that the government isn't giving them a big enough payment though. Stop taking payments from the government, problem solved. If more physicians would stand up for themselves, rather than act like passive victims to the system, maybe things would change. Stick to private insurance or cash pay, problem solved. If enough people do it the government will eventually blink.
 
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They've never had a supermajority large enough to allow for a Medicare tax increase, because that's the only way finding could increase. Hell, even the ACA required an enormous amount of compromise to get through the door and that was during a time when they could hurdle the filibuster without issue.

As to who ruined things, well, when was the Golden Era of medicine and who was in power?
View attachment 362276
When did things start to get ugly? When Reaganites started demanding cuts to government services and taxes. Both of the systems that have led to you having lower pay over the last 20+ years were designed by Republicans and passed by Republican majorities to contain how much the government spends on you. Not that Democrats have any of us in mind either- they serve nursing unions and hospital systems. But to pretend it's some big conspiracy solely on the part of Democrats to socialize medicine in this country is nonsense. Republicans are the reason your salaries are being cut and Democrats are the reason private practice is dying due to administrative nonsense added by the ACA that were designed to serve hospital systems. One party is trying to take your money, the other your autonomy. Stop thinking either of them have your best interests in mind.

It is always amusing for me to see conservatives complain that the government isn't giving them a big enough payment though. Stop taking payments from the government, problem solved. If more physicians would stand up for themselves, rather than act like passive victims to the system, maybe things would change. Stick to private insurance or cash pay, problem solved. If enough people do it the government will eventually blink.

You still don't get that it is a design problem. The D's designed the payment schemes to favor reimbursement in institutional settings like the HOPD and not independently-owned businesses. They like this scheme because it is easier for them to control.
 
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They've never had a supermajority large enough to allow for a Medicare tax increase, because that's the only way finding could increase. Hell, even the ACA required an enormous amount of compromise to get through the door and that was during a time when they could hurdle the filibuster without issue.

As to who ruined things, well, when was the Golden Era of medicine and who was in power?
View attachment 362276
When did things start to get ugly? When Reaganites started demanding cuts to government services and taxes. Both of the systems that have led to you having lower pay over the last 20+ years were designed by Republicans and passed by Republican majorities to contain how much the government spends on you. Not that Democrats have any of us in mind either- they serve nursing unions and hospital systems. But to pretend it's some big conspiracy solely on the part of Democrats to socialize medicine in this country is nonsense. Republicans are the reason your salaries are being cut and Democrats are the reason private practice is dying due to administrative nonsense added by the ACA that were designed to serve hospital systems. One party is trying to take your money, the other your autonomy. Stop thinking either of them have your best interests in mind.

It is always amusing for me to see conservatives complain that the government isn't giving them a big enough payment though. Stop taking payments from the government, problem solved. If more physicians would stand up for themselves, rather than act like passive victims to the system, maybe things would change. Stick to private insurance or cash pay, problem solved. If enough people do it the government will eventually blink.
I’m confused ... history is forgotten.
The majority of us (small business owners) converted to S corporations to avoid the extra 3 % Medicare tax increase caused by the ACA and dems. Consult your account …
 
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I’m confused ... history is forgotten.
The majority of us (small business owners) converted to S corporations to avoid the extra 3 % Medicare tax increase caused by the ACA and dems. Consult your account …
I mean a broad tax increase. Yes Medicare taxes went up for a small minority of filers, but there is not the political will to do a flat 2%+ across the board for all taxpayers that would be required to maintain payouts without leading to substantial government deficits.
You still don't get that it is a design problem. The D's designed the payment schemes to favor reimbursement in institutional settings like the HOPD and not independently-owned businesses. They like this scheme because it is easier for them to control.
Again, this was done to appease hospitals, not to control physicians. Hospitals don't like competition, and in an age of increasing consolidation they saw their only path to growth being the swallowing of various physician groups. This isn't communism, it's corporate greed trying to make us cogs in the machine that make money for CEOs instead of ourselves
 
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“Elections have consequences”?? Total non-sequitur.
We all agree this trend is turning medicine into a bureaucratic mess run by nurses and MBAs, but the liberal/conservative divide has little to nothing to do with it. That graph goes all the way back to 2000, roughly equal numbers of years under Democratic and Republican administrations, and as you can clearly see, physician compensation is a nearly flat line all the way across.

Flat line means it’s not keeping up with inflation
 
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I don't know how working people can afford to raise a family with the cost of parasitic healthcare and education scams.
 
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this talk seems to suggest you are open to healthcare for all, and education for all....
Him Disagreeing with dishonest brokers and doctors/hospitals that purposely lie and deceive to extract money from patients is a far cry from supporting bloated, inefficient government state health care.
 
The average NHS physician only works 3 days a week?
Motivation: No matter how great your medical skills, you earn scale. Excellence earns no extra pay.

This is what differentiates academics/VA/Kaiser from a private practice mindset.
 
private practice is not motivated by excellence.

private practice is motivated by money.

its easy to decieve yourself from either side of the coin.


self-driven desire for excellence is what motivates excellence.
 
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this talk seems to suggest you are open to healthcare for all, and education for all....
I've already made detailed proposals for healthcare. It can be delivered by states but it can't be allowed to piggy back on and destroy the private healthcare market. Unfortunately, that's what has happened.

Education is already virtually free and generally accessible within 6 feet of every American in the form of a cell phone. What's not free is self discipline lessons and day care. The solution has nothing to do with giving tax payer money to corrupt universities with multi billion dollar endowments and progressive agendas.
 
private practice is not motivated by excellence.

private practice is motivated by money.

its easy to decieve yourself from either side of the coin.


self-driven desire for excellence is what motivates excellence.
self driven excellence is done WELL BEFORE private practice....it starts by getting good grades and investing in yourself to go through and fund college and medical school, followed by internship and residency and fellowship.
 
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private practice is not motivated by excellence.

private practice is motivated by money.

its easy to decieve yourself from either side of the coin.


self-driven desire for excellence is what motivates excellence.

You sound like someone who has never signed the front of a paycheck. Private practice is all about Excellence every day.
 
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private practice is not motivated by excellence.

private practice is motivated by money.

its easy to decieve yourself from either side of the coin.


self-driven desire for excellence is what motivates excellence.
Who said private practice is motivated by excellence? I didn’t.

I said excellence earns extra pay.

And you said private practice is motivated by money.

So, seems like you kind of agree with me.
 
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