A conversation with an ObamaCare supporter — by guestblogger Deanna

Recently, while at work, I listened to a physician discuss why Americans should support Obama’s health care plan. I sat quietly for a while as she assured everyone that there has never been any attempt to compare the results of various health care systems around the world (that is not true) and then declared repeatedly that the concerns being brought up by those on the right are simply part of a “mythology.”

At this point, I decided to ask her some questions. The conversation went something like this:

Me: “Well, many people are wondering why President Obama’s health care reform has to be pushed through in three weeks. Why can’t we take time to discuss this?”

Doctor: “It’s impossible to discuss the health care reform with any sort of intelligence because these people (those who disagree with Obama’s plan) don’t allow conversation.”

Me: “Many people ARE interested in discussing this but Obama and Congress are insisting that the bill be passed right now. What is the rush?”

Doctor: “Look. There isn’t even an actual plan yet so there really isn’t anything for them to be upset about. And all of these people who are showing up at these meetings and screaming that they don’t want government to pay for health care are the same ones who are on Medicare and Social Security. Seriously, it doesn’t matter whether we do this in three weeks or five years.”

Me (absolutely dumbfounded. If she freely acknowledges there isn’t really a plan yet on something as monumental as health care reform, then why is she comfortable with Obama and Congress trying to push it through without delay? I pressed on.): “Well, that is another issue. Medicare makes Social Security look solvent. We can’t even afford just these two programs. Why are we not first discussing getting Medicare and Social Security in better financial shape before we start yet another very expensive program?”

Doctor (obviously frustrated and slightly disgusted): “Well, what we really need to do is discuss stopping these two stupid wars so we can pay for health care. Lots of countries use their wealth to pay for health care.”

Me: “Yes, other countries do pay for health care but these countries haven’t had to engage in the “guns versus butter” debate in quite some time because we have been taking care of their defense needs. When was the last time Germany had to fund its own defense?”

Doctor (glaring): “This conversation is over.”

She stood up and walked away. So much for promoting “intelligent” conversation and allowing room for discussion!

Five minutes pass. The doctor returns.

Doctor: “Look. I didn’t mean to cut off our conversation. But it was apparent that we had come to an impasse.”

Me: “No – it’s fine. I also am interested in achieving health care reform. But I guess that I’m just puzzled as to why this has to be done right this minute. I think many of these Americans are just worried about the speed at which this is happening and the prohibitive costs.”

Doctor (again, clearly frustrated): “Well why are these people so concerned about rushing to get health care reform and the cost when they weren’t worried about rushing into two very expensive wars?”

Me: “Congress authorized both of those wars after considerable deliberation.”

Doctor: Silence. And a look of complete incomprehension.

She then walked away for the second time. The conversation was truly over.

I think it was good for me to have this interaction with this woman. Until then, I guess I had held onto the belief that Conservatives and leftists or statists could sit down and rationally discuss issues. Call me naïve but in the back of my mind, I thought discussion was possible, or hoped it was possible.

But to so many leftists, logic is optional. I’m not suggesting that political opinions and logic are one and the same – they are not. But how can anyone believe that we should proceed with something as important and game-changing as taxpayer funded health care in the space of one month? It simply makes no sense. How can anyone believe that we can afford yet another multi-trillion dollar program when it is simply a FACT that we aren’t able to pay for existing programs like Medicare and Social Security?

I admit that I have been somewhat troubled at the tenor of the town hall meetings that have been taking place around the country. I am not a fan of screaming and in-your-face arguing (even though Obama encouraged his supporters to do just that during the election! Funny how things change . . .).

But if leftists cannot even look at the evidence, the black and white realities that are fundamental to the issue of health care reform, how can we hope to discuss even the mid-level details of the program, not to mention the nuts and bolts of how it will all work?

Ace of Spades recently had a blog post about Dr. Krauthammer’s concern about the behavior of some people at the town hall meetings. Andy McCarthy of the NRO responded to Dr. Krauthammer, writing that criminal mob behavior can never be endorsed but this is not a “nice, ivory tower, Oxford debate.” He writes, “Making clear to a pol who is trying to insult your intelligence that you don’t appreciate . . . is entirely appropriate . . . We’re not talking trivia here. We’re talking about what kind of country we’re going to be from here on out. That’s something worth getting whipped up about. If we’re not whipped up, we lose. If we are whipped up and the Democrats try to use that fact as an excuse to ram this through, then they were going to ram it through anyway.” (See “Krauthammer vs. McCarthy on Pure Angry Venting At Town Halls”, August 11, 2009 at http://ace.mu.nu/)

The very nature of our country and freedom will change forever if this thing passes. Unfortunately, too many people on the other side are convinced that they must manage our health and wealth for us because we are too ignorant to know what is for our own good. I now realize that it would be foolish for us to hope that calm debate and discussion will save the day. These people mean business and it is clear that they do not let politeness, respect or even reason stand in the way of getting (or taking) what they want. I still believe that we must always attempt to be principled and honorable in our interactions with others. But if we hesitate to be passionate about our beliefs, if we are reluctant to voice our concerns in a clear and unapologetic manner, we are going to lose to a group of people who will ensure that there will only be one opinion that will ever matter: the government’s.

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  • Danny Lemieux

    Hi Deana…that was brilliantly insightful. You gave us so much with which to work. Your physician is a case in point that intelligence and stupidity are not mutually exclusive. Your discussion may have had quite a different impact on other people in the room. Have you gotten any response from the other people in the meeting? They are the ones that count.

    Your strategy in this discussion was absolutely perfect…you painted her into a corner from which there was no extrication. A side note: does this physician have any idea of how much her income will drop under ObamaCare?

    If I could make a small suggestion: you say “But to so many leftists, logic is optional.” Perhaps that should be “But to so many leftists…logic is illogical”.

    I am not at all averse to the in-your-face tactics of these meetings. As we Bookworm aficionados know all to well and as you pointed out in your post, Liberal/Lefties don’t understand reasoned logical discussion. The tenor of the townhall and Tea Party protests addresses the Liberal/Lefties in the only language they know…”feelings”!

  • http://ymarsakar.wordpress.com/ Ymarsakar

    They’ve done this before with such things as Social Security and the welfare debilitation of black middle class families in LBJ’s Age.

    Now in the Age of Obama, they are using these foundations, which already permanently changed the country, to produce even more permanent changes. Without amendments, without compromise, and without disaggregation of power in the federal government.

    They created a SS program, Social Security, which taxed people’s lives and put it in a fund, which the Democrats then raided to pay for other Leftist power grabs, which ended up creating Medicare and other programs, which also extract taxes from individuals into a fund, which is also raided to pay for more Democrat re-elections and bills.

    You see how this works? It’s like a Rube Goldberg machine, except it’s not particularly complicated. It’s more like a Perpetual Motion Machine, one that just grinds down energy into the basic disordered pattern of a Heat Death Universe.

    This one will work, because it doesn’t need to output more resources than it takes in. It just needs to take in stuff and spew out waste.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    Propaganda about Iraq and Afghanistan now buttresses people’s beliefs about healthcare. The systemic programming of a human individual isn’t just based upon talking points. It actually changes the way people think, by controlling the filters, memories, feelings, and even thoughts of individuals dealing with the stimuli of their external perceptions.

    It’s not precisely brainwashing, of course. This doesn’t strip a person’s free will away. It doesn’t insert an artificial personality matrix over another. It’s not even stoking up beliefs where there doesn’t exist beliefs. It’s more like telling people what they’d like to believe. Things that easily helps them figure things out, at least from their perspective.

    Once a person falls prey to this dynamic, the psyche starts building a chain where every link is reinforced by your previous experiences, emotions, and beliefs. Every chain, linked to the one before. Every belief, linked to a personal experience.

    It becomes invested with psychic energy, emotion, and formed into part of your integral identity.

    Thus to admit wrongness on one point is to risk the destruction of the entire chain of pearls. People would then be forced to confront the specter that their entire world view might collapse: but more so that it deserves to collapse.

    Only a strong and shocking psychological blow, to the very survival of the body or mind, would be enough to motivate somebody to conduct the necessary introspection to pierce the veils of illusion. Absent that, there can be gradual de-programming of emotions and prejudices. The first is dangerous, since a person can easily solidify their fervor rather than to question their beliefs. The second is more subtle, but also longer ranged and isn’t particularly useful against a strong self-deceptive streak.

    Me: “Congress authorized both of those wars after considerable deliberation.”

    While Afghanistan was immediately launched, as quickly as possible, Iraq took quite a long time. It’s why Bush was so closely connected to WMDs in people’s minds. Because the UN route took time. Years. The invasion happened in March 2003. September 11 was in 2001, and Afghanistan occurred shortly afterwards and OEF ended shortly afterwards. That’s more than a year.

    Obama hasn’t even been in power for a year, yet.

    People need to have their heads screwed on straight, and if they don’t, Obama may lobotomize them to the Social Consciousness soon enough for their own good.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    One of the better propaganda terms to use when describing health rationing to ordinary people is the word ‘downsizing’.

    An even more powerful word than that is ‘outsourcing’.

    Outsource people’s medical care and decisions from the individual, the family, and the doctors with medical degrees to the bureaucrats, the DMV mavens, the politicians, and the social workers.

    Rational debate allows people to come up with their own ideas that connect two different data points together. People connect the dots by focusing in on the data, how they know the data, and how that data, given its validity, connects to other data, forming what epistemology calls knowledge.

    Propaganda does something similar. It allows people to make connections, but not because they decided to. But because the propagandist decided to encourage these connections through external stimuli, aka propaganda operations.

    And propaganda operations involves, in part, using emotional language such as outsourcing in order to smash one person’s life experiences to the current political climate. It manipulates their reactions on a current plan by stoking up their past experiences or prejudices. You don’t have to ‘create’ hate or anger. You just stoke it up on another source and then re-direct it. It is fairly simple, so long as you know people’s triggers.

    The Democrats have not come to their current destination through rationality or ‘thought’. They’re tools, the base pyramid part at least, not sovereign individuals and moral actors. Their moral responsibility is aggregated amongst their group, their clan, their political party. They aren’t guilty, by their own claims, because Republicans are the problem or politicians are the problem or government inefficiency is the problem.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    By the way, many people don’t like ‘ in your face’ because of the social disturbance. MOst people are not very comfortable in confrontations. American society and culture have trained them to prefer peace and order. Not, perhaps, as well as Germans, but better than Arabic culture, at least. Arabs will threaten to stab you in the back in an alley way sometime in the future, as part of their bluster, and they see no problem of cowardice on this aspect.

    I understand that and sympathize with it. As someone who grew up in predominantly black metropolitan or suburban neighborhoods, I myself personally do not prefer their cultural templates when it comes to confrontations or inter-personal relationships. They are too confrontational, too quick to attribute causes to prejudice or superstitions. Whites, in comparison, were more orderly and less prone to prejudice against my race. Blacks often told me that Asians are smarter than whites, as if the genetics of skin color decided intelligence. If that was true, that would prove historical white claims about dumb arsed black slaves that couldn’t ‘talk straight’.

    But take it from me, these crowds aren’t dangerous. They aren’t prone to mob like behavior. There is no charismatic figure stoking them up, as may be the case with Democrat terrorists or Arabic Islamists.

    It’s feasible that they can be stoked up to anti-social levels, but anti-social is like the lightspeed limit. 1 is perfectly social and 5 is murder and mass executions. The anti-social fights you normally see are on the 5 end part, but it never gets to 5. It gets closer, and closer, and closer, but never gets there. Because 5 isn’t on the spectrum at all. It’s in another universe, you may say.

    Most people progress on this social relatonship spectrum from 1, peaceful and calm, to 3, agitated and angry, to 4, anti-social fighting, physical confrontation, to 4.5, 4.7, to 4.999, to 4.99999. But it is all social.

    Asocial, 5, can be seen in this fashion.

    A man and woman is at a bar. 3 guys come over and want the woman, so they ask, “What’s your name, sweetheart” and the girl responds “Ask him (pointing to her male companion)”.

    The 3, 4, and 4.5 stages would be consistent with male yelling, shoving, bar fight, perhaps even grabbing some blunt tools to protect themselves. It might go into killing, because people get angry enough.

    An asocial jump is an immediate jump. It’s going from somebody asking the question “What’s your name, sweetheart” and as a response, you pull out a gun, gut shot the guy that spoke, and then headshot their others. Then you, execution style, put a few more into the brain case of those that are already down. And you aren’t angry at all. You never felt fear, you never worried about what they were going to you or her. You just executed them, because they annoyed you with their question. That’s called an asocial jump from 1 to 5. You skip all the social crap in the middle.

    That’s asocial. And you don’t have to be afraid of the crowd of town hall people jumping like that. They may progress to progressively more anti-social relations, but they won’t make the jump. So don’t be worried about that. It’s not really the problem.

    The problem is anti-social behavior caused by emotions. When I watched the St. Louis video, I could hear and feel some of the crowd’s anger. I didn’t know what they were saying, cause their voices were too loud and discordant, but I knew what they were feeling. And if I knew that, just imagine how more powerful it would have been if I had been in the crowd, sharing in their conditions and stimuli.

    And I also saw the immediate drop in ‘tension as people called it, when people started out with God Bless America. The Marine with the child on his shoulders probably contributed much to organizing and re-directing people’s anger into more social and productive avenues.

    That kind of jump, back down the scale, is very rare.

    So long as people keep themselves in control at these town halls, in the social and legal realm, I’m not worried. I feel no fear. Partially because they won’t hurt me. Not because they may not try, but because I won’t let them. I’m more worried that they’ll hurt each other. That some Brownian Motion of a herd reflex may stomp on some girl or child. (Like Walmart stampede)

    I’m also worried that SEIU agitators will instigate violence and anti-social behavior. They know, perhaps not as well as me, but enough how to create agitations amongst a crowd. They’re union thugs, they’ve been out in more crowds than I have. But I’ve been studying the psychology of sociopaths more. Which, I suppose, is one of those balancing issues.

  • http://ymarsakar.wordpress.com/ Ymarsakar


    That is quintessentially what young Democrats are like emotionally and on a maturity scale.


    Doctor (glaring): “This conversation is over.”

    Damn, if that doesn’t sum it all up.

    When confronted with logic and facts, it’s very clear their one-act play ends. Curtains down. Lights out. Stage right (left) exit.

    Once again, it’s these people approach that creates another layer of resentment. I am sure the bewitched (with the plan) doctor would have used the old tried and true, you Republicans, but since it was a dialogue (?) at work, it morphed into ‘these people’.

    I, on the other hand, who just left my local beauty salon, just departed a conversation among four women. Woman a) 19 and receptionist, Woman b) 30ish, who also worked at the salon Women c) 50 Owner and caretaker of my ‘roots’ and myself. I can assure you of the following:

    They are not reading blogs.
    They are not going to Town Hall Meetings.
    They are paying attention to events as they unfold.
    They are very angry and upset and have no qualms about expressing their displeasure with current politics, while the voices remained calm and collected……

    A planned catastrophe in the making (Health Care). What happens when/if we are successfully targeted again by our enemies or if there is a natural catastrophic event.

    …..watch out, these women will grab pitchforks and stones, if necessary, and will be shouting THE CONVERSATION NEVER BEGAN. I have a strong feeling that there are many men and women, sitting in offices, salons, barber shops and in big and small towns, who are on the edge of their seats and once pushed off or too far, will not exit the stage with any decorum.

    Stupid doctor, not all wars are fought on battlefields nor authorized by Congress.

    p.s. Deane..very nicely piece. I really should have started with that before I ranted. Sorry.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    In a curious fashion, I am bemused by the anger, rage, or whatever you want to call it today.

    I felt all of that, but before, during, and after Iraq. To me, this has already happened to me, if you consider only the emotional experience.

    To a certain extent, Iraq only tied people up who were interested. If you weren’t, you could stop watching the news.

    Healthcare, it seems, seems to be inveigling a far greater number of people, voluntarily or not.

    Defectors from the Left or the KGB or other countries run by autocrats aren’t surprised: again, they’ve seen and experienced this before.

    It is the rest of America that seems to be clueless. That expected different things. They thought they could outsource America’s prosperity to the Man, except make him Black this time. Yeah, turn White Privilege into Black Privilege and everything will be utopian once more.

    People are now worried about ‘death panels’, whatever that means while those like me have tried our best to visualize the executions of thousands in order to figure out how to prevent it in the present and future. We’ve been over this before. Most weren’t interested, however. It was Vietnam, part of history. Or it was Iraq, a quagmire and Bush’s war anyways.

    Now it’s hit home. Now it’s domestic politics. Now, because politics are local, they’re getting interested. As opposed to before, when it was foreigners and Americans dying outside the borders of America, when few were interested. And those few had to acquire unofficial channels in order to be educated or informed.

    This means they get taken by surprise, sometimes. But they learn quick. In any high density and high reaction fight, people learn quick. It’s no slack in the brain.

    Regardless, it is interesting to see people come to similar conclusions that I have. Not through the same life experiences, but pretty similar, all in all. After all, we as individuals are different, but the Left never changes.

  • Charles Martel

    (I may have previously mentioned what I’ve written below. If so, I apologize.)

    Regarding how people come to the point of getting out of their comfortable chairs and doing something, I recall something that happened when I was on the local school board about 10 years ago.

    One of our members, a do-gooder who was always bemoaning the lack of citizen participation, said our board was a failure because only three or four people would show up at our semi-monthly meetings.

    I told her she was flat-out wrong. The reason for low attendance was the opposite—it was because we were a very good board that was doing exactly what the voters wanted us to do. It was OUR job, not theirs, to take care of running the school district. As long as we were doing that job, there was no need to show up at our meetings. (The reason why I’m neither a Marxist nor a libertarian is that under each system I would have to spend 80 hours a week debating sewers, street lights and fire protection at interminable volunteer committee meetings.)

    I asked her to recall the times when we did get a huge turnout: invariably when some big issue was at stake, and people wanted to come make personal pleas and keep an eye on us. In situations like that there were always a lot of suspicions about us, fed by the rumor mill and people’s post-Watergate distrust of elected officials.

    But we were an honest and open board. People quickly saw that we answered their questions with as much detail as we could and, after watching us civilly debate, they realized that we were not at all the conniving, conspiratorial claque that they had come in expecting us to be.

    The lesson here is quite clear: As long as elected officials are doing what we want them to do, we’re not going to show up en masse. But as soon as they try to stonewall us over a vital issue, they’re going to get 10,000 townhalls.


    If you did mention it, Charles, I guess my memory is challenged enough that I forgot what I read.

    But as soon as they try to stonewall us over a vital issue, they’re going to get 10,000 townhalls.

    I read the final line so quickly, that I thought it was written to read, ‘they’re going to get 10,000 stone walls. Actually, thinking about my reading error, ‘they’re going to get 1,000,000 … to throw stones, up, or epitaphs.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    That’s new to me, Hammer.

  • suek

    >>I asked her to recall the times when we did get a huge turnout: invariably when some big issue was at stake, and people wanted to come make personal pleas and keep an eye on us.>>



    I remember one meeting when I was maybe 10 minutes late. I couldn’t find a parking place. Ended up walking up a block and a half. All the time asking myself – “what’s up? there was nothing special coming up in the meeting was there? What’s the problem? Why’s everybody here?”…

    Only to learn that that evening was the first night of Little League (they used the school baseball field) and there really wasn’t anybody in the meeting other than the usual required folks…!!

  • Deana

    So many good points!

    Danny – Yes, indeed, intelligence and stupidity are NOT mutually exclusive. This is one of the reasons why I was so shocked prior to the election at the number of people who were just sure that Obama was smart because he was a Harvard trained attorney. That doesn’t guarantee anything.

    And no, the physician did not mention what would happen to her salary should this atrocious bill pass. I personally believe the public does not care about that. Many people will just say that doctors make too much anyway. What people don’t realize is that millions of therapists, nurses, and other personnel also will have our salaries reduced. Danny, I am a new nurse making a new nurse salary but I’m telling, I can’t afford to make much less. If that happens, I will have to make a decision on whether or not I can continue to be a nurse.

    Y – Your paragraph that started “Only a strong and shocking psychological blow, to the very survival of the body or mind, would be enough . . .” was spot on. My mom and I were talking the other night about the exact same thing. We wondered what sort of shock would have to happen to shake people out of their stupor. The “drip, drip, drip” of outrages isn’t going to cut it for most people – it will take something large and unimaginable.

    Sadie – I was encouraged to hear your account of what happened at the beauty salon. If these types of people are getting concerned, that is enormous. And powerful. It is one thing when we “blog heads” get worked up about something – we are hyper aware of the details. But it is quite another when people who aren’t plugged in are getting worked up. That has to be alarming Washington.

    Charles – Your point is well taken. If Washington were doing its job, no one would hear a peep. The fact that people who have never been politically engaged are interested enough to start reading dreadful bills and attending town hall meetings simply illustrates how terrible the President and Congress are doing.


  • http://ymarsakar.wordpress.com/ Ymarsakar

    Deana, I admit I haven’t heard any Democrat propaganda apparatuses using the pay of doctors to stoke up populist rage and envy. They certainly can, I admit that, but I haven’t heard or seen it used. They use it against corporations, to shake down employers that won’t let SEIU or other Unions to monopolize their workers, but doctors have mostly been left alone on this score.

    I wonder why. Perhaps because polls hold them in very high regard, higher than the US military even I recall.

  • http://ymarsakar.wordpress.com/ Ymarsakar

    Stage right (left) exit.

    Nationalize the stage, Sadie ; ) Why need exit when you can own it like Great Stalin Daddy did!!

  • suek

    >>They certainly can, I admit that, but I haven’t heard or seen it used. >>

    How about Obama’s tonsil removal instead of medication or $50,000 for an amputation comments? You don’t think those were income/greed inferences?

    I agree that we haven’t heard any “doctors make bundles and bundles of money” comments, but I think those items were definite “cloaked” accusations. “Everybody” knows all doctors are rich….but what can you do – we need them!

    The Dems need the AMA on their side – out and out criticizing of doctors is not going to win points. At this point, it appears that doctors are critical of the AMA for it’s support of the health care bill – stirring up antagonism would not be advisable.

    More and more doctors are opting out of taking Medicare/Medicaid patients, according to what I’ve been reading. If they respond by making it mandatory, there _will_ be trouble, I think.

  • Danny Lemieux

    I heard that Medicare only reimburses surgeons $750 for a foot amputation. Is that all that gets reimbursed? Knowing how much nursing care, overhead etc. that goes into an operation like that, how can anyone make money on this? How long does such an operation take, with prep-time, post-op and all included?

    Deana…can you shed light on this?

  • http://ymarsakar.wordpress.com/ Ymarsakar

    How about Obama’s tonsil removal instead of medication or $50,000 for an amputation comments?

    I needed to have been there to see the impact on the audience.

    However, even though the military is viewed favorably by most Americans, it doesn’t stop the Left from subverting public opinion on this score and it sure didn’t stop them in Vietnam. They will try to whip people’s emotions in line, but they often will decide not to depending on how hard the job is.

  • Deana

    Danny –

    I would assume (and it is definitely an assumption) that if the $750 reimbursement is true, it would only be the reimbursement to the actual surgeon. It would not be the reimbursement to cover the cost of nurses, therapists, etc. Prep-time and the surgery would take a minimum of two hours. I have never been involved with an amputation surgery but I would suspect that the pt. would need to be in the hospital for at least one week plus extensive therapy.

    I also have NOT heard anyone mention anything about doctors being paid to much. I think it is because everyone is so overwhelmed with what the health care reform will mean for themselves and family members as patients. Few people have thought much about what this will mean to health care workers, insurance employees, the increase in the growth of the federal government, the logistics, and so forth.

    I believe that if and when the public starts becoming more familiar with what this will all mean and they understand that it will result in the decrease in pay for health care workers, they won’t really care. There seems to be a great deal of class warfare so people will simply say, “So what if doctors make less,” not understanding that we already have a nursing shortage, and if nurses are going to paid less, there will be fewer nurses . . . .



  • http://ymarsakar.wordpress.com/ Ymarsakar

    Keep fighting the good fight, Deana. I and many other Americans know that people like you save lives. The Democrats only cull them.

    They will try to blame you, in the end, out of desperation. Just as they do with the military and with Republicans. But we’ll try to cut them off at the knees so they bleed out on the floor still yelling about their Utopia ; )

  • Deana

    Suek –

    With regard to Medicare:

    Just yesterday, I was taking care of a patient who had the second part of her cardiac stress late in the morning. The plan was that IF the stress test turned out ok, she could go home that day.

    Well, she finished her test and then came back to her room to wait for the doctor to read the results of the test and let us know whether she could go home. We found out she could go home at about 14:30 in the afternoon. Shortly thereafter, the care manager rushed up to me and said we absolutely had to discharge the patient no later than 16:00.

    I asked why.

    I was told that according to Medicare regulations, the patient could only be in “inpatient” status in the hospital for no more than 48 hours. If she were there longer, the hospital would lose significant reimbursement from Medicare. The care manager did not know whether this was a new rule, but she DID say that the government has become very strict recently with Medicare reimbursement rules so everyone is having to cross their Ts and dot their Is carefully.

    Let me tell you: there are 50,000 things that can happen that can impact when a patient gets discharged from a hospital. And now we have to worry about whether we can get a patient discharged before this random 48 hour designation.

    What if the doctor couldn’t read the results as quickly?

    What if the patient got done with the test, came back to the room, and suddenly developed nausea that required us to delay their discharge?

    I asked how the case manager keeps it all straight. She showed me a thick book that has page after page after page of tiny print that lists the 253 reasons why a patient can be classified as being in “Intermediate Care ” status according to Medicare.

    It makes you dizzy. And this is what we are dealing with now – constantly having to evaluate NOT THE PATIENT, but what is happening to the patient to make sure they are classified properly for Medicare purposes. The case manager said it drives the doctors into an utter tizzy. The doctors just know that their patient needs to be in the hospital and needs to be given a certain level of care. They have neither the time nor the patience to scour through a big notebook to make sure they are doing everything according to Medicare dictates.

    It makes me wonder: how bad will all of this get if we go to a nationalized health care system?

  • Deana

    Y – I love that image! Ha-ha-ha!