Obama and Tonsil

Excuse my spelling. I watched Obama’s special news conference for his universal health care agenda. Once again I am convinced of his cogitation skill, memory capacity, and leadership ability, the three pillars of good statemanship. But one sentence towards part 4 of the reporter Q&A session struck me as resonating with my personal experience, that of tonsil cutting as a form of treatment for infection and perhaps common cold. He pointed out that doctors sometimes are motivated purely by profit to perform such surgical operation, rather than for the true benefit of the patient, based on solid medical evidence. That’s troubling because things like that, especially of a surgical nature, abounds in our daily life, from removal of wisdom teeth, to appendititis operations. It really makes the world feel unsafe, by placing the burden of making the right decision on the patients rather than the doctors themselves. It’s like in the movie saving private Ryan, where the guy who was badly injured was asked if he wants more morpheme or not. But here the problem is the doctors act like they know everything and give you no reason or room to argue against them, while in fact they could be just like one of those barely surviving phd candidates in my own department who traded time for a certificate.
  Obama’s tonsil reference also solidified my support for the nationalization program of US health care. If with a competitive system doctors don’t seem that competent, then I don’t see anything wrong with a more socialistic system in which doctors might not consist of the best exam takers and ambitious money driven mercenaries, but indeed live up to the title of a doctor, just like any other doctors, by performing at their best effort, in the hope of contributing something positive to the world, much like a science phd aspires to contribute to the general knowledge of the human race. And then it’s perfectly ok to still have private clinics, in analogy with the distinction between private and public universities and even some research group in big corporations like Microsoft. Those doctors who deem themselves worth a lot more than what the nation’s tax payers are willing to offer can certainly seek to go for the rare market, but because the majority of the demand among the middle to lower class of society is satisfied by the national program, their markets will inevitably be squeezed so that they will only target at extremely rich customers, who can afford to "own" them. The presence of such an elite class of privately owned doctors will also create a nominal incentive for the rest of the medical industry, but because of the predetermined ratio between public and private sectors, will not tip off the balance and eventually water down the value of the VIP status. Though lacking further research, I believe this is what is happening in many industrialized nations. The trickling down effect of prestige is a healthy way of fostering competition, and avoids polarization in the profession.
  But the analogy of medical doctors and doctors in academia must stop here. To introduce a tenure track system and displace the unqualified into "lower" professions such as nursing, would spell a dichotomic screening among the patients to go for the desparate tenure track toiling practitioners, in the hope of better security.


About aquazorcarson

math PhD at Stanford, studying probability
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One Response to Obama and Tonsil

  1. James says:

    I am an ENT doctor. Pediatricians don’t remove tonsils, ENT doctors do. Obama’s administration is concerned about incorrect information in the media yet what he said about tonsils is total ignorance. First of all, I only remove tonsils if it is indicated, and that depends on the individual situation. Allergies don’t cause tonsillitis! Second, his comment about reimbursement is ludicrous. I get paid about $100-150 to remove tonsils which takes an hour of my time for the surgery and anesthesia. I could make 3-4 times that seeing patients in my office. So financially, it would cost the healthcare system a lot less to remove the tonsils instead of having these patients return to the Pediarician or my office with recurrent tonsillitis 6 to 10 times or more a year! If you include the cost of antibiotics and the lost hours of productivity because of the parent taking time off from work, there is no comparison between the costs. Thirdly, there is a risk of the child bleeding after surgery. Even though this is rare, I still worry about this in every child I operate on. I would prefer not to remove a child’s tonsils however in certain situations I know that the health of the child would be significantly improved with their tonsils removed. I practice medicine based on what is the standard of care in this country, not on a particular reimbursement from a health insurance company that many times will take up to one year to pay me for a surgery. President Obama needs to talk to a physician and research his topic before making false statements on the airways, the same type of comments that he criticizes.

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