14 January 2013

Apparently I'm a pimp


I actually have no interest in responding to this. I decided some time ago that life is too damn short to waste it arguing with assholes on the internet. I've stuck to that reasonably well, and been happier for it. But since I have been personally named I suppose I should give it a perfunctory response. That's all it deserves. 

I wouldn't bother at all, in fact, if it weren't for the steaming mass of ad hominem attacks piled on top of it. But that's his style: he uses strawman arguments and personal insults to obscure fuzzy thinking. Apparently, in the minds of the free-market, anti-government zealots out there, if I support expanded government funding and regulation of health care insurance, which I long have and still do, then I may never ever criticize or disagree with anything the government does. 

That's the mindset of an ideologue: purity above all else. You are for the government or you are for the private market. It’s an either-or, absolutist position. You cannot logically have a nuanced view or a pragmatic approach: that’s unpossible! 

Clearly, there’s no point in discussing anything with this sort of person, so I won’t bother. But I will make one point — just one point — in rebuttal. The worst abuses I have encountered, thus far, have been by private, not governmental actors. Contracted Medicare carriers and insurance companies have been far more aggressive in trying to exploit the logical catch-22 in the medical necessity rules. For those who say they fear the government intruding into medical care, I agree it’s a fair point. But given their financial incentives and lack of ethics, I will always fear the private insurers even more.

24 comments:

Anonymous said...

Excellent response!
Donna Schoonover

Anonymous said...

I have never visited this blog before, but your lack of a substantive reply to valid criticisms just makes you seem self-righteous.

As a physician in a group that runs its own billing operation (~25 employees) I can honestly say one must be insane to worry more about private insurers than medicare. Private insurers can rankle you with slow pay (or no pay) but the govt can show up brandishing a search warrant, guns draw and throw you in jail.

shadowfax said...

Anon 7:00. Let me be clear. If it was a substantive critique I'd give it a fair response. It was, however, a sole snarky point - be careful what you wish for - buried within 2,000 words largely given over to personal insults. Strip out the assholery and I'll engage in a discussion.

Anonymous said...

Welcome to the future Shadowfax.

Anonymous said...

Welcome to the future Shadowfax.

Anonymous said...

Thanks for this blog and your personal views. The article may have been snarky-so what? Now is the time to realize you have allowed yourself to be taken in. To embrace truth is priceless.

Kathy said...

Personal attacks are easy and designed to intimidate and shut you up. I enjoy your blog and hope you keep on "pimpin". Being a female MD and sharing many of your views I suppose that makes me a prostitute.

Future OMSI said...

Shadowfax. Long-time lurker. You shouldn't have even bothered responding sorry. The comments section on that post displayed perfectly the intellect of its intended audience. There are many sides to the ACA debate, but when people can't even discuss rationally, then there is no point in taking part.

Also, major LOL at the commenter on that post who brought up how most medical school classes are "vaginas and asians" now to appease the minority groups, and the other whose local hospital was full of "foreign born DOs". Classic.

Keep on writing man, your opinion pieces on health-care policy are always thought-provoking whether I agree or not.

Anonymous said...

What is that middle ground situation-- can companies, can people decide to opt out of the Obamacare plan in a pick-and-choose fashion? Is there a good source of summary info on that?

Anonymous said...

I find it hard to sympathize with your plight and cries of injustice, especially after reading this article (http://spectator.org/archives/2013/01/11/a-pimp-for-obamacare-feels-the) and spending the time to read your other posts. You are a fine example of someone who fails to grasp the concept that Liberalism tends to produce the opposite of the intented result.

Anonymous said...

Let me get this straight. You aren't upset about the $38 trillion dollar liability that the author highlighted. The fact that unqualified bureaucrats are telling you as a physician what treatments are and are not needed (which is absolutely true) doesn't really rankle you. What does bother you is that the government is picking your pocket and that the writer accused you of pimping.

You are missing the point ... you were (and continue to be) wrong about government controlling health care. You are merely using your thin skinned excuse that being accused of pimping is so horrible that you shouldn't respond to the facts presented.

I don't think you were pimping at all when you endorsed Obamacare. I think the government was the pimp who was using a vocal minority of poorly informed elites as prostitutes. Stalin referred to people who pandered to his barbarism as "useful idiots". Do you fall into that class?

Anonymous said...

After reading the article I think it deserves a response. The article is much more than "be careful what you wish for"; maybe that is how you originally read it but I would suggest another reading and a proper response.

Anonymous said...

I have to agree with most here. The unintended consequences of most of what Obama has done and intends to do will send damaging ripples through our lives and of course his supporters will blindly deny or misplace blame. Liberalism is deadly.

Anonymous said...

"unqualified bureaucrats are telling you as a physician what treatments are and are not needed"--so you agree with Shadowfax that private insurers are more to be feared than "the government"?

Anonymous said...

"unqualified bureaucrats" so..... private insurance companies?

Because if you think complete private control of the health insurance sector is the answer... well look at the broken system we have now. There's your answer.

Please note that complete gov't control isn't the answer either.

"can people decide to opt out of the Obamacare plan in a pick-and-choose fashion?" this is just not what obamacare is at all, sorry.

Anonymous said...

As an onlooker, I absolutely do concur that private insurers are more to be feared than government-funded healthcare.

I've been insured pretty much continuously since I started working at 15, which is about thirty-five years ago. I've always worked and am a professional in the upper 5% of income distribution. I paid for my own college through graduate school, working multiple jobs, and my wife of 25 years did the same.

Natural conservatives, right? You'd think we would hate ACPPA, and deride it as 'socialism,' for 'takers...'



Oh, wait, no - we're not stupid. We long ago recognized that we can be as healthy as I want, have all the healthcare we can get, but we're still at major risk if herd immunity and herd net health is compromised because the office cleaner, or the cooks on the work cafeteria, or the Starbucks clerk, or doesn't have health insurance. If they get sick, they HAVE to work - they don't have healthcare and often have little or no sick time. And that exposes me and mine to things I'd rather not, good health care or not.

It's about thinking beyond your own skin, and looking at what's best for the society as a whole. Unfortunately, tea party right wing libertarian big-government-is-always-bad idiots simply can't do that - they're so afraid that someone of color might just do better than they will, given a level playing field, that they deride basic human decency as 'socialism' and 'taking' and other racially- and ethically-tinged dog-whistle code words. As noted author China Mieville states, "In its maundering about a mythical ideal-type capitalism, libertarianism betrays its fear of actually existing capitalism, at which it cannot quite succeed. It is a philosophy of capitalist inadequacy."


I'm in the 5%. I pay my taxes. I don't complain about paying for healthcare for other people who have not had the advantages - white, good basic education, raised in an area of the country friendly to rational policies (vs. some regions' hyper-religiosity which tends to be at odds with empirical reality).

It's called the Social Contract. Rousseau wrote about it over two hundred years ago. Denying the validity of the social contract doesn't make anyone a bold crusader for individual rights. Instead, it shows them to be the petty, small-minded, near-horizoned, deeply selfish people they are.

And I deeply respect Shadowfax for his advocacy for ALL of the people for whom he cares as an EM physician - not just the ones who make him money.

Skip said...

I'm not following your post very well. Would help if you could cite those straw-man arguments in the article. It looks like he's just reprinting what you already said. As far as personal insults go, "self-satisfied sawbones" seems to be the strongest of the lot. And judging by your reaction, he seems to have nailed it.

I mean, you seem to have changed your original position, and you've been called on it. Does that mean your original position really hasn't changed? Or that you acknowledge that the socialist paradise proposed by Obamacare really doesn't exist, unless it's operated by selfless people (like yourself)?

Anonymous said...

"but the govt can show up brandishing a search warrant, guns draw and throw you in jail."

OMG you are just a hoot.

-SCRN

Anonymous said...

Let me just say this about Mr. Catron... Ass clown.

David Meybohm said...
This comment has been removed by the author.
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Anonymous said...

As a future doctor (1 year until residency), I can say the linked article made my blood boil - always nice to hear a consultant dismiss MDs as ignorant about health care economics. Also, FYI, talking to my classmates (who are at a private, top ten university) - the percentage of future doctors in the US who are comfortable with or even support increased federal involvement in our "medical delivery system", even amongst students at an expensive private school, may not comprise 100% of the student body, but they are sure as heck not a small minority either.

Anonymous said...

As a future doctor (1 year until residency), I can say the linked article made my blood boil - always nice to hear a consultant dismiss MDs as ignorant about health care economics. Also, FYI, talking to my classmates (who are at a private, top ten university) - the percentage of future doctors in the US who are comfortable with or even support increased federal involvement in our "medical delivery system", even amongst students at an expensive private school, may not comprise 100% of the student body, but they are sure as heck not a small minority either.

Jessica said...

This is a great post. Life is really short and we need to do things we like and want now without waiting for tomorrow.