I’ve been trying to avoid talking about health-care reform (or deform, if you want to be accurate) on here, because it makes me so angry that I’m virtually speechless. I’ve also stopped talking about politics with my liberal friends at work. I used to enjoy a friendly debate, but there’s nothing fun about the looming disaster.
I can’t not talk about this any more. I just opened a mass email to all the physicians at my hospital, informing us that, in addition to compazine (a very basic anti-nausea medicine; cheaper and more effective than zofran, and less sedating than phenergan; my go-to drug for post-op nausea) and some iv narcotics, and antibiotics, there is now a national shortage of propofol (the fast-acting sedative used to induce anesthesia for a general case, used as almost the sole agent for a conscious-sedation outpatient procedure, and relied on heavily to sedate ICU patients, because its very short duration of action means you can turn it off quickly to check for neuro status, and trials of vent weaning, and get it back on quickly if needed), and we are going to be using the European variant, whose key features are that people who are allergic to peanuts can’t have it, and it doesn’t have the same anti-microbial agents built in, meaning it’s more liable to acting as a culture tube for bacteria.
I can’t see any explanation for this sudden, simultaneous shortage of all kinds of basic drugs (which I have never seen before in my career; one at a time, maybe, and usually more rarely used drugs) than that pharmaceutical manufacturers are scared stiff of the antics in Congress, and are trying to cut their losses by not manufacturing surpluses when they can’t tell if they’ll get paid properly in the near future.
In other words, it’s starting to feel like a third-world country (or maybe just Europe) and they haven’t even settled on which gigantic, mysterious, debt-riddled, unworkable socialist plan they’re actually going to force down our throats. (Anyone else seeing this phenomenon too? Any less depressing explanations?)
60% disapproval rating across all polls, and it’s still full-steam ahead? Who still thinks Obama gives a rat’s — what the people really want?
Although I have to say, since a majority of the American people were idiots enough to vote for this traitor, after having heard him advertise his socialist agenda loud and clear for a year’s worth of campaigning, it’s their own fault that he’s now giving them exactly what he promised. (And I say traitor because I mean it, in the sense of someone who’s committed to the destruction of Constitutional government and the traditional American way of life, and perhaps even national security. Think KSM trial in New York.)
If any non-medical people are reading this, and if you’ve been wondering what the medical profession thinks of Obamacare, I have two remarks for you: the AMA does not represent us, and we haven’t been screaming simply because we’re too busy taking care of patients, and too despairing of being able to stop this railroad crash, to try to express our fear and disapproval. (And a minority of us are socialists, don’t ask me why.)
Guys, this is how freedom is lost: we’re celebrating Christmas, we’re not watching, and Obama and his socialist cronies in Congress are about to transfer 15% of the national economy to government control, after having already taken banking and finance. . . this is going down fast. I’m glad I got to at least see America as a free nation, although I guess I won’t get to spend much of my grown-up life in that country. . . If I wanted socialism and multiculturalism gone crazy, I would move to Europe. . .
Merry Christmas.
Cut On The Dotted Line 
December 23, 2009 at 7:17 pm
In fact I do know physicians who favor this plan…
This is not the first time there have been shoratages of medicines in this country – but if it can be said to be the fault of Obama why not blame him?? I mean it hasn’t passed yet so how can this have ANYTHING to do with the health care reform.
Obama will get the boot in 3 years if the country doesn’t like what he does. That is how it works here in the USA. Some of us had to live 8 years under Bush.
December 23, 2009 at 7:47 pm
paranoia much?
a bit of a stretch, even for you.
December 23, 2009 at 7:53 pm
And in the meantime, while your patients receive excellent care with pharmaceuticals that are adequate for their given clinical indications, tens of thousands of Americans fail to receive basic and necessary healthcare due to a lack of insurance. Many die as a result. Excellent healthcare for those who can afford it while others who, through circumstance or other forces beyond their control, cannot is not a functioning healthcare system in any sense of the term. It is a violation of what should be a basic right for all Americans regardless of their ability to pay.
And I find your attribution of this problem to the supposed Obamacare system disingenuous. Not one piece of healthcare legislation has been passed and implemented, thereby affecting your practice in the clinical setting. To imply otherwise betrays a willful ignorance of the facts.
December 23, 2009 at 8:23 pm
I whole heartedly agree with Alice. Pharmaceutical companies are not idiots – they manage their drug lines just like any other company would. No company seeing a likely decrease in demand for their product is going to keep manufacturing it and end up with a surplus when there is no demand.
This same pattern is going to show up all over the healthcare sector. With the government elbowing in, socializing everything, and destroying competition, there will be no incentive for individual researchers or companies to continue innovating or providing high quality supplies. Look at Canada, England, Europe. They don’t lead the world in developing new drugs and therapies.
I for one plan on doing black market work once I graduate.
December 23, 2009 at 10:43 pm
I still love you anyway, Christian Surgeon!
Signed,
A Socialist Fan of Your Blog
December 24, 2009 at 5:59 am
I suppose we have to decide whether health care it a human right, or a privilege you have to pay for.
My suggestion would be to come work in Europe. I’m working a stint here at the moment, and I think they’ve got it great! I expect if you had a closer look, you’d find it’s not as bad as you think.
I expect you will soon see how you’re actually able to cut costs without cutting quality of care.
December 24, 2009 at 10:41 am
someone above said something about some of your patients receiving excellent care using the pharmaceuticals that were appropriate for their clinical indications, and other receiving nothing. The sad fact is, now NOBODY is going to get the excellent care as everything will be mediocre. Sure the people who had no insurance get an exponential increase in care, but the 85% of people who were insured (not that 85% is a vast majority…) get a decrease in the level of healthcare they receive. As you say, drugs won’t be as readily available, which someone above dismisses because “people are dying from not having insurance”, but people receiving worse care will also die from not having the appropriate medication readily available anymore, or when doctors are TOLD what tests they can and cannot do without trouble from insurance companies. People say its a waste of money, but I’d rather have that one extra test to confirm I’m not sick.. thats just me.. At very least allow people who want to/can pay for the high level of care they are receiving now to do so.
December 24, 2009 at 11:18 am
Alice, I agree with you. Pardon my rant in your own comment section, but I felt like I was punched in the gut after hearing the vote results. When are the American people going to stop nuzzling the government teat long enough to WAKE UP and find that government entitlements are ACTUALLY government enslavement?
Oh yes, and HEALTH CARE IS NOT A RIGHT. Sorry. How can health care be a “right,” but food, shelter, and clothing not be a right? What’s next? Free housing for all? Free groceries for all? Oh, wait, it isn’t FREE (and it isn’t FOR ALL). The commenter above is exactly right, all this will do is bring the quality of healthcare down to a mediocre (if we are *lucky*) standard. Sure, you won’t pay for it (directly), because it isn’t worth paying for.
Those of us still productive in this country are footing the bill for the unproductive (that’s right, I SAID IT) while struggling to support our own families (who don’t *deserve* our own (read “government”) support because we are far too “well off.”) How long will it take for the rest of us to say, enough is enough?
December 25, 2009 at 1:10 am
Drug shortages are a staple of medicine, and have been for at least the entire decade that I’ve worked in pharmacy. It just hadn’t hit the particular drugs you use frequently before now. There have actually been shortages of propofol before, but hospital pharmacies are trying to carry less inventory these days, and consequently don’t have the back stock to ride these kind of shortages out anymore.
Your issue stems from the current status quo in health care, not the coming reforms.
December 25, 2009 at 11:49 pm
In Australia, we’re watching the so-called Obamacare reforms with interest. Mainly because although our universal health care is a very long way from perfect, the thought of practicing medicine in a system where those who cannot afford it get pretty well nothing, is scary.
In my time in the health care system (and I am not well versed in the ins and outs of politics thereof), I have to say that no system will ever be perfect. Probably never even come close. But surely you guys can do better.
December 26, 2009 at 11:19 am
All I can say, is a big, resounding DITTO to this entire post. As a pre-med student, it makes me terrified as to how I’ll ever be able to pay off my monstrous student loans after Obama is done vilifying specialists, and destroying their reimbursement. Not to mention how I will be able to competently take care of my patients with a bureaucracy standing over my shoulder rationing my care. This was a terrible call for America, and let’s not forget, it was BOUGHT. With a 300 million dollar promise in the house, and a 100 million dollar promise in the senate. And Mr. Obama, who promised to end ear marks, and introduce transparency simply shakes his head in agreement when his puppet master says “that’s what legislation is nowadays,” as if we should just accept that and be okay with it. Disgusting, is what it is.
December 26, 2009 at 11:28 am
Furthermore, I can’t believe that people are either too desperate or too stupid to understand that a government takeover of healthcare will lead to a grinding halt of cutting edge research, innovative technologies, and what has been the best health care available in the world. Patients coming in droves from other countries with socialist health care policies, isn’t this indication enough that it doesn’t work for the majority of citizens? Essentially all we are doing here is throwing under the bus those of us who work for a living, and sacrifice luxuries in order to provide GOOD, QUALITY healthcare for our families, in order to provide mediocre care that covers those who don’t bother to do the same. ‘The problem with socialism is that you eventually run out of other people’s money,’ as well as the complete destruction of the work ethic that’s driven this country since its inception. There can only be so many years of penalizing those who make good choices in their lives, plan a financial, and professional future, and reward those who thumb their nose up at basic ideals of work, and planning, before ambition itself is thwarted, after all, what’s the point? Socialism might be a vast improvement for those in the lowest sectors of the socioeconomic system (which incidentally is a small segment of the population), but dooms the vast majority of us to settle for mediocrity. This is a losing plan for the vast majority of Americans. We are sacrificing the many, in order to save the few. You tell me how that math makes sense?
December 26, 2009 at 4:35 pm
Alice, I love it when you talk Dirty,I mean politics…
I’d watch out calling the Doctor in Chief (Peace be upon Him) a “Traitor” even though, as you pointed out, he is one…
That’s because Traitors get the death penalty, and we don’t want that, cause then instead of the first African American President, we’d have the first Retarded, I mean, Mentally Challenged President in Joe Biden…
I’m old enough to remember Jimmy Carter wearing a sweater and tellin me to drive 55 and cut the thermostat down to 68..who was that guy who beat him in 1980????
Frank
December 26, 2009 at 5:47 pm
@Undead Doctor, comment #6:
I have spent most of my life in Central Europe. The term we have for the health-care offered by the European system is “too little to survive, too much to die.”
Interestingly enough, Massachusetts now has a mandated and subsidised health insurance. Guess what? Mass. is going broke over it, and access to health-care is not better. How odd that the results should be the same as in Europe!
Oh, and those 47 million uninsured? Make that 8 million — the rest wouldn’t be eligible (I am a foreigner, have to pay my own or find a nice employer) or don’t want to pay for insurance (twenty years old and invulnerable).
No, what this country needs is not nationalised health-care — it needs a humongous barrel of tar and a vast pile of feathers.
Cheers,
Felix.
P.S.: The state that you are so trustingly handing over a sixth of the national economy is the same one that already made such a dog’s breakfast of Medicare. Insanity: Attempting the same failed strategy again and again, expecting different results.
December 30, 2009 at 10:29 pm
“multiculturalism gone crazy”
How wonderful that you are a doctor – you sound like a truly compassionate and inclusive human being.
December 30, 2009 at 10:41 pm
Hmm – my last comment was more snarky and sarcastic than I intended; my apologies. However I think it is disappointing, intellectually weak and kind of mean to write off European multiculturalism in one fell swoop.
November 20, 2011 at 9:44 pm
Well, here it is, nearly 2012 and the things Dr. Alice points out in this post have in no way improved. In fact, things have gotten much worse. The FDA is taking an active role in making sure the drug manufacturing and distribution system in the United States will fail. It’s my opinion that the administration is hoping things will become so bad we’ll beg for a national system of drug manufacturing to go along with our health care. I can tell you from direct experience that things are much worse than most people outside healthcare realize. The lives of patients are being sacrificed for political power.
March 26, 2012 at 5:54 pm
electronic joint…
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