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    I’m a Democrat physician and I’m voting for Trump

    Editor’s Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Anish Koka, a cardiologist in private practice in Philadelphia. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

     

    Dr. KokaAs a long-standing member of the Democratic Party, I have a confession to make. I am voting for Donald Trump. The journey from a man like Obama to a man like Trump was surprisingly short, forged as I started a small independent practice three years ago in the crucible that is healthcare.

     

    Related: Obamacare receives a big, fat 'F' from physicians

     

    Current times mandate that I first dispense with the incoherent and tired case made to disqualify Trump as a racist, misogynist, xenophobe who is a harbinger of the apocalypse. We have come to live in an age where dissent from a very narrow norm validated by an equally narrow band of liberal elites is not to be tolerated.  Dissenting opinion is vilified and deemed offensive.  Saying all lives matter makes you are a racist.  Arguing for more restrictive immigration makes you a xenophobe.  So yes, I have trouble digesting that Donald Trump, the socially liberal, Elton John-loving recent Democrat will threaten democracy, the republic, or civilization as has been solemnly warned.  

    Hyperbolic threats to the republic aside, a very concrete threat to medicine exists in the form of well-intentioned administrators trying desperately to save medicine from its physicians.  Sachin Jain, M.D., the former senior adviser to the Obama-appointed administrator of the Centers for Medicare & Medicaid Services (CMS), Harvard Medical School alum and current rising star in healthcare delivery notes:

    “The simple image of the physician-patient relationship that draws many of us to medicine – the dedicated physician, the thankful patient—is no longer.”

    Is it any surprise, then, that the innovation that has emerged over the last eight years relates to the physician as data-entry clerk, reporting on quality metrics that do not relate to actual value?

     

    Did you see this? Internist has starring role at RNC

     

    The patchwork of payment schemes is now to be replaced by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which in turn took the place of the prior flawed Bill Clinton-era Medicare Sustainable Growth Rate (SGR). The MACRA proposed rule has been panned almost universally by the practicing physician community due to its immense complexity. Stunningly, the messiah who was supposed to solve the healthcare cost conundrum, Barack Obama, weakly mustered a plan to reduce physician reimbursement, yet left untouched the monthly mortgage that hospitals can charge the uninsured for a pack of Band-Aids.

    As a result of avoiding the pesky cost issue, the Affordable Care Act (ACA) expanded coverage effectively but costs a pretty penny to the government in the form of federal subsidies, and to the average patient in the form of high deductibles and ever-increasing premiums. The higher non-deductible cost to patients is by design as it is intended to turn patients into bargain shoppers who would, in an ideal world, exert downward pressure on healthcare costs. Unfortunately, the gentleman with the dissecting aorta for some reason does not appear to be in the best position to bargain when he needs surgery.

    Next: Trump will move us off the current trajectory

    Anish Koka
    Anish Koka is a cardiologist in private practice in Philadelphia trying not to read the writing on the wall. Follow him on twitter ...

    10 Comments

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    • daniel.ginsberg@------.org
      I'm skeptical that Trump would improve the health care system, but even if I thought he would, I still would not vote for him and would rather take a 50% pay cut than see him elected. He has a history of being racist (his company, along with his father, was proven to avoid renting to blacks), misogynist, promotes violence (has repeatedly encouraged it towards protestors at his rallies and even made a veiled threat against Hillary Clinton), believes global warming is a hoax (that attitude alone will cost trillions), and has no government experience. He is a businessman, but so what? He has a history of bankruptcies, and numerous documentation of his having stiffed small business owners. He is dishonest, repeatedly denying having said things documented in his twitter feed, book, and audio/video recordings. He has expressed support for nuclear proliferation. He has repeatedly supported Putin, a near dictator, whose country has hacked our computer systems, invaded another country (which Trump didn't know), and fights against us in Syria. He promises to get rid of ISIS, etc. but won't say how. Just because you say you will do something, doesn't mean you can or will. How about this? If I'm elected president, I'll decrease unemployment in half, cut crime in half, double growth, cure cancer, and give everyone a new iPhone or Android every year. I won't just make America great again, I'll make it Super Duper Great. That's even better than what Trump promised, even though he said he was the ONLY one who could fix things. I said it and it's on the internet now, so it must be true!
    • nsf@------.edu
      If health care, my profession for 30 years, was my only concern in this world, I might be able to understand Dr Koka's comments. However, I am concerned about many other things: human rights, global warming, peace and stability in our world, reproductive rights, and others. Mr Trump is a flashy business man whose main successes have come at a big cost to others, mainly the American people (he doesn't pay income taxes, doesn't pay contractors who have done work for him, and has his manufactured products made overseas). Why any thoughtful person can see this as the right path for America is inexplicable to me.
    • jbarakeh@------.com
      First to Dr. Koka, maybe this is the first step in weaning yourself off the Democrat Kool-Aid. Good luck to you. Now to "anonymous", first of all, grow some cojones and show your real name. Second, Obamacare is falling apart this year, literally as we speak, so supporting its good intentions is not a viable point of view, even for an "idiot". Third, it is beyond idiocy to consider voting for the warmongering Goldman Sachs criminal Clinton. You Democrat trolls don't have a monopoly on name-calling, so, like Trump, we will not hesitate to reply in kind, "Doctor".
    • UBM User
      jbarakeh, give 'em hell!
    • Anonymous
      Malik Obama, the older half-brother of the President, is a full-blooded African and Kenyan, a proud self-avowed Muslim, a U.S. citizen and a responsible businessman, has strongly endorsed Donald Trump. Malik Obama agrees with Dr. Anish Koka on that matter. I call on all commenters to remain polite and respectful of each other, and stop calling names like "idiot".
    • UBM User
      Yeah, even Obama's brother thinks Obama's a tool...
    • Anonymous
      How embarrassing for you.
    • amperrymd@------.com
      Dr Koka. Good for you. I made the transition about your age. I enjoy reading your comments. I thought you might like this: https://1drv.ms/w/s!Ar9MIXbYsvAygVa1ItJjFAAjGzD0
    • Anonymous
      Hate to make this personal, but you are an idiot. Is the Affordable Care Act perfect? No, far from it. Is it the first serious step we have made towards improving health care coverage? Definitely. Will Trump do anything to improve the lives of our patients or of physicians? Not a chance. Is Trump a megalomaniacal, thin-skinned huckster? Most certainly. There is a reason that for the first time in history the majority of those with a college education are supporting the Democrat. Clearly you are an exception who has bought into his hateful nonsense. Shame on you.
    • UBM User
      Any physician who agrees with the "Affordable" Care Act is a moron. One of it's authors, Jonathan Gruber, actually admitted that the ACA was pushed through because of a "lack of transparency" (translation: lies and deception), and "the stupidity of the American voter (which is true). It's all about money and control and has NOTHING to do with improving health care coverage. Grow up!

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