Mike Weissberger

dad, dogdad, trying to be as cool as my wife, geriatrician in my free time. My tweets are my own, no representation of others’ views.

[Mike Weissberger @gurami]

Good summary of current evidence about risk: there is no single rule of thumb. Instead: work to reduce your risk as best you can!

[Mike Weissberger @gurami]

Not sure if anyone cares, but the @united ground crew at Chicago o’Hare made my bag’s connection in less than 15 minutes as I sprinted to my connection from my delayed inbound flight. So grateful and impressed with your staff. Great job.

[Mike Weissberger @gurami]

@chiglinsky Many of my colleagues have stopped paying attention to new guidelines and recommendations from this CDC. Really is remarkable the destruction brought to the CDC by people who have no capacity to understand how much damage they’ve done — much of it by design.

[Mike Weissberger @gurami]

@rejectedjokes ATTENTIVE!

[Mike Weissberger @gurami]

@chiglinsky So disheartening for folks who care for patients.

[Mike Weissberger @gurami]

@chiglinsky Also awesome: when your 3.5 year old loses all muscle tone and refuses to leave the bath after an hour.

[Mike Weissberger @gurami]

@DrDiGiorgio Means testing is expensive to do and doesn’t work well. It just as often excldues people who do qualify for the benefit as people who don’t.

There’s a reason that universal programs are successful: programs for the poor often become poor programs, neglected and underfunded.

[Mike Weissberger @gurami]

@usnehal @BKRBusinessMin Most of my colleagues in primary care love what we do. See also ID, peds, peds subspecialties. I could have easily matched into a more lucrative specialty. I just didn’t want to. Most folks in primary care aren’t doing it because we failed to match at something else.

[Mike Weissberger @gurami]

@baseballcrank How about, if your head of state is a fascist, doing fascist and unconstitutional things, you’re not supposed to follow those directions?

[Mike Weissberger @gurami]

@chiglinsky @daveweigel Have you never heard of video game thumb, Brian

[Mike Weissberger @gurami]

@chiglinsky White national security moderate

[Mike Weissberger @gurami]

@chiglinsky But did you have a meme with bald Glenn Youngkin on your phone?

[Mike Weissberger @gurami]

@kksheld 🦆

[Mike Weissberger @gurami]

@DutchRojas Dutch, just because you are only motivated by competition and the monetary incentive, doesn’t mean everyone else is. Markets kill patients. Medicine has no room for profit-taking. Also - if you haven’t stopped smoking that daily cigar…I would! That one’s free.

[Mike Weissberger @gurami]

@aribindi @DrDiGiorgio Absolutely. I never said patients never need specialists. Just more should be done in the primary care office. Specialty care absolutely is vital. But it is overused for many patients who have insufficient access to skilled primary care physicians.

[Mike Weissberger @gurami]

@davetp @DrDiGiorgio Thanks for the measured reply - this is exactly my experience with patients coming to me. I value my specialist colleagues, I just think many of my patients don’t need them.

[Mike Weissberger @gurami]

@EvanThomas84 @MaxJordan_N @DrDiGiorgio Neurosurgery is 7 years. Primary care residencies vary from 3-4 years. Do you think primary care residents don’t spent “off the books” time studying and researching?

[Mike Weissberger @gurami]

1/ @MaxJordan_N Was raked over the coals for 2 basic truths: 1) high paid proceduralists are paid 5-10x as much as primary care w/o 5-10x the training or value. 2) Medicaid provides lifesaving care. @DrDiGiorgio was thinks vouchers or cash subsidies will cut it as a replacement.

[Mike Weissberger @gurami]

10/ I don’t know what the right answer is. But I do know that our current solution is broken. And that the right answer won’t come from people treating patients as profit-taking opportunities. Appreciate the civil conversation.

[Mike Weissberger @gurami]

I appreciate your willingness to engage with me, and to agree (partially) with several of my points.

My suggestion that publicly funded insurance is superior to private for-profit insurance is borne of years listening to and caring for my pts who die b/c of for profit medicine

[Dutch Rojas @DutchRojas]

You’ve mistaken bureaucracy for benevolence and cartel consolidation for care.

Let’s forget the disaster post by your friend Max. I think we have all had enough of that debacle. Let’s just get your points.

1/ You assert private insurance companies “cost more” and “provide less care.” True enough, but only partially.

You omit that they operate within a system shaped, distorted, and reinforced by public policy: tax exclusion of employer-sponsored insurance, CMS-driven fee schedules, and anti-competitive Certificate of Need laws.

The private market has never truly existed in American healthcare. What we have is a state-sanctioned oligopoly, not capitalism.

2/ You invoke UnitedHealthcare as an example of failure, rightly, but neglect to mention its most powerful allies: nonprofit health systems, especially those like @UCLAHealth .

These institutions:

•Receive 3–5x higher Medicare reimbursements than independent practices,

•Pay no federal, state, or property taxes,
Issue tax-exempt municipal bonds,

•Collect tax-deductible donations,

• Dolinate regional markets like robber barons with clerical collars.

United is the villain and the nonprofit health systems are its bishops.

3/ Your call to abolish private insurance entirely rests on a romanticized faith in Medicare. But Medicare is the engine of price distortion:

•It undervalues primary care while overpaying large systems through facility fees.

•It entrenches administrative overhead via MACs and billing codes.
It also created the very Relative Value Scale, which deforms clinical incentives.

To suggest Medicare for All would resolve these issues is to propose the arsonist as fire chief.

4/ On workforce imbalance: you lament our surplus of specialists and shortage of PCPs. Fair critique. But again, who designed the pipeline? The federal government, comprised of Marxist bureaucrats, subsidizes academic centers to train specialists, funds residency slots through Medicare and allows hospitals to capture GME dollars without accountability.

The solution isn’t central planning of physician labor.

It’s exposing the actual cost, value, and demand for services via transparent pricing, something neither public nor private monopolies permit.

5/ You cite Amdahl’s Law to argue that physician salaries are a rounding error. True. But this only strengthens the counterargument: The problem is not the physicians, it’s the system.

A system that:

•Obscures price
•Rewards consolidation
•Penalizes independence
•And spins regulatory complexity into profit

Until that changes, your dream of government controlled, top-down equity , run by non profit health systems will produce the same result as all prior attempts: a bureaucratized empire of mediocrity.

[Mike Weissberger @gurami]

9/ It’s why I enroll my children in public education. It’s why I am comfortable drinking the water from my tap and buying the food I serve my family. The simple fact that a market is regulated or limited doesn’t immediately condemn it as substandard.