Joshua Scott

simple country surgeon, veteran, fly fisherman

[Joshua Scott @Row_Jimmy_Row]

@GuntherEagleman I’d rather ram white hot pokers into my urethra and then stick my weiner in a jar of hot acid than what these American hating twat balls.

[Joshua Scott @Row_Jimmy_Row]

Several county commissioners where I reside are against Prop 1. They spew alarmist rhetoric such as the ambulance won’t come to get you when you have a heart attack and it will be your fault for being stingy for voting on Prop 1. They also cite data where other communities pay more taxes and therefore we should be just like them! They also threaten that is likely that there will then be a state income tax caused by the stingy “Yes” voters. They are not leaders. However, what pisses me off the most, is that not a single one of them have any introspection on how they can budget and be better stewards of public money. They don’t have a great track record of that either.

[Joshua Scott @Row_Jimmy_Row]

Do you really believe there is a healthcare free market in the US? If there is, you should easily be able to provide to me the price of a trauma laparotomy. Should be simple, right? Is only one type of surgery. I’ll wait….

Sure, surgeons can opt out of insurance and accept cash. But let’s be realistic about what that means.

An appendectomy, trauma laparotomy, or mastectomy isn’t a haircut. Patients generally don’t choose their surgeon based on price. Are you going shopping for the best price and highest quality of care when you’re having a heart attack or hemorrhaging from your spleen after a car wreck? I don’t recommend you do.

A surgeon can set a cash price, but cannot unilaterally set reimbursement from Medicare, Medicaid, or private insurers. A lower cash price makes it nearly impossible to eliminate the enormous overhead of running a surgical practice to perform these operations. This is why more and more surgeons are choosing to become hospital employees.

I believe in market competition, transparency, and physician autonomy. My dream is to be a part of free market healthcare, but that ain’t never gonna happen. There are waaaayyy too many middlemen and politicians lining their pockets with our healthcare dollars to ever allow that. Pretending that a mass exodus to cash-only practice would provide affordable surgical care for an entire community ignores both the economics and the ethical obligations of our profession.

[Joshua Scott @Row_Jimmy_Row]

@Hello26790754 @NeilFlochMD Ok got it. Your wording was confusing when you asked that the surgeon charges. Again, the actual surgeon charges nothing. The facility/hospital itself doesn’t charge any certain rate.

[Joshua Scott @Row_Jimmy_Row]

@custerrichard @ajlamesa Precisely

[Joshua Scott @Row_Jimmy_Row]

Yes, you’re absolutely correct about that. However, that surgeon would not be serving the entire population of his community who mostly have private insurance, Medicare or Medicaid. I have some moral reservations about excluding a very large part of my community to only those who can afford to pay cash.
Since you mentioned price, I will ask you- what is the price of a trauma laparotomy, appendectomy or a mastectomy?

[Joshua Scott @Row_Jimmy_Row]

@tonychiarello @X0_1_7ex @NeilFlochMD Indeed, a surgeon can set his or her own price so long as it’s cash only. Hiwever, most surgeons who serve the public do not decide fees/charges if there is a third party payer to include private insurance, Medicare or Medicaid.

[Joshua Scott @Row_Jimmy_Row]

@Hello26790754 @NeilFlochMD The surgeon who does a life saving trauma laparotomy at 2AM on a Sunday morning: $173/hr.

[Joshua Scott @Row_Jimmy_Row]

@Asst_to_the_RM @burnerjoy The “quietness”. GTFOOH.

[Joshua Scott @Row_Jimmy_Row]

@Asst_to_the_RM He’s a veteran. One pathway to care at WR are those with Tricare. You know that.

[Joshua Scott @Row_Jimmy_Row]

@Johnny_Joey We should also live stream abortions.

[Joshua Scott @Row_Jimmy_Row]

@Osint613 Fuckin’ based.

[Joshua Scott @Row_Jimmy_Row]

@DailyMail I don’t know her well, but she gained a fan.

[Joshua Scott @Row_Jimmy_Row]

@GovKathyHochul “still much we don’t know about what happened in Marble Hill.” Yet you’re outraged. You choose to be outraged before knowing anything and admit it. Details don’t matter to you. You obviously don’t give a flying fuck about New Yorkers or American citizens.

[Joshua Scott @Row_Jimmy_Row]

@SSharkansky @SenSanders Schmuck? You’re way too kind, sir.

[Joshua Scott @Row_Jimmy_Row]

@DGlaucomflecken @sdixitmd Owned by Unitedtacobellcostcoamazon Healthcare.

[Joshua Scott @Row_Jimmy_Row]

@earle36 @DGlaucomflecken Taco Bell

[Joshua Scott @Row_Jimmy_Row]

@DGlaucomflecken @sdixitmd Good name for a band- Ozempic and the Boner Pills.