RE: Medicare as a shining example (Full Version)

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Musicmystery -> RE: Medicare as a shining example (8/18/2009 4:21:07 PM)

quote:

ORIGINAL: OrionTheWolf

I propose what I always have, and that is holding our politicians accountable. A complete review of Medicare, and the waste that goes on there would be in order. Hell the money we save there would pay for some kind of healthcare.


Not defending the waste...but these are easy words.

Understandably, someone's going to say "rent instead of own, hospital visits instead of opening the door to home visits, will ultimately save money, even if there are a few glitches." And on the face of it, they'd probably be right.

So the system needs a means to allow reasonable exceptions. MOST systems in work cultures have this problem. Yes, it can be overcome, but it's very difficult, and resistance to changing it is strong for number of reasons. Key among those reasons, though, is administration would have to empower people in the system to make those decisions. They don't want to do so, because they are the ones who will be held accountable. Businesses all the time spend thousands avoiding paying hundreds. You must see this yourself in your consulting work.

Politicians are in an even worse position. Voters don't carefully examine issues as a rule--they shoot from the hip. Someone who came along and told them the truth about what was needed and what it would take would be shoved out the door immediately as someone wasting taxpayer dollars, even though their proposal will save thousands, millions or billions. "You want to fund a complete review of Medicaid? In this economy? More government money wasted on top of what Medicaid wastes!" All people want to hear is tax cuts. Consequently, many government agencies have neither the staff nor the funds to actually do their jobs--OSHA is a good example; FDA oversight is another. And the continued postponement of addressing health over cost has and continues to cost us billions, and at ever-rising rates of increase. We should throw out politician who DON'T want to spend that money--but you know that will never happen.

I agree with you...but we'll need more than just "hold them accountable."

Have you written to your representatives about the situation? How have they responded? I have found that often they can jump in and untangle red tape to solve such snafus. If you haven't, it's worth a try, and won't take long. Just like in business--it the support staff is uncooperative, talk to the sales rep (who wants your "vote," your return business).

After that's solved, give 'em an earful about Medicaid.

Live well,

Tim




DomKen -> RE: Medicare as a shining example (8/18/2009 4:27:45 PM)


quote:

ORIGINAL: OrionTheWolf

This is an example of a ridiculous reply, utterly ridiculous. I am not talking about getting rid of Medicare, and I do not believe anyone else is, so your bullshit strawman does not stand up, it just stinks. What is be discussed is the wastefulness of that system, which seems to be inherent of our government. Change the system, fix what is broken, don't keep adding on to a foundation that is obviously faulty and dangerous.


quote:

ORIGINAL: DomKen

Basic question for those attacking Medicare, what would seniors do without it? Would you be willing to right now permanently opt out of both mecicare and SS if they are such terrible freedom destroying socialist programs?


Sorry no. This is the second timeyou've attacked Medicare recently. Once it was because you used to supply durable medical devices, like home oxygen systems, and now it is over the red tape invovled in getting and keeping durable medical devices.

First you claimed it was too easy to get the devices and there was much fraud in the process and now you're complaining about the system in place to control costs and prevent fraud.

Maybe its all just coincidence.

I asked a question that has merit in this debate. You aren't required to answer my question but I am certainly allowed to ask it.



Louve00 -> RE: Medicare as a shining example (8/18/2009 4:27:55 PM)

quote:

ORIGINAL: DomKen

Basic question for those attacking Medicare, what would seniors do without it? Would you be willing to right now permanently opt out of both mecicare and SS if they are such terrible freedom destroying socialist programs?


I am not attacking medicare.  My husband is on disability and with it, comes medicare.  He needs it.  What we don't need is the wasteful spending that goes with it.  Not only with medicare.  With the whole health care system.



mnottertail -> RE: Medicare as a shining example (8/18/2009 4:33:14 PM)

Well; yeah, to all here.  The first thing is; is that we are looking to reform healthcare, and reduce skyrocketing costs, don't give a fuck if it is single payer, or million payer, it needs simplification, reduction of costs, reduction of wastes, and meaningful healthcare instead of adversarial interaction with insurance, the fed, the state, the hmo et al.

The method of payment delivery is not reform, but it might be the best first step we can do......



Blaakmaan -> RE: Medicare as a shining example (8/18/2009 5:05:07 PM)

Well I, for one, could give lots and lots and lots of examples of private enterprises--the very lifeblood of capitalism, that could be run better by 5-year-olds.

Like... a McDonald's that ran out of soda and only had water to sell.

It is to laugh...

Between the government and the "health insurance" companies, I'll go with the government.

At least the government's goal is to provide you with health care, as opposed to making every dime they can possibly make, even if it means disapproving or delaying care they should cover--like the good old "health insurance" companies.



mnottertail -> RE: Medicare as a shining example (8/18/2009 5:11:21 PM)

Blaakmaan,

I agree, I would rather deal with well meaning, inept, simpletons who try to have my best interests at heart than evil, inept, simpletons who are only self-interested.    



Blaakmaan -> RE: Medicare as a shining example (8/18/2009 5:20:32 PM)

quote:

ORIGINAL: mnottertail

Blaakmaan,

I agree, I would rather deal with well meaning, inept, simpletons who try to have my best interests at heart than evil, inept, simpletons who are only self-interested.    


Damn!
Why didn't I put it that way?
Well said... and true!



Sanity -> RE: Medicare as a shining example (8/18/2009 5:33:33 PM)


Orion is right on this one, as right as can be. Bureaucrats and politicians have several dishonorable characteristics, cronyism and laziness and a desire for power over their fellows aren't the least among them.

Businesses have to make a profit to continue to make payroll. Bureaucrats though? They just have their sponsoring career politicians raise taxes a little higher every year...

One other thing that I've witnessed personally is, if a given government entity fails to waste as much one year as they did the previous year they get their budget cut - and so there is always a mad frenzy of deliberate wastefulness towards the end of every budget year.

For whatever reason, bureaucracies develop into the most inhuman, incompetent and wasteful entities that there are. The culture that develops among bureaucrats is horrid and intolerable, and it feeds on itself. Ever hear of a bureaucracy cutting costs, trimming the fat or  "right sizing"?

And it doesn't get better with time, it gets worse.



quote:

ORIGINAL: Blaakmaan

Well I, for one, could give lots and lots and lots of examples of private enterprises--the very lifeblood of capitalism, that could be run better by 5-year-olds.

Like... a McDonald's that ran out of soda and only had water to sell.

It is to laugh...

Between the government and the "health insurance" companies, I'll go with the government.

At least the government's goal is to provide you with health care, as opposed to making every dime they can possibly make, even if it means disapproving or delaying care they should cover--like the good old "health insurance" companies.




mnottertail -> RE: Medicare as a shining example (8/18/2009 5:35:49 PM)

quote:

ORIGINAL: Sanity

For whatever reason, bureaucracies develop into the most inhuman, incompetent and wasteful entities that there are. The culture that develops among bureaucrats is horrid and intolerable, and it feeds on itself.

And it doesn't get better with time, it gets worse.



And large corporations differ in what way?



Sanity -> RE: Medicare as a shining example (8/18/2009 5:42:52 PM)


IF they don't get huge bailouts, they must remain competitive in order to survive. They have to do some occasional naval gazing, even answer to Congress for a show trial.

Name the last time Congress grilled the head of Health & Human Services?

quote:

ORIGINAL: mnottertail

quote:

ORIGINAL: Sanity

For whatever reason, bureaucracies develop into the most inhuman, incompetent and wasteful entities that there are. The culture that develops among bureaucrats is horrid and intolerable, and it feeds on itself.

And it doesn't get better with time, it gets worse.



And large corporations differ in what way?



mnottertail -> RE: Medicare as a shining example (8/18/2009 5:46:20 PM)

you have to ifs to qualify your statements, and they both argue against you.  they have been bailed out, and they dont need to be competitive, they make rules advantageous to their interest via lobby that then gives them a mortal lock. And HandHS has navel gazed quite often in congress........nobody was really watching. 



Sanity -> RE: Medicare as a shining example (8/18/2009 5:55:00 PM)


Bureaucrats don't need to compete, they don't need to innovate, they just need more taxes. GM could make Yugos if it were just giving them away and had no competition, and no one would ever even know that there was a potential for so much more. Corporations exist in real life, bureaucrats exist in a weird world that's part fantasy because their existence is purely subsidized.

In real life, Chrysler is being broken up and sold off, and Toyota and Ford aren't, for good reason.

Read the OP again, Ron. Any CEO worth half a shit would send some department heads rolling if waste such as that came to light. In a bureaucracy though, that's just another day in paradise.







mnottertail -> RE: Medicare as a shining example (8/18/2009 6:00:58 PM)

And healthcare is broken in this country, so what's the fuckin' point value here, Sanity?

Rhetoric is aplenty out here buddy and it always will be, corporations are not behaving as you ascribe to them from the Milton Friedman playbook.  And you cannot divorce the fact of taxes must rise (because the government is a corporation at its core) and ignore the fact that to survive a company must grow, and they are going to take it out of your ass if they can't get it from somewheres else.....(like people who cant afford insurance)

So, I do not buy your assumptions that there is no twain in my arguments.

Same, same.  Each a cheek of the horses ass.  But I can vote (and thereby fire) a senator, I cannot (unless I own a heavy chunk of thier stock) fire a CEO.  



Blaakmaan -> RE: Medicare as a shining example (8/18/2009 6:14:33 PM)

quote:

ORIGINAL: Sanity


Bureaucrats don't need to compete, they don't need to innovate, they just need more taxes. GM could make Yugos if it were just giving them away and had no competition, and no one would ever even know that there was a potential for so much more. Corporations exist in real life, bureaucrats exist in a weird world that's part fantasy because their existence is purely subsidized.

In real life, Chrysler is being broken up and sold off, and Toyota and Ford aren't, for good reason.





Well, it just ain't that simple.

Even government agencies have budgets that they have to meet.  They don't have printing presses where they can just print up some greenbacks.

And, as for that golden child, private enterprise--aren't the banks and the mortgage brokers and the Wall Street firms, private enterprises all--the very entities that got us into this deep-ass hole that the inefficient government had to dig their asses out of?

Government is not always wasteful, and it's not a bad thing.

Private enterprise is not always efficient (some of you must work for or make use of these horribly inefficient private corporations that could not give a damn less about their customers.

Cable tv anyone?  Your cellphone company?  Your health insurer?  Your auto repair shop?

The "government wasteful/bad," "private enterprise efficient/good" dichotomy is just false.

Private enterprise as healthcare provider is what we have now.  How does it look to you?

If it was so damned good and efficient, we wouldn't even be having this conversation.




gift4mistress -> RE: Medicare as a shining example (8/18/2009 6:17:52 PM)

quote:

ORIGINAL: elegantcdgoddess

i dont think that is medicare issue. The problem is in healthcare. Why dont we have physicians with regular home visits in US?

I know it might sound harsh, but there is nothing wrong with medicare decision. Elderly, ill patients should see physician and be evaluated, rather then medicated blindly. That is actually great concept. The problem is in healthcare system who cannot organize themself to serve the patient.


That is absolutely the dumbest thing I have ever herd. Our health care is the best in the world though our system isn't.



OrionTheWolf -> RE: Medicare as a shining example (8/18/2009 6:22:42 PM)

quote:

ORIGINAL: Musicmystery

quote:

ORIGINAL: OrionTheWolf

I propose what I always have, and that is holding our politicians accountable. A complete review of Medicare, and the waste that goes on there would be in order. Hell the money we save there would pay for some kind of healthcare.


Not defending the waste...but these are easy words.


No they are not easy words. I have been involved in effeciency audits of companies before, and really all it takes is for the politics to stop, and someone with some stones to say "enough!".

quote:


Understandably, someone's going to say "rent instead of own, hospital visits instead of opening the door to home visits, will ultimately save money, even if there are a few glitches." And on the face of it, they'd probably be right.


I suggest maybe some research on your end, such as what Louve mentioned. Hospital beds for the home is another one where the rent of the bed is several times the actual cost of buying it. These are just a few examples.

quote:


So the system needs a means to allow reasonable exceptions. MOST systems in work cultures have this problem.


Only when medocrity and corruption are allowed to flourish.

quote:


Yes, it can be overcome, but it's very difficult, and resistance to changing it is strong for number of reasons. Key among those reasons, though, is administration would have to empower people in the system to make those decisions. They don't want to do so, because they are the ones who will be held accountable. Businesses all the time spend thousands avoiding paying hundreds. You must see this yourself in your consulting work.


Independent investigations are done all the time for the government, all they need to do here is have an independent effeciency audit done. Yeah someone would have to take some responsibility, and yeah I see it in my consulting work, and those companies are still operating pretty strongly.

quote:


Politicians are in an even worse position. Voters don't carefully examine issues as a rule--they shoot from the hip.


I agree that we the people are responsible for the monsters we have created, either through our active doing or accepting things as a necessary evil.

quote:


Someone who came along and told them the truth about what was needed and what it would take would be shoved out the door immediately as someone wasting taxpayer dollars, even though their proposal will save thousands, millions or billions.


This is why the people have to support this kind of change. The change that was used as rhetoric during the campaign, and people talk about happens with the people first. Also, your statement above is what you surmize the situation would be, as no one has even proposed it.

quote:


"You want to fund a complete review of Medicaid? In this economy? More government money wasted on top of what Medicaid wastes!"


Effeciency audits are more likely to be done by companies during lean times than boom times. Are you saying the American people would not support an audit of the government to find waste? I believe Obama even made a campaign promise about auditing the government to find waste.

quote:


All people want to hear is tax cuts. Consequently, many government agencies have neither the staff nor the funds to actually do their jobs--OSHA is a good example; FDA oversight is another. And the continued postponement of addressing health over cost has and continues to cost us billions, and at ever-rising rates of increase. We should throw out politician who DON'T want to spend that money--but you know that will never happen.


Why not start with one agency and then move forward. Use the money saved in one to fund the audits for the others. Right now people are talking about healthcare, so I cannot see a better time than to address the one healthcare the Feds have been handling. Shape it up and then say "See what a great job can be done!" I also see most of your comments as a form of surrender, once mediocrity is acceptable because of any reason, then failure exists. Sorry but I do not accept that.

quote:


I agree with you...but we'll need more than just "hold them accountable."


Oh I agree, and this is why I have not voted for an incumbant in over 12 years. If the people of this country were to say "I have had enough!" and vote out their current congressperson, it would send a strong message. the reason they do not is because of many of the excuses you list, as well as a host of others. The American people do not have the collective balls to do it, because of either petty differences, or selfish interest.

quote:


Have you written to your representatives about the situation?


That was the first place I write, as well as a copy to the local paper.

quote:


How have they responded? I have found that often they can jump in and untangle red tape to solve such snafus.


Looked like a canned response of basically "we will look into it." Also, it is not a snafus, it is the Medicare requirements. They are following the letter of the rules. No one is technically doing anything wrong.




Blaakmaan -> RE: Medicare as a shining example (8/18/2009 6:28:04 PM)

quote:

ORIGINAL: gift4mistress

quote:

ORIGINAL: elegantcdgoddess

i dont think that is medicare issue. The problem is in healthcare. Why dont we have physicians with regular home visits in US?

I know it might sound harsh, but there is nothing wrong with medicare decision. Elderly, ill patients should see physician and be evaluated, rather then medicated blindly. That is actually great concept. The problem is in healthcare system who cannot organize themself to serve the patient.


That is absolutely the dumbest thing I have ever herd. Our health care is the best in the world though our system isn't.



Now, how can those two things both be true, since health care is delivered though the health care system?



Sanity -> RE: Medicare as a shining example (8/18/2009 7:38:02 PM)


Actually, no - it was career politicians, bureaucrats, and the inherant cronyism that come with them. Look into Barney Frank's very special relationship with Fannie Mae just to begin with.

quote:

And, as for that golden child, private enterprise--aren't the banks and the mortgage brokers and the Wall Street firms, private enterprises all--the very entities that got us into this deep-ass hole that the inefficient government had to dig their asses out of?



Sanity -> RE: Medicare as a shining example (8/18/2009 7:45:00 PM)


quote:

ORIGINAL: mnottertail

...to survive a company must grow, and they are going to take it out of your ass if they can't get it from somewheres else.....(like people who cant afford insurance)


No - companies can and do downsize, split, merge, fail, and so on.

Bureaucracies just grow, bureaucracies need to do nothing but feed like fat pigs on taxes from your wallet. Government's habit of just printing money up is going to have a harsh ending, but politicians refuse to live in the real world where actual businesses have to live, and if we don't get with the program everythings gonna come crashing down hard because the real world can be a bitch if it's ignored too long before its paid its due.

quote:


But I can vote (and thereby fire) a senator, I cannot (unless I own a heavy chunk of their stock) fire a CEO.  


Many if not most Senate seats are lifetime positions, and Senators tend to become very wealthy somehow. A person can generally fire any company at any time by taking their business elsewhere.

Who was the last Senator who you fired, anyway? I'm curious to know.






Louve00 -> RE: Medicare as a shining example (8/18/2009 7:59:46 PM)

If you think companies don't operate for profit, you better think again.  If you think an insurance company is looking to save (by means of denying coverage over a certain thing or other), again...think again.  The goals may be different.  The outcomes are the same.  Competition is their motive, you say?  Well, yea, you're probably right.  They're competing for you as their customer, so they can be king and lord over your health for the sake of.....profit! 

Not at all meaning to sound like a whiney, 'sympathize-for-me' female.  When my husband (a non-smoker) was diagnosed with lung cancer.  What we paid in premiums, thinking was good insurance was slowly telling us this test, that test, and every other test that "they" thought was justified or not was approved or not.  Even insured thru private insurance, you can become bankrupt.  To delude yourself into thinking everything's ok in your world cuz you're covered is just that....an illusion.

Aside from the wasteful spending of the gov't, we can look at another private batch of companies.  The pharmaceutical companies.  Thats an issue thats also disheartening to learn of whats going on there. 

Reform.  Good reform.  Thats what we need.  My only suggestion to anyone that does have a good idea is, write your congressman.  Don't email him, write him.  Provide sources and references.  Write over and over again.  Albeit, your one man in a million expressing yourself, voicing your views.  But its proactive and a helluva lot better than critcizing. 

Unless of course you think its fine as it is now.  But I'm here to tell you thru experience.  Don't be too sure of anything.



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