RE: A simple idea about healthcare

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eyesopened -> RE: A simple idea about healthcare (3/6/2010 2:47:59 PM)
quote: ORIGINAL: truckinslave Just skimming part of the CBO study: "Many of the studies conclude that tort reform can affect outcomes most closely related to the tort system in much the same way that advocates of changing the tort system would claim. Those studies find that reforms in general have decreased the number of lawsuits, reduced awards," and "States that enacted tort reforms had lower Medicare spending for hospitalization of elderly patients with heart disease and heart attacks, with no significant increase in adverse health outcomes." It's nonsensical to argue that high punitive damage awards, and/or unlimited pain and suffering awards, do not result in more extensive testing. We really do need some commonsense thinking and action, not more "black is white" argument. If you think that suing doctors into oblivion reduces cost, go try to convince someone else (you can argue increased quality, sensibly, but not decreased cost). Tort reform, pooling, and buying across state lines are all ideas whose time has come. Obamacare? Maybe not. I would ask you to read the story I posted this morning about one doctor who is giving surgery away for FREE. But in the article it mentions that he's been running into roadblocks from the hospitals who do not want to donate space and surgical suite. Here's the deal. Healthcare providers and facilities are worried about litigation. They settle a lot of litigation that you never hear about. Facilities (hospitals, out-patient surgery centers and the like) have such a fear of litigation that they will order more costly tests than a person actually needs. Not because anyone thinks those tests are "medically necessary" but because they want to be on record as having "done everything." When my daughter had her tubes tied last week, they took a picture of those destroyed tubes to keep in her file. Why do you suppose they did that? Cuz litigation isn't a huge problem? Tort reform isn't the only answer but it's one that might have a shorter-term remedy than waiting for a plethora of new doctors to graduate. Another thing to think about... Medicare simply does not pay for tests or procedures that are not medically necessary. Doctors and facilities accept this because they are guranteed their money in 15 days or less. Medicare is good for their cashflow. My mother's doctor order a doppler scan and Medicare denied it, saying it cost too much and a plain ultrasound could provide the same data. The doctor had a choice to challenge the decision by proving the enhanced detail of the doppler was medically necessary. Medicare would have paid. If the doctor ordered it cuz the hospital got a new gadget and are promoting its use, then the doc gets to eat the cost of the test. One thing that could lower costs right now is for people to take charge of their healthcare and ask "is this medically necessary?" I've said it before. Wellness is cheaper than illness. A LOT cheaper. GO to health fairs that offer free screenings, get regular check-ups and screenings. Heck, if we had a public plan that just paid for wellness, it would be better for everyone.

Musicmystery -> RE: A simple idea about healthcare (3/6/2010 2:59:42 PM)
quote: ORIGINAL: Fellow quote: Fellow- OK, lets go down that route; suppose we enact strong governmental controls that somehow magically reduce medical costs. So a $100,000 treatment is reduced to $50,000. For most working families, a $50,000 bill might as well be a million. Fixating on medical cost is fine, but we are still dancing around the issue of whether we can or will commit to providing non-emergency medical care to those who can't pay. There is no magic needed. Other countries do it. How else can you provide the care for people who can not afford it? People resist increasing taxes to feed the current medical racket. Borrowing from Chinese can not be a long-term solution. You completely ignored his point. Reducing costs is fine. It doesn't insure the uninsured or solve any of the abuses. These costs come back to taxpayers. He'd agree with you about the Chinese. That's why he wants to solve the problem.

AnimusRex -> RE: A simple idea about healthcare (3/6/2010 5:41:06 PM)
quote: ORIGINAL: truckinslave I suppose everyone who really looks at this would like to replace emergency care with routine care. But it doesn't take a 2700 page bill devoted to accounting gimmicks to do that. It would be interesting to see a bill addressing that part of the problem. I agree- it doesn't need to be complicated; we could simply open Medicare to everyone under a certain income level, and the problem would be solved. Except..... We would still have to figure out how to pay for it. Which, come to think of it, is exactly, precisely, the issue. Are we willing to have money taken out of our paychecks to provide health care to some indigent family who can't afford it? In my case, yes. I do think we have a moral obligation to help those who can't help themselves. We can argue about the details, but that is the general principle.

Brain -> RE: A simple idea about healthcare (3/6/2010 6:57:55 PM)
We're going to have a health care bill soon that will reduce health care expenses by a hundred billion dollars. If they pass a health care bill with the public option using reconciliation it will save significantly more than $100 billion. It looks like Obama and the Democrats are going to do a lot about health care and do a lot of good for the American people. Would a public option actually help reduce health care costs? Two factors could limit the public option’s ability to drive down costs through increasing competition. First, fees will be negotiated rather than imposed, and second, the public option will have less bargaining power than the massive Medicare system because it will likely have far fewer participants. As a result, the CBO expects that under the House bill, the government-run plan will end up paying providers the same rates as comparable private plans. The public plan would likely have lower administrative costs, though, because insurance would be sold directly to individuals, and not through a broker. But, the public plan could pay off in the long run. Although providing care may cost more initially, if the public option becomes a vehicle for a large number of currently uninsured people to gain coverage, it could save money — and lives. Its enrollees could avoid becoming chronically ill from a lack of medical attention. And instead of waiting until they’re sick and turning to costly emergency rooms for treatment, Americans insured through the public option could get preventive care to reduce their risk of developing serious diseases. http://moneywatch.bnet.com/economic-news/article/health-care-reforms-public-option-everything-you-need-to-know/364824/

DomKen -> RE: A simple idea about healthcare (3/6/2010 10:45:04 PM)
quote: ORIGINAL: truckinslave Just skimming part of the CBO study: "Many of the studies conclude that tort reform can affect outcomes most closely related to the tort system in much the same way that advocates of changing the tort system would claim. Those studies find that reforms in general have decreased the number of lawsuits, reduced awards," and "States that enacted tort reforms had lower Medicare spending for hospitalization of elderly patients with heart disease and heart attacks, with no significant increase in adverse health outcomes." It's nonsensical to argue that high punitive damage awards, and/or unlimited pain and suffering awards, do not result in more extensive testing. We really do need some commonsense thinking and action, not more "black is white" argument. If you think that suing doctors into oblivion reduces cost, go try to convince someone else (you can argue increased quality, sensibly, but not decreased cost). Tort reform, pooling, and buying across state lines are all ideas whose time has come. Obamacare? Maybe not. Maybe you missed what these studies mean, tort reform has already been implemented and has already reaped all the big savings it is going to get. Any more limiting of access is pointless and likely to result in negative outcomes.

truckinslave -> RE: A simple idea about healthcare (3/6/2010 11:26:49 PM)
I think you missed ALL the points. Thesse are small programs in a very few (small, for the most part) states. Many are so new CBO commented that they are hard to score for lack of data.

DomKen -> RE: A simple idea about healthcare (3/6/2010 11:39:14 PM)
quote: ORIGINAL: truckinslave I think you missed ALL the points. Thesse are small programs in a very few (small, for the most part) states. Many are so new CBO commented that they are hard to score for lack of data. What are you talking about? At the time of the CBO study, 2004, every state in the union, except TN, had implemented some form of tort reform. The other studies are more recent and continue to document what the CBO found.

tazzygirl -> RE: A simple idea about healthcare (3/7/2010 10:37:34 AM)
13000 x 30,000,000 = 390,000,000,000 / 270,000,000 = 1444.45. 13000 = costs of health care for one person for a year. 30,000,000 = the suggested number of people without health care 270, 000, 000= those with health care. 1444.45 = if all those who had insurance paid for those who didnt. Now, these are not the accurate numbers. Many of these people are eligible for medicare, medicaid or other form of assistance. what i do see is this number, those without insurance, climbing. i see a system perched on the edge of collapse. i see the health care industry potentially being the next AIG. And i say... let it go under. Its the only way we will get true reform. And, to add, its about time we got medicine back to the way it was... all about the desire to help people... not about the desire to own a porche and a 5 million dollar home. Most of sciences biggest advancements were made my men and women who craved to help, to discover... not by those who craved money.

Sanity -> RE: A simple idea about healthcare (3/7/2010 11:16:13 AM)
But, but, but... Canada was supposed to be the ideal. Why in the world could it possibly be that turning doctors and nurses and other health care providers into underpaid governmental bureaucrats isn't working out... ? quote: ORIGINAL: zephyroftheNorth quote: The price of an x-ray machine, never mind an MRI machine, or a CT or ultrasound is outrageous. Not to mention the cost of having enough people to run those machines.....and people to read the scans....and people to type the reports in a timely manner. The hospital I work at has a lovely PET scanner, donated by hockey player Saku Koivu, BUT we don't have enough people to do the scans so the wait is long. We are greatly understaffed when it comes to technologists, and 30 (I think) are getting ready to retire with noone to replace them. That is a major problem here, along with the shortage of family doctors.

Musicmystery -> RE: A simple idea about healthcare (3/7/2010 11:21:36 AM)
We have the same problem here. In Japan, though, the machines and the procedure are less than half the price, and appointments readily available, as several places do the scans.

DomKen -> RE: A simple idea about healthcare (3/7/2010 12:16:19 PM)
quote: ORIGINAL: Sanity But, but, but... Canada was supposed to be the ideal. Why in the world could it possibly be that turning doctors and nurses and other health care providers into underpaid governmental bureaucrats isn't working out... ? The Canadaian government does not directly employ the vast majority of health care workers in Canada. Please stop making stuff up.

juliaoceania -> RE: A simple idea about healthcare (3/7/2010 12:35:07 PM)
quote: I posted about a doctor who donates his time and service. One problem he's run into is hospitals unwilling to donate space anymore. It's that hospitals are so afraid of lawsuits that they fear being humanitarian. There really are doctors who do not charge much. There really are doctors who donate their time and talents. It's really isn't the doctors who are the problem... it is the lawyers and the people who feel that they are absolutely entitled to sue their way through life. There are also drug addicted doctors, doctors who preform unnecessary procedures, doctors who operate drunk, doctors who are inept and sloppy Doctors bury their mistakes, they call it "practicing" medicine for a reason

Moonhead -> RE: A simple idea about healthcare (3/7/2010 12:35:10 PM)
Surely you don't expect him to be capable of discussing failures in European healthcare systems instead?

truckinslave -> RE: A simple idea about healthcare (3/7/2010 11:56:18 PM)
quote: Are we willing to have money taken out of our paychecks to provide health care to some indigent family who can't afford it? The question is more properly: "Are we willing to have more money taken out of our paychecks by force by a tyrannical government who will poorly use half or more of it, and use most of the remainder to pay for medical care for someone who decided he needed two new cars and a bigger house more than he needed health insurance?" The indigent, you see, already have free health care... That having been said, the first law ever made in this country by a European was, in effect: "Work or starve". I like both the law and the spirit of it. People make many bad decisions; some of them are in fact fatal. I'm not sure that correcting all of those bad decisions is a proper function of gummint.

eyesopened -> RE: A simple idea about healthcare (3/8/2010 5:27:15 AM)
quote: ORIGINAL: juliaoceania quote: I posted about a doctor who donates his time and service. One problem he's run into is hospitals unwilling to donate space anymore. It's that hospitals are so afraid of lawsuits that they fear being humanitarian. There really are doctors who do not charge much. There really are doctors who donate their time and talents. It's really isn't the doctors who are the problem... it is the lawyers and the people who feel that they are absolutely entitled to sue their way through life. There are also drug addicted doctors, doctors who preform unnecessary procedures, doctors who operate drunk, doctors who are inept and sloppy Doctors bury their mistakes, they call it "practicing" medicine for a reason I'm not saying no one would ever be able to sue. If people only sued criminally negligent providers I'm sure malpractice would look differently. And I don't believe tort reform to be the only answer but one that could have a more immediate impact. I favor a public option that would be or at least mimic Medicare complete with waste, fraud and abuse oversight. Allow people to opt for PartA, B, C, and/or D. I would even favor a public plan that paid only for preventive care. We might actually have to force people financially to take care of themselves. Look, you buy a car with a warranty. But if you fail to get regular maintenance on that car, the warranty is void. Most Americans never go to a doctor until they are sick. Many times they don't go to a doctor unless their illness has become chronic or acute. Chronic or acute costs a lot. Blood tests, cancer screenings and immunizations don't cost nearly as much. A big problem is people don't want to bother staying well but they don't want to have to foot the bill for being sick. You can't buy hurricane insurance during hurricane season, you can't buy hurricane insurance after your home was destroyed by a hurricane but that's what we seem to want with our healthcare system. We don't want health care, we want sickness pay.

Sanity -> RE: A simple idea about healthcare (3/8/2010 5:45:52 AM)
Arpig, a Canadian, boasts that his health care is "free". So if he doesn't pay for it and the Canadian government doesn't pay for it, that means those poor Canadian doctors must be slave laborers. Unless the key word in your post is the word "directly". [8\|] quote: ORIGINAL: DomKen quote: ORIGINAL: Sanity But, but, but... Canada was supposed to be the ideal. Why in the world could it possibly be that turning doctors and nurses and other health care providers into underpaid governmental bureaucrats isn't working out... ? The Canadaian government does not directly employ the vast majority of health care workers in Canada. Please stop making stuff up.

tazzygirl -> RE: A simple idea about healthcare (3/8/2010 5:57:31 AM)
quote: ORIGINAL: truckinslave quote: Are we willing to have money taken out of our paychecks to provide health care to some indigent family who can't afford it? The question is more properly: "Are we willing to have more money taken out of our paychecks by force by a tyrannical government who will poorly use half or more of it, and use most of the remainder to pay for medical care for someone who decided he needed two new cars and a bigger house more than he needed health insurance?" The indigent, you see, already have free health care... That having been said, the first law ever made in this country by a European was, in effect: "Work or starve". I like both the law and the spirit of it. People make many bad decisions; some of them are in fact fatal. I'm not sure that correcting all of those bad decisions is a proper function of gummint. The indigent have health care... Medicaid.. Medicare, ect The rich have health care... private plans. Big employers offer health care... BCBC, Aetna, ect. Then there is a huge segement that has no insurance, no way to buy any at an affordable rate, yet these are the same people who work their asses off everyday. Here is a challenge for everyone. Take one week and ask everyone you associate within that week two questions.... 1) Does your job provide health insurance... 2) Do you purchase your employers plan... Those at the lower rungs of the income ladder are those without the option. But, hey, i have none. Im waiting for the collapse, the panic. Im eager to see the money hungry physicians leave the market. People... MANY people... are making a fortune on the illnesses of others. Pass by the local hospital. How many have expensive statues outside? Inside? Fabulous prints on the walls in the offices that no one sees? Do you honestly think the sick care whats on a wall or outside the building? Who are these art objects placed for? There is SO MUCH waste in health care... starting with the hospitals, the corporations, the management, the physicians.

cuckoldmepls -> RE: A simple idea about healthcare (3/8/2010 7:50:29 AM)
The solution to healthcare is multi-faceted. What the democrats are doing is just throwing money at the problem, and incurring more liabilities which drive up the cost of healthcare. I'm talking about providing Illegal aliens with free healthcare, when it is non emergency. They also block tort reform at every opportunity since 95% of money raised by trial lawyers goes to democrats. . Creating more doctors would help, but they could still charge whatever they want, and it's completely Constitutional. I think we need to copy the Japanese system, which has a pricing book for each procedure. Keep in mind, that doctors could still charge whatever they wanted but just like with medicare and medicaid, if the doctors didn't want to participate then they would have to rely on wealthy patients with better insurance. Eventually those wealthy patients are going to dry up percentage wise, since the next generation will not have 2 retirement plans that some senior citizens had, and the doctors will wake up and smell the coffee. Some senior citizens had 3 retirement plans. Company pension plan, 401k, and social security. This is the real solution and it does not create another massive government program that will continue to bankrupt us. http://babelishere.webs.com/health.html

tazzygirl -> RE: A simple idea about healthcare (3/8/2010 7:53:17 AM)
Show me where they are planning to provide illegals non-emergent health care. When you do, be prepared to find that i will show you at least a dozen more sources. including the bills themselves, that show they are not.

tazzygirl -> RE: A simple idea about healthcare (3/8/2010 7:54:52 AM)
~FR The following article, i think, hits the nail on the head of the health care issue... Health Care, Greed and Aesthetics I recently read an interview with the health researcher Avedis Donabedian just before he died from cancer. Donabedian was the founder of the process-structure-outcome model of assessing quality in health care that is standard fare these days. In the interview he mostly waxed philosophical on the dominance of the profit motive and economic models applied to health care, where the idea that somebody can make money in health care without actually supplying care themselves struck him as "perverse, as a kind of racketeering." Along those lines, Bruce Vladek, a former HCFA director and a speaker at SLHI's February 2001 conference on employer-based health insurance, noted that the CEO of one of the country's leading health plans made $8 million last year, while the head of Medicare, which covers literally millions more people than any commercial plan, made a tiny fraction of that amount. At that same conference, Mark Pauly, a leading health economist, expressed his great belief in "the forces of greed in American capitalism" as the antidote to excessive and inefficient government regulation and control. But what is greed? Eight million a year for a CEO? Drug company profits at two to four times the average of other industries? One million plus in salary for a heart surgeon at a popular boutique hospital? At some point excessive profit and greed become poor form. They may not be illegal - and they are accounted for by understandable market forces - but the aesthetics are not morally pleasing. This point is easier to draw in, say, sports and entertainment, where even even the average fan ridicules the $20 million salaries of certain ballplayers. It's harder to draw in a field like health which, like education, is viewed as a public good, and therefore operates under a different set of public expectations and values than the private, for-profit business world. Whether health care ought to operate under a different set of expectations and values is, of course, the issue. Instead of continuing to swim upstream in the murky waters of social justice and make arguments for the redistribution of social goods on the basis of fairness and equity, it would be interesting to begin a public discussion on the aesthetics of health care: the attributes of sensibility, taste, style and values that comprise "good form." I wonder whether it's even possible anymore to make aesthetic judgments in the public realm, but by framing the debate on resource allocation along some continuum of what is aesthetically pleasing - as distinct from what is fair or legal - we might find more agreement on a set of standards and expectations than we think. As for myself, I'm not sure it's not fair that a health insurance executive can make $8 million a year when millions can't afford health insurance. But I do find it to be in poor taste. http://www.slhi.org/publications/drift/11_01_2001.shtml

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