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How's the "Affordable Healthcare" going for everyone?
This thread has 260 replies. Displaying posts 76 through 90.
Post 76 made on Friday October 4, 2013 at 12:38
BigPapa
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On October 4, 2013 at 10:09, cnacht said...
I am directly involved in health care and Mogul seems to understand many of the factors of why the ACA is not good for this country. No one is arguing that this system was not messed up in the first place, but the ACA will not fix what it was intended to fix. I would say the poor or worse yet the working poor will have just as hard of a time obtaining health care once this law goes into effect. People that have insurance that are happy with it will see costs go up higher than they were already inflated to support the newly insured.

Why is that?

He is also right that the private sector health care costs are inflated due to government programs, but I will concede that it is not the only factor.

How much does the cost increase due to government involvement? Are these costs necessary for the effective management and delivery of health care?

Are you going to imply that these costs are unnecessary and wasteful because government is inefficient, which is a key point made by Mogul?

Malpractice does increase the cost of Healthcare. Defensive medicine is a big part, but also passing cost to insurance companies and patients contribute. Some OB/GYN doctors pay 6 figures a year for malpractice. Try having that fixed cost on an annual basis and see what you have to do to prices. 

Yes, some OB/GYN's pay six figures. Many don't. OB/GYN's in only a few counties in some states pay that much. Many doctors pay 4 figures. It's easy to figure this out in the link I posted above with 10 minutes of reading. You're overstating the cost of medical malpractice insurance.

I think this country needs to decide what it wants.

It did.
Post 77 made on Friday October 4, 2013 at 12:57
Mogul
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On October 4, 2013 at 10:07, NSP01 said...
I have no answers but I do have a question.

If the American Health Care Act is so unwanted by the people as we keep being told, why are connections to the internet site constantly clogged? Is it a plot or is it because there are too many people trying to gain access?

It appears that reports of widespread enrollment are largely exaggerations by proponents of the law.

It has been reported that at least one state's exchange servers were hit by Denial of Service attacks. The 5 million visitor number thrown out by CA for day one was quietly revised downward to less than 500,000. The actual number of enrollees thus far is just over 7000 and none of these people are actually "in the system" yet because CA says its staff hasn't been trained to process the applications...Awesome.

I read that Louisiana and Kansas have ZERO enrollees as of yesterday...

Here's an anecdotal description of what's actually happening in the populous:
[Link: ac360.blogs.cnn.com]

All of that said, BCBS's servers have been completely overrun this week with policy holders scrambling to find a way to lower their increased premiums, so even non-governmental types cannot handle the concentrated onslaught of panicked citizens [which may indicate that this isn't a good approach].

I want to respond in detail to BP and FPC, but I've got to do something billable for a while--maybe tonight.

In the meantime--to clarify--I was not asserting that malpractice insurance premiums were the SOLE or CHIEF driver of medical costs. I was merely responding in a focused way to BP's assertion that citing medical malpractice costs as a cause for high prices is a "logical canard."  I also purposefully focused on a specific cost that affects individual doctors--who are human beings--since there's such a societal penchant for discounting the challenges they face as individuals.

That said, here's the NIH's tally of estimated medical malpractice-related costs:

[Link: ncbi.nlm.nih.gov]

The NIH doesn't attempt to break-out malpractice insurance premiums alone, but the costs of medical malpractice insurance and damages pay-outs tallied about $10 Billion in 2008. You may say "pish-posh," I say that's significant when you understand that we ARE paying for it.

I completely agree that defensive medicine is a far more significant driver of rising health care costs, as is shown by the NIH report.  OCare attempts to remedy this by restricting payments for preventative testing that a panel of experts/bureaucrats deems unnecessary while doing little else to absolve doctors and hospitals of the liability they must still incur if anything goes wrong. 

And just to reinforce my irrational and inflexible ideology, here's what radical right wing extremist conservative Tea Bagger Dr. Drew thinks will inevitably happen as a result of OCare :-)
"Whatever is rightly done, however humble, is noble." [Sir Henry Royce]
Post 78 made on Friday October 4, 2013 at 14:06
cnacht
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On October 4, 2013 at 12:38, BigPapa said...
Why is that?

People that scrape by and get insurance now, will pay more for it. The insurance that will be offered in the exchange, is by no means be affordable. To make it affordable, one would have to have a high deductible. When patients have high deductibles, they do not come in for their important preventative care that could possibly save money for the system.
How much does the cost increase due to government involvement? Are these costs necessary for the effective management and delivery of health care?

I do not have those figures, nor do I have the desire to look them up. If you have them, go ahead and sock it to me. Of course there are some costs that are necessary by the government for delivery of health care. That is not what I am saying. What I am saying is that there are health systems such as Virginia Mason, Geisinger, Kaiser Permanente that can deliver better quality care and more efficiently than the federal government. I would prefer to have health care that is delivered based on models that they have made rather than our congressmen that do not have a clue about health care delivery.
Are you going to imply that these costs are unnecessary and wasteful because government is inefficient, which is a key point made by Mogul?

Yes some are waste-full, but some are required. We run our own health plan and the way the government delivers health care is a joke.
Yes, some OB/GYN's pay six figures. Many don't. OB/GYN's in only a few counties in some states pay that much. Many doctors pay 4 figures. It's easy to figure this out in the link I posted above with 10 minutes of reading. You're overstating the cost of medical malpractice insurance.

I will admit that I gave an extreme example, but the cost of medical malpractice insurance and defensive medicine provide a substantial cost to the system. I would agree that it is completely underestimated partly because of political reasons (trial lawyers which many in congress have been before elected), but also because doctors are probably ashamed to admit how often they order labs or tests to cover there ass. By the way, none of the doctors in my clinic pay 4 figures are malpractice insurance. I think we can all concede that malpractice dose contribute to the cost of healthcare to some extent. If so then why wouldn't you put Tort reform into the ACA if it was truly designed to improve the affordability of health care.
It did.

I guess you could say the public did choose, but what they wanted and what they got in the form of the ACA are 2 different things.
Chad

Last edited by cnacht on October 4, 2013 15:09.
Post 79 made on Friday October 4, 2013 at 14:19
Mr. Stanley
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On October 3, 2013 at 14:21, cnacht said...
Well said Mario and Mr. Stanley.
No doctors I know are crying poor and that is not the issue. The issue is that there is a certain dollar amount it takes to put up with a lot of the crap that comes with being a physician some of which Mr. Stanley has elluded to.
I see the same thinking from people in this forum all the time. For example, how many posts complain about a pain in the ass customer that you don't want to deal with so you make a ridiculous bid so you can either walk away or the money will be worth the BS.
I love being a physician, but at some point the BS may not be worth it, and unfortunatly a lot of the BS comes mandated from the government which just got bigger in the form of the ACA. I have read plenty of threads on this forum with similar theme, just different profession.
Unfortunatly the doctor pay issue falls on deaf ears because nobody is going to feel sorry for someone making 6 figures, but it is part of the whole health care equation that needs to be figured out otherwise we will see a mass exudice from the profession and certainly will see no one going into primary care which is already at a shortage.
Chad

The two Dr.s I know also face the threat of malpractice suits constantly. They say they both feel like they are working at McDonald's - because of the constant pressure to see as many patients per day as possible - which equates to difficulty in diagnosing, and poor Dr. / patient relationships. At the end of each day they spend 3 hours on BS paperwork.
I don't understand how professional athletes can earn Millions and millions of dollars to throw or catch a ball, and a lot of Dr.'s end up earning about the same as your local car mechanic. This could be why there are a lot of bad doctors out there, because all of the good ones are going away due to exhorbinate(sp?) insurance premiums, threat of lawsuits, stress & not that great of money when all is said and done. This is especially true for OBGYN's. Their insurance is CRAZY!
"If it keeps up, man will atrophy all his limbs but the push-button finger."
Frank Lloyd Wright
OP | Post 80 made on Friday October 4, 2013 at 15:00
Mr. Brad
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Well, its been four days and I still can't tell if I have an actual account. Errors at every step of the processes.

Even though I have attempted to create an account and sign into the page, it doesn't mean that I'm trying to enroll in any of the plans. I already have insurance and I'm afraid to see what the cost will be through one of these plans if my private insurance is canceled.

I sure hope I'm not included in group of anxious applicants that is excited about this opportunity.

My honest opinion is that the program will crash and burn before it even gets implemented.
Post 81 made on Friday October 4, 2013 at 15:05
ceied
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I know i do not want 1/7 of the US economy or my healthcare in the hands of the government...

besides the military i cant think of anything the government does well...
Ed will be known as the Tiger Woods of the integration business, followed closely with the renaming of his company to "Hotties A/V". The tag line will be "We like big racks and tight holes"...
Post 82 made on Friday October 4, 2013 at 15:16
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Post 83 made on Friday October 4, 2013 at 15:31
FP Crazy
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I know a wide variety of docs, many of them are my customers. Specialty surgeons are not hurting... although it's coming for them too. Most specialty surgeons have been doing quite well for the last 15-20 years. Many of my customers, have 3 or 4 vacation homes.

GPs, Family Docs, OBGYNs and certain other types of docs have been getting crunched for years and most are ready to throw the towel in.

Given that, I don't think we can make a blanket statement one way or the other that doctors are under paid or over paid. Some are and some aren't. I have 5 anesthesiologist for customers. They have insane malpractice insurance, but I can tell you from their lifestyles and personal assets, they are all living quite well, in spite of their high insurance. I suspect the bubble is about to burst, even for specialty docs very soon. A systemic correction is coming, O'Care or not, and whenever there is a bubble burst correction, there is unfair collateral damage and carnage along with it (think Wall Street 5 years ago). GPs have been getting unfairly hammered for several years and I don't think their undeserved punishment is yet over.

When the system has been screwed up for so long, there is enough punishment to go around, and the American people are getting their just deserts for failing to allow anything to be done about it, idly sitting by and allowing Big Pharma, Insurance, bloated multi conglomerate hospital systems (and even the federal gov't to some extent) to siphon from our pocket books and running the system into the gutter.

It's a big pile of money, and whenever you have a big pile of money, it's going to attract a lot of capitalistic self interest, system be damned.

Our country has the most expensive health care system in the world, not even a close comparison. It is not the even in the top 5 of quality of service (I'd have to look it up but I don't think it's even in the top 20), no matter what metrics you use to rank it. That's what unbridled, free market capitalistic health care can get you!

But again, most of the onus falls on us. As a majority, we refuse to eat proper, we refuse to exercise, we think taking a pill should solve all our problems (playing right into Pharma's plot), fast food places are freaking everywhere, corn subsidies are running the food supply, diabetes and obesity is rampant, and on, and on, and on.

And the doc is right, we spend way too much money on the last 6 months of life. Yet the conservatives keep harping abut "death panels". I suspect if the system asked the family to pay out of pocket for the last 6 months of life, most families would start believing in euthanasia. We treat our dogs better than we treat our own family members.
Chasing Ernie's post count, one useless post at a time.
Post 84 made on Friday October 4, 2013 at 15:39
Mac Burks (39)
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I treat my dog better than anyone or anything else on the planet. Shes the only one who deserves it.
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Post 85 made on Friday October 4, 2013 at 15:54
cnacht
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And the doc is right, we spend way too much money on the last 6 months of life. Yet the conservatives keep harping abut "death panels". I suspect if the system asked the family to pay out of pocket for the last 6 months of life, most families would start believing in euthanasia. We treat our dogs better than we treat our own family members.

Although I tend to sway to the conservative/libertarian point of view, it drives me nuts when the Republicans play to peoples fears by calling these things "Death Panels". As far as I am concerned a panel that would decide what is appropriate to provide based on evidence based medicine would be the only thing that would decrease cost in the ACA.
FP Crazy is right about the money spent on the last 6 months of a persons life. I have countless stories of people having everything done for them even though the outcome would be the same. Unfortunately this is an area that no one in Congress will touch politically because they will be accused of being Kevorkian and doctors shy away because of fear of lawsuits and being accused of being a Kevorkian as well.

Last edited by cnacht on October 4, 2013 16:15.
OP | Post 86 made on Friday October 4, 2013 at 16:24
Mr. Brad
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On October 4, 2013 at 15:05, ceied said...
I know i do not want 1/7 of the US economy or my healthcare in the hands of the government...

besides the military i cant think of anything the government does well...

+1 trillion
Post 87 made on Friday October 4, 2013 at 21:29
BigPapa
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On October 4, 2013 at 15:05, ceied said...
I know i do not want 1/7 of the US economy or my healthcare in the hands of the government...

besides the military i cant think of anything the government does well...

Both statements I've heard on talk radio repeated I don't know how many times. It's bumper sticker intellectualism.

The government has been running 1/7th of the US Economy (more like 22%) in health care for a really long long time. It's called Medicare and Medicaid. 

The military has it's problems with $: politicians wanting to spend billions on a very expensive fighter plane that the military doesn't want as one example. The military has had successes and failures. Do you recommend we let the private sector compete in warfare? We dabbled in that in Iraq, didn't seem to work out that well.

While it's easy and en vogue to complain about government 'not doing things well' it really doesn't mean anything. It's a feeling, a belief, but not a useful concept to initiate in problem solving. 

But it really works well if you want to maintain the status quo. Then it's useful. 
Post 88 made on Saturday October 5, 2013 at 00:55
cnacht
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On October 4, 2013 at 21:29, BigPapa said...
|

Both statements I've heard on talk radio repeated I don't know how many times. It's bumper sticker intellectualism.

The government has been running 1/7th of the US Economy (more like 22%) in health care for a really long long time. It's called Medicare and Medicaid.

The military has it's problems with $: politicians wanting to spend billions on a very expensive fighter plane that the military doesn't want as one example. The military has had successes and failures. Do you recommend we let the private sector compete in warfare? We dabbled in that in Iraq, didn't seem to work out that well.

While it's easy and en vogue to complain about government 'not doing things well' it really doesn't mean anything. It's a feeling, a belief, but not a useful concept to initiate in problem solving.

But it really works well if you want to maintain the status quo. Then it's useful.

I get it, you feel the government is the solution to the health care problem. Correct me if I am wrong, but you feel that we should have a socialized medical system and that would fix most of the issues with our health care system because the private sector could never figure it out. I say you are wrong based on my 15 years of not only being a physician, but being a board member of a multi-specialty clinic. Medicare has been around for ages and is not going away and we get that, but it the most screwed up system we have to deal with. Every year they throw some more unfunded mandate our way, most of which only make it harder to take care of our patients.
I will have to say that us physicians are partly to blame, and not because of our pay. Most of us spend all of our time caring for our patients and we didn't take the time to take the lead on this issue. Due to our apathy, we got a solution that beurocrats created which is less than ideal. There are examples of private systems that have figured it out. I would say that our physician owned and run health plan is a good example, but big players like Viginia Mason, Geisinger, and Kaiser are examples of how a good system can be scaled out.
I applaud your idealism on this issue, and think it would be great to deliver health care to every one as well. The problem is that you can't do that without rationing, and no one has the stomach for that in this country. If you don't ration in a national health care system, it will go bust. When you try to please everyone, you please no one.
Chad
Excellent thread. With with all the differing opinions, you can see why there are no easy solutions. I hope I was able to provide some insight from the inside. I think from here on out I will watch you guys duke it out on this issue as I have fallen behind by responding on this thread instead of doing my paper work.
Post 89 made on Saturday October 5, 2013 at 06:28
iform
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Interesting reading
[Link: en.wikipedia.org]
Post 90 made on Saturday October 5, 2013 at 08:04
Mac Burks (39)
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On October 5, 2013 at 06:28, iform said...
Interesting reading
[Link: en.wikipedia.org]

More liberal commie socialist muslim decepticon propaganda. Making it that simple and mutually beneficial takes away our freedoms as Americans to have our pockets picked by our corporate masters.
Avid Stamp Collector - I really love 39 Cent Stamps
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