Gavin Allan
Well-Known Member
Hugh, I am a bureacrat too, with an MPA. Maybe we could get together and figure out how to become middlemen. :banana:
ObamaCare Incompetence
- Thread starter OLE442
- Start date
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LOL, I am starting to consider law school after the MPA because it seems those are the only protected working citizens anymore. Even gov't jobs are endangered now. Healthcare middle men does look promising considering it's unlimited taxing ability.
Gavin Allan
Well-Known Member
Yeah, once we get the debit authorizations for all the citizens' bank accounts, the sky will be the limit!!!
:banana:
:banana:
Robert Thomas
Well-Known Member
I'm the innocent bystander
Somehow I got stuck between the rock and a hard place
And I'm down on my luck, yes I'm down on my luck
Well I'm down on my luck
All right, send lawyers, guns and money
Send lawyers, guns and money
Send lawyers, guns and money
Send lawyers, guns and money
Yeah, yeah, yeah
WARREN ZEVON :banana::banana:
Somehow I got stuck between the rock and a hard place
And I'm down on my luck, yes I'm down on my luck
Well I'm down on my luck
All right, send lawyers, guns and money
Send lawyers, guns and money
Send lawyers, guns and money
Send lawyers, guns and money
Yeah, yeah, yeah
WARREN ZEVON :banana::banana:
Mark K 2
Well-Known Member
In the UK, they'd just give you the penicillin for a 2-pound copay and send you on your way. That is, of course if you met the observable signs of strep. If not, gargle with salt water and come back in a week if not better. And that's how you keep costs down.
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I may have mentioned her father is a doctor. He was the one that said it looks like strep based on the spotting on her throat and her symptoms. To be sure, he recommended a strep test which is something he doesn't have at home, or his own office as an anesthesiologist. She was already gargling salt water and he could have just written her a prescription for amoxicillin and been done with it.
The thing is, we want healthcare, not best guesses. Come back in a week if we guessed wrong? Really?
If that's what you want, that's what you're going to get with ObamaCare, but that is not acceptable medical advice for me and my family. This isn't "House" where doctors just pump you full of medications or perform surgeries as they guess along the way until they figure it out.
I'm surprised I even have to write that out. You would trade lower costs for actual care?
:banghead:
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Gavin Allan
Well-Known Member
"Oops-- that isn't strep, It is 3rd degree throat cancer. Wish we would have caught it several weeks ago. Death Panel will not approve treatment for throat cancer. Go home and die." Next?
Mark K 2
Well-Known Member
When Medicare started in 1965, the doctors were told to be honest and reasonable to avoid making it a bureaucratic mess. What happened? Doctors started admitting people five days before a tonsillectomy for "tests." They admitted people who simply wanted a break from home life for a week, even though there was no medical reason for admission. Well, we know how that turned out for the Medicare program. Hell... Our local hospital even doubled its inpatient unit to deal with the increased admissions (and later closed it down when the government started the DRG system). Bottom line: The doctors need some administrative oversight.
My doctor sent me for a sinus CT for a sinus symptoms. The insurance company refused to pay it, stating that sinusitis is can be diagnosed using a standard sinus xray and patient symptoms. I had to come up with $2200 out of pocket. Without oversight, the docs are like kids in a candy store.
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Ok, I don't agree with some of the assessments of Medicare posted here. I have been on Medicare for nearly 2 years now and it has worked fine for me.
Many hospitals and physicians offices rely on Medicare patients to keep their offices open. I agree that many treatment facilities have jacked up the prices and Medicare, as well as other Health Insurance companies have continued to cut back on what they pay for services...and increased what they charge for premiums.
When a doctor or a hospital stop taking Medicare, or other insurances, they are only operating for maximum profit and will eventually only accept Self-Pay patients. There is a very small market for Self-Pay only clients which tends to be for people who are extremely wealthy and want elective procedures that are not covered by Medicare and most insurances anyway...Those are the Boob jobs, Liposucktion, and other forms of cosmetic surgeries.
Medicare and most other forms of insurance will not pay for experimental or unproven procedures. I have never heard of any case where a proven acceptable procedure was denied to a patient on Medicare. The problem appears to be that just because some doctor or hospital is willing to do the unproven procedure, does not mean that Medicare or other insurances will pay for that...Just like they don't pay for any procedure that has not been scientifically proven to be beneficial to the patient.
It is understanding that a cancer patient being desperate to save their lives are willing to accept the most far out procedures as long as Medicare or some other Insurance company is paying the bills. That's where a lot of the Medicare fraud is coming from...Doctors who are using unorthodox treatments that cannot be documents as beneficial to the patient, but generate a lot of high cost charges for doing little or nothing to help the patient. To some extent, it is declining some payments for unorthodox treatments is protecting our tax dollars from fraud.
I still don't care for ObamaCare because it is based on a lot of deception and arguably cost a lot more than Obama's Administration is willing to admit.
...Rich
Many hospitals and physicians offices rely on Medicare patients to keep their offices open. I agree that many treatment facilities have jacked up the prices and Medicare, as well as other Health Insurance companies have continued to cut back on what they pay for services...and increased what they charge for premiums.
When a doctor or a hospital stop taking Medicare, or other insurances, they are only operating for maximum profit and will eventually only accept Self-Pay patients. There is a very small market for Self-Pay only clients which tends to be for people who are extremely wealthy and want elective procedures that are not covered by Medicare and most insurances anyway...Those are the Boob jobs, Liposucktion, and other forms of cosmetic surgeries.
Medicare and most other forms of insurance will not pay for experimental or unproven procedures. I have never heard of any case where a proven acceptable procedure was denied to a patient on Medicare. The problem appears to be that just because some doctor or hospital is willing to do the unproven procedure, does not mean that Medicare or other insurances will pay for that...Just like they don't pay for any procedure that has not been scientifically proven to be beneficial to the patient.
It is understanding that a cancer patient being desperate to save their lives are willing to accept the most far out procedures as long as Medicare or some other Insurance company is paying the bills. That's where a lot of the Medicare fraud is coming from...Doctors who are using unorthodox treatments that cannot be documents as beneficial to the patient, but generate a lot of high cost charges for doing little or nothing to help the patient. To some extent, it is declining some payments for unorthodox treatments is protecting our tax dollars from fraud.
I still don't care for ObamaCare because it is based on a lot of deception and arguably cost a lot more than Obama's Administration is willing to admit.
...Rich
Mark K 2
Well-Known Member
I like Medicare. What I was saying is that the doctors ruined Medicare for themselves in 1965. The Feds wanted to keep it simple, but the docs quickly abused the system, so the Feds instituted tight constraints on them.
Obama's right about changing how doctors are paid. Right now, docs are paid for every test or admission they do. Assuming they have part or whole ownership in lab, xray, and other ancillary services, they get paid for charging the patients more. They need to be changed to an outcome-based payment system.
That's the only way Medicare and Medicaid will stay solvent.
Obama's right about changing how doctors are paid. Right now, docs are paid for every test or admission they do. Assuming they have part or whole ownership in lab, xray, and other ancillary services, they get paid for charging the patients more. They need to be changed to an outcome-based payment system.
That's the only way Medicare and Medicaid will stay solvent.
They purchase the equipment because it's necessary for their jobs. Who is going to pay for the equipment if they can't cover the costs of purchase, maintenance and updates/upgrades? I know Mark likes visual inspection and diagnosis like the Brits, but I don't consider that great healthcare. That's how it was done in the 1800s.
Advancing healthcare cannot be cheap. It's the very nature of advancement.
Maintaining status quo can eventually stabilize pricing...if that's the goal.
Going backward can make it cheap, and that's the only way to make it cheap.
I'm not against Medicare and Medicaid in principle. I support it wholly. It's implementation has been horrible, though. I could even support financial waste in these programs if the result was better healthcare for all.
Doctors are retiring at an alarming rate and the shortage is about to become very real and apparent, especially in rural America. New recruits with lower standards will be pushed through. Everything will become cheaper. See my note above about cheap healthcare. It will remain but become even more apparent that the wealthiest among us will have access to the best healthcare.
Hell, police protection is now being privatized out to the wealthiest neighborhoods. See Los Angeles. Civil protection should be easier and cheaper to manage than healthcare and our government is failing even at that. I hold little hope for their ability to manage and advance healthcare.
Hugh,
For the most part I agree with you.
The big reason why healthcare is so expensive is that it takes very long trials to get any new Equipment, Medicines or procedures approved and there are so many people who do not have insurance.
The self-pay typically don't have a family doctor and they walk into the Emergency room for treatment of many non-emergency ailments like the flu, colds, rashes, etc. Here in Texas, Emergency rooms are not allowed to turn anybody away even if it is not an emergency. Of course, the charges for ER treatment is much more expensive than the same treatment would be in a doctor's office, but since many don't have insurance they don't intend to pay anyway, so cost is not a factor to them.
The other problem regarding Medicare is the complexity of the system. I don't think the doctors wanted it this way, but many found that they could work the system by adding on a lot of extra charges and get more money That required Medicare to limit or restrict the charges and go to a DRG system (Diagnosis Related Group). That meant that if a doctor was treating a patient for Appendicitis, Medicare would only pay a flat fee for that Diagnosis and Treatment and not allow additional charges for tongue depressors, bandaids, X-Rays, Lab tests, etc.
They also had to put limits on inpatient hospital stays because some hospitals where milking the system with longer stays, and some patients actually enjoyed being in the hospital where they were given food, medications, and could lay in bed and watch TV all day. Sounds crazy, but it is true (I worked at a hospital for ten years and followed that as a Hospital systems consultant)
So, I agree that Doctors and Hospitals manipulating charges has contributed to the complexity of Medicare and the whole healthcare system in the US. Medical and Insurance companies will spend hundreds of $$$ Millions to lobbyist to push their agendas in Washington, so they can deny payments for legitimate approved treatments???
The simple rule of thumb is, if the Government is paying for it, it will always cost more because the programs are being designed and controlled by politicians.
...Rich
For the most part I agree with you.
The big reason why healthcare is so expensive is that it takes very long trials to get any new Equipment, Medicines or procedures approved and there are so many people who do not have insurance.
The self-pay typically don't have a family doctor and they walk into the Emergency room for treatment of many non-emergency ailments like the flu, colds, rashes, etc. Here in Texas, Emergency rooms are not allowed to turn anybody away even if it is not an emergency. Of course, the charges for ER treatment is much more expensive than the same treatment would be in a doctor's office, but since many don't have insurance they don't intend to pay anyway, so cost is not a factor to them.
The other problem regarding Medicare is the complexity of the system. I don't think the doctors wanted it this way, but many found that they could work the system by adding on a lot of extra charges and get more money That required Medicare to limit or restrict the charges and go to a DRG system (Diagnosis Related Group). That meant that if a doctor was treating a patient for Appendicitis, Medicare would only pay a flat fee for that Diagnosis and Treatment and not allow additional charges for tongue depressors, bandaids, X-Rays, Lab tests, etc.
They also had to put limits on inpatient hospital stays because some hospitals where milking the system with longer stays, and some patients actually enjoyed being in the hospital where they were given food, medications, and could lay in bed and watch TV all day. Sounds crazy, but it is true (I worked at a hospital for ten years and followed that as a Hospital systems consultant)
So, I agree that Doctors and Hospitals manipulating charges has contributed to the complexity of Medicare and the whole healthcare system in the US. Medical and Insurance companies will spend hundreds of $$$ Millions to lobbyist to push their agendas in Washington, so they can deny payments for legitimate approved treatments???
The simple rule of thumb is, if the Government is paying for it, it will always cost more because the programs are being designed and controlled by politicians.
...Rich
Robert Thomas
Well-Known Member
From my experience of being in a hospital (If a patient enjoys being in the Hospital" they need to be in the hospital, on the 7th floor in a straight jacket.
Redfish,
They like being in the hospital because they are being fed, and cared for...something they won't get at home alone. If they were at home, they probably could not afford the food, the medications or the utilities to run the Heat/AC and TV. They were probably cut off for non-payment.
I agree that most people can't stand to be in the hospital, and the food is generally bland and crappy tasting...but I assume it's not so bad when compared to their normal home diet of canned pet food..:grin:
...Rich
They like being in the hospital because they are being fed, and cared for...something they won't get at home alone. If they were at home, they probably could not afford the food, the medications or the utilities to run the Heat/AC and TV. They were probably cut off for non-payment.
I agree that most people can't stand to be in the hospital, and the food is generally bland and crappy tasting...but I assume it's not so bad when compared to their normal home diet of canned pet food..:grin:
...Rich
Mark K 2
Well-Known Member
I'm not a fan of private practice in the 21st century. There's no way a single physician can provide comprehensive care without getting into to trouble with insurance companies with conflict of interest issues.
I like the idea of physicians working for brick-and-mortar health companies. For example, the local doctors are hired by a hospital/clinic and use diagnostic equipment and services owned by the hospital/clinic. The idea of the doctors owning the hospital or clinic is outdated.
I like the idea of physicians working for brick-and-mortar health companies. For example, the local doctors are hired by a hospital/clinic and use diagnostic equipment and services owned by the hospital/clinic. The idea of the doctors owning the hospital or clinic is outdated.
Mark,
That is certainly the trend as more an more physicians close their private practices to either retire or go to work for large HMO's.
Here in Waco, my doctor for 14 years closed her office about 2 years ago to go work for the local VA Hospital. In my search for a new doctor, I found that there were very few private practice physicians left, and most of them were not taking new patients. Even a lot of the doctors who worked for the large, local HMO's were not taking new patients !!!
I eventually found a new doctor, and while he seems competent enough, he lacks the personal touch and attention to detail that my previous doctor had. My old doctor always insured that I had all the regularly scheduled test, screenings and vaccinations. I don't like Colon-osscopies any more than the next person, but she made sure I got them...and always appeared to be genuinely interested in my health.
My new doctor, not so much....and I am begining to lose confidence in him when he did a blood test for some back pain I was having (possible kidney problem) and said my Cholesterol was elevated??? It requires a fastin blood test for a Lipid blood test and that was not done?
Just a few months before my cholesterol was 120 (excellent) and the nurse who was passing on the message could not even find where he had requested or received a cholesterol test and said he must have made an error.???? I can only assume he confused me with another patient ???? That's not the first time he seemed to have me confused with someone else and perhaps people at the clinic are posting blood tests to the wrong medical records. Two nurses said they were going to check on where the doctor got that information, but as of yet, nobody has called to inform me of what happened ???
...Rich
That is certainly the trend as more an more physicians close their private practices to either retire or go to work for large HMO's.
Here in Waco, my doctor for 14 years closed her office about 2 years ago to go work for the local VA Hospital. In my search for a new doctor, I found that there were very few private practice physicians left, and most of them were not taking new patients. Even a lot of the doctors who worked for the large, local HMO's were not taking new patients !!!
I eventually found a new doctor, and while he seems competent enough, he lacks the personal touch and attention to detail that my previous doctor had. My old doctor always insured that I had all the regularly scheduled test, screenings and vaccinations. I don't like Colon-osscopies any more than the next person, but she made sure I got them...and always appeared to be genuinely interested in my health.
My new doctor, not so much....and I am begining to lose confidence in him when he did a blood test for some back pain I was having (possible kidney problem) and said my Cholesterol was elevated??? It requires a fastin blood test for a Lipid blood test and that was not done?
Just a few months before my cholesterol was 120 (excellent) and the nurse who was passing on the message could not even find where he had requested or received a cholesterol test and said he must have made an error.???? I can only assume he confused me with another patient ???? That's not the first time he seemed to have me confused with someone else and perhaps people at the clinic are posting blood tests to the wrong medical records. Two nurses said they were going to check on where the doctor got that information, but as of yet, nobody has called to inform me of what happened ???
...Rich
Medical records are getting very screwed up right now. My mother works for Wellstar, a big provider in the Atlanta area (maybe elsewhere as well?) and going electronic is not going so smoothly and errors are easy to make and difficult to catch. The information is also very widely available now and to people you may not want having that information. Many of the errors my mother is catching within their office are done in offices their patient has never visited but their file somehow gets the information of another patient. At that point, it's nearly impossible to find out who's chart that info actually belonged in and they have to review the chart with their patient to ensure accuracy. The patients get upset at the bearer of bad news, no fault of their provider or themselves. My opinion of centralized healthcare and records (make no mistake, that's where we're headed) is that is it going to get really messy really fast.
In our trip to the ER, the nurse practitioner was apologizing for all the time he was spending on the computer and scanning barcodes for every motion he made. He admitted to having quotas to make. He also showed us one of the checkboxes (probably only because he's a family friend) that made him verify that he did a particular action with a smile. He said he now felt more like a cashier than a health provider. I probably don't need to mention that the hospital is run by a medical corporation.
Can't wait until Wal Mart gets into medicine. Perhaps $4 prescriptions are just the beginning.
:grin:
I don't follow.
In our trip to the ER, the nurse practitioner was apologizing for all the time he was spending on the computer and scanning barcodes for every motion he made. He admitted to having quotas to make. He also showed us one of the checkboxes (probably only because he's a family friend) that made him verify that he did a particular action with a smile. He said he now felt more like a cashier than a health provider. I probably don't need to mention that the hospital is run by a medical corporation.
Can't wait until Wal Mart gets into medicine. Perhaps $4 prescriptions are just the beginning.
:grin:
I don't follow.
Frank screwyourednecks
Well-Known Member
Patient Protection and Affordable Care Act>> Most major provisions become effective in 2014. Completely by 2020.
Anyone on this thread that is speaking ill of the law is lying, trying to spin, or just spewing partisan slander. Uneducated, or UNDER educated. The effectiveness has yet to be determined.
It is a fact that heathcare in the United States was in need of revamping. But I guess you cannot change 25 percent of the US voting popluations closed minds.
oh how I have missed some of you. (25% of you)
Anyone on this thread that is speaking ill of the law is lying, trying to spin, or just spewing partisan slander. Uneducated, or UNDER educated. The effectiveness has yet to be determined.
It is a fact that heathcare in the United States was in need of revamping. But I guess you cannot change 25 percent of the US voting popluations closed minds.
oh how I have missed some of you. (25% of you)
EddieS'04
In Memoriam 1950-2022
We actually dont remember you................:kiss_it:
