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Old 05-12-2009, 08:47 AM   #61
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Re: the new health care?

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Originally Posted by Schneed10 View Post
Boy has this thread gotten retarded. You guys are going down the path that led the Warpath to once put a moratorium on all political threads.

You're not quite all-out bashing each other, but you've gotten into a pissing match over generalized political ideology and consequently gotten so far off topic that now the thread is near meaningless.

This could have been a good thread too. If anybody actually wants to talk healthcare, I'm willing, it's my line of work.
Welcome to the parking lot where even the most innocent of threads gets thrown off track into political bashing.
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Old 05-12-2009, 09:11 AM   #62
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Re: the new health care?

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Welcome to the parking lot where even the most innocent of threads gets thrown off track into political bashing.
You damn hippie-socialist-liberal.
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Old 05-12-2009, 10:51 AM   #63
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Re: the new health care?

schneed, im not sure why the insurance companies would have any say in the matter. it really is all about cutting health care costs, isn't it? one would think if the costs go down, everyone would benefit, no?
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Old 05-12-2009, 10:55 AM   #64
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Re: the new health care?

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Originally Posted by dmek25 View Post
schneed, im not sure why the insurance companies would have any say in the matter. it really is all about cutting health care costs, isn't it? one would think if the costs go down, everyone would benefit, no?
Insurance companies employ people too. They can be part of the process but not the process.
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Old 05-12-2009, 11:09 AM   #65
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Re: the new health care?

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Originally Posted by dmek25 View Post
schneed, im not sure why the insurance companies would have any say in the matter. it really is all about cutting health care costs, isn't it? one would think if the costs go down, everyone would benefit, no?
There are lots of places costs can come from, though.

When you pay your health insurance premiums, some of the money gets paid out to doctors to cover office costs. Some gets paid out to hospitals to cover costs of getting an operation and staying in the hospital. Some gets kept by your insurance company so they can pay their people and make a profit. Some gets paid to the pharmacy where you pick up the drugs your doc prescribed you. Etc.

So hospitals can play a role by: Being more efficient. Hospitals are big huge places and administration needs to be on top of doctors and staff to treat patients fast, get them healthy, and get them out sooner. The longer a patient stays in the hospital, the more it costs. Many times a doctor will order a MRI or a lab test to confirm a problem before he makes his next move, well if the hospital dawdles in getting that test done it delays the doctor, which screws up his schedule, and before you know it the weekend rolls around and he says well just keep the patient until Monday, I'll do a procedure then.

Doctors can play a role by: using more efficient staffing. Nurse Practitioners can address 90% of physical ailments, and they make right around $100K as opposed to $150K on up to god knows what.

Insurance companies can play a role by working to simplify their reimbursement agreements with providers. Make the payment system simpler so there are fewer denied payments and thus fewer appeals. The less you have of this kind of stuff, the fewer administrative support employees your insurance company has to pay.

The government can play a role by:

- Mandating and helping hospitals, insurance companies, and doctors get up to speed with Information Systems allowing seamless integration of medical records and information. This prevents deaths due to drug interactions and would cut workers out of the system. Each hospital and doc office needs filing clerks just to handle the massive files of charts. Imagine how much you could save doing away with those salaries.

- Forcing insurance companies to reimburse according to Medicare rules. It's a simple way of doing it. I'd suggest they add a pay for performance mandate too.

- Cap malpractice awards. Huge multimillion dollar payments to plaintiffs only drive up malpractice insurance premiums to doctors and hospitals, who just end up raising their charges and passing the hit along to all of us.

- Providing incentives for the poor and underinsured to use a primary care doctor. Preventative medicine saves us the most money in the long run. Poor people need to stop using the ER for the sniffles.

And the people can play a role by learning when you really need to see the doctor, and when you can let that sinus infection clear up on its own.
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Old 05-12-2009, 12:02 PM   #66
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Re: the new health care?

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Originally Posted by Schneed10 View Post
There are lots of places costs can come from, though.

When you pay your health insurance premiums, some of the money gets paid out to doctors to cover office costs. Some gets paid out to hospitals to cover costs of getting an operation and staying in the hospital. Some gets kept by your insurance company so they can pay their people and make a profit. Some gets paid to the pharmacy where you pick up the drugs your doc prescribed you. Etc.

So hospitals can play a role by: Being more efficient. Hospitals are big huge places and administration needs to be on top of doctors and staff to treat patients fast, get them healthy, and get them out sooner. The longer a patient stays in the hospital, the more it costs. Many times a doctor will order a MRI or a lab test to confirm a problem before he makes his next move, well if the hospital dawdles in getting that test done it delays the doctor, which screws up his schedule, and before you know it the weekend rolls around and he says well just keep the patient until Monday, I'll do a procedure then.

Doctors can play a role by: using more efficient staffing. Nurse Practitioners can address 90% of physical ailments, and they make right around $100K as opposed to $150K on up to god knows what.

Insurance companies can play a role by working to simplify their reimbursement agreements with providers. Make the payment system simpler so there are fewer denied payments and thus fewer appeals. The less you have of this kind of stuff, the fewer administrative support employees your insurance company has to pay.

The government can play a role by:

- Mandating and helping hospitals, insurance companies, and doctors get up to speed with Information Systems allowing seamless integration of medical records and information. This prevents deaths due to drug interactions and would cut workers out of the system. Each hospital and doc office needs filing clerks just to handle the massive files of charts. Imagine how much you could save doing away with those salaries.

- Forcing insurance companies to reimburse according to Medicare rules. It's a simple way of doing it. I'd suggest they add a pay for performance mandate too.

- Cap malpractice awards. Huge multimillion dollar payments to plaintiffs only drive up malpractice insurance premiums to doctors and hospitals, who just end up raising their charges and passing the hit along to all of us.

- Providing incentives for the poor and underinsured to use a primary care doctor. Preventative medicine saves us the most money in the long run. Poor people need to stop using the ER for the sniffles.

And the people can play a role by learning when you really need to see the doctor, and when you can let that sinus infection clear up on its own.
What about just paying your doctor cash when you really need to see him?
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Old 05-12-2009, 01:02 PM   #67
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Re: the new health care?

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Originally Posted by Trample the Elderly View Post
What about just paying your doctor cash when you really need to see him?
That's a good way in that it makes people think about whether or not they really need to see the doctor.

That said, this approach should not be used for well-visits (the kind of annual checkup where you get immunizations and such). If poorer people had to pony up for this, they'd never choose to go, which would just end up costing more in the long run.

And of course the cash on delivery method doesn't work for big hospital stays, because it's flat out too costly. You need insurance for the big stuff.

But this is exactly how you go about putting the financial incentive to manage healthcare costs in the hands of the patient.
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Old 05-12-2009, 02:00 PM   #68
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Re: the new health care?

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Originally Posted by Schneed10 View Post
That's a good way in that it makes people think about whether or not they really need to see the doctor.

That said, this approach should not be used for well-visits (the kind of annual checkup where you get immunizations and such). If poorer people had to pony up for this, they'd never choose to go, which would just end up costing more in the long run.

And of course the cash on delivery method doesn't work for big hospital stays, because it's flat out too costly. You need insurance for the big stuff.

But this is exactly how you go about putting the financial incentive to manage healthcare costs in the hands of the patient.
Who then pays for the poor?
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Old 05-12-2009, 07:13 PM   #69
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Re: the new health care?

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This is what the Constitution says:

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The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;
If the Founders meant that "general Welfare" equated to free health care, why didn't they explicitly confer the right to a doctor the way they explicitly said we have the right to an attorney?
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Old 05-12-2009, 08:12 PM   #70
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Re: the new health care?

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If the Founders meant that "general Welfare" equated to free health care, why didn't they explicitly confer the right to a doctor the way they explicitly said we have the right to an attorney?
They didn't for the same reason they didn't say "the right to bare assault weapons." Are you expecting them to be explicit with respect to everything and all possible situations? I would also like to add that the right to an attorney is fundamental and necessary right in that the state is trying to to strip a person of their right to life, liberty and the pursuit of happiness. The founders would have been hypocrites if they did not include such provision in the constitution.
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Old 05-12-2009, 08:37 PM   #71
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Re: the new health care?

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They didn't for the same reason they didn't say "the right to bare assault weapons." Are you expecting them to be explicit with respect to everything and all possible situations? I would also like to add that the right to an attorney is fundamental and necessary right in that the state is trying to to strip a person of their right to life, liberty and the pursuit of happiness. The founders would have been hypocrites if they did not include such provision in the constitution.
No, no.

First of all, the term "assault weapon" is redundant. If you mean semi-automatic rifles then the analogy still doesn't fit because there were certainly doctors in their age. So it's not as if they couldn't envision doctors they way they couldn't envision automatic or semi-automatic weapons.

And no, I don't believe they had to specifically mention all the rights the people are entitled to. That's what the Ninth Amendment was for. But to use the general welfare clause to imply that everybody gets the services of a doctor, nurse or hospital free of charge, is to seriously misunderstand the Constitution and everything the Founders established.
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Old 05-12-2009, 09:44 PM   #72
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Re: the new health care?

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Originally Posted by Trample the Elderly View Post
Who then pays for the poor?
Taxpayers, just like we do now. We all pay taxes to fund our state's Medicaid program.

The trick is to tweak that program to incent the poor to use preventative care services. Successfully doing so would reduce the tax burden on all of us.

That said, doing so is much easier said than done. One of the biggest barriers preventing the poor from seeking preventative care is basic transportation. For many, if they can't walk to it, they're not interested. (And in that case I'm inclined to say eff 'em, let 'em die of pneumonia, but that doesn't really fly.)
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Old 05-12-2009, 10:10 PM   #73
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Re: the new health care?

I would be more inclined to except a government base health care coupled with a la cart items. I've only been to the doctor once in 20 years and that was for a knee operation. Being fairly active outdoors I can see myself signing up for some extra orthopedic/chiropractic services. As far visiting a doctor for sinus infections, flu, stomach virus, etc, I just stay home, get rest and fluids.

I really hope we don't have some "one size fits all" health care package. I think that the cost is just going to be more excessive as far what I'm paying into and what I'm getting out of it.
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Old 05-12-2009, 10:25 PM   #74
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Re: the new health care?

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I would be more inclined to except a government base health care coupled with a la cart items. I've only been to the doctor once in 20 years and that was for a knee operation. Being fairly active outdoors I can see myself signing up for some extra orthopedic/chiropractic services. As far visiting a doctor for sinus infections, flu, stomach virus, etc, I just stay home, get rest and fluids.

I really hope we don't have some "one size fits all" health care package. I think that the cost is just going to be more excessive as far what I'm paying into and what I'm getting out of it.
Yeah, and if you don't incorporate enough choice into the program, many people will just say 'eh, this ain't for me' and they'll go without insurance.

Then when they get hit by a bus we're right back where we started with the whole uninsured problem. Choice is a must.
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Old 05-12-2009, 11:06 PM   #75
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Re: the new health care?

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Originally Posted by Schneed10 View Post
Taxpayers, just like we do now. We all pay taxes to fund our state's Medicaid program.

The trick is to tweak that program to incent the poor to use preventative care services. Successfully doing so would reduce the tax burden on all of us.

That said, doing so is much easier said than done. One of the biggest barriers preventing the poor from seeking preventative care is basic transportation. For many, if they can't walk to it, they're not interested. (And in that case I'm inclined to say eff 'em, let 'em die of pneumonia, but that doesn't really fly.)
I'm inclined to say eff'em regardless. The only preventative medicine that most of the poor that I see use is Night Train. There's a guy that lives under the Manchester Bridge where I work. He's as healthy as a bull but he's only interested getting loaded. I think churches are better places for the poor than homeless shelters. They don't let them smoke base in the church.
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