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Old 09-04-2008, 08:45 AM   #383
Schneed10
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Join Date: Feb 2005
Location: Newtown Square, PA
Age: 46
Posts: 12,458
Re: Update: McCain Selects Gov. Sarah Palin as Running Mate

Quote:
Originally Posted by Dirtbag359 View Post
I have never been so captivated by a speach since Al Pacino's inches speech in Any Given Sunday. It really was well done. Also does anyone know the chances of implementing National Health Care if Obama gets elected. I know that politicians promise a lot of things that go untouched when they get in office but this one scares the shit out of me.

In my personal experience I had a condition two years ago called Alergic Fungal Sinusitis. Its a condition where the body overreacts to fungus within the naval cavity and causes the nose to swell. My condition had gotten so bad that the fungal debris stuck in my nose was eroding my skull. Today theres a small hole in my head.

Thanks to the current health care system I was able to get surgery from the top doctor for AFS in the country within a month. In fact the actual surgery was booked a week in advance on a whim. Of course there was a lot of crap in my nose and 6 hours on the operating table was only enough to clear out one side, so they had to wait five weeks for my blood count to go back up so I could have another operation. The second operation took 5 hours.

Even though the worse was over my body still continued to have flare ups, though the danger to my eroding skull had been taken care of. For the next year and a half I worked with my doctors and had it not been for the frequent access I had to these physicians I would not have been able to get 100% cured from AFS (which in some cases is a lifelong condition and I had the most violent case among all my doctors patients save a close tie with a 14 year old girl).

If national health care was implemented then in theory it woruld have taken approximately 19.5 weeks to get an appointment with any specialist not to mention the top doctor in his field (who worked with my insurance to get covered by the way). I'll admit there seems to be a need for change so more people can get covered but to put the same orginazation that runs the DMV with something as complex as medical care is simply unexceptible. Especially with the problems for quality of treatment, research, effectiveness, and incentives to become doctors that are lacking in nationalized health care systems like the UK and Canada.

Anyway thats my rant for today

*Steps down from soapbox
I like to pretend I'm an expert in a lot of things, like the salary cap, beer, fantasy football, how to please a woman, etcetera. But the one thing I truly am expert on is the healthcare system - it's my job, I'm the manager of financial planning for a major health system in Philadelphia. We treat more Medicaid patients than anybody else in Pennsylvania, so I'm exposed first hand to all of these issues.

Obama will NEVER, not in a million trillion years, be able to implement national healthcare. Dare I even say million trillion billion?

First, the logistics are a nightmare to overcome. Changing to a national health care system would require a complete overhaul to the manner in which Medicare (the federal government) reimburses hospitals and physicians. There is an intricate system currently in place to help ensure that hospitals and physicians get fairly reimbursed for each patient, based on that patient's "acuity" level, which is another way of saying how expensive it is to treat that patient's illness. Switching to national healthcare would require a complete tear-down of this intricate system, and a complete rebuild. Further, state Medicaid programs, and many other commercial insurance carriers, step off of the current Medicare system when reimbursing healthcare providers. If Medicare modifies their system, states and insurance companies would need to follow suit.

These obstacles could be overcome for sure, but Obama drastically underestimates the time and money this will take. Taxpayers, especially at the state level where Medicaid systems will be overhauled, would pay dearly, and as a result Obama will face much more political resistance than he thinks.

Second, insurance carriers and most healthcare providers (doctors and hospitals) will oppose this vehemently. Some would essentially stand to go out of business. The current reimbursement system is such that doctors and hospitals in areas with many well-insured patients get reimbursed better, because insured patients (and their insurance carriers) actually pay the hospitals. The hospitals and doctors located in poor areas with high Medicaid populations get reimbursed very poorly as they're forced to write off a lot of accounts to charity care (because many simply can't pay for emergency services). 80% of doctors and hospitals are currently doing well enough under the current system, because most of their patients are insured. Under a national healthcare system, those 80% would see a significant decline in revenues, while the other 20% would see a boost (my health system would see a boost). But the voice of the 80% is louder than the voice of the 20%, so the providers and carriers would vehemently oppose such a plan.

Third, any decline in revenues to those 80% of hospitals would result in a direct negative impact to the quality of care they provide. Investment in the latest clinical equipment would slow, hospitals would scale back on services, there will be fewer places to go have a baby as nearby hospitals would consolidate and create Women's Centers. Most hospitals will be forced to specialize in only certain services; meaning you'll have to drive 5 miles east if you have a Cardiac problem, or 4 miles west if you have a neurological problem, or 6 miles south for a gastrointestinal problem. Hospitals will no longer be able to afford treating any ailment.

Fourth, Obama would need to solve the malpractice problem that would be exacerbated by national healthcare. Malpractice insurance is the fastest growing expense of all healthcare-related expenses. North Philadelphia now only has two hospitals which deliver babies, Temple University Hospital and Northeastern Hospital. Five years ago, North Philly had 11 hospitals delivering babies. Hospitals have closed OB/GYN programs because they face the highest malpractice rates of all physician specialties. But under the current system, commercial insurance carriers help foot the bill for those high malpractice rates. The high insurance premiums doctors pay get passed along to the commercial insurance carriers. If Obama can't successfully curtail the growth in malpractice settlements, the GOVERNMENT will be the ones footing this bill. With no end in sight to the growth, malpractice is the number one reason our healthcare expenses won't stop growing any time soon. Taxpayers will be on the hook under a national healthcare plan.

Access to care will indeed become a major problem.

Obama has not put in anywhere near the thought required for such a change to take place. But I guess that's how he plans to get elected. CHANGE! Of course, he never says how, so nobody can ever tell him it's not possible.

Reality sucks, doesn't it?

McCain's plan is way more realistic and actually has a fighting chance of making an impact. Everyone in the healthcare industry knows it.
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