Impeding changes to our Health Care system

[classicman]

Originally Posted by Shawnee123

Lies.
you don't listen,
you don't discuss
you dance around
never anything with meaning or purpose.
FUCK YOU, ASSHOLE."
what a dick you can be.

and yet again. You do all this trash-talking, name-calling and hurl accusations while acting like I'm the guilty party simply because I disagree. Boy I really must have struck a nerve

[Shawnee123]

and yet again. "who me?" *bats eyes*

It's not about disagreeing, it's about your dancing about when you have absolutely NO argument. You're maddening as hell in that respect, and you keep at it until someone calls you out for being an ass, then you get to play like you're so flabbergasted anyone could think that.

Like G-dub Bush. No dummy. Knows some things. Plays innocent. Evil lurks beneath. Never admit a mistake.

[classicman]

Same tired argument when someone disagrees - that is all I've done. When you are taken off your talking points you resort to personal attacks :yawn:

Wait maybe this will be better . . .

All will be OK, Obama will take care of me. If not, then it's Bush's fault.
That better? <takes another swig>

Originally Posted by classicman

Same tired argument when someone disagrees - that is all I've done. When you are taken off your talking points you resort to personal attacks :yawn:

Wait maybe this will be better . . .

All will be OK, Obama will take care of me. If not, then it's Bush's fault.
That better? <takes another swig>

"Denial ain't just a river in Egypt"

- Mark Twain

You're in denial, dude.

I know it, you know it, Shawnee and Sam and anyone viewing this thread know it. Hell, even Merc knows it, but he's been in that river so long, he doesnt know which way is up.

Taking another swig wont help.

[classicman]

Anyway - back on topic.

These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next two decades.
However, the legislation would maintain and put into effect a number of procedures that might be difficult to sustain over a long period of time.
(1)

Under current law and under the proposal, payment rates for physicians’ services in Medicare would be reduced by about 21 percent in 2010 and then decline further in subsequent years. At the same time, the legislation includes a number of provisions that would constrain payment rates for other providers of Medicare services. In particular, increases in payment rates for many providers would be held below the rate of inflation. The projected longer-term savings for the legislation also assume that the Independent Payment Advisory Board is fairly effective in reducing costs beyond the reductions that would be achieved by other aspects of the legislation.
(2)

Based on the longer-term extrapolation, CBO expects that inflation-adjusted Medicare spending per beneficiary would increase at an average annual rate of less than 2 percent during the next two decades under the legislation—about half of the roughly 4 percent annual growth rate of the past two decades. It is unclear whether such a reduction in the growth rate could be achieved, and if so, whether it would be accomplished through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care.(3)

Link

(1) I recognize that assumptions must be made in order to give some sort of guesstimations.
But assuming that the legislation remain untouched for 20 years is not going to happen. Therefore virtually all of the opinions contained herein regarding any budgetary cost increases or reductions are, to me, worthless. However, we must make these assumptions in porder to have some sort of discussion.

(2) So initially they make an assumption that the "Independent Payment Advisory Board"

which would hold sway over Medicare payment formulas. Under the legislation, the board would make annual recommendations to the president, Congress and private entities on actions they can take to improve quality and constrain the rate of cost growth in the private sector. Its Medicare recommendations are non-binding in years where Medicare growth is below the targeted growth rate. The board will develop its first recommendations in 2013 for implementation two year later.

Who constitutes this board, and if their recommendations are in some cases non-binding then how are there going to be savings?

Furthermore, reducing physician payments will further reduce the number of providers accepting medicare as a payment form. Medicare is already reimbursing providers at a rate of approx. 20 -35% less than standard insurance carriers. Let me put it this way, Do you support a 20%+ pay cut to physicians who see Medicare patients? How many of you would take that? What alternatives are available to these doctors - retirement or not accepting Medicare patients.
If you are not willing to pay them what they are currently receiving now and instead reduce that amount by 21% in the future, there will obviously be less providers accepting medicare as a form of payment. That is simply basic econ101.

(3) Now I know that this is from the CBO, and apparently there are provisions in the bill somewhere that specify all this quite clearly, but I couldn't find it. This is one of the troubling parts that the left says isn't rationing care, and the right refers to as the "Death Panel." I don't know how else to look at it other than as it is written. "It is unclear whether such a reduction in the growth rate could be achieved, reduce access to care or diminish the quality of care." There is no guarantee, but it seems pretty clear that that the reduction of benefits is an option according to the CBO. Even taking that the care won't be rationed, it isn't clear to the CBO whether the cost reductions are even a viability.

Lastly, What steps are being taken to ensure that there will be enough primary care physicians, medical supplies and facilities to handle the increase in demand even though a shortage already exists today? Fewer physicians are currently accepting Medicare patients, and not all of the baby-boomers have retired?

Cue the partisan talking points.

[TheMercenary]

Originally Posted by Redux

Hell, even Merc knows it, but he's been in that river so long, he doesnt know which way is up.

Up the Demoncratic river of bullshit one finds it hard to know which a-hole is dumping into it at any one time. Pretty common event in the last 2 years.

[jinx]

Originally Posted by Redux

I know it, you know it, Shawnee and Sam and anyone viewing this thread know it. Hell, even Merc knows it, but he's been in that river so long, he doesnt know which way is up.

Fail.

[TheMercenary]

Originally Posted by classicman

Anyway - back on topic.


Link

(1) I recognize that assumptions must be made in order to give some sort of guesstimations.
But assuming that the legislation remain untouched for 20 years is not going to happen. Therefore virtually all of the opinions contained herein regarding any budgetary cost increases or reductions are, to me, worthless. However, we must make these assumptions in porder to have some sort of discussion.

(2) So initially they make an assumption that the "Independent Payment Advisory Board"

Who constitutes this board, and if their recommendations are in some cases non-binding then how are there going to be savings?

Furthermore, reducing physician payments will further reduce the number of providers accepting medicare as a payment form. Medicare is already reimbursing providers at a rate of approx. 20 -35% less than standard insurance carriers.
If you are not willing to pay them what they are currently receiving now and instead reduce that amount by 21% in the future, there will obviously be less providers accepting medicare as a form of payment. That is simply basic econ101.

(3) Now I know that this is from the CBO, and apparently there are provisions in the bill somewhere that specify all this quite clearly, but I couldn't find it. This is one of the troubling parts that the left says isn't rationing care, and the right says is. I don't know how else to look at it other than as it is written. "It is unclear whether such a reduction in the growth rate could be achieved, reduce access to care or diminish the quality of care." There is no guarantee, but it seems pretty clear that that the reduction of benefits is an option according to the CBO. Even taking that the care won't be rationed, it isn't clear to the CBO whether the cost reductions are even a viability.

Lastly, What steps are being taken to ensure that there will be enough primary care physicians, medical supplies and facilities to handle the increase in demand even though a shortage already exists today? Fewer physicians are currently accepting Medicare patients, and not all of the baby-boomers have retired?

Cue the partisan talking points.

All good questions. I have been asking them for quite some time now. Still no responses from the talking heads who support this BS.

[classicman]

Merc, I think we pretty much all know where you stand on this issue. The fact that you are "in the system" seems to be overlooked or ignored by some. Let them have at it. I know we need reform, but the question remains is this bill the reform we need or not?

Originally Posted by classicman

Merc, I think we pretty much all know where you stand on this issue. The fact that you are "in the system" seems to be overlooked or ignored by some. Let them have at it. I know we need reform, but the question remains is this bill the reform we need or not?

Yeah....its very impressive that a guy "in the system" can only flood the site with partisan opinion columns and doesnt even know enough to offer an original thought of his own.

And my 20+ years in public policy and the fact that I post facts that neither of you ever accept, or that I have taken the time to try to explain the bill to you as I understand it from having spoken and interacted with experts across the political spectrum as part of my job, means nothing.

But I would agree that we both know a hell of lot more about health care than you.

Originally Posted by jinx

Fail.

I stand corrected.

I should have said objective and knowledgeable.

Originally Posted by Shawnee123

It's not about disagreeing, it's about your dancing about when you have absolutely NO argument. You're maddening as hell in that respect, and you keep at it until someone calls you out for being an ass, then you get to play like you're so flabbergasted anyone could think that.

Quoted for truth.

Its not about you or me. Its about you and Merc consistently suggesting that your opinions are non-partisan and more credible than mine or anyone who might disagree with you.

Now back to your dodging and weaving.

[classicman]

Originally Posted by Redux

I stand corrected.

That about sums it up.

What no response to the FACTS? No reply to the questions posed? Nothing? You really got nothing? I was expecting all sorts of reassurances and . . . I'm shocked. I clearly laid out FACTS from the CBO and followed up with valid opinions from them. Is the CBO now a partisan cite? wtf?

All you got is a another lame personal attack? I expected much more from you.

ETA: and to then take a complete cheap shot at Jinx? That is beyond lame.

[TheMercenary]

Originally Posted by Redux

Yeah....its very impressive that a guy "in the system" can only flood the site with partisan opinion columns and doesnt even know enough to offer an original thought of his own.

I have offered plenty of them. You can look for them over the last 100+ pages. Because you didn't look does not mean they don't exist.

And my 20+ years in public policy and the fact that I post facts that neither of you ever accept, or that I have taken the time to try to explain the bill to you as I understand it from having spoken and interacted with experts across the political spectrum as part of my job, means nothing.

You post Demoncratic Propaganda. Those are not facts. But you can try to convince yourself that they are, most know better.

Its not about you or me. Its about you and Merc consistently suggesting that your opinions are non-partisan and more credible than mine or anyone who might disagree with you.

I back up my points with subject matter experts. You are not one. Much of the stuff I have posted is non-partisan. Just because they disagree with the bull shit your whores in Congress believe doesn't make them partisan.

Originally Posted by classicman

I expected much more from you.

My expectations of you were much lower.

You made this personal...not me.

How many posts have I contributed to answer your questions in the past? Not with partisan columns, but with facts from the bills or my best judgment of those bills. Only to be called a partisan or a mouthpiece for Obama in response.

You made this personal...not me.

And, I'm fucking tired of it.

[classicman]

Yeh? Too bad. Cheap shots ain't cuttin' it.

I'll wait patiently for your "objective and knowledgeable" response.

Originally Posted by classicman

Yeh? Too bad. Cheap shots ain't cuttin' it.

I'll wait patiently for your "objective and knowledgeable" response.

Sorry...I dont have the patience for your partisanship anymore.