Impeding changes to our Health Care system

[Shawnee123]

ch'yeah. Just what I was saying.

(note: c-man's regurgitation of my post about assholes was a conglomeration where I said I'd have more respect if he would just come out and call someone an asshole rather than prancing around playing smarter than thou martyr man.)

[Shawnee123]

Here are my posts:

Oh bullshit.

This is the next step after avoiding any points: talk about how nice you are about it all.
Seriously? Oh well, at least you got merc to suck your dick again.

Oh, am I being a name-caller? Well, YES I am! I freely admit it.

Oh, merc? It's challenge, not CHALLANGE. And, when you mean MORE THAN, as in TOO MUCH, it's T-O-O. Not TO MUCH. Unless you're going to a town called MUCH, in which case TO MUCH would be correct.

Maybe someone will learn something today after all.

Lies.

And thanks for all your valuable input. I gave up providing valuable input a long time ago, when I realized you don't listen, you don't discuss: you dance around and throw quotes around but it's never anything with meaning or purpose.

As Redux said, when you are confronted with facts you play "who me?" and bat your eyelashes, oh so innocent, which I think is infinitely worse than a REAL and TRUE "OH YEAH? FUCK YOU, ASSHOLE."

I mean, it's so passive-aggressive. That's worse than truth telling, even if the truth points out what a dick you can be. You really don't know what you're talking about half the time, do you?

This is what classhole man turned them into:

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.

Posted by classicman: 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

Stop bastardizing my quotes, correcting my grammar, and generally being a public nuisance. You hope no one will go back and check and call you on your lies. Wrong.

[classicman]

Originally Posted by Shawnee123

classhole

I kinda like that - thanks.

[Shawnee123]

Oh, honey baby doll, you're so welcome.

[TheMercenary]

SamIam, check these out.

http://www.harpers.org/archive/2009/12/0082740

http://www.realclearpolitics.com/art...sts_99526.html

http://www.washingtonpost.com/wp-dyn...06.html?sub=AR

http://healthaffairs.org/blog/2009/1...health-reform/

[SamIam]

Originally Posted by TheMercenary

It has been my experience that many people in this group also fails to seek care until the last minute, over uses care that they know they don't have to pay for, and is often less compliant with their care when they do receive it.

Well, my experience has been the opposite. I think one reason the uninsured don't seek help until the last minute is probably about fear of having yet another bill that they can't pay. Plus, a visit to the ER frankly sucks. Its often over-crowded, you get to see a doc for about 5 minutes after a 3 hour wait, there is no continuity of care, etc., etc. Its also hard to be compliant when you have little or no money. It costs a fortune to fill many prescriptions. But we are both speaking anectdotally here. I would like to see some actual numbers/studies.

I think the reason that they may receive less theraputic care because the hospitals know they are not reimbursed for much of it, so they get just what they need when the hospital has to eat all the costs.

It is my understanding that the Federal Government actually makes payments to hospitals to cover care for the uninsured. This is one reason hospitals are not as interested in universal coverage.

You only need to look at the state of Mass and see how their experiment in healthcare reform to see many of the same failures in this new plan. There is absolutely no promise that people are going to go out and get insurance, mandatory or not. That is exactly what happened in Mass. People still waited to the last minute to seek care, they still did not go out and get the mandatory insurance, and the costs were shifted to the state and individually insured to pay the bills. It is breaking their bank.

I would be interested in seeing a source for this.

P.S. Thanks for the cites. I'll take a look at them.

[TheMercenary]

Originally Posted by skysidhe

I have to agree with sam just because it's personal now.

weirdly

I found a clinic that will take payments and an ENT specialist who I have seen before will take payments too. I am stalling. I don't want a bill. I'm thinking I'll end up paying a 300 dollars to tell me what I already know.

What should the uninsured do? I think do the minimum and if it is crucial do a surgery?I'm not saying I need surgery but I have had the same kind of thing happen twice before and I don't want it. Surely the doctors would not overtreat someone who does not have insurance and would only elect to do something like surgery if it was absolutely necessary ? after all it's their money right? Especially sense they would know my history.

I think I just convince myself it will be alright. Thanks for letting me sort of hijack but then we are talking about health care and insurance so I'm sure I'll be forgiven I hope.

No worries. I will tell you that there is a pervasive feeling among physicians that the tendency among Medicaid patients is that they will sue you first. They are prayed upon by the legal system which hawks malpractice for a living. If they can be convinced that they will get something out of it they will. I don't blame them for the way they get worked over by the predatory malpractice lawyers, because they are not all that way (the lawyers or the patients), but it creates an environment where more tests are done to cover ones ass and minimize the risk of giving anyone an excuse that something was not checked. That is my experience.

[TheMercenary]

Originally Posted by SamIam

Well, my experience has been the opposite. I think one reason the uninsured don't seek help until the last minute is probably about fear of having yet another bill that they can't pay. Plus, a visit to the ER frankly sucks. Its often over-crowded, you get to see a doc for about 5 minutes after a 3 hour wait, there is no continuity of care, etc., etc. Its also hard to be compliant when you have little or no money. It costs a fortune to fill many prescriptions. But we are both speaking anectdotally here. I would like to see some actual numbers/studies.

I will look for some numbers for you.

It is my understanding that the Federal Government actually makes payments to hospitals to cover care for the uninsured. This is one reason hospitals are not as interested in universal coverage.

The feds make payments to the states. The states divi up the money to pay the hospitals. The states determine what they are going to pay individual hospitals for indigent care.

(Mass)I would be interested in seeing a source for this.

http://www.boston.com/bostonglobe/ed...is_failing_us/

http://www.pnhp.org/news/2009/februa...tts_is_no_.php

http://www.huffingtonpost.com/iyah-r..._b_380718.html

http://articles.latimes.com/2009/oct...assachusetts17

http://www.lawlib.state.ma.us/subjec...insurance.html



This supports the changes but points out the issue of costs and costs to the patients in individual insurance.

http://healthcarereform.nejm.org/?p=2135

[SamIam]

OK, I read Merc's links and I'm on information overload. I might be able to make an intelligent comment after a night's rest.

[SamIam]

OK, I'm recovering from information and opinion overload. I don't know if anyone besides me and Redux and Merc and C-Man care about this much detail, but here goes. Critics of the bill say among other things that:

• Congress will never do any cost cutting of Medicare and the Sustainable Growth Rate adjustment for doctors (SGR)
  
• If you give people insurance, they will use it (duh)
  
• Congress is dancing with special interests

I checked out the Center on Budget and Policy Priorities (a NONPARTISAN think group) http://www.cbpp.org/cms/index.cfm?fa=view&id=3021 and here's what they state

on Sustainable Growth Rate adjustment for doctors

Congress likely will never let the full SGR cuts take effect, and it probably won’t offset the cost of scrapping them. But that cost is neither part of, nor in any way a result of, health care reform — the federal government will incur this cost regardless of health care reform, not because of it. This fact is undeniable: if health reform legislation were to die tomorrow, the full SGR cost would remain. To be sure, it would be better if Congress offset the cost of cancelling the SGR cuts. But that issue is separate from the question of whether the health care reform bills themselves add to the deficit or not.

I also might add that the perception that Congress will not act to control Medicare costs is a false one. Again check out the documentation in the link above if you're interested.


If you give people insurance they will use it (duh)

Providing insurance coverage for tens of millions of uninsured Americans will necessarily raise total health care spending in the short term. The real issues here are: (1) whether health reform includes provisions to cover the costs of these insurance expansions so that deficits and debt do not increase; and (2) whether health reform includes steps that begin to slow the rate of health cost growth so that total health spending is lower in the longer run than it otherwise would be. The House and Senate bills meet the first test, according to the Congressional Budget Office (CBO), with the House bill reducing deficits by $138 billion over ten years, the Senate bill reducing deficits by $130 billion over that period, and both bills continuing to reduce deficits for at least a decade after that. The bills also hold promise for the second test, CBO says, although policymakers will need to do more to slow health cost growth as we learn more about how to do it, such as by applying the knowledge gained in the coming decade from pilot projects in the health bills, comparative effectiveness research, and the like.

Congress is dancing with special interests

This is just my opinion. Congress dances with special interests on EVERYTHING. And look at Dick Cheney's connection with Halliburton or Bush's tie with big oil and the Bin Laden's. I won't say that this complaint does not have some validity, but it is part of a larger over-all problem in American government. Republicans are lapdogs to one set of groups and Democrats to another. And often special interest groups will try to play one party off against another. I'm sure the Roman Empire had the same problem. It would be nice if we could cure it, but I feel it is an issue seperate from the health care debate.

[TheMercenary]

Originally Posted by SamIam

Congress will never do any cost cutting of Medicare and the Sustainable Growth Rate adjustment for doctors (SGR)

Have you looked at the history of Congress and how they have cut costs of Medicare over say, let's pick the last 4 years, and can you show me what a great job they have done at cutting costs?

If you give people insurance, they will use it (duh)

Nope, they will not get it unless they need it.

Congress is dancing with special interests

Absolutely!

I checked out the Center on Budget and Policy Priorities (a NONPARTISAN think group) http://www.cbpp.org/cms/index.cfm?fa=view&id=3021 and here's what they state

on Sustainable Growth Rate adjustment for doctors

I also might add that the perception that Congress will not act to control Medicare costs is a false one. Again check out the documentation in the link above if you're interested.

I do not believe that for one minute. Remember now that cost controls are not just a factor of reducing payments to the providers. All that does is make more docs drop Medicare payments as reimbursements decrease. Ok, let me ask you this. If it is such a big deal why have they not fixed it until now? Why? Because of lobbyists and special interests have prevented them from doing so. All of a sudden it is a big frigging deal. So they have let us get screwed for all these years and now it is an issue?

http://www.heritage.org/research/healthcare/hl857.cfm

This is just my opinion. Congress dances with special interests on EVERYTHING. And look at Dick Cheney's connection with Halliburton or Bush's tie with big oil and the Bin Laden's. I won't say that this complaint does not have some validity, but it is part of a larg Her over-all problem in American government. Republicans are lapdogs to one set of groups and Democrats to another. And often special interest groups will try to play one party off against another. I'm sure the Roman Empire had the same problem.

Agreed.

[xoxoxoBruce]

Now my brother, who is 54, reasonably healthy, and single, has decided to drop his health insurance which costs him close to $500 a month. He figures it's cheaper to pay the federal and state(MA) penalties, then buy insurance (pre-existing conditions allowed) if something serious develops.

Is there a flaw to this reasoning?

[jinx]

I don't see one.

[TheMercenary]

Originally Posted by xoxoxoBruce

Now my brother, who is 54, reasonably healthy, and single, has decided to drop his health insurance which costs him close to $500 a month. He figures it's cheaper to pay the federal and state(MA) penalties, then buy insurance (pre-existing conditions allowed) if something serious develops.

Is there a flaw to this reasoning?

None. I would rather pay an $800 penalty when I need it and save all the money in between.

[SamIam]

Originally Posted by xoxoxoBruce

Now my brother, who is 54, reasonably healthy, and single, has decided to drop his health insurance which costs him close to $500 a month. He figures it's cheaper to pay the federal and state(MA) penalties, then buy insurance (pre-existing conditions allowed) if something serious develops.

Is there a flaw to this reasoning?

Cancer, heart disease, crippling accidents, and all the others ills that human flesh is heir to.