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It's not medical rationing

Home Forums General Columbus Discussion Everyday Chit Chat It’s not medical rationing

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Viewing 12 posts - 91 through 102 (of 102 total)
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  • #410842

    Parker
    Participant

    Obamacare is like Reaganomics. They are shorthand. We pack them with whatever meaning we want to send and the listener imports whatever meaning they want to hear.

    I think the whole “repeal” Obamacare” is pretty silly. Once the hearings start and people see what is in the legislation most will find things they like and the hearings will backfire.

    Doctors will not quit in droves. Some may retire – fine, let them, good riddance. Where are they going to go? Canada? Europe? HA!

    #410844

    Parker
    Participant

    Obamacare is like Reaganomics. They are shorthand. We pack them with whatever meaning we want to send and the listener imports whatever meaning they want to hear.

    I think the whole “repeal” Obamacare” is pretty silly. Once the hearings start and people see what is in the legislation most will find things they like and the hearings will backfire.

    Doctors will not quit in droves. Some may retire – fine, let them, good riddance. Where are they going to go? Canada? Europe? HA!

    #410846

    Parker
    Participant

    sorry about the triple post. My browser refreshed itself then crashed.

    #410843

    columbusfoodie
    Participant

    Parker wrote >>
    Obamacare is like Reaganomics. They are shorthand. We pack them with whatever meaning we want to send and the listener imports whatever meaning they want to hear.
    I think the whole “repeal” Obamacare” is pretty silly. Once the hearings start and people see what is in the legislation most will find things they like and the hearings will backfire.
    Doctors will not quit in droves. Some may retire – fine, let them, good riddance. Where are they going to go? Canada? Europe? HA!

    You’re ignoring the obvious, though – yes, these doctors may retire, but someone has to replace them just to maintain the current level of care. If you’re publicizing medicine, you have to have providers who will treat people – as it stands now, to become a doctor in this country, one must go through years and years of schooling, internships and residency, take out student loans whose monthly payments are oppressively high, and then pay an arm and a leg for malpractice insurance because there hasn’t been any tort reform in Ohio. The practice of medicine, as it stands now, is lucrative enough that some people feel the sacrifice is worth it, whether it is for humanitarian reasons, financial reasons, prestige or whatever.

    I’m not sure if you’re familiar with how billing a government program (Medicare, Medicaid, Tricare) works from a medical practice perspective, but to say that the coding is extremely complicated and picky is an understatement (case in point: http://www.cms.gov/home/medicare.asp?). Many practices have a billing specialist just for Medicare/Medicaid claims. And HHS are a nightmare to deal with. I used to dread when we were the secondary payor coordinating benefits with Medicare because the delays in paying the claims and sending out EOBs (which our claims processors needed to release a claim for payment) meant that the patient got screwed and billed because six months or more had passed from the time the provider had sent us the claim. There is absolutely nothing efficient about the government.

    But back to these providers that you don’t mind retiring. Without the current incentives to enter the field of medicine, one is going to be hard pressed to not only replace those that retire, but have enough doctors to provide services for all these new people who suddenly have access to healthcare choices that they didn’t have before. Long waits to see specialists, schedule surgeries, etc. are absolutely inevitable. You seem to think that health care is like a well that is never emptied, when in reality water is a scarce resource, and when that well is dry, there’s no water for anyone unless you find a new source of water. I’m convinced when and if it is implemented, the future of healthcare in the country, at least when it comes to primary care, will be handled by advanced practice nurses. Great for nurses (but not really, since the government isn’t exactly generous with what they pay), not so much for doctors, who still have the student loans, the overhead, and the threat of malpractice without reaping any benefits.

    Tell me again how you think this is going to work?

    #410845

    DCist
    Member

    I dont think any one that has posted on this board has seriously read through the ACTUAL bill to find out what is in there. (This is how the “death panels”/”abortion bill”/whatever came about, from people posturing without researching). I’m not even going to interject my opinion about whether its good or bad, but I dont think anyone should talk until they’ve done the research.

    #410847

    Andrew Hall
    Member

    DCist wrote >>
    I dont think any one that has posted on this board has seriously read through the ACTUAL bill to find out what is in there. (This is how the “death panels”/”abortion bill”/whatever came about, from people posturing without researching). I’m not even going to interject my opinion about whether its good or bad, but I dont think anyone should talk until they’ve done the research.

    I have. It is my job.

    I can’t remember if it was here, but I have systematically picked apart claims about what was in it. Specifically that I remember, the falsehood that got tossed around that private insurance would be outlawed. It is not fun to read through laws like this.

    A.

    #410848

    columbusfoodie
    Participant

    DCist wrote >>
    I dont think any one that has posted on this board has seriously read through the ACTUAL bill to find out what is in there. (This is how the “death panels”/”abortion bill”/whatever came about, from people posturing without researching). I’m not even going to interject my opinion about whether its good or bad, but I dont think anyone should talk until they’ve done the research.

    I *have* read it, which is more than can be said for the Congressmen and Senators that voted to pass it. Like Andrew said, not a fun read – and we both have experience with the subject matter.

    #410849

    DCist
    Member

    columbusfoodie wrote >>

    DCist wrote >>
    I dont think any one that has posted on this board has seriously read through the ACTUAL bill to find out what is in there. (This is how the “death panels”/”abortion bill”/whatever came about, from people posturing without researching). I’m not even going to interject my opinion about whether its good or bad, but I dont think anyone should talk until they’ve done the research.

    I *have* read it, which is more than can be said for the Congressmen and Senators that voted to pass it. Like Andrew said, not a fun read – and we both have experience with the subject matter.

    As do I. No one seems to give a shit about the system as a whole or the worst off members, just their individual situation and how changes may or may not affect them. Its disgusting.

    #410850

    Andrew Hall
    Member

    DCist wrote
    As do I. No one seems to give a shit about the system as a whole or the worst off members, just their individual situation and how changes may or may not affect them. Its disgusting.

    That is a nice pithy response and I am sure it makes you feel better, but it is crap. Look above. I give a simplified example of exactly why these are not easy questions – the individual situation and the “system as a whole” can have oppositional interests. Neither has some absolute claim to the high ground and calling one “disgusting” doesn’t further any chance of honest discussion.

    A.

    #410851

    dru
    Participant

    Andrew Hall wrote >>
    Am still waiting for an answer on this reporting requirement for all medical (ie non-Medicare) information …
    A.

    @AH – Since I don’t see it here, I presume the OP just PM’d you the citation for this new reporting requirement. After all, it’s surprising someone this would directly impact and who remains conscientious of the law is not aware of the need to fulfill this requirement. So can you post the citation that was sent for the rest of us?

    #410852

    KSquared
    Member

    DCist wrote >>

    columbusfoodie wrote >>

    DCist wrote >>
    I dont think any one that has posted on this board has seriously read through the ACTUAL bill to find out what is in there. (This is how the “death panels”/”abortion bill”/whatever came about, from people posturing without researching). I’m not even going to interject my opinion about whether its good or bad, but I dont think anyone should talk until they’ve done the research.

    I *have* read it, which is more than can be said for the Congressmen and Senators that voted to pass it. Like Andrew said, not a fun read – and we both have experience with the subject matter.

    As do I. No one seems to give a shit about the system as a whole or the worst off members, just their individual situation and how changes may or may not affect them. Its disgusting.

    How is being concerned for one’s own well being, and the well being of one’s family, disgusting? Do you donate your entire paycheck to charity or do you just enjoy posting supercilious remarks?

    #410853

    columbusfoodie wrote >>
    I’m not sure if you’re familiar with how billing a government program (Medicare, Medicaid, Tricare) works from a medical practice perspective, but to say that the coding is extremely complicated and picky is an understatement (case in point: http://www.cms.gov/home/medicare.asp?). Many practices have a billing specialist just for Medicare/Medicaid claims. And HHS are a nightmare to deal with. I used to dread when we were the secondary payor coordinating benefits with Medicare because the delays in paying the claims and sending out EOBs (which our claims processors needed to release a claim for payment) meant that the patient got screwed and billed because six months or more had passed from the time the provider had sent us the claim. There is absolutely nothing efficient about the government.

    A lot of your emphasis seems to be we should keep the government out of health insurance because they don’t know what they’re doing. I’ve been staying out of this discussion, but just want to clarify a couple of points that I’m not sure if you’re aware of.

    1. Health insurance companies all use the same codes and forms that the government uses for submission of claims. Auto-adjudication of claims has been going on for a long time. If claims are submitted with poor coding, they run into problems anywhere the bill is submitted (and yes, I do agree the coding is complex, and is requiring people specially trained in order to code claims).

    2. Medicare and Medicaid recipients have had the ability to choose other insurers for a long time. A lot of Medicare and Medicaid claims are already processed by major insurers, not the government.

    BTW – when it comes to collecting and analyzing data about outcomes, CMS has the clout to get some impressive things done — and these methods are then followed by insurance companies. This includes hospital payments using diagnosis related groups, and recently, reducing payments to hospitals for hospital acquired conditions (as an incentive to encourage better prevention). I wouldn’t be so quick to say the government doesn’t have a clue.

Viewing 12 posts - 91 through 102 (of 102 total)

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