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Subject: Health care debates Posted by: Perm Dude - [154552311] Fri, Jul 17, 2009, 20:16 A place to park the opinions. Here's one: Many bloggers are lazy. The flip side of the huge army of bloggers overlooking mounds of data is that many of the aren't really reading, understanding, and forming coherent opinions on the topic. They are skimmers. Most of them are just looking for stuff that matches their own biases--the internet is a sort of arms bazaar for those people, where they can go from table to table gearing up for the fight. The problem (among many) is that these are the self-appointed "new news" people. And on complicated issues like climate change, health care, and the economy skimming for sound bites is a huge disservice all around. I don't have an answer here, BTW. I'm just sayin'. | |||||||
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| 1778 | Pancho Villa ID: 2131916 Thu, Jan 01, 2015, 23:17 |
doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average Since doctor involvement in primary care has dwindled to almost nothing, perhaps that's a fair assessment. In fact, a person could get the entire scope of primary care without ever even seeing an MD. PAs, MAs, LPNs and RNs handle every necessary procedure in varying degrees. This is especially true with the low wage medical assistant. - The general increase in demand will require more MA work. - Work is shifting from venues that use few MAs (e.g., emergency rooms) to doctor’s offices, where MAs are prevalent. - Work is moving from higher-paid, higher-credentialed practitioners to lowerlevel, lower cost practitioners, including MAs. - Many wellness programs can use lower-skilled workers, including MAs. - Electronic record requirements will increase demand for MAs with strong informatics skills. - Regulation of MA work is relatively loose and may be further relaxed. - In our research, several other possibilities for MAs were suggested: – As sicker patients are released to their homes, rehab facilities, and nursing homes, home health workers and LPNs may be replaced by MAs (who have more training). – New roles are emerging for which MAs may be qualified, including health coaches, health communicators, and patient care coordinators. – There will be significant pressure to improve all MA skills, including professionalism, clinical knowledge, and informatics. – Special training in geriatrics or obesity may be a differentiator. Surgery, of course, is an entirely different issue, although PAs are more and more performing procedures that used to be the sole duty of an MD. a dubious gamble that doctors would work for half-price A lie. Too bad you're not worried about the medical assistant who does a lot of the work a doctor(or nurse) used to do when starting wages range from $21,000 to $25,000 and median wages range from $29,000 to $30,000. Free market solutions. | ||||||
| 1779 | Boldwin ID: 510591420 Fri, Jan 02, 2015, 11:55 | "If you like your doctor, you can see an MA"? That was the promise? | ||||||
| 1780 | Khahan ID: 2162589 Wed, Jul 08, 2015, 10:25 |
Does this fall under the ' I told you so ' category? Not necessarily the big hikes after the fact. But look at the reasoning - more people are sicker than we thought. You can't subsidize health care. Just imagine if over the past 5 years our government had taken all the resources put into Obamacare and put it into really and honestly fixing health care in America so it was affordable. | ||||||
| 1781 | biliruben ID: 229341622 Wed, Jul 08, 2015, 12:26 |
Seeking and getting are two different things. State insurers have to approve price hikes. Back when I was an actuary, we saw requests like this, and sometimes much higher all the time. This is just sensational anti-obama redmeat. Obamacare is currently coming in cheaper than original estimates, with higher numbers of enrollees, with the exception of medicaid in the states where their governments hate poor, largely black people. But that's not a failure of Obamacare. In pretty much every metric, it's been a massive, surprisingly overwhelming success. Now if we start seeing actually, mean increases in the 20-40% range, these please come back and say I told you so. Right now, it is looking very much like business as usual for insurance companies, adapting to a new program this is a wonderful, smashing success. It ain't single-payer, but you can't have everything in our twisted country that worships markets even is situations where markets don't work. | ||||||
| 1782 | biliruben ID: 229341622 Wed, Jul 08, 2015, 12:26 |
Seeking and getting are two different things. State insurers have to approve price hikes. Back when I was an actuary, we saw requests like this, and sometimes much higher all the time. This is just sensational anti-obama redmeat. Obamacare is currently coming in cheaper than original estimates, with higher numbers of enrollees, with the exception of medicaid in the states where their governments hate poor, largely black people. But that's not a failure of Obamacare. In pretty much every metric, it's been a massive, surprisingly overwhelming success. Now if we start seeing actually, mean increases in the 20-40% range, these please come back and say I told you so. Right now, it is looking very much like business as usual for insurance companies, adapting to a new program this is a wonderful, smashing success. It ain't single-payer, but you can't have everything in our twisted country that worships markets even is situations where markets don't work. | ||||||
| 1783 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 22:18 | ...and chocolate rations have been increased to 20 grams. | ||||||
| 1784 | biliruben ID: 229341622 Wed, Jul 08, 2015, 23:07 |
Sarcasm is brilliant. When got nothing else. | ||||||
| 1785 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:07 |
OMG, where do I begin. First off, setting an incredibly low bar is no measure of success. Obamacare threw more people off their preferred insurance and onto more expensive plans than the few people who got insurance. The director of the CBO testified that 800,000 jobs will be lost over the next decade as a result of the law. And that's with Obama being able to get them to fudge their numbers with garbage in/garbage out. You will find numerous liberals crowing about Obamacare not having produced a shift to part-time labor force. What these liberals FAIL to tell you is that the employer mandate was shifted until after all the elections in Obama's two terms were concluded. Yes, it goes into effect in 2016, well after Obama's last election. The extra IRS muscle that was hired is hardly a win. Any business is now required to waste time filing a 1099 tax form for every transaction over $600. If you think that's not crazy you've never been in business. There are so many taxes hidden in Obamacare it's like a giant toxic christmass cake. Already insolvent states have been driven further into unsustainable debt. Obamacare hasn't truly hit yet. Somewhere between 1/3 to 1/2 of Americans will eventually be thrown off their plans because the insurance companies cannot make the numbers work. But that was the plan. Deliberately fail and then tell people the only solution is more marxism, a totally marxist system. All the exemptions haven't run out. Even Obama realized those situations were a disaster he didn't want to pay a political price for. When they do, the reason they were issued will become apparent. Emergency rooms are more crowded, not less. Contrary to promise. Doctors are retiring in droves and those numbers are not being replaced. Even tho Obamacare will drive up demand. So whats the fix to that, libs? Gonna legally require doctors to work where they don't want to? Take in less than they need to pay off their educations and overhead? Just the increased paperwork is driving them out, let alone the inadequate reimbursement, government required unethical reductions in quality of coverage, and threats to their consciences. Too onerous for business. Even ridiculously liberal Starbucks CEO says, "under the current guidelines, the pressure on small businesses, because of the mandate, is too great." Obama administration’s chief Medicare actuary reported, "Providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program." Great. You've got coverage. You're still poor so even tho you've got coverage you can't afford the aluminum plan deductible so you'll still just not go to the doctor. And no one will be left to deliver the healthcare anyway. Thanks for nothing. | ||||||
| 1786 | biliruben ID: 229341622 Wed, Jul 08, 2015, 23:10 | I guess you can just make shit up, but that ain't a critique. I stopped when I got through the first 10 fact-free bullet points. | ||||||
| 1787 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:18 |
Since you won't accept any facts which Obama's Annenberg buddies don't recognize there's not much point in footnoting every one of those points. For any non-troll who genuinely intends to stay in the reality based community, I'll happily back up every one of those points. | ||||||
| 1788 | biliruben ID: 229341622 Wed, Jul 08, 2015, 23:21 | Okay. Start with 1 through 10. | ||||||
| 1789 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:28 | Later. | ||||||
| 1790 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:40 |
Point 1 Out of curiosity, what is your explanation for why every uninsured impoverished American didn't rush out and pick himself up some free Obamacare and dance thru the streets celebrating? Why does even Obama predict 30 million will still be uninsured ten years from now even after being fined to death in an effort to blackmail them into it? Why do more than half of Americans LOATHE Obamacare? | ||||||
| 1791 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:52 |
You do realize that only 3/4 of the people for whom it is absolutely free have signed up...right? You do realize less than 40% of people eligible for subsidies have signed up...right? You do realize medical insurance is already in the death spiral...right? How is this some freaking success? Calling THIS a success is setting the bar pretty low. | ||||||
| 1792 | Boldwin ID: 49572022 Wed, Jul 08, 2015, 23:57 | You should listen in when the Illinois Health Connect former Acorn worker, now pulling in +50K to indoctinate me, calls. The poor thing has nothing to do all day but call people up and poll them. No one wants to talk to him tho. I think he was audibly weeping when he hung up on me last time. | ||||||
| 1793 | Boldwin ID: 49572022 Thu, Jul 09, 2015, 00:09 |
And that single payer you think is the real panacea... Vermont, which brought us openly marxist Bernie Sanders and which attempted to bring in a single-payer system and which government was just packed with Obama worshiping true believers in the socialist way... ...looked at the numbers and bailed. They were that bad. Even insanely leftist hacks can't pull that much money out their @$$e$. So no, it doesn't get better after O-care crashes and burns and they try pure marxism. | ||||||
| 1794 | Boldwin ID: 49572022 Thu, Jul 09, 2015, 01:07 |
And every half hour another lawyer [who couldn't make it in politics] comes on the tube, "Has any doctor, surgeon, medical device maker, inventor, nurse or health facility ever tried to help you? Let's sue them so hard their great grandkids are still poor." Just hard to see how we could stop the runaway medical costs. Nope...nothing comes to mind. I wonder what is driving prices thru the roof? No idea. *shrug Hey, marxism! That's always efficient.  Venezuela | ||||||
| 1795 | biliruben ID: 229341622 Fri, Jul 10, 2015, 15:20 |
I ask for facts, and I'll I get is regurgitated nonsense. Learn how to draw a trend line, doomer.  Sure, it takes a while for new services to be adopted, particularly when half the state's governments are doing all they can to build giant walls between the uninsured and the coverage they are entitled to. And there will always be a certain percentage of uninsured, as groups like undocumented immigrants are not legally allowed coverage. But I sure looks from the graph that we are headed towards 5% uninsured, and fast. I know Obama haters would love to see a return to 10s of millions at risk of losing everything at the first expensive medical complication, and actively rooting for more misery, but tough shit, doomer. ACA is here to stay. | ||||||
| 1796 | Khahan ID: 386391014 Fri, Jul 10, 2015, 15:41 |
Bili - yes more people are now insured but again, that is because of a government mandate stating, "buy this product or else," which I find offensive. The government has no business telling its citizens they must buy a product in a free society. Anything else Obamacare may accomplish is lessened because of the methods used in my eyes. Nobody is arguing more people are actually uninsured now. We all agree that more people are insured. The questions and info we need to look at are 'why' and 'how'. They certainly aren't insured for cheaper than they were before. I've had way too many customers in my office discussing their health care premium increases over the past few years I know Obama haters would love to see a return to 10s of millions at risk of losing everything at the first expensive medical complication, and actively rooting for more misery This whole argument is one of the biggest and worst examples of red herrings ever conceived. Show me one place where anybody on these boards said, "Yes, lets make sure people get financially ruined by illness, disease or injury and laugh at the poor downtrodden souls." (ok, I'll even take a paraphrase of that!). Its easy to feel like you are winning the debate when you make up the arguments for the other side. But we're not making that argument. I'll state my argument again here for you. I'm sure you can find me making this argument in the past because I've been pretty consistent about it. My beef with Obamacare is that it forces people to buy into a broken system. It never actually fixed the problem with healthcare, which is the cost. Oh, and that whole, "buy or else" ultimatum from the government in the land of the free. If we really want to fix healthcare then we need to address: 1. How much doctors, hospitals and health care providers in general charge for services 2. How much influence health insurance companies have in how much services cost 3. How much influence health insurance companies have in deciding treatment Those are the major factors in my eyes. There are many other issues that typically fall into one of those 3 categories (cost of schooling, cost of liability insurance, for profit involvement and stockholders in corporations etc). It truly believe that fixing those issues first and making healthcare be a product that is cost effective to begin with will do more to help everybody get healthcare than a government mandate ordering everybody buy a product or face a fine (especially when mandate does nothing to fix the broken product). | ||||||
| 1797 | biliruben ID: 229341622 Fri, Jul 10, 2015, 15:58 |
There are actually many provisions built into ACA that are directed at all 3 of those points. And they are all working. They are daylighting costs. Healthcare is not going up as fast as it was. I personally would have liked to see insurance companies made completely illegal. That is my wish. ACA was a kludge. A fix thought up by market-loving conservative technocrats. I hate it. But I hate the previous status quo far more. | ||||||
| 1798 | Khahan ID: 236471015 Fri, Jul 10, 2015, 16:47 | ACA may have provisions to address those points but I'm still waiting to see the results of them. | ||||||
| 1799 | Boldwin ID: 49572022 Fri, Jul 10, 2015, 21:36 |
Forcing people into a system they hate is not a success. The only reason I have it is because my religion discourages civil disobedience. Yet I am in the group you crow about. And so are half the people in there. Who would be happy to go back to the land of the free if we could find our way back. | ||||||
| 1800 | biliruben ID: 561162511 Mon, Jul 13, 2015, 15:55 |
There isn't really any debating. ACA is an unqualified success. It's has achieved or working to achieve every objective it set out to achieve. This was a massive compromise, and as such, the structure where everyone is required to particpate is pretty horrible, but essential for it to function. As I said, I'd much rather sweep away all the 10s of billions in wasted bureaucracy (making health insurance illegal to sell and instituting single-payer like the rest of the civilized world) attempting to placate and satisfy those who insisted on us making some faux-market solution in a situation not at all suited to a competitive market place, but it really is the only politically viable solution as we stand today in the US. | ||||||
| 1801 | Boldwin ID: 49572022 Tue, Jul 14, 2015, 09:17 | So basically you'd be sticking your chest out and crowing about a huge success if the death panels had those of us who hate Obamacare put to death...as long as Obama is happy, it's a huge success. The opinion of 'the health cared' doesn't matter one iota to you, does it? And you don't think you are a fascist. | ||||||
| 1802 | Khahan ID: 24636148 Tue, Jul 14, 2015, 09:36 |
I think we have different definitions of success, Bili. Watching customers come into my office and sit down with our health care guy and being told their old premium of $250 a month for a solid healthcare plan is out the window and now for a plan with high co-pays and more restrictions on doctors and a deductible in the thousands of dollars they need to pay $480 a month....how is that a success? That is what I witnessed on a regular basis last year. To my eyes, ACA is an unmitigated disaster. Throwing partisan politics out the window. Watching it in action and talking on a regular basis to somebody who sells it....it is horrible. | ||||||
| 1803 | biliruben ID: 28420307 Tue, Jul 14, 2015, 11:08 | In what fantasy world did anyone get a solid healthcare plan for $250? I have crap for $1400 (largely employer paid). And that was both before and after ACA. | ||||||
| 1804 | biliruben ID: 28420307 Tue, Jul 14, 2015, 11:11 |
No, Baldwin. If you read "I hate it" as sticking my chest out and crowing, you have brain damage. The definitions of success were written by the heritage foundation. Take it up with them. | ||||||
| 1805 | Khahan ID: 176181412 Tue, Jul 14, 2015, 13:19 |
Single older people before ACA who could pick and choose the healthcare they wanted (as opposed to having to take a full all out health plan with everything on it. After ACA they'd see a monthly increase in the hundreds of dollars for a worse plan. Sorry but if your eyesight is fine and you don't want vision then paying for it is not making it a better plan. Its just making it a more expensive plan. What family can afford to pay $1400 a month for health insurance that in turn has them paying $100 copays or $8000 deductible (meaning the insurance does nothing until there are $8000 in bills?) Isn't the family much, much better off saving $16800 every year and taking care of the little things they have to take care of anyway? THAT is the problem with healthcare in this country and it is something the ACA only made worse. Really think about it bili - you said you are paying $1400 a month. That is $16800 every year to insurance. What could you and your family do with that money instead of putting it into a pot for something you actually hope you don't use? How much savings could you have as a rainy day fund? How often would repairs on a car come up and be already covered rather than be something that has to be worried about? I think something almost all of us agree on is that before the ACA was implemented healthcare in this country was broken and needed fixed. Do you agree with that statement? Going with the premise you do agree with that last statement I'll a step further: It was broken because it was a cost prohibitive purchase. People couldn't afford it. They also couldn't afford health care. The insurance was too expensive, the healthcare was too expensive. Are we still in agreement? If so we have a good foundation for a discussion - healthcare and health insurance before ACA was in bad shape in the USA because it was too expensive. If we are in agreement on that then how can we not conclude that healthcare and health insurance in the USA are STILL in bad shape? Why? Because both are even more expensive than they used to be before the ACA. | ||||||
| 1806 | Tree ID: 161036918 Tue, Jul 14, 2015, 17:55 |
In what fantasy world did anyone get a solid healthcare plan for $250? the late 90s, early 2000s fantasy world. i had a good plan when i was in the music biz. it probably cost closer to 300 a month. i had co-pays for doctor visits and such, pretty much everything was paid for. but since i left that field, i haven't had a good insurance plan. mine now is decent, not as good as i had previously, but definitely better than what i've had at any other point since 2008. | ||||||
| 1807 | biliruben ID: 28420307 Tue, Jul 14, 2015, 18:46 |
I don't disagree with most any of that, Khahan. It's still in bad shape. But many more people are covered and it's less expensive than it would be otherwise. Also, people who need it but can't afford it are subsidized. If you want to burn down Humana I'll contribute to your legal bills. If you have a better idea to insure millions of people who weren't previously insured, subsidize those who can't afford insurance and make sure the insurance companies can't toss you off the roles when you get cancer, I'll contribute to your campaign. I've already mentioned one. But that involves burning down Humana. | ||||||
| 1808 | WiddleAvi ID: 506382610 Tue, Jul 14, 2015, 19:00 | Kahan - I think everyone agrees that our health care system is broken. I think the biggest problem is the GOP refusing to even consider a single payer system (as boldwin/fox news would say - it's socialism/marxism blah blah). Because we don't have health care for all Obama care came along and said the GOP is going to block that so lets do the best we can and get insurance for as many people as possible so no one is stuck without insurance. Hopefully this pushes the GOP to work and come up with a better solution to health care. IMO the only solution is health care for all like the rest of the modern world. It's about time we did away with health insurance completely. Access to health care should be a basic human right. | ||||||
| 1809 | Bean ID: 14147911 Tue, Jul 14, 2015, 19:24 |
<1808> "Access to health care should be a basic human right." Agreed, but I also believe that it should be paid for by the country you are a citizen of. The US tax payer should not be providing free health care to non US citizens simply because they are inside our borders, either legally or illegally. | ||||||
| 1810 | bibA ID: 275441414 Tue, Jul 14, 2015, 20:39 |
The US tax payer should not be providing free health care to non US citizens simply because they are inside our borders, either legally Even if they are paying their taxes? | ||||||
| 1811 | Boldwin ID: 49572022 Tue, Jul 14, 2015, 21:28 | Oh, yeah, because so many illegals are earning enuff rise above collecting EIC instead of contributing, or even more unlikely, rising above large O-care subsidies. | ||||||
| 1812 | biliruben ID: 81382416 Tue, Jul 14, 2015, 22:21 | Don't get your panties in a bunch. Undocumented immigrants aren't eligible for ACA subsidized health insurance. | ||||||
| 1813 | Boldwin ID: 49572022 Tue, Jul 14, 2015, 23:17 |
Except it's illegal for the Obamacare system to ask them if they are illegals... ...so right back atcha. They certainly will not be denied Obamacare and subsidies. | ||||||
| 1814 | Bean ID: 14147911 Wed, Jul 15, 2015, 00:44 |
<1810> Well, when we are discussing the creation of a hypothetical single payer system, we must be conscious of the fall out. It would require a total re-work of our tax system, and all things would be on the table then. Perhaps that was the inertia that Obama care avoided. Green cards do not come with a guarantee of citizenship, there is no social contract with the hired help. Sorry green card holders, you still hold your allegiance to another country, you are not American citizens. Imagine if a green card worker's company had to pay for that employee's health care to entice them to come here. They might be more inclined to hire an out of work American instead, assuming they weren't just inclined to break the law and hire an illegal instead. | ||||||
| 1815 | biliruben ID: 561162511 Wed, Jul 15, 2015, 15:23 |
Necessary and healthy fallout, I think. And you seem to be talking in circles. You suggest in your last sentence that, in order for US workers to be on more equal footing with undocumented workers, we should actually insist they be given coverage. This is argument number 5211 for moving towards a single-payer system. We would take the burden of health insurance away from corporations and allow them to be more internationally competitive. | ||||||
| 1816 | Tree ID: 161036918 Wed, Jul 15, 2015, 15:41 |
Except it's illegal for the Obamacare system to ask them if they are illegals... also a lie. | ||||||
| 1817 | Boldwin ID: 49572022 Wed, Jul 15, 2015, 21:21 |
Unlike anyone else here, I actually read virtually all of the 1000+ pages and I know that the law blythely lies and says they are not eligible [which is just blowing smoke for political cover] and then elsewhere it makes it illegal for any Obamacare healthworker to ask about immigration status or to use that information against them. While it is true that applying online using questionnaire forms will ask if they are legal, any illegal can get obamacare and subsidies if he keeps trying and he will never get thrown off once he gets covered. | ||||||
| 1818 | Boldwin ID: 49572022 Wed, Jul 15, 2015, 21:23 | As basic google skills quickly reveal. | ||||||
| 1819 | Boldwin ID: 49572022 Thu, Jul 16, 2015, 09:51 |
Better smile than Mengele ...and fava beans. | ||||||
| 1820 | Tree ID: 161036918 Sun, Jul 19, 2015, 23:14 | you do love the highly edited videos. your heroes deceive and lie, and you praise them to the cross. | ||||||
| 1821 | Boldwin ID: 49572022 Mon, Jul 20, 2015, 00:21 | The whole 2 hour uncut video is on youtube and there really isn't any way to describe carefully crushing a baby to preserve the valuable parts for resale that can survive public sensibilities, edited or not. | ||||||
| 1822 | Boldwin ID: 49572022 Mon, Jul 20, 2015, 00:42 | On a related note *I hear* that while Hillary campaign workers are not allowed to talk to the press, they are however allowed to accept baby organ donations. | ||||||
| 1823 | Khahan ID: 396562015 Mon, Jul 20, 2015, 16:56 |
As if we needed more examples to illustrate the problem with healthcare in America. This article actually hints at some of the other factors but does a good job of bringing at least 1 factor out into the open. Again this is something that Obamacare did NOT address. | ||||||
| 1824 | biliruben ID: 229341622 Sat, Jul 25, 2015, 00:12 |
 Hey, whaddayaknow. Single payer does work, when the proper controls and people who don't hate the very idea of government are in charge. | ||||||
| 1825 | Boldwin ID: 49572022 Sat, Jul 25, 2015, 00:24 | Tell it to the Gruber groupies in Vermont. | ||||||
| 1826 | Boldwin ID: 49572022 Wed, Aug 12, 2015, 15:38 |
Here's how it happens, state by state. Illegals of all ages getting Obamacare. What I said. What you derided as impossible and illegal. Or maybe you were just lying long enuff to get it passed. | ||||||
| 1827 | Boldwin ID: 49572022 Fri, Aug 14, 2015, 21:23 |
 Euthanasia, reductions in payout, higher age eligibility, all soon...soon. | ||||||
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