patrick.net

...and, with "with no discernible improvement in [purported beneficiaries'] health."

Straw Man says

“You would conclude what you wanted to conclude depending on which side of political aisle you were on,” he said, adding, “Now we have an answer.”

Anybody who was intellectually honest and paying attention, from either side of the political aisle, knew this result from the experience of Romneycare. And, once people go to a hospital, they are at risk of "medical misadventures" that increase mandatory spending (and thus lobbyists' revenues) still further. That is the point of the legislation.

Right. We should not give poor people more health care, because then they will use more health care. (sarcasm alert)

The story was on PBS Newshour last night. The interviewee was from Harvard School of Public Health, and her name was Katherine Baicker. Here is the NPR version:

http://www.npr.org/blogs/health/2014/01/02/259128081/medicaid-expansion-boosted-emergency-room-visits-in-oregon

It is quite possible that poor people that suddenly get insurance just have not learned yet that emergency room visits can be avoided by going to the regular doctor EARLIER. The behavior of using the emergency room as the default may be somewhat ingrained, but can be unlearned. It is also possible that the 40% higher rate (1.4 visits in 18 months versions 1.0 visits in 18 months for the uninsured control group) was largely because the patients had some urgent need and did not dare to go before, for fear of the exorbitant bills they would get.

In summary, the whole story smacks of right-wing propaganda to discredit Obamacare and other forms of healthcare for the poor.

You're welcome.

This argument is like people bitching because hungry people show up at McDonald's.

... Oh they do bitch about that too? Well fuck me, you can't please the Liberal people NONE of the time.

It is quite possible that poor people that suddenly get insurance just have not learned yet that emergency room visits can be avoided by going to the regular doctor EARLIER. The behavior of using the emergency room as the default may be somewhat ingrained, but can be unlearned. It is also possible that he 40% higher rate (1.4 visits in 18 months versions 1.0 visits in 18 months for the uninsured control group) was largely because the patients had some urgent need and did not dare to go before, for fear of the exorbitant bills they would get.

----------------

You are obviouslu far disconnected from the lives and fears of the poor. You actually had the gall to suggest that poor people would opt to die of illness for fear of hospital bills? Get real

Its far more likely that corporate propaganda has instilled the mindset that there is something wrong with you, and the doctor can fix you up, with drugs.

How else do you explain the entirety of modern man eating a diet filled with toxins, and then treating the ailments that arise from said diet, with drugs?

justme says

In summary, the whole story....

Your ad hominem and counterfactual response illustrates a basic problem with current public discourse. The experience of Romneycare showed the same result long before the latest study, but your theory blinds you to contrary facts and impels you to impugn the motives of anyone who presents them. You are divided and misruled, and it isn't just you.

errc says

eating a diet filled with toxins, and then treating the ailments that arise from said diet, with drugs?

Exactly. The Capitol auction sells policy to the highest bidder, with the predictable result that we get the most wasteful policies possible: those that cost the most while delivering the least value, leaving the biggest markup for patronage networks. Compared to a world where people eat healthy food and get a reasonable amount of exercise and spend less on medical intervention, the current system "creates jobs" (poisoning people and emptying bedpans) and maximizes revenue for lobbyists.

Meanwhile, a majority of voters are easily divided into polarized camps that insult each other instead of reasoning together. Bop69 wants to hang all the "liberals" (a word he can't even define), while "justme" and homefool dismiss or ignore any facts that might disprove their cherished but over-simplified narrative.

Predictably, the right-wing propagandist are interpreting the Oregon Study as meaning that poor people are ignorant, foolish and wasteful, and therefore good health care is wasted on them. Isn't that right? Or what exactly is it you want to change about healthcare for the poor , including Medicaid and Obamacare? Please explain yourself.

Everyone, Right-wingers and all, should read fully both the linked articles, the NY Times one and the NPR one, including the good comments that people have already made.

There they will find all kinds of good reasons why emergency room in Oregon was 40% higher for a group of newly insured versus the control group that was still uninsured.

I will list and re-list some of the good reasons newly insured people would use emergency care 40% more in the first 18 months of coverage:

1. the knowledge that going to the emergency room would not cause you to be hounded by large bills and bill collectors.

2. an overhang of untreated or undiagnosed conditions that caused an early spike after gaining insurance coverage.

3. the fact that poor people often are single parents working hourly and irregular jobs, with less ability to schedule time off several days ahead of an appointment.

4. the added burden of the poor doing night shifts, causing daytime appointments to be more difficult than going to the ER after regular daytime hours.

5. unlearning old ingrained behavior of going to the emergency room when sick, because that used to be the ONLY way to get care for uninsured persons.

From your NPR link, "Researchers found no measurable health benefits in the Medicaid group for several chronic conditions, including hypertension, high cholesterol and diabetes." Since you call everyone who doesn't share your insurance fetish "right wing propagandists," what should those who disagree with you call you? Since you are attracted to a bs policy, does that make you a bovine coprophiliac?

@Curious2,

"Researchers found no measurable health benefits in the Medicaid group for several chronic conditions, including hypertension, high cholesterol and diabetes."

So now that I have dispelled the myths generated by the study, you are moving on to a different fake claim? Are you giving up on blaming poor but insured people for overusing the ER? That's great.

Now let me dispatch your next fake issue: You are basically saying that there should be measurable improvement in chronic conditions after only 18 months. Is that really a realistic demand? When a condition is already chronic one can perhaps expect the condition to stabilize, but asking for improvement in just 18 months may be asking too much.

justme says

I have dispelled the myths....

If you think you have dispelled any myths, then that is just you. If anything, you have attempted unsuccessfully to resuscitate mythical policy claims, fooling only yourself. Try reading the study, which controlled for times of day, and compare it to your myth #4 above, for example. What you now call a "fake claim" was a direct quote from your link, which was to a blog post but I read it anyway. The fact that all these additional costs conferred no discernible benefit in terms of people's actual health should alert you to a flaw in your theory, or rather your bovine coprophilia.

A short term study said ER visits went up. Another long term study said they went down. This is what passes for "news" these days.

@curious2,

I did not call it a fake claim, I called it a fake issue. The issue made out of lack of IMPROVEMENT in chronic conditions over 18 months is a fake issue. You cannot expect already CHRONIC and previously undertreated conditions to improve in 18 months. Maybe you can expect them to stabilize. That is why your issue is a fake one.

(sarcasm on)

What is it you think you have proven, exactly? That providing health care to poor people does not help them, as evidenced by lack of improvement in already CHRONIC and previously undertreated conditions within 18 months?

Is it so that healthcare just does not work for the poor, because they are so ignorant and wasteful? Is that why we should stop giving it to them? To wit, they actually do just as well without healthcare as with healthcare, as proven by the study. It is just astonishing, and you knew this all along?

Clearly the top 80% are paragons of health virtue, and treatments work much better on them, just because they are not poor.

I can see the headline now: "Oregon Study proves that health care just does not work on poor people, so we should just stop giving it to them."

(sarcasm off now)

justme says

I did not call it a fake claim,

Yes, you did, and it's on this very screen, so now you're merely lying.

justme says

your issue

Again, it was a quote from your link, "no measurable health benefits in the Medicaid group" compared to the group that didn't get enrolled, despite increases in both "preventive" and emergency visits.

Obamacare is, for some (e.g. Homeboy) an addiction. For others (e.g. you), it is a religion. Your comments become increasingly irrational. You started with ad hominem attacks, now you've moved on to lying with straw men. Your sarcasm is not worthy of my time nor anyone else's, so I will stop answering you now and let you have the last word. Please let us know what a lying bovine coprophiliac says when invited to have the last word...

If you want to be dishonest, there is no stopping you. You know damned well that I did not dispel the study claim that there was no improvement in certain chronic conditions. That metric may be right or wrong, but at the moment I have taken the claim at face value.

What I did was to say that you made a fake issue out of the study result, namely by implying that healthcare for the poor does not work, because, look, their chronic conditions should have IMPROVED. Whereas I say that improvement cannot be expected in 18 months, but perhaps stabilization can.

Any more goalposts you want to move around?

Once I had an infected finger. As I was driving back from someplace, it swelled up to twice its size. It was late at night, so when I got near my apartment, I drove up to the emergency area of the local hospital. There was no rush, but they speedily completed papers, and got me to a medical room where they put me in a chair, applied a local anesthesia and lanced the finger to drain it, and shot it up with some anti-biotics.

Today's "emergency" area is really also a 24 x 7 doctor's office.

This thread got hijacked by one commenter's insistence on ad hominem tribal fighting, and it isn't just them. I've been thinking about it, why do so many people insist on seeing this policy along tribal lines, and I think that's just the way most people are.

On a forum about cost and value, primarily in the housing sector, I had hoped people might look at this policy in terms of its cost and benefits. The Oregon study showed, as Massachusetts studies had shown before, the obvious: the cost of the policy is high, and the purported benefits are illusory, while the real beneficiaries are the revenue recipients. Anyone comparing the numbers in for example the US and the UK, or the US and Canada, could have told you that spending more money was not what the US needed to do. Anyone looking at what Obamacare actually does, despite the shell game promises, would see it's fundamentally about spending more money, which the recipients call revenue.

The question is, how does a polity become so polarized, so deeply divided and badly misruled? The answer can be seen right here, on this very page. Most people are genetically wired to hate the other tribe, and stick with their own tribe, even adopting the most absurd beliefs imaginable. They lie with abandon, because facts and reason don't really matter to them, only hatred of the visiting team wearing a different uniform, and loyalty to the home team wearing their uniform. The result is people paying more to die sooner, people getting poisoned and butchered and robbed in broad daylight, year after year.

justme says

The story was on PBS Newshour last night.

Ah, the "News" hour, brought to you by UnitedHealth Group, principal beneficiary of Obamacare. They got the biggest contracts to develop the website, then got an even bigger contract to fix it in a "tech surge." They stand to reap many billions from the legislation. If that's your source for news, and you dismiss all others, then I suppose your confusion is partially understandable, though your blatant lying can only come from spending too much of your time among people who don't actually listen and question what you say. Any environment where you could get away with that is one in which you don't learn.

@Curious2,

The question remains, why do the right-wingers only hate healthcare for the poor? Why is it only healthcare for the poor that brings loud complaints about lack of efficiency in the health system? Can you answer me that?

Indeed, why do the right-wingers hate Medicare and Medicaid so much, given that these institutions are by far the most cost-effective healthcare programs in the US. Should we not just institute Medicare for all, and then we could cut the costs in half to the level that UK has, and with better results than the current system?

It is fair to question the overall efficiency of our healthcare system. But that is not what this thread was about. This thread was about justifying taking health care away from poor people, based on some very questionable logic being applied to the Oregon study.

The essential premise of this thread was that poor people can not be trusted with healthcare, because they are ignorant, foolish and wasteful. This was "proven" by some newly insured in Oregon who used the ER 40% more than the uninsured control group, in the first 18 months of the program.

The conclusions were wrong, but the right-wing poorcare-haters just couldn't contain themselves and nearly wet their pants with glee.

Medicare for all is the solution, to cover everyone, and to cover them at low cost.

bob2356 says

All of curious george's issue's are fake ones. He firmly believes if everyone avoided doctors,hospitals, and prescription drugs America would be a nation of healthy people.

I guess so, but why does he get so singularly excited about especially "helping" poor people by keeping that particular demographic away from the health care that he so much despises? It is very noble and all, because clearly only poor people need such "help".

justme says

The question remains, why do the right-wingers only hate healthcare for the poor? Why is it only healthcare for the poor that brings loud complaints about lack of efficiency in the health system? Can you answer me that?

Why is it that the poor don't have to pay their fair share, my 74 year old mother certainly does. A fair share that was decided by a group of people who despise the Old people in an age where the rabble mob was crying to string them all up. And her late husband fought in WWII, then for over 40 years as a Merchant marine, and was promised by Wiser more truthful people this administration, that she/he would be provided for in their old age.

If the social contract is broke for some, then it's broke for all. Fuck the poor, they can like the floor like the rest of us, when they get a tummy ache.

@CaptainShuddup,

Please go back and rewrite that demented ramble. It is 50% gobbledigook. Maybe a case of right-wing healthcare derangement syndrome?

@curious2, why do you write such rambling and ciphered essays? Couldn't you just have written

"I think Bob's wife is an MD that that is moving from state to state to avoid malpractice claims. Now explain why you love him so much."

Then maybe I had thought it was worth answering, but probably not.

ADDENDUM: I have no idea why curios2 has this opinion about Bob. It seems very unlikely that there is any truth to it. It was perhaps an unfortunate example to use as to how little information there is in the rambles of curious2.

If people gave a crap about the health of others, or even themselves, they'd bone up on nutrition and realize that the simplest way to improve the health of all, is thru nutrition. I loathe all the shitty apples to oranges comparisons I've read over the ppaca debated years (imagine half of your mechanics customers stiffing him on the bill and you picking up the tab LOL), but if you're an analogy type of person,,,,,,the western diet suggested by the usfedgov insists that people put gasoline mixed with sugar into their diesel fuel tank. And then let's all flail about like idiots when the car is destined to the mechanic for repairs so costly it may as well be totalled

is this a facebook action?
CaptainShuddup says

Fuck the poor, they can like the floor like the rest of us, when they get a tummy ache.

Call it Crazy says

Rah Rah Rah.... Blue Team, Blue Team, Blue Team....

That's why....

Yes, but then the question becomes, with an awful policy that affects everyone and polls at -10, how does Blue Team continue to win elections, and the answer to that question is because Red Team is even worse. Red Team campaigned on policies that poll around -40. I think probably only 20% think honestly about what's going on, and the remaining 80% repeat whatever their tribal leaders tell them.

Homeboy says

"sugar in the gas tank"?

Subsidized corn and dairy and the resulting subsidized "food" that you buy at McD's and other fast "food" places, fattening you up for your SSRIs. Oh wait, you ignore me, so nevermind, eat up.

errc says

You actually had the gall to suggest that poor people would opt to die of illness for fear of hospital bills?

I have personal experience with this.

My brother has a series of symptoms that are extremely alarming. He is barely scraping by, with some help, has been living in his car some. If I had them, I'd be at a doctor immediately. He has no insurance and would have had to pay out of pocket for what could be quite serious so he just doesn't go and tried to pretend it's not there. He's been living from dayjob to dayjob, and TRYING to get a real job. He won't go to the ER because he's afraid of what he'd find out, and he's paranoid that any employers he has applied to, might get word through his smalltown grapevine that he's got health problems. Because you know in an ER, you have to explain to a whole lot more random staffers what is going on with you.

In case anyone is thinking about starting a thread about "Straw Man cowardly deleting posts", go ahead, but the only stuff I cleaned up was, IMO, useless bickering and personal attacks which added no value to the discussion.

I'm just curious - which part of that, exactly, is "sugar in the gas tank"?

USDA recommendations:

"A healthy eating pattern emphasizes nutrient dense foods such as whole grains"

We all know that they ditched the food pyramid, which suggested the majority of ones diet be comprised of breads,grains, and cereal,,,,for the modern version of pretty much the same thing, choose my plate.gov.

Grains are the sugar in the gas tank, science tells us so

errc says

USDA recommendations:

"A healthy eating pattern emphasizes nutrient dense foods such as whole grains"

That's not recommendations plural it's recommendation singular. You left out the other 14 items they recommend that aren't grains. Are you actually trying to make a point or just spewing your ideology fixation.

The old pyramid suggested that grains should be the majority of what you eat. The scientific consensus changed on that, so they changed the pyramid.

-----------

What was it that "consensus science" found out, that they didn't know before, that led them to suggest eating less grains? Was there something bad about consuming all that bread and grains?

Consensus science lol!

I don't know the first thing about Atkins. I've never read any of those books, nor do I know what they say about nutrition, so don't put words in my mouth

justme says

The question remains, why do the right-wingers only hate healthcare for the poor?

That was never the question. You are either using your own private definitions of those words, or merely lying. A better question would be, why do people who insist on butchering and poisoning the poor, as lucratively as possible, call themselves liberal? Do they think that word sounds better than what they really are, or is it a false flag attack? Here we have data showing once again that increased spending isn't helping, or if any of the poor did coincidentally benefit then that was offset by so much harm that their net benefit was zero, and yet some people insist on even more.

Atkins-bot? I've never heard the term. I know what atkins diet is more or less, I just never read any of dr atkins books.

I've answered it plenty of times.

Whole grains is the "sugar in the gas tank"

I also feel that "fat free or low fat milk products" is horrible advice

Lean meats is bad advice

I feel animal fats are to be enjoyed, not avoided.

So there you have it, I've answered all your questions, and you will likely continue to avoid mine.

"More than a third of health-care spending may be wasteful in Massachusetts, where costs are among the highest in the nation, a state report released on Wednesday said.

Main drivers of excess spending included patients returning to hospitals for preventable reasons and emergency-room visits that better primary care could have warded off, the state’s Health Policy Commission concluded, citing data from 2012."

Implementation of Romneycare began in 2006, and is going national this year. In fairness to Massachusetts though, the National Academies' Institute of Medicine reported 30% waste nationwide based on numbers from 2009. These percentages reflect only what the institutions could prove; the total of waste, fraud, and abuse more likely exceeds 50%.

errc says

The old pyramid suggested that grains should be the majority of what you eat. The scientific consensus changed on that, so they changed the pyramid.

-----------

What was it that "consensus science" found out, that they didn't know before, that led them to suggest eating less grains? Was there something bad about consuming all that bread and grains?

Consensus science lol!

So, the bottom line is: another supposed benefit of of ACA - reduced ER visits by uninsured was a lie. They either didn't have data to support that claim, or deliberately deceived the public. Would it pass if it was known then?

Straw Man says

Would it pass if it was known then?

It was known then. The legislative "debates" were nearly a fact free zone, the public verbiage being irrelevant. Both major parties made up whatever nonsense they thought would fool the base. In the House, one representative after another stood up and read verbatim the same talking points as the one before, to get onto the local news. PhRMA bought the national news (count the ads and see for yourself who's paying those pied pipers), as part of a secret deal the White House initially denied but then admitted, in exchange for hundreds of billions in federal $$$. The federal government spewed propaganda across the airwaves and the web ("healthcare.gov"). Even with all that, the policy polled around negative 10 anyway. All that really mattered was the fix, the vig, who got what kickback and revolving door patronage.

Straw Man says

the only stuff I cleaned up was, IMO, useless bickering and personal attacks which added no value to the discussion.

That's fine, it's your thread, but in my opinion you could have deleted this one also. You deleted my reply, which explained his motive, but left the provocation. (That troll has a long history of drive-by sarcastic strawmen; when he tries to buzz me, I swat him like a fly, but he returns whenever he senses heat from another direction, hoping for a chance to pile on. Some trolls have an adrenaline addiction, they need to fight, and that one needs to boast about driving 80mph sideways, anything for another fix of adrenaline.) You can delete this comment also if you want. Here on this forum we merely exchange anonymous words in the ether; we're not actually legislating over other people's lives.

Put my man Christie in the White House, and emergency rooms will be limited to foot traffic.

HydroCabron is Kochel 271 says

Put my man Christie in the White House, and emergency rooms will be limited to foot traffic.

No need to distract him with executive power, just lay him across the receiving bay, mouth open, so the EMTs can spring the gurneys and pop the patients into his mouth. Think Newman as the cleaner, in Seinfeld.

http://www.youtube.com/embed/qRTBVPgHM3Y

curious2 says

That's fine, it's your thread, but in my opinion you could have deleted this one also.

I agree. I missed it. It's gone now.

HydroCabron is Kochel 271 says

Put my man Christie in the White House, and emergency rooms will be limited to foot traffic.

Walking is good for ya!