patrick.net

4X says

3. Reducing the fees of doctors. It should not cost $350 for a 15 minute doctors visit.

Yea - Docs are soooooooooooooo overpaid. I went to the doc and she charged me $100 for a 10 minute follow up. The insurance paid her $5 and I paid her $15. She wrote off $80.

She also paid her staff, her malpractice, her unemployment insurance, her staff's benefits, her rent & various overhead, student loans, supplies, etc. out of that. Not all docs are overpaid, in fact, many are struggling due to massive amounts of bills. Someone who gives up 10 years of their life for school, more for training, more for ongoing training, is oncall 24/7, is responsible for my healthcare... Yea, $350 a year for an exam is worth it. My doc caught something serious and "fixed" it so that I can live a relatively pain-free, happy life.

People pay auto mechanics to fix their cars, change the belts & plugs & such. New tires, etc. But they bitch about what they pay their docs. Do some docs make money hand over fist? Sure - but many of them make their money from investing in equipment companies, home health/hospice companies, etc. Those who contract with hmo's get paid shit wages for their patients, while the insurance companies make bank.

I know we need reform, but it's the big insurance companies that make money hand over fist by denying benefits.

I'm not saying that doctors don't make huge amounts - some do. But most are hard working professionals who don't have the opportunity to benefit from the money they make. Just sayin.

Thanks Ellie,

That was well said. We agree that insurance companies are much of the problem (a problem the government collaborated with them to create).

It is funny to me that many of the same people who have a distaste for wiretaps (patriot act style), endless wars (to make the world safe for "democracy" and democratic organizations like Blackwater and Halliburton) and government abuse of power in these areas somehow desire that that same corrupt government take over health care. When you call me "all over the place." I just laugh because this philosophy of so many on this site is all over the place. You want central government planning of health care but not war. You want central planning of welfare but not a survelience state. You want central planning of our economy but hate it when corporatism takes over as a result. How is that working for you?

elvis says

What concerns me, and appears to be of concern to millions of vocal, patriotic Americans is where all this centralized government control is leading. Taxes are the largest single expenditure for most Americans…approximately 50% (by the time ALL taxes, fees, permits, license fees, etc, etc, etc are included). $ TRILLIONS of new government deficit spending is taking place with even more being proposed. It’s time to stop the insanity.
Millions of Americans do not want to become slaves to the state, nor mortgage their children’s futures because the politicians can’t live within their budget(s). Millions of Americans don’t want their basic rights stripped away. They don’t want to live in a pathetic “Nanny State”. They don’t want a panel of disinterested bureaucrats, or under-paid government employees, making health care decisions for them. They don’t want to live in a master-slave relationship - without the freedom and liberty that Americans fought and died for. The very thought is repugnant.

You are aware that over half of your federal taxes goes to the military aren't you? Another 20% goes to interest on the debt. How this is not concerning to millions of vocal patriotic americans who don't want to be slaves of the state is a mystery to me. Could someone explain this oversight of the elephant in the room? What's left is over goes to the pathetic nanny state that is obviously the root of all evil in America today. A nanny state that is doing terrible communist things like feeding hungry children which must consume at least .02% of the federal budget or about the cost of 1 jet fighter.

I certainly don’t want a panel of disinterested bureaucrats, or under-paid government employees, making health care decisions for me. I much prefer a bunch of interested bureaucrats at the insurance companies whose paycheck and bonuses depend on how much healthcare they deny me or how quickly they can cancel my policy if I get truly sick. Let freedom ring.

I find it hard to believe that any of the people who are so against the idea of government healthcare have ever actually been seriously sick or hurt. I have been both. The amount of paper work and time involved to track and pay everything or even worse to get the insurance company to pay is just staggering. The game is to deny, deny, deny until the doctor just gives up or the patient just pays it. What make it even worse is that most doctors offices and hospitals are terrible at billing/accounting, frequently they are just plain incompetent. I broke my hand last year and spent 8 months and probably 50 hours of my time getting everything paid. I think. My father in law had chemo and the paperwork was well over 2 feet tall. Anyone who was seriously ill could not possibly track and deal with this. Which I believe is something insurance companies actually count on.

I've been (and currently am) aresident of several of the dreaded government health care countries over the years. I never saw a bill of an kind and received zero paperwork for any medical services while receiving care that was just as good as any I've gotten in the states. The way it works elsewhere is the government provides basic care and you can buy very reasonably prices health insurance if you want to go outside the public system. Hardly what any reasonable (key word) would call slavery or stripping away of basic rights. Certainly none of the other countries systems are perfect, but it's just ridiculous that congress is forging ahead with major changes in health care without at least carefully looking at what works and doesn't work for the rest of the world first.

AdHominem says

When you call me “all over the place.” I just laugh because this philosophy of so many on this site is all over the place.

The reason that I say you're all over the place is because your arguments aren't pertinent, concise or easily understood. Nor do they make sense. The common thread in all of your posts is that you tend to blame the government for everything - if something is bad, it's the government's fault, while if something is good, it's in spite of the government. Perhaps you believe that there's a huge conspiracy against you personally. That's possible.

But you started this thread using an opinion piece to support your theory that someone - an unelected body - will dictate your future medical decisions. Unfortunately, that's already happening but since it's private enterprise, not the government, it doesn't fall within your paranoid ramblings so you don't give it any play.

On another thread you use an anecdote about a woman who can't get care at her local clinic and meds at her pharmacy as an example of how Medicare doesn't work. But - Medicare is the payment source, not the provider. According to you, private enterprise should be in control of medical care - yet in that instance, it is and you complain about that.

Hence the comment(s) that you're all over the place.

Troy says

elvis says

And if health care is a “right,” shouldn’t an automobile be a right? And shouldn’t every car have safe tires and good brakes? Shouldn’t everyone have a house, or at least a nice condo - with a view, and a TV. And every household should have the right to a computer, and computer service, or how else could they pay their government subsidized bills on-line?

The eurosocialists have basically answered this question, and it correlates pretty closely to my philosophy.
Modern society is productive enough to afford ALL PEOPLE access to that which is necessary to become and remain a productive member of society.
Also, this does not entail “FREE” goods and services, rather the government establishes itself as an intermediary — a Single Payer if you will — to nudge the Free Market (peace be upon it) to operate more effectively than is its wont.
The teabagger blindness is to ignore the vast amount of rentierism that operates in any Free Market (peace be upon it).
They way I see it, our incomes after necessities and luxuries just end up in higher land values. As long as we’re paying $300,000 or more for a house we’ve got plenty of room to raise taxes to more fully fund the egalitarian acccess that I think everyone has a right to. I think every dollar of taxes we raise drops land values a dollar, a good thing in my book.

So how is it cool that a 15 minute visit cost me $150 plus whatever my insurance paid them?....the docs, insurance and pharms are in this together to keep their profits.

elliemae says

AdHominem says

When you call me “all over the place.” I just laugh because this philosophy of so many on this site is all over the place.

The reason that I say you’re all over the place is because your arguments aren’t pertinent, concise or easily understood. Nor do they make sense. The common thread in all of your posts is that you tend to blame the government for everything - if something is bad, it’s the government’s fault, while if something is good, it’s in spite of the government. Perhaps you believe that there’s a huge conspiracy against you personally. That’s possible.
But you started this thread using an opinion piece to support your theory that someone - an unelected body - will dictate your future medical decisions. Unfortunately, that’s already happening but since it’s private enterprise, not the government, it doesn’t fall within your paranoid ramblings so you don’t give it any play.
On another thread you use an anecdote about a woman who can’t get care at her local clinic and meds at her pharmacy as an example of how Medicare doesn’t work. But - Medicare is the payment source, not the provider. According to you, private enterprise should be in control of medical care - yet in that instance, it is and you complain about that.
Hence the comment(s) that you’re all over the place.

Yeah, Adhom...what is up with that? You celebrating now that private insurance gets to dictate their prices?

elliemae says

AdHominem says

When you call me “all over the place.” I just laugh because this philosophy of so many on this site is all over the place.

The reason that I say you’re all over the place is because your arguments aren’t pertinent, concise or easily understood. Nor do they make sense. The common thread in all of your posts is that you tend to blame the government for everything - if something is bad, it’s the government’s fault, while if something is good, it’s in spite of the government. Perhaps you believe that there’s a huge conspiracy against you personally. That’s possible.
But you started this thread using an opinion piece to support your theory that someone - an unelected body - will dictate your future medical decisions. Unfortunately, that’s already happening but since it’s private enterprise, not the government, it doesn’t fall within your paranoid ramblings so you don’t give it any play.
On another thread you use an anecdote about a woman who can’t get care at her local clinic and meds at her pharmacy as an example of how Medicare doesn’t work. But - Medicare is the payment source, not the provider. According to you, private enterprise should be in control of medical care - yet in that instance, it is and you complain about that.
Hence the comment(s) that you’re all over the place.

Ellie may,

I believe I have been quite consistent in insisting that government should not confiscate anyone's earnings, or spend money on anyone's care.

I have been critical of Government spending programs from the beginning and will continue to be so until the problem is resolved. As far as this lady and her health care goes, if it is not an example of how the government run Medicare program is failing, then how would you describe it? "Oh its just her own darn fault the government confiscated her wealth and now is making it hard to get some of it back?" Or a dazzling success providing labor for thousands of bureaucrats since 1965?

Yeah, Adhom…what is up with that? You celebrating now that private insurance gets to dictate their prices?

No one should dictate prices to anyone. Did you see my post on the other thread. We (through government regulation) have given too much power to providers and insurers. The answer is not to give that power to the government but to return it to the people.

AdHominem says

No one should dictate prices to anyone.

And yet you believe that the provider of care in a rural clinic should accept Medicare - which dictates the prices it pays to providers. You can't have it both ways. AdHominem says

As far as this lady and her health care goes, if it is not an example of how the government run Medicare program is failing, then how would you describe it?

Seeing as how you don't know if she's enrolled in a Medicare Advantage plan, which places limits on providers, or if she is in the traditional program which pays all providers a certain amount, it's hard to tell what is going on there. For instance, if she's in an Advantage plan she has to have a PCP, who will be assigned if she doesn't choose one. If the clinic in her area isn't accepting new patients on that plan, she'll have to go elsewhere. If it's traditional Medicare, that's different.

I wouldn't describe your anecdote as a failure - except that you fail to provide enough information to adequately describe the problem if there is one. The payment is there - which Medicare provides - but the private provider doesn't accept her payment. That's a failure of the patient for not checking to see who she can go to, certainly not the provider. And she has the ability to receive care, perhaps not within 15 miles of her home, but she still has payment for her care at a provider who will accept it.

AdHominem says

Oh its just her own darn fault the government confiscated her wealth and now is making it hard to get some of it back?”

The government isn't making it hard for her to get some of her "wealth" back. She can access healthcare and she can access a pharmacy - she didn't choose a plan that had her medications in their formulary. She has access to medications through the mail order pharmacy and through whatever pharmacy is closest to her home that accepts her insurance plan. That's a common thing in the healthcare industry - but you wouldn't know that because it's not what you do. It's also common for people to have an MD for years, then change jobs or not have coverage and find that they have to find another MD.

That's private enterprise at work.

AdHominem says

Yeah, Adhom…what is up with that? You celebrating now that private insurance gets to dictate their prices?

No one should dictate prices to anyone. Did you see my post on the other thread. We (through government regulation) have given too much power to providers and insurers. The answer is not to give that power to the government but to return it to the people.

How would poor people pay for healthcare under your policy?

4X says

How would poor people pay for healthcare under your policy?

Under his policy poor people would have no coverage. They'd get really sick, go to the hospital and be turned away because no coverage. They'd die. Problem solved.

elliemae says

And yet you believe that the provider of care in a rural clinic should accept Medicare - which dictates the prices it pays to providers. You can’t have it both ways.

When did I ever say that? now you are surely putting words in my mouth. I was simply pointing out that Medicare failed her because she CAN'T use it at her doctors office. It is not her fault, not her doctors fault either.

Yes it is traditional medicare A and B with Medicare D for drugs.
elliemae says

The government isn’t making it hard for her to get some of her “wealth” back. She can access healthcare and she can access a pharmacy - she didn’t choose a plan that had her medications in their formulary. She has access to medications through the mail order pharmacy and through whatever pharmacy is closest to her home that accepts her insurance plan. That’s a common thing in the healthcare industry - but you wouldn’t know that because it’s not what you do. It’s also common for people to have an MD for years, then change jobs or not have coverage and find that they have to find another MD.

No, it is very easy to find a new doctor and drive dozens of miles in either direction to get what you used to get in walking distance. My bad. There is only one pharmacy in her town. It doesn't take medicare. For the past 15 years she has been happy with her health plan. When medicare came in, now she can't do anything in her home town. But I am sure she is better off with it than on her old plan right? Again, my bad

Do you know why doctors don't accept Medicare patients or limit the number of Medicare patients? Reimbursement rates are low. Do you know why just about every hospital I've ever worked at wants to be known as a great cardiac center? Medicare reimburses cardiac care at higher than normal levels. Do you know why most hospitals have outsourced their kidney dialysis? Crappy reimbursement. Do you know that some procedures get chosen over others even though the less chosen has better outcomes? Higher reimbursement rates.

Leigh says

Do you know why doctors don’t accept Medicare patients or limit the number of Medicare patients? Reimbursement rates are low. Do you know why just about every hospital I’ve ever worked at wants to be known as a great cardiac center? Medicare reimburses cardiac care at higher than normal levels. Do you know why most hospitals have outsourced their kidney dialysis? Crappy reimbursement. Do you know that some procedures get chosen over others even though the less chosen has better outcomes? Higher reimbursement rates.

Thanks Leigh, you are right on.

And these are all examples of how government intervention is failing/causing more waste and mis-allocation of resources in the health care marketplace.

AdHominem says

Kev you are on to something. You might enjoy this one. It talks about that very thing. How “liberals” became the new “conservatives” and vice versa.

"Conservatives" today aren't anything like the liberals of the 1800s. They happen to agree on certain aspects of economics, and that's about it.

Kevin says

AdHominem says

Kev you are on to something. You might enjoy this one. It talks about that very thing. How “liberals” became the new “conservatives” and vice versa.

“Conservatives” today aren’t anything like the liberals of the 1800s. They happen to agree on certain aspects of economics, and that’s about it.

Just read the book, then we'll talk.

And I recommend this great book: How Doctors Think

http://www.jeromegroopman.com/how-doctors-think.html

It's not just Medicare reimbursement rates that are problematic.

AdHominem says

When medicare came in, now she can’t do anything in her home town. But I am sure she is better off with it than on her old plan right? Again, my bad

She's eligible for Medicare. Just as with her old insurance, there are rules and some providers don't accept that reimbursement. Medicare isn't better than her old plan - and it's probably no worse than her old plan. It's different.

Again, free enterprise comes into play. If the government ran healthcare, the clinic & pharmacy would be providers. They don't. And she'll need to find new providers. Just as she would if the clinic closed, or the doctor died and she had to find another provider. Same with the pharmacy. This isn't a good example of how the government should stay out of healthcare.

The subject of this thread is about the unelected body that will dictate future medical decisions - but we already have unelected people running our healthcare. And, using your example, it's not working so well.

Just sayin.

Leigh says

And I recommend this great book: How Doctors Think
http://www.jeromegroopman.com/how-doctors-think.html
It’s not just Medicare reimbursement rates that are problematic.

This is true. Private pay is the only way to go. End all third party payers.

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I'm sure it will make her feel a whole lot better.

AdHominem says

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I’m sure it will make her feel a whole lot better.

I'd be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.

tatupu70 says

AdHominem says

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I’m sure it will make her feel a whole lot better.

I’d be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.

555-HIPPA violation

She can contact Tatupu70 w/out violation of HIPPA.

This is a double post since we seem to have two similar threads going.

AdHominem, can you address this previous comment. It’s a crucial part of the debate. What would folks 65 and older do for insurance w/out Medicare? What would the housewife who has never worked out of the home and now is widowed do for health care? What are your solutions?

“OK, say we throw Medicare out the door. Take all the money she had been contributing these past 40 years and put it toward private insurance after retirement. How much money do you think that would be? Would it be adequate to afford the premiums in the ‘free market’, imagine all of her pre-existing conditions. Would she have enough funds for 20 years of premiums, co-pays and deductibles, medications? And consider the premiums would be based on age and health.

In my mind, the 65 and older folks drain the health care dollars. Not only would their premiums be sky high but there will be much more scrutiny of where the dollars are going. Yes, private insurance has ‘death panels’ just ask any transplant doctor.”

Do you realize how much health care is consumed by this age group? You really think charity can absorb half of it. You will see death panels if charity is what the majority of this age group is left with. DO you realize how much an MI can cost you especially if it involves bypass surgery, an ICU stay and meds, assuming you lived? Would the debt get passed on to your loved ones?

AdHominem says

tatupu70 says
AdHominem says
elliemae says
Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.
Tell that to her. I’m sure it will make her feel a whole lot better.
I’d be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.
555-HIPPA violation

I'm not asking for her medical records.. Giving out a phone number is not a HIPPA violation or else bars would be out of business...

SHould all of our veterans rely on charity health care?

^ I can answer that; veteran's care is a direct cost of war. Without it, there would be no volunteers. And drafts would fail.

Veterans earn their benefits with their national service. Speaking in the general, of course. National security is worth more than all the gold in Ft Knox (and is state of being provided by the economic services of our . . . servicemen). Just ask the French in 1940, the Russians in 1941, and the Iraqis in 2003.

'course, the problem comes when we throw our military into places that aren't really national security related but more power projection. Here, the payers of the bills and the beneficiaries of the action are rather disjoint.

Troy, how about if you just did your 4 years then moved on, never stepping foot in another country or did the Reserve/Guard thing and there too never went beyond the one weekend a month. Do they deserve a life time of health care? Our VA system is overwhelmed. And with more unemployed and losing health bennies the waiting list is grwoing longer.

Leigh says

Do they deserve a life time of health care?

Sorry, I misunderstood. I thought current VA benefits were limited to service-related conditions. The VA site isn't too clear about this. AdHom can answer the question on whether veterans deserve more than that.

tatupu70 says

AdHominem says

tatupu70 says

AdHominem says

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I’m sure it will make her feel a whole lot better.

I’d be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.

555-HIPPA violation

I’m not asking for her medical records.. Giving out a phone number is not a HIPPA violation or else bars would be out of business…

bars are not a covered entity under hippa, though they do dispense (self)medication. Please enjoy their products in mass quantities.

Leigh says

She can contact Tatupu70 w/out violation of HIPPA. She sure could. If she knew him and cared to talk to a socialist (I mean it in a good way).

AdHominem, can you address this previous comment. It’s a crucial part of the debate. What would folks 65 and older do for insurance w/out Medicare? What would the housewife who has never worked out of the home and now is widowed do for health care? What are your solutions?

---I propose anyone who is 55 or older continue on Medicare as planned. Everyone else can choose to continue paying in or get a full refund with interest. And yes, I believe charity can take care of the rest.

Troy says

Leigh says

Do they deserve a life time of health care?

Sorry, I misunderstood. I thought current VA benefits were limited to service-related conditions. The VA site isn’t too clear about this. AdHom can answer the question on whether veterans deserve more than that.

Veterans deserve whatever they were promised. I am not sure what, if anything that is. But if they were promised health care then "we" owe it to them.

But VA is government run health care. You're OK with that?

Troy says

Leigh says

Do they deserve a life time of health care?

Sorry, I misunderstood. I thought current VA benefits were limited to service-related conditions. The VA site isn’t too clear about this. AdHom can answer the question on whether veterans deserve more than that.

Nope, my father-in-law got a triple bypass operation basically for free at a VA hospital - nothing at all to do with his military service, just the sort of thing that happens to many of us as we get older. I'm extremely glad that he had this option because it would have been hidiously expensive otherwise and I don't think we could have afforded it.

Leigh says

But VA is government run health care. You’re OK with that?

It probably would be more efficient if we allowed more competition. Also, I would not guess that the best and the brightest doctors aspire to work at the VA, as a patient that would concern me. It does concern me as well when we make an open ended commitment for spending. Like a blank check.

bdrasin says

Troy says

Leigh says

Do they deserve a life time of health care?

Sorry, I misunderstood. I thought current VA benefits were limited to service-related conditions. The VA site isn’t too clear about this. AdHom can answer the question on whether veterans deserve more than that.

Nope, my father-in-law got a triple bypass operation basically for free at a VA hospital - nothing at all to do with his military service, just the sort of thing that happens to many of us as we get older. I’m extremely glad that he had this option because it would have been hidiously expensive otherwise and I don’t think we could have afforded it.

I believe my grandpa died prematurely due to incompetence at the VA. They attempted an operation he was not well enough to endure. It killed him.

AdHominem says

I believe my grandpa died prematurely due to incompetence at the VA. They attempted an operation he was not well enough to endure. It killed him.

I believe it. The VA used to be absolutely awful in the 1970s and 1980s. Its changed a lot for the better; my father-in-law got very good care I believe. Sorry about your grandfather.

tatupu70 says

AdHominem says

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I’m sure it will make her feel a whole lot better.

I’d be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.

:)

elliemae says

tatupu70 says

AdHominem says

elliemae says

Medicare isn’t better than her old plan - and it’s probably no worse than her old plan. It’s different.

Tell that to her. I’m sure it will make her feel a whole lot better.

I’d be happy to. What is her phone number? I would like to speak with her and hear her story firsthand.

Would you start with something like this?
"Hi, I don't know you but I just wanted to see how Medicare is working for you. You see I am a socialist and I find it hard to believe that you are not happy with your "coverage". Some guy is claiming that you have been forced to find a new doctor 25 miles away, and a new pharmacy as well. Can this be true?" And if so, isn't it better to be like all the other people who are forced to change the way they get their care? Isn't it better that we all suffer the same rather than some people getting better care than others? I mean this is America right? Land of the free and home of the bureaucracy! With wiretaps and bailouts for all."

Yea - that's exactly how I'd start out. And then I'd laugh maniacally and make fun of the way she dressed. Then I'd turn her into homeland security for questioning the Medicare system and hope that they wiretapped her while I drove to my bailout bank.

You certainly are difficult to take seriously. I stopped some time ago.

elliemae says

Yea - that’s exactly how I’d start out. And then I’d laugh maniacally and make fun of the way she dressed. Then I’d turn her into homeland security for questioning the Medicare system and hope that they wiretapped her while I drove to my bailout bank.
You certainly are difficult to take seriously. I stopped some time ago.

Are you coming on to me? Aw, shucks. And I thought I was starting to win you over.