Don't click or your IP will be banned


Hittin' The Web with the Allman Brothers Band Forum
You are not logged in

< Last Thread   Next Thread ><<  1    2  >>Ascending sortDescending sorting  
Author: Subject: My Professional Take on The Affordable Care Act

True Peach



Karma:
Posts: 12503
(12493 all sites)
Registered: 4/4/2003
Status: Offline

  posted on 10/6/2014 at 04:36 PM
quote:
quote:
quote:
quote:
quote:
You guys both seem to be saying the same thing: There are lots of bad, dishonest people in healthcare. So why even try to monitor them? Just give up and let it go unchecked. Besides, it might cost too much to even try.
If we're saying the same thing its because the model is broken, and this current proposal will not fix that.

The only model that will improve on this is when the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer. As long as health care insurance decisions are made by third-parties (employers, gov't, etc.) and the providers feel more responsible to them instead of the health care consumer, waste and fraud will flourish. Giant agencies will never make decisions as well as individuals and will never monitor costs to the degree that millions of consumers will.
How do you you foresee your theory being accomplished - "the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer"? How do millions & millions of disconnected individual consumers monitor & step in the middle of shenanigans exhibited by the various sectors of the health care industry? I'm not disagreeing with your theory, but it just seems like an impossibility to achieve. I don't think a free market concept works here by bypassing the middle layer. Can you provide some specific details on how this can be actualized from a practical standpoint?
The Swiss already do it. Individuals buy their own level of care directly from insurers. Gov't regulates a number of factors so that reasonable protections exist.

It's not a free market, but insurers must satisfy and compete for customers, or risk loosing them. At the same time, incentives exist for individuals to monitor their charges and protect their overall costs from billing mistakes or fraud. They are not the cheapest health care, but are about 20-30% less expensive than what we spend.


This sounds interesting. I'm sure there is source info. on this. Before I Google & get a bunch of hits, can you recommend a good site that details the best representation of this.

What makes the gov't. regulation different in Sweden, & I'm assuming less than in the monopolistic competition that exists in the USA?

Does the gov't. oversee the individual incentives?

It does not surprise me that the cost of health care is cheaper in Sweden. Our costs increase year after year way beyond the level of inflation. There's plenty in our system that's not kosher.


Swiss = Switzerland

 

____________________
I pledge and support the elimination of the derogatory use of the r-word from everyday speech and promote the acceptance and inclusion of people with intellectual disabilities. http://www.r-word.org/

 

Maximum Peach



Karma:
Posts: 8497
(8498 all sites)
Registered: 3/22/2006
Status: Offline

  posted on 10/6/2014 at 07:24 PM
quote:
quote:
quote:
quote:
quote:
You guys both seem to be saying the same thing: There are lots of bad, dishonest people in healthcare. So why even try to monitor them? Just give up and let it go unchecked. Besides, it might cost too much to even try.
If we're saying the same thing its because the model is broken, and this current proposal will not fix that.

The only model that will improve on this is when the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer. As long as health care insurance decisions are made by third-parties (employers, gov't, etc.) and the providers feel more responsible to them instead of the health care consumer, waste and fraud will flourish. Giant agencies will never make decisions as well as individuals and will never monitor costs to the degree that millions of consumers will.
How do you you foresee your theory being accomplished - "the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer"? How do millions & millions of disconnected individual consumers monitor & step in the middle of shenanigans exhibited by the various sectors of the health care industry? I'm not disagreeing with your theory, but it just seems like an impossibility to achieve. I don't think a free market concept works here by bypassing the middle layer. Can you provide some specific details on how this can be actualized from a practical standpoint?
The Swiss already do it. Individuals buy their own level of care directly from insurers. Gov't regulates a number of factors so that reasonable protections exist.

It's not a free market, but insurers must satisfy and compete for customers, or risk loosing them. At the same time, incentives exist for individuals to monitor their charges and protect their overall costs from billing mistakes or fraud. They are not the cheapest health care, but are about 20-30% less expensive than what we spend.
This sounds interesting. I'm sure there is source info. on this. Before I Google & get a bunch of hits, can you recommend a good site that details the best representation of this.

What makes the gov't. regulation different in Sweden, & I'm assuming less than in the monopolistic competition that exists in the USA?

Does the gov't. oversee the individual incentives?

It does not surprise me that the cost of health care is cheaper in Sweden. Our costs increase year after year way beyond the level of inflation. There's plenty in our system that's not kosher.
The Swiss would be the first ones to tell you that their system isn't perfect. There are complaints there just like here. However, they recently held a referendum on switching from private to gov't-run care, and they voted 62% in favor of keeping their private system and not going to a more socialized, gov't-based system.

Lot's of info exists if you just Google "Swiss health care". I don't have any one source to recommend. I started paying attention to what they do years ago as the debate here heated up. Funny thing is; some Obama administration officials claim that Obamacare is based off the Swiss system. Maybe parts of it....

What I like is that they have preserved a consumer-driven system. Only with a consumer-driven system can you get the added benefit of the users watching costs. Obamacare forgets this important element.

 

____________________
If the Ukrainians didn't know, there ain't no quid pro quo

 

True Peach



Karma:
Posts: 14594
(14594 all sites)
Registered: 3/28/2006
Status: Offline

  posted on 10/7/2014 at 01:33 PM
quote:
quote:
quote:
Liberals have a basic mistrust of people, and call on the government to provide every solution possible to make up for it.

This tells me you don't understand liberals at all.


Maybe not, but there seems to be powerful evidence all around us. Is it mistrust, or maybe just a skepticism or an underestimation of people? Liberals seem to want to legislate activities in life to save people from themselves or save the planet.




I think there are a lot of bad apples in the health care industry, & it is an industry that smacks of greed from many levels. You can start with the drug manufacturers, the insurance providers, and go from there. How much do they really give a $hit about people? How much can they squeeze out of people is more of their motivation.


See what I mean?

But lets examine the two that you mention. Health insurers are #86 in profit margin at 3.3%. Any less greedy than that and it starts getting difficult to justify staying in business.

I would agree the major drug companies are a different story, coming in at #7 with a 16.5% average profit margin.


What everyone forgets with the drug companies is the tremendous risks they take when developing new drugs and the limited of time they can hold a patent. For this reason high profits on the drugs that do make it to market are justfied. Without this no company would take the kind of risk necessary to develop new life saving drugs.


What you claim at the end is a farce. Watch last night's 60 Minutes about the insane cost of cancer drugs. They showed drug companies charging more than double for new drugs that were found through studies to be either less effective or equally effective as the older drugs those drugs replaced gouging cutomers and bankrupting them.

They also caught them raising prices in some cases by two times of already existing effective drugs. I always thought prices went down on existing drugs as time passes??? WTF is that and how does that benefit customers/patients???? They are greedy money makers at the expense of sick patients and it has nothing to do with the cost of discovering new drugs. It is about greed.

Like I said, watch last night's eye opening 60 Minutes. They scam cancer patients with impossible prices that bankrupt just about anyone who has to pay for them. Like one of the cancer doctors said during the clip, the most effective drugs for patients are drugs they can afford to take. For people who can't afford to pay these draconian prices it is just too bad, you die.

[Edited on 10/7/2014 by sixty8]

 

____________________
Pete

 

Zen Peach



Karma:
Posts: 16027
(16019 all sites)
Registered: 10/13/2007
Status: Offline

  posted on 10/7/2014 at 02:25 PM
IMO another factor that gets overlooked when comparing our medical care costs with other systems is the fact that we discover and develop most of the breakthroughs. Whether it be in medical instruments, drugs, procedures, the US has been at the cutting edge.

We bear the initial costs of these developments and breakthroughs and those costs must be factored in.

 

Zen Peach



Karma:
Posts: 16027
(16019 all sites)
Registered: 10/13/2007
Status: Offline

  posted on 10/7/2014 at 02:34 PM
As much as "free market" medical care gets trashed, one could argue that the plethora of medical breakthroughs discovered in the US is a direct result of that system.

Enlightened self-interest (profit) is a powerful motivator.

 

World Class Peach



Karma:
Posts: 5032
(5027 all sites)
Registered: 12/27/2003
Status: Offline

  posted on 10/7/2014 at 06:07 PM
There is no perfect system obviously. No matter how it's set up, there are going to be major flaws because of the nature of American capitalism. Free capitalism sure has it perks, and can be credited for booming economies. But our healthcare system is a prime example of a negative effect of free capitalism. As long as it's legal for insurance companies to profit off of illness, then we are going to have huge costs to treat them, and flawed insurance programs. Most importantly, our free capitalist society allows for any company to produce, market, and sell harmful products to the citizens in the name of "freedom". Not only do companies have a support system to mass produce harmful products, like junk food, and sell them to the masses, but we also seem to embrace self-indulgence of these products as another symbol of our "freedom". People can blame Obama all they want, but it's our collective society that is to blame for the healthcare problems. Any proposed law to limit or regulate the production and sale of harmful products is deemed anti-American. I propose placing a hefty tax on junk food companies that goes toward health care costs.
 

Maximum Peach



Karma:
Posts: 8434
(8434 all sites)
Registered: 10/12/2002
Status: Offline

  posted on 10/7/2014 at 07:04 PM
quote:

As long as it's legal for insurance companies to profit off of illness, then we are going to have huge costs to treat them, and flawed insurance programs.


Here's another way Obamacare is putting down the hammer:

http://www.npr.org/blogs/health/2014/10/02/353306337/medicare-fines-record- number-of-hospitals-for-excessive-readmissions

[Edited on 10/8/2014 by robslob]

 

____________________
Don't let the sounds of your own wheels
Drive you crazy
Lighten up while you still can
Don't even try to understand
Just find a place to take your stand
And TAKE IT EASY

 

Maximum Peach



Karma:
Posts: 8434
(8434 all sites)
Registered: 10/12/2002
Status: Offline

  posted on 10/7/2014 at 07:35 PM
quote:

I'm not saying to give up an let it go unchecked. For instance, you saw a problem and could have reported it. That's a good way to check it -- a witness on the scene, not a third party government employee hundreds of miles away looking at a computer screen.


I never said anyone working in a hospital, physician or otherwise, should be monitored by "a third party government employee hundreds of miles away looking at a computer screen." Here's a direct quote, what I DID say:

quote:

By the way, how long does it take to look at documentation on a computer screen of how many admissions a particular physician's patients have had, how long his patients stay on a ventilator, how long they stay in ICU? Then compare it to the patient data of other physicians. Isn't that why we have computers? And isn't that the type of thing that highly paid hospital administrators are supposed to be doing with their time?


Alloak41: When you modify a statement such as that into "a third party government employee hundreds of miles away", you lose ALL credibility, at least with me. I said "hospital administrators". That means the "higher-ups", or CEO and upper level Managers right there at the facility.

The Affordable Care Act did not take away those managerial types at hospitals. It IS whipping on them hard to make sure they do their job (See above NPR article which I just posted). I cannot understand the viewpoint of anyone who thinks that is a BAD thing.

You said, "you saw a problem and could have reported it". I happen to think you're getting a little out of your realm regarding hospital politics if you think that a Respiratory Therapist should be the watchdog for ICU physicians. I won't elaborate any more on that subject because it's pretty obvious to me that your experience in this realm is quite limited.

The Affordable Care Act is trying to ensure that the administration already in place at the facility is the watchdog for physicians and other healthcare professionals. They should have been the watchdog for this particular physician in question who I used as an example when I started this thread. They were not. "Why" is not for me to know or me to explain. It may have been unprofessionalism, it may have been laziness, it may have been that they loved the extra cash that he was bringing into the facility (again, see above NPR article). NOW, they are being forced to do their job. Saying that a healthcare provider like myself should have been doing their job for them is just ludicrous. Do you REALLY think for a minute that they didn't know this was going on? Hey, maybe I ought to be cleaning the toilets and emptying wastebaskets, too.



[Edited on 10/8/2014 by robslob]

 

____________________
Don't let the sounds of your own wheels
Drive you crazy
Lighten up while you still can
Don't even try to understand
Just find a place to take your stand
And TAKE IT EASY

 

Zen Peach



Karma:
Posts: 16027
(16019 all sites)
Registered: 10/13/2007
Status: Offline

  posted on 10/7/2014 at 09:00 PM
Rob- I don't really understand your beef. On one hand you scoff at the idea that a government official will be monitoring the upper level staffing. Then later concede that's exactly what the ACA will be doing -- "forcing them to do their job" as you put it. Sounds a lot like monitoring.

I think we may have uncovered something else. Apparently a contributing factor to spiraling costs can be blamed on hospital politics. If the staff is afraid to report wrongdoing because of politics or intimidation that's really a shame.





[Edited on 10/8/2014 by alloak41]

 

Maximum Peach



Karma:
Posts: 8434
(8434 all sites)
Registered: 10/12/2002
Status: Offline

  posted on 10/7/2014 at 10:18 PM
quote:

Rob- I don't really understand your beef. On one hand you scoff at the idea that a government official will be monitoring the upper level staffing. Then later concede that's exactly what the ACA will be doing -- "forcing them to do their job" as you put it. Sounds a lot like monitoring.

I think we may have uncovered something else. Apparently a contributing factor to spiraling costs can be blamed on hospital politics. If the staff is afraid to report wrongdoing because of politics or intimidation that's really a shame.


You are talking apples and oranges here. I never scoffed "at the idea that a government official will be monitoring the upper level staffing." Once again, you are changing around my meaning for your own benefit. Why don't you quote me if you are going to say I scoffed at the idea that a government official will be monitoring upper level staffing. Go ahead, quote me, I'm waiting. You are putting words in my mouth.

As I said before, it is not my job or within my scope of knowledge to make a decision as to whether a physician is "milking" charges. I may have an opinion about it, yeah. Opinions are like assh*les, everyone's got one. Over 20 years I've had opinions about a LOT of M.D.'s I've worked with, some good, some bad. Should I go to administration every time that opinion is not so great?

One more thing: Just so you know, I WAS heavily involved with bringing down an unscrupulous Respiratory Therapy Manager. It had NOTHING to do with patient care, it had to do with the fact that he was trying to hire a Respiratory Therapist who had both sexual harassment and falsification of charting charges against him. He was already working at the hospital, but as a contractor. I had help, but I was the one who led the charge. We went to The Respiratory Care Board of California and we got both the Manager and the Therapist in question ousted. In fact, the Therapist in question had his license revoked by the State. The Manager was forced into an early retirement.

But like I said, that had nothing to do with patient care. I should not be the one to monitor the level of care going on. Thanks to The Affordable Care Act, the watchdogs have had a fire lit under their asses.



[Edited on 10/10/2014 by robslob]

 

____________________
Don't let the sounds of your own wheels
Drive you crazy
Lighten up while you still can
Don't even try to understand
Just find a place to take your stand
And TAKE IT EASY

 

Zen Peach



Karma:
Posts: 16027
(16019 all sites)
Registered: 10/13/2007
Status: Offline

  posted on 10/7/2014 at 11:37 PM
quote:
As I said before, it is not my job or within my scope of knowledge to make a decision as to whether a physician is "milking" charges. I may have an opinion about it, yeah. Opinions are like assh*les, everyone's got one. Over 20 years I've had opinions about a LOT of M.D.'s I've worked with, some good, some bad. Should I go to administration every time that opinion is not so great?
[Edited on 10/8/2014 by robslob]


The first thing you did is establish the guy's guilt. Your opinion or scope of knowledge didn't enter into it. Maybe you should go back and re-read your opening paragraph.

 

World Class Peach



Karma:
Posts: 5032
(5027 all sites)
Registered: 12/27/2003
Status: Offline

  posted on 10/9/2014 at 10:55 AM
God bless our freedom!



[Edited on 10/9/2014 by BoytonBrother]

 

Zen Peach



Karma:
Posts: 16027
(16019 all sites)
Registered: 10/13/2007
Status: Offline

  posted on 10/9/2014 at 11:20 AM
quote:
God bless our freedom!


Indeed.

 

Peach Head



Karma:
Posts: 106
(106 all sites)
Registered: 1/2/2012
Status: Offline

  posted on 10/9/2014 at 10:45 PM
quote:
quote:
quote:
quote:
quote:
You guys both seem to be saying the same thing: There are lots of bad, dishonest people in healthcare. So why even try to monitor them? Just give up and let it go unchecked. Besides, it might cost too much to even try.
If we're saying the same thing its because the model is broken, and this current proposal will not fix that.

The only model that will improve on this is when the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer. As long as health care insurance decisions are made by third-parties (employers, gov't, etc.) and the providers feel more responsible to them instead of the health care consumer, waste and fraud will flourish. Giant agencies will never make decisions as well as individuals and will never monitor costs to the degree that millions of consumers will.
How do you you foresee your theory being accomplished - "the providers - insurers, hospitals, doctors, etc. - have to be responsible directly to the consumer"? How do millions & millions of disconnected individual consumers monitor & step in the middle of shenanigans exhibited by the various sectors of the health care industry? I'm not disagreeing with your theory, but it just seems like an impossibility to achieve. I don't think a free market concept works here by bypassing the middle layer. Can you provide some specific details on how this can be actualized from a practical standpoint?
The Swiss already do it. Individuals buy their own level of care directly from insurers. Gov't regulates a number of factors so that reasonable protections exist.

It's not a free market, but insurers must satisfy and compete for customers, or risk loosing them. At the same time, incentives exist for individuals to monitor their charges and protect their overall costs from billing mistakes or fraud. They are not the cheapest health care, but are about 20-30% less expensive than what we spend.


This sounds interesting. I'm sure there is source info. on this. Before I Google & get a bunch of hits, can you recommend a good site that details the best representation of this.

What makes the gov't. regulation different in Sweden, & I'm assuming less than in the monopolistic competition that exists in the USA?

Does the gov't. oversee the individual incentives?

It does not surprise me that the cost of health care is cheaper in Sweden. Our costs increase year after year way beyond the level of inflation. There's plenty in our system that's not kosher.


Here's a short clip about monoplies from one of my favorite authors / social philosophers. Monopolies cannot happen in a TRUE free market society. This applies to health care as much as any other "business". Lobbyists and constitutional lawyers arguing to bend laws to the political whims of whatever party happens to be in power are and have been the root cause of the deterioration of what was once the greatest idea of a government of the people, by the people, for the people.
https://m.youtube.com/watch?v=OE9NGOgdrIo

[Edited on 10/10/2014 by scottdaugherty]

[Edited on 10/10/2014 by scottdaugherty]

 

True Peach



Karma:
Posts: 12503
(12493 all sites)
Registered: 4/4/2003
Status: Offline

  posted on 10/10/2014 at 09:11 AM
quote:
Monopolies cannot happen in a TRUE free market society.

The closest thing to a TRUE free market society the world has seen is pre-China Hong Kong. The US has never been that.

 

____________________
I pledge and support the elimination of the derogatory use of the r-word from everyday speech and promote the acceptance and inclusion of people with intellectual disabilities. http://www.r-word.org/

 

Maximum Peach



Karma:
Posts: 8271
(8271 all sites)
Registered: 6/9/2002
Status: Offline

  posted on 10/14/2014 at 09:32 AM
A few months ago my wife had a health scare that sent her to the emergency room and resulted in a two day hospital stay. She was admitted for an endoscopy. I asked her, "Why are you in the hospital for an endoscopy? I've had two and both were outpatient."

We shook out heads and enjoyed the view of the river and downtown Fredericksburg from the 7th floor window.

A few weeks later we received a letter from the insurance company saying they would not pay for the hospital stay because it was deemed unnecessary.

I freaked out. My wife is upper level management and I have often complained to her about the corporations change from Blue Cross to United Healthcare. This gave me another reason to launch a tirade.

My wife is smarter than me and read the entire letter. Not only was the insurance company not paying the hospital, we were instructed not to pay any bills, and were also told that the hospital was not allowed to bill us for the stay.

To date we have not received a bill from the hospital.

I don't think that is government monitoring the health care system. I think that is a system of checks and balances that exists only because of government regulation that protect all Americans from an abusive health care system.

 

____________________
Capitalism will always survive, because socialism will be there to save it.

Ralph Nader's Father


 
<<  1    2  >>  


Powered by XForum 1.81.1 by Trollix Software

Privacy | Terms of Service | Report Infringement | Personal Data Management | Contact Us
The ALLMAN BROTHERS BAND name, The ALLMAN BROTHERS name, likenesses, logos, mushroom design and peach truck are all registered trademarks of THE ABB MERCHANDISING CO., INC. whose rights are specifically reserved. Any artwork, visual, or audio representations used on this web site CONTAINING ANY REGISTERED TRADEMARKS are under license from The ABB MERCHANDISING CO., INC. A REVOCABLE, GRATIS LICENSE IS GRANTED TO ALL REGISTERED PEACH CORP MEMBERS FOR The DOWNLOADING OF ONE COPY FOR PERSONAL USE ONLY. ANY DISTRIBUTION OR REPRODUCTION OF THE TRADEMARKS CONTAINED HEREIN ARE PROHIBITED AND ARE SPECIFICALLY RESERVED BY THE ABB MERCHANDISING CO.,INC.
site by Hittin' the Web Group with www.experiencewasabi3d.com