Health Carepalooza 2010 Catch-All

Pages

Well, looks like the big ticket item on President Obama's agenda is on its way to becoming law after the compromise on the abortion issue. But, on the other hand, we have a couple dozen states ready to sue in order to not comply with this bill, so it may not be over yet.

Rat Boy wrote:

Well, looks like the big ticket item on President Obama's agenda is on its way to becoming law after the compromise on the abortion issue. But, on the other hand, we have a couple dozen states ready to sue in order to not comply with this bill, so it may not be over yet.

I think the Federal government should immediately cease all Medicaid and Medicare payments to those states. Let's see how long it takes for them start screaming for government healthcare.

We spent an entire day at our national sales meeting engrossed in healthcare finance. If the average citizen had any concept of how close most hospitals are to bankruptcy they'd be screaming for reform.

It's easy to Female Doggo about healthcare reform when you can just show up at and ER and be treated. It's another matter entirely when the hospital in your backyard shuts it's doors.

Bear wrote:

I think the Federal government should immediately cease all Medicaid and Medicare payments to those states.

I thought they were already slashing funds to Medicaid and Medicare in order to contain costs under the new, now passed, bill.

I liked the 'baby killer' comment--make me think of this:

http://kotaku.com/5481821/fallout-2s...

I'm tempted to post this on 'serious' political sites, but um, I don't want to bring that kind of heat down on gaming right when politicians are probably going to forget about us for a while.

Those are EXCELLENT episodes! I second your recommendation.

I will just say I'm shocked the Democrats got this done. I feel like I don't know enough about the intricacies to comment in depth, but the system is so broken, I don't see how changes could make it worse.

For people, like me, who feel a bit overwhelmed by the details and the rhetoric, I suggest these two episodes of This American Life. (I also suggest the This American Life IPhone Ap. you can stream every episode ever released)

The first episode looks at the healthcare system from the point of view of the three major players, (patients, Doctors, and insurance companies) to investigate their responsibility for the rising costs of healthcare. The second episode looks at some other aspects of the health care system. Prescription drug costs, pet insurance, and a really interesting segment on how we ended up as one of the only countries with a health care system tied to employment.

http://www.thisamericanlife.org/radi...
http://www.thisamericanlife.org/radi...

Bear wrote:

Those are EXCELLENT episodes! I second your recommendation.

They're particularly good for us foreign types who might not be familiar with the vagaries of the US system.

All that said, I've never met a landmark bill that the courts didn't rip to shreds.

Rat Boy wrote:

I thought they were already slashing funds to Medicaid and Medicare in order to contain costs under the new, now passed, bill.

The Medicaid and Medicare rates are the problem, it's the fraud that happens in the billing. It's worth pointing out though that the majority of the "fraud" is unintentional. The reimbursement coding system is so convoluted that basically no one has a complete handle on it. Even the best intentioned providers make mistakes because the system is stupidly complex.

I haven't read the entire bill but it's my understanding that they're looking at a 3 phase approach. This is based on conversations our CEO has had with Senator Hatch. The phases are:

1. Access - every has to be insured. We already pay for the uninsured through fees and surcharges so this was the obvious first step.
2. Cost control - perhaps the most important piece
3. Science based medicine - there are over 6000 hospitals in the U.S and we don't use outcome data to standardize care. That's just nuts! The long term goal is to determine the absolute best proven way to treat health issues and make the standards of care uniform throughout the U.S.

With that said, we work a lot with hospital CFO's and the consensus thought is that hospitals and health agencies should start gearing up to operate on Medicaid and Medicare reimbursement rates. That equates to around a 30% reimbursement reduction. The other consensus thought is that the healthcare business will adjust. There was a massive freak out when DRG's were introduced although I think there was less rhetoric.

Healthcare is a business and as such, will adapt to meet the changes.

Rat Boy wrote:

All that said, I've never met a landmark bill that the courts didn't rip to shreds.

Like what? I'm trying to think of landmark bills that have been ripped to shreds, and I can't come up with many, and none of those are entitlement programs. Best I can come up with is ERISA, and that wasn't so much ripped to shreds as turned into something much different than I think anyone envisioned.

edit: here's the best I could find

http://www.cbsnews.com/stories/2006/...

Freedom died a little bit last night.

Maybe we will all be better off, but we won't be sure for years.

Grats!

Greg wrote:

Freedom died a little bit last night.

Maybe we will all be better off, but we won't be sure for years.

If the PATRIOT Act didn't kill Freedom I don't really see how healthcare reform is going to finish the job.

Congratulations on becoming a socialist country America!

IMAGE(http://i5.photobucket.com/albums/y187/Gumbydunzeeto/Health.jpg)

Spoiler:

I'm kidding

bnpederson wrote:
Greg wrote:

Freedom died a little bit last night.

Maybe we will all be better off, but we won't be sure for years.

If the PATRIOT Act didn't kill Freedom I don't really see how healthcare reform is going to finish the job.

Make no mistake, I think the healthcare act was a tragedy, a slow-motion disaster, but it didn't kill freedom. The two Bushes killed any real concept of liberty in this country. This is just spitting on the corpse.

All those attempts at bipartisanship and attempts to appease the blue dogs resulted in ZERO votes from any of them. They fought to insert unpopular amendments and in the end unanimously voted no. Party of No, indeed.

I really hope the Dems take a long hard look at that and for completely ignore the Republicans and continue to pass bill after bill. Bipartisanship doesn't work when the Republicans have their head in the sand.

Also, I want to know what country Limbaugh is moving to.

I thought they were already slashing funds to Medicaid and Medicare in order to contain costs under the new, now passed, bill.

Medicare has been seeing cuts via reductions in allowable costs for years. That's nothing new. These two programs need to be fixed, but the overall bill had to come first.

Freedom died a little bit last night.

Maybe we will all be better off, but we won't be sure for years.

Odd positions in combination. Your argument seems to be that we'll be better off with a loss of freedom, possibly? I'm not sure how that is (or, for that matter, what mandating insurance does to freedom - you do drive a car, right?)

Sad sad days...thank you Lard for making me laugh though. Good stuff. Maybe we can be Canada's little brother in the arena of crappy socialized healthcare. We'll invite Britain over as the distant cousin, eh?

IUMogg wrote:

For people, like me, who feel a bit overwhelmed by the details and the rhetoric, I suggest these two episodes of This American Life. (I also suggest the This American Life IPhone Ap. you can stream every episode ever released)

The first episode looks at the healthcare system from the point of view of the three major players, (patients, Doctors, and insurance companies) to investigate their responsibility for the rising costs of healthcare. The second episode looks at some other aspects of the health care system. Prescription drug costs, pet insurance, and a really interesting segment on how we ended up as one of the only countries with a health care system tied to employment.

http://www.thisamericanlife.org/radi...
http://www.thisamericanlife.org/radi...

I listened to these episodes a few months ago and they are excellent.

I see one of the primary problems being that the average health care consumer has no idea what the true cost of his health care is. Instead of employers negotiating with health insurance companies to provide some kind of plan how about they just give their employers $X a year and say "Here is your health care benefit, go out in the free market and get the best plan you can." That way actual competition would be introduced into the system. Competition always results in lower prices.

I see one of the primary problems being that the average health care consumer has no idea what the true cost of his health care is. Instead of employers negotiating with health insurance companies to provide some kind of plan how about they just give their employers $X a year and say "Here is your health care benefit, go out in the free market and get the best plan you can." That way actual competition would be introduced into the system. Competition always results in lower prices.

There will be more competition under the new system, as before companies were limited in the states in which they could operate. BTW, competition does *not* always result in lower prices; sometimes it results in collusion. Tell me, have your music cd prices dropped much since the early 90's?

Pigpen wrote:

Sad sad days...thank you Lard for making me laugh though. Good stuff. Maybe we can be Canada's little brother in the arena of crappy socialized healthcare. We'll invite Britain over as the distant cousin, eh? :-)

I know what you mean. Certis is constantly complaining on the podcast about his crappy healthcare system. The boards here are just overflowing with angry Canadians all talking about their crappy socialized healthcare.

Crappy socialized healthcare is a FAR better alternative than watching my premiums increase by 40% a year. At that rate I'd have health insurance for about 5 more years before it was just completely unaffordable.

Won't get into much Bear - I agree with the massive need to overhaul and curbing the premiums - there is tons that needs to be done. But the undercurrent of letting the government get their hands into 'managing' healthcare is wrong. I've never been for socialized healthcare or federal government provided healthcare-for-all, and in my experience, government run social programs have never proven to be 'more efficient or more effective' at running...well, anything.

I clearly think we jumped on a bridge too far here, and I firmly believe time will bear out that this program will not save costs and we'll see if premiums are brought under control. My thoughts were and remain that we should have targeted the key areas, such as reform and premium control, instead of some over-massive burdensome system that will prove to be another welfare/medicaid hybrid program.

But again, want to reiterate, I see some good provisions in the bill, and I do recognize the need for reform and controlling premiums. I just think we missed hitting the targeted boat, and instead, took aim and shot at the ocean...

Boehner is claiming that the current bill is chock full of earmarks and sweetheart deals, and that this week he's going to uncover them all. I'm curious to see what he'll actually find, given that both Republicans and Democrats have "promised" not to add any earmarks or pork to bills going forward.

Honestly I'm pretty pleased this has gotten through. Obama has a dedication to the American Public and a strength of will that seems pretty unmatched.

Pigpen wrote:

Won't get into much Bear - I agree with the massive need to overhaul and curbing the premiums - there is tons that needs to be done. But the undercurrent of letting the government get their hands into 'managing' healthcare is wrong. I've never been for socialized healthcare or federal government provided healthcare-for-all, and in my experience, government run social programs have never proven to be 'more efficient or more effective' at running...well, anything.

I clearly think we jumped on a bridge too far here, and I firmly believe time will bear out that this program will not save costs and we'll see if premiums are brought under control. My thoughts were and remain that we should have targeted the key areas, such as reform and premium control, instead of some over-massive burdensome system that will prove to be another welfare/medicaid hybrid program.

But again, want to reiterate, I see some good provisions in the bill, and I do recognize the need for reform and controlling premiums. I just think we missed hitting the targeted boat, and instead, took aim and shot at the ocean...

If the next step is not a massive restructuring of healthcare financing then I agree with you 100%. I think it's obvious that that healthcare industry is not capable of self regulating their costs. The Federal government is going to use their Medicaid/Medicare clout to force cost control.

Pigpen wrote:

Sad sad days...thank you Lard for making me laugh though. Good stuff. Maybe we can be Canada's little brother in the arena of crappy socialized healthcare. We'll invite Britain over as the distant cousin, eh? :-)

Don't you have socialized healthcare through the military system?

Funken, we do - and its definately NOT the best healthcare that you can get. That said, its not socialized from the true sense of the work, because, those in the military work and work damn hard for it. We don't get it for free, we pay in blood, sweat and tears. See the difference on the fundamental principal I stand on.

Bear...

The Federal government is going to use their Medicaid/Medicare clout to force cost control.

If they do that...a) I'll be singing Amen alongside you for it b) the Federal gov't has never used its clout to force cost control. While in the military, I could always buy a $800 laptop for the bargain price of $2.3K, AND...they would throw in 6-12 week FREE delayed shipping with it. The use of the FAR in gov't contracts effectively locks the gov't into 'fair and equitable' contracts and contract negotiation, often aimed at small (thus, more costly) businesses. In effect, while the use of economies of scale would, in theory, provide the clout to force down prices, the system that is set up prohibits the use of said clout, and all the businesses who deal with the gov't know it. Sadly, I expect there will be some huge cost savings from companies who bid...offset by huge new areas that they add costs in for the contract bids. The price of fair deals is the gov't will never get a bargain deal...no reason to do so from a private industry standpoint.

FSeven wrote:

All those attempts at bipartisanship and attempts to appease the blue dogs resulted in ZERO votes from any of them. They fought to insert unpopular amendments and in the end unanimously voted no. Party of No, indeed.

I really hope the Dems take a long hard look at that and for completely ignore the Republicans and continue to pass bill after bill. Bipartisanship doesn't work when the Republicans have their head in the sand.

Yes, this was straight partisanship, because every single Dem voted for it, right? Except for those 34 who didn't of course. Unless my math fails me that's nearly 15% of the Dems themselves that didn't want to pass this monstrosity. While I certainly acknowledge that the Reps are often being obstinate for the sake of obstinance, is it possible in your mind that some of them legitimately believe this to be a bad bill?

And it is, by the way. We needed changes, absolutely. This wasn't/isn't it, and is going to have a ridiculous amount of unintended consequences.

THis isn't 'socialised' healthcare. It's bears no resemblance the system we have here. Your government isn't running your healthcare system or attempting to.

What the U.S. govt seems to have done, from our perspective, is make sure that consumers aren't getting ripped off. But not ripped off as in 'Man, I bought this TV and it's busted', but as in 'Man, I paid insurance premiums for decades and now I'm f*cked because they pulled coverage'.

I've seen lots of videos of Americans castigating the UK and European countries. Judging from what they said, the way they said it and their overall attitudes, I suspect most of them have never been to the UK and have never spoken to anyone that's really used the NHS.

The NHS isn't perfect. It has many problems. But it's the reason I am alive today.

Pigpen wrote:

Funken, we do - and its definately NOT the best healthcare that you can get. That said, its not socialized from the true sense of the work, because, those in the military work and work damn hard for it. We don't get it for free, we pay in blood, sweat and tears. See the difference on the fundamental principal I stand on.

I'm interested to hear this idea fleshed out a bit more, as I have relatives who work for the "socialized government healthcare" through the VA. Is there anything that sets an American warrior apart from, say, an American retail employee that would cause the warrior to deserve free health care when the retail employee doesn't?

I'm just confused as to how one can be seen as socialized and the other isn't. Especially since one of those examples takes place in (an admittedly tweaked) free market system, while the other one is the VA.

Greg wrote:

Freedom died a little bit last night.

Methinks you misunderstand what "freedom" actually is. You could make a case that freedom was mortally wounded on October 26, 2001. The other night the US simply moved our medical system closer to that of the rest of the modern world. Or do you seriously think the US was, prior to the passage of this medical bill, the only free nation on Earth?

Pigpen wrote:

But again, want to reiterate, I see some good provisions in the bill, and I do recognize the need for reform and controlling premiums. I just think we missed hitting the targeted boat, and instead, took aim and shot at the ocean...

This is 100% my view too.

Pigpen wrote:

Funken, we do - and its definately NOT the best healthcare that you can get. That said, its not socialized from the true sense of the work, because, those in the military work and work damn hard for it. We don't get it for free, we pay in blood, sweat and tears. See the difference on the fundamental principal I stand on.

There are a lot of poor people who work hard and can't get insurance. But the army lowliest private working a mailroom or clerking at a desk gets free health care. Some air force guy flying a UAV out of Nevada gets free healthcare paid with taxpayer dollars. These are guys who aren't at any greater risk than the general public at getting injured, but they get free healthcare for themselves and their families.

The government, in a non-socialized system, would simply do what they do with private contractors. Pay a soldier X amount, and let the military member select from a private insurer a plan that fits his or her needs. Those who are in jobs at greater risk of injury would get paid more to account for higher insurance premiums.

Pages