The Sad Case of the Patient Protection and Affordable Care Act

[unofan]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I think it's more that kids are treating sex like a rite of passage to becoming an adult. I know I've been chastised a few times because I've never had intercourse, and have seen shocked looks that I "could control myself". Sex doesn't make you a man/woman. What makes you a man/woman is the ability to create the consequences of having sex (and I'm talking the kids, not the diseases). Perhaps it's the artificial barriers to manhood/womanhood that are created by society (i.e. 18 years of age), and teenagers need a way to show they truly are biological adults.

See, and I give you shiat because you still think like a teenager insomuch as you believe Ayn Rand created a great political philosophy.

I couldn't care less that you're a virgin, so long as you don't go all Tebow or Lolo Jones about it.

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

There needs to be a like button on here

Thanks Les I think it is more a function of the fact that those of us who have been in medicine for a long time (and in my case it is now a long, long time) know what good medical practice should be. What is being foisted on the public (here and other countries) is medicine as determined by the dollar. It would not be so bad-if the powers that be were honest about it and explained that what they are suggesting is being done SOLELY for the purpose of saving money and in fact that practicing cheap medicine can at times be worse than practicing no medicine. But to keep trying to ram down our throats that they are just interested in our benefit and providing BETTER care is baloney. I do not see the health plans for the politicians in Washington limiting their access to care and in fact, they do not limit their medications to generic drugs. I am pretty sure when a Senator (like Ted Kennedy) needed care for his brain tumor that cost was never an issue to his insurer and that he was immediately approved for experimental, untested, therapies that you and i could never get and that his medications were top branded and perhaps even being used off label and not the Tier one commonly used generics that our health plans would limit us with. We will of course never know but it sure would be interesting to see what percentage of their medical care Congressmen are personally responsible for compared to what the rest of us are burdened with.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Doc, Mrs. Les,

It seems to me that one of the most misguided ideas of all is that increasing health care costs "must be" a bad thing. If quality improves, wouldn't we want to pay commensurate with the increase in quality? Also, as income rises, shouldn't people have the right to increase discretionary healthcare spending? A relatively trivial example is orthodontia: poor people cannot afford it, but if their income goes up, it can make a big difference in your child's quality of life.

As you both point out, people with no skin in the game are forcing their views on the rest of us without our consent.

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Doc, Mrs. Les,

It seems to me that one of the most misguided ideas of all is that increasing health care costs "must be" a bad thing. If quality improves, wouldn't we want to pay commensurate with the increase in quality? Also, as income rises, shouldn't people have the right to increase discretionary healthcare spending? A relatively trivial example is orthodontia: poor people cannot afford it, but if their income goes up, it can make a big difference in your child's quality of life.

As you both point out, people with no skin in the game are forcing their views on the rest of us without our consent.

FF: Always knew i liked you and this just adds to it. Over the years medical care has changed in just so many ways. From just providing basic care (since that is all we knew how to do) to all sorts of extras like MRI's, CT Scans, orthodontia, plastic repairs, etc. Medical care has also changed in that it was never paid for by the government and way back, not even by insurers. Now that has all changed-some argue for the better although some aspects may be argued against. Should healthcare be considered a right? Why? Should it be absolutely equal in all respects for anyone and everyone? If so, should housing be considered a right? Why? Should it be absolutely equal in all respects for anyone and everyone? How about food? Should everyone get to dine at Loch Ober's? Fundamental questions-and you point out the most important point-that people with no skin in the game are forcing thie views on the rest of us without our consent. They use statistics to explain the rationale for their decisions on controls-trying to show how medical care here compares with that in Japan, Sweden, Canada, etc. meaningless-they are comparing apples and oranges since the populations are not at all similar. In numbers or composition. These medical stats are not created in a vacuum. It has always been considered a criminal act to practice medicine without a license-is it not practicing medicine when you make decisions on who gets treated and how they get treated?
I am educated enough to know a little bit about a lot of things-probably not all that much about many-but my entire life has been spent in medicine. I am just one physician who has seen what has happened since the 1960's. Medical practice has changed greatly (and in many ways for the better) but overall it has been a steady trend of the government deciding, insurance companies(using the government decisions for medicare as their basis)deciding, and bottom line-the cost deciding the medical care you receive. It is rapidly becoming a situation where your physician(that is if you even get to see one) has little choice or decision making for you. I have said in the past and actually believe this-what the government would see as the ideal case is that you live until age 65-contributing to the medicare fund for all your working life-and then just drop dead so you never need to collect anything from the fund.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I have said in the past and actually believe this-what the government would see as the ideal case is that you live until age 65-contributing to the medicare fund for all your working life-and then just drop dead so you never need to collect anything from the fund.

When a person of non-government affiliation tries this, it's called a ponzi scheme.



OK, so the video is social security, but Medicare is no different.

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Going back a long way for this-but i remember in the 1960's physicians (and they were called physicians in those days and not providers) arguing vehemently about whether the Medicare Act was a good or bad thing. Some, being totally mercenary, felt it was going to be wonderful-in that they would reap all sorts of monetary benefits now that seniors would all fall into the net and be paid for. Many others, maybe even a majority, were very skeptical. I recall one physician who i admired greatly at the time at Albany Medical Center saying that once the government begins to pay for something-they will eventually see how much it really costs and not be very happy about it. Then they will simply feel that if they pay for it, they ought to be able to control it, limit it, and reduce the cost without any regard for whether it is for the benefit of the patient. He was a phenomenal surgeon, and only recently have I begun to understand how well he understood what would happen.

[brookyone]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Not a whole lotta perspective from the chronically ill here...or their experiences with the psuedo free market. Lot of "perspective" on their behalf from a couple who pretty clearly don't have a real grasp of that perspective.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Not a whole lotta perspective from the chronically ill here...or their experiences with the psuedo free market.

Special risk pools for the chronically ill have been available from state governments for decades. your point?

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Not a whole lotta perspective from the chronically ill here...or their experiences with the psuedo free market. Lot of "perspective" on their behalf from a couple who pretty clearly don't have a real grasp of that perspective.

You're chronically ill, eh?

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Special risk pools for the chronically ill have been available from state governments for decades. your point?

FF: I have to repeat something i posted a while back-In my 45+ years in Medicine-I cannot recall anyone in the locations where I have been in practice either refused necessary medical care or not receive medical care in any emergency situation that arose regardless of ability to pay or insurance status. And I have mostly practiced in what would be considered blue collar environments. I am sure such cases do exist-but I personally have never seen one. There are of course some people(perhaps a lot of people) who just do not feel any responsibility to take care of themselves and their family and choose not to seek that care.

[brookyone]

Re: The Sad Case of the Patient Protection and Affordable Care Act

You're chronically ill, eh?

Yes, I have a chronic disease and have frequent contact with many in the same boat.

[brookyone]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Special risk pools for the chronically ill have been available from state governments for decades. your point?

They're not as "available" as you think.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

They're not as "available" as you think.

Are you looking in the right places?

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

They're not as "available" as you think.

First, let me apologize for my earlier snark. that was uncalled for. You are definitely not one of the [redacted] that makes life miserable for anyone who dares to disagree with them.

Second, that doesn't surprise me. There were plenty of things that were commonplace 25 or 30 years ago that made a lot of sense and were reasonably affordable that have since disappeared. At one time, for example, you could get a health insurance policy with a $25,000 deductible at a very inexpensive rate (people used them to "wrap around" other coverage that had caps or benefit limits). those are all gone now. At one time, an individual could buy health insurance through his/her trade association at group rates. Those seem to have disappeared as well.

The long-time professionals in the field (Dr. D, Mrs. Les, etc) have all pointed out a pretty clear and direct correlation: the more government gets involved in health insurance regulation, the fewer choices we have and the more expensive they become. yet somehow the answer always is "more government involvement"?? and then the cycle repeats itself anew, and guess what the response is? yeah.

"when will we ever learn?"

[DrDemento]

Re: The Sad Case of the Patient Protection and Affordable Care Act

First, let me apologize for my earlier snark. that was uncalled for. You are definitely not one of the [redacted] that makes life miserable for anyone who dares to disagree with them.

Second, that doesn't surprise me. There were plenty of things that were commonplace 25 or 30 years ago that made a lot of sense and were reasonably affordable that have since disappeared. At one time, for example, you could get a health insurance policy with a $25,000 deductible at a very inexpensive rate (people used them to "wrap around" other coverage that had caps or benefit limits). those are all gone now. At one time, an individual could buy health insurance through his/her trade association at group rates. Those seem to have disappeared as well.

The long-time professionals in the field (Dr. D, Mrs. Les, etc) have all pointed out a pretty clear and direct correlation: the more government gets involved in health insurance regulation, the fewer choices we have and the more expensive they become. yet somehow the answer always is "more government involvement"?? and then the cycle repeats itself anew, and guess what the response is? yeah.

"when will we ever learn?"

Fish-I only can really comment with any expertise on medicie. But it has been my experience that everything the government gets involved with ends up costing more. And usually exponentially more than they either promised or figured. I wonder what hammer prices are going for now paid by the US government? or toilet seats for that matter?