The Sad Case of the Patient Protection and Affordable Care Act

[DrDemento]

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

Great to hear from you. Sounds like you got to work the equivilent of a mash unit. Hopefully the No'Easter will peter out.

No real major trauma cases. Mostly people that were a little sick but more scared than anything else that if they did not get seen things would get worse. Glad i did not have to do any deliveries-my last one was 1969! I think I practiced more psychiatry than anything else but even after 43 years since medical school-it still feels good. The hospital of course accepted whatever medical insurance people had-but the look on patient's faces when they were told we would not charge for any of our medical services was priceless.

[leswp1]

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

Great to hear from you. Sounds like you got to work the equivilent of a mash unit. Hopefully the No'Easter will peter out.

[DrDemento]

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

Not many I of the ones I saw today!

On a more serious note. RFAlph posted on a couple of other threads that DrDemento is from the Jersey Shore area. No one has been able to make contact with him since Monday night. Send out the good thoughts/vibes rayers for him and his wife! Hoping he is OK

Thanks Les!! We are fine but did without electric, cable, TV, internet, heat, cooking everything from Monday morning until today. We were well prepared-the kitties all had food and litter, we had tons of canned goods, we burned 3 cords of wood in the fireplace for heat and Jenny is like pioneer woman. She cooked some fabulous meals in the fireplace. Bigger problem was no gasoline to go anywhere, traffic lights all out or down, roads all blocked and the absolute imbeciles who live on the Jersey Shore who just cannot survive or behave without computers, cell phones and electronic conveniences. It was stressful of course but mostly because we had no contact with friends and family. Our saving grace was a Verizon landline which stayed live. I will NEVER ever live without one landline. The cell towers here were useless-either down or overwhelmed. We live a short ditance from a small hospital which was running on emergency generator power and virtually no staff-so we just drove over and helped anyone who could get there that needed some sort of care. I practiced about 9 different specialties and had a blast. But the highlight was having Jenny there as my nurse for the first time working in regualr clothes-no white hat, no white stockings, no white shoes or uniform-almost did not recognize her. Old time medicine-the way it used to be-and the way I relly wished it was today. It is still a mess down here and we expect a noreaster in 3 days to wreck havoc all over again. Just hoping we retain power and cable this time. Best regards to all who posted and asked about us.

[leswp1]

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

Dr. D has been heard from. OK but "hunkered down"

I saw RFAlph's post. Phew!

[joecct]

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

Not many I of the ones I saw today!

On a more serious note. RFAlph posted on a couple of other threads that DrDemento is from the Jersey Shore area. No one has been able to make contact with him since Monday night. Send out the good thoughts/vibes rayers for him and his wife! Hoping he is OK

Dr. D has been heard from. OK but "hunkered down"

[leswp1]

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

It's fascinating to me that people's attitude toward dental care is so different than it is for health care in general.

I think it is safe to say that nearly everyone brushes their teeth at least daily; many people do brush after every meal.

Yet how many people tend to their health with the same fealty?

Not many I of the ones I saw today!

On a more serious note. RFAlph posted on a couple of other threads that DrDemento is from the Jersey Shore area. No one has been able to make contact with him since Monday night. Send out the good thoughts/vibes rayers for him and his wife! Hoping he is OK

[FreshFish]

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

It's fascinating to me that people's attitude toward dental care is so different than it is for health care in general.

I think it is safe to say that nearly everyone brushes their teeth at least daily; many people do brush after every meal.

Yet how many people tend to their health with the same fealty?

[DrDemento]

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

Research indicates that patients with VIP medicine have worse outcomes.

RS: When I hear that kind of statement i have to ask-what criteria is used to determine outcomes? How can we be sure that the populations involved are the same? Perhaps those that seek that kind of treatment do so simply because they are more ill or older and in need of more care? Comparing the statistics of outcomes is not always easy. I often see the life expectancy compared in this country with that of Sweden and Japan-however the results here can be skewed by obvious things-we have more young men losing life at an early age serving in the Middle East and more young drivers killed on the highways and we certainly have more young black men getting shot in the streets. Not to mention the poorer health of a large pool of immigrants here. Losing all these 16-24 years olds can certainly weigh on the numbers. I am not in any way disagreeing with your statement, I honestly do not know the answer, but i can see how that answer would need a lot of control of the populations involved to make it valid.

[RStarr]

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

What do you all think about "concierge" medicine?

Research indicates that patients with VIP medicine have worse outcomes.

[DrDemento]

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

What do you all think about "concierge" medicine?

It is being tried in some areas. I suppose it is an option in some areas of the country where the population has substantial assets or earnings and works better for some specialties than others. The few internists that I know who practice this way are very happy with their practices. The patients must be happy or else they would not pay for the services. Because of the out of pocket costs I just do not see it ever being a major player in the overall medical picture. My patients were 90% blue collar or seniors who probably would never be interested or have the disposable money needed.

[joecct]

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

What do you all think about "concierge" medicine?

[Foxton]

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

While I certainly don't want to "defend" the health insurance companies, I would suggest a little bit of perspective as well.

First, an analogy, and as we know, all analogies eventually break down if you push them too far or too hard.

You go into a retail store, and you buy $100 of items. The proprietor charges you $106.50. Irate, you ask him/her: "what's going on here?!*@#& ? the price tags add up to $100! what's this additional $6.50 you're charging me?"

And s/he patiently explains that is the state sales tax.

so you ask, "if it's the state sales tax, why are you the one collecting it then? I repeat, what's going on?"


The example is that many times the government designates a business to do its job for it rather than doing the job directly itself.

Hey now!
*****http://i107.***********.com/albums/m285/mcfoxton/oqkEe.jpg******

[FreshFish]

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

While I certainly don't want to "defend" the health insurance companies, I would suggest a little bit of perspective as well.

First, an analogy, and as we know, all analogies eventually break down if you push them too far or too hard.

You go into a retail store, and you buy $100 of items. The proprietor charges you $106.50. Irate, you ask him/her: "what's going on here?!*@#& ? the price tags add up to $100! what's this additional $6.50 you're charging me?"

And s/he patiently explains that is the state sales tax.

so you ask, "if it's the state sales tax, why are you the one collecting it then? I repeat, what's going on?"


The example is that many times the government designates a business to do its job for it rather than doing the job directly itself.

[brookyone]

Re: A system that doesn't want to change

Dr.D I fear you are right. It is also nice to have some one get it. I am cut of the old cloth as well (not to the hat, stockings and whites but the dedication to the patients thing)I am so sick of hearing this is the new normal.

Probably totally illogical but I have very little prob with medicare/aid limiting things- at least they give something and those who get that should be grateful. (something I think people forget) It is the for profit insurance co that feed the general public the hooha about caring for the patient, how it hurts them to cut things, it is all the gov't/ regulations fault while their CEOs make more than the GNP of half the developing conunties that makes me want to puke. The $ is the only motivator and it is amazing people don't realize that.

Sometimes I want to go work at the community ctr but the red tape to change practices takes about 6 months and the thought of having to learn a new system/leave my patients behind stops me..

THIS...bears repeating. Great to have informed commentary.

[FreshFish]

Re: A system that doesn't want to change

I have very little prob with medicare/aid limiting things- at least they give something and those who get that should be grateful.

That by itself in theory should be innocuous; the problems start when what was supposed to be the floor becomes the mandatory ceiling! people cannot opt out of Medicare even if they want to! that wouldn't be "fair" to the rest of us, you know....