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  • #46
    Re: The PPACA Thread Part III - Let's have a healthy debate!

    Originally posted by FreshFish View Post
    PPACA has some good parts do it, and it has some awful parts to it.
    Slowly they turn, step by step, inch by inch.

    The conservative evolution on every social advance:

    Year 01: It's laughable!

    Year 21: It's evil!

    Year 41: It's too soon!

    Year 81: It was our idea.
    Cornell University
    National Champion 1967, 1970
    ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
    Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

    Comment


    • #47
      Re: The PPACA Thread Part III - Let's have a healthy debate!

      Originally posted by Kepler View Post
      Slowly they turn, step by step, inch by inch.

      The conservative evolution on every social advance:

      Year 01: It's laughable!

      Year 21: It's evil!

      Year 41: It's too soon!

      Year 81: It was our idea.
      You mean like the Bin Laden thing, you push and push for us to get out, never take the action, but all of a sudden when you get power, you want to do it so you can get the credit? The other side is no different.

      Comment


      • #48
        Re: The PPACA Thread Part III - Let's have a healthy debate!

        Originally posted by DrDemento View Post
        Scooby: I was just too young to appreciate much of what [my father] used to say.
        You and Mark Twain!

        paraphrase:

        "When I was 16, my father was an ignorant dunce. By the time I was 21, I was amazed at how much the old man had learned in five years."
        "Hope is a good thing; maybe the best of things."

        "Beer is a sign that God loves us and wants us to be happy." -- Benjamin Franklin

        "Being Irish, he had an abiding sense of tragedy, which sustained him through temporary periods of joy." -- W. B. Yeats

        "People generally are most impatient with those flaws in others about which they are most ashamed of in themselves." - folk wisdom

        Comment


        • #49
          Re: The PPACA Thread Part III - Let's have a healthy debate!

          Originally posted by DrDemento View Post
          Bad medicine is worse than no medicine. I also strongly believe that the most important phrase in medicine is the phrase " I don't know."
          Two sentences to live by.
          In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

          Originally posted by burd
          I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

          Comment


          • #50
            Re: The PPACA Thread Part III - Let's have a healthy debate!

            My real reason for asking for a citation was because I have heard that said by physicians that they would "leave medicine" but I have not seen the data to back that up.

            I think the argument can be made that small private practice is all but dead. As others have said, the trend is for much larger practices or hospital groups as they are much easier to handle the bureaucracy and take the load off of the physicians. However, I do not think I have seen anything that convinced me that more people have left practicing medicine that otherwise would have. Instead, I think the case can be made that most adapted the way they practice in some way (which is really required throughout a career).

            I find it very interesting talking to different generations of physicians. Every generation has had to adapt in some way and I am pretty confident they all had their gripes about the "paucity" of the new physicians education. Some of the older generation absolutely hate electronic medical records but I cannot fathom working efficiently without them. I have worked on paper and although it has its merits (brevity is encouraged), I am not sure I could manage a patient's care as well as with the EMR.

            My generation will not know to run their own blood work like residents of generations past. We can use our time doing other things in the morning/seeing more patients but I try to keep the thought of me running my own blood work to make me contemplate if a test is truly necessary.
            In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

            Originally posted by burd
            I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

            Comment


            • #51
              Re: The PPACA Thread Part III - Let's have a healthy debate!

              Originally posted by WisconsinWildcard View Post
              My generation will not know to run their own blood work like residents of generations past. We can use our time doing other things in the morning/seeing more patients but I try to keep the thought of me running my own blood work to make me contemplate if a test is truly necessary.
              One of the most offensive things Obama has said about the practice of medicine is that he thinks doctors order additional unnecessary tests in order to pad their bottom line. Either he does not understand how that process works, or he is tacitly accusing doctors of taking kickbacks.
              "Hope is a good thing; maybe the best of things."

              "Beer is a sign that God loves us and wants us to be happy." -- Benjamin Franklin

              "Being Irish, he had an abiding sense of tragedy, which sustained him through temporary periods of joy." -- W. B. Yeats

              "People generally are most impatient with those flaws in others about which they are most ashamed of in themselves." - folk wisdom

              Comment


              • #52
                Re: The PPACA Thread Part III - Let's have a healthy debate!

                Originally posted by FlagDUDE08 View Post
                You mean like the Bin Laden thing, you push and push for us to get out, never take the action, but all of a sudden when you get power, you want to do it so you can get the credit? The other side is no different.
                As in the other thread, your "pox on both houses" mask is slipping. However I can honestly say you've lost me with this post. The most I can get out of it is it appears to be a grammatically correct English sentence.
                Cornell University
                National Champion 1967, 1970
                ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
                Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

                Comment


                • #53
                  Re: The PPACA Thread Part III - Let's have a healthy debate!

                  Originally posted by FreshFish View Post
                  One of the most offensive things Obama has said about the practice of medicine is that he thinks doctors order additional unnecessary tests in order to pad their bottom line. Either he does not understand how that process works, or he is tacitly accusing doctors of taking kickbacks.
                  Source?
                  Cornell University
                  National Champion 1967, 1970
                  ECAC Champion 1967, 1968, 1969, 1970, 1973, 1980, 1986, 1996, 1997, 2003, 2005, 2010
                  Ivy League Champion 1966, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1977, 1978, 1983, 1984, 1985, 1996, 1997, 2002, 2003, 2004, 2005, 2012, 2014, 2018, 2019, 2020

                  Comment


                  • #54
                    Originally posted by FreshFish View Post
                    One of the most offensive things Obama has said about the practice of medicine is that he thinks doctors order additional unnecessary tests in order to pad their bottom line. Either he does not understand how that process works, or he is tacitly accusing doctors of taking kickbacks.
                    Some clearly do, just as some lawyers do extra work just to pad their fees, mechanics push for unnecessary repairs to pad their fees, etc.

                    Any profession who is paid by service rather than outcome will have some members of the profession who scam the system.

                    Or are you saying there is absolutely no health care fraud going on?

                    Comment


                    • #55
                      Re: The PPACA Thread Part III - Let's have a healthy debate!

                      Originally posted by WisconsinWildcard View Post
                      My real reason for asking for a citation was because I have heard that said by physicians that they would "leave medicine" but I have not seen the data to back that up.

                      I think the argument can be made that small private practice is all but dead. As others have said, the trend is for much larger practices or hospital groups as they are much easier to handle the bureaucracy and take the load off of the physicians. However, I do not think I have seen anything that convinced me that more people have left practicing medicine that otherwise would have. Instead, I think the case can be made that most adapted the way they practice in some way (which is really required throughout a career).

                      I find it very interesting talking to different generations of physicians. Every generation has had to adapt in some way and I am pretty confident they all had their gripes about the "paucity" of the new physicians education. Some of the older generation absolutely hate electronic medical records but I cannot fathom working efficiently without them. I have worked on paper and although it has its merits (brevity is encouraged), I am not sure I could manage a patient's care as well as with the EMR.

                      My generation will not know to run their own blood work like residents of generations past. We can use our time doing other things in the morning/seeing more patients but I try to keep the thought of me running my own blood work to make me contemplate if a test is truly necessary.
                      For some people, they would rather the small practice over practicing at all. Big fish in a small pond, support small, not be a slave to the man, whatever you want to call it, it's the same concept. There are still family doctors out there (accepting a crate of tomatoes, a duck, and so on), but the sue happy generation ruins that, as it just takes one grumpy city slicker to bankrupt that doctor.

                      Sadly, everything's getting consolidated these days, and the PPACA itself is no exception, as people were too lazy to shop around for what they want, or to go to it if it isn't available in their area, so they get mommy and daddy government to force a one-size-fits-most system on the entire country with no alternative. Take a look at legal immigrants; they're setting a prime example of what a citizen base should be doing. Their former country doesn't give them what they want, so they head to greener pastures to get what they want, and accept all of the side effects that come with the territory.

                      Comment


                      • #56
                        Re: The PPACA Thread Part III - Let's have a healthy debate!

                        Originally posted by WisconsinWildcard View Post
                        My real reason for asking for a citation was because I have heard that said by physicians that they would "leave medicine" but I have not seen the data to back that up.

                        I think the argument can be made that small private practice is all but dead. As others have said, the trend is for much larger practices or hospital groups as they are much easier to handle the bureaucracy and take the load off of the physicians. However, I do not think I have seen anything that convinced me that more people have left practicing medicine that otherwise would have. Instead, I think the case can be made that most adapted the way they practice in some way (which is really required throughout a career).

                        I find it very interesting talking to different generations of physicians. Every generation has had to adapt in some way and I am pretty confident they all had their gripes about the "paucity" of the new physicians education. Some of the older generation absolutely hate electronic medical records but I cannot fathom working efficiently without them. I have worked on paper and although it has its merits (brevity is encouraged), I am not sure I could manage a patient's care as well as with the EMR.

                        My generation will not know to run their own blood work like residents of generations past. We can use our time doing other things in the morning/seeing more patients but I try to keep the thought of me running my own blood work to make me contemplate if a test is truly necessary.
                        Nicely stated. I tend to believe that the reason physicians do not leave the practice of medicine, or often even retire at an advancing age, is simply that most of us do not know how to do anything else. My medical education was so skewed towards just learning medicine. We had zero business training, zero training in dealing with insurance and zero training in dealing with the government. Granted that was a long time ago, but physicians from my era really knew little else than medicine. I have had to self teach myself anything else necessary to survive in this world. My investment and accountant friends have told me very often that doctors are the worst businessmen and the least knowledgeable investors they see.(yet most of them would never admit it since it is very hard for most doctors to ever admit they do not know anything)
                        I have not seen many leave the field(but I must admit some have left earlier than one would have expected) but I have seen many alter how they practice.
                        Take the shortest distance to the puck and arrive in ill humor

                        Comment


                        • #57
                          Re: The PPACA Thread Part III - Let's have a healthy debate!

                          Originally posted by unofan View Post
                          Some clearly do, just as some lawyers do extra work just to pad their fees, mechanics push for unnecessary repairs to pad their fees, etc.

                          Any profession who is paid by service rather than outcome will have some members of the profession who scam the system.

                          Or are you saying there is absolutely no health care fraud going on?
                          Agree 100%. I also wonder how much disability fraud there is going on by regular folks who receive stipends often for life when they could be actually quite physically and mentally productive?
                          Take the shortest distance to the puck and arrive in ill humor

                          Comment


                          • #58
                            Re: The PPACA Thread Part III - Let's have a healthy debate!

                            Originally posted by FreshFish View Post
                            One of the most offensive things Obama has said about the practice of medicine is that he thinks doctors order additional unnecessary tests in order to pad their bottom line. Either he does not understand how that process works, or he is tacitly accusing doctors of taking kickbacks.
                            For some, this is the case, especially if they receive a government subsidy, and try to use it up in order to make sure they get the same amount in the next year. However, many of the tests are not necessarily relevant, but used as protection against a lawsuit. For example, when a woman goes in, they'll almost immediately give her a pregnancy test.

                            Comment


                            • #59
                              Re: The PPACA Thread Part III - Let's have a healthy debate!

                              Originally posted by FlagDUDE08 View Post
                              For some, this is the case, especially if they receive a government subsidy, and try to use it up in order to make sure they get the same amount in the next year. However, many of the tests are not necessarily relevant, but used as protection against a lawsuit. For example, when a woman goes in, they'll almost immediately give her a pregnancy test.
                              The answer to that question is why if there is such of volume of tests the costs of the test never go down. Testing should be a good thing and it should be encouraged. We need to get to the point where the costs of testing is minimal.
                              **NOTE: The misleading post above was brought to you by Reynold's Wrap and American Steeples, makers of Crosses.

                              Originally Posted by dropthatpuck-Scooby's a lost cause.
                              Originally Posted by First Time, Long Time-Always knew you were nothing but a troll.

                              Comment


                              • #60
                                Re: The PPACA Thread Part III - Let's have a healthy debate!

                                Originally posted by ScoobyDoo View Post
                                The answer to that question is why if there is such of volume of tests the costs of the test never go down. Testing should be a good thing and it should be encouraged. We need to get to the point where the costs of testing is minimal.
                                Is the demand for the test changing, or is the demand elasticity for the test changing? If the idea for the suppliers of the test is to maximize revenue, and the demand elasticity diminishes (i.e. making the product so essential that you have a low chance of being able to function without it, similar to gasoline), there is no incentive to lower your price point in order to get more "customers", because you will get them anyway.

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