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America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

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Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

I'm not sure tort reform is where they should be starting their efforts. I'm a bit skeptical that frivilous lawsuits are the reason why their population is so unhealthy.

Similarly, while this effort is worthwhile on a national level, its far from the highest priority and can be looked at after the main reform bill is passed.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Rover said:
I'm not sure tort reform is where they should be starting their efforts. I'm a bit skeptical that frivilous lawsuits are the reason why their population is so unhealthy.
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While it may not have much to do with the nation being unhealthy, when it comes to the cost of health care and how rampant unnecessary test have become it is at least a part of the problem.

Rover said:
Similarly, while this effort is worthwhile on a national level, its far from the highest priority and can be looked at after the main reform bill is passed.
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This I would agree with. I do think it needs to be a separate bill. I would also be very cool with the individual states doing something about it as every state has different tort laws.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Bill said:
Here's an example from Mississippi, where premiums went down by 42%:

http://www.washingtonexaminer.com/o...ident----its-called-Mississippi-59990137.html
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Rover said:
I'm not sure Mississippi is a state we should be taking health care reform tips from. Aren't they about the unhealthiest state in the nation (along with Kentucky, WVA, etc)?
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I read the article and the first thing I thought of was if it was a total cesspool then the percent improvement might line it up with the other states? Miss has horrible healthcare, horrible access to healthcare and there is an almost complete monopoly for insurance coverage.

Not saying that torte reform should be dismissed but Miss is so dysfunctional I have a hard time feeling their process would translate well in some of the more functional states.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

So here is a reason for insurance reform~
Insurance can dock us pay for measures we don't meet. I do all my prescriptions via the electronic medical record. They tell me I have 80 % compliance. My colleagues who use the same system have compliance rates that are sig lower. No one uses paper prescriptions in our practice. The insurance co refuses to give us a list of where we are not compliant but won't give us the cash. They also are flunking us on some other measures we are sure we are in compliance for but the insurance co.refuses to give us access to that data aswell. The stated purpose of the measures are to improve pt care and outcomes. If they do not let us find out which things we are falling down on this can not be the real goal. It is also odd that the numbers remain static, no matter what we do. WHat isn't odd is that we are losing thousands in reimbursement because there is no avenue to challenge their findings.

Meanwhile we are having to spend multiple man hours with paperwork to prove to other carriers what we have done by scanning thru charts to prove what they have already been billed for.

More man hours to deal with referrals that the PHO is refusing despite volumes of documentation. None of this is reimbursed at all. Anyone want to guess why no one does primary care?

Hmm.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
I read the article and the first thing I thought of was if it was a total cesspool then the percent improvement might line it up with the other states? Miss has horrible healthcare, horrible access to healthcare and there is an almost complete monopoly for insurance coverage.

Not saying that torte reform should be dismissed but Miss is so dysfunctional I have a hard time feeling their process would translate well in some of the more functional states.
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It's not just in Mississippi that tort reform has reduced costs:

http://www.foxnews.com/politics/200...actice-costs-biggest-money-saver-tort-reform/
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Bill said:
It's not just in Mississippi that tort reform has reduced costs:

http://www.foxnews.com/politics/200...actice-costs-biggest-money-saver-tort-reform/
Click to expand...

I am not saying that torte reform is bad. For heaven's sake I would save a boat load in malpractice insurance. I was just saying that Miss is screwed up.

I think torte is very important. I do not see the reasoning behind trying to lump it into the current initiative. That makes no sense to me at all. It would be buried in a bunch of other things. It should be in a different bill so it can be debated and addressed correctly by itself.

I think the insurance thing is a much bigger piece of the puzzle. It effects every person who seeks or needs to seek health care or anyone who provides it. It creates way more barriers to care and use (or overuse in some cases) of resources than any torte stuff. I view the torte thing as a lovely smoke screen that may save some money and testing but will not address the roots of the issue which are IMHO access and non-uniformity/ availability of resources, convoluted and ever-changing policies created by insurance that are not evidence based (and which prevent/delay care as well as payment unnecessarily) and the total lack of primary care providers coming into the pipeline.

Torte is not going to fix any of that.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

That was a bad run on sentence. Hope the grammar horse isn't around:o
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

leswp1 said:
So here is a reason for insurance reform~
Insurance can dock us pay for measures we don't meet. I do all my prescriptions via the electronic medical record. They tell me I have 80 % compliance. My colleagues who use the same system have compliance rates that are sig lower. No one uses paper prescriptions in our practice. The insurance co refuses to give us a list of where we are not compliant but won't give us the cash. They also are flunking us on some other measures we are sure we are in compliance for but the insurance co.refuses to give us access to that data aswell. The stated purpose of the measures are to improve pt care and outcomes. If they do not let us find out which things we are falling down on this can not be the real goal. It is also odd that the numbers remain static, no matter what we do. WHat isn't odd is that we are losing thousands in reimbursement because there is no avenue to challenge their findings.

Meanwhile we are having to spend multiple man hours with paperwork to prove to other carriers what we have done by scanning thru charts to prove what they have already been billed for.

More man hours to deal with referrals that the PHO is refusing despite volumes of documentation. None of this is reimbursed at all. Anyone want to guess why no one does primary care?

Hmm.
Click to expand...

You could probably sue them for what they owe you and then they'd have to disclose everything. Maybe tort reform would stop that though :)
You could also just force your patients to pay in full and make them handle the reimbursements from the insurance companies.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Bill said:
Although the Dems have reduced the amount of the proposed excise tax (penalty) on those individuals who don't purchase health insurance under the health care bill, it looks like the IRS potentially could make it much worse:

http://online.wsj.com/article/SB10001424052748704471504574439243760133458.html
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I don't care what you call it~ tax, payment, insurance, tiddlywinks. If you are uninsured and land in the ER you cost a few 100K when you have a heart attack without insurance. There is no way for people to sign away getting care when in extremis. If there was I would be all for the libertatrian view of to each his own. Currently that view allows you to be irresponsible and then the rest of the world has to pick up the pieces. If you are uninsured your costs spill over to the family, the various medical providers and facilities and the entire community (when all of those medical entities have to eat the unpaid bills).,

You use up my tax dollars when you crash and burn and land on public insurance. That is a tax on me. I can't say no. Why should you be able to say no? Until the legal system allows medicine to reject giving care it is not right that people can assume that someone will care for them without giving into the system if they are capable.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

pardonme said:
You could probably sue them for what they owe you and then they'd have to disclose everything. Maybe tort reform would stop that though :)
You could also just force your patients to pay in full and make them handle the reimbursements from the insurance companies.
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W put an end to the insurance companies getting sued for just about everything- that is when the thing started to swirl the bowl. No accountability.

Some insurance companies forbid direct billing. They have agreement for what they will reimburse. If you bill more it is considered double billing/fraud to make the patient pay the full price if I understand things correctly.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

pardonme said:
You could also just force your patients to pay in full and make them handle the reimbursements from the insurance companies.
Click to expand...

1 - That's illegal.

2 - Even if it were legal the insurance company would only reimburse a patient what they were going to reimburse the health care provider.

3 - The point is to get their money from the insurance company, not to bankrupt their patients.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Bill said:
Grassley introduced an amendment to the health care bill requiring that immigrants signing up for Federal health care programs show a photo ID as proof of their identity, but the Dems defeated the amendment:

http://thehill.com/blogs/blog-brief...-back-id-requirement-for-immigrant-healthcare
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That's because you already have to produce a birth certificate as proof of your identity. Next.


Moving on from talk show discussion points, there's a proposal from Sen Carper to allow the public option on a statewide basis - if the state chooses to do so. So, it would be up to each one whether or not to enact it without being required to do so. That seems like a good idea to me. Wondering what the objections might be....
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Rover said:
Moving on from talk show discussion points, there's a proposal from Sen Carper to allow the public option on a statewide basis - if the state chooses to do so. So, it would be up to each one whether or not to enact it without being required to do so. That seems like a good idea to me. Wondering what the objections might be....
Click to expand...

States can already do it (see Massachusetts). Next.
 
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Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

There was an article in a major newspaper the other day of making health insurance like fire insurance in that HI would take care of the catastrophies, but not the regular day to day stuff.

Now to define what is a "catastrophy" would be an interesting spectator sport as all sorts of special groups would see their illness/disease/life event as a catastrophy.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Rover said:
That's because you already have to produce a birth certificate as proof of your identity. Next.
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To enroll in any government health care program? Even then, a photo ID helps to prove its really you. At any rate, why reject an amendment asking that photo ID be required as further proof of identity?
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

joecct said:
Now to define what is a "catastrophy" would be an interesting spectator sport as all sorts of special groups would see their illness/disease/life event as a catastrophy.
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I'd bet that would just happen to work out to be where the treatment money is. Erectile dysfunction: the Holocaust of the 21st century.
 
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies

Kepler said:
I'd bet that would just happen to work out to be where the treatment money is. Erectile dysfunction: the Holocaust of the 21st century.
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Nah, I don't think we're that soft.
 
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