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

[leswp1]

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

And look what the R's got for that.

That's where the fear is rooted: The electorate has shown they're more than willing to slap hard and turn on a dime. And it's just as easy to benefit as get punished by it.

Mr. Bush not getting out of Iraq is what cost the R's the election. Not the economy. And the economy is what should have run him out. (He overspent.)

Mr. Obama's continued tilting at the cap-and-trade and health care windmills will cost him. Why? Because people want jobs to be talked about right now, not more government regulations or programs. Jobs.

Fix the labor market and Mr. Obama fixes that and health care (as most jobs provide some level). And as a bonus tax revenues go up too.

People vote their wallets or their frustrations. Woe be to the one who irks both.

Not so sure I agree with this. I am around a lot of people who view this as a top priority. A lot of seniors who are retired for example.

Every business prices the cost of insurance on their business into their cost structure.

Doctors are no different.
And malpractice insurance premiums are high because of the legal costs and judgements doctors may face.

You have to deal with all aspects of this, trial lawyers lobby be ****ed.

This might be true if we could set a fee schedule and get what we charge. Reimbursement rates are governed by the insurance co. Most hospitals around here have PHOs (Physician Hospital Organizations). What that group negotiates is what all who belong to the group are required to agree to. To be outside of the group gets you excluded from the contracts for that insurance. An example- Blue Cross and the PHO made an agreement (that our practice vehemently disagreed with) that disallows any referrals outside of the local hospital network even for pre-exsisting conditions that had been followed by an out of network Dr. They also have a huge withhold that we will never see because the idiots who negotiated things agreed to impossible benchmarks with no resources to meet them. Altho we did not sign on our referrals still must be cleared thru that panel. Our rates are what that panel and the insurance negotiate. We can not build in fees to absorb the cost. The fees are frequently predicated on what Medicare will reimburse. Instead we go short staffed or lose cash. It would be lovely if we could just increase the fee abitrarily.

To be fair I am looking at this from a primary care perspective. Specialists do not get hit with the benchmarks like we do and charge ridiculous amounts that get reimbursed at higher rates than we get for same service provided.

I did hear Tort reform mentioned in a more positve light than last speach which gave me some hope. FOr those wha are mentioning that isn't the complaint the bill is too large already? I would like to see that in a different bill so it doesn't get bogged down with other stuff.

 

[Slap Shot]

Either they have an accounting of 90Bn in savings a year or they have to go back and find more. How they get there might be tough to predict. Assessing whether or not they did get there isn't.

I disagree. Given the history of spend, spend, spend and spend some more in Washington, you are willing to assume they will get there? I'm not.

 

[leswp1]

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

So I read thru all this and there is a lot of analysis of whether O hit a HR or not. I was struck that no one said anything to address the Lie thing in respect to the Bill (not that the guy was an azzhat). I saw a number of clips of folks holding up paper. Great theater. I thought I was listening to the House of Lords/Parlament when I tuned in last night and heard all the yelling

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. I really would love the R's to put out the parts of the bill quoted that they think are contradictory to the promises O made. Not saying this sarcastically. I kind of was hoping someone would have done that in here.

When I read thru the thread if folks hadn't quoted those I had on ignore half the thread would have been missing (only 2 on ignore)

 

[ScoobyDoo]

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

So I read thru all this and there is a lot of analysis of whether O hit a HR or not. I was struck that no one said anything to address the Lie thing in respect to the Bill (not that the guy was an azzhat). I saw a number of clips of folks holding up paper. Great theater. I thought I was listening to the House of Lords/Parlament when I tuned in last night and heard all the yelling

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. I really would love the R's to put out the parts of the bill quoted that they think are contradictory to the promises O made. Not saying this sarcastically. I kind of was hoping someone would have done that in here.

When I read thru the thread if folks hadn't quoted those I had on ignore half the thread would have been missing (only 2 on ignore)

Interestingly enough I heard tonight that you are NOT allowed to call someone a liar while speaking in Parliament.

 

[mookie1995]

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

This might be true if we could set a fee schedule and get what we charge..

what you charge??!?!

nobody knows what the doctor "charges" them. probably very few people know what their scripts run.

they know, "i pay $20 in co-pay".

i get the bills sent to me whenever billing is effed up (usually 1 out of 3) and my regular office visit (2x yr) is $1,493.00! that is obscene. if i was paying this out of my own pocket, there is no way we would come to that via negotiation.

i don't pay the plummer what he wants. we discuss it.

i never go into a doctors office and see a price list

 

[mookie1995]

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

So I read thru all this and there is a lot of analysis of whether O hit a HR or not. I was struck that no one said anything to address the Lie thing in respect to the Bill (not that the guy was an azzhat). I saw a number of clips of folks holding up paper. Great theater. I thought I was listening to the House of Lords/Parlament when I tuned in last night and heard all the yelling

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. ...

i either read something on cnn.com or had someone email me the article with the part where there is wording in the bill where you can't inquire as to someone's legal standing... much like the state troopers in MA can't ask for proof of citizenship.

but who cares... they'll all get citizenship anyhows soon enough, so there will be no 'illegals' to complain about anyhow.

 

[leswp1]

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

Interestingly enough I heard tonight that you are NOT allowed to call someone a liar while speaking in Parliament.

So that is how Parliament is spelled I was thinking that before the Liar thing. When I was a kid we lived over there and everyone yells. Interesting as the stiff upper lip doesn't seem to apply in this case.

what you charge??!?!

nobody knows what the doctor "charges" them. probably very few people know what their scripts run.

they know, "i pay $20 in co-pay".

i get the bills sent to me whenever billing is effed up (usually 1 out of 3) and my regular office visit (2x yr) is $1,493.00! that is obscene. if i was paying this out of my own pocket, there is no way we would come to that via negotiation.

i don't pay the plummer what he wants. we discuss it.

i never go into a doctors office and see a price list

Holy Crud. Nothing I would do would come close to getting you a bill like that. They should do global fees for things. Instead they make us code and charge for every stupid thing. They no longer do chart review. They check for what is coded and billed. If it is not billed you get docked if it is a benchmark.

For a physical I have to bill for a base physical, a handling fee for anything sent out, a breast exam, a pap, the pelvic, (if a man then the corresponding exams), lab tests- each seperate, vision, hearing, immunization, immunization administration fees, any screening questionaires and more stuff but I am too tired to remember it off the top of my head. How ridiulous is that. If it is routine I should do it not bill for every stupid thing separately. Not only that but the insurance companies frequently change rules and then billing folks compare notes to keep up so they get stuff reimbursed with all these silly little secret codes that you can submit but only if you know about them.

You get universal coding that doesn't change every few months and you could save a sheeat load of cash in time and billing personel $.

 

[Rover]

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

So I read thru all this and there is a lot of analysis of whether O hit a HR or not. I was struck that no one said anything to address the Lie thing in respect to the Bill (not that the guy was an azzhat). I saw a number of clips of folks holding up paper. Great theater. I thought I was listening to the House of Lords/Parlament when I tuned in last night and heard all the yelling

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. I really would love the R's to put out the parts of the bill quoted that they think are contradictory to the promises O made. Not saying this sarcastically. I kind of was hoping someone would have done that in here.

When I read thru the thread if folks hadn't quoted those I had on ignore half the thread would have been missing (only 2 on ignore)

I believe the House bill bars using this legislation to cover illegal aliens. Its specifically prohibited in one version. What the righties are clinging to is that if illegals need treatment at the ER, presumably for a real emergency, the hospital won't turn them away - hence illegal care is being paid for by the govt. This would happen regardless of the bill however, and I suspect they know that. Its just that they're running out of ridiculous assertions and are trying to trot out the "illegals" boogeyman.

 

[Bill]

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

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. I really would love the R's to put out the parts of the bill quoted that they think are contradictory to the promises O made. Not saying this sarcastically. I kind of was hoping someone would have done that in here.

I haven't read much of the earlier draft bills, nor do I plan to at this point. I'll wait until the final bill comes out. I wish I could say I'll read all/most of it, but assuming it is another monster (size wise) of a bill, I'll likely only try to read portions of it. I wish we could make Congress write bills that are short and to the point and not filled with govermentese or legalese. Whether anything about illegal aliens is included in the bills that have come out previously, I can't say. Even if the final bill excludes coverage of illegal aliens per se, I don't think that will end the issue. I think there is concern from the Reps that Obama and the Dems might grant amnesty to all illegal aliens down the road, thus making them legal, and getting them coverage that way. I think that is a legitimate concern.

 

[Patman]

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

I haven't read much of the earlier draft bills, nor do I plan to at this point. I'll wait until the final bill comes out. I wish I could say I'll read all/most of it, but assuming it is another monster (size wise) of a bill, I'll likely only try to read portions of it. I wish we could make Congress write bills that are short and to the point and not filled with govermentese or legalese. Whether anything about illegal aliens is included in the bills that have come out previously, I can't say. Even if the final bill excludes coverage of illegal aliens per se, I don't think that will end the issue. I think there is concern from the Reps that Obama and the Dems might grant amnesty to all illegal aliens down the road, thus making them legal, and getting them coverage that way. I think that is a legitimate concern.

The gist of it is that anything that is written cannot actually prevent illegals from receiving care since there is no mechanism set up to check status. The other bit is that it'll be mandatory for any person who has been in the US X months to sign up for something... thus putting illegals into the system.

As with a lot of these bills, the devil is in little legal landmines. There's a reason much of this text has been done up under the cover of night several months before this debate ever started. When you're determined to get things by hook or by crook you'll come up with a lot of ways to disguise what you wanted to do all along.

 

[ScoobyDoo]

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

The gist of it is that anything that is written cannot actually prevent illegals from receiving care since there is no mechanism set up to check status. The other bit is that it'll be mandatory for any person who has been in the US X months to sign up for something... thus putting illegals into the system.

Total hypocrisy. They had their chance to ram through real immigration reform and all they did was build a fence that evidently doesn't work.

 

[Rover]

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

I Whether anything about illegal aliens is included in the bills that have come out previously, I can't say. Even if the final bill excludes coverage of illegal aliens per se, I don't think that will end the issue. I think there is concern from the Reps that Obama and the Dems might grant amnesty to all illegal aliens down the road, thus making them legal, and getting them coverage that way. I think that is a legitimate concern.

I think that's one of the stupidest concerns I've ever seen written. Who are you - Sarah Palin?

 

[mookie1995]

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

I think that's one of the stupidest concerns I've ever seen written. Who are you - Sarah Palin?

make them citizens!!

once they start paying taxes, they'll be republicans in no time

 

[mookie1995]

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

oh, and my two rx's that aren't generic now 'cost' $227.99 & $449.99 monthly according to cvs.

crazy!!!!

ponzi scheme... all y'all healthy folk subsidize me!

thanks.

 

[leswp1]

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

I believe the House bill bars using this legislation to cover illegal aliens. Its specifically prohibited in one version. What the righties are clinging to is that if illegals need treatment at the ER, presumably for a real emergency, the hospital won't turn them away - hence illegal care is being paid for by the govt. This would happen regardless of the bill however, and I suspect they know that. Its just that they're running out of ridiculous assertions and are trying to trot out the "illegals" boogeyman.

Well that sort of clarifies things. This is where ethics conflict with legal stuff. More than 15 yrs ago there was a huge thing about ER visits for people with insurance. Basically the HMO insurance companies were trying to cut down on the silly ER visits and required the primary to give a referral to the ER to have it covered. This could be retroactive (in those days every other referral needed to be made before you walked thru the door) but if the primary could have treated it in the office then the referral was supposed to be denied and pt had to pick up the cost. There was a huge legal thing (details are fuzzy in my brain) but to the best of my recollection they came out with a definition saying that there was no way to expect a lay person to decide if it was a medical emergency. If the patient felt it was an emergency then it was. The ER needed to see them and insurance needed to pay. That is when huge co-pays for ED visits started.

Patients have to sign something saying they will cover the cost of what ever treatment is given if insurance denies or if they have no coverage. Illegal or not some of those folks never pay. In our state it is heavily in skewed- the legal residents being the non-payers.

People do not get total care in the ER. They get just enough so they aren't going to die or have permanent damage and referred out to either their primary or a specialist for management.

I haven't read much of the earlier draft bills, nor do I plan to at this point. I'll wait until the final bill comes out. I wish I could say I'll read all/most of it, but assuming it is another monster (size wise) of a bill, I'll likely only try to read portions of it. I wish we could make Congress write bills that are short and to the point and not filled with govermentese or legalese. Whether anything about illegal aliens is included in the bills that have come out previously, I can't say. Even if the final bill excludes coverage of illegal aliens per se, I don't think that will end the issue. I think there is concern from the Reps that Obama and the Dems might grant amnesty to all illegal aliens down the road, thus making them legal, and getting them coverage that way. I think that is a legitimate concern.

I have a hard time with this slippery slope thing. We always hear it but I still haven't had anyone give an example where it actually happened. If it says it won't cover the illegals then OK to that. Fight amnesty on another day.

The gist of it is that anything that is written cannot actually prevent illegals from receiving care since there is no mechanism set up to check status. The other bit is that it'll be mandatory for any person who has been in the US X months to sign up for something... thus putting illegals into the system.As with a lot of these bills, the devil is in little legal landmines. There's a reason much of this text has been done up under the cover of night several months before this debate ever started. When you're determined to get things by hook or by crook you'll come up with a lot of ways to disguise what you wanted to do all along.

This is an ER. How in God's earth is a health care person supposed to worry about whether someone is legal when they are in extremis? Yes there are idiots that go for a cold or a hang nail but by definition those patients that are there are there because they feel they have an 'emergency'. They might not stop to remember their license or other proof when they just sawed off their finger. Last time I checked no one has legal or illegal tattooed onto their chest.

If the person is in the US for X months they need to sign up- to me addressed the folks on visas, work permits etc. Otherwise if they show up without coverage- nightmare ensues. This is why all the Canadian hockey players at school are required to carry supplemental insurance when they are here.

If this is a bugaboo put in the bill 'legally here'. Either way the person is a human being. I would guess the percentage of people who come here illegally just so seek medical care is pretty low. Could you as a human being look at another human being and not treat a heart attack because you weren't sure they were supposed to be here? I would treat even if I knew the person is illegal. Morally and ethically if the person is in front of a health care person treatment is priority, not their status. Currently illegals get care because of this and the risk of legal action if the person might be legal after all. No bill would change that. Leave that junk to a piece of legislation addressing the immigration problem.

Anyone know the percentage of ER visits for illegals on the national basis? the southwest is getting slammed but I don't think this is a big percentage in most states.

 

[leswp1]

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

Oh, and thank you for answering seriously. Makes me understand why folks are upset.

 

[theprofromdover]

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

oh, and my two rx's that aren't generic now 'cost' $227.99 & $449.99 monthly according to cvs.

crazy!!!!

ponzi scheme... all y'all healthy folk subsidize me!

thanks.

Viagra and Cialis?

 

[huskyfan]

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

I What the righties are clinging to is that if illegals need treatment at the ER, presumably for a real emergency, the hospital won't turn them away - hence illegal care is being paid for by the govt.

this is already true - except it is paid for by those with health care.

 

[mookie1995]

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

No Jack. Them there give me some gawd awful headaches!!!

 

[MinnFan]

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

What I immediately wondered when the guy yelled lie (after I thought that O has a great Daddy look) was OK, if this is a lie then please point me to the portion of the bill that is saying it will cover the illegals. I would love to see snippets of the bill that refuted what O said. I really would love the R's to put out the parts of the bill quoted that they think are contradictory to the promises O made. Not saying this sarcastically. I kind of was hoping someone would have done that in here.

The R's tried to add to attachments to the house bills that would have specifically prohibited coverage for illegal aliens and coverage for abortion and they were voted down by the Dems.