America's Affordable Health Choices Act of 2009 - The USCHO debates

[ScoobyDoo]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Who knows? The WH has lost control of the message, and it's starting to lose complete control of the issues.

I'd say they have lost control of it. I'd be shocked if it passes now.

 

[The Sicatoka]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

"Thank God for Obama. He's looking out for us."

Statements like that give easy follow to comparisons between the Orwellian "Big Brother" and Mr. Obama.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

So, why did Obama keep saying the AARP endorses the bill when it doesn't? Why lie like the other side does?

Dumb.

A little splitting of hairs here. From this link, it appears they're endorsing the effort to reform the present system.

http://assets.aarp.org/www.aarp.org_/articles/legislative/204378HCR.pdf

There isn't an overall bill yet to endorse. However, if the AARP doesn't like him saying that, I imagine its in their power to issue a correction.

 

[ScoobyDoo]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

A little splitting of hairs here. From this link, it appears they're endorsing the effort to reform the present system.

http://assets.aarp.org/www.aarp.org_/articles/legislative/204378HCR.pdf

There isn't an overall bill yet to endorse. However, if the AARP doesn't like him saying that, I imagine its in their power to issue a correction.

Well, they have issued the correction. That's why I'm mentioning it today.

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

"Thank God for Obama. He's looking out for us."

Statements like that give easy follow to comparisons between the Orwellian "Big Brother" and Mr. Obama.

You're against poor kids getting private money, and then some govt money, to buy school supplies? Is there a particular reason why you're so bitter?

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Well, they have issued the correction. That's why I'm mentioning it today.

Problem solved then.

 

[The Sicatoka]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Camille Paglia, far from a tin-hat W-lovin' righty as some would cast their worthy opponents, nails the problem:

.. I must confess my dismay bordering on horror at the amateurism of the White House apparatus for domestic policy. When will heads start to roll? ... Obama seems to be surrounded by juvenile tinhorns, bumbling mediocrities and crass bully boys.

I'm guessing the "amateurism of the ... juvenile tinhorns, bumbling mediocrities and crass bully boys" thought their minor one-off statement about AARP in Mr. Obama's speech would go unnoticed.

Instead, the "juvenile tinhorns, bumbling mediocrities and crass bully boys" have raised the ire of a key constituency, the AARP. Whups.

 

[The Sicatoka]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

You're against poor kids getting private money, and then some govt money, to buy school supplies? Is there a particular reason why you're so bitter?

I'm glad the kids got money for schools supplies. I was part of a campaign for that where I live.

I'm not seeing this near dieification of Mr. Obama as a good thing. He's President, not a god or savior as some so seem to want to see him.

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I'm glad the kids got money for schools supplies. I was part of a campaign for that where I live.

I'm not seeing this near dieification of Mr. Obama as a good thing. He's President, not a god or savior as some so seem to want to see him.

But... school supplies for the poor HAVE to come from the government. They can't come from private sources.

So Obama kind of is a god. Probably not THE God, but at least A god.

 

[ScottM]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

But... school supplies for the poor HAVE to come from the government. They can't come from private sources.

Most teachers I know end up forking over their own money to buy supplies for their students since their parents cannot, or will not in some cases, buy basics like pencils, paper, etc. Perhaps the DOE and/or school districts should set up exclusive arrangements with Target, WalMart, etc. to offer "group discounts" or cut rate programs instead of relying on teachers to fill the gaps.

 

[Handyman]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Most teachers I know end up forking over their own money to buy supplies for their students since their parents cannot, or will not in some cases, buy basics like pencils, paper, etc. Perhaps the DOE and/or school districts should set up exclusive arrangements with Target, WalMart, etc. to offer "group discounts" or cut rate programs instead of relying on teachers to fill the gaps.

Yes they do and since teachers make so much it doesn't put a dent in their pocketbook at all. I don't see where the problem is...the kids need supplies so the government helped them out...since they didn't have what they needed it would seem obvious the teachers couldn't help and other private options weren't helping either. Is it really so bad they got the kids some frigging pencils and notebooks? (The Deification of Obama is annoying so I just ignore)

And I love how according to some offering a public option is akin to 1984...that is so patently ridiculous I don't know what to say. It is no more 1984 than wiretapping everyone and having access to all our emails and correspondence and on the off chance we are all terrorists where was your outrage then? We started down this path a long time ago Obama didn't start it.

I am pretty sure Bob Dole supported the movement in 1993 (he was helping Clinton write it) and didn't he run for president under the flag of the GOP? Weird...

 

[Rover]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

I'm not seeing this near dieification of Mr. Obama as a good thing. He's President, not a god or savior as some so seem to want to see him.

I'm not sure one person being thankful for getting school supplies that they otherwise couldn't afford = a beatification movement for President Obama, but okay...

But... school supplies for the poor HAVE to come from the government. They can't come from private sources.

So Obama kind of is a god. Probably not THE God, but at least A god.

I've long since given up the notion that you actually take the time to read and then comprehend, but money DID come from a private source - Soros, as the article clearly states. You really need to stop lobbing up softballs over the plate for me to slam over the fence.

 

[streaker]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

So long as it also doesn't have tax dollars for its initial setup costs, salaries, capital expenditures, real estate purchases, etc, then it wouldn't. But I guess the public option has died anyway, so it's moot.

Well, maybe, maybe not. Who determines the regulatory body overseeing these things? Who does it for the private sector? I am always leery of the fox making up the rules for the henhouse, let alone living in the same complex. The private sector has to "ask" for rate increases, typically to a state insurance commission. Who would the gov't ask, or would they just divert funds from somewhere else... like what has happened to the social security funds...?

 

[Kepler]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

"Thank God for Obama. He's looking out for us."

Statements like that give easy follow to comparisons between the Orwellian "Big Brother" and Mr. Obama.

OMG, this is totally unprecedented!

 

[The Sicatoka]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

OMG, this is totally unprecedented!

That's just as sickening.

 

[leswp1]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Haven't read much of this and none since a few weeks ago. Have to rant somewhere and this seems the appropriate place.

I work in healthcare- have done for ~30 yrs and now am in Primary care. I am not sure what "the Bill" is selling anymore because there are so many people trying to tweak it. I do have some thoughts on the way things are being distorted and the PR/propaganda thing is humming to the general public.

-Why is everyone ranting about rationed healthcare and the government controlling what we can do???? We presently have that. The insurance companies have control and the patient is paying them to have the rationing. Costs are going up exponentially (personally we have seen our coverage significantly decrease and are paying 2/3rds more than a yr ago) If you are rich or poor you get medical coverage. If you are the avg Joe you might get it.

-I work as a primary healthcare provider in a suburb. On some days more than 50 % of my mostly nice white middle class patient population can not afford to do what I tell them. They can't get the meds, they can't afford copays for specialists, tests, they can't afford to take time off of work, etc. Many times they wait until they are in crisis before they come back. These are working stiffs.

-Massachussetts plan is failing. The folks that used to save money for appts now shell out 350 (most closer to 600) a month for a plan that has mostly catastrophic coverage because it has a 3000$ deductible. I know of one person who is opting to pay the fine at the end of the year because it is less expensive than the coverage and she is more able to pay her costs without insurance. Can't make ends meet if she gets the required coverage. In my area there is one primary care practice taking new patients. The primaries are inundated and the resources to care for the influx as well as the availability of appts for many specialists are at a premium. They shoved this thru so Romney would look good but no one thought of the consequences without getting stuff in place.

-I routinely spend a few hours a week (I only work part time) filling out pages of paperwork for insurance companies about meds that are required. Sometimes they send 2 or 3 layers of paperwork before I get an answer. Formularies change every 3-6 months. Meds are on and off formularies because of deals between the pharma companies and insurance. They are not always on there because of evidence based meds. The paperwork is not standard. For some insurances they have multiple forms for different medications. Just getting the right form can be a challenge and most assuredly delays when the insurance pays out. I routinely prescribe generics but there are times when there aren't any that will manage the problem or the patient has a reaction.

I have had an insurance company (Fallon) tell me they would not approve a med because they had not deemed it safe. The patient was unable to tolerate all other meds in the class and was surviving on what samples I could supply. The drug in question was FDA approved and had been for months. My only recourse was to provide the patient with the name of the person rejecting them.

Another patient was started on insulin using a 'pen'. They switched insurances. The new insurance refuses to pay for the pen even tho it is cost neutral. The patient now needs to come in to learn how to measure out insulin in a syringe and use one which means extra cost for the patient, and the insurance company. It also means more waste- difficulty with disposing of the syringes, multiple supplies etc.

-The local PHO (physician hospital organization)just cut a deal with BlueCross that makes it literally impossible for patients to go out of network (they must see local specialist) even denying referrals for patients who have longstanding relationships with specialist who are out of network. This is unprecedented. Breaching an established relationship has never been done routinely before. There is no medical basis for this the only reason is cash flo.

- what is the shiz about the death committees? First- Medicaid already requires us to have on record a health care proxy. If you discuss that without talking about end of life issues you are not doing your job. Why is Palin trying to make out medical providers as puppets. We spend countless hours fighting the insurance for care, why would we be trying to deny it. Many hospitals have ethics boards that discuss questionable cases already.

-Many insurances are using HEDIs measures. They withhold part of the reimbursement until the end of the yr and 'grade' on certain measures. This may be well meant- they are measures that look at stuff like did the patient have a mammogram, did they have certain lab tests, screening tests that would be good care for their dx. This is all grand but if the patient willfully does not follow thru then the provider doesn't get paid even if they have hounded the patient daily (excellent use of resources, why is the patient not responsible for refusing to follow thru?) and documented it. There is great concern that these patients that are non-compliant are going to be 'fired' from practices that cannot absorb the cost. They can be let go for breach of pt/Dr relationship as they are not willing to follow advice.

-Mass is also allowing capitation- you get X dollars for each patient in a flat rate. If they see you 0 times you make out but if they come 100 times you are way in the hole. This has, in the past, caused practices to screen out complex patients or to find ways to get rid of them because they are so costly.

-Many insurance plans no longer cover an annual exam or screening tests. They do however dock us if the patient does not have the exam or do the screening recommended.

So- I have no idea what to do to fix this stuff but I would love if people would stop the idiotic and spouting crud about socialism and not being like Canada and throwing out everything that is being considered.

Why not actually stop complaining long enough to consider we are in big trouble. A large segment of our population is unserved/underserved for medical care that is standard in most industrialized countries. We are aging and the accuity of illness we are seeing is rising exponentially. We have no education to help people to prevent stuff- classes in health, nutrition and gym are being cut. More people cannot afford prevention measures so the population of people that are medically in trouble is not going to diminish. Folks can't help themselves when they don't even know the basics of prevention.

You might believe that it is each individuals responsibility to care for themselves but those that don't or can't cost us all. If they present sicker they use way more resources, they take more time to take care of, they fill hospital beds, they clog ERs. All this affects you if you need care and can't get a bed, an appt with a specialist, a test scheduled etc. (sickest get precedence)

If we are such a brilliant country why do we have people telling us it is impossible to solve something before we even begin to try. And now I am off to work to deal with it all again....

(whew that felt good to get off my chest)

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

So- I have no idea what to do to fix this stuff but I would love if people would stop the idiotic and spouting crud about socialism and not being like Canada and throwing out everything that is being considered.

You aren't fooling anyone, Barack.

If we are such a brilliant country why do we have people telling us it is impossible to solve something before we even begin to try.

Or, on the reverse, people telling us this is the only way and people who are against it are either just racist or in the pocket of some "special interest."

 

[Patman]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

-Why is everyone ranting about rationed healthcare and the government controlling what we can do???? We presently have that. The insurance companies have control and the patient is paying them to have the rationing. Costs are going up exponentially (personally we have seen our coverage significantly decrease and are paying 2/3rds more than a yr ago) If you are rich or poor you get medical coverage. If you are the avg Joe you might get it.

Government does so by the point of a gun... private insurance just won't pay for you... there are options in private insurance.

- what is the shiz about the death committees? First- Medicaid already requires us to have on record a health care proxy. If you discuss that without talking about end of life issues you are not doing your job. Why is Palin trying to make out medical providers as puppets. We spend countless hours fighting the insurance for care, why would we be trying to deny it. Many hospitals have ethics boards that discuss questionable cases already.

The gov'ts priority is to decrease costs to a level the tax payer will accept. Seeing as what we accept will shift what you will see is the rationing of those high end costs. Obama talked about the utility of his own grandmother's hip surgery with the implication that he'd do it for his grandmother but it might be stupid to do it for yours and it might be stupid to do it for you, Zeke Emmanuel (Rahm's brother) talks about in the forms of life-years. To call them "death committees" is accurate... these will be the boards that decide that your life is too expensive to maintain and deny access to treatment X. The Public Option will become supreme because that's what the dems need it to be so there'll be very little option other than the gov't so denied access will likely be denied access.

The worry about her little child is that, like you, the child is not a senior citizen YET. There will be open talk about the pragmatism of weighing the "quality of life" and I'm sure one of those will be the quality of life of the mentally handicapped. We've already seen it argued that such children are a burden on society. WE'VE ALREADY SEEN IT ARGUED THAT THIS SPECIFIC CHILD IS A DE FACTO BURDEN ON SOCIETY. The fact is old people are a financial burden but its one we accept right now because of own desires and our morals system. Government is often much colder than this dependent on the "just doing my orders" mentality or owing to specific cold realities or ideological pronouncements.

Of course they won't be called "death panels" nobody would call it that and nobody would want to call themselves that... Britain has NICE boards and the US legistlation also calls the program NICE but the words specifically means different things. To reign in costs those "tough decisions" will be made whether people like them or not. Those "tough decisions" will be made by the government. Similarly, there's items in the bill which stress DNRs and other matters.... what happens if its in the gov'ts interest to not generate costs and one manner of cutting costs is to insist on DNRs for those over a certain age as the numbers tell them the costs are not worth it.

Pay attention to what they say because they've been talking in these terms for years. The difference is that they're OK with this system and terminology because they've decided its morally ethical to the state and to their fellow man. After all, they're the knowledgeable pragmatists that are trying to save us.

 

[ScoobyDoo]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

You aren't fooling anyone, Barack.


Or, on the reverse, people telling us this is the only way and people who are against it are either just racist or in the pocket of some "special interest."

Wow. A nice comprehensive posting like that and you decide to go gutter ball. I guess I shouldn't be surprised.

 

[Red Cloud]

Re: America's Affordable Health Choices Act of 2009 - The USCHO debates

Wow. A nice comprehensive posting like that and you decide to go gutter ball. I guess I shouldn't be surprised.

I cracked a joke and offered an addition. I guess that's "gutter ball" to someone who lives with his head in the gutter.