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The PPACA Thread Part III - Let's have a healthy debate!

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

WWC: My only experience with the Whipple procedure was assisting on a case performed back in the late 60's at Albany Medical Center (not because I knew anything but simply because I was the only one available). It lasted so long that I became hypoglycemic holding retractors and passed out falling backwards to the floor. My areas of expertise are as far removed from that surgery as one could imagine but i would not think ti to be something to attempt unless absolutely necessary.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

DrDemento said:
WWC: My only experience with the Whipple procedure was assisting on a case performed back in the late 60's at Albany Medical Center (not because I knew anything but simply because I was the only one available). It lasted so long that I became hypoglycemic holding retractors and passed out falling backwards to the floor. My areas of expertise are as far removed from that surgery as one could imagine but i would not think ti to be something to attempt unless absolutely necessary.
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In medical school, one of the surgeons did 1-2 Whipples a week. When you were in his case, he would welcome you to the "game" and pimp you for 10+ hours straight about anything and everything. It was stressful at the time but in hindsight, quite the worthwhile activity. They are extensive operations which is why they are largely only done with curative intent, not palliative. However of the oncologists I work with, most will make a comment along the lines of "that is impressive" when they run across a patient 5+ years out from a Whipple 2/2 pancreatic cancer.

They were very aware of hypoglycemia during the long cases. If you showed any signs, you were told to leave, eat something, and come back. There were usually enough hands that one could scrub out and scrub back in without any delay.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Here we go again....

WASHINGTON—A federal judge on Wednesday allowed House Republicans to proceed with part of a lawsuit challenging the Obama administration’s implementation of the 2010 health-care law....

Judge Collyer said the House has legal standing to bring claims alleging the Obama administration was violating the Constitution in how it was paying for part of the ACA. The judge rejected the Obama administration’s argument that the court shouldn’t referee a political dispute between the other two branches of government.

“The mere fact that the House of Representatives is the plaintiff does not turn this suit into a non-justiciable political dispute,” she wrote in a 43-page decision....

The House lawsuit alleged the administration was defying Congress by paying insurance companies billions of dollars for discounts on deductibles they must offer to very-low-income consumers under the health law. Lawmakers said they never appropriated funds for the administration to do this.

Judge Collyer ... said the House had a core constitutional interest in protecting its role in authorizing the spending of public money, which gave it a right to proceed in court against the Obama administration. “Congress’s power of the purse is the ultimate check on the otherwise unbounded power of the Executive,” she wrote.
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(cross-post from SCOTUS thread)
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
Here we go again....




(cross-post from SCOTUS thread)
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You're willing to get astroglided a 3rd time! Fishy, I'm starting to think you're enjoying it. :D :D :D

Hmmm....this won't get to the SCOTUS most likely, but even if it did Roberts from his court rulings has become an outright advocate of the law. But I'll play along! How do you see him ruling on this Fishy, bearing in mind your track record on predictions ain't good.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Rover said:
Hmmm....this won't get to the SCOTUS most likely, but even if it did Roberts from his court rulings has become an outright advocate of the law. But I'll play along! How do you see him ruling on this Fishy, bearing in mind your track record on predictions ain't good.
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My track record actually is pretty good:
-- PPACA would be found unconstitutional under the commerce clause: it was (1 for 1)
-- I said nothing whatsoever about whether it would be constitutional under Congress' power to tax (not sure how to interpret this one, I was not wrong and neither was I right).
-- SCOTUS would uphold King v Burwell because too many people had already received subsidies and the Court would not ask them to pay the money back (2 for 2). I believe I used the term "scriveners' error" as the justification they would use, and that is exactly how it turned out.

You seem to mistake my understanding that the law is mathematically unsustainable with my expectations about how the Court will view it. Even Roberts, in upholding it, said it was a terrible law that couldn't possibly work!!

So far, this case has not been decided, so it is premature to make a prediction. Judge Collyer merely said that the lawsuit could proceed. There hasn't been any ruling yet, one way or the other. Let's see how the suit turns out first, and what the rationale is for the decision, and then we can make predictions. This one will get to SCOTUS unless the Democrats get a majority in the House in 2016.

the House had a core constitutional interest in protecting its role in authorizing the spending of public money, which gave it a right to proceed in court against the Obama administration. “Congress’s power of the purse is the ultimate check on the otherwise unbounded power of the Executive,” she wrote.
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Re: The PPACA Thread Part III - Let's have a healthy debate!

Officially got my 2 day Mayo executive check up covered 100% as its preventative. Saw about 10 doctors over two days. It looks like it will be positively life changing on several lifestyle fronts.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Kepler said:
https://www.youtube.com/watch?v=xECUrlnXCqk
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Hey! I know ;)

But it is seriously a major misconception among the general public. It makes for very challenging end of life conversations when the tragic happens. One generally has to correct a lot of preconceived notions before they can talk about the issue at hand. Often, you have to spend most of your time explaining complex medicine instead of focusing on how the family/friends are coping and what they need. Also makes organ procurement much more challenging.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

Insurance deductibles at work jumped from $1,300 to $1,500 for next year. Premiums flat for high deductible plans. PPO premiums went up.

Very high deductible plans saw their deductibles also jump $200.

Sounds like we have new prescription drug limits now. Could be interesting to see what those are. They said the letter was coming in October.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

dxmnkd316 said:
Insurance deductibles at work jumped from $1,300 to $1,500 for next year. Premiums flat for high deductible plans. PPO premiums went up.

Very high deductible plans saw their deductibles also jump $200.

Sounds like we have new prescription drug limits now. Could be interesting to see what those are. They said the letter was coming in October.
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One of the TV stations ran a report stating that MN gov't market rates are going up anywhere between 27% (forget which provider) to 49% (BCBS). You're likely seeing the group plan response to that same situation.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

St. Clown said:
One of the TV stations ran a report stating that MN gov't market rates are going up anywhere between 27% (forget which provider) to 49% (BCBS). You're likely seeing the group plan response to that same situation.
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One thing that is very frustrating about those kinds of news stories is that they don't provide any link between a change in prescription drug prices and the consequent change in healthcare costs down the line.

Effective medication for hypertension might easily be worth the increase in Rx costs if it works better and there are fewer side effects. Similarly with diabetes: people who have other health complications that result from ineffective management of their condition incur huge medical bills; a better diabetes medicine might well be worth it.




I am reminded of the old brain teaser which shows an apparently bad outcome at first glance which is really a fantastic improvement when you look at the overall big picture.

The British Army in WWI introduced an innovation. Head injuries increased by 2,000% as a result. They were elated at how well the innovation worked. What is the innovation?

Answer in white: Helmets. All those head injuries occurred to people who would otherwise be dead.
 
Re: The PPACA Thread Part III - Let's have a healthy debate!

FreshFish said:
One thing that is very frustrating about those kinds of news stories is that they don't provide any link between a change in prescription drug prices and the consequent change in healthcare costs down the line.

Effective medication for hypertension might easily be worth the increase in Rx costs if it works better and there are fewer side effects. Similarly with diabetes: people who have other health complications that result from ineffective management of their condition incur huge medical bills; a better diabetes medicine might well be worth it.

[/COLOR]
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Possible. As of several years ago anyway, 70 - 75% of health care costs were for treatment of chronic diseases.
 
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