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

[SonofSouthie]

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

There are a lot of similarities to our country. The emergency department is filled with people who are told the specialist they want to see is a 2+ month wait.

Emergency room also filled with people that have a cold but they have Mass Health so they don't have to wait to see their PCP or cough up(pun intended) a co-pay.

 

[Jimjamesak]

I have never experienced anything like that here.

How about not being able to see the only specialist in your state because he's not in your insurance network and you can't afford the upfront cost? (Happening with my wife)

 

[busterman62]

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

Emergency room also filled with people that have a cold but they have Mass Health so they don't have to wait to see their PCP or cough up(pun intended) a co-pay.

Since Pence has joined forces with tDonald most will think he and his policies are evil too. However, this is an interesting experiment. Time will tell if it's successful or not but a 42% drop in ER visits is amazing.

 

[walrus]

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

.

My primary care doctor's office called a few weeks ago to say it's time for my yearly checkup. They were booking in November. For a primary care doctor. (who I need to change anyway because I moved and now it takes too long to get to his office.)

is that Doctor affiliated with EMMC, I'd bet on it.

 

[walrus]

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

Since Pence has joined forces with tDonald most will think he and his policies are evil too. However, this is an interesting experiment. Time will tell if it's successful or not but a 42% drop in ER visits is amazing.

Did I miss something? What did pence do to get that drop?

 

[WisconsinWildcard]

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

I have never experienced anything like that here.

It varies greatly by specialty and by area. When I was back in Wisconsin, it was a 3-4 month wait at minimum to see a pediatric neurologist. In Cleveland, there are three large health systems and there is a lot of fractured care (people seeing specialists from all three systems) because of different wait times for different specialties.

 

[busterman62]

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

Did I miss something? What did pence do to get that drop?

It's kind of in the linked article. (Just looked and see I didn't highlight it. here it is again: http://khn.org/news/in-conservative-indiana-medicaid-expansion-makes-poorest-pay/ )
TLDR version: Medicaid Pts have a flex spending account. They have to contribute their own $ based on income. Can upgrade coverage with PCP visits and screening. Can lose upgrade and coverage for missing appts, not paying in, inappropriate utilization, etc. Providers are paid a competitive rate and paid rapidly.

 

[William Blake]

I like the state by state approach because you can individualize it to see what works. Since VT tried single payer a few years back, would love to see them for example apply some lessons learned and take the lead on state based public option. Mass could do it I suppose but we already lead the nation in coverage. Also, I think the latest effort here is on efficiencies since expansion is now a done deal.

We've got a bill or proposition on the ballot in Colorado this year for single payer, I think. Not sure if it'll pass, though, it's an easy thing to scare people away from trying

 

[FreshFish]

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

We currently have the most expensive healthcare in the world. What we have now is a money pit.

That is a bit misleading because you are not correlating cost to quality.


To some extent, parts of healthcare are a luxury item: in other countries, you have a hip problem, you get a cortisone shot and a bottle of advil. Here, you get a hip replacement. The latter is much more expensive than the former, but if it was your hip and you had the money available, which would you choose?


People complain that healthcare is too expensive yet wail and gnash their teeth when you try to restrict usage, which is how the governments in single-payor plans reduce costs.

It is a phantom reduction: maybe the cost in dollars goes down, the real cost is incurred through waiting longer to see someone and suffering much more in the interim.

 

[Kepler]

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

We've got a bill or proposition on the ballot in Colorado this year for single payer, I think. Not sure if it'll pass, though, it's an easy thing to scare people away from trying

Colorado seems like Oregon. Camel distribution with one hump of educated liberals and another hump of rural conservatives, and not much else. In OR the war is over: the liberals won. CO still seems to be teetering, but you'll get there soon.

 

[Kepler]

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

People complain that healthcare is too expensive yet wail and gnash their teeth when you try to restrict usage, which is how the governments in single-payor plans reduce costs.

Every system restricts usage. The profit model system rations health care based on how poor you are. Oddly, many people find this immoral.

 

[cF[Authentic]]

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

Colorado seems like Oregon. Camel distribution with one hump of educated liberals and another hump of rural conservatives, and not much else. In OR the war is over: the liberals won. CO still seems to be teetering, but you'll get there soon.

I'm no expert in Colorado politics but traditionally, you'll have Boulder, Denver and some of the suburbs vote Democrat and then some other suburbs, Colorado Springs (2nd largest city) and all the rural areas go conservative. It's not as city vs rural as you'd expect. There are a lot of "educated" conservatives in both Colorado Springs and Denver.

I'm glad you followed through with your bias of liberals are all educated and conservatives must be rural hicks.

 

[Kepler]

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

I'm no expert in Colorado politics but traditionally, you'll have Boulder, Denver and some of the suburbs vote Democrat and then some other suburbs, Colorado Springs (2nd largest city) and all the rural areas go conservative. It's not as city vs rural as you'd expect. There are a lot of "educated" conservatives in both Colorado Springs and Denver.

I'm glad you followed through with your bias of liberals are all educated and conservatives must be rural hicks.

Always happy to oblige.

There are plenty of educated conservatives, if for no other reason than education correlates with wealth and many wealthy people seek ways of rationalizing them not helping others. Conservatism provides many such exonerations. A few of them aren't even all that transparent.

 

[Handyman]

I'm no expert in Colorado politics but traditionally, you'll have Boulder, Denver and some of the suburbs vote Democrat and then some other suburbs, Colorado Springs (2nd largest city) and all the rural areas go conservative. It's not as city vs rural as you'd expect. There are a lot of "educated" conservatives in both Colorado Springs and Denver.

I'm glad you followed through with your bias of liberals are all educated and conservatives must be rural hicks.

Maybe if the conservative leadership didn't have the IQ of a sugar beet he wouldn't have a point

 

[5mn_Major]

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

It varies greatly by specialty and by area. When I was back in Wisconsin, it was a 3-4 month wait at minimum to see a pediatric neurologist. In Cleveland, there are three large health systems and there is a lot of fractured care (people seeing specialists from all three systems) because of different wait times for different specialties.

This is true, even in Minnesota. If you're looking for a visit to a family doctor, its this week. If you're looking for a visit to a highly qualified specialist in many fields its 3 months. That can include areas like nephrology and even dermatology.

I'm no expert in Colorado politics but traditionally, you'll have Boulder, Denver and some of the suburbs vote Democrat and then some other suburbs, Colorado Springs (2nd largest city) and all the rural areas go conservative. It's not as city vs rural as you'd expect. There are a lot of "educated" conservatives in both Colorado Springs and Denver.

I'm glad you followed through with your bias of liberals are all educated and conservatives must be rural hicks.

This is largely true. I would say 'rural areas' are split into mountain resorts and the rest. Mountain resorts of Aspen, Vail, etc are liberal (rich limosine liberals and ski bums who toy with pot) and other rural CO areas are like neighboring Kansas.

 

[brookyone]

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

This is true, even in Minnesota. If you're looking for a visit to a family doctor, its this week. If you're looking for a visit to a highly qualified specialist in many fields its 3 months. That can include areas like nephrology and even dermatology.

I have never experienced the extended wait times I hear so many complain about. Including a Nephrologist, Dermatologist, Endocrinologist, Cardiologist, and Oncologist. Three weeks...the longest I've waited. This, all at the U of M Fairview Med Center on campus.

 

[dxmnkd316]

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

The longest I had to wait was three months. But that's ok since it's a recurring, six-month appointment and my doctor went down to just Mondays so she could get back into teaching.

 

[5mn_Major]

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

I have never experienced the extended wait times I hear so many complain about. Including a Nephrologist, Dermatologist, Endocrinologist, Cardiologist, and Oncologist. Three weeks...the longest I've waited. This, all at the U of M Fairview Med Center on campus.

I had two nephrologists, a Mayo visit, and a dermatologist that frankly averaged about 2 months (none through the U of M). Not saying anything about your doctors...but I do my research and perhaps its that these were top of their field physicians.

 

[brookyone]

I had two nephrologists, a Mayo visit, and a dermatologist that frankly averaged about 2 months (none through the U of M). Not saying anything about your doctors...but I do my research and perhaps its that these were top of their field physicians.

Well... that's the consensus regarding all those I saw at U of M as well. For critical care, we all do our research...I hope. I have also been a patient at Mayo. A great staff. They all know their colleagues in their fields of at U of M and respect each others abilities and k knowledge.

 

[FlagDUDE08]

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

I have never experienced the extended wait times I hear so many complain about. Including a Nephrologist, Dermatologist, Endocrinologist, Cardiologist, and Oncologist. Three weeks...the longest I've waited. This, all at the U of M Fairview Med Center on campus.

Specialist waits are awful in Central NY; heck PCP waits are bad. It's what happens when administration has been shoved down the practitioners' throats for the last 50 or so years (even before the PPACA), combined with business-unfriendly NYS and a not-so-rural area, you're gonna have a bad time.

Might as well also mention Emergency Rooms are bad, too. I can't remember the last time I went to a hospital and they weren't over-filled (FlagDUDETTE calls it a code white, though I think it may have a different meaning...)