Where do I go for that 'free' healthcare?

August · 04-07-10, 02:33 PM

Quote:

Originally Posted by Zachstar

When it comes to health they had a crap poor record at even trying. What are you saying anyway? Public option got stripped.

So what exactly is this massively expensive bill going to actually accomplish then?

tater · 04-07-10, 02:44 PM

This bill addresses none of the real issues facing healthcare delivery in the US. AFAIK, it's to try and liberalize the electorate by making as many as possible beholden to the state, nothing more.

It piles more people on medicaid—a system that only exists by mandate, and pays so little that providers actually lose out of pocket money to treat them.

It does zero to encourage "conservative care," and in fact, since medicaid dirtballs are more likely to sue, AND medicaid pays so poorly, it actually encourages needless tests, etc, to try and run the bill up to offset the other losses.

Since the bill mentions adding more primary care docs (by magic!), but not specialists, it does not address the critical shortage of specialists. No offense to any primary care guys who might be here, but face it, you see your primary care doc when you have either nothing wrong with you, or 99% of the time, self-limiting stuff (meaning it gets better with no care at all). More GPs, contrary to claims of "preventative care" doesn't really help, you need more specialists. Instead, we have more deadbeats (medicaid) for the same number of specialists—that means longer waits. That's fine unless you have something time critical, then I guess you get to take one for the team unless you are lucky enough to be personal friends with enough specialists that you can always get squeezed in.

Actually, that might help increase the number of docs—if you want decent care for your own family, go to medical school!

BTW, the US system—warts and all—has better outcomes than anywhere else when you look at metrics not confounded by lifestyle, etc.

tater · 04-07-10, 02:46 PM

Actually, you don;t have to buy insurance. This has been shown in Mass, actually.

The fine imposed is less than insurance. The law disallows charging people more WHO SHOULD BE CHARGED MORE (preexisting conditions SHOULD BE CHARGED MORE).

So pay the minimal fine, then insure yourself AFTER you become actually ill.

Profit!

Zachstar · 04-07-10, 02:45 PM

Quote:

Originally Posted by August

So what exactly is this massively expensive bill going to actually accomplish then?

Force them to try

tater · 04-07-10, 02:46 PM

Quote:

Originally Posted by Zachstar

Force them to try

ROFL.

How?

Be precise, since clearly you've read, and understand the bill.

GoldenRivet · 04-07-10, 02:48 PM

Quote:

Originally Posted by tater

since clearly you've read, and understand the bill.

Not

Zachstar · 04-07-10, 02:49 PM

The Preexisting crap stuff being handled in forcing them to try. Heck maybe now that they don't need the army of insurance issue finders (To deny coverage) Maybe they can invest some of that money in say reducing costs! Nah that wont happen but atleast the preexisting crap is going.

GoldenRivet · 04-07-10, 02:59 PM

hey Zach,

as i said before... the pre-existing condition stuff was a step in the right direction, but...

A. there is a lot of pet project "fat" to trim off this bill

and

B. they should not force any citizen to buy anything under duress... its nonsense.

BO came to within a gnat's nuts of having full bipartisan support on this thing but they got too carried away and added too much fluff and too little substance.

If there were probably 5 or 6 big ticket items cut out of this thing... i would be all over this thing with support.

but lets use an analogy

Silent Hunter 5's Online DRM is to the Gamers

as

The health care bills requirment to buy is to me

agitating, irritating, intrusive... etc etc

Zachstar · 04-07-10, 03:02 PM

I will put it this way the ending of preexisting as well as the diseases caught early and treated quickly instead of festering outweighs the bad parts of the bill.

tater · 04-07-10, 03:14 PM

Quote:

Originally Posted by Zachstar

I will put it this way the ending of preexisting as well as the diseases caught early and treated quickly instead of festering outweighs the bad parts of the bill.

No it doesn't IMO. How? Be specific.

Prexisting premium increases help keep the insurance business afloat—you do realize that insurance profits are only 1-2% of total healthcare expense in the US, right? They could operate not for profit, and it would do almost nothing to costs in the US.

Treated quickly? The vast majority of those who are without coverage are without coverage BY CHOICE.

This bill simply plops them into medicaid, or forces them to buy into some insurance. Yes, people who have it use it more. How does this catch disease early? Disease that matters, that is. Catching self-limiting stuff doesn't help, it actually hurts since it wastes provider time (and typically results in empirical care—dosing with antibiotics for every damn thing). Since the providers that are already stretched thin have XX% more patients, waits are longer.

Hmm, that timely care thing isn't looking so good.

As for REAL medical problems, primary care doesn't actually catch them early. Something has to present to be caught, and the people most capable of noticing early are the specialists. Doing testing—say PSA testing—has not been shown to actually improve outcomes overall, it just costs money. It's done a lot as defensive medicine, though (CYA, don't get sued). When you do present with, say, rectal bleeding, to your GP, you've just wasted a GP visit, when you really need to see a gastroenterologist. If you had no insurance at all, you'd likely have headed to the ER when you were bleeding out yer ass, right? Guess what, ER doc would have called the gastroenterologist on call. Zero difference.

tater · 04-07-10, 03:00 PM

Preexisting CRAP?

What is insurance? The idea is that people pay in who are healthy, gambling that if they ever get really sick they will come out ahead. The whole point is that this must NOT BE TRUE for the majority.

People with preexisting conditions SHOULD PAY MORE as they are demonstrably a higher risk.

If you are a professional climber, for example, you should pay more for trauma coverage. Ditto a race car driver. Why should someone who is far more likely to use care not pay more?

This is where the republicans derail, frankly, since no one wants to say that mom should have to pay more because she had bilateral breast cancer 10 years ago. Guess what, she should have to pay more, she's at far higher risk. (my mom was in this position, but guess what, it was fair)

You know what actually controls costs well?

HMOs.

Everyone HATED the HMO period when it was the new thing, and it's largely gone away, but look at the stats, it worked.

No one wants a real solution, they all want something for nothing.

04-07-10, 02:49 PM	#7
Zachstar Sea Lord Join Date: Feb 2005 Location: Shreveport, Louisiana Posts: 1,956 Downloads: 13 Uploads: 0	The Preexisting crap stuff being handled in forcing them to try. Heck maybe now that they don't need the army of insurance issue finders (To deny coverage) Maybe they can invest some of that money in say reducing costs! Nah that wont happen but atleast the preexisting crap is going. __________________

04-07-10, 02:59 PM	#8
GoldenRivet Subsim Aviator Join Date: Mar 2007 Location: Texas Posts: 8,729 Downloads: 146 Uploads: 0	hey Zach, as i said before... the pre-existing condition stuff was a step in the right direction, but... A. there is a lot of pet project "fat" to trim off this bill and B. they should not force any citizen to buy anything under duress... its nonsense. BO came to within a gnat's nuts of having full bipartisan support on this thing but they got too carried away and added too much fluff and too little substance. If there were probably 5 or 6 big ticket items cut out of this thing... i would be all over this thing with support. but lets use an analogy Silent Hunter 5's Online DRM is to the Gamers as The health care bills requirment to buy is to me agitating, irritating, intrusive... etc etc __________________

04-07-10, 03:02 PM	#9
Zachstar Sea Lord Join Date: Feb 2005 Location: Shreveport, Louisiana Posts: 1,956 Downloads: 13 Uploads: 0	I will put it this way the ending of preexisting as well as the diseases caught early and treated quickly instead of festering outweighs the bad parts of the bill. __________________

04-07-10, 02:44 PM	#2
tater Navy Seal Join Date: Mar 2007 Location: New Mexico, USA Posts: 9,023 Downloads: 8 Uploads: 2	This bill addresses none of the real issues facing healthcare delivery in the US. AFAIK, it's to try and liberalize the electorate by making as many as possible beholden to the state, nothing more. It piles more people on medicaid—a system that only exists by mandate, and pays so little that providers actually lose out of pocket money to treat them. It does zero to encourage "conservative care," and in fact, since medicaid dirtballs are more likely to sue, AND medicaid pays so poorly, it actually encourages needless tests, etc, to try and run the bill up to offset the other losses. Since the bill mentions adding more primary care docs (by magic!), but not specialists, it does not address the critical shortage of specialists. No offense to any primary care guys who might be here, but face it, you see your primary care doc when you have either nothing wrong with you, or 99% of the time, self-limiting stuff (meaning it gets better with no care at all). More GPs, contrary to claims of "preventative care" doesn't really help, you need more specialists. Instead, we have more deadbeats (medicaid) for the same number of specialists—that means longer waits. That's fine unless you have something time critical, then I guess you get to take one for the team unless you are lucky enough to be personal friends with enough specialists that you can always get squeezed in. Actually, that might help increase the number of docs—if you want decent care for your own family, go to medical school! BTW, the US system—warts and all—has better outcomes than anywhere else when you look at metrics not confounded by lifestyle, etc.

04-07-10, 02:46 PM	#3
tater Navy Seal Join Date: Mar 2007 Location: New Mexico, USA Posts: 9,023 Downloads: 8 Uploads: 2	Actually, you don;t have to buy insurance. This has been shown in Mass, actually. The fine imposed is less than insurance. The law disallows charging people more WHO SHOULD BE CHARGED MORE (preexisting conditions SHOULD BE CHARGED MORE). So pay the minimal fine, then insure yourself AFTER you become actually ill. Profit!

04-07-10, 03:00 PM	#11
tater Navy Seal Join Date: Mar 2007 Location: New Mexico, USA Posts: 9,023 Downloads: 8 Uploads: 2	Preexisting CRAP? What is insurance? The idea is that people pay in who are healthy, gambling that if they ever get really sick they will come out ahead. The whole point is that this must NOT BE TRUE for the majority. People with preexisting conditions SHOULD PAY MORE as they are demonstrably a higher risk. If you are a professional climber, for example, you should pay more for trauma coverage. Ditto a race car driver. Why should someone who is far more likely to use care not pay more? This is where the republicans derail, frankly, since no one wants to say that mom should have to pay more because she had bilateral breast cancer 10 years ago. Guess what, she should have to pay more, she's at far higher risk. (my mom was in this position, but guess what, it was fair) You know what actually controls costs well? HMOs. Everyone HATED the HMO period when it was the new thing, and it's largely gone away, but look at the stats, it worked. No one wants a real solution, they all want something for nothing.