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Medicare Patients - Vote, as if your life depends on it.

Fisher said:
Unless doctor pay is tamped way down, government provided healthcare will bankrupt the nation, but then people will not want to go into medicine if they are not making $250K a year. There are major systemic problems not being addressed by Obamacare.
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Requirements for doctors are too high?
 
lonewolf said:
Millions of americans will be effected by a little known part of the Obamacare that went into effect this week Hospitals will be fined big if too many of Medicare patients have to return to the hospital within 30 days. Many people do have to go back to the hospital for followup care.

Obamacare push the hospital to discharge the patient as soon as possible. The penalty is going to apply to all Medicare patients.

What about care? If the patient has pneumonia many times the hospital will send the patient home but it can get worse and pneumonia can kill you. If the pneumonia patient is sent home but if they get worse the the hospital is not allowed to re-admit the patient or the hospital will be fined for re-admitting the Medicare patient.

Anyone who post that Obamacare is good does not have a clue about healthcare.
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This morning I heard a former Doctor in charge of a Hospital go over this provision and his thoughts on it. He seemed to think that it's a good move in the right direction. That currently hospitals are penalized when they provide care that doesn't require return visits and are rewarded for not providing the best care on the first visit.
 
shiang said:
Requirements for doctors are too high?
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Cost containment v. depression of those entering the profession. The costs (i.e. salaries) have to be brought down to sustain the system but to do so will curb people wanting to enter the profession which would require both we cap pay and incentivize the professions with free tuition/grants etc. perhaps. Either way, the current system is unsustainable on the public side due to the economics of it, but who cares if the system is totally destroyed in 50 years just as long as I get mine.
 
If we pay down the tuition of med degrees then that cost is passed on to taxpayers. Simpler is to lower the requirement of simple family doctors that may not need to be the best doctors in the world.


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not related to previous post

Are you guys going to listen to the opinions of doctors and med students or politicians trying to destroy Obama at any cost?
 
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Fisher said:
Cost containment v. depression of those entering the profession. The costs (i.e. salaries) have to be brought down to sustain the system but to do so will curb people wanting to enter the profession which would require both we cap pay and incentivize the professions with free tuition/grants etc. perhaps. Either way, the current system is unsustainable on the public side due to the economics of it, but who cares if the system is totally destroyed in 50 years just as long as I get mine.
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So in no way do you think it's possible to provide healthcare to our whole population at affordable prices? When you look around the world other countries do it. Our system is the only one that's completely out of control regarding high cost and lack of coverage for so many people.
 
shiang said:
If we pay down the tuition of med degrees then that cost is passed on to taxpayers. Simpler is to lower the requirement of simple family doctors that may not need to be the best doctors in the world.
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Is it better to pay the tuition of a doctor once and pay him $65K per year or it better to repay that doctor year in a year out for that tuition? Unless salaries are capped, all the downward pressure on the money will come out of patient care before it will come out of the hospital/doctor pockets.
 
iliveonramen said:
So in no way do you think it's possible to provide healthcare to our whole population at affordable prices? When you look around the world other countries do it. Our system is the only one that's completely out of control regarding high cost and lack of coverage for so many people.
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How many of those systems are free market systems and how many of them have placed, among other things, wage caps? The government should control the industry completely or it should stay out of the business completely.
 
Fisher said:
How many of those systems are free market systems and how many of them have placed, among other things, wage caps? The government should control the industry completely or it should stay out of the business completely.
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The hospitals are free market. The doctors are free market. The only government controlled entity is who pays the bills (unless you'd prefer a private insurer). The government can use it's size to get better prices on drugs, visits etc. Just like any large company does. It's no different than Wal Mart who due to their size can tell a supplier "we'll pay you X" and do to their size and number of customers they represent the supplier generally will increase effeciency in order to provide goods at the price at a profit.

Obviously private insurers aren't adequately filling that role. Our Medical system is pretty ineffecient and wasteful.
 
Fisher said:
Is it better to pay the tuition of a doctor once and pay him $65K per year or it better to repay that doctor year in a year out for that tuition? Unless salaries are capped, all the downward pressure on the money will come out of patient care before it will come out of the hospital/doctor pockets.
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In the end it comes out to be about the same, as to make a doctor it's takes more than just tuition it takes a dedicated/talented individual. They would still cost a lot, maybe a little less but still a lot. A neurosurgeon getting paid $1 mill isn't going to all of a sudden be payed 64k just because the tuition is free. But I do strongly agree with paying down college tuition, especially for those who can't afford it. Not only for med school, but higher education in general should be affordable. Here's a good cause for tax payers and the nation as a whole should help pick up the tab.
 
iliveonramen said:
Obviously private insurers aren't adequately filling that role. Our Medical system is pretty ineffecient and wasteful.
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The way the government contains cost in the legal profession for instance, is two-fold: The government caps private counsel fees for court-appointed work or they hire the lawyers and cap their salaries through the way of direct employment. Either way, it is a cap. Why can there not be a similar system in medicine where government is even a bigger player in the provision of services to the poor than it is in law?
 
Fisher said:
The way the government contains cost in the legal profession for instance, is two-fold: The government caps private counsel fees for court-appointed work or they hire the lawyers and cap their salaries through the way of direct employment. Either way, it is a cap. Why can there not be a similar system in medicine where government is even a bigger player in the provision of services to the poor than it is in law?
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Well generally don't they through Medicare payments? Or are you talking about government clinics like VA clinics?
 
iliveonramen said:
Well generally don't they through Medicare payments? Or are you talking about government clinics like VA clinics?
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Well government run hospitals would be one option. Medicare puts a cap on procedure costs but they do not put a cap on visit costs. I guess my analogy would be a lawyer gets paid X amount per hour and only gets paid up to Y hours per case based upon the type of case so it doesn't matter how many more hours after that cap the lawyer spends, he isn't going to paid any more but lawyers still do those cases. I would prefer a per visit cap because they are just getting around it by churning procedures. Oh your back hurts today, here let me do a sonogram, an X-ray, some bloodwork, and EKG, etc.

The long and short of it, we have an unsustainable model for healthcare paid for by the taxpayer directly or indirectly. Something is going to have to give and I would rather we start in that direction now rather than when we are holding onto that fiscal cliff by our fingernails.
 
Fisher said:
Why can there not be a similar system in medicine where government is even a bigger player in the provision of services to the poor than it is in law?
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Because the government is hopelessly incompetent in the delivery of retail goods and services. See, for example, the Indian Health Service in action here: link.
 
lonewolf said:
Obamacare,
This is very dangerous to everyone. Discharges and re-admissions happen because of complications that went unforeseen. Now a hospital will be very hesitant to re-admit you because they will get hit with a huge fine. Do you think you will stay young forever? Are you on disability? This gives others the power to make decisions on your healthcare treatment. You would be very naive to think that business decisions will take precedence over your health. Welcome to Obamacare.

We Have to Pass the Bill So That You Can Find Out What Is In It" .... Nancy Pelosi


Starting Monday, Medicare will fine hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to cut costs.

About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.

Many people will die before their time because of this law.

Obamacare fines begin Monday October 1, 2012, Medicare will fine hospitals, Penalties will average $125,000 per facility this coming year, Taxpayers hit again | Citizen WElls
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Obamacare is a give away to Insurance Companies as Medicade Part D was a give away to the Pharmaceutical companies. Anyone who thinks that Obama is different than George Bush does not have a clue about politics.
 
lonewolf said:
Millions of americans will be effected by a little known part of the Obamacare that went into effect this week Hospitals will be fined big if too many of Medicare patients have to return to the hospital within 30 days. Many people do have to go back to the hospital for followup care.

Obamacare push the hospital to discharge the patient as soon as possible. The penalty is going to apply to all Medicare patients.

What about care? If the patient has pneumonia many times the hospital will send the patient home but it can get worse and pneumonia can kill you. If the pneumonia patient is sent home but if they get worse the the hospital is not allowed to re-admit the patient or the hospital will be fined for re-admitting the Medicare patient.

Anyone who post that Obamacare is good does not have a clue about healthcare.
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Could you please post a link to this part of the new health care policy. Thanking you in advance.
 
lonewolf said:
Obamacare,
This is very dangerous to everyone. Discharges and re-admissions happen because of complications that went unforeseen. Now a hospital will be very hesitant to re-admit you because they will get hit with a huge fine. Do you think you will stay young forever? Are you on disability? This gives others the power to make decisions on your healthcare treatment. You would be very naive to think that business decisions will take precedence over your health. Welcome to Obamacare.

We Have to Pass the Bill So That You Can Find Out What Is In It" .... Nancy Pelosi


Starting Monday, Medicare will fine hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to cut costs.

About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging around $125,000 per facility this coming year, according to government estimates.

Many people will die before their time because of this law.

Obamacare fines begin Monday October 1, 2012, Medicare will fine hospitals, Penalties will average $125,000 per facility this coming year, Taxpayers hit again | Citizen WElls
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That is just a blog site. Please post from a reputable source.
 
joko104 said:
Except poor people. So it is only poor people Obama want to kill off. Part of his debt reduction plan and how to cover some of that $700 billion taken away.
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I think Obama must like poor people. He created so many of them.
 
lonewolf said:
Millions of americans will be effected by a little known part of the Obamacare that went into effect this week Hospitals will be fined big if too many of Medicare patients have to return to the hospital within 30 days. Many people do have to go back to the hospital for followup care.

Obamacare push the hospital to discharge the patient as soon as possible. The penalty is going to apply to all Medicare patients.

What about care? If the patient has pneumonia many times the hospital will send the patient home but it can get worse and pneumonia can kill you. If the pneumonia patient is sent home but if they get worse the the hospital is not allowed to re-admit the patient or the hospital will be fined for re-admitting the Medicare patient.

Anyone who post that Obamacare is good does not have a clue about healthcare.
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do you have a source for your claims?
 
joko104 said:
Pneumonia - one of those listed - is treated by antibodics. Each person needs different antibodics and it unknown which is going to work. Other than taking antibodics - unless the pneumonia is severe - the patient is sent home. Under the Obama plan, either people will just sit in the hospital day after day after day after day after day after day - for no reason - or the doctor makes a live or die crap-shoot guess of which antibodic.
Stitches and staples do not require hospital stay, but generally need to be removed before 30 days or the are grown over and can cause infections. Have people sit in the hospital for 2 weeks just waiting to have stitches and staples removed.

Telling someone who had heart surgery either 1.) stay in the hospital for 30 days or 2.) do not come back for a month under any circumstance.

ANY treatment that requires antibodics requires a return if the initial prescribed antibodics don't work. Doctors tend to start with the weakest that might work to avoid a person building up an antibodic intolerant or rendering them not working anymore.

Under Obama's plan of only 1 visit every 30 days allowed seems to require that a doctor 1.) prescribe every possible drug a person might need and teaching each patient how to diagnois which ones are working and which are not and 2.) teach each patient how to diagnois possible complications themselves. Every patient should be prescribed an X-ray machine, CatScan machine, and a blood testing lab to they can follow up themselves.

What is being eliminated is follow up visits to insure the person has been cured or healed. Medicare patients will have to do post op and post treatment examinations on themselves.
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First it isn't he PERSON that responds to the antibodic (sic) it is the organism. Antibiotics work by destroying the cell wall of the organism. The human cell has a cell membrane and not a cell wall. Second, no one in their right mind would want to be admitted to or stay in a hopsital with all the nosocomial infections floating around there. I know I do everything I can to stay OUT of the hospital.
 
Fisher said:
Well government run hospitals would be one option. Medicare puts a cap on procedure costs but they do not put a cap on visit costs. I guess my analogy would be a lawyer gets paid X amount per hour and only gets paid up to Y hours per case based upon the type of case so it doesn't matter how many more hours after that cap the lawyer spends, he isn't going to paid any more but lawyers still do those cases. I would prefer a per visit cap because they are just getting around it by churning procedures. Oh your back hurts today, here let me do a sonogram, an X-ray, some bloodwork, and EKG, etc.

The long and short of it, we have an unsustainable model for healthcare paid for by the taxpayer directly or indirectly. Something is going to have to give and I would rather we start in that direction now rather than when we are holding onto that fiscal cliff by our fingernails.
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The lawyer's cut of a plaintiff case has not increased at all. It is still 1/3. And the lawayer bears all the risk. If he doesn't win, he gets nothing.
 
Maenad said:
The lawyer's cut of a plaintiff case has not increased at all. It is still 1/3. And the lawayer bears all the risk. If he doesn't win, he gets nothing.
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I was referring to lawyers who get paid by the government to represent poor people, not personal injury stuff. Sorry for the confusion.
 
Here is the deal with Obamacare and other government aid programs. The bill gets passed then future admininstrations get to worry about how to actually pay for it because of all the voodoo economics used to justify the program. Then realizing the program is unsustainable people who are depended on it get screwed when services get cut and people get dropped. Yes, vote as if your life depended on it. Vote for repealing Obamacare.
 
Very interesting article from the AARP Bulletin: Being 'Observed'.

Just because you are in the hospital for five days doesn't mean you were ever an inpatient. You may have been there for "observation" (treated as an outpatient by Medicare) - the hospital thereby avoids the re-admittance penalties, and the patient is stuck with a huge bill because an "observation" stay is covered under Part B instead of Part A.

Jean Arnau spent five days in the hospital with a fractured spine—lying in a hospital bed, wearing a hospital gown and ID bracelet, eating hospital food and receiving regular nursing care.

But when she was discharged to be transferred to a rehab facility, her family learned that she’d never been formally admitted to the hospital as an inpatient. Instead, she’d been classified as an outpatient under “observation”—a status that would cost her thousands of dollars.
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And further:

What determines whether a patient is classified as an inpatient or placed under observation? Usually the call is made by the hospital, which, in many cases, may overrule the patient’s own physician. But Medicare’s guidelines are not clear, and many experts suggest that hospitals are placing more and more patients under observation to protect themselves against new policies that penalize hospitals for unnecessary admissions and frequent readmissions of the same patient.

In an effort to rein in spiraling costs, Medicare is now taking a tougher line with hospitals, investigating not only fraud but also cases in which Medicare officials suspect that “medically unnecessary” hospitalizations have occurred. Also, to improve the quality of care, Medicare will soon start penalizing hospitals that readmit patients in less than 30 days—raising the question of whether hospitals might label people as observation patients so that they cannot be counted as readmissions if they happen to return. Cost-control measures are “perfectly understandable,” says Zhanlian Feng, the Brown University study’s lead author. “On the other hand, those policies may have unintended consequences” that affect patients adversely.
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This is a sad example of how Medicare is misrepresented to the public, and how bureaucratic rule-making becomes no better than the "evil" insurance companies it is supposed to be replacing with "compassion" for the sick and elderly.
 
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