• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

Why ObamaCare failed

jaeger19 said:
Expanded access means more patients..

THE WAY.. that revenue has been decoupled from the FFS treadmill means that providers are not getting paid for their time. And by the way.. paying for non face to face time.. when you are reducing overall reimbursement pushes patients away from face to face time.

Ah.. yes quality is going down and its not being measured by any valid metric,

Tell me.. Does Obamacare require any physical functioning requirements prior to discharge? And post discharge?

Did Medicare require any metrics of physical functioning and independence prior to Obamacare that can be measured?

Oooops..no.

So patients are being sent home from the hospital.. and to avoid readmissions.. (which ARE being monitored)... hospitals are sending patients home just as sick or even sicker.. but are telling home health agencies that if they send them back to the hospital.. they are not going to get referrals. So home health agencies are keeping patients that are not doing well at home.. and if they have to transfer them.. they are sending them to OTHER hospitals to avoid getting dinged by the original hospital. Because the hospital is keeping a "score card".. on them.

They are doing the same thing with SNF's and even assisted livings.

They are telling SNF's.. that regardless of the patients needs and potential.. they need to be "discharged on this date". and too bad if the patient has the potential to improve past that level. And if you go over that date.. then you face hurting your "scorecard" and not getting transfers from the hospital.

That's if they are even sending the patient to a snf. I just had a patient enter my office who had a stroke.. who instead of going to rehab.. the hospital sent him to an assisted living where he languished there for 2 months.. with no OT. No SLP and PT once a week on average.

He only left that assisted living and got to us where he was admitted to a rehab because his family had a PT in it that understood what he needed and what against what the home health and assisted living wanted. And I had to personally intervene because it was the right thing to do.. even though financially it was going to hit us.

So.. yeah.. why bother to measure quality with valid measures... when you can listen to folks that have no clue of the actual provision of healthcare and what is actually going on spout off on ideology.?

If you are asking if the quality of our services are going down? YES.. YES THEY ARE. I treat more patients per day.. than I have before. I spend less patient time and more documentation time. Our facilities see more patients with less qualified staff. Our rehabs and home healths are being pressured by outside hospitals to provide what fits THEIR profit margin regardless of whats best for the patient.

I hope to god that you never have a family member have to suffer needlessly because of this system. Of course.. you won';t probably know... because you have no clue what SHOULD have occurred. And of course you don't want to know.

.
Click to expand...

This sounds quite disturbingly like the VA in action.

Could my prediction as to the quality and efficacy of government run healthcare ending up with everyone having healthcare like the VA been accurate? Hmmm.
 
Hawkeye10 said:
This is right in line with how schools manipulate graduation rates. And police manipulate crime rates. And the government manipulates unemployment rates. and so on and so on. Numbers are great if they are reliable, but put in a financial or political incentive to manipulate the numbers and you can be sure that they will be manipulated.
Click to expand...

Exactly my point above. Aren't VA administrators given bonuses if their numbers come up like they are supposed to?
 
eohrnberger said:
Exactly my point above. Aren't VA administrators given bonuses if their numbers come up like they are supposed to?
Click to expand...

Of course.

Numbers are great if the numbers are right, and you know what they mean. The combination of both happens so little anymore, because the elite tend to be immoral morons who are sure they are BRILLIANT!
 
Hawkeye10 said:
Of course.

Numbers are great if the numbers are right, and you know what they mean. The combination of both happens so little anymore, because the elite tend to be immoral morons who are sure they are BRILLIANT!
Click to expand...

Exactly why the political elites need to get a serious wake up call, and given the territory into which this election has progressed to, it may be just what they desperately needed, whether they admit it or not.
 
eohrnberger said:
Exactly why the political elites need to get a serious wake up call, and given the territory into which this election has progressed to, it may be just what they desperately needed, whether they admit it or not.
Click to expand...

That IS what Trump is for.

But I am not very confident that these idiots can learn their lesson on the first try, They have never lately shown to be that good, their dads and granddads were much better at it.
 
Hawkeye10 said:
That IS what Trump is for.

But I am not very confident that these idiots can learn their lesson on the first try, They have never lately shown to be that good, their dads and granddads were much better at it.
Click to expand...

Quite true.
 
eohrnberger said:
LOL. I've had my share of being accurate, yes, that's true.
Click to expand...

I got my eye on you pal, I am going to see, bet U do better.

I am right more than my share of times, cause I got educated you see.

I have kinda sorta seen you around these parts, not enough to know you, I am going to fix that, you see.


SIGNED:
HAWkEYE10
:2party:
Proud Member of THE REBELLION Since 9.10.15
 
Greenbeard said:
What the hell are you talking about? As you seem to have forgotten the flow of the conversation, I'll remind you: you made the (unsubstantiated) claim that hospital discharges to HHAs and SNFs came with special strings that were designed specifically to harm patients experiencing acute episodes in need of a hospitalization within 30 days of a discharge. Let me refresh you:
We're not talking about MRIs or labs or physician clinics or some broad conversation about referral patterns. We're talking about your allegation that America's hospitals are actively harming their patients by bribing, cajoling, forcing post-acute care providers to somehow intervene in critical situations and prevent a patient from going to a hospital. To, as you say, "avoid the wrath of the original hospital."

Wrath exercised using, of course, a mechanism that does not exist since hospitals are required by law to include any HHAs or SNFs in a patient's discharge plan that wish to be included and must make patients aware of all available options for post-acute care. Special protections written into law and regulation specifically covering the class of provider with which you started the conversation and not the unrelated ones to which you're now desperately attempting to shift the conversation.

This has nothing to do with the financial case for acquisition of a physician practice or whatever other nonsense deflections you want to toss out to try and obscure your obvious unfamiliarity with the regulatory framework and incentives in place with respect to the topic of conversation. You made a dumb claim, you can't support it, and now you're off to the races trying to throw any random thing at the wall in the hope it'll stick. I think we're done here.
Click to expand...

yes.. I know exactly what I said. And its hardly a "dumb claim" when you experience it on a daily basis.

Heres where you go wrong:

Wrath exercised using, of course, a mechanism that does not exist since hospitals are required by law to include any HHAs or SNFs in a patient's discharge plan that wish to be included and must make patients aware of all available options for post-acute care.
Click to expand...

that does not mean that a mechanism does not exists. Cripes man.. that's like saying speeding on highways does not exist because speed signs are posted and therefore all drivers obey the speed limit. :roll:

Not only does such a mechanism exist.. since the hospitals control the discharge process, there is a financial incentive for the hospitals to control the referral patterns.

In fact.. they are expected to do so according to the Medicare 5 star rating system.

Now.. please explain the mechanism/metric that's in place that can catch this?

Sorry.. whats clear here is that you don't understand the medical system.. and are falling back on your ideology.

.
 
eohrnberger said:
This sounds quite disturbingly like the VA in action.

Could my prediction as to the quality and efficacy of government run healthcare ending up with everyone having healthcare like the VA been accurate? Hmmm.
Click to expand...

well.. its a bit more complex than that.

this is really an unintended consequence of what should on paper make sense.

Hospitals are supposedly paid to provide better care in the hospital and reduce complications and lengthy rehab stays post hospital.

For example.. instead of hospital staff inserting a catheter in a patient and then for convenience (instead of having to take them to the bathroom)... leaving the catheter in until 2 hours before discharge to home or a SNF and letting them deal with it,

the hospital SHOULD be taking the catheter out earlier.. doing bladder retraining and checking to make sure the patient is doing fine without a catheter.

Now.. on the face of it.. that makes sense.

And of course folks like Greenbeard.. whose ideology gets in the way.. lacks any objectivity and assumes that this is whats happening (and in some cases it probably is.. of course these hospitals were doing it in the first place most likely).

What is happening with other hospitals.. is that instead of doing any care really differently... the hospital is still pulling the catheter two hours before discharge.. and sending the patient off to home health or a skilled nursing facility.

then if there is a problem.. (like the patient retaining urine), they punish the discharge entity if it sends these patients back to the ER for care. Basically making the SNF's and home health responsible for handling the hospitals problems.

Your point though about the VA is very valid however.

For years.. folks.. touted how wonderful the VA was. How great the care.. how great the efficiency etc. Folks.. much like greenbeard here who have an agenda, held up the va as a shining example of how wonderful care could be.

"Look at these numbers"... they cried.


And now. years later.. we find out that they fudged those numbers. That those numbers and metrics were not valid. And all those vets.. that made those "unfounded claims".. about not being seen, not getting care etc... were RIGHT.

Its a cautionary tale.. of what happens when one is not objective and only acts to support ones ideology.
 
jaeger19 said:
well.. its a bit more complex than that.

this is really an unintended consequence of what should on paper make sense.

Hospitals are supposedly paid to provide better care in the hospital and reduce complications and lengthy rehab stays post hospital.

For example.. instead of hospital staff inserting a catheter in a patient and then for convenience (instead of having to take them to the bathroom)... leaving the catheter in until 2 hours before discharge to home or a SNF and letting them deal with it,

the hospital SHOULD be taking the catheter out earlier.. doing bladder retraining and checking to make sure the patient is doing fine without a catheter.

Now.. on the face of it.. that makes sense.

And of course folks like Greenbeard.. whose ideology gets in the way.. lacks any objectivity and assumes that this is whats happening (and in some cases it probably is.. of course these hospitals were doing it in the first place most likely).

What is happening with other hospitals.. is that instead of doing any care really differently... the hospital is still pulling the catheter two hours before discharge.. and sending the patient off to home health or a skilled nursing facility.

then if there is a problem.. (like the patient retaining urine), they punish the discharge entity if it sends these patients back to the ER for care. Basically making the SNF's and home health responsible for handling the hospitals problems.

Your point though about the VA is very valid however.

For years.. folks.. touted how wonderful the VA was. How great the care.. how great the efficiency etc. Folks.. much like greenbeard here who have an agenda, held up the va as a shining example of how wonderful care could be.

"Look at these numbers"... they cried.


And now. years later.. we find out that they fudged those numbers. That those numbers and metrics were not valid. And all those vets.. that made those "unfounded claims".. about not being seen, not getting care etc... were RIGHT.

Its a cautionary tale.. of what happens when one is not objective and only acts to support ones ideology.
Click to expand...

OK, Jaeger. A bit more complex. But I don't have the hands on with the system that you apparently do. As a patient, I go to my GP perhaps 2 times a year, and that's it (thankfully). None the less, as the older years start to catch up with me, I'm pretty sure that I'll have some age related issues that will need timely attending to.

As such, I dislike government involvement, corruption, distortions and inefficiencies, such as ObamaCare, from the care that I receive.
 
eohrnberger said:
OK, Jaeger. A bit more complex. But I don't have the hands on with the system that you apparently do. As a patient, I go to my GP perhaps 2 times a year, and that's it (thankfully). None the less, as the older years start to catch up with me, I'm pretty sure that I'll have some age related issues that will need timely attending to.

As such, I dislike government involvement, corruption, distortions and inefficiencies, such as ObamaCare, from the care that I receive.
Click to expand...

Well and there is the other side of the coin.

without government involvement you would have no healthcare and probably die at a much earlier age.

Government involvement is why you have medicare..and why you will probably have Medicaid.. (if you live long enough and aren;t rich).

Government involvement in healthcare.. in having medicare.. not only benefited seniors.. who would not have insurance without it..

because frankly... its simply not cost effective for a private insurance company to provide primary insurance to old people that need it. The risk ration is simply too high.

and not only do senior benefit from the government involvement.. but everyone else as well.


Because the minute the government provided healthcare insurance that paired people who needed healthcare (seniors).. with the ability to pay for it (the medicare)... there was an explosion of new technology and techniques because now it was profitable to provide them.

and that technology and techniques benefit younger people as well.
 
jaeger19 said:
Well and there is the other side of the coin.

without government involvement you would have no healthcare and probably die at a much earlier age.

Government involvement is why you have medicare..and why you will probably have Medicaid.. (if you live long enough and aren;t rich).

Government involvement in healthcare.. in having medicare.. not only benefited seniors.. who would not have insurance without it..

because frankly... its simply not cost effective for a private insurance company to provide primary insurance to old people that need it. The risk ration is simply too high.

and not only do senior benefit from the government involvement.. but everyone else as well.


Because the minute the government provided healthcare insurance that paired people who needed healthcare (seniors).. with the ability to pay for it (the medicare)... there was an explosion of new technology and techniques because now it was profitable to provide them.

and that technology and techniques benefit younger people as well.
Click to expand...

Well, fair enough. Medicare and Medicaid were just fine, and don't justify the additional government involvement, corruption, distortions and inefficiencies, as represented by ObamaCare in this case.

More worrisome still is that ObamaCare's collapse set up the next 'sales pitch' of 'we the governmnet can do better with single payer'.

So when does this throwing good money after bad going to end? Most with an ounce of common sense don't do that, yet the government has demonstrated this penchant more than anything else.
 
eohrnberger said:
Well, fair enough. Medicare and Medicaid were just fine, and don't justify the additional government involvement, corruption, distortions and inefficiencies, as represented by ObamaCare in this case.

More worrisome still is that ObamaCare's collapse set up the next 'sales pitch' of 'we the governmnet can do better with single payer'.

So when does this throwing good money after bad going to end? Most with an ounce of common sense don't do that, yet the government has demonstrated this penchant more than anything else.
Click to expand...

Yes.. you have a point about the single payer schtick.

And you will see more calls more "medicare for all".

Which would mean an end to medicare as we know it. Because medicare is only sustainable because people put in their whole working lives and then take out older.

Adding people to it that have not paid in will kill the financials for it.
 
You must log in or register to reply here.
Back
Top Bottom