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Pipe dream? Obamacare
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Joined: 03 Mar 2007
Posts: 2807

PostPosted: Mon Mar 25, 2013 7:49 am    Post subject: Reply with quote

rigitrite wrote:

Well my costs per % of my GDP continue to rise without limit, oh yeah, and I continue to get less and less for my money.

And the presidents, CEOs, and stockholders of those publicly-traded health insurance companies thank you mightily for your payments and the opportunities that your money gives them to make additional mountains of money at your expense.


Doctors are getting screwed by the health insurance companies almost as much as we are.
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Joined: 28 Mar 2001
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PostPosted: Mon Mar 25, 2013 10:21 am    Post subject: Reply with quote

Human nature & our culture make us too complacent when looking for and listening to doctors. We seem to dumb down and assume that they are all good at what they do.

What you must do to get good care:

1. Become knowledgeable about your body and the things that can/do go wrong.
2. If something isn't working right, research as much as you can about the problem.
3. The hard one.......... Find a good Dr. This means networking with friends & on line research. If you have one Dr. you trust, ask who they would see for: (whatever is wrong with you).
4. Establish a relationship with your doctors. Make them appreciate the fact that you are special, so they will take good care of you. Here you have to find something that sets you above the regular crowd. If you are old and fit, that alone gives you an advantage, hype it! Windsurfing itself can make you different, tell them about what you do. Doctors like to help people that take care of themselves and are special in some way. They will spend time with you if you are interesting.
5. Get second or third opinions for the serious stuff.

My wife was in healthcare so it was pretty easy to find the best doctors, but now she is retired and we are in another state, so it's back to the basics outlined above.

Catching problems early is critical. Avoiding the Dr. because of $, procrastination or bad experiences can be a big mistake.
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Joined: 26 Oct 2009
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PostPosted: Mon Mar 25, 2013 10:25 am    Post subject: Reply with quote

Rigitrite is correct, IMO. Costs have been out of control for years and we continue to be less healthy. The system rewards doctors and hospitals that provide specialized care to treat the illness rather than health. Healthcare providers are compensated at a much higher rate for procedures than patient contact time. Wellness and preventative care have, largely, been uncompensated. The consumer is left to manage his health, on his own, until he is sick...then the costs really add up.

This is not Obamacare...this is our current system.

We arrived at this point, for a lot of reasons. Medicare (the nations largest insurer) for years increased reimbursement for procedures at the expense of primary care. Fear of lawsuits promotes over-testing and over-drugging. Unions resisted universal health care to maintain membership advantages. Gilded health plans received significant tax breaks. Unhealthy lifestyles are over-burdening the system. Technological advances in medicine and consumer expectations drive over-utilization of expensive medical imaging and testing equipment. Spending for end of life care is exorbitant. And, market forces and competition are, almost, completely lacking in medicine.

Will Obamacare work to decrease costs, in the long term? I do not know. But, the emphasis on preventative care may correct some of the problems. Unless we accept some limits on what medical care should be provided we cannot slow this spending.
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PostPosted: Mon Mar 25, 2013 10:46 am    Post subject: Reply with quote

CB, as ususal, you make very good points. How do we incentivize doctors to get their patients healthier? Mike Bloomberg is a hero of mine, and I agree with 99% of everything he says and does. I have been addicted to his product for 20 years, and now I am enjoying his attempt to make us healthier. I wish people would ease up on the "big brother" concept, and realize that if we want to reduce health costs as a percent of GDP, its going take a huge effort on all fronts...with prevention being the most important.
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PostPosted: Mon Mar 25, 2013 11:24 am    Post subject: Reply with quote

rigitrite wrote:
Our current system SUCKS. I avoid going to the doctor, because it costs money, in fact everyone I know does this: we avoid going to the doctor and put off routine check ups as long as possible, because it makes economic sense. ... we're completely screwed at the moment. .... we've already entered the drain with the Republican plan...


Going to the doctor costs me zero beyond the premiums on my four insurance plans. i.e., fixed cost covers virtually everything (you should try it some time). Good deal, right? Not when most doctors are too swamped or tight-fisted to do their damned jobs ... when I can find a competent one. That = screwed, all right, whether the Elephant or the Ass is responsible (I don't understand your "Republican Plan" reference to today's health care; it's evolved over centuries). But not one politician or pundit I've seen expects Obamacare to improve that situation. Quite the contrary; O-care's stated (by Obama himself) objectives are first and foremost to cover almost everyone not presently covered, as a stepping stone towards taxpayer-funded government managed health care for all -- the dictionary definition of socialized medicine -- within 10-15 years from now.

That alone = screwed on steroids.

Then add the fact, as another objective, that doctors are being driven out of private practice into hospitals. That alone has been proved to cut their productivity by 30%, at the same time another 30M people will be covered. That guarantees less time for your doctor to diagnose your ailment and prescribe the right pills ... let alone actually try to treat you properly.

Then add Ocare's additional suppression of medical research, a U.S. strength for generations.

Add the premium increases of 50%, 100%, even more, already being announced within the industry for small businesses and private policies.

Screwed, on steroids, squared.

Finally, stir in the reduced incentives, even negative in many aspects, for people to become doctors. These very smart cookies often have lofty egos and goals to match their brain power, and many will not want to practice cookie-cutter, pill-dispensary, cattle-prodding medicine for pedestrian wages. How's that not going to reduce their quality even further? Heck, even Obamacare's chief proponents admit that most of our ordinary medical care will be in the hands of nurses and physicians' assistants. They're good, but we're still ...

Screwed, on steroids, cubed.

Last but clearly of great consequence is that the health care providers' crushing workload will tend to snuff out their last hopes of even trying to keep up with the few advances still coming out of the peer-reviewed medical research. I've already encountered many physicians, every one of them a specialist, who are ignorant of the very research they are obliged to base their care on.

Screwed to death ... and a big part of why I have literally chosen a decade of vigor over 15 years of radiation side effects.
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PostPosted: Mon Mar 25, 2013 11:41 am    Post subject: Reply with quote

Boggsman... I am not sure that wellness should be the responsibility of the physician. Their training is in the treatment of disease and injury. And, this is what we need from them.

IMO, we need a "triage" system. Specialists (do not need to be physicians) trained in preventative care and health care management should be the front line. Someone needs to say "you do not get a knee replacement until you loose weight". The best surgeon I know just wants to cut. He is not interested in talking to someone about their fat belly, and money is not really the motive. So, incentives to physicians will fall flat.

This will only work if we change the expectations of the consumer on health care. We all expect to walk in and receive the full service, even if it makes no sense. And, the legal/medical/insurance model is perfectly willing to oblige.

As you indicated, this needs to be an "all fronts" approach. Including, attaching medical costs to products such as big gulps. coal power plants, Big Macs and ammunition. We need to establish rigorous treatment protocols that limit liability exposure for health care providers. We need, as a society, to decide how end of life care should be administered and financed.
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PostPosted: Mon Mar 25, 2013 1:10 pm    Post subject: Reply with quote

Well said techno900, I couldn't agree more, particularly with your last sentence. As a person that for years avoided going to doctors, I ultimately from that there can often be a huge price to pay for that kind of mindset. I found out just how stupid I was, and payed a price for that, but fortunately I was lucky. One of my problems could have easily killed me, as it often does to many who weren't as lucky as me. Believe me, I learned an important lesson from these health experiences. Don't ignore or procrastinate if you experience health problem signs.

coboardhead, as always, your take on the health care scene is spot on in my view. Even though there are a lot of imperfections with the ACA, we are clearly on a better path than we have following for decades. It will be interesting to see when the ACA really begins to have a positive affect. Like you, I'm much more inclined to believe that it will.
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PostPosted: Tue Mar 26, 2013 2:57 pm    Post subject: Reply with quote

coboardhead wrote:
Rigitrite is correct, IMO.

Let's all hope so. Even the biggest-name, most moderate opponents of that positive paradigm expect at the very LEAST a second recession deeper than the last one, with some still-moderate big names suggesting it may match or even beat the Great Depression. I'm doing my best to cover both theirs and Cob's/Rigit's expectations for myself, 'cause I sure as hell don't know how this will turn out or when we'll know either way.

Mort Zuckerman of U.S. News and World Reports posted today in the WSJ that "The Great Recession Has Been Followed by the Grand Illusion" regarding employment (it's 14-15%). . Bottom line: we're being fed a line of purely political BS.

Why that's newsworthy escapes me.
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Joined: 21 Dec 2008
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Location: The eye of the universe, Cen. Cal. coast

PostPosted: Wed Mar 27, 2013 10:18 am    Post subject: Reply with quote

Like most people didn't already know this.
I still can't get over the name of this "The Affordable Healthcare Act"
What a sick joke on the country.

Sebelius: Yep, ObamaCare is raising insurance costs
By: John Hayward
3/27/2013 07:46 AM

A watershed moment in the ongoing disaster of ObamaCare, as Health and Human Services Secretary Kathleen Sebelius finally admits that health insurance premiums are rising because of the President’s health insurance takeover, per the Wall Street Journal:

Ms. Sebelius’s remarks come weeks before insurers are expected to begin releasing rates for plans that start on Jan. 1, 2014, when key provisions of the health law kick in. Premiums have been a sensitive subject for the Obama administration, which is counting on elements in the health law designed to increase competition among insurers to keep rates in check. The administration has pointed to subsidies that will be available for many lower-income Americans to help them with the cost of coverage.

The secretary’s remarks are among the first direct statements from federal officials that people who have skimpy health plans right now could face higher premiums for plans that are more generous. She noted that the law requires plans to provide better benefits and treat all customers equally regardless of their medical claims.

“These folks will be moving into a really fully insured product for the first time, and so there may be a higher cost associated with getting into that market,” she said. “But we feel pretty strongly that with subsidies available to a lot of that population that they are really going to see much better benefit for the money that they’re spending.”

Ms. Sebelius added that those customers currently pay more for their health care if their plans have high out-of-pocket costs, high deductibles or exclude particular types of coverage, such as mental health treatment. She also said that some men and younger customers could see their rates increase while women and older customers could see their rates drop because the law restricts insurers’ ability to set rates based on age and gender.

For the rest~

I don't drink the 'cool' aid, I drink tequila, it's more honest.
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PostPosted: Wed Mar 27, 2013 10:53 am    Post subject: Reply with quote

NW...I see you started your day with a dosage of Drudge, good work. The question isn't if we will see more insurance costs, the question is will we(the US) be spending/paying more for healthcare overall. I think not. As Michael Milken says, health and healthcare is the #1 economic issue in this country, and if people have access to health care, they will make better economic choices, be healthier, and more productive. So, the net result could be quite positive. But, I dont want to rain on your negative carry on.
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