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techno900
Joined: 28 Mar 2001
Posts: 4161
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 Posted: Wed Jan 28, 2015 8:36 am Post subject: |
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| Actually good news. However, at the rate of the current increase in Dr's in training, it will take 18 years to balance out the 90,000 projected deficit in needed doctors. The projected deficit number is for 2020, so where will we be in 18 years? I guess we will just print or borrow the necessary federal funding for the needed resident programs. It's not all peaches and honey just yet, but at least some are willing to give medicine a go during a period of upheaval. |
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isobars
Joined: 12 Dec 1999
Posts: 20935
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| Posted: Tue Feb 17, 2015 7:49 pm Post subject: |
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Excerpts from today's WSJ, "ObamaCare’s Electronic-Records Debacle" at
http://tinyurl.com/lq8vcaa , by Dr. Jeffrey Singer, a surgeon in Phoenix and an adjunct scholar at the Cato Institute.
The electronic health records (EHR) rule raises health-care costs even as it means doctors see fewer patients while providing worse care ...
mandated for physicians like myself who treat Medicare patients ...
EHRs harm patients more than they help.
The program was inspired by Kaiser Permanente and the VA [the VA lost ALL my records ... TWICE. Only my own hard copies of everything saved my butt].
The federal government barely bothered to study EHRs before requiring them nationwide. They now contribute to two major problems: lower quality of care and higher costs.
The former is evident in ... a shift from individual care to IT compliance ... an impediment to providing personal medical attention. Patients are complaining so loudly that the AMA had to defend the EHR program in a 2013 report, blaming its problems on bad bedside manner.
Apparently our poor bedside manner is a national crisis, as 67% of doctors are “dissatisfied with [EHR] functionality.” Three of four physicians said EHRs “do not save them time,”... Doctors reported wasting an average of 48 minutes each day [that's what ... 5-10 patients' worth?] dealing with this system.
Three of four physicians think electronic health records “increase costs” due to [time for fewer patients, thus higher prices per patient, EHR implementation costs]. ... the average five-physician primary-care practice would spend $162,000 to implement the system, followed by $85,000 in first-year maintenance costs ... passed on to their patients. Thus doctors increasingly sell out to hospitals for relief, producing “vertical integration” which is proven to lead to “higher hospital prices and spending.”
Proponents of electronic health records nonetheless claim that EHRs decrease record-keeping errors and increase efficiency. My own experience again indicates otherwise and is corroborated by research.
The EHR system's rigidity inhibits my ability to tailor my questions and treatment to my patient’s actual medical needs and [interferes with] critical thinking and medical investigation.
A study showed that EHRs “endanger patient safety or decrease the quality of care.” .... real-life example was the recent Ebola crisis, when “patient zero” received a delayed diagnosis due in part to problems with EHRs.
Ending the mandatory electronic-health-record program should be a plank in the Republican Party’s health-care agenda. For all the good intentions of the politicians who passed them, electronic health records have harmed my practice and my patients.
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Yeah, yeah, we know: it's Mikey's fault, or Fox News', or the Tea Party's ... ANYthing to divert the peanut gallery's attention from the real issues. |
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mac
Joined: 07 Mar 1999
Posts: 17747
Location: Berkeley, California
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| Posted: Tue Feb 17, 2015 11:10 pm Post subject: |
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A Lasik surgeon who works for the Cato Institute. Now those are the credentials of an unbiased source, eh?
Too busy making money to save lives? |
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techno900
Joined: 28 Mar 2001
Posts: 4161
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| Posted: Fri Feb 20, 2015 3:18 pm Post subject: |
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Liberals and our money at work:
From yahoo.com
| Quote: | In the final day leading up to Obamacare’s sign-up deadline, the website was once again hit with technical glitches that prevented people from signing up for health insurance.
The problems stemmed from a function on the site that verifies people’s income to determine if they qualify for federal subsidies, and if so, how much. Officials from the Department of Health and Human Services confirmed the issues on Saturday, saying some people weren’t able to submit their applications because the website couldn’t verify their income.
On Saturday afternoon, health officials instructed people to continue creating accounts on HealthCare.gov, browse their options for coverage, and then save their progress so they could return later when the issues had been resolved.
The glitches were fixed around 8 p.m., according to HHS officials, who said they would be contacting consumers who had issues to tell them they can continue completing their applications. It’s unclear if the deadline to sign up will be extended.
HealthCare.gov is the main website for consumers living in the 37 states that rely on the federal exchange. The website had been relatively glitch free this year, compared to Obamacare’s rollout last year, when the site was so plagued with problems that only six people were able to sign up for coverage on the first day. To date, the administration has spent a total $2.2 billion to build and repair the website.
Even though the site is complicated, the user base is relatively small. By comparison, Facebook has 1.9 billion users and experts say Facebook could have been built easily for $1 million in 9 months – not the nearly 3 years it took to launch the first version of Healthcare.gov.
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isobars
Joined: 12 Dec 1999
Posts: 20935
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| Posted: Fri Feb 20, 2015 3:43 pm Post subject: |
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Aaaaand, nachurally, the IRS gave out wrong information to 800,000 Obamacare policyholders, so they must file again from scratch.
Can you spell "Keystone Cops"? |
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mac
Joined: 07 Mar 1999
Posts: 17747
Location: Berkeley, California
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| Posted: Wed Mar 04, 2015 2:48 pm Post subject: |
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Read this right wing op ed piece on Obama care and then decide whether they have gone off the deep end.
| Quote: | By Michael R. Strain January 23
Michael R. Strain is a resident scholar at the American Enterprise Institute.
Say conservatives have their way with Obamacare, and the Supreme Court deals it a death blow or a Republican president repeals it in 2017. Some people who got health insurance as a result of the Affordable Care Act may lose it. In which case, liberals like to say, some of Obamacare’s beneficiaries may die.
During the health-care debates of 2009, Rep. Alan Grayson (D-Fla.) brought a poster on the House floor: “The Republican Health Care Plan: Die Quickly.” In the summer of 2012, when Obamacare was threatened by a presidential election, writer Jonathan Alter argued that “repeal equals death. People will die in the United States if Obamacare is repealed.” Columnist Jonathan Chait wrote recently that those who may die are victims of ideology — “collateral damage” incurred in conservatives’ pursuit “of a larger goal.” If these are the stakes, many liberals argue, then ending Obamacare is immoral.
Except, it’s not.
In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending. This opinion is not immoral. Such choices are inevitable. They are made all the time.
Consider, for example, speed limits. By allowing people to drive their cars at speeds at which collisions result in death, our government has decided that the socially optimal number of traffic fatalities is not zero. Some poor souls die: There were more than 30,000 traffic fatalities on America’s roads in 2013. If we didn’t accept that risk, we’d lower the speed limit to a rate at which accidents simply don’t kill, such as 10 mph. Instead, we’ve raised it periodically over the years, and you can now go as fast as 85 mph on a few highways.
It is tragic that thousands of people die each year in car crashes. At the same time, there are huge (if dispersed) benefits to a 70 mph speed limit over a 10 mph limit: a transportation sector that can deliver goods quickly across the country; increased productivity, because millions of commuters can spend more time at work than in transit; and more time at home with our children.
Likewise, thousands of people die in homicides in the United States every year. We could reduce this number substantially, but we have (at least implicitly) decided that the costs — financial and otherwise — of more intrusive monitoring, additional policing, stricter sentencing and other, harsher measures are not worth the benefit. (Though we should continue debating whether marginally higher costs are worth marginally fewer deaths.) A sentry on every street corner and a government-monitored camera in every private room and hallway in America would significantly lower the homicide rate. But I wouldn’t make that trade-off.
How do policymakers decide such things? In the deepest sense, every human life is inestimably valuable. But in a fallen world where trade-offs are inevitable, public policy can’t treat each life that way.
First, public policies — such as speed limits, gun-control measures and many others — usually affect the probability of death, rather than resulting in any specific person’s death. So economists can estimate the amount of money people are willing to pay to avoid slight increases in the probability of dying and then use that estimate to calculate the “value of a statistical life” (VSL).
This measure “serves as the basis for the standard approach used by government agencies to establish monetary benefit values for the predicted reductions in mortality risks from health, safety, and environmental policies,” economist W. Kip Viscusi, a leading VSL expert, writes in a recent paper. He says, based on an analysis of government policies, that the United States places the value of a statistical life between $6 million and $10 million.
“The Food and Drug Administration’s 2011 regulatory impact analysis of labeling for bronchodilators to treat asthma used a VSL of $8.1 million, the Occupational Safety and Health Administration’s 2011 analysis of general working conditions in shipyard employment used a value of a statistical life of $9.5 million, the Food Safety and Inspection Service’s 2011 analysis of inspection and test result procedures used a VSL of $7.3 million, the Federal Aviation Administration’s 2012 analysis of flight crew duty and rest requirements used a VSL of $6.6 million, and the U.S. Environmental Protection Agency’s 2012 regulatory impact analysis of new source performance standards for petroleum refiners used a VSL of $9.8 million,” Viscusi writes.
This approach is not without controversy, but the VSL is a key factor in many decisions made by federal agencies. And it shows that trade-offs between benefits and costs, including deaths, are routinely made by government agencies. “Policies for which the net cost per expected life saved exceeds the VSL will not pass a benefit-cost test,” Viscusi writes.
But most Americans — including their elected representatives — do not think this way when they debate major policy changes. The legislative process in some ways is simpler, but it is an outcome of a raucous, messy, imprecise and reductive political process. That’s why arguments sound like “repeal equals death.”
Repealing Obamacare could — although wouldn’t necessarily — result in more people dying. But it clearly would not be immoral.
Consider this question: Should society have as its goal that the government prevents all deaths from any health-related ailment other than natural causes associated with ripe old age? The notion is absurd — to both conservatives and liberals. There are limits to the proper amount of scarce resources, funded by taxpayers, that Washington should redirect toward health care.
I doubt Obamacare supporters would argue for a society that spends half or two-thirds of its national income on health care in an attempt to ensure that every person with a treatable disease or injury avoids death. Liberals aren’t arguing for a paramedic on every street corner and a nurse in every private building. Liberals and conservatives agree that in a world of finite resources, some people are going to die of potentially treatable illness and injury.
It wasn’t long ago that conservatives were the ones injecting too much talk of death into the health-care debate. Sarah Palin urged Americans in 2009 to oppose the “death panels” — in reality, end-of-life counseling — in the Democrats’ health-care bills. Liberals argued that this discussion was unhelpful. They were right.
A better discussion, both then and today, is about appropriate social goals and the resources required to meet them. Among the many needed reforms to our health-care system, one should be that we move closer to universal insurance coverage — on this point, the president is correct. But what should universal coverage look like? It requires a nuanced answer.
The insurance system should be designed to financially protect people from low-probability events, rather than provide comprehensive coverage for all health events, as Obamacare envisions. People should be free to pay for whatever care they like, but the government should not take money out of their paychecks to subsidize small-scale events that will happen with near-certainty (such as my annual sinus infection) or truly elective procedures (some states choose to cover acupuncture and most cover chiropractic care under their interpretations of the law). Instead, universal coverage should concern itself with the catastrophic expenses associated with serious medical events that will affect a minority of the population. People who can afford such coverage should be incentivized to purchase it, and those who can’t should receive a government subsidy to do so.
Such a plan would lower premiums and offer more choice than Obamacare. It would require less spending, fewer tax dollars, less coercion and less regulation, leaving more money for other important government programs or for taxpayers to spend as they wish. A few conservative plans along these lines already exist, and not just among economists and think tank scholars. GOP Sens. Richard Burr (N.C.) and Orrin Hatch (Utah), along with former senator Tom Coburn (R-Okla.), have a well-developed, well-known proposal, the thrust of which has growing support among many conservative intellectuals and members of Congress.
The Burr-Coburn-Hatch plan would repeal the Affordable Care Act, including the individual mandate to purchase insurance, and leave the current system of employer-sponsored coverage largely in place. It would cap the tax preference for employer-provided coverage (though only for extremely generous plans) and use the revenue to provide a tax credit for people who don’t get their health insurance through their jobs. Their plan would provide “continuous coverage” protection, so that people who remain enrolled in insurance can’t be financially penalized for getting sick; offer new federal funding for high-risk pools; and allow Medicaid participants to receive the tax credits and enroll in individual-market plans. A paramount goal of this proposal is to ensure that no one who is or becomes gravely ill goes without adequate medical care.
The plan has not been scored by the Congressional Budget Office, but according to the Center for Health and Economy, a health-care research organization, relative to Obamacare the senators’ proposal would lower premiums, result in roughly the same number of individuals covered by insurance policies and yield a significant 10-year net budget savings.
Repealing Obamacare and replacing it along these lines may result in more people dying — or fewer. That’s a pretty tough forecast to make. But as with speed limits, gun laws, agency regulations and many other policies, including Obamacare, the shape of future health-care policy will require trade-offs. There are only so many resources, so choices between directing them to health care and allowing them to flow to other uses are inevitable. (Thankfully, such choices are both reversible and adjustable.)
If Obamacare perishes — and I hope it does — conservatives should be ready to coalesce around a concrete replacement plan, like I’ve described here. And liberals should be ready to debate them, knowing all the while that they, too, are advocating policies that will fail to save some of the sick and injured from the fate that ultimately awaits us all.
michael.strain@aei.org |
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mac
Joined: 07 Mar 1999
Posts: 17747
Location: Berkeley, California
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| Posted: Tue Mar 10, 2015 1:27 pm Post subject: |
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None of the conservatives will get this news on their e-mail servers. None of them will actually read any of the details:
| Quote: | By Peter Sullivan - 03/09/15 05:31 PM EDT
ObamaCare got some good news from the nonpartisan Congressional Budget Office on Monday, which projected that the law’s price tag will be lower than previously thought.
The budget scorekeeper said that health insurance premiums will be lower, so the cost of helping people afford coverage has gone down. The lower prices are part of a broader slowdown in the rise of health costs that is encouraging to supporters of the law.
Fewer people will also lose employer-provided health insurance than previously thought, which is welcome news for the administration given Republican attacks over people’s plans being canceled.
“It’s still a very controversial law but the fact that it is costing the federal government less than expected is no doubt heartening to its advocates, and I think it bolsters the case that [the law] is helping reduce the deficit,” said Larry Levitt, senior vice president at the Kaiser Family Foundation, a health policy non-profit group.
The CBO report comes on the same day that Health and Human Services Secretary Sylvia Mathews Burwell announced that 11.7 million people had signed up for private insurance through ObamaCare up to Feb. 22. |
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nw30
Joined: 21 Dec 2008
Posts: 6485
Location: The eye of the universe, Cen. Cal. coast
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| Posted: Tue Mar 10, 2015 4:00 pm Post subject: |
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| mac wrote: | None of the conservatives will get this news on their e-mail servers. None of them will actually read any of the details:
| Quote: | By Peter Sullivan - 03/09/15 05:31 PM EDT
ObamaCare got some good news from the nonpartisan Congressional Budget Office on Monday, which projected that the law’s price tag will be lower than previously thought.
The budget scorekeeper said that health insurance premiums will be lower, so the cost of helping people afford coverage has gone down. The lower prices are part of a broader slowdown in the rise of health costs that is encouraging to supporters of the law.
Fewer people will also lose employer-provided health insurance than previously thought, which is welcome news for the administration given Republican attacks over people’s plans being canceled.
“It’s still a very controversial law but the fact that it is costing the federal government less than expected is no doubt heartening to its advocates, and I think it bolsters the case that [the law] is helping reduce the deficit,” said Larry Levitt, senior vice president at the Kaiser Family Foundation, a health policy non-profit group.
The CBO report comes on the same day that Health and Human Services Secretary Sylvia Mathews Burwell announced that 11.7 million people had signed up for private insurance through ObamaCare up to Feb. 22. |
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That's only part of the story, here's the rest.
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Obamacare exchange customers set for significant premium spikes, CBO predicts
By Stephen Dinan - The Washington Times - Monday, March 9, 2015
Obamacare exchange customers are about to see spikes in their premiums, the Congressional Budget Office predicted Monday, saying insurers that offer plans are facing twin pressures from the government and the marketplace that will mean hikes of more than 8 percent a year through 2018.
Now in the second year of full operation, the exchanges are critical to the success of the law. The government is using tax subsidies to attract more customers to help offset costs for the rest of the system.
Nearly 11.7 million Americans bought plans on the exchange in the second enrollment period, Health and Human Services Secretary Sylvia Mathews Burwell announced Monday afternoon, hours after the CBO’s analysis was released.
The CBO said premiums for the key “benchmark” exchange plans will rise an average of 8.5 percent per year from 2016 to 2018, faster than the rest of the health care market.
The budget analysts said part of the reason is that the plans offered now are narrower than private plans and reimburse providers at lower rates. They said both trends probably will change, forcing insurers to raise premiums.
Overall, the CBO said, health care costs for the government and for private consumers are lower than expected just a few years ago. That means Obamacare is less expensive than predicted when the Affordable Care Act was enacted in 2010, though it’s covering fewer Americans than President Obama hoped.
Read more: http://www.washingtontimes.com/news/2015/mar/9/obamacare-premiums-spike-law-cheaper-expected/#ixzz3U1D1q2yf |
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isobars
Joined: 12 Dec 1999
Posts: 20935
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| Posted: Tue Mar 10, 2015 4:19 pm Post subject: |
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| nw30 wrote: | | [b]Obamacare exchange customers set for significant premium spikes |
Obama was briefed on that in April, 2010 (source cited several times), then lied to the public about it. |
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mac
Joined: 07 Mar 1999
Posts: 17747
Location: Berkeley, California
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| Posted: Tue Mar 10, 2015 4:30 pm Post subject: |
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| In the bubble, 1/3 lower prices become "significant price spikes." Too funny. |
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