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2017-01-16 8:14 AM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?
I think they went about health care reform all wrong. They forced people to buy insurance.....even people that didn't want it and that statistically, didn't need it. I think they should have first addressed the ridiculous cost of medical coverage....like charging BC/BS $500 but if you are not an insurance company it cost $2,300. Also need to stop people (on the government dime) from going to the ER for a case of the sniffles because the ER is covered but a family doc is not. They also need to increase competition by allowing insurance to be sold across state line.

I guess they really need to define the goal. Is it for everyone to have insurance or for everyone to have health care?

I'm sure there are many ways to crack this nut without breaking what was not previously broken.


2017-01-16 8:58 AM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by spudone

So- are we all agreeing here that there IS no replace plan?  So, Trump and all the GOP talking heads are just blatantly lying?

If there was a detailed counter-plan to the ACA that was agreed upon by most / all of the Republicans in Congress, then it would've been pitched to us sometime during the past 8 years, probably during an election cycle.

When they finally do offer a plan, it will be the usual conservative checklist: block grants to states, defund Planned Parenthood, deregulate insurance companies (hello high risk pools and lifetime maximums), and oh yeah run up even more of a deficit.

And before anyone goes off and flames me, why don't we just sit back and see if my prediction comes true.




I think they just concentrated on the repeal aspect of it. There was never a chance that they could have replaced it because obama vetoed it every time. We've had a stalemate in goobermint for quite some time now. I honestly don't think they believed they would actually beat hillary either. Hence, no need to plan, just push forth with the 'suggestion' that they were doing something about it. Suddenly… BAMO. They're holding all the chips and have been caught with their ****s in their hands. Defunding PP is a given. The Republicans love to beat on that dead horse and will no doubt tie it into their plan somewhere.

I'm not sure I agree that allowing insurance to be sold across state lines is the equivalent of dereg. Don't they have high risk pools and max benefits in place already? Run up more deficit? I haven't heard any democrats complaining about the staggering debt the o admin piled on top of our collective backs. Why be concerned about it now? However, I doubt you'd be wrong. The Republicans proved during W's administration that they could spend the heck out of some money too. The only thing I see holding them back from doing that is Trump. It's up to him to keep his promise to put the brakes on deficit spending. This is one of the many Trump unknowns that I'm going to have to give him the benefit of doubt to see how he plays it.

Why do you think you were going to get flamed? You posed an honest and respectful post. We can be and need to able to discuss politics in this country without bringing personal emotion into it.
2017-01-16 9:27 AM
in reply to: mdg2003

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Subject: RE: What is the Obamacare 'replace'?

This is just my opinion but I believe that free market principles fail to combat costs in the health care industry.  Put Apple against Google?  Sure, that works.  If I don't like Apple's offering I go elsewhere.  Or I skip it altogether.

But when someone is dying, suddenly they're willing to do or pay anything to be taken care of.  And the pharmaceutical and insurance industries know it.  That's why I mentioned the Medicare thing - because it is built-in leverage (old people vote a lot; Medicare isn't going anywhere) -- without necessarily going to single-payer.

This really isn't that hard - the rest of the world has figured out that governments can and should stand up to these industry giants.

n=1  -- I had an emergency in Canada last year.  I think my total bill before insurance was around $1k, including a 30 min ambulance ride and ER.  The last time I had an ambulance ride in the U.S. was 2 miles to the hospital and billed at around $5k.  For just the ambulance.  Yes insurance covered that but it's a great example of the b.s. pricing that Rogillio is talking about.

2017-01-16 9:30 AM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?

$1k Canadian dollars haha.  Even better.

2017-01-16 9:48 AM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?
I think fundamentally we have put too much on health "insurance". Insurance ought to cover unexpected high cost items. Not routine physicals and a case of the sniffles or an ear infection. If auto insurance were like health insurance you'd file a claim every time you changed the oil. After all, that is preventative in nature and avoids high costs later.

Ok, let me go out on a limb and tell you what is really wrong with healthcare in our country....IN MY OPINION.

The most powerful 'union' in the country is the AMA. Why do doctors make so much money? Supply and demand. There is just not enough competition. Why? Because the AMA says you have to go to 4 years of undergraduate school before you can even start medical school. Doesn't really matter what your undergrad degree is in.....what matter is how well you do on your MCATS. So the brainiac valedictorian from HS looks at 12 years of school to become a doctor and says 'no way!'. The medical profession is a very exclusive club. There are nurses and PAs that are every bit as competent as the doctors they support but the make a fraction of what the doctor makes.

If they eliminated the need for a 4 year undergrad degree to get into medical school they'd have thousands of more people becoming doctors. And I mean smart, capable people.

BTW, it is not just doctors that hold the keys to their club. Education, engineering, plumbers, electricians, machinists, etc. Tons of people that can teach. Take a stay at home mom that has raised 5 kids and they are grown. She knows how to handle children and can certainly master 2nd grade reading.....why not let her teach! Let the local school board/principal decide if she is competent. And btw, just having a degree in elementary education and a teaching certificate is no guarantee of competency.

2017-01-16 9:51 AM
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Subject: RE: What is the Obamacare 'replace'?

One of the things I have learned over the years is that health care, like almost everything else in life, is not equal for everyone.  I think more people need to learn that.

I recently lost my best friend to cancer.  He had decent insurance, and he got the standard care and treatment from his local hospital.  It was interesting for me to watch because my brother currently has terminal liver cancer......and he has decent insurance, and a lot of money, so he's at the Sloan Kettering institute getting cutting edge care.  A year ago he was given 6 months to live, but through some of the best cancer care available on the planet, he is now cancer free and his prognosis is much brighter......5-10 years, but that comes with the idea that more and better treatment will be developed during that time frame and then who knows?  He picked up and moved to New York when he was diagnosed.  Rented a 6K/month apartment nearly next door to the Cancer Center, and lived there a year.  The type of treatment available to him was not even an option for my friend who died.......the cutting edge type treatments are just not available at your local hospital (for the most part).

I agree that nobody should be without health care in our country, but we're not all going to get equal care.  That's life.  We changed to a more expensive plan so that we could have access to the best orthopedics in our area.  That's important to our active and athletic family.  We feel fortunate that we could afford the more expensive plan.  But we had orthopedic care before, as do the people who still see those doctors that we had been seeing.  I don't think the care is equal at all, but paying a bit more is part of the deal.  That's life.  You either can or you can't and you make life decisions based on what's important to you.  Better health care or a new car for instance.  An Iphone or a cheaper phone. Steak or hamburger.  Eating out or cooking at home.  These types of decisions are endless and were a staple of life when I was growing up.  Now everyone thinks they have a right to what everyone else has, cost be damned.  No, that's NOT life. 

Healthcare will never be equal for all.....like everything else in life.  Your life decisions will carry a bigger weight on your type of care (and most everything else) then anything the govt. comes up with.



Edited by Left Brain 2017-01-16 9:55 AM


2017-01-16 10:20 AM
in reply to: Left Brain

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by Left Brain

One of the things I have learned over the years is that health care, like almost everything else in life, is not equal for everyone.  I think more people need to learn that.

I recently lost my best friend to cancer.  He had decent insurance, and he got the standard care and treatment from his local hospital.  It was interesting for me to watch because my brother currently has terminal liver cancer......and he has decent insurance, and a lot of money, so he's at the Sloan Kettering institute getting cutting edge care.  A year ago he was given 6 months to live, but through some of the best cancer care available on the planet, he is now cancer free and his prognosis is much brighter......5-10 years, but that comes with the idea that more and better treatment will be developed during that time frame and then who knows?  He picked up and moved to New York when he was diagnosed.  Rented a 6K/month apartment nearly next door to the Cancer Center, and lived there a year.  The type of treatment available to him was not even an option for my friend who died.......the cutting edge type treatments are just not available at your local hospital (for the most part).

I agree that nobody should be without health care in our country, but we're not all going to get equal care.  That's life.  We changed to a more expensive plan so that we could have access to the best orthopedics in our area.  That's important to our active and athletic family.  We feel fortunate that we could afford the more expensive plan.  But we had orthopedic care before, as do the people who still see those doctors that we had been seeing.  I don't think the care is equal at all, but paying a bit more is part of the deal.  That's life.  You either can or you can't and you make life decisions based on what's important to you.  Better health care or a new car for instance.  An Iphone or a cheaper phone. Steak or hamburger.  Eating out or cooking at home.  These types of decisions are endless and were a staple of life when I was growing up.  Now everyone thinks they have a right to what everyone else has, cost be damned.  No, that's NOT life. 

Healthcare will never be equal for all.....like everything else in life.  Your life decisions will carry a bigger weight on your type of care (and most everything else) then anything the govt. comes up with.




Well you are not politically correct but you are right. The idea that everyone is equal is just not the case. When it comes to athletics, I was born in the shallow end of the gene pool. No matter how hard I worked, I was never going to be able to hit a major league baseball. Try as he might, my roommate in college was never going to be able to do the calculus I was doing. We are all born with different gifting and some of use have the added benefits of parents who raised up to work hard, stay in school, be honest and trustworthy. Men and woman are different. Period. Not just physically but mentally we are hard-wired differently. I saw an article about a couple who had 4 kids....2 boys and 2 girls. They were flower-child liberals and decided they wanted to raise their kids in a gender neutral environment....no blue for the boys and pink for the girls in their house. They found that when they gave the girls dolls, the girls played house/family with them. When they gave dolls to the boys, the boys played swords with them. I have a brother and 2 sisters and I can totally relate to this.

Ohamacare called my insurance a 'Cadillac Plan' because it paid virtually everything at zero cost to me. So in order to insure those without insurance, for whatever reason, they decided my insurance had to cost more and cover less. So my costs when waaay up! For the life of me, I can't see how penalizing my company for giving good benefits helps to ensure people who no insurance.

I don't know what the 'fix' is to Omabacare but you can bet your sweetass I won't be getting my Cadillac medical plan back! That ship has sailed and Elvis was on it.....mixaphorically speaking.




2017-01-16 10:56 AM
in reply to: Rogillio

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by Rogillio

I think fundamentally we have put too much on health "insurance". Insurance ought to cover unexpected high cost items. Not routine physicals and a case of the sniffles or an ear infection. If auto insurance were like health insurance you'd file a claim every time you changed the oil. After all, that is preventative in nature and avoids high costs later.

Ok, let me go out on a limb and tell you what is really wrong with healthcare in our country....IN MY OPINION.

The most powerful 'union' in the country is the AMA. Why do doctors make so much money? Supply and demand. There is just not enough competition. Why? Because the AMA says you have to go to 4 years of undergraduate school before you can even start medical school. Doesn't really matter what your undergrad degree is in.....what matter is how well you do on your MCATS. So the brainiac valedictorian from HS looks at 12 years of school to become a doctor and says 'no way!'. The medical profession is a very exclusive club. There are nurses and PAs that are every bit as competent as the doctors they support but the make a fraction of what the doctor makes.

If they eliminated the need for a 4 year undergrad degree to get into medical school they'd have thousands of more people becoming doctors. And I mean smart, capable people.

BTW, it is not just doctors that hold the keys to their club. Education, engineering, plumbers, electricians, machinists, etc. Tons of people that can teach. Take a stay at home mom that has raised 5 kids and they are grown. She knows how to handle children and can certainly master 2nd grade reading.....why not let her teach! Let the local school board/principal decide if she is competent. And btw, just having a degree in elementary education and a teaching certificate is no guarantee of competency.




The AMA doesn't represent the majority of physicians and lets not forget they backed the ACA. If you believe PA's and NP's are the equivalent of MD's then by all means go see one. However do not think that they are equivalent, because the training isn't remotely close. My wife (MD,double boards, med school faculty, prof of clinical medicine) teaches/trains med students and residents says that unless you have been through medical education you cannot imagine what it takes. Sure, there are a lot of "smart capable" people out there and most of them do not have what it takes to be a MD. I know I don't.

I am not downing mid level providers, they fill a need, but they are not the answer to the primary care doc shortage.





2017-01-16 12:02 PM
in reply to: NXS

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by NXS

Originally posted by Rogillio

I think fundamentally we have put too much on health "insurance". Insurance ought to cover unexpected high cost items. Not routine physicals and a case of the sniffles or an ear infection. If auto insurance were like health insurance you'd file a claim every time you changed the oil. After all, that is preventative in nature and avoids high costs later.

Ok, let me go out on a limb and tell you what is really wrong with healthcare in our country....IN MY OPINION.

The most powerful 'union' in the country is the AMA. Why do doctors make so much money? Supply and demand. There is just not enough competition. Why? Because the AMA says you have to go to 4 years of undergraduate school before you can even start medical school. Doesn't really matter what your undergrad degree is in.....what matter is how well you do on your MCATS. So the brainiac valedictorian from HS looks at 12 years of school to become a doctor and says 'no way!'. The medical profession is a very exclusive club. There are nurses and PAs that are every bit as competent as the doctors they support but the make a fraction of what the doctor makes.

If they eliminated the need for a 4 year undergrad degree to get into medical school they'd have thousands of more people becoming doctors. And I mean smart, capable people.

BTW, it is not just doctors that hold the keys to their club. Education, engineering, plumbers, electricians, machinists, etc. Tons of people that can teach. Take a stay at home mom that has raised 5 kids and they are grown. She knows how to handle children and can certainly master 2nd grade reading.....why not let her teach! Let the local school board/principal decide if she is competent. And btw, just having a degree in elementary education and a teaching certificate is no guarantee of competency.




The AMA doesn't represent the majority of physicians and lets not forget they backed the ACA. If you believe PA's and NP's are the equivalent of MD's then by all means go see one. However do not think that they are equivalent, because the training isn't remotely close. My wife (MD,double boards, med school faculty, prof of clinical medicine) teaches/trains med students and residents says that unless you have been through medical education you cannot imagine what it takes. Sure, there are a lot of "smart capable" people out there and most of them do not have what it takes to be a MD. I know I don't.

I am not downing mid level providers, they fill a need, but they are not the answer to the primary care doc shortage.








I believe that using mid level providers and clinics is the direction our country is headed under the ACA. I've seen 'urgent care clinics' popping up all over the city in the last 5-6 years. Most of these clinics are staffed with PAs under the supervision of one MD.
2017-01-16 12:26 PM
in reply to: mdg2003

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Subject: RE: What is the Obamacare 'replace'?

Originally posted by mdg2003
Originally posted by NXS
Originally posted by Rogillio I think fundamentally we have put too much on health "insurance". Insurance ought to cover unexpected high cost items. Not routine physicals and a case of the sniffles or an ear infection. If auto insurance were like health insurance you'd file a claim every time you changed the oil. After all, that is preventative in nature and avoids high costs later. Ok, let me go out on a limb and tell you what is really wrong with healthcare in our country....IN MY OPINION. The most powerful 'union' in the country is the AMA. Why do doctors make so much money? Supply and demand. There is just not enough competition. Why? Because the AMA says you have to go to 4 years of undergraduate school before you can even start medical school. Doesn't really matter what your undergrad degree is in.....what matter is how well you do on your MCATS. So the brainiac valedictorian from HS looks at 12 years of school to become a doctor and says 'no way!'. The medical profession is a very exclusive club. There are nurses and PAs that are every bit as competent as the doctors they support but the make a fraction of what the doctor makes. If they eliminated the need for a 4 year undergrad degree to get into medical school they'd have thousands of more people becoming doctors. And I mean smart, capable people. BTW, it is not just doctors that hold the keys to their club. Education, engineering, plumbers, electricians, machinists, etc. Tons of people that can teach. Take a stay at home mom that has raised 5 kids and they are grown. She knows how to handle children and can certainly master 2nd grade reading.....why not let her teach! Let the local school board/principal decide if she is competent. And btw, just having a degree in elementary education and a teaching certificate is no guarantee of competency.
The AMA doesn't represent the majority of physicians and lets not forget they backed the ACA. If you believe PA's and NP's are the equivalent of MD's then by all means go see one. However do not think that they are equivalent, because the training isn't remotely close. My wife (MD,double boards, med school faculty, prof of clinical medicine) teaches/trains med students and residents says that unless you have been through medical education you cannot imagine what it takes. Sure, there are a lot of "smart capable" people out there and most of them do not have what it takes to be a MD. I know I don't. I am not downing mid level providers, they fill a need, but they are not the answer to the primary care doc shortage.
I believe that using mid level providers and clinics is the direction our country is headed under the ACA. I've seen 'urgent care clinics' popping up all over the city in the last 5-6 years. Most of these clinics are staffed with PAs under the supervision of one MD.

Yep, and the "masses" are happy because it's covered by their INSURANCE.  It's not better care then going to the ER with no insurance.....in fact, it's an easy argument that the care is actually worse.  That brings me back to my original comment on this thread.  The ACA was good for insurance companies, and a huge gain for drug companies......nobody can convince me that the level of care was increased. 

2017-01-16 1:02 PM
in reply to: Left Brain

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Subject: RE: What is the Obamacare 'replace'?

Yep, and the "masses" are happy because it's covered by their INSURANCE.  It's not better care then going to the ER with no insurance.....in fact, it's an easy argument that the care is actually worse.  That brings me back to my original comment on this thread.  The ACA was good for insurance companies, and a huge gain for drug companies......nobody can convince me that the level of care was increased.

Sure it's a worse deal for someone with a sniffle.  But I'd rather have them chipping in their co-pay and keeping the ER clear for people who are, you know, dying.

And then the other big thing IMO - goes back to what Rogillio was saying.  The *primary* goal of insurance should be to cover the random catastrophic stuff.  I don't know what you group under "level of care" but getting more people insured is good on this point.  Because a) someone faced with disaster now doesn't have to mortgage his house or take on a debt that might pass to his or her family.  And b) because putting people under an insurer does a way better job of handling liability claims, etc, which are a drain on our medical system.

Do I think insurance companies are scummy and shafting us?  Well sure, that's what they do.



2017-01-16 1:12 PM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?

Originally posted by spudone

Yep, and the "masses" are happy because it's covered by their INSURANCE.  It's not better care then going to the ER with no insurance.....in fact, it's an easy argument that the care is actually worse.  That brings me back to my original comment on this thread.  The ACA was good for insurance companies, and a huge gain for drug companies......nobody can convince me that the level of care was increased.

Sure it's a worse deal for someone with a sniffle.  But I'd rather have them chipping in their co-pay and keeping the ER clear for people who are, you know, dying.

And then the other big thing IMO - goes back to what Rogillio was saying.  The *primary* goal of insurance should be to cover the random catastrophic stuff.  I don't know what you group under "level of care" but getting more people insured is good on this point.  Because a) someone faced with disaster now doesn't have to mortgage his house or take on a debt that might pass to his or her family.  And b) because putting people under an insurer does a way better job of handling liability claims, etc, which are a drain on our medical system.

Do I think insurance companies are scummy and shafting us?  Well sure, that's what they do.

I have heard the "mortgage the house" to pay for medical care thing for many years.  I don't know if I buy into that.  I have no doubt that relatively few people got into financial trouble over medical bills that they basically had no choice in amassing......but this idea of a large amount of people basically be being put out in the street over medical care is an urban myth.  As far as I can tell......the "best" thing the ACA did was give people access to cheaper medicine.....and I'm a looooong way from thinking that was a great thing under the current addiction climate.

As I said.  I think that making insurance available to everyone is a good thing.  The idea that all will be miraculously saved is quite another thing. The idea that all will have equal access to the same good care is just absolutely wrong.

2017-01-16 1:45 PM
in reply to: NXS

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by NXS

Originally posted by Rogillio

I think fundamentally we have put too much on health "insurance". Insurance ought to cover unexpected high cost items. Not routine physicals and a case of the sniffles or an ear infection. If auto insurance were like health insurance you'd file a claim every time you changed the oil. After all, that is preventative in nature and avoids high costs later.

Ok, let me go out on a limb and tell you what is really wrong with healthcare in our country....IN MY OPINION.

The most powerful 'union' in the country is the AMA. Why do doctors make so much money? Supply and demand. There is just not enough competition. Why? Because the AMA says you have to go to 4 years of undergraduate school before you can even start medical school. Doesn't really matter what your undergrad degree is in.....what matter is how well you do on your MCATS. So the brainiac valedictorian from HS looks at 12 years of school to become a doctor and says 'no way!'. The medical profession is a very exclusive club. There are nurses and PAs that are every bit as competent as the doctors they support but the make a fraction of what the doctor makes.

If they eliminated the need for a 4 year undergrad degree to get into medical school they'd have thousands of more people becoming doctors. And I mean smart, capable people.

BTW, it is not just doctors that hold the keys to their club. Education, engineering, plumbers, electricians, machinists, etc. Tons of people that can teach. Take a stay at home mom that has raised 5 kids and they are grown. She knows how to handle children and can certainly master 2nd grade reading.....why not let her teach! Let the local school board/principal decide if she is competent. And btw, just having a degree in elementary education and a teaching certificate is no guarantee of competency.




The AMA doesn't represent the majority of physicians and lets not forget they backed the ACA. If you believe PA's and NP's are the equivalent of MD's then by all means go see one. However do not think that they are equivalent, because the training isn't remotely close. My wife (MD,double boards, med school faculty, prof of clinical medicine) teaches/trains med students and residents says that unless you have been through medical education you cannot imagine what it takes. Sure, there are a lot of "smart capable" people out there and most of them do not have what it takes to be a MD. I know I don't.

I am not downing mid level providers, they fill a need, but they are not the answer to the primary care doc shortage.








I wasn't suggesting shortening medical or clinic/internships.....but IMO the added 4 years of an undergraduate degree just make it not worth the time and money. The AMA may not represent them but it is my understanding that they make the 'rules' as to who can and cannot practice medicine. While taking English Lit in college may makes you a more well rounded person I don't think it makes you a better doctor.

We've had a ton of the Doc in a Box places open up around here lately too. I think these are great. Do you really need 12 years of schooling/training to look into someone ear and say, "Yes, it is infected." and prescribe the latest ear infection drug? BTW, my doctor looks up everything anyway! She carries an iPad or laptop with her and is constantly looking things up.

Back to the ACA....I also think tort reform is part and parcel to health care reform. I think there is far too much CYA medicine practiced. I also think the vast majority of people who go to the doctor's when they have a cold (including my wife!) are given prescriptions unnecessarily...that the insurance ends up paying for. Some of this is CYA but some of it is to make the patient feel like they did the right thing by going to the doctor even though they have a virus and medical science has NEVER cured a virus...any virus.....ever.

2017-01-16 1:47 PM
in reply to: Left Brain

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Subject: RE: What is the Obamacare 'replace'?

I guess to rephrase - insurance is all about a distributed burden.  We each pay in a little to protect against the *chance* of something really bad happening.

The problem in the U.S. is that everything is "really bad" nowadays.  If medical pricing was more transparent and equal for those paying cash vs. those using insurance, then we wouldn't need insurance to pay for every little thing.

2017-01-16 1:49 PM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?

Originally posted by spudone

I guess to rephrase - insurance is all about a distributed burden.  We each pay in a little to protect against the *chance* of something really bad happening.

The problem in the U.S. is that everything is "really bad" nowadays.  If medical pricing was more transparent and equal for those paying cash vs. those using insurance, then we wouldn't need insurance to pay for every little thing.

There!  I agree 100%.

2017-01-16 2:28 PM
in reply to: Left Brain

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by Left Brain

Originally posted by spudone

I guess to rephrase - insurance is all about a distributed burden.  We each pay in a little to protect against the *chance* of something really bad happening.

The problem in the U.S. is that everything is "really bad" nowadays.  If medical pricing was more transparent and equal for those paying cash vs. those using insurance, then we wouldn't need insurance to pay for every little thing.

There!  I agree 100%.




Me too!

There out to me a menu at the hospital:

Aspirin: $17

Q-tip: $9

Room per night: $800

Cotton swab: $19

Rubber gloves: $53

X-rays: $150 per shot (total, not $100 for the technician and $200 for the X-ray doc who can read them)


Come to the doctor with a runny nose: $100

Ear infection: $10

Burns when you pee......

Well, whatever.

The government regulates taking advantage of people all the time. If there is a storm and you lose power and you sell bottled water for $10 a bottle you will go to jail. Only movie theaters are allowed to charge that much for bottle water! Same out to be the case for 'sick' people. You can't take advantage of them just because they tripped on the skateboard and broke their arm. That ought not be a lottery ticket for the hospital!





2017-01-16 6:17 PM
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Subject: RE: What is the Obamacare 'replace'?
Originally posted by spudone

I guess to rephrase - insurance is all about a distributed burden.  We each pay in a little to protect against the *chance* of something really bad happening.

The problem in the U.S. is that everything is "really bad" nowadays.  If medical pricing was more transparent and equal for those paying cash vs. those using insurance, then we wouldn't need insurance to pay for every little thing.




Bingo! One of many things to do is allow catastrophic policy with an HSA. Lost mine with the ACA, didn't qualify. So the next best option for us had the price increase of $18K. Guess what we went uninsured and my wife left private practice to get benefits. The few times we have had to use the hospital (for x-rays, testing), I asked what the cash price was and medicare reimbursement. I then dickered to see if I could get the cheaper of the two. They usually are willing to negotiate.

One of the problems that was mentioned is over use. My child fell off the sofa and needs a cat scan. Really? Or one that will hit close to home here, my joint hurts I need to see an ortho. I know stop training and using for 6+ months and it will be ok, but I want the surgical procedure so I can get back to the bike, running or swimming. What it all boils down to is WE are the reasons rates are so high.

Its not an easy fix. My only suggestion is get input from docs in the trenches of healthcare. They can tell you what works and what doesn't for healthcare delivery.




Edited by NXS 2017-01-16 6:18 PM
2017-01-17 12:33 PM
in reply to: NXS

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Subject: RE: What is the Obamacare 'replace'?

One of the problems that was mentioned is over use. My child fell off the sofa and needs a cat scan. Really? Or one that will hit close to home here, my joint hurts I need to see an ortho. I know stop training and using for 6+ months and it will be ok, but I want the surgical procedure so I can get back to the bike, running or swimming. What it all boils down to is WE are the reasons rates are so high.

It's a fine balance.  You want doctors to be free to make a full and confident diagnosis with the proper tools.  I'm an athletic guy... when I had a pulmonary embolism, I was biking 20 miles the next day.  But after still "not feeling right" I went to urgent care.  That doctor easily could've sent me home but he went down the checklist, and I was also fortunate they had a CT scan on-site, and basically saved my life.

2017-01-17 12:48 PM
in reply to: spudone

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Subject: RE: What is the Obamacare 'replace'?

Yeah, more agreement.....it IS a fine line, and the orthopedic is a bad example IMO.  Then again, we don't have any surgery-happy docs that we see.  BUT....back when we had poor orthopedic care we once had surgery set up for one of our kids over what turned out to be a ganglion cyst.  The second opinion doctor was incredulous that doc #1 wanted to operate.

Like I said before, me3dical care isn't all GOOD medical care, and having insurance doesn't necessarily mean you get good care.

2017-01-18 10:16 AM
in reply to: Left Brain

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by Left Brain

Like I said before, me3dical care isn't all GOOD medical care, and having insurance doesn't necessarily mean you get good care.




still insurance still might be better than do it yourself ad hoc care. While insurance requirements for testing might over do it in some case. It does help prevent a test happy doctor. from over testing and a poor person from only approving cheap tests.
2017-01-19 9:39 AM
in reply to: chirunner134

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Subject: RE: What is the Obamacare 'replace'?

I'm hoping that one of tenets of any "replace" focuses on patient outcomes vs. patient encounters as a reimbursement trigger. 

If I take my car into the shop to get a squeak fixed, and they do stuff that doesn't fix it and charge me $500, I'm taking the damn thing back and demanding they fix it (I know that's oversimplifying a bit).

In our current healthcare system, if I'm sick, I go to the doctor.  They do some tests and prescribe a treatment.  The treatment doesn't work.  I get a bill for the visit and maybe the treatment and some combination of my insurance and me pays the bill.  The treatment doesn't work.  I go back to the same doctor, and they prescribe a different course of treatment.  I get ANOTHER bill.  Somehow I'm not upset at all.

How does THAT make sense?



2017-01-19 11:02 AM
in reply to: jmhpsu93

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by jmhpsu93

I'm hoping that one of tenets of any "replace" focuses on patient outcomes vs. patient encounters as a reimbursement trigger. 

If I take my car into the shop to get a squeak fixed, and they do stuff that doesn't fix it and charge me $500, I'm taking the damn thing back and demanding they fix it (I know that's oversimplifying a bit).

In our current healthcare system, if I'm sick, I go to the doctor.  They do some tests and prescribe a treatment.  The treatment doesn't work.  I get a bill for the visit and maybe the treatment and some combination of my insurance and me pays the bill.  The treatment doesn't work.  I go back to the same doctor, and they prescribe a different course of treatment.  I get ANOTHER bill.  Somehow I'm not upset at all.

How does THAT make sense?




I think they justify that by calling it "practicing medicine."
2017-01-23 11:23 AM
in reply to: mdg2003

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Subject: RE: What is the Obamacare 'replace'?
Originally posted by mdg2003

Originally posted by jmhpsu93

I'm hoping that one of tenets of any "replace" focuses on patient outcomes vs. patient encounters as a reimbursement trigger. 

If I take my car into the shop to get a squeak fixed, and they do stuff that doesn't fix it and charge me $500, I'm taking the damn thing back and demanding they fix it (I know that's oversimplifying a bit).

In our current healthcare system, if I'm sick, I go to the doctor.  They do some tests and prescribe a treatment.  The treatment doesn't work.  I get a bill for the visit and maybe the treatment and some combination of my insurance and me pays the bill.  The treatment doesn't work.  I go back to the same doctor, and they prescribe a different course of treatment.  I get ANOTHER bill.  Somehow I'm not upset at all.

How does THAT make sense?




I think they justify that by calling it "practicing medicine."


I heard a doctor say he was told this in medical school but maybe its an old saying. Good news half what we know about medicine is true. trouble is we do not know what half.

I was a big fan of tv show house. in the show house had to nearly kill the person 4 times before he got it right. While I know that is a tv show I can see that. Some things scream what it is. I was going into liver shutdown and my PA had to send me to a specialist to be sure. I thought the yellow skin and eyes was a pretty good give away.
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