Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[bcl05]

I don't think the answer is simply to do less.  I think it is to do smarter health care.  I think there is a lot of health care happening that doesn't need to, and a lot that should be happening that isn't.  If we spent more on prevention, population health, early detection screening, etc, we could be a lot healthier as a country.  That should be the goal, I think.  

 

I think we need a system that incentivizes health and best practices, which would be very different than the system we have today.  The goal shouldn't be to simply spend less.  It should be to make our people healthier.  I think if we do that, our health care costs would drop.

[Larry]

Maybe the path to incentivizing wellness is more of an HMO model.  The provider gets X$ per patient, as opposed to X$ per treatment.  It's to their advantage to keep the patient from needing treatment.  

 

But there's a reason why patients hate that model.  They have a problem with having to convince underlings that they actually do need to see a doctor, for example.  (Silly customers.)  

 

And there's practical problems with it, too.  For example, it really can only work as long as the patient remains within one provider's service area.  

 

[LadySkinsFan]

2 hours ago, Springfield said:

 

 

I think the biggest problem to solve when lowering the overall cost of health care is the fact that many, many people will lose their jobs.

 

I happen to agree with this, that a large employment sector will lose their jobs, and we are not preparing for this occurrence. 

 

The ACA was a first step if it is implemented in total. This will take decades to achieve, and much forethought. 

 

A commission that takes everything into account with the end result of realistic, affordable healthcare will have to be created. And to get rid of a healthcare system that is profit driven, that isn't advertised, that isn't tied to employment/employer decisions. Since Nixon signed into law the HMO system, it's been decades to where we are now. It will take decades, dedication, non-politics to fix this mess. I see several phases to this process.

[Larry]

Had some thoughts while driving to the restaurant to eat an unhealthy diet, before going in to my health care job. 

 

Lets assume that that at least part of the problem is doctors being invented to order more treatments or procedures. We have at least anecdotal evidence that it's happening. 

 

I assume we we can all see problems with a system that invents NOT caring for patients. 

 

Maybe be the problem is that doctors have become too tied to companies that actually deliver care. 

 

If the company that the doctor works for doesn't perform colonoscopies, then the doctor has no incentive to order colonoscopies for borderline patients. He can make his decision based only on the patient. (At least no DIRECT incentive. Maybe there would be the equivelant of drug reps. But the drug rep wouldn't be the doctor's employer.)

 

Is that something that can be done?  Make doctors more independent?  

 

Edit, now that I'm back home.  

 

Maybe a rule?  Medicare will not pay a company for a procedure that was ordered by an employee of the same company?  

 

(If the procedure costs more than X$.  I think we can go too far with ordering "separation of diagnosis and treatment".  Don't think we want a world where doctors have to say "Well, that cut on your kid's elbow is infected.  now I have to give you this piece of paper that tells you to go somewhere else so somebody else can drain it, and apply antibiotic and a band aid."  I don;t think we have a problem with an osteopath diagnosing a broken bone, and applying a cast in the same office.)  

Edited July 8, 2017 by Larry

[Sacks 'n' Stuff]

Ever wonder why there are commercials on TV for prescription drugs?

[Hersh]

3 minutes ago, Sacks 'n' Stuff said:

Ever wonder why there are commercials on TV for prescription drugs?

One of my best friends and I were just discussing this as he was talking about how costly litigation is for these big pharma. When I made the point about the absurdity of their advertising budgets (they shouldn't advertise) he mentioned that a part of the litigation comes from bad commercials when they promise something that doesn't deliver. 

[Larry]

9 minutes ago, Sacks 'n' Stuff said:

Ever wonder why there are commercials on TV for prescription drugs?

 

Well, now we're getting into another possible source of pressure on doctors to over treat - patient pressure.  

 

I assume that we all agree that we can't prevent the doctor from considering the patient's wishes, when weighing treatment options.  

 

But I would assume that the proliferation of deductibles and copays in health insurance would exert a downward pressure on that source of pressure.  If the patient is on the hook for the price of some or all of the bill, then they might not exert so much pressure on the doctor to order more procedures.  

 

(But again, I think we can go too far in that direction.  I think a case can be made that some procedures, like routine screening tests or vaccinations, ought to be low or no cost.  Because we want to encourage people to get those done, as opposed to treating them when it's more expensive.)  

 

[Busch1724]

I have the solution...ban soda and energy drinks!

 

There done!

 

But really, getting back to the points made by bc105...I have a family member who is also a doctor and often talks about and agrees with many of the points you've made. He is interested, should say at this point in time that he doesn't have an opinion or assumption on the subject yet, in seeing if the increase of QHDH plans will have an impact on the overall population's health. An argument could be made for it and one against it.

 

Where I teach, we switched to one a couple of years ago. This will be our third year in it. Our health care costs have gone down about 25%, right in line with what research shows. As a result, our premiums have gone down. I know everyone employed by the district is much more aware of the insurance usage. I'm not sure if we're healthier. Maybe it's incentivized some to lead a healthier lifestyle, but who really knows  for sure without getting everyone's honest opinion about their health care expenses. 

Edited July 8, 2017 by Busch1724
added some more thoughts.

[@DCGoldPants]

When a drug company puts out an ad and lists the benefits of their product. They also have to list the possible side effects. 

 

I'd like elected officials have to do the same when talking vaguely about their new policies or law. 

 

*Trumpcare may lead to bankruptcy, illness, and death for tens of millions of Americans. Trumpcare will lead to tax breaks for those who need them the least. Consult your common sense before taking Trumpcare. 

[LadySkinsFan]

The side effects of the drugs advertised are scary. 

 

I have diabetes and those drugs are scary. 

[Going Commando]

Loss of insurance industry and drug company jobs could be offset by far more valuable healthcare delivery jobs.  You'd have to massively expand the healthcare infrastructure of the country to meet the demand that universal healthcare would create.  Also... A lot of the private bureaucracy in hospital/office billing departments and insurance companies would be replaced by a public one.

 

Let's be honest, most of the healthcare industry (pharmaceuticals, device makers, insurance companies) are primarily extracting ruinous rents from our economy.  The cost of nuking the ****ers and losing those jobs by switching to single payer could probably be far more than completely offset by the country not having to pay an exorbitant amount of its income on healthcare.

[skinsmarydu]

15 hours ago, Sacks 'n' Stuff said:

Ever wonder why there are commercials on TV for prescription drugs?

A few years ago, Michael Moore absolutely NAILED Chris Matthews on MSNBC...I vividly remember...Chris was arguing healthcare with Moore, and was going to commercial break...Moore said, (not really a direct quote, but damn close)... "On the other side, we'll discuss how many of these commercials are for Big Pharma"...

[Larry]

11 hours ago, LadySkinsFan said:

The side effects of the drugs advertised are scary. 

 

I have diabetes and those drugs are scary. 

 

I always like "Don't take this drug if you're allergic to it."  (Of course, the only way to find out if you're allergic to it, is to take it.)  

 

Although lately, "this drug may lead to an increased risk of death" has been getting my attention, too.  

 

[skinny21]

1 hour ago, Larry said:

 

I always like "Don't take this drug if you're allergic to it."  (Of course, the only way to find out if you're allergic to it, is to take it.)  

 

Although lately, "this drug may lead to an increased risk of death" has been getting my attention, too.  

 

That is too funny - since I first started noticing drug ads (and listing of side effects), I'd joke around with that exact line.  

 

Speaking of Big Pharma, I'm surprised they haven't gone all in to change the "Don't do drugs" slogans taught at school.  Something to differentiate themselves a bit.  

[visionary]

'Anyone need a spine?  It's a bit dusty, but only slightly used.'

 

 

[No Excuses]

When in doubt blame the Left even though you control every apparatus of the federal government.

 

 

[LadySkinsFan]

Marco Rubio on point with the talking points, like a good little parrot.

[StillUnknown]

 

[visionary]

 

 

 

 

[LadySkinsFan]

He and his family are "we".

[Sacks 'n' Stuff]

He's seen Republicans? Where?!?!?

[Cooked Crack]

7 minutes ago, Sacks 'n' Stuff said:

He's seen Republicans? Where?!?!?

Who you think he's been golfing with?

[LD0506]

Quote

Aetna claimed this summer that it was pulling out of all but four of the 15 states where it was providing Obamacare individual insurance because of a business decision — it was simply losing too much money on the Obamacare exchanges.

Now a federal judge has ruled that that was a rank falsehood. In fact, says Judge John D. Bates, Aetna made its decision at least partially in response to a federal antitrust lawsuit blocking its proposed $34-billion merger with Humana. Aetna threatened federal officials with the pullout before the lawsuit was filed, and followed through on its threat once it was filed. Bates made the observations in the course of a ruling he issued Monday blocking the merger.

 

http://www.latimes.com/business/hiltzik/la-fi-hiltzik-aetna-obamacare-20170123-story.html

[LadySkinsFan]

One reason why I didn't buy Aetna supplement insurance, that merger.

[TheGreatBuzz]

On 7/8/2017 at 9:51 AM, LD0506 said:

 

https://www.dailykos.com/story/2017/7/5/1678174/--I-Don-t-Like-Obamacare-Because-of-Obama-Says-Woman-on-Obamacare?detail=emaildkre

 

Ok, somebody explain to me exactly why I ought to give one small **** about these people? I tell my son "Stupidity should always be painful", how am I not supposed to root for some good ole suffering for idiots?

Similar to people that are fine letting someone who OD'd just die instead of get help.  Stupid choices and all.  Can't have it both ways.

 

 

To me, our nations biggest issue is what people expect from our healthcare.  Who go for a run when I can just get a pill to fix me later?  Got a cold?  Why deal with it and let it run it's course when I can go get some pills?