Want to start saving money in health care?

[Alaska Darin]

ever heard of howard dean?

Yeeeeeeeeeeeeeeeeeeeeeeeeeeahhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh!

[/dev/null]

ever heard of howard dean?

Yeeeeeeeeeeeeeeeeeeeeeeeeeeahhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhhh!

 

birdog, you got to admit you set yourself up for that one

[KD in CA]

c'mon. nobody? how bout if he is refused but agrees to pay cash for the heroic measures? i think i can guess your answers but what about the implications?

 

What implications? Ralph is no different than anyone else; no, heroic measures should not be taken to prolong the life of someone simply because they own a football team and yes, of course he is free to spend his own money on himself if that's what he chooses.

[Pine Barrens Mafia]

What implications? Ralph is no different than anyone else; no, heroic measures should not be taken to prolong the life of someone simply because they own a football team and yes, of course he is free to spend his own money on himself if that's what he chooses.

 

I'm of the opinion that death isn't something to fear. But that's just me. If I can't truly LIVE, then I don't want to be alive in this body.

[John Adams]

I'm of the opinion that death isn't something to fear. But that's just me. If I can't truly LIVE, then I don't want to be alive in this body.

 

I also don't fear death. Like you, I have no idea what comes next but fearing something that inevitable seems a waste of time. And delaying it when you're near the inevitable end makes no sense as well.

[John Adams]

c'mon. nobody? how bout if he is refused but agrees to pay cash for the heroic measures? i think i can guess your answers but what about the implications?

 

The implications? He can pay cash anytime. Medicare shouldn't pay for extraordinary end of life treatment. That's simple. Where that line is drawn is hard but so be it.

 

The real issue is that people need to get more comfortable with choosing hospice. Saying "no" to doctors when they want to prolong life. Doctors need to get better at having a discussion with patients that involves quality of end-of-life and not just work so hard on keeping life going.

 

Right now, doctors fight death until they are out of options, which makes someone live longer (perhaps) but reduces that quality of life to something negligible. I would rather have 3 relatively pain free months in my home at the end of my life than 9 pain-wracked ones in chemo and in and out of a hospital. Most people don't make that decision.

[birdog1960]

The implications? He can pay cash anytime. Medicare shouldn't pay for extraordinary end of life treatment. That's simple. Where that line is drawn is hard but so be it.

 

The real issue is that people need to get more comfortable with choosing hospice. Saying "no" to doctors when they want to prolong life. Doctors need to get better at having a discussion with patients that involves quality of end-of-life and not just work so hard on keeping life going.

 

Right now, doctors fight death until they are out of options, which makes someone live longer (perhaps) but reduces that quality of life to something negligible. I would rather have 3 relatively pain free months in my home at the end of my life than 9 pain-wracked ones in chemo and in and out of a hospital. Most people don't make that decision.

ah...that's where fee for service has failed. despite good intentioned docs, the temptation is sometimes too great especially if the pt wants to keep going or the family wants it. the more you do. the more you make. its also the reason why 50 million CT scans were done last year on 330 mil americans (that and malpractice worries). the implication for tiered medicine is lack of access for the middle class and below. we are already seeing concierge practices where pts pay retainers of several thousand dollars for better access to their md. insurance of any kind is generally not accepted and pt panel are severely limited. docs make substantially more money for less work. given the shortage of primary care docs and 30 million more pts who want access in 2014, this will likely become a huge problem soon.

[OCinBuffalo]

ah...that's where fee for service has failed. despite good intentioned docs, the temptation is sometimes too great especially if the pt wants to keep going or the family wants it. the more you do. the more you make. its also the reason why 50 million CT scans were done last year on 330 mil americans (that and malpractice worries). the implication for tiered medicine is lack of access for the middle class and below. we are already seeing concierge practices where pts pay retainers of several thousand dollars for better access to their md. insurance of any kind is generally not accepted and pt panel are severely limited. docs make substantially more money for less work. given the shortage of primary care docs and 30 million more pts who want access in 2014, this will likely become a huge problem soon.

Well then, you should ask yourself why, in the Health Care Utopia to our North in Canada, the very practice you are describing is happening...but...differently.

 

You see, it's not the same old whipping boy, "the rich" who are setting up private clinics there. In fact, it is the doctors there setting up their own private clinics, and offering modest fees for service to the middle class.

 

So, the problem, as you have defined it, seems to be happening, whether single payer is in place or not. So, I don't see how implementing yet another massive bureaucracy gets us anywhere, since, the one in Canada hasn't removed the dreaded "fee for service" model you are obsessing over. Yes, single payer solves none of the supply problems, none of the provider cost problems, and none of the demand problems. So, exactly what does it solve? Besides, you know, the need for misguided fools to delude themselves into thinking they need to "beat business"?

 

Do me a favor, tell me how artificially lowering the price of something or giving it away for free, without increasing supply, and holding demand constant(a gift for you), does not lead to scarcity of that good/service. While you are at it, define exactly how scarcity WILL NOT lead to rationing.

 

(As if I will ever get a straight answer to that one. The answer is:

100% of the time rationing is the only way to deal with the scarcity, so, get ready to stand line...

But, I might as well try. Others may learn something)

[birdog1960]

Well then, you should ask yourself why, in the Health Care Utopia to our North in Canada, the very practice you are describing is happening...but...differently.

 

You see, it's not the same old whipping boy, "the rich" who are setting up private clinics there. In fact, it is the doctors there setting up their own private clinics, and offering modest fees for service to the middle class.

 

So, the problem, as you have defined it, seems to be happening, whether single payer is in place or not. So, I don't see how implementing yet another massive bureaucracy gets us anywhere, since, the one in Canada hasn't removed the dreaded "fee for service" model you are obsessing over. Yes, single payer solves none of the supply problems, none of the provider cost problems, and none of the demand problems. So, exactly what does it solve? Besides, you know, the need for misguided fools to delude themselves into thinking they need to "beat business"?

 

Do me a favor, tell me how artificially lowering the price of something or giving it away for free, without increasing supply, and holding demand constant(a gift for you), does not lead to scarcity of that good/service. While you are at it, define exactly how scarcity WILL NOT lead to rationing.

 

(As if I will ever get a straight answer to that one. The answer is:

100% of the time rationing is the only way to deal with the scarcity, so, get ready to stand line...

But, I might as well try. Others may learn something)

it absolutely will lead to rationing...just not economic rationing that we have now

[John Adams]

ah...that's where fee for service has failed. despite good intentioned docs, the temptation is sometimes too great especially if the pt wants to keep going or the family wants it. the more you do. the more you make. its also the reason why 50 million CT scans were done last year on 330 mil americans (that and malpractice worries). the implication for tiered medicine is lack of access for the middle class and below. we are already seeing concierge practices where pts pay retainers of several thousand dollars for better access to their md. insurance of any kind is generally not accepted and pt panel are severely limited. docs make substantially more money for less work. given the shortage of primary care docs and 30 million more pts who want access in 2014, this will likely become a huge problem soon.

 

Try grammar: It's invigorating.

[OCinBuffalo]

it absolutely will lead to rationing...just not economic rationing that we have now

Fully as expected. No straight answer there. Um you mean, like, if you can't afford to pay for something, you don't get to buy it? EDIT: ...and we wonder where all this credit card debt comes from....amazing.

 

Or, most likely, you spent all your money on the 'essentials' and there's no money left for health care? That kind of rationing? God forbid that we live in a world where personal choices and their consequences are borne by the ones that make them. I forgot, "it takes a village" right? It's not my fault that trailer park Jimmy Squirrel wants to spend his money on lottery tickets and beer instead of his own health care, but, I have to pay for it anyway....

 

...because we don't want to "economically ration" it away from him.

 

Laughable.

[birdog1960]

Try grammar: It's invigorating.

try not being a pompous ass

[Magox]

try not being a pompous ass

He cant help himself, so just accept it.

[LeviF]

try not being a pompous ass

Welcome to PPP. I see you're new here.

[Magox]

Welcome to PPP. I see you're new here.

All pompous asses are not created equal....

[John Adams]

try not being a pompous ass

 

Sorry that I expect you to make an attempt to communicate the way most people do. Carry on and don't be shocked that no one takes you seriously except Wawrow.

[OCinBuffalo]

Sorry that I expect you to make an attempt to communicate the way most people do. Carry on and don't be shocked that no one takes you seriously except Wawrow.

Whoa! That's a good shot from a long way away.

 

I had to check to make sure it wasn't 4:15am and all the bars were closing....

[birdog1960]

Sorry that I expect you to make an attempt to communicate the way most people do. Carry on and don't be shocked that no one takes you seriously except Wawrow.

that's good. i admire his writing and like to think i'm as good at my job as he is at his- plus, the Little Willies tape he recommended is really good...might suit you well. i am shocked though.

[John Adams]

Whoa! That's a good shot from a long way away.

 

ee cummings Wawrow doesn't mind a little shrapnel.

[3rdnlng]

the public and the profession would demand that doctors dominate the "panels". a patient's own family doctor would almost certainly be intimately involved. medicine is about as close to a meritocracy as you'll find in the US. 90%+ of successful med school applicants are in the top 10% academically and even some of these wash out during the rigors of training. reputation is mostly based on performance and i doubt poor performers would be asked to sit on such a panel. therefore, i feel your fears of incompetents running the show are unfounded.

 

Yes, we would never have incompetents running the show.