The Affordable Care Act II - Because Mr. Obama Loves You All

[TakeYouToTasker]

It's coming to my attention, in this thread, that several posters who believe that inaction is a form of tyranny have, at best, a very cloudy understanding of what "rights" are.

 

Mr. Wowrow, if you would be so kind...

 

Define the concept of rights for me, please.

 

birdog, JuanGuzman: please feel free to do the same.

[birdog1960]

It's coming to my attention, in this thread, that several posters who believe that inaction is a form of tyranny have, at best, a very cloudy understanding of what "rights" are.

 

Mr. Wowrow, if you would be so kind...

 

Define the concept of rights for me, please.

 

birdog, JuanGuzman: please feel free to do the same.

perhaps you should read the majority SCOTUS decision on the ACA.

[Azalin]

There are industries where a completely free market produces the best results, health care is not one of them.

that's bull. you're obviously too young to remember a time when there wasn't anywhere near the amount of regulation in health & insurance that exists now, and are relying on pundits and bureaucrats to define the issue for you.

 

it isn't complicated. reduce the amount of regulatory intrusion and allow doctors and insurance agents to do their damned jobs, and stop viewing every industry as a system to be tweaked and molded by regulatory agencies.

 

this new way of doing things in the health insurance industry has left millions of people uninsured that already had their own insurance. very typical of government interference. trying to excuse or justify that is nothing more than typical partisan-based lack of thinking.

[TakeYouToTasker]

perhaps you should read the majority SCOTUS decision on the ACA.

My question wasn't about SCOTUS decisions, as SCOTUS decisons speak to the interpretation of American law, rather than rights.

 

My question was about the definition of "rights".

[3rdnlng]

it's my opinion. isn't nearly everthing posted here opinion? even if it's an opinion originally generated and disseminated by the far right wing propaganda machine....

 

Either there is some basis for your opinion or there isn't. Which is it? If there is a basis then you should come forward to explain your words in post # 231 "yes, but there's beauty in that. the right wing talk show dudes generally hang up on, never engage in the first place or plant a patsy to argue against."

 

How do you know the quoted part to be true?

[B-Large]

CVS is spending its time preparing for the future rather than whine about the ACA.

 

http://www.cnn.com/2014/02/05/health/cvs-cigarettes/

 

they'll have a high profitable, high convenient, high quality "Little Clinic" in each and every store on every corner in Amercia in a few years. The ACA is a go send for these retail Rx filler and convenience grocers.

 

!@#$ing brilliant.

[birdog1960]

CVS is spending its time preparing for the future rather than whine about the ACA.

 

http://www.cnn.com/2...cvs-cigarettes/

 

they'll have a high profitable, high convenient, high quality "Little Clinic" in each and every store on every corner in Amercia in a few years. The ACA is a go send for these retail Rx filler and convenience grocers.

 

!@#$ing brilliant.

except that they won't be doing any of the grunt work: refills of maintenance meds, reviewing consult letters from specialists, reviewing hospitalizations and scheduling follow up, scheduling immunizations, mammograms, colonoscopies... this is cherry picking at it's extreme. kinda like the radiologists rolling into town and selling $200 screening xrays, finding equivocal "abnormalities" and leaving it to people like me to explain it to the patient (when i never would have ordered the studies to begin with).. this is where the "medical home" concept becomes even more important. there needs to be adequate financial incentive to be one and disincentive to cherry pick. i think there will be.

[B-Man]

Liberals, Obamacare and Work.

by Ross Douthat

 

So far, nearly all of the left-of-center responses to the latest C.B.O. projections on Obamacare and workforce participation have emphasized the upside of the downward trend — the fact that what we’re seeing is just the end of job lock in action, which gives parents the freedom to cut their hours, near-retirees the chance to stop working a job they hate a little early, and so on down a sympathetic list. ”If Obamacare really does cause millions of people to voluntarily leave full-time employment,” Matt Yglesias writes in a representative piece, “that shows us how much avoidable suffering the earlier system was causing,” and you can find roughly similar arguments from Jonathan Cohn, Jonathan Chait, and others too numerous to name.

 

 

 

Yes, it’s almost as if they’re all part of an email list or something, distributing the same talking points. . . .

 

But read on to see what they’re not talking about.

 

.

[IDBillzFan]

CVS is spending its time preparing for the future rather than whine about the ACA.

 

Maybe that's because CVS isn't a person who lost their health insurance coverage in the middle of cancer treatment. I know how those whining cancer patients really drag a good law down, huh?

 

And if getting rid of cigarettes was as important to the left as they make it sound, they'd have made them illegal when they passed ACA with full control of WH, House and Senate.

 

But no. You can smoke cigarettes, and weed isn't as bad as alcohol, but dammit...if only people would stop using all this stuff, hour health care costs would go down.

 

I believe progressives usually call this hypocrisy.

[OCinBuffalo]

and i'm still attempting to analyze the psychopathology involved in arguing under multiple aliases on an anonymous political opinion board. so far i've only concluded that it appears to be common but is definitely pathologic.

Dude, we have people here who can't even recognize their own posts, slightly tweaked and written back at them. Posting as different people at least has the potential to be funny. I mean, arguing against yourself, as 2 different posters, in an effort to rile certain posters, or even mods...you have to admit: that has humor potential. But, yeah, if it's done for any reason besides humor: it's weird.

it's my opinion. isn't nearly everthing posted here opinion? even if it's an opinion originally generated and disseminated by the far right wing propaganda machine....

Sure, but, there's a difference: opinion based on facts/honest effort at doing your own reasoning, and, opinion based on whatever crap you read at slate dot com yesterday.

CVS is spending its time preparing for the future rather than whine about the ACA.

 

http://www.cnn.com/2...cvs-cigarettes/

 

they'll have a high profitable, high convenient, high quality "Little Clinic" in each and every store on every corner in Amercia in a few years. The ACA is a go send for these retail Rx filler and convenience grocers.

 

!@#$ing brilliant.

Ok, it's the Walmart idea, except it's CVS, and, you're moving the line from TPA, over to urgy care. Now, if we get rid of Obamacare, and use HSAs to pay for CVS Minute Clinic costs, we are really doing something.

 

It's all the same thing to me: use the pre-existing economies that already exist for huge companies like CVS to deliver basic health care. Whether that's via insurance, or more smart and efficiently, through HSAs, doesn't really matter, because we always end up at the same place. Optometry has been doing this for decades.

 

They will attract more of that business, the cheaper they make it. Insurance hinders that/has no effect, HSAs helps it. It's simple really. Meanwhile, if Walmart does the same thing? Now we are talking. Real competition, no government.

 

Now, of course I expect the government to start regulating/sending surveyors in to kill this innovation. Don't you? Haven't you been working at a hospital for years?

 

President Obama "I love this" publicly, then, "how can we tax it/create Federal/State jobs from it?" privately.

[B-Man]

Then: "If you like your health plan, you can keep your health plan!"

 

Now: "Your old health plan was terrible! You should be happy to have this new, more expensive plan!"

 

 

 

Then: "If you like your job, you can keep your job! ACA will result in millions of new jobs!"

 

Now: "Your job sucked anyway! Now you can stay home and have more free time!"

 

 

 

 

 

[DC Tom]

CVS is spending its time preparing for the future rather than whine about the ACA.

 

http://www.cnn.com/2...cvs-cigarettes/

 

they'll have a high profitable, high convenient, high quality "Little Clinic" in each and every store on every corner in Amercia in a few years. The ACA is a go send for these retail Rx filler and convenience grocers.

 

!@#$ing brilliant.

 

Preparing for their future, mostly. CVS has seemed to have for a while a business plan of moving from a retailer to some sort of health care provider. I don't think it has anything to do with the ACA, considering their business plan predates it.

[B-Large]

except that they won't be doing any of the grunt work: refills of maintenance meds, reviewing consult letters from specialists, reviewing hospitalizations and scheduling follow up, scheduling immunizations, mammograms, colonoscopies... this is cherry picking at it's extreme. kinda like the radiologists rolling into town and selling $200 screening xrays, finding equivocal "abnormalities" and leaving it to people like me to explain it to the patient (when i never would have ordered the studies to begin with).. this is where the "medical home" concept becomes even more important. there needs to be adequate financial incentive to be one and disincentive to cherry pick. i think there will be.

 

But Dog, you of all people should realize you want 10 higher acuity people on your afternoon schedule, rather than 10 low acuity people who really don't need to to see you and access your training and expertise. People will, in theory still visit you for their Annual Exam, where you will order the Scope, Mammograms, and other age based screenings- that doesn't change, and you will be the medical home for these folks. But CVS can offer walk in, high quality treatment of that cough or allergies, and you can see the really sick people.

 

We did a study and of the 60K visits in our Internal Medicine practice, 30% could have been handled either over the phone or by a provider like and NP or PA and have reduction in outcome or quality. 30%. Some of that is poor triage by staff, but if you could cut that in half, in every practice across the Nation... I can't fathom the savings.

[DC Tom]

But Dog, you of all people should realize you want 10 higher acuity people on your afternoon schedule, rather than 10 low acuity people who really don't need to to see you and access your training and expertise. People will, in theory still visit you for their Annual Exam, where you will order the Scope, Mammograms, and other age based screenings- that doesn't change, and you will be the medical home for these folks. But CVS can offer walk in, high quality treatment of that cough or allergies, and you can see the really sick people.

 

We did a study and of the 60K visits in our Internal Medicine practice, 30% could have been handled either over the phone or by a provider like and NP or PA and have reduction in outcome or quality. 30%. Some of that is poor triage by staff, but if you could cut that in half, in every practice across the Nation... I can't fathom the savings.

 

That is a very good point. I need a tetanus booster (I'm a woodworker, so I keep up to date with them). Generally my choices are ER, which is wasteful in the extreme; or an appointment with my primary, which is also wasteful in the extreme (a full physical, 20 minutes talking about my health, a shitload of waiting and paperwork for him and me...all I need is a jab in the arm, dammit!) I was not even aware until looking in to CVS's overall business plan as a result of this discussion that there's a MinuteClinic a mile from me where I can walk in and get a tetanus booster. That is such a more efficient use of health care resources.

 

Of course, the counter-argument to that is that I'm something of a special case: I pay attention to and manage my own health care. I don't rely on the pharmacy to track my prescriptions, or on the insurance to monitor and plan my medical treatment; I keep my own copies of all my medical records (so much as I can) and make sure they're distributed to all my doctors. I get the sense I'm something of a minority in that regard, though...I think most people think of "health care" as something that someone else is responsible to provide them, not something they're responsible for themselves. Which is probably why your 30% never will go see an NP or PA - they've been conditioned at this point to believe that MDs are responsible for those sorts of decisions, not them as patients.

[B-Large]

That is a very good point. I need a tetanus booster (I'm a woodworker, so I keep up to date with them). Generally my choices are ER, which is wasteful in the extreme; or an appointment with my primary, which is also wasteful in the extreme (a full physical, 20 minutes talking about my health, a shitload of waiting and paperwork for him and me...all I need is a jab in the arm, dammit!) I was not even aware until looking in to CVS's overall business plan as a result of this discussion that there's a MinuteClinic a mile from me where I can walk in and get a tetanus booster. That is such a more efficient use of health care resources.

 

Of course, the counter-argument to that is that I'm something of a special case: I pay attention to and manage my own health care. I don't rely on the pharmacy to track my prescriptions, or on the insurance to monitor and plan my medical treatment; I keep my own copies of all my medical records (so much as I can) and make sure they're distributed to all my doctors. I get the sense I'm something of a minority in that regard, though...I think most people think of "health care" as something that someone else is responsible to provide them, not something they're responsible for themselves. Which is probably why your 30% never will go see an NP or PA - they've been conditioned at this point to believe that MDs are responsible for those sorts of decisions, not them as patients.

 

so do you woodwork as juts a hobby? are you a turner of funiture builder?

 

I agree, my wife and I go to Walgreen fro Flu Shots every year even though I get them here at my job... they are 24 hour, takes 15 minutes, in and out- at work it is a 2 hour session where I wait in line forever, they only have flue shot session at certain times.. pain in the ass.

 

I would agree most people just assume the PCP has all their records from every provider they have seen since birth, that every specilist sends a consutl report back to that MD, etc. But I do believe most people are also cheap and do path of least resistence... that is why I htink the CVS outlet strategy is so damn good- most people will opt for easy rather than hard. There are some people who insist on seeing an MD for a hangnail (cliche, I know) and get pissed when they cannot see their MD every time- but I get the sense those people represen the minority as well.

 

Preparing for their future, mostly. CVS has seemed to have for a while a business plan of moving from a retailer to some sort of health care provider. I don't think it has anything to do with the ACA, considering their business plan predates it.

 

Everybody (ideally) covered now have deductibles. It will nto take people long to realize a visit to my hospital will run them 250+ for a sore throat, a trip to a Little Clinic will be drastically less- they already have the physcial space and are on every corner so no addtioanl overhead cost other than an NP and liability. When you have a 3,000 deductible, all of the sudden people talk to each other and become savvy consumers.. well, maybe savvy is overshooting... lol

[OCinBuffalo]

except that they won't be doing any of the grunt work: refills of maintenance meds, reviewing consult letters from specialists, reviewing hospitalizations and scheduling follow up, scheduling immunizations, mammograms, colonoscopies... this is cherry picking at it's extreme. kinda like the radiologists rolling into town and selling $200 screening xrays, finding equivocal "abnormalities" and leaving it to people like me to explain it to the patient (when i never would have ordered the studies to begin with).. this is where the "medical home" concept becomes even more important. there needs to be adequate financial incentive to be one and disincentive to cherry pick. i think there will be.

Oh Jesus Christ on a crutch. Here we go. It's always "they're gonna kill that poor woman" with you, isn't it?

 

You really think CVS, is going to do anything at all that presents a PR risk for them? CVS would rather give away free X-rays for a year, than have a doc like you go on 60 minutes and complain about them. That's their solution btw, they'd give away free Xrays, marginalize you until you go away, and allow them to keep filling the scripts, which is where the real $ is.

 

If you were smart, rather than complaining:

you'd set up a business that manages everything you just said, partner with CVS, make deals with local docs/hire in your own people, and resell every single one of those services you listed to CVS nationally. You offer end-to-end services, for each of the ones you want to do, with integrated data, etc. You'd get CVS to pay for your advertising, via upselling from their "basic services"(known to you as cherry picked) to your "advanced services"(know to you as "grunt work"). You would have: 0 sales/marketing cost, and a permanent stream of customers, thereby turning your bitching into a boatload of $. Your complaining = The Pitch. They'd do it just to avoid the PR risk, get a piece of the upsell, and refer all other birdog complaining: to you. I don't know the ins/outs fully, but I know something is there, and now so you do.

 

But, that requires you being smart, and not complaining. Tall order, especially the complaining part. I'd even help you out with IT stuff, and my VC contacts. (EDIT: now that I think about it, you only need to bring this to 1 guy, he loves schit like this) Or, you can pick squash and complain.

 

Also, there are tons of "medical homes" right now, filled with nothing but the cherry picked. GentleCare comes to mind. So does Greenhouse project.

 

You know anything about either?

Edited February 6, 2014 by OCinBuffalo

[Doc]

And there you have it; a devout progressive criticizing people for lacking original thought...by parroting a far left meme that is bereft of original thought.

 

Absolutely precious.

Beat me to it.

 

That is a very good point. I need a tetanus booster (I'm a woodworker, so I keep up to date with them). Generally my choices are ER, which is wasteful in the extreme; or an appointment with my primary, which is also wasteful in the extreme (a full physical, 20 minutes talking about my health, a shitload of waiting and paperwork for him and me...all I need is a jab in the arm, dammit!) I was not even aware until looking in to CVS's overall business plan as a result of this discussion that there's a MinuteClinic a mile from me where I can walk in and get a tetanus booster. That is such a more efficient use of health care resources.

 

Of course, the counter-argument to that is that I'm something of a special case: I pay attention to and manage my own health care. I don't rely on the pharmacy to track my prescriptions, or on the insurance to monitor and plan my medical treatment; I keep my own copies of all my medical records (so much as I can) and make sure they're distributed to all my doctors. I get the sense I'm something of a minority in that regard, though...I think most people think of "health care" as something that someone else is responsible to provide them, not something they're responsible for themselves. Which is probably why your 30% never will go see an NP or PA - they've been conditioned at this point to believe that MDs are responsible for those sorts of decisions, not them as patients.

If you were to tell your doctor "all I need/want is a tetanus shot, so if you can't make it snappy, I'm going to CVS instead," I'm sure he/she would "see" you and let you come in and have a nurse administer it. Is this true, birddog?

 

And yes, you are correct about what the majority of people think when it comes to health care, i.e. that it's someone else's job to keep track of it, manage it, and provide it to them at the lowest cost possible, if not free. I have had many patients come in for a colonoscopy who have said "I have to have this done." I tell them "no, you don't have to have this done, you should want to have this done for your own benefit."

[TakeYouToTasker]

And yes, you are correct about what the majority of people think when it comes to health care, i.e. that it's someone else's job to keep track of it, manage it, and provide it to them at the lowest cost possible, if not free. I have had many patients come in for a colonoscopy who have said "I have to have this done." I tell them "no, you don't have to have this done, you should want to have this done for your own benefit."

No one wants to have a camera snaked up their ass. You should pare back your expectations to begrudging acceptance of the fact that it should be done for their own good. More than that, and your dealing with freaky-ass weirdos.

Edited February 6, 2014 by TakeYouToTasker

[IDBillzFan]

so do you woodwork as juts a hobby?

 

Please don't get Tom talking about his woodworking. Not only do his posts start to resemble OCinBuffalo, but I ultimately have to bring in Steve Martin's old plumbers joke to add some levity.

 

"This lawn supervisor was out on a sprinkler maintenance job and he started working on a Findlay sprinkler head with with a Langstrom 7" socket wrench..."

[B-Man]

Please don't get Tom talking about his woodworking. Not only do his posts start to resemble OCinBuffalo, but I ultimately have to bring in Steve Martin's old plumbers joke to add some levity.

 

"This lawn supervisor was out on a sprinkler maintenance job and he started working on a Findlay sprinkler head with with a Langstrom 7" socket wrench..."

 

"I said Sprocket.......not Socket"