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Healthcare better worse or same


Healthcare better or worse?   

16 members have voted

  1. 1. Is your health care

    • Better and cheaper than it used to be
      3
    • Worse and more expensive
      11
    • Same
      2


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Corporate medicine has destroyed quality. Ā You're probably more likely to see a mid level than an MD in an ER or primary care office. Ā Then get referred all over the place for simple stuff that they should be able to take care of. Ā And tested to bankruptcy cuz tests are a money maker and the way they now usually make diagnoses. Ā Oh, and your "provider" might look up from the keyboard once or twice in a visit. Ā What do I know?...I'm a dinosaur.

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Welp. when the ACA was sold as a way to drive down cost, but ended up being a huge handout to the industry, wrote by the industry.Ā 

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Good luck even seeing one's doctor or nurse practitioner. seems more and more insurance companies are pushing free/low cost teledock as the firstĀ  line of care.Ā Ā 

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How hard would it be to just allow people to purchase Medicaid.Ā  Ā 

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they current system sucks and isnt getting better any time soon.

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Edited by Chris farley
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9 hours ago, redtail hawk said:

Corporate medicine has destroyed quality. Ā You're probably more likely to see a mid level than an MD in an ER or primary care office. Ā Then get referred all over the place for simple stuff that they should be able to take care of. Ā And tested to bankruptcy cuz tests are a money maker and the way they now usually make diagnoses. Ā Oh, and your "provider" might look up from the keyboard once or twice in a visit. Ā What do I know?...I'm a dinosaur.

Morning Hawk. Iā€™ve always said Iā€™m not a healthcare voter (knock on wood, and thanks be to God), but Iā€™m curious where you see the service quality log jam to be. Is it the insurance companies? The hospitals? Both?Ā 

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41 minutes ago, Chris farley said:

Welp. when the ACA was sold as a way to drive down cost, but ended up being a huge handout to the industry, wrote by the industry.Ā 

Ā 

Good luck even seeing one's doctor or nurse practitioner. seems more and more insurance companies are pushing free/low cost teledock as the firstĀ  line of care.Ā Ā 

Ā 

How hard would it be to just allow people to purchase Medicaid.Ā  Ā 

Ā 

they current system sucks and isnt getting better any time soon.

Ā 

Ā 

Ā 

Ā 

Ā 

Ā 

Ā 

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Itā€™s more complicated than that imo.

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Health insurance companies are part of the problem to be sure. Ā Personally, Iā€™d prefer Teladoc for many interactions, though Iā€™m generally pretty healthy and that shapes my opinion on things.Ā 
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However, legislation has perpetually been an issue as well. Ā Prior to ACA, each state had its own fiefdom, rules and regulations that contributed to cost and benefit decisions. Ā While the care associated with oneā€™s health is an emotional and personal issue, the costs associated with delivery is a financial one. Ā At the regulation level, itā€™s generally treated as a political issue, and that complicates things greatly.Ā 
Ā 

Many doctors operate on a for-profit model, where $$ are an integral part of the system. Ā That can result in a mill-type process of health care.Ā 
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When it comes right down to it, people frequently prioritize other things in life over their health and health care. Ā A person who has no concerns about perpetually upgrading their iPhone, or dropping $7 a day on specialty coffee, or $482 a month to lease a car, balk at the notion of out of pocket costs, co-pays and high deductible health plans that might actually save their lives one day.Ā 
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As for Medicare, sobering financial reality is itā€™s solvent through 2026 according to this recent projection from trustees. Ā  The argument is that resources directed to private health care would recaptured. Ā Of course, that would lead to the potential for government to do government things, blowing up cost and leading to declarations like ā€œā€¦.projected to be solvent through 2029.ā€.Ā 
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Also, letā€™s not forget that Medicare operates on a fee schedule approach not all that different than insurance companies use, but typically at a much lower rate. Ā That begs the question, would Medicare for all be a popular option for the for-profit medical profession? Ā 


https://www.aha.org/news/headline/2021-09-01-medicare-trustees-project-trust-fund-solvent-until-2026

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3 minutes ago, leh-nerd skin-erd said:

Itā€™s more complicated than that imo.

Ā 

Health insurance companies are part of the problem to be sure. Ā Personally, Iā€™d prefer Teladoc for many interactions, though Iā€™m generally pretty healthy and that shapes my opinion on things.Ā 
Ā 

However, legislation has perpetually been an issue as well. Ā Prior to ACA, each state had its own fiefdom, rules and regulations that contributed to cost and benefit decisions. Ā While the care associated with oneā€™s health is an emotional and personal issue, the costs associated with delivery is a financial one. Ā At the regulation level, itā€™s generally treated as a political issue, and that complicates things greatly.Ā 
Ā 

Many doctors operate on a for-profit model, where $$ are an integral part of the system. Ā That can result in a mill-type process of health care.Ā 
Ā 

When it comes right down to it, people frequently prioritize other things in life over their health and health care. Ā A person who has no concerns about perpetually upgrading their iPhone, or dropping $7 a day on specialty coffee, or $482 a month to lease a car, balk at the notion of out of pocket costs, co-pays and high deductible health plans that might actually save their lives one day.Ā 
Ā 

As for Medicare, sobering financial reality is itā€™s solvent through 2026 according to this recent projection from trustees. Ā  The argument is that resources directed to private health care would recaptured. Ā Of course, that would lead to the potential for government to do government things, blowing up cost and leading to declarations like ā€œā€¦.projected to be solvent through 2029.ā€.Ā 
Ā 

Also, letā€™s not forget that Medicare operates on a fee schedule approach not all that different than insurance companies use, but typically at a much lower rate. Ā That begs the question, would Medicare for all be a popular option for the for-profit medical profession? Ā 


https://www.aha.org/news/headline/2021-09-01-medicare-trustees-project-trust-fund-solvent-until-2026

Is it a coincidence that Medicare goes insolvent the same year the Bills new stadium is scheduled to open? Hmmm?

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In all seriousness, theyā€™ve been projecting the insolvency of these entitlement programs for decades. Now, Iā€™m not saying theyā€™re wrong, but what happens then? We just pay a higher copay or premium for it? We add more to the national debt?Ā 

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1 minute ago, SoCal Deek said:

Is it a coincidence that Medicare goes insolvent the same year the Bills new stadium is scheduled to open? Hmmm?

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In all seriousness, theyā€™ve been projecting the insolvency of these entitlement programs for decades. Now, Iā€™m not saying theyā€™re wrong, but what happens then? We just pay a higher copay or premium for it? We add more to the national debt?Ā 

I think ultimately smoke, mirrors and political maneuvering provide a short term fix. Ā Long term? Ā Debt, hand-wringing, fair share, etc. Ā Nothing really changes.

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1 minute ago, leh-nerd skin-erd said:

I think ultimately smoke, mirrors and political maneuvering provide a short term fix. Ā Long term? Ā Debt, hand-wringing, fair share, etc. Ā Nothing really changes.

Well if insolvency is real, then you canā€™t stay ahead of the bill collector forever. Someone must have a plan. Iā€™ve often wondered whether at some point the cost simply outpaces Americanā€™s ability to pay for it, and the seemingly unlimited level of care rapidly declines. Letā€™s face it, our standard of care looks nothing like what it did just a few decades ago. When you see a photo of hospital back then, it was pretty much just a bed and a nurse standing by.

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33 minutes ago, SoCal Deek said:

Morning Hawk. Iā€™ve always said Iā€™m not a healthcare voter (knock on wood, and thanks be to God), but Iā€™m curious where you see the service quality log jam to be. Is it the insurance companies? The hospitals? Both?Ā 

Good morning, Deek. Ā It's all of the above. And drug companies. Ā They all have massive lobbying power. Ā And they use it mostly for profit and not to benefit patients. Ā They all answer to shareholders. Ā Taking care of people and getting rich in medicine are not compatible. Ā doctors can make a very good living the good old fashioned way - running from room to room, seeing thousands of patients and retiring earlyšŸ˜€. Ā But it's more difficult today because private practice is almost dead, by design. Ā the suits are in control and wringing every penny they can from a broken system. Ā btw, if I were to go back to work, part time teledoc work would be appealing (I sent a resume to Amazons new venture just for giggles) but it's generally not the best way to take care of patients. Ā Long term, face to face relationships are, imo. Ā 

Edited by redtail hawk
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8 minutes ago, redtail hawk said:

Good morning, Deek. Ā It's all of the above. And drug companies. Ā They all have massive lobbying power. Ā And they use it mostly for profit and not to benefit patients. Ā They all answer to shareholders. Ā Taking care of people and getting rich in medicine are not compatible. Ā doctors can make a very good living the good old fashioned way - running from room to room, seeing thousands of patients and retiring earlyšŸ˜€. Ā But it's more difficult today because private practice is almost dead, by design. Ā the suits are in control and wringing every penny they can from a broken system. Ā btw, if I were to go back to work, part time teledoc work would be appealing (I sent a resume to Amazons new venture just for giggles) but it's generally not the best way to take care of patients. Ā Long term, face to face relationships are, imo. Ā 

So given all of that, are you then a proponent of universal healthcare? Or does that just bring with it a new and different set of problems?Ā 

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22 minutes ago, SoCal Deek said:

So given all of that, are you then a proponent of universal healthcare? Or does that just bring with it a new and different set of problems?Ā 

realistically, I think it must be done incrementally. Ā Start with negotiating drug prices. Ā Then make insurance companies liable for malpractice suits. Then legislate that Hospital systems C level execs must be clinicians (Hell, if Desantis can run Disney...). Ā then see what happens.

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As a Registered Nurse for over 40 years I can tell you it is (unfortunately) worse.

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Medications and diagnostics have improved, but the care a person receives is much worse.

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I would recommend to anyone that has a loved one in the hospital to have someone stay with them to advocate.

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20 minutes ago, redtail hawk said:

realistically, I think it must be done incrementally. Ā Start with negotiating drug prices. Ā Then make insurance companies liable for malpractice suits. Then legislate that Hospital systems C level execs must be clinicians (Hell, if Desantis can run Disney...). Ā then see what happens.

Thanks. Who would negotiate the drug prices? I've considered drug prices to be somewhat of a side issue to the core healthcare debate. My personal opinion is that we are way, way over-medicated.

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