Here's my question. We all know that the present system can't go on
working. We can't have 15% of the population not have some way to pay
for health care and at the same time pass laws that force hospitals to
care for them anyway. That's like having a law that a restaurant has
to serve you even though you are obviously not going to pay. Hey, you
could be starving. Do both sides agree that what we have now isn't
going to go on working forever? If so then at the end of the day
don't we really just have 2 options.

Option 1, figure out some way to get those people back into the system
with some minimal benefits as the rest of us.

Option 2, no tickey, no laundry. You can't pay the the hospital is
within it's rights to turn you away.

I'm not advocating one or the other with this post. I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

On Apr 16, 1:50*pm, wrote:
On Fri, 16 Apr 2010 10:16:17 -0700 (PDT), jamesgangnc





wrote:
Here's my question. *We all know that the present system can't go on
working. *We can't have 15% of the population not have some way to pay
for health care and at the same time pass laws that force hospitals to
care for them anyway. *That's like having a law that a restaurant has
to serve you even though you are obviously not going to pay. *Hey, you
could be starving. *Do both sides agree that what we have now isn't
going to go on working forever? *If so then at the end of the day
don't we really just have 2 options.

Option 1, figure out some way to get those people back into the system
with some minimal benefits as the rest of us.

Option 2, *no tickey, no laundry. *You can't pay the the hospital is
within it's rights to turn you away.

I'm not advocating one or the other with this post. *I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

Those people just got thrown back to the states in the Medicaid plan.
There was no federal money that went along with this (unless you are a
corn husker) . That is how this was "revenue neutral" for the feds. It
is the broke assed states who will be paying these bills. BTW there
are already plenty of hospitals and doctors who will not take Medicaid
patients unless they come in through the ER and even then, they just
stabilize and transport.
I know that a lot of hospitals simply don't have an ER, that
eliminates the problem.- Hide quoted text -

- Show quoted text -

Sure, there are loopholes that some hospitals use. But eventually the
people end up getting treatment somewhere and can't pay for it.

So do you want # 1 or # 2? Or do you see a # 3 I've missed. And I
mean a #3 that isn't just a variation of 1 or 2.

"jamesgangnc" wrote in message
...
On Apr 16, 1:50 pm, wrote:
On Fri, 16 Apr 2010 10:16:17 -0700 (PDT), jamesgangnc





wrote:
Here's my question. We all know that the present system can't go on
working. We can't have 15% of the population not have some way to pay
for health care and at the same time pass laws that force hospitals to
care for them anyway. That's like having a law that a restaurant has
to serve you even though you are obviously not going to pay. Hey, you
could be starving. Do both sides agree that what we have now isn't
going to go on working forever? If so then at the end of the day
don't we really just have 2 options.

Option 1, figure out some way to get those people back into the system
with some minimal benefits as the rest of us.

Option 2, no tickey, no laundry. You can't pay the the hospital is
within it's rights to turn you away.

I'm not advocating one or the other with this post. I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

Those people just got thrown back to the states in the Medicaid plan.
There was no federal money that went along with this (unless you are a
corn husker) . That is how this was "revenue neutral" for the feds. It
is the broke assed states who will be paying these bills. BTW there
are already plenty of hospitals and doctors who will not take Medicaid
patients unless they come in through the ER and even then, they just
stabilize and transport.
I know that a lot of hospitals simply don't have an ER, that
eliminates the problem.- Hide quoted text -

- Show quoted text -

Sure, there are loopholes that some hospitals use. But eventually the
people end up getting treatment somewhere and can't pay for it.

So do you want # 1 or # 2? Or do you see a # 3 I've missed. And I
mean a #3 that isn't just a variation of 1 or 2.


It's worse than that... those who "get treatment somewhere" and can't pay,
tend to be much more expensive to treat at that point. We have to get them
into the system. I can't think of any other options... we already have a
modified #2 (caveat previously noted), so I vote for #1.

Interesting about the stabilize and transport model... just curious where he
thinks they get transferred to? Some places have been "transporting" people
to skid row.

--
Nom=de=Plume

On Apr 16, 3:40*pm, wrote:
On Fri, 16 Apr 2010 11:16:10 -0700 (PDT), jamesgangnc





wrote:
On Apr 16, 1:50*pm, wrote:
On Fri, 16 Apr 2010 10:16:17 -0700 (PDT), jamesgangnc

wrote:
Here's my question. *We all know that the present system can't go on
working. *We can't have 15% of the population not have some way to pay
for health care and at the same time pass laws that force hospitals to
care for them anyway. *That's like having a law that a restaurant has
to serve you even though you are obviously not going to pay. *Hey, you
could be starving. *Do both sides agree that what we have now isn't
going to go on working forever? *If so then at the end of the day
don't we really just have 2 options.

Option 1, figure out some way to get those people back into the system
with some minimal benefits as the rest of us.

Option 2, *no tickey, no laundry. *You can't pay the the hospital is
within it's rights to turn you away.

I'm not advocating one or the other with this post. *I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

Those people just got thrown back to the states in the Medicaid plan.
There was no federal money that went along with this (unless you are a
corn husker) . That is how this was "revenue neutral" for the feds. It
is the broke assed states who will be paying these bills. BTW there
are already plenty of hospitals and doctors who will not take Medicaid
patients unless they come in through the ER and even then, they just
stabilize and transport.
I know that a lot of hospitals simply don't have an ER, that
eliminates the problem.- Hide quoted text -

- Show quoted text -

Sure, there are loopholes that some hospitals use. *But eventually the
people end up getting treatment somewhere and can't pay for it.

So do you want # 1 or # 2? *Or do you see a # 3 I've missed. *And I
mean a #3 that isn't just a variation of 1 or 2.

I think the real solution is to get some cheaper care on the street
for routine and minor problems. You don't need 12 years of school to
fix a hangnail but it is illegal to do it.
If we are dumping 15 million under served people into the system we
need more practitioners today, not in 2022. I still suggest mining the
pool of former military medics.
If we would just come home from our mid east misadventures we would
have the perfect people to deal with the kind of injuries that come
into an inner city ER along with being the initial contact for the
normal ailments of life..- Hide quoted text -

- Show quoted text -

That trend is already happening. Most of these things like "minute
clinic" are staffed by nurse practictioners rather than drs. And even
when you see a dr a lot of triage has already been done by others so
that the dr doesn't need to waste time with the routine. You have an
injury and a dr might look at during the evaluation process but actual
treatment is often done by someone else.

On Apr 16, 3:48*pm, wrote:
On Fri, 16 Apr 2010 11:26:40 -0700, "nom=de=plume"

wrote:
Interesting about the stabilize and transport model... just curious where he
thinks they get transferred to? Some places have been "transporting" people
to skid row.

In DC it was DC General;. In Lee County it is Lee Memorial, both
government supported hospitals. Basically it still comes back on the
taxpayer.
The real question is where will they go when they do get their
Medicaid this year? Probably the same place.
The real question is, what's cheaper, letting the hospital eat the
bill and put it on the government tab or create a whole insurance
bureaucracy to pay them through the normal channels?

BTW did you watch Frontline this week?
They did a show on the back room dealing in this health care bill and
pointed out the senate bill was really written by 2 former United
Health Care lobbyists who went around the revolving door and work for
the government now. It is no surprise how things came out

Check it out on the PBS.ORG web site. Called "Obama's Deal".

Frankly I think we could save a whole lot from the administrative
costs and returning insurance back to the non-profit state. Right now
we have two layers of profit and two layers of administrative costs
coming out of every health care dollar.

jamesgangnc wrote:
On Apr 16, 3:48 pm, wrote:
On Fri, 16 Apr 2010 11:26:40 -0700, "nom=de=plume"

wrote:
Interesting about the stabilize and transport model... just curious where he
thinks they get transferred to? Some places have been "transporting" people
to skid row.
In DC it was DC General;. In Lee County it is Lee Memorial, both
government supported hospitals. Basically it still comes back on the
taxpayer.
The real question is where will they go when they do get their
Medicaid this year? Probably the same place.
The real question is, what's cheaper, letting the hospital eat the
bill and put it on the government tab or create a whole insurance
bureaucracy to pay them through the normal channels?

BTW did you watch Frontline this week?
They did a show on the back room dealing in this health care bill and
pointed out the senate bill was really written by 2 former United
Health Care lobbyists who went around the revolving door and work for
the government now. It is no surprise how things came out

Check it out on the PBS.ORG web site. Called "Obama's Deal".

Frankly I think we could save a whole lot from the administrative
costs and returning insurance back to the non-profit state. Right now
we have two layers of profit and two layers of administrative costs
coming out of every health care dollar.

I heard that two thirds of Medicare spending is for the last year of life.
That's why the Dems want death panels.
Lowers the cost. Got nothing to do with hangnails.
Remember how they killed that Schiavo girl down here?
Took her off life support. Too expensive.
Then you got your trial lawyers.

Jim - Watch what you wish for. You might get it.

In article ,
says...

Sure, there are loopholes that some hospitals use. But eventually the
people end up getting treatment somewhere and can't pay for it.

So do you want # 1 or # 2? Or do you see a # 3 I've missed. And I
mean a #3 that isn't just a variation of 1 or 2.

I think the real solution is to get some cheaper care on the street
for routine and minor problems. You don't need 12 years of school to
fix a hangnail but it is illegal to do it.
If we are dumping 15 million under served people into the system we
need more practitioners today, not in 2022. I still suggest mining the
pool of former military medics.
If we would just come home from our mid east misadventures we would
have the perfect people to deal with the kind of injuries that come
into an inner city ER along with being the initial contact for the
normal ailments of life..

I do know that they are sending military doctors into city ERs to deal
with knife wounds and bullet wounds. This isn't experience you get at
most military hospitals stateside.

The should be sending medics and Corpsman out with the ambulances and
EMTs to gain experience with handling issues in the field. The problem
is you may get the unions up in arms if the military guys apply a band-
aid to a boo-boo.

wrote in message
...
On Fri, 16 Apr 2010 11:26:40 -0700, "nom=de=plume"
wrote:

Interesting about the stabilize and transport model... just curious where
he
thinks they get transferred to? Some places have been "transporting"
people
to skid row.

In DC it was DC General;. In Lee County it is Lee Memorial, both
government supported hospitals. Basically it still comes back on the
taxpayer.
The real question is where will they go when they do get their
Medicaid this year? Probably the same place.
The real question is, what's cheaper, letting the hospital eat the
bill and put it on the government tab or create a whole insurance
bureaucracy to pay them through the normal channels?

As you said, funnelling it back to the state doesn't equate to the hospital
"eating" the bill.

In the long run, a single-payer system is less expensive with better
results. But, what you're talking about happening so far isn't a "whole
insurance bureaucracy" either. And, even if it were, it wouldn't happen
overnight.


BTW did you watch Frontline this week?
They did a show on the back room dealing in this health care bill and
pointed out the senate bill was really written by 2 former United
Health Care lobbyists who went around the revolving door and work for
the government now. It is no surprise how things came out

Check it out on the PBS.ORG web site. Called "Obama's Deal".

The current bill that passed has problems. No doubt, but it's the beginning,
and probably the best that could be had in the short term. I'll check out
the show later tonight.


--
Nom=de=Plume

"jamesgangnc" wrote in message
...
On Apr 16, 3:40 pm, wrote:
On Fri, 16 Apr 2010 11:16:10 -0700 (PDT), jamesgangnc





wrote:
On Apr 16, 1:50 pm, wrote:
On Fri, 16 Apr 2010 10:16:17 -0700 (PDT), jamesgangnc

wrote:
Here's my question. We all know that the present system can't go on
working. We can't have 15% of the population not have some way to pay
for health care and at the same time pass laws that force hospitals to
care for them anyway. That's like having a law that a restaurant has
to serve you even though you are obviously not going to pay. Hey, you
could be starving. Do both sides agree that what we have now isn't
going to go on working forever? If so then at the end of the day
don't we really just have 2 options.

Option 1, figure out some way to get those people back into the system
with some minimal benefits as the rest of us.

Option 2, no tickey, no laundry. You can't pay the the hospital is
within it's rights to turn you away.

I'm not advocating one or the other with this post. I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

Those people just got thrown back to the states in the Medicaid plan.
There was no federal money that went along with this (unless you are a
corn husker) . That is how this was "revenue neutral" for the feds. It
is the broke assed states who will be paying these bills. BTW there
are already plenty of hospitals and doctors who will not take Medicaid
patients unless they come in through the ER and even then, they just
stabilize and transport.
I know that a lot of hospitals simply don't have an ER, that
eliminates the problem.- Hide quoted text -

- Show quoted text -

Sure, there are loopholes that some hospitals use. But eventually the
people end up getting treatment somewhere and can't pay for it.

So do you want # 1 or # 2? Or do you see a # 3 I've missed. And I
mean a #3 that isn't just a variation of 1 or 2.

I think the real solution is to get some cheaper care on the street
for routine and minor problems. You don't need 12 years of school to
fix a hangnail but it is illegal to do it.
If we are dumping 15 million under served people into the system we
need more practitioners today, not in 2022. I still suggest mining the
pool of former military medics.
If we would just come home from our mid east misadventures we would
have the perfect people to deal with the kind of injuries that come
into an inner city ER along with being the initial contact for the
normal ailments of life..- Hide quoted text -

- Show quoted text -

That trend is already happening. Most of these things like "minute
clinic" are staffed by nurse practictioners rather than drs. And even
when you see a dr a lot of triage has already been done by others so
that the dr doesn't need to waste time with the routine. You have an
injury and a dr might look at during the evaluation process but actual
treatment is often done by someone else.


Also, there are lots of Physician Assistants coming on board. As you said
otherwise...
--
Nom=de=Plume

"W1TEF" wrote in message
...
On Fri, 16 Apr 2010 10:16:17 -0700 (PDT), jamesgangnc
wrote:

I'm not advocating one or the other with this post. I'm just asking
at the 20,000 foot level is there a 3rd choice I'm missing?

Yes. Open the system similar to the auto insurance industry (and
other insurance industries) nationwide and let the market settle it.
Establish a minimum requirement, like catastrophic care (similar to
collision and liability) and go from there - you want more coverage,
add it on.

Second, reform tort laws sufficiently that outrageous settlements for
hangnails aren't available to ambulance chasing lawyers.

It's funny you should bring this up. I had my regular three month
specialists appointments today - the bone doc and the rheumatologist
and when asked what they thought of this recently passed system, they
went ballistic.

At best, it will cost them money per patient if the proposed measures
go through. And their insurances will go up. And thats assuming they
stay in the system at all because it is going to be difficult to
maintain acceptable standards and practices in a constantly evolving
regulatory environment where anything and everything can change at the
whim of a beaurucrat.

One made the case that Obamacare is going to create more legal issues
which will increase third party insurance costs both for the patients
and for the doctors.


Tort reform is a right-wing canard. It's about 3-4% of the problem. Same
goes with the "maintain acceptable standards" bs. Nothing evolves that
quickly. It's all about legislation and underlying statuary laws. Those take
time. Your docs should stick to doctoring or get a law degree.

--
Nom=de=Plume