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Old 06-18-2009, 06:49 AM
 
Location: Londonderry, NH
41,505 posts, read 51,230,061 times
Reputation: 24606

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I advocate a single payer system run by a few government clerks with a big computer. Every citizen is issued a health care card and uses it, along with a suitable co-pay to discourage hypochondriacs, to obtain the care required. All aspects of medicine including eye and dental care would be covered. The cost is covered by a health care tax on all income from all sources (a key consideration in my tax system proposals) and the systemic savings created by eliminating the private insurance systems overhead and profit. Other saving would be realized by limiting the return on investment on hospitals and health machinery providers.
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Old 06-18-2009, 06:57 AM
 
3,568 posts, read 3,269,990 times
Reputation: 1364
Quote:
Originally Posted by GregW View Post
I advocate a single payer system run by a few government clerks with a big computer. Every citizen is issued a health care card and uses it, along with a suitable co-pay to discourage hypochondriacs, to obtain the care required. All aspects of medicine including eye and dental care would be covered. The cost is covered by a health care tax on all income from all sources (a key consideration in my tax system proposals) and the systemic savings created by eliminating the private insurance systems overhead and profit. Other saving would be realized by limiting the return on investment on hospitals and health machinery providers.
The system you have just described has been tried. It's called Medicare. How's that working out?
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Old 06-18-2009, 07:15 AM
 
1,650 posts, read 967,740 times
Reputation: 442
Quote:
Originally Posted by JimMe View Post
The system you have just described has been tried. It's called Medicare. How's that working out?
When was the last time there was an increase in what you pay for Medicare?
When was the last time there was an increase in what you pay for health insurance?"
Nuff said.
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Old 06-18-2009, 07:47 AM
 
3,568 posts, read 3,269,990 times
Reputation: 1364
Quote:
Originally Posted by jimw144 View Post
When was the last time there was an increase in what you pay for Medicare?
When was the last time there was an increase in what you pay for health insurance?"
Nuff said.
Medicare premiums go up annually based on the CPI. The premiuums are low because they are subsidized by the rest of us. Government uses its power to dictate to providers how much they will pay. So the providers turn around and raise the prices of their services to those with private insurance to make up the difference. That's part of the reason that private insurance premiums are through the roof--cost shifting. Face it. No matter what politicians tell you, there's no such thing as a free lunch. Someone always pays.
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Old 06-18-2009, 08:48 AM
 
Location: Foot of the Rockies
86,883 posts, read 102,281,764 times
Reputation: 32946
Quote:
Originally Posted by fopt65 View Post
Quote:
Originally Posted by Katiana View Post
What do you propose to do? Shoot them? Of course, more money is spent on health care in the last six months of a person's life (usually). People are usually sicker the last six months of their lives.
I'm not proposing any shooting thanks. Here is a snippet of the conversation President Obama had talking with the NY TImes about the cost associated with his dying grandmother (sorry, I didn't have the original NY Times link..this link showed up on a google search). Philosophical changes will have to be made about the maintain life at all costs mentality which we currently have if we want to fund universal access without completetly bankrupting the economy. Will we hear this during the campaigning for his health plan, or will it be glossed over until after the bill is passed? Will we hear his specific recommendations for what will be covered and what won't? I'm guessing we won't. I hope I'm wrong and he'll be upfront about everything about the plan, good and bad. We deserve the truth.

OBAMA ON END-OF-LIFE HEALTH CARE | The Revolutionary Review by Jonas Clark
Well, there's a difference between "maintaining life at all costs" and cutting off care for the last six month of life, which you can only know in retrospect, anyway. Hospice care, supportive care, etc costs, too. We will probably always spend more for care in the last few months of life, except for people who die suddenly.

And here is where I think Obama is naive. In general, we don't do that now. With my 97 year old father-in-law, the docs talked to my MIL about his chances, and she put him in hospice. That is just one example. We should probably expand hospice services.

Another naiveity (sp?) of his is that I heard him say (on NPR, don't have a link, sorry) that people are over-utilizing hospitla services. This is BS. You have to practically be at death's door to get admitted to a hospital these days. The days when people went in to the hospital for "tests", etc are long gone, about 30 years gone. The HMOs took care of that, for better or for worse.
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Old 06-18-2009, 09:28 AM
 
Location: Northglenn, Colorado
3,689 posts, read 9,433,278 times
Reputation: 946
Quote:
Originally Posted by GermanCiticen View Post
republicans@

Why dont you consider health care a basic right for everyone?

However in Germany the health care system is declining too .... and in general im not a friend of the mainstrem medicine, because pharma- lobbies (yes the criminal chemistry companies like Bayer, Syngenta, DuPont, Monsanto) pressure the hospitals very strong
you mean the criminals that spend billions of dollars researching new medications that will cure, or treat thousands of illnesses? I for one am very thankful for Teva Nerosciences and a few other pharmacy companies that have produced a treatment for MS so that I can still play with my 3yo daughter
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Old 06-18-2009, 11:42 AM
LML
 
Location: Wisconsin
7,109 posts, read 8,099,343 times
Reputation: 5160
Quote:
Originally Posted by GregW View Post
I advocate a single payer system run by a few government clerks with a big computer. Every citizen is issued a health care card and uses it, along with a suitable co-pay to discourage hypochondriacs, to obtain the care required. All aspects of medicine including eye and dental care would be covered. The cost is covered by a health care tax on all income from all sources (a key consideration in my tax system proposals) and the systemic savings created by eliminating the private insurance systems overhead and profit. Other saving would be realized by limiting the return on investment on hospitals and health machinery providers.
I would vote for you. This is exactly the kind of system we need.
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Old 06-18-2009, 05:00 PM
 
Location: Texas
43,409 posts, read 52,403,598 times
Reputation: 70378
Quote:
Originally Posted by jimw144 View Post
When was the last time there was an increase in what you pay for Medicare?
When was the last time there was an increase in what you pay for health insurance?"
Nuff said.

When was the last time the case manager harrassed me to change an order or told me we couldn't do something for a patient because of their medicare 'rules'?

Oh, like 5 minutes ago.
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Old 06-18-2009, 07:26 PM
 
5,397 posts, read 6,873,186 times
Reputation: 4043
Quote:
Originally Posted by Katiana View Post
Well, there's a difference between "maintaining life at all costs" and cutting off care for the last six month of life, which you can only know in retrospect, anyway. Hospice care, supportive care, etc costs, too. We will probably always spend more for care in the last few months of life, except for people who die suddenly.

And here is where I think Obama is naive. In general, we don't do that now. With my 97 year old father-in-law, the docs talked to my MIL about his chances, and she put him in hospice. That is just one example. We should probably expand hospice services.

Another naiveity (sp?) of his is that I heard him say (on NPR, don't have a link, sorry) that people are over-utilizing hospitla services. This is BS. You have to practically be at death's door to get admitted to a hospital these days. The days when people went in to the hospital for "tests", etc are long gone, about 30 years gone. The HMOs took care of that, for better or for worse.
I agree hospice should be increased. It is a wonderful program to allow someone to die by their choice without any extraordinary means being done to prolong the suffering.
Some less painful cuts that should be considered to help reduce some o fthe costs of healthcare (particulary end of life costs)
I would enact an automatic DNR and mandate an advance directive for every medicaid paid nursing home resident to help save money. Also rates for long term home care should be slightly lower than acute care as the numbers of visits will offset the loss in revenue.

Standing prn orders for increasing lasix on home bound patients with CHF to help revent excessive rehospitalizations. Why bring them to the ER to do an 80 mg push of Lasix on those who are routine CHF admissions?

Functional status evals on all joint replacement patients prior to surgery. No replacements on obese patients..lose the weight first to see if that will control your pain. If you haven't been active or walked in years, you don't get the surgery. If fracture your hip, pining should be the surgery of choice not the hip replacement. You are up early, out of hospital sooner, and less side effects of surgery.

Replace the lap band surgery for weight loss with jaw wiring. Lot cheaper and much safer. The death rate for lap bands is atrocious for an elective surgery.

I also agree that HMOs have done a lot of the cost containing that Obama says is currently lacking. I guess the super benefits that Fed govt workers get don't have the strict gate keeping us poor *******s get in our HMOs
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Old 06-18-2009, 08:27 PM
 
Location: Foot of the Rockies
86,883 posts, read 102,281,764 times
Reputation: 32946
Quote:
Originally Posted by fopt65 View Post
I agree hospice should be increased. It is a wonderful program to allow someone to die by their choice without any extraordinary means being done to prolong the suffering.
Some less painful cuts that should be considered to help reduce some o fthe costs of healthcare (particulary end of life costs)
I would enact an automatic DNR and mandate an advance directive for every medicaid paid nursing home resident to help save money. Also rates for long term home care should be slightly lower than acute care as the numbers of visits will offset the loss in revenue.

Standing prn orders for increasing lasix on home bound patients with CHF to help revent excessive rehospitalizations. Why bring them to the ER to do an 80 mg push of Lasix on those who are routine CHF admissions?

Functional status evals on all joint replacement patients prior to surgery. No replacements on obese patients..lose the weight first to see if that will control your pain. If you haven't been active or walked in years, you don't get the surgery. If fracture your hip, pining should be the surgery of choice not the hip replacement. You are up early, out of hospital sooner, and less side effects of surgery.

Replace the lap band surgery for weight loss with jaw wiring. Lot cheaper and much safer. The death rate for lap bands is atrocious for an elective surgery.

I also agree that HMOs have done a lot of the cost containing that Obama says is currently lacking. I guess the super benefits that Fed govt workers get don't have the strict gate keeping us poor *******s get in our HMOs
I don't think medicaid patients should get an automatic DNR simply b/c they are on medicaid. Many patients enter nursing homes as private pay, then when all their resources are exhausted (to the legal limit, which is, I believe a house, a car, and a small savings account for the spouse, if any) they go on medicaid. I think objective criteria should be used.

As far as the standing order for Lasix, I suppose the reason for the ER visit is to have a professional do it and monitor it??

Don't know much about the other stuff. Hip-pinnng used to be the treatment of choice, now everyone gets total hips. The death rate within a year of a fractured hip is quite high, I don't remember the figure right now.
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