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The point...which you missed...is that if obummer doesn't fix this, it's his fault and yours for voting for him. It isn't about what what was done in the past. It's about what the candidates can do today and in the future. We are where we are and obummer either has the skill set to deal with that or he doesn't. From where I sit, he doesn't. You will get what you voted for, unfortunately, so will I.
no no no here in liberal america nothing is Obamas fault. Its bushes or fox news fault ,
Are you telling me I have no one to blame but myself? I didn't vote for any of this. I tried to stop it.
You'll notice that the one post of yours that I quoted, I agreed with. (the other I rep'd but I'm only allowed one rep)
The final comment was to those who support Obamacare. I didn't understand you to be in this group. If you are, I'll take back the rep I gave you.
BTW, I tried to stop it too. It's a classic piece of "NObamacare", drafted and passed without the input and participation of the people and their represenatives, presented to us as a "take it or leave it"proposition, and if you choose to "leave it", just pay the tax.
Somebody tell me what is democratic about this kind of abuse of power.
Yup.
Fee for outcome is going to be a double edge sword. In the past, hospitals were reimbursed on a DRG system{diagnostic related grouping}. If for instance, you were admitted for pneumonia, the hospital would get $5000 for the admission. If you were discharged in 3 days....the hospital made money. If you stayed for 10 days...they lost big.
The new model calls for anyone being re-admitted for the same issue within 30 days...there will be no more reimbursement to the hospital. I'm not sure at this point if DRG will also remain as part of the equation.
And now the patient's own doctor doesn't decide if the patient should stay longer - the hospitalist that is an employee of the hospital will discharge the patient to a nursing home where the patient will soon die.
I have always stressed to my children and it is apparent from the responses on this thread, education is in no way synonymous with intelliogence.
Hell, if you are moving to Australia, stop talking and just get the hell out!!!
If you are stupid enough not to realize that there have been less P.C. Doctors for the last decade because they make no money, then stop posting.
If you are stupid enough to believe in "death panels" then don't go to the doctor, just choose to die from treatable conditions.
Why so angry? What's it to you, and why call another person stupid?
Yes, private practice doctors/family physicians have been leaving their fields. Does that mean we ought to be happy that now more of them will leave? The ones who have stayed are enjoying patient care and are dedicated to them. My experience has been that they are more of the Dr. Welby time (yes, there still are a few of that rare breed around). We have one who set aside one day a the week to made house calls to the elderly who couldn't get out to the office. This doctor is being pushed into a larger conglomerate, or will have to retire from practice.
This is why I support mandatory nurse-to-patient ratios, like in CA.
Whaaaaat???? More government intervention? I'm shocked!
Actually, I agree. Then maybe most nurses wouldn't leave hospital employ by age 40.
Quote:
Originally Posted by malamute
And now the patient's own doctor doesn't decide if the patient should stay longer - the hospitalist that is an employee of the hospital will discharge the patient to a nursing home where the patient will soon die.
40+ years ago this was true as well. It was insurance that made the decision then, and still does now.
Whaaaaat???? More government intervention? I'm shocked!
Actually, I agree. Then maybe most nurses wouldn't leave hospital employ by age 40.
40+ years ago this was true as well. It was insurance that made the decision then, and still does now.
Are they being willfully obtuse ~ or just stupid? Or just not paying attention to what has been going in in the Healthcare industry for the past 20 years?
Why so angry? What's it to you, and why call another person stupid?
Yes, private practice doctors/family physicians have been leaving their fields. Does that mean we ought to be happy that now more of them will leave? The ones who have stayed are enjoying patient care and are dedicated to them. My experience has been that they are more of the Dr. Welby time (yes, there still are a few of that rare breed around). We have one who set aside one day a the week to made house calls to the elderly who couldn't get out to the office. This doctor is being pushed into a larger conglomerate, or will have to retire from practice.
Dr. Welby???...no wonder you people are appearing so seemingly demented!!!!
[QUOTE
40+ years ago this was true as well. It was insurance that made the decision then, and still does now.[/quote]
Not entirely true.
Insurance has a say in it in that they set rates, but internal utilization review is how physicians are "encouraged" to discharge patients. The DRG system was implemented a few decades ago and hospital reimbursement was dictated by this. As I said before, reimbursement to hospitals is based on the admitting diagnosis. They get a set amount depending on the illness. Short stays mean they make money and long stays mean they lose. The battle over how long a patient stays in the hospital is between the doctor and the hospital administration. The doctor is "prodded" to discharge but the doctor has the final and decisive say. No hospital administration is going to demand a doctor discharge a patient.....too much liability involved. "Medical necessity" usually wins over "length of stay".
[QUOTE
40+ years ago this was true as well. It was insurance that made the decision then, and still does now.
Not entirely true.
Insurance has a say in it in that they set rates, but internal utilization review is how physicians are "encouraged" to discharge patients. The DRG system was implemented a few decades ago and hospital reimbursement was dictated by this. As I said before, reimbursement to hospitals is based on the admitting diagnosis. They get a set amount depending on the ilness. Short stays mean they make money and long stays mean they lose. The battle over how long a patient stays in the hospital is between the doctor and the hospital administration. The doctor is "prodded" to discharge but the doctor has the final and desisive say. No hospital administration is going to demand a doctor discharge a patient.....too much liability involved. "Medical necessity" usually wins over "length of stay".[/quote]
My point is - none of this is NEW. So let's not blame it on the current President.
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It isn't about what what was done in the past. It's about what the candidates can do today and in the future. We are where we are and obummer either has the skill set to deal with that or he doesn't. From where I sit, he doesn't. You will get what you voted for, unfortunately, so will I.
(the other I rep'd but I'm only allowed one rep)
The ones who have stayed are enjoying patient care and are dedicated to them. My experience has been that they are more of the Dr. Welby time (yes, there still are a few of that rare breed around). We have one who set aside one day a the week to made house calls to the elderly who couldn't get out to the office. This doctor is being pushed into a larger conglomerate, or will have to retire from practice.
