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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".
My point is - none of this is NEW. So let's not blame it on the current President.[/quote]
I dont! BUT that doesnt mean I feel Obamacare is the answer. Something needed to be done but as I stated earlier; changes will come to Obamacare OR it will be replaced with a more sustainable model
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.
This is Fabian Society at it's finest.
George B Shaw
A lifelong socialist and a member of the Fabian Society.
"You must all know half a dozen people at least who are no use in this world, who are more trouble than they are worth. Just put them there and say Sir, or Madam, now will you be kind enough to justify your existence?"
If you can’t justify your existence, if you’re not pulling your weight, and since you won't, if you’re not producing as much as you consume or perhaps a little more, then, clearly, we cannot use the organizations of our society for the purpose of keeping you alive, because your life does not benefit us and it can’t be of very much use to yourself."
Did you NOT read the part that says 90% of doctors say we're on the wrong track??? It's where we're headed they fear. Not where we are now.
If YOU read the whole article, you would have understood that this has been going on for a long time, with corporations, hospitals and government making things so difficult for doctors to do their jobs. The Affordable Act is not perfect but it's the first time anyone has tried to make things right for the current uninsured or ininsurable. Give it time to work out the kinks. Big money, pharmaceuticals and government regulation is behind all that ails the medical industry today and that has been the case for years. Somebody had to start somewhere, Republican obstructionists be damned. Let's try something new instead of doing what we've always done - which is the definition of insanity. The medical industry has been a disaster for years. Let's work together to try to make it less of a disaster, with adequate care available to all who need it.
This last election should have taught us all that the right/left divisions in this country are getting us nowhere. Indeed, they are setting us back. It's time for everyone to sit down at the table and work this sh*t out. If everyone leaves the table pissed off, then we'll know it's getting somewhere. It will mean that compromises have had to be made, and that's a good thing.
My point is - none of this is NEW. So let's not blame it on the current President.
I dont! BUT that doesnt mean I feel Obamacare is the answer. Something needed to be done but as I stated earlier; changes will come to Obamacare OR it will be replaced with a more sustainable model[/quote]
I'm certainly not opposed to tweaking anything. I know - in my large corporation - when a new product is rolled out - there is often a good bit of tweaking that needs to be done in order to make it work.
If YOU read the whole article, you would have understood that this has been going on for a long time, with corporations, hospitals and government making things so difficult for doctors to do their jobs. The Affordable Act is not perfect but it's the first time anyone has tried to make things right for the current uninsured or ininsurable. Give it time to work out the kinks. Big money, pharmaceuticals and government regulation is behind all that ails the medical industry today and that has been the case for years. Somebody had to start somewhere, Republican obstructionists be damned. Let's try something new instead of doing what we've always done - which is the definition of insanity. The medical industry has been a disaster for years. Let's work together to try to make it less of a disaster, with adequate care available to all who need it.
This last election should have taught us all that the right/left divisions in this country are getting us nowhere. Indeed, they are setting us back. It's time for everyone to sit down at the table and work this sh*t out. If everyone leaves the table pissed off, then we'll know it's getting somewhere. It will mean that compromises have had to be made, and that's a good thing.
Couldn't agree with you more except that right now the only ones who have left the table and are pissed off are the Republicans. The Democrats are reveling in their "win" and rubbing it in the faces of the Republicans. They are dancing in the streets so to speak and the Republicans are shell-shocked. Lets hope the dancing soon stops and the Republicans find their way back to the table. Maybe then, both sides can be pissed off.
Couldn't agree with you more except that right now the only ones who have left the table and are pissed off are the Republicans. The Democrats are reveling in their "win" and rubbing it in the faces of the Republicans. They are dancing in the streets so to speak and the Republicans are shell-shocked. Lets hope the dancing soon stops and the Republicans find their way back to the table. Maybe then, both sides can be pissed off.
This reveling happened at the beginning of the first term also. Then Obama's campaining started, during which time the Senate pushed through Obamacare (and did it behind locked doors so that the Republicans couldn't participate).
If YOU read the whole article, you would have understood that this has been going on for a long time, with corporations, hospitals and government making things so difficult for doctors to do their jobs. The Affordable Act is not perfect but it's the first time anyone has tried to make things right for the current uninsured or ininsurable. Give it time to work out the kinks. Big money, pharmaceuticals and government regulation is behind all that ails the medical industry today and that has been the case for years. Somebody had to start somewhere, Republican obstructionists be damned. Let's try something new instead of doing what we've always done - which is the definition of insanity. The medical industry has been a disaster for years. Let's work together to try to make it less of a disaster, with adequate care available to all who need it.
This last election should have taught us all that the right/left divisions in this country are getting us nowhere. Indeed, they are setting us back. It's time for everyone to sit down at the table and work this sh*t out. If everyone leaves the table pissed off, then we'll know it's getting somewhere. It will mean that compromises have had to be made, and that's a good thing.
This reveling happened at the beginning of the first term also. Then Obama's campaining started, during which time the Senate pushed through Obamacare (and did it behind locked doors so that the Republicans couldn't participate).
Many Americans don’t realize that those who pushed hardest to impose Obamacare on the American people, exempted themselves from it. The President, Vice President and Executive Branch political appointees are also curiously exempt from participation in the exchanges.
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.
I didnt vote for Obama, you assume too much.
And my point (which you seem to keep missing) is this mess has existed for decades and simply blaming the current President is disingenious.
I do not think Obamacare will fix everything (to be fair I dont recall him claiming it would)...like any and all human endeavors there will be good and bad outcomes from it.
My personal and professional problem is that its essentially a giant subsidy for health insurance companies; they needed less clout in the market, not more.
Edit: On the subject of increased use of nurse practioners and PA's..this is a good thing. It allows for treatment of routine/minor ailments that really never required a physician in the first place like sprains, otits media, URI's, etc.
Physician care costs more and they're spread thin as it is. This is a common-sense cost reduction method.
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BUT that doesnt mean I feel Obamacare is the answer. Something needed to be done but as I stated earlier; changes will come to Obamacare OR it will be replaced with a more sustainable model
Did you NOT read the part that says 90% of doctors say we're on the wrong track??? It's where we're headed they fear. Not where we are now.
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.
