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  1. #41  
    Quote Originally Posted by groovy View Post
    I agree with some of what he says...especially the part about the VA becoming much more efficient and decreasing costs. I have no idea how he defines efficiency (I'll dig up the article) but you notice he left out patient safety. EMR's can improve costs if there is a high penetration of the concept. If a patient goes to two different hospitals and they don't communicate with each other, then nothing is gained. There has to be a network....like the VA. I can walk into our VA and pull up medical records on any patient seen in any VA clinic and find out what his last medication change was. For individual hospitals, I do think they have potential to save money for patients that are complex and are seen by a number of different docs. Believe it or not, patients don't always remember what meds they're taking and what the dosage is. Having access to that info in the ER when a patient comes in really sick may not save money, but it can help provide better quality care. The real reason for EMR's is improved patient care. With a broad network, money will be saved,just like the VA. I know of one hospital linked with a geriatric practice and also with a nursing home. It has been very successful at improving communication among physicians, making sure medication lists are accurate....it's been a good thing. But there is a kernel of truth in the statement that hospitals may not be as motivated to provide massive cost savings. Believe it or not, some hospitals are motivated by profit. You know, the American way. Make them all public, put a great EMR system in them (like the VA's) and you will see cost savings.
  2. #42  
    Quote Originally Posted by mrgrim800 View Post
    I never said I had a fix. All I have said is this Healthcare reform is too much a garbled mess to understand.

    Ironically very close to your yarn to Opie comparison, It honestly gives me the Analogy of yarn>Opie = E. Coli > $H1t when thinking of you.

    I only brought up my father operating on and giving the ability for some to walk, is because if this future Healthcare bill comes to pass and something terrible does happen to a family who can not pay:

    a) (Future Times) - say the family of 66k a month has for whatever reason been late on their monthly payment for 3 months... His daughter gets in a wreck. He is already late on his monthly payments trying to make ends meet. So it should be no surprise he can also not make the deductable. This is money owed to the government, and if you can not pay, what will they do if you owe them money? The government will make you pay.. with either money or time.

    b) (Present Times) Same scenario above, up until the wreck the family takes the daughter to the emergency room, they have no money.... GUESS WHAT?!?! IT IS ILLEGAL TO TURN DOWN MEDICAL AID TO ANYONE ON THE GROUNDS OF THE UNITED STATES OF AMERICA; CITIZEN OR NOT! So the daughter gets better the family has a debt and no one is in prison.... Do you see what I'm getting at?

    This whole time yall have been trying to trim my argument down with all the centralized medical system and the defintion of Class II to III posts.. When in reality I have never said one thing being against a centralized medical system. Its time to let me grow or burn me down. Come on people burn me with intelligent posts.

    Tell you what, Opie. Read the 1500 posts in the thread about healthcare reform, then come back. There's quite a bit of discussion about your plan for health care....providing it through the ER. It's moronic, expensive and poor quality. Your Indiana doctor link: blah blah blah Acorn blah blah blah socialism blah blah blah intrusion of privacy blah blah blah destroying private care. You want opinions from doctors? Read the posts. I don't need some anesthesiologist who nurses at the teat of Rush Limbaugh to tell me about what it means to care about patients. By the time they get to him they've already passed the wallet biopsy test and they're asleep. Wonder how much exposure he gets to the homeless and uninsured? I'd also be real willing to bet any amount of money you want that he accepts Medicare payment. The system we currently have, the "private medicine" system he values so highly, has failed miserably. We don't need people screaming "the sky is falling, they're going to implant chips in our head and ration care". It's ludicrous, juvenile, and obstructionist. So why don't you try coming up with an idea to solve the problem?
  3. Micael's Avatar
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    #43  
    Quote Originally Posted by davidra View Post
    You scan it as an individual, and then all the composite records are stored in your database. I volunteered on a technology assessment panel for an HMO and took students out four times a year to tour their facilities so they would get an honest idea that all health plans aren't Satanic. I know that the right person can get enough information about a patient to do a number of observational studies, and that the patient services side of their plan interviewed patients on a regular basis and took notes. A number of patients in disease management programs interact daily with the health plan, admittedly only by referral from their physician, but that data is kept by the plan. I have had to get the highest security clearance to go into the central offices where the data is kept. If you don't actually know that, then I apologize for suggesting you did....but that's the case. It may not all be in one dossier (or it might, for all I know), but your health plan has a whole lot of personal health information on you that is just as accessible to people as if it were kept in government databases...and maybe more. So I agree that there isn't much difference between private and public data storage....and that suggests that having a more robust public option will not significantly change anyone's risk of having their personal health information pirated.
    It is true that we keep records of the claims we've paid, and of any letters we send out. And we are required by law to follow HIPAA rules when handling all patient information. That data is only used for historical purposes, kind of like keeping your banking records. We're required to keep them by law. I think it's 7 years. As for observational studies, for the purpose of tracking and analyzing case managment metrics, they do not include individual personal information. There's no reason for them to. This is separate from claims processing. Case management is offered as a benefit to our clients, and most of them love it. It's nice to have one on one assistance, with the same nurse.

    I can assure you that we follow all applicable laws, and are just as careful than the providers are with patients data. At least in my company, we take this very seriously.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  4. #44  
    Quote Originally Posted by Micael View Post
    It is true that we keep records of the claims we've paid, and of any letters we send out. And we are required by law to follow HIPAA rules when handling all patient information. That data is only used for historical purposes, kind of like keeping your banking records. We're required to keep them by law. I think it's 7 years. As for observational studies, for the purpose of tracking and analyzing case managment metrics, they do not include individual personal information. There's no reason for them to. This is separate from claims processing. Case management is offered as a benefit to our clients, and most of them love it. It's nice to have one on one assistance, with the same nurse.

    I can assure you that we follow all applicable laws, and are just as careful than the providers are with patients data. At least in my company, we take this very seriously.
    Yes....and do you really think you take it more seriously than people who are taking care of the Medicare database? If so, why? That's not the point. It is kept by the insurance company, not the provider. Personal health information, in some cases information that is NOT kept by the provider, is available to anyone that gets by Humana's security system.

    And yes, case management is essential, useful, and improves quality of care.Yes, study results are de-identified unless informed consent is used, but the point is that stuff exists and is accessible in your database....and nobody seems upset. But talk about it residing in a Medicare database, with probably even tighter controls of access, and everyone is up in arms. The Medicare database has been more secure than most private ones, from what I've seen, and it's much larger with more people having access.
  5. Micael's Avatar
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    #45  
    Quote Originally Posted by davidra View Post
    Yes....and do you really think you take it more seriously than people who are taking care of the Medicare database? If so, why? That's not the point. It is kept by the insurance company, not the provider. Personal health information, in some cases information that is NOT kept by the provider, is available to anyone that gets by Humana's security system.

    And yes, case management is essential, useful, and improves quality of care.Yes, study results are de-identified unless informed consent is used, but the point is that stuff exists and is accessible in your database....and nobody seems upset. But talk about it residing in a Medicare database, with probably even tighter controls of access, and everyone is up in arms. The Medicare database has been more secure than most private ones, from what I've seen, and it's much larger with more people having access.
    I guess I'm not getting what you're driving at. You seem to be saying that patient information housed in insurance company databases is insecure? Less secure than government databases? Please make your point. We need to have government health insurance for patient's privacy and security? If that's your point, then perhaps all banking and credit card information should be managed by the government as well? And then there's the schools and universities.... wait. The government already has those.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  6.    #46  
    Quote Originally Posted by davidra View Post
    Believe it or not, some hospitals are motivated by profit. You know, the American way. Make them all public, put a great EMR system in them (like the VA's) and you will see cost savings.
    Ignorance; how can you talk about the American way. When after this reform bill is passed is going to dictate how much doctors make and on top of that having the government decide who will become a doctor with prefrence going to disadvantaged applicants... Thanks for the offer, but I'm going to have to pass.

    Quote Originally Posted by davidra
    I'd also be real willing to bet any amount of money you want that he accepts Medicare payment. The system we currently have, the "private medicine" system he values so highly, has failed miserably. We don't need people screaming "the sky is falling, they're going to implant chips in our head and ration care". It's ludicrous, juvenile, and obstructionist.
    Damn no kidding he probably accepts Medicare; don't feel like a genious for figuring that one out.

    How has our public medicine failed miserabley? If you really are poor in this country you have a form of healthcare welfare as we speek. Are you only able to come at me with slanders?

    You just go along and don't question anything. Have you forgotten how this country was forged? Stay the sheep you are.
  7. #47  
    Quote Originally Posted by mrgrim800 View Post
    Ignorance; how can you talk about the American way. When after this reform bill is passed is going to dictate how much doctors make and on top of that having the government decide who will become a doctor with prefrence going to disadvantaged applicants... Thanks for the offer, but I'm going to have to pass.



    Damn no kidding he probably accepts Medicare; don't feel like a genious for figuring that one out.

    How has our public medicine failed miserabley? If you really are poor in this country you have a form of healthcare welfare as we speek. Are you only able to come at me with slanders?

    You just go along and don't question anything. Have you forgotten how this country was forged? Stay the sheep you are.
    Like I said, Opie, read some of the other threads and maybe you'll learn something. Maybe even how to spell "genius". Or "miserably" or even "speak". Ignorant indeed. Like most uninformed people, you have incorrect assumptions about almost everything. The uninsured are not the poor. They have Medicaid. The uninsured are workers. 80% of the uninsured are from working families. Really, do some reading, pay attention to the world around you, take a look at the percent of the GDP that goes to health care, and tell me you think the health care system is just fine as it is. And by the way. I'm involved in determining who gets into medical school, and there is no plan for the government to determine that. I am a doctor and I'm not the least bit worried about the government telling me how much I can make. It won't happen. It doesn't even happen in those socialist countries like Germany, Italy and Canada. Wake up and educate yourself, then weigh in.
    Last edited by davidra; 12/16/2009 at 02:45 PM.
  8. #48  
    Quote Originally Posted by Micael View Post
    I guess I'm not getting what you're driving at. You seem to be saying that patient information housed in insurance company databases is insecure? Less secure than government databases? Please make your point. We need to have government health insurance for patient's privacy and security? If that's your point, then perhaps all banking and credit card information should be managed by the government as well? And then there's the schools and universities.... wait. The government already has those.
    All I'm saying is that there is a segment of the teabaggers and other conservative groups that are raising concerns about a national ID card, the government having all our personal health information, and for cripe's sake, implanting chips in our heads. I'm just pointing out that people other than providers already have that information, and that is hardly a justification for not having a public option. Is that clearer?
  9. #49  
    two weeks ago my friend broke a bone in his knee. They discovered that he has stage four lung cancer that has metastasized and gone into his bones. It's already started become a financial burden and longterm could devastate his families financial well being. And it's not if his carrier will cover any treatments.

    It is right to reform healthcare to take care of our own American citizens like him. If you believe in all men are created equal we have a duty to take care of your own citizens. Not just yourself, or people of your own social strata or socioeconomic class.
  10. Micael's Avatar
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    #50  
    Quote Originally Posted by davidra View Post
    All I'm saying is that there is a segment of the teabaggers and other conservative groups that are raising concerns about a national ID card, the government having all our personal health information, and for cripe's sake, implanting chips in our heads. I'm just pointing out that people other than providers already have that information, and that is hardly a justification for not having a public option. Is that clearer?
    Lumping everyone into one big whacko category makes it a lot easier for you shoot them down. That's certainly clear.

    These are not reasons that I've raised against a public option, nor are they the primary reasons many people oppose it (who are not all from the groups you've mentioned).
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  11. #51  
    Quote Originally Posted by mrgrim800 View Post
    Its about the amount of control they would have over you. They could cut you off from your bank acount and society with a flip of a switch. And before you try to use big words we already have Centralized Medical Records. And if you are a doctor you already have access to that info, you are just a sheep in this world I do not expect for everyone to understand. But you are so blind I'm sure you don't realise we are all slaves. Do you even know who you pay your income tax to?
    Micael, all we can do is address absurdities one at a time. Health care reform is not about "the amount of control" the government would have over you. We're not all slaves, and health care reform won't make us slaves. Ridiculous talking points adding nothing to the conversation except incredulity that someone actually believes that crap.
  12. #52  
    Quote Originally Posted by blackmagic01 View Post
    two weeks ago my friend broke a bone in his knee. They discovered that he has stage four lung cancer that has metastasized and gone into his bones. It's already started become a financial burden and longterm could devastate his families financial well being. And it's not if his carrier will cover any treatments.
    To many in this thread, your friends situation is irrelevant. They truly believe that he has no constitutional right to health, or for his family to not lose everything they've worked for their entire lives....as long as they keep their own money.

    It always comes back to "me, me me" vs. "we".
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    #53  
    Quote Originally Posted by Bujin View Post
    To many in this thread, your friends situation is irrelevant. They truly believe that he has no constitutional right to health, or for his family to not lose everything they've worked for their entire lives....as long as they keep their own money.

    It always comes back to "me, me me" vs. "we".
    That's why conservatives, you know them as obstructionists, are the biggest givers of time and money to charities. They're just a bunch of selfish so-and-so's. Or...
  14. #54  
    Quote Originally Posted by groovy View Post
    That's why conservatives, you know them as obstructionists, are the biggest givers of time and money to charities. They're just a bunch of selfish so-and-so's. Or...
    Maybe blackmagic's friend can rely on the charity of others to keep his family from losing everything. Or maybe, when they lose their home, they can live in a charity-funded shelter. That seems much more giving.

    I was going to say "empathetic", but conservatives don't like empathy.
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    #55  
    Quote Originally Posted by Bujin View Post
    Maybe blackmagic's friend can rely on the charity of others to keep his family from losing everything. Or maybe, when they lose their home, they can live in a charity-funded shelter. That seems much more giving.

    I was going to say "empathetic", but conservatives don't like empathy.
    They don't? Or is that just your take? I was trying to open your mind a bit to the possibility that something more is going on than pure selfishness but I don't think it helped.
  16. #56  
    Quote Originally Posted by groovy View Post
    They don't? Or is that just your take? I was trying to open your mind a bit to the possibility that something more is going on than pure selfishness but I don't think it helped.
    And just what "more" is going on? Reality, not idealistic donations to charity, is what that person needs. Real assistance, not community fundraisers. I think there is a lack of empathy among many conservatives, but there's also a lack of empathy for everyone who has their own insurance and never has to deal with the problems of inadequate or unavailable insurance. There seems to be some attitude about the uninsured that they aren't deserving, that they don't work hard enough (because the vast majority of them are working) and that they bring it on themselves. They don't. And they don't deserve a country that ignores their physical and financial health. The US is better than that, indeed.
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    #57  
    Quote Originally Posted by mrgrim800 View Post
    by the way its not saying a class II device is a RFID, it is saying one class II device that is implantible is a RFID. Read it again. The logic and grammar is fine.
    No, what you said was:

    What exactly is a class II device that is implantable? Approved by the FDA, a class II implantable device is an "implantable radio frequency transponder system for patient identification and health information." The purpose of a class II device is to collect data in medical patients such as "claims data, patient survey data, standardized analytic files that allow for the pooling and analysis of data from disparate data environments, electronic health records, and any other data deemed appropriate by the Secretary."

    So, you said that a Class II implantable device is a RFID, which is wrong.

    And, you used "surveillance" wrong too. You said:

    Why would the government use the word "surveillance" when referring to citizens? The definition of "surveillance" is the monitoring of the behavior, activities, or other changing information, usually of people and often in a secret manner. The root of the word [French] means to "watch over."

    "Surveillance", in the bill, is surveillance of the use of Class II devices (all Class II devices, not RFIDs), which is important to ensure that Class II devices are safe and effective. Surveillance here is collecting data on adverse events associated with the use of a medical device or drug. A National Medical Device Registry will allow that information to be collected and analyzed to ensure that medical devices and drugs that aren't working are taken off the market. FDA hasn't been doing enough post-marketing suveillance of medical devices and drugs. This part of the bill is designed to require more surveillance and the registry to collect and analyze the data.
  18. Micael's Avatar
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    #58  
    Quote Originally Posted by davidra View Post
    Micael, all we can do is address absurdities one at a time. Health care reform is not about "the amount of control" the government would have over you. We're not all slaves, and health care reform won't make us slaves. Ridiculous talking points adding nothing to the conversation except incredulity that someone actually believes that crap.
    Ok, lets talk increased taxes and premiums. Reduction of choices. Fewer doctors.

    Whether or not the public option is in "this" bill or not is deceptive. The framework for it will be in place, and we'll be one step closer to setting up for a government takeover. We'll "get it" in the end....
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  19. #59  
    Quote Originally Posted by Micael View Post
    Ok, lets talk increased taxes and premiums. Reduction of choices. Fewer doctors.

    Whether or not the public option is in "this" bill or not is deceptive. The framework for it will be in place, and we'll be one step closer to setting up for a government takeover. We'll "get it" in the end....
    You have no evidence that that is the case. It's like the domino theory in Viet Nam. Will there be increased taxes? Yes, I hope so. Increased premiums? Not with regulation. Reduction of choices? Maybe, but Medicare doesn't, unless you really want to go to someone (in the small minority) who don't accept Medicare. Fewer doctors? Why would you say that? We need more doctors, but we don't need more plastic surgeons and pediatric neurosurgeons. We need more primary care docs and especially we need more geriatricians. Physician manpower needs are important, and sometimes they clash with individual choice. A number of medical schools have been funded by their states to train more primary care docs who stay in the state. They have made their efforts to do so, but guess what? Their students still want to be ophthalmologists and neurosurgeons, who make a whole lot more money. Frankly, I am totally in support of ways to get more primary care physicians....and they aren't that invasive. Offer scholarships, correct pay inequity....but all this is a totally separate discussion. I see nothing in the bills that would mandate any of the things you raise....except for higher taxes, which is fine with me. We'll get back much more in return.
  20. #60  
    Quote Originally Posted by Bujin View Post
    To many in this thread, your friends situation is irrelevant. They truly believe that he has no constitutional right to health, or for his family to not lose everything they've worked for their entire lives....as long as they keep their own money.

    It always comes back to "me, me me" vs. "we".
    very much so. There are many who believe in limiting government to helping themselves and only those they identify with. Many that call themselves Christian seem to act as if Jesus would have said, "sorry sick person, i can't help you." I'm not overly religious but if not constitutional how about religious grounds? Civic grounds? Moral Grounds? I think there are many reasons in addition to constitutional grounds.

    Quote Originally Posted by groovy View Post
    That's why conservatives, you know them as obstructionists, are the biggest givers of time and money to charities. They're just a bunch of selfish so-and-so's. Or...
    Even if we take that as true i think it's safe to argue they likely give overwhelmingly to causes that they identify with. I think its still an us vs. them issue. Charity is far from a a wholly altruistic act. I doubt you see them giving equally to the United Negro College fund. I don't think merely giving to charity makes someone unselfish.
    Last edited by blackmagic01; 12/18/2009 at 04:58 AM.
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