Page 3 of 4 FirstFirst 1234 LastLast
Results 41 to 60 of 67
  1. psm9's Avatar
    Posts
    328 Posts
    Global Posts
    340 Global Posts
    #41  
    Quote Originally Posted by Workerb33 View Post
    um, that was a Steve Jobs joke...
    Ouch. Sorry I missed it. My bad.
  2. groovy's Avatar
    Posts
    941 Posts
    Global Posts
    955 Global Posts
    #42  
    Quote Originally Posted by BARYE View Post
    If you are a 40 year old with cancer, a bad heart, a lame knee -- yes I want you to get care that can extend your life, improve the quality of your life.

    I have a hunch that a 93 yr old human will not get a meaningful benefit from having a defibrillator installed whilst they're getting end of life care for terminal cancer.

    ECUs are immensely expensive -- yet many 93 yr old humans spend their last days there. An enormous part of public health resources go just for palliative end of life craziness.

    Similarly hospitals devout a crazy amount of money to "save" very sick, very premature babies -- babies doomed to short lives of poor quality.

    If government resources are not unlimited, health expenditure ought be targeted toward those who can most receive benefit.

    Heroic, cost be damned efforts ought not be lavished on the very very old -- or the very very young.
    So, we know what the extremes look like. But what about the middle? Where's the line? What does it look like?
  3. groovy's Avatar
    Posts
    941 Posts
    Global Posts
    955 Global Posts
    #43  
    Quote Originally Posted by psm9 View Post
    Yeah. I'm complicated. On one hand, we could vaccinate thousands of children from the money spent on one liver transplant. On the other, liver transplants were crazy experimental 20 years ago and are now much more common and standardized. The "ridiculous" expenses of the past now lead to years and years of productive life for people in the prime of their lives. No easy answers...

    I do think that people need to be able to make their own choices to accept or refuse extreme care.
    That's a great point. The benefits often extend beyond the individual.
  4. groovy's Avatar
    Posts
    941 Posts
    Global Posts
    955 Global Posts
    #44  
    Quote Originally Posted by switchedgear View Post
    Well if it wasn't for us americans a lot of canadians would be speaking german right now!;-)
    On the other hand, if it weren't for Canadians, we'd only have ourselves to blame.
  5. #45  
    Quote Originally Posted by psm9 View Post
    For me, it's not about saving money and resources. Health care should not be a for-profit system. Health coverage should be a universal right in this country and not a privilege. [...]
    I think the real question is what is meant by 'health coverage'. IOW, what degree of coverage is a right?
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  6. #46  
    Quote Originally Posted by groovy View Post
    So, we know what the extremes look like. But what about the middle? Where's the line? What does it look like?
    I wrote you an answer -- but it died in a windows crash ... (after 2 months unconscious in an ICU, using public funds)
    755P Sprint SERO (upgraded from unlocked GSM 650 on T-Mobile)
  7. psm9's Avatar
    Posts
    328 Posts
    Global Posts
    340 Global Posts
    #47  
    Quote Originally Posted by Toby View Post
    I think the real question is what is meant by 'health coverage'. IOW, what degree of coverage is a right?
    That's the whole issue, right? Oregon tried to limit health care in its Medicaid program in the 90's. They rated every possible health service by cost and drew a line. Anything more than that (organ transplants was the main one I remember) wouldn't be covered. They made the argument I did. For the cost of one transplant, thousands of people can get preventive care. People freaked out and they had to recant. Never mind that they would be able to provide better, basic care to many people. All we have to do is be faced with one cute 4 year old who needs a kidney transplant and we all melt.

    The rational arguments are easy - more lives would be saved with immunizations and good preventive care than with one organ transplant- but on an emotional level, nobody can make the call to let the 4 year old die. Even though more kids die for lack of good prenatal care. But that's not glamorous, so nobody gets excited about it.
    Palm V -->m505 -->Tungsten T3-->T5->Centro-->Pre!
  8. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #48  
    Quote Originally Posted by psm9 View Post
    The rational arguments are easy - more lives would be saved with immunizations and good preventive care than with one organ transplant- but on an emotional level, nobody can make the call to let the 4 year old die. Even though more kids die for lack of good prenatal care. But that's not glamorous, so nobody gets excited about it.
    There are already many options available for low or no cost prenatal care. If you're a doctor, you should know that already. And there's plenty of people out there that are passionate about such care. Here's some resource information I gathered quickly via our friend google:

    Here are some places that you can look for locally to help you get prenatal care:

    Local Health Department
    Your local health department will be able to tell you where a prenatal care clinic is run. They may have one that they run or can help you find free or reduced prices on prenatal care depending on your income level. You can call 1-800-311-BABY (1-800-311-2229) to connect you to your local health care department. This information is also available in Spanish by calling 1-800-504-7081.

    Local Medical School
    If you live in an area with a medical school or even have a bigger medical school in your state, even if it is not in your town, call their clinics. They often run clinics for prenatal care both at the medical school and in local towns within a certain distance. These are staffed by trained and qualified doctors and midwives who are training residents (doctors who have graduated from medical school but are learning the specialty of obstetrics), midwives and sometimes student doctors and nurses. Costs will vary depending on income.

    Planned Parenthood
    There are many cities that are serviced by Planned Parenthood. They do provide sliding scale prenatal care. This means it will be based on your ability to pay.

    Medicaid
    This is a sponsored program for women who do not have the money to pay for prenatal care. After the application process, you will be given a list of providers of care. This should include doctors and midwives in your area who have already agreed to take Medicaid. They will provide you with the exact same medical care as private pay or insurance based patients. Check in the blue pages of your phone book.

    Other Resources
    You may have local resources that are helpful for finding prenatal care. It may be that your religious family has a prenatal care provider who will work with you. Or perhaps you can make payment arrangements with a local midwife or doctor. Be up front about your situation. Be truthful about what you can and can't afford.
    You're welcome to continue beating your drum about 'nobody cares', but there are in fact solutions available. If anything, this is a communications issue, not a resource availability issue.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  9.    #49  
    Quote Originally Posted by clemgrad85 View Post
    Waste in health care? I had back surgery about 4 weeks ago, and a week before surgery I had to go get a back brace....I was told the hospital required me to have a back brace before I left the hospital. When they were "fitting" me for the brace (fitting was a ridiculous term, they showed me how to put it on) I asked how much this brace was going to cost and when the little assistant looked at me, I knew it would be ridiculous but was not expecting her to say $1000! When I expressed shock at this, you know what her response was? "Oh, don't worry, we have already had this approved by your insurance company." I told her that was not the issue, but rather the cost. Well, I got my EOB statement last week and the billed cost was $1500 but after the discount, it was brought down to $804.51. They also charged me $200 for the fitting, of which the insurance company didn't pay anything for (which I don't blame them, as it was 5 minutes of showing me how to put the brace around me and tighten it, I will be fighting this charge). I showed this brace to a woman who works at a PT office and she said I could have gotten a similar brace for $200 - $250.

    Obama's health care plan will do nothing....NOTHING...to reduce this fraud. In fact, I believe obama health care plans on putting an additional tax on durable medical equipment which will simply be passed along to the consumer. This is why our health premiums are so high.....physicians who are greedy and only care about making money. Now....I personally am not opposed to anyone making money....but....I do get annoyed when some physicians blame the insurance companies for rising health care costs or playing hard ball on negotiated rates when we need physicians to stop charging these ridiculous rates.

    Congratulations. Guess why it costs so much? Because hospitals have to make up for the indigent care they provide in order to stay in business. But of course you are opposed to the fix, which would be quite easy: universal health care. Yes, the current bill didn't go nearly far enough to solve the problem. Does that mean you now are in favor of a public option?

    Our governor just vetoed $9 million dollars going to our hospital for indigent care, over the legislature. Since there was an equal amount of matching funds coming from the government, we are losing almost $20 million dollars from our hospital's budget. We are having to dramatically decrease amount of indigent care we provide in order to stay in business. People will be denied care because of this. But you really have no solution for that, do you?
  10.    #50  
    Quote Originally Posted by groovy View Post
    As you know, when it comes to health care, as with most things the average person doesn't understand, most people just want to be told what would be the best thing--by an expert they trust. I wouldn't really trust a person who seems so biased towards a certain outcome.



    One point brought out in the video was that there's no incentive to reduce cost because patients don't actually pay for their treatment. And the expense of that "perverse" system is compounded in terminal cases. I'm guessing you don't agree with that assessment?
    As I think you know, I have a lot of respect for your discussions about this issue, because you actually put some thought into things without knee jerks. As you know, because we've discussed this many times, the costs of health care are now way too high to expect people to pay for their own care. We can decrease that cost by providing care to indigents for which doctors and hospitals get reimbursed. Our "self-pay" patients are allowed to work out very liberal payback plans, so they do contribute...but it is a minimal amount compared to the overall costs. In general, then, I don't agree that in our current state we can expect anybody except the very rich to pay for their unexpected health care needs...without providing some reimbursement to the many that provide no reimbursement at all.
  11.    #51  
    Quote Originally Posted by Micael View Post
    This argument boils down to who decides the how and when someone else should die. The family - the doctor - the insurance company - or the government. It seems to me that you believe that it should be the government, based on the fantasy that the goverment will save money and resources. Does that about sum it up?
    I don't recall stating that the government should determine who should live or die. I have discussed ways to improve the problem, but I also stated I would never, and never allow the insurer, government or not, determine who should die and when. But that will not solve the problem of lack of education in families about the realities of death. I have nothing to do with the government...but I can predict with very good accuracy when many patients are going to die, regardless of how much money is spent, and I am hardly prescient. Any doctor with experience will tell you the exact same thing. It's the culture that needs to be changed and education is the way to do it...
    I am not saying this is easy. If you are really interested in this issue, and if you want a first-hand extremely well-written discussion about this, read the following article written by Atul Gawande, a surgeon at Harvard who is one of the finest medical writers alive today....and he's very young.

    The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end.
    More often, these days, medicine seems to supply neither Custers nor Lees. We are increasingly the generals who march the soldiers onward, saying all the while, “You let me know when you want to stop.” All-out treatment, we tell the terminally ill, is a train you can get off at any time—just say when. But for most patients and their families this is asking too much. They remain riven by doubt and fear and desperation; some are deluded by a fantasy of what medical science can achieve. But our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come—and to escape a warehoused oblivion that few really want.


    Read more Hospice medical care for dying patients : The New Yorker
  12.    #52  
    Quote Originally Posted by Micael View Post
    Interesting. On one hand you extoll the advances that have saved countless premies, and on the other, you wish to destroy the very system that made those advances - a system supported by those "evil profits". It's our for-profit companies that funded the research that discovered those improved methods, not the government teet (i.e., our taxes).

    The unescapable truth is that healthcare costs money. There is no "free" system. All systems have thier quirks, but so far the free market seems to drive the advances. Look to the stagnation of the USSR system to see the antithesis.
    Again, you ignore the fact that the majority of major advances have been initiated by funding from the National Institutes of Health. You know, your tax money.
  13. psm9's Avatar
    Posts
    328 Posts
    Global Posts
    340 Global Posts
    #53  
    Quote Originally Posted by Micael View Post
    You're welcome to continue beating your drum about 'nobody cares', but there are in fact solutions available. If anything, this is a communications issue, not a resource availability issue.
    For many things, you're right. There are good resources available for prenatal care and vaccination and there is certainly a communication issue, but I think that's a sign that "the healthcare system" is failing in some measures. Why do some poorer countries have better pregnancy outcomes than us? Clearly we have room for improvement. With or without universal coverage, we need to improve resource allocation. Personally, I think the government has a better shot at this than private industry
    Palm V -->m505 -->Tungsten T3-->T5->Centro-->Pre!
  14.    #54  
    Quote Originally Posted by Micael View Post
    There are already many options available for low or no cost prenatal care. If you're a doctor, you should know that already. And there's plenty of people out there that are passionate about such care. Here's some resource information I gathered quickly via our friend google:

    Local Health Department
    Your local health department will be able to tell you where a prenatal care clinic is run. They may have one that they run or can help you find free or reduced prices on prenatal care depending on your income level. You can call 1-800-311-BABY (1-800-311-2229) to connect you to your local health care department. This information is also available in Spanish by calling 1-800-504-7081.

    Local Medical School
    If you live in an area with a medical school or even have a bigger medical school in your state, even if it is not in your town, call their clinics. They often run clinics for prenatal care both at the medical school and in local towns within a certain distance. These are staffed by trained and qualified doctors and midwives who are training residents (doctors who have graduated from medical school but are learning the specialty of obstetrics), midwives and sometimes student doctors and nurses. Costs will vary depending on income.

    Planned Parenthood
    There are many cities that are serviced by Planned Parenthood. They do provide sliding scale prenatal care. This means it will be based on your ability to pay.

    Medicaid
    This is a sponsored program for women who do not have the money to pay for prenatal care. After the application process, you will be given a list of providers of care. This should include doctors and midwives in your area who have already agreed to take Medicaid. They will provide you with the exact same medical care as private pay or insurance based patients. Check in the blue pages of your phone book.

    Other Resources
    You may have local resources that are helpful for finding prenatal care. It may be that your religious family has a prenatal care provider who will work with you. Or perhaps you can make payment arrangements with a local midwife or doctor. Be up front about your situation. Be truthful about what you can and can't afford.

    You're welcome to continue beating your drum about 'nobody cares', but there are in fact solutions available. If anything, this is a communications issue, not a resource availability issue.
    Great examples. The Health Department is a government agency. Many health departments have had to dramatically cut back on their services because of lack of funding. Local medical schools provide care to the underserved largely through either state funds, or Medicaid, both government sources of funding. Planned Parenthood survives on donations and federal grants (your tax money again). So of all the opportunities you mention, all are government funded except for the possibility that you belong to a church that includes a doctor that will happen to donate care.

    Are you suggesting we should dramatically increase government funding for health care? Finally, we agree on something.
  15. #55  
    Quote Originally Posted by davidra View Post
    Congratulations. Guess why it costs so much? Because hospitals have to make up for the indigent care they provide in order to stay in business. But of course you are opposed to the fix, which would be quite easy: universal health care. Yes, the current bill didn't go nearly far enough to solve the problem. Does that mean you now are in favor of a public option?
    No, I am not now in favor of a public option. This brace didn't come from the hospital, it came from the doctor practice....but nice try good doctor. I don't mind my doctor making a reasonable profit margin.....but my guess would be they made something along the lines of 300% to 400% on this product (based on finding out I could have bought one for $200 to $250).

    I will add, I was very pleased with the overall timing of my health services. From the time I went to the doctor the first time, got an MRI, met with the doctor to review it, and got surgery it was 16 days! Yes, how about that for speed? I'll bet had I been in some public option plan, I'd still be popping pills for the pain trying to get in for the MRI. No thank you.....I'll stick with a system that provides good care in a reasonable time period.

    On a side note.....when I went for my MRI they required a payment up front....understandable. Because I had been putting money aside into my HSA account for almost 4 years I had the funds for it. So, before they took me in the back for the MRI, I had to pay and they told me it would be $1,495. I questionsed the woman that it seemed high and was that after the in-network discount? She assured me it was. I was skeptical, but they got me by the balls at this point as if I don't pay, I get no procedure. So, I paid the $1,495. Well, the EOB arrives and sure enough the discounted price was $960. Now the fun begins....trying to get money back from a physician's office. They take it quick....but it sure comes back slow.
    PalmPilot, PalmIIIc, Treo 650, Pre, Pre 3, Nokia 1020, Lumia 950

    "It's good to be the King" - Mel Brooks, History of the World, Part 1

    "I would rather have a German division in front of me than a French one behind me." General George S. Patton
  16. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #56  
    Quote Originally Posted by davidra View Post
    Again, you ignore the fact that the majority of major advances have been initiated by funding from the National Institutes of Health. You know, your tax money.
    Source?
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  17. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #57  
    Quote Originally Posted by psm9 View Post
    I think the government has a better shot at this than private industry.
    Based on thier fabulous track record?
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  18. Micael's Avatar
    Posts
    736 Posts
    Global Posts
    739 Global Posts
    #58  
    Quote Originally Posted by davidra View Post
    Great examples. The Health Department is a government agency. Many health departments have had to dramatically cut back on their services because of lack of funding. Local medical schools provide care to the underserved largely through either state funds, or Medicaid, both government sources of funding. Planned Parenthood survives on donations and federal grants (your tax money again). So of all the opportunities you mention, all are government funded except for the possibility that you belong to a church that includes a doctor that will happen to donate care.

    Are you suggesting we should dramatically increase government funding for health care? Finally, we agree on something.
    Nice spin. All I was saying was that resources were already available. I was quite aware that some of my tax dollars go to fund some of these, but your point is 'largely' overstated. You largely ignore the billions in donations that private individuals and corporations make to these same services and schools. The data's out there, if you're interested.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  19.    #59  
    Quote Originally Posted by clemgrad85 View Post
    No, I am not now in favor of a public option. This brace didn't come from the hospital, it came from the doctor practice....but nice try good doctor. I don't mind my doctor making a reasonable profit margin.....but my guess would be they made something along the lines of 300% to 400% on this product (based on finding out I could have bought one for $200 to $250).

    I will add, I was very pleased with the overall timing of my health services. From the time I went to the doctor the first time, got an MRI, met with the doctor to review it, and got surgery it was 16 days! Yes, how about that for speed? I'll bet had I been in some public option plan, I'd still be popping pills for the pain trying to get in for the MRI. No thank you.....I'll stick with a system that provides good care in a reasonable time period.

    On a side note.....when I went for my MRI they required a payment up front....understandable. Because I had been putting money aside into my HSA account for almost 4 years I had the funds for it. So, before they took me in the back for the MRI, I had to pay and they told me it would be $1,495. I questionsed the woman that it seemed high and was that after the in-network discount? She assured me it was. I was skeptical, but they got me by the balls at this point as if I don't pay, I get no procedure. So, I paid the $1,495. Well, the EOB arrives and sure enough the discounted price was $960. Now the fun begins....trying to get money back from a physician's office. They take it quick....but it sure comes back slow.
    So you just love a system that dramatically overcharges you for profit, makes it nearly impossible to get the money back you already paid, because you THINK that you got services much faster than you would have gotten in a different system with which you have no experience? Not that I'm surprised by that. Of course, if you happened to not have insurance, you'd never get surgery, but that's not of interest to you.
  20.    #60  
    Quote Originally Posted by Micael View Post
    Nice spin. All I was saying was that resources were already available. I was quite aware that some of my tax dollars go to fund some of these, but your point is 'largely' overstated. You largely ignore the billions in donations that private individuals and corporations make to these same services and schools. The data's out there, if you're interested.
    Oh really? There is data that "private individuals and coporations" donate billions to Medicaid and the public health department? And I really don't know how knowledgable you are about donations to medical schools (something I am very knowledgable about). Let's just say those donations are not to general revenues, and aren't meant to provide care to the underserved or underinsured. About 95% of it is targeted for specific programs.
Page 3 of 4 FirstFirst 1234 LastLast

Tags for this Thread

Posting Permissions