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  1.    #41  
    Quote Originally Posted by clemgrad85 View Post
    WOW.....who are you? I leave for more than a month and you actually admit a single payor plan would go bankrupt? Look at you getting all logical and realistic. But you did leave out the main reason as for why a single payor plan would likely go bankrupt, and that's the government would be in charge.
    I have never argued with the fact that Medicare is non-sustainable AS IT IS NOW. Those data are pretty clear. And you're totally wrong, as usual, about why. Do you really think any private company could have provided services that Medicare has provided without costing even more because of their overhead? Have you ever heard of Medicare Advantage? If you want to go bankrupt even faster, just let for-profits get involved. As usual, you think the government is the ogre and in fact they do a fine job. They will do an even better job when they are allowed to get control of costs.
  2.    #42  
    Quote Originally Posted by clemgrad85 View Post
    Good doc....it would depend on who is doing the approval of procedures. I think you would quickly say it shouldn't be the insurance company....and you know I don't want the government making such decisions....so who would control what doctors can or can't order? I'm not sure why you think I would be against that, but, gotta be careful on who is making those decisions and who in turn controls that "board".
    As I've told you at least ten times, the obvious choice is the Agency for Healthcare Quality and Research. They determine efficacy based on reviews by non-governmental panels. I've posted their website lots of times. Frankly, I sure wouldn't trust a group of private practice docs to determine what is efficacious and what should be paid for. Would you? I'll take the government every time in that situation.
  3. #43  
    Quote Originally Posted by davidra View Post
    As I've told you at least ten times, the obvious choice is the Agency for Healthcare Quality and Research. They determine efficacy based on reviews by non-governmental panels. I've posted their website lots of times. Frankly, I sure wouldn't trust a group of private practice docs to determine what is efficacious and what should be paid for. Would you? I'll take the government every time in that situation.
    No.....no I wouldn't take the government every time. I don't think it should be a government agency. You and I would just have to disagree on this. Again points out the difference between you and me.....you believe every dang thing the government tells you (as long as it's back by liberal politicians) and I look suspiciously at everything that comes from the government, regardless of who says it (though I will admit, I tend to believe more from the right, but that shouldn't surprise you, right?).
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  4. #44  
    Quote Originally Posted by davidra View Post
    I have never argued with the fact that Medicare is non-sustainable AS IT IS NOW. Those data are pretty clear. And you're totally wrong, as usual, about why. Do you really think any private company could have provided services that Medicare has provided without costing even more because of their overhead? Have you ever heard of Medicare Advantage? If you want to go bankrupt even faster, just let for-profits get involved. As usual, you think the government is the ogre and in fact they do a fine job. They will do an even better job when they are allowed to get control of costs.
    LOL....oh doc....I always enjoy how you define success as an entity bringing in less than they pay out. You act as if Medicare is on solid ground with no financial problems. You are right, a private company would not have lasted long if they brought in the same premium dollars and paid out more in benefits. Of course, the government can do this because people are afraid to rock the boat.

    It's just like social security....every politician is afraid to rock the boat because tough decisions (delaying benefits until age 72?) mean they lose votes. Oh sure, everyone knows this needs to be done, but no one has the balls to do it. Yet another reason to have term limits....this would allow the folks who respresent us to make decisions based on what is right for the country, not what is right to get re-elected. Until this happens, people like you will keep their head buried in the sand thinking everything is just fine. Get that head outta the sand doc.
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  5. #45  
    Quote Originally Posted by davidra View Post
    As I've told you at least ten times, the obvious choice is the Agency for Healthcare Quality and Research. They determine efficacy based on reviews by non-governmental panels.
    sounds like something right out of russia...
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  6.    #46  
    Quote Originally Posted by clemgrad85 View Post
    No.....no I wouldn't take the government every time. I don't think it should be a government agency. You and I would just have to disagree on this. Again points out the difference between you and me.....you believe every dang thing the government tells you (as long as it's back by liberal politicians) and I look suspiciously at everything that comes from the government, regardless of who says it (though I will admit, I tend to believe more from the right, but that shouldn't surprise you, right?).

    Just once again showing your lack of comprehension, but it appears you have company. AHRQ is in charge of the US Preventive Services Task Force, a group that has been making recommendations to doctors for about fifteen years or more, long before health care problems crossed your mind. The expert groups that are organized to help determine what tests make sense and what don't are not employed by the government, are not responsible to anyone except their own knowledge of the content area. Doctors volunteer to be a member of these groups. It's a great honor, in fact. It's amazing how little you understand, just amazing. You would probably rather have a group of people like Bill Frist, who has a lifetime of ownership of a for-profit health plan, figuring out what should and shouldn't be paid for. That will really save a lot of money. Please, by all means, give us your particular plan for who should determine what is effective and what isn't? What should be paid for and what shouldn't? With your superior knowledge of the subject, I'm waiting breathlessly.
  7.    #47  
    Quote Originally Posted by clemgrad85 View Post
    LOL....oh doc....I always enjoy how you define success as an entity bringing in less than they pay out. You act as if Medicare is on solid ground with no financial problems. You are right, a private company would not have lasted long if they brought in the same premium dollars and paid out more in benefits. Of course, the government can do this because people are afraid to rock the boat.
    I swear. Medicare Advantage was exactly what you espouse. A private company determining what benefits Medicare recipients should get. Even when they tried to control costs, they couldn't. In fact, they did much worse than Medicare, and provided fewer services. Just like the article I posted, the problem is NOT who pays (although more overhead and making profit will make things worse) but what the costs are.

    Sorry, but I don't see this as a difference of opinion, although you are certainly have the right to have your own and express it. I see it as someone who thinks they know about something and they really don't. And politics has nothing to do with it.
  8. #48  
    Quote Originally Posted by davidra View Post
    Just once again showing your lack of comprehension, but it appears you have company. AHRQ is in charge of the US Preventive Services Task Force, a group that has been making recommendations to doctors for about fifteen years or more, long before health care problems crossed your mind. The expert groups that are organized to help determine what tests make sense and what don't are not employed by the government, are not responsible to anyone except their own knowledge of the content area. Doctors volunteer to be a member of these groups. It's a great honor, in fact. It's amazing how little you understand, just amazing. You would probably rather have a group of people like Bill Frist, who has a lifetime of ownership of a for-profit health plan, figuring out what should and shouldn't be paid for. That will really save a lot of money. Please, by all means, give us your particular plan for who should determine what is effective and what isn't? What should be paid for and what shouldn't? With your superior knowledge of the subject, I'm waiting breathlessly.
    Doc.....I simply don't have time to investigate every post of yours....sorry....spent my day on the road traveling and just can't put the time into posting like you. Anyway, if that board is made up of doctors, I have no problem with that. However, I do have a problem if politicians are putting these doctors in place. I just don't believe the government should be involved with it. Whenever people start to get "appointed" to boards or panels by politicians, suddenly, they start to get thinking they owe somebody something. That's all I'm saying. I have said insurance companies shouldn't be involved, and I meant that. It certainly would have to be doctors, I don't think it would be wise to put construction workers on the panel!
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  9. #49  
    Quote Originally Posted by davidra View Post
    I swear. Medicare Advantage was exactly what you espouse. A private company determining what benefits Medicare recipients should get. Even when they tried to control costs, they couldn't. In fact, they did much worse than Medicare, and provided fewer services. Just like the article I posted, the problem is NOT who pays (although more overhead and making profit will make things worse) but what the costs are.

    Sorry, but I don't see this as a difference of opinion, although you are certainly have the right to have your own and express it. I see it as someone who thinks they know about something and they really don't. And politics has nothing to do with it.
    You know I'm all for getting doctors to stop over charging and over prescribing. If you agree with that, then you are CORRECT, we are on the same page.
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  10.    #50  
    Quote Originally Posted by clemgrad85 View Post
    Doc.....I simply don't have time to investigate every post of yours....sorry....spent my day on the road traveling and just can't put the time into posting like you. Anyway, if that board is made up of doctors, I have no problem with that. However, I do have a problem if politicians are putting these doctors in place. I just don't believe the government should be involved with it. Whenever people start to get "appointed" to boards or panels by politicians, suddenly, they start to get thinking they owe somebody something. That's all I'm saying. I have said insurance companies shouldn't be involved, and I meant that. It certainly would have to be doctors, I don't think it would be wise to put construction workers on the panel!
    About ten years ago I worked out a deal with a local non-profit health plan. They would take a large group of students four times a year, give them a tour of their facilities, explain to them the philosophy of a health plan, demonstrate the services they provide for patients, and in exchange I would serve on their technology assessment committee. Docs who have contracts with them and who want new technology approved apply to this committee, which is composed of private docs and their own administration. The staff collects published articles that have evaluated the new technology. After about six months on this panel, one thing became clear: I was without a doubt the most conservative person there in terms of approving new technology, even though I had no financial interest whatsoever. Even the physician administrators were more likely to approve stuff for use, and it would be a financial loss for them. The fact was that most of this stuff did not pass my standards for effectiveness, or clearly demonstrated that they were better than currently existing treatments or technology. Cost had NOTHING to do with it, it was the poor quality of the science. That is exactly the attitude of those that work for AHRQ, and I say that with first-hand experience. One of my best friends was the first director. They are not now and never have been concerned about politics or costs, except in the context of comparisons with existing therapies. If two artificial joints, or two drugs for that matter, have not been found to be any different in performance, I would favor the cheaper one. Not rocket science.

    Your distrust of the government is misplaced, at least in regard to this issue. These decisions are NOT made to save money.They are made to provide a higher quality of health care in a cost-efficient safe manner. And that is EXACTLY what the country needs to begin to control health care costs.
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