Author Topic: Talking Heads - Healthcare Reform (Read 101139 times)

bellemere · « **Reply #560 on:** January 05, 2010, 11:06:05 AM »

Ado Annie, thanks for the support! I am in Massachusetts which alreaady has universal health care and is struggling through the second year, tweaking and making adjusments, but the economy is making it verydifficult. However, our state chose to put "people first"
withe universal coverage , and then ot figure out how to pay for it all! With predictable results, but we are not going back!
I just read that the big Harvard Medical
School hospitals in Boston are putting limits on the amount of money their doctors can make from sitting on boards of health-care related companies, and giving talks sponsored by them. Never knew they could make 5 thousand dollars for going to a one-day annual board meeting! No heavy lifting, as they say. Now that is all in the past.
Also the Mass Health program, our Medicare, supplies counseling and medication to people who want to quit smoking, and has cut the rate of smoking among low income people by 13 percent. Not much, but it will make a big differcnce in theri health.

Babi · « **Reply #561 on:** January 06, 2010, 08:08:18 AM »

Nice to hear some good news, ANNIE.

ANNIE · « **Reply #562 on:** January 06, 2010, 08:53:16 AM »

Did anyone hear about the Mayo Clinic in Arizona refusing to honor Medicare claims?? They will no longer take Medicare patients either. You will have to pay them with check or cash or credit card.

bellemere · « **Reply #563 on:** January 06, 2010, 09:54:12 AM »

Ado annie, we have to look closely at that! Seems to come under the cost reduction banner. But what a pain in the butt for us to have to make the Medicare claim for ourselves! Does the Mayo offer a trained social worker to help those of us who are hopelessly illiterate in these manners, like me?
When we get treatment at a hospital in a foreign country, our Medicare Advantage program covers it on the base of a credit card receipt. No checks.
and only if it is urgent or emergency care.
It seems "shared sacrifice" means something unpleasant for everybody. Oy, veh!

maryz · « **Reply #564 on:** January 06, 2010, 01:14:05 PM »

I've been going to my rheumatologist for about 6-7 years. His office does not "accept" any insurance, including Medicare. Payment is expected at the time of the visit (credit cards accepted). The office files the insurance for you, almost immediately, and reimbursement is usually received within a couple of weeks. I saw him in midDecember, and got my Medicare reimbursement check today. So I have no problems with that.

Of course, we're fortunate that we are able to pay at the time of the visit. I know that's not an option for lots of folks. I don't know what this office would do with folks who have no way of doing that.

bellemere · « **Reply #565 on:** January 06, 2010, 04:30:09 PM »

I read the article about the priary care clinic in Phoenix; yes, they are not accepting Medicare for primary care visits any more. they still accept them for specialist care, lab work, etc. The reason givn is that the Medicare reimbursment is not adequate to cover the costs.
Many doctors give this reason for not accepting Medicare patients. And for not accepting poor people's Medicaid insurance, which is even stingier in some state.
But who sets the costs? The provider does. If your neighbor has a huge mansion, two Caddies in the driveway, a swimming pool, vacatons in Europe or the tropics every few monts, and then says, "My employer is not paying me enough to cover my costs," what would your first thought be?
Patients have no idea what the actual cost of their care is, do they? Each component of the medical syste is "selling" something to some other coponent, and charging as much as they can. The bitter truth is that there will be no reform, and no cost control unless hospitals, doctors, drug companies and equipment manufacutrers, and insurance companies, make LESS money. They will fight like tigers to keep that from happeinin, even though if they dont, and the upward trend continues, Medicare will be GONE by 2017, if not sooner, according to some economists. Think what that is going to mean.
Can't stop this rant without saying that I think primary care doctors are not making enought money; one of the consequences will be a lack of primary care internists, pediatricians, ob/gyns and geriatricians. I dont know how accurate this is but someone told me the average income for a primary care doctor is only about100thousand Some Wall St guys make that in an hour.

maryz · « **Reply #566 on:** January 06, 2010, 04:37:18 PM »

Our family care doc (whom we thought would outlive us) left private practice to work for the city and manage the clinic the city provides for its employees. He was working himself to death, keeping up his practice and working part-time for the city. And, like you say, these docs are the ones who are getting the shaft.

ANNIE · « **Reply #567 on:** January 07, 2010, 09:53:10 AM »

My dr's nurse tells me she only has three yrs to go before retiring and along with her will be many drs and nurses from her generation. Their fear for the medical system and the patients is the fact that there aren't enough primary care drs now and not many nurses either and it can only go downhill from now on.

I read about a young new dr who on graduating from school and training was offered a job of taking care of one whole town and the town would pay his debts for medical school. He will be overwhelmed, sad to say. I hope he gets much joy from helping these folks.

bellemere · « **Reply #568 on:** January 07, 2010, 11:23:39 AM »

Don't you think forgiving the school loans of priary care doctors is one good way to increase the supply? Right now they can get reibursed for gvt. loans by serving in the army or in a a dr satically underserved area; some end up working in prisons, a real fun scene.

ANNIE · « **Reply #569 on:** January 07, 2010, 06:16:17 PM »

OH, yes, I do approve. Was just telling the story and giving my opinion, Belle. I think this is a wonderful way for small towns to help new graduate drs and nurses.

pedln · « **Reply #570 on:** January 07, 2010, 11:11:54 PM »

Have you read anything by Atul Gawande? He a young surgeon, associated with an academic medical center in Boston. I've read parts of his Complications, but my public health daughter referred me to a recent New Yorker article by him that compares early 20th century agricultural reforms to what we are or may experience with health reform. Mainly he talks about the government agricultural pilot programs begun in this period, one of the most successful being the county extension programs. Apparently many of the pages in the volumes of the health bills describe a number of pilot programs. Gawande does not go into great detail on individual programs, but does point out some included in the bills. His message is that the small program approach worked well for agriculture; it could also work for health.

Testing, testing by Atul Gawande

Babi · « **Reply #571 on:** January 08, 2010, 08:16:36 AM »

I do hope Congress is giving this subject as much attention as we are.

ANNIE · « **Reply #572 on:** January 08, 2010, 09:44:54 AM »

Too many patients with similar problems who can't use the same solution as the guy next in line. And, it will be lines, everywhere we go.

bellemere · « **Reply #573 on:** January 08, 2010, 09:58:39 AM »

I have been reading Atul Gawande for a long time, both his articles and his books. I missed the article your daughter referred to when my subscription lapsed for a month. But this weeks has some letters from three people, discussing the aricle, I wil have to hit the librar to get filled in.
The only way legislators willknow we are paying attention is to tell the, earlhy and often. having said that, I realize that I haven't called our guys for a while, maybe because i know where they stand.
Another responsible voice I read, but don't always completely agree with is David Brooks. He describes the "Tea Partyy" view that the government is being taken over by an " educated class" that is not taking their views into account. Most strangely, I have heard this from friends of one of my daughters: they hate Barack Obama; they thing the "edcuated class" looks down on them. But these are all women with college degrees; some with professional credentials like registered nurse, certivied financial planner, etc, and most of them are working hard to put their children through good colleges! Producing more members of the "educated class
that they scorn. Health care is just one of their "anti" issues. They don't believe in global warming; they don'b believe that the Supreme Court was right in recognizing women's right to choose abortion, and they definitely don't believe in gun control. This in an affluent suburb far from any inner city crime scenes. I I find it very puzzling.

pedln · « **Reply #574 on:** January 09, 2010, 12:36:31 PM »

Bellemere, I find your daughter's friends' attitudes puzzling too. It sound like "we've got ours, we don't care about yours."

Click on the link Testing, Testing -- above. That is the New Yorker article by Gawande.

Steph · « **Reply #575 on:** January 11, 2010, 06:40:17 AM »

Still struggling with the insurance and medical bills. The insurance company has promised me a pay out, but they are not willing to help with sorting out the medical liens, etc. Hmm.. My older son and I are debating. I think I need to talk to both the hospital and medicare.. I dont mind doing all of this, but I really assumed that the insurance company helped a lot more than they are.

ANNIE · « **Reply #576 on:** January 11, 2010, 08:09:45 AM »

I didn't know that your insurance wouldn't just pay the hospital and doctor bills as they were sent in. This must be very trying for you, Steph.

Steph · « **Reply #577 on:** January 12, 2010, 06:37:02 AM »

Lots of stress, but I do honestly think that the insurance company knows how to do these things and I am mostly getting annoyed that they want to push it off on me. They say their responsibility ends with the PIP ( uninsured motorists) and the larger payout is for me to decide. Makes no sense.

bellemere · « **Reply #578 on:** January 15, 2010, 02:27:49 PM »

Trying to get my mind around the catastrophe in Haiti. Just incredible, people who had nothing to start with, being hit this way.
that humanitarian Rush Limbaugh is discouraging people from donating without some assurance that "the government" is not just trying to get their name and address to add them to "a list" \
We are giving to Doctos Without Borders and I will be happy to be on their list.

ANNIE · « **Reply #579 on:** January 15, 2010, 07:08:41 PM »

That man has become a fruitcake and I am being nice here!
We donated to the Red Cross as we have confidence in their being able to use the money wisely.

bellemere · « **Reply #580 on:** January 15, 2010, 09:01:59 PM »

Did he really say that the President's appeal for help for Haiti was " a black president's attempt to burnish his reputation with black voters'
I heard that second hand, never listen to him my self.
And did an Iowa senator or congressman want to send all the illegal Haitian immigrants back to Haiti to be rescue workers? With no food or wather they wouldn't ve very efficient, would they?

Steph · « **Reply #581 on:** January 17, 2010, 06:41:07 AM »

Limbaugh seems to be off the deep end in his hatred for the current administration. Why people listen and believe is beyond me.
The thing in Haiti,, they need to get down to the basics to make that country into something that will actually work. Haiti turns out the most venal politicians on earth. All reports I read say the government is not functioning at all. Bet they will, when money comes in to be spent. And it wont get spent where it is supposed to.. Their Presidential palace when the country is so poor was simply an abomination.

ANNIE · « **Reply #582 on:** January 17, 2010, 10:44:38 AM »

Couldn't agree more, Steph. And one feels so helpless when they show pictures.
Did you see the news headline that Venezuela was hit two days ago by a 5.6 quake? Haven't heard the talking heads even mention that one.
I did hear a reporter compare a 5.6 with a 7.3. I think he said the 7.3 was ten times worse than a 5.6. I had no idea.
We had cousins in the quake that hit Northridge, CA a few years ago. They were not damaged or hurt but their neighbors were in bad shape. My cousin went around the neighborhood helping people do repairs or removal of the damage. Needless to say, he felt quite blessed.

bellemere · « **Reply #583 on:** January 17, 2010, 05:54:40 PM »

Massachusetts voters go to the polls on Tuesday to elect a senator to take Ted Kennedy's seat. I tis very close. the Republican candidate, calls himself and independent thinker, but says he will vote to kill the curren thealth cre bill passed by the House and the Senate and undergtoing final conference. This would end health care reform for our lifetime and possibly for our children's. Millions of people will go without insurance, and those with indurance will pay huge increases in premiums to cover the care of the uninsured. And some of those "uninsured' could affort the subsudized insurance offered in the bill, but would rather not pay even those premiums. It is very close, an enourmous question hangs in the balance. Masschusetts will continue workijg out our uniberal health care problems; the rest of you are goin to have your chance at health reform scuttled by this one Massachusetts man. Stranger than fiction, huh?

Steph · « **Reply #584 on:** January 18, 2010, 07:33:21 AM »

Its truly sad that they turned the health bill into a political dog fight. Why cant they simply vote on how they feel. Seems unknown.. We would never have had a constitution if our founding fathers had simply taken opposite sides and did not discuss anything.

Babi · « **Reply #585 on:** January 18, 2010, 09:22:30 AM »

BELLE, I trust you plan to vote for the other guy, right? Will that one
seat really have that much influence, do you think?

Obviously there are strong 'feeling' on this issue, on both sides. I am
reading a book now (sci/fi) titled "Haze", about a planet where the
lawmakers must not involve themselves in the emotional views of
their constituents, but consider only the greater good of the planet
as a whole. Sounds incredible, doesn't it?

bellemere · « **Reply #586 on:** January 18, 2010, 10:35:20 AM »

yes I plan to vote for "the other guy" who is a woman, Martha Coakley, the state's attorney general. She has been on the winning side and sometimes the losing side of really important issues: at least she has engaged her talents on behalf of the people of Mass. I like that she managed to get millions of dollars from the shady contractors on the Big Dig, Boston's mammoth highway project, and also millions from Goldman Sachs for their shaky mortgage practices. She is a fighter.
Your book proposes a radical view of the duty of public servants. should they be guided solely by the emotional reactions of their consittuents, or by principles that promote the general good of the public. Good question.
It seems to me that ex-presidents, free of worry about re-election, are free to do more real good than they ever did as presidents: Carter, and now Clinton. Maytbe the presidency is just a baptism of fire for our future Great Men and Women.

bellemere · « **Reply #587 on:** January 18, 2010, 02:35:00 PM »

Regarding the Founding Fathers, they too had their dirty trade off deal: the continuation of slavery, without it theywould have lost the Southern states. Instead of being settled at the beginning of our country, it had to wait for a bloody war. I guess compromises are the life blood of politics.

Steph · « **Reply #588 on:** January 19, 2010, 06:29:19 AM »

I agree about the founding fathers, but they did not knee jerk. Slavery at that point seemed to be a sensible solution for the southern states. It wasnt, but it took almost 100 years to understand that.

bellemere · « **Reply #589 on:** January 19, 2010, 01:07:03 PM »

Jefferson said that while writing the Declaration of Independence the thougt of slavery went off like an alarm bell in his head. Yet he, too, kept slaves.

Steph · « **Reply #590 on:** January 20, 2010, 06:43:26 AM »

Amazing the complications. Even though we owned everything in common and according to the estate lawyer, there was no need to file the will, I am now told that because of the medical bills, a probate attorney must file it in order to obtain the money.. Oh well. Geico is paying for the attorney.

bellemere · « **Reply #591 on:** January 20, 2010, 09:26:31 AM »

Glad things are moving along for you. Maybe you will be able to resolv everything soon.
Massahchusetts did indeed vote to elect Scott Brown, a relatively inexperienced state legislator, to the U.S. Senate. He has vowed to be the deciding vote agians the Health Care Reform bill. but people were not so much mad at the Health Care bill, to me it seem s that they are mad at .........everything! It's the strangesp phenomenon I have ever seen.

nlhome · « **Reply #592 on:** January 20, 2010, 07:27:00 PM »

I agree, bellemere, people are angry and they are responding to it in ways that may hurt them later, in many situations. They are not thinking, they are reacting emotionally.

Steph · « **Reply #593 on:** January 21, 2010, 06:24:00 AM »

I t oo am amazed at the anger in everyday life. Its like if national health is passed, they will lose something. The most interesting thing is that if they lost their jobs, they would be the first to yell.
Also Massachusetts has some sort of health program in place already.. Hmm..

bellemere · « **Reply #594 on:** January 21, 2010, 12:54:02 PM »

Yes, Massachusetts has universal health care and Senator-elect Brown voted for it. He reportedly said,"WE have Health Care in Massachustts. Why should we pay for people in Texas?" Don't know why he picked on Texas, but doesn't that sound like the mind set today? "I've got mine, too bad for you"
Interesting to see what happens now, isn't it?

Steph · « **Reply #595 on:** January 22, 2010, 06:32:50 AM »

Yes, the Ive got mine attitude is sort of scary. But I really dont understand how he could vote yes in Massachusetts and now declare no on national. Ah politics.

nlhome · « **Reply #596 on:** January 22, 2010, 07:53:36 AM »

Frankly, although I support health care reform and believe we desperately need it, there is much in the current bills that were passed that is just plain wrong. Anyone in Congress interested in reforming the system knows that.

I know the common wisdom seems to be that the little true reform in the bills is better than nothing, as a start, but that was the attitude with the Medicare Modernization and Improvement Act that brought us Medicare Part D. Yet Part D and the Medicare Advantage plans as set up in that act are draining Medicare, and the corrections and adjustments to make Part D better and Medicare Advantage less costly to the government are way too slow in coming. Congress and the President needed to get it right from the beginning, and they didn't.

Babi · « **Reply #597 on:** January 22, 2010, 08:36:47 AM »

Quote

Congress and the President needed to get it right from the beginning, and they didn't.

That's hard to do, NL. I think you would have to have uniform brilliance
and a touch of the seer to know all the questions, much less find all the
answers.

bellemere · « **Reply #598 on:** January 22, 2010, 09:24:47 AM »

could you state what specifically you think in the Health Care bill is (or are) the most contentious? Is it the mandate that everyone buy insurance? Is it the amount of the subsidy that the governemtnt must come up with for low income people? Is it the restrictions on the insurance companies that will prevent them from denying coverage for pre=existing conditions? Is it the tax on "Cadillac " plans? Is it the r equireent that insurance companies pay out a certain percentage of their premium income in claims? Is it the cuts in Medicare payments to hold down costs? Is there any room for compromise in any of these things?
I have lost faith in our legislative system to do anything for p eople. The cost of getting eleted and reelected dominates the thinking of the representatives. And will do so even more after the Supreme Court decision handing our elections over to big corporationst. Why bother even to vote?

ANNIE · « **Reply #599 on:** January 22, 2010, 11:12:04 AM »

Quote

bellemere
I have lost faith in our legislative system to do anything for p eople. The cost of getting eleted and reelected dominates the thinking of the representatives. And will do so even more after the Supreme Court decision handing our elections over to big corporationst. Why bother even to vote?

I feel that I must vote to complain about what's going on in Washington. But, maybe, I will just complain anyway.
Did you know that if you choose Original Medicare for your Medicare coverage that you pay part of the premium for the Advantage insured folks? Frankly, I think they need to get rid of some of the perks in the Advantage insurances. I have a friend who's Advantage program thru Aetna is paying for her to go to the YMCA(at the cost of $400 a year) and frankly it tics me off. Her former job, working for the state, was able to give her more than most of us get from Aetna. For instance, our company insurance, with Aetna,(Original Medicare supplement) gives me $10 off a year to go to a fitness center without a pool. Isn't that special?? And, we are paying $650 a month for that privilege.
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Author Topic: Talking Heads - Healthcare Reform (Read 101139 times)