Going Rogue

[pshrynk]

Originally Posted by Ralph Sir Edward

Ummm.....Pshrynk, does the amount you get paid not affect the treatments you are able to provide? This is not a dig at your personal integrity, but an observation that if "the system" won't pay for an expensive, but in your professional opinion, necessary treatment for your patient, doesn't that limit what you can do for your patient?

Fortunately for my ability to shave in the morning without major lacerations, I work for a bunch o nuns who pay me for doing my job. I get paid for seeing someone whether they have no insurance, government insurance, or BLue Cross Blue Shield Platinum Wipe Yer Butt For Ya insurance.

When I was in private practice, one of the very difficult decisons facing me was to accept or not accept Medicaid patients. They were, at that time and place, paying about $.07 on the dollar billed. I could not take any non-insured patients unless they paid at time of service. I would give a steep discount for cash over the barrel head, but could not be running a lneding institution as well as office practice.

I eventually left private practice to work for the Sisters, because I was just fed up with the whole shebang. We see anyone who walks in and we send them a bill. If they can't pay, we write it off as charity care. We have the highest percentage of charity care in our catchment area. The Nuns go around prodding rich folks in town to contribute to the Foundation so we can stay in business.

In a more direct answer to your question, in some circumstances, physicians are having to limit the care they can offer to people who cannot pay.

I have not really said it so far, but I am actually an old die-hard National Health supporter. Yeah, it woudl be lousy care at times, but it would be care. Not a popular position, I know.

[rhadin]

Originally Posted by desertgrandma

I don't know where you live, but each time I go to a hospital, there are signs everywhere stating no one will be turned away for lack of funds.

That's as a result of a federal law and a compromise that was insisted on originally by Republicans with some Democrats. It is also one of the reasons why health care is so expensive -- the costs are not being shared by all. Those who do have insurance have to pay more to cover the costs hospitals incur in treating the uninsured. And the minority of uninsured who do pay their hospital bills pay significantly more than even the insured for the same procedure because of a lack of bargaining power and the need for hospitals to make up for losses incurred from the uninsured who do not pay.

[pshrynk]

Originally Posted by kazbates

Since you brought it up (and since we're so far off topic anyway), would it have been better to leave Saddam Hussein in power even though his regime had so many human rights violations?

I don't know the answer to that. I was against invading Iraq but struggle with that issue. It reminds me of all the out cry about Darfur. When do you draw the line?

Iraq? I was talking about Paris in 1940...

GOTCHA! (Now we have to invoke some sort of internet rule, don't we?)

[desertgrandma]

Originally Posted by pshrynk

I have not really said it so far, but I am actually an old die-hard National Health supporter. Yeah, it woudl be lousy care at times, but it would be care. Not a popular position, I know.

Please see post #325.

[kennyc]

Originally Posted by pilotbob

And whom pray tell do you think pays for that?

BOb

And I can assure you it's not the corporation that owns the hospital.....

they will still provide dividends and returns on investment to the stockholders.

[pshrynk]

Originally Posted by desertgrandma

Please see post #325.

Like I said, not a particularly popular stance pretty much anywhere...

If we could have the VAMC system for everyone, that would not be great, but it would be something.

If we could have teh Medicare system for everyone, that would not be great but it would be something.

If we could have the Military Medical Command system for everyone, tha would be great, and moderately expensive, but probably not more so than the current system. I don't know for sure, because no one does economic forecasts on that approach any more.

[rhadin]

Originally Posted by desertgrandma

And to have a sitting president tell me that it will be passed regardless of what the country may want, is incredibly arrogant.

I would think no more so than any other president.

Harry Truman integrated the military even though popular opinion was against it.

Dwight Eisenhower sent troops to Little Rock even though every poll said the public wouldn't stand for it.

John Kennedy and Lyndon Johnson sent us to Vietnam contrary to the wishes of the people.

Lyndon Johnson brought about Civil Rights legislation even though most of the targeted areas were vehemently opposed.

Richard Nixon bombed Cambodia in opposition to the public's want.

and the list goes on.

All presidents tread on someone's toes, either actively or passively.

[pshrynk]

Originally Posted by rhadin

I would think no more so than any other president.

Harry Truman integrated the military even though popular opinion was against it.

Dwight Eisenhower sent troops to Little Rock even though every poll said the public wouldn't stand for it.

John Kennedy and Lyndon Johnson sent us to Vietnam contrary to the wishes of the people.

Lyndon Johnson brought about Civil Rights legislation even though most of the targeted areas were vehemently opposed.

Richard Nixon bombed Cambodia in opposition to the public's want.

and the list goes on.

All presidents tread on someone's toes, either actively or passively.

And as your examples show, sometimes for the greater good or the longer detriment of the country. Nixon also extended the hand of diplomacy to China against the will of many people who were vehemently anti-communist.

[rhadin]

Originally Posted by kazbates

Since you brought it up (and since we're so far off topic anyway), would it have been better to leave Saddam Hussein in power even though his regime had so many human rights violations?

I don't know the answer to that. I was against invading Iraq but struggle with that issue. It reminds me of all the out cry about Darfur. When do you draw the line?

If our reason for going to war is to free the oppressed, then let's be upfront about it and let's be consistent. Personally, I opposed invading Iraq and Afghanistan but supported going to Darfur and Rwanda. What we Americans do not accept readily is that we cannot be the morals arbiter for the world. We need to insist that others step up to the plate.

[Sparrow]

Originally Posted by rhadin

What we Americans do not accept readily is that we cannot be the morals arbiter for the world. We need to insist that others step up to the plate.

I don't think America can 'insist' what particular plates others step to, that would just be imposing their moral arbitration on the world.

[Spartacus2112]

Bottom line....they are overhauling a system that works for 85% of American citizens to adress a problem that exists for probably 7% or 8%.

[Ea]

Originally Posted by Ralph Sir Edward

OK, some more examples...

From the late 1800's through the 1980's, Sunday closing laws, banning retail stores from being open both days of a weekend.

Involuntary military conscription from 1940 through 1974.

Federal laws limiting the ability to donate money to a candidate since the early 1980's.

No-knock search and seizure, despite explicit banning of it in the constitution. From the 1970's.

Seizure of property in criminal investigations prior to conviction. According to our constitution - No person shall have his life, liberty, or property abridged without due process of law. Pretty clear. But laws have been passed in the 1980's seizing property so the accused can't use it to pay for a legal defense, even while any person charged with a crime is guaranteed a counsel. (Just not a good one...)

Requiring paper trails on economic activity about $10,000 US.

Need more?


Ea, the "people" here are not homogeneous. There are many small groups, each with their own view of how the government should be run. Most of them disagree with each other. There is no clear "majority" on how things should be done on most issues. Logically, one should do nothing in such circumstances, because as you help one group, you hurt another group. Unfortunately, whenever one of these small groups get into power, they then try to legislate their preferences no matter what anyone else thinks. Because of that tendency, people fear and distrust government. We in Texas had a novel way of solving this problem, which still works nicely at state level. We don't let the legislature meet more the 140 days every two years. if they can't meet, they can't pass laws....

I'm sorry, but apart from people not being homogenous I donøt quite seem to understand your point? Of course thye might have a different idea of government than I - but why exactly FEAR the idea? That's what I still don't get. It is not sensible.

As for your examples, they seem arbitrary and "spread" (I can't find the right expression in english - sorry) - I'm not really sure what they are meant to show.

[pilotbob]

Originally Posted by Spartacus2112

Bottom line....they are overhauling a system that works for 85% of American citizens to adress a problem that exists for probably 7% or 8%.

16% of the people in the US are uninsured. I would guess 99% would like to see the cost of health care decline.

BOb

[Sparrow]

Originally Posted by Ea

I'm sorry, but apart from people not being homogenous I donøt quite seem to understand your point? Of course thye might have a different idea of government than I - but why exactly FEAR the idea? That's what I still don't get. It is not sensible.

Is it not a similar sentiment to that in Denmark when they voted No in the European Referundum? Wariness of a federal Europe.

[kennyc]

Originally Posted by pshrynk

The hospitals are required by law, that to participate in Medicare they have to have the no turn away policy. It stemmed from one point where corporate hospital systems were sending uninsured people to a county or charity hospital and keeping those with insurance or lots of money.

It was sort of like the insurance companies who turn away those with expensive illnesses or dump someone when they get an expensive illness. Health Care reform should, in my opinion, have at it's core the rquirement that insurance companies cannot do that, so that they are on the same playing field as the hospitals.

It should also have the public option. And please read this sentence very carefully: NOT to "dictate healthcare" but to have an affordable insurance ption for those who are unable to get insurance from an employer or on their own.

My reason for this is: Right now, Medical facilities have high prices because they must compensate for Medicare and Medicaid and uninsured patients. The insurance companies do not pay full fare, either. If everyone in the US had coverage to pay for medical care, everyone would, over time be paying basically the same price. Economics assures us of that. The lack of insurance for 45 million (or whatever) unisured patients going to ER's to get primary care is a huge driver for medical costs.

You will please note that I have not at any time said that the government should tell me how to practice, or where, or for whom, or in any capacity. The role of government in this approach to care is strictly financial. Will they bung it up? Probably. They keep stealing from teh Medicare and Soc Sec trust funds to pay for trinkets. But it would work better than what we got.

Excellent post.