Of course it is needed. The economy is creating jobs and healthcare will
multiple the jobs and lower costs. The Koch brothers have healthcare.
Re:KVCI agree we need to train more primary care physicians. One
way might be to subsidize the training of primary care physicians, in addition
to your suggestion of higher compensation. There are some concerns
how ACA/Obamcare will affect the "safety-net" hospitals--those that
serve disproportionate numbers of the uninsured. And some fear physicians fees
will be cut, though it is speculation at this point. As Obama has demonstrated
flexibility, he has stated he is willing to make changes where needed. No doubt
some changes will be needed. Time will tell. As for
malpractice:Thousands of people die every year from medical mistakes.
Research on the cost and role of medical malpractice is mixed. The CBO
estimated tort reform would save $50 billion over 10 yrs., (far less than the
estimated savings of a public option). Obama offered to consider tort reform,
but of course that would require compromise on the part of Republicans which is
a non-starter. Many states have already enacted tort reform. For example, here
in CA, non-economic damages are capped at $250,000. Texas also has tort reform.
What say you about for-profit corporations pressuring Drs. to
perform unecessary procedures?
Cont:Number 2: Reform the medical liability system. Currently most
lawsuits are not won or lost based actual malpractice, only outcome. Why is
this? because patients expect a a perfect outcome everytime, and lawyers can
always find an "expert" who says they would have done it differently,
and had a better outcome. To avoid lawsuits at all costs, doctors order every
test in the book, which is very expensive, to be as close to 100% as possible.
This is what Americans demand. Does it usually lead to better outcomes? No. But
if it is not done, we are at risk to be sued. The average cost to defend a
Malpractice suit and win for a physician is $60,000. So even winning gets
expensive, and many times insurance companies will settle for a lower cost, but
it goes on the physicians record, and hurts their chance for employment down the
road.The truth about all of these "cheaper health systems" in the
world is that they don't have this type of malpractice system. They
severely limit the ability to sue a doctor, and severely limit access to the
expensive tests in the process. Will Americans accept that?
Truthseeker:Did you read the entire article? It also mentioned how it is
predicted that 20% of hospitals will become unprofitable due to the Obamacare
concessions, and how an increasing number of physicians in both Primary and
Specialty care are limiting their Medicare patients because o substantially
lower Medicare reimbursement compared to private insurance, and that was under
the previous scheme. Now factor in that Obamacare will decrease physician
reimbursement even more, how does that lead to improved access?It is
actually very simple how to solve our cost issues. The drivers of cost in our
system are high paid specialists and procedures,and unnecessary tests that most
doctors perform to avoid lawsuits. How do we fix that? Two ways to start. Number 1: pay Primary Care doctors more. Currently Primary Care is at the
bottom of the pay scale for doctors. This leads med students to choose more
lucrative specialties. With higher pay, more would choose Primary Care lessening
the shortage and creating greater access.
Re:KVCAccording to a Wall Street Journal article, Mayo's
problems precede Obamacare--closing a facility in AZ in 2010."Mayo's doctors are salaried and work in teams, which have become
known more broadly as accountable care organizations, or ACOs. Mayo would prefer
to receive a bundled payment for an episode of illness, rather than the Medicare
practice of reimbursing for individual procedures. As it is now under Medicare,
Mayo's less-is-more model means it can't make up its true costs on
volume."Do you think voucherizing Medicare would provide better
access to services for the elderly? What do you see as the
As a physician I can tell you some truth about Obamacare. It cuts services for
patients, especially Medicare. Many doctors are limiting or no longer seeing
Medicare patients. With the aging population, this means decreased access to
care for the elderly. Even the World Renowned Mayo Clinic, an organization
praised by Obama, has limited its Medicare patient load due to its financial
losses in its current form. The truth is, Obamacare is designed to fail.
Why? If this system fails, liberals can argue that "now we need socialized
medicine". The goal is to get more individuals dependent othe government
system, expanded Medicaid and subsidies to buy insurance are the start. Dems
know that once you start a government handout, it becomes almost impossible to
stop it. Those that get it, don't want to give it up. That is the Democrat
election model. Get as many people on government programs as possible, then tell
them they need to keep voting in your party in if they want to keep their
handouts. Truthfully it is nothing more than buying votes with other
@Truthseeker,Your memory is correct. In the fall of 1976, we were
without insurance for four months while I was making the transition to being
self-employed. Almost immediately after the insurance lapsed, we found out that
our daughter had cancer and that it was terminal. Friends and family helped pay
those bills. All the bills that we received were paid in full. No one was
asked to provide services without payment. Some providers waived their fees.
The rest were paid.There was a way to handle obligations. Not one
cent came from the government. It was not easy, but it was possible.We had insurance before my daughter died from cancer and we've had
insurance ever since. Since that time, we've tried to return the favor
when relatives or neighbors needed help. Government is not the
answer. It has never been the answer. Follow the money. Obama wants 18% of
America's wealth, but not to provide health care. It will be mixed with the
general fund just like SS.
Hospitals are not forced to admit anyone who needs healthcare. Hospital ERs are
required to ensure that patients needing treatment for life threatening issues
are seen and stabilized. There are requirements that must be met in order for a
hospital to admit a person. Insurances (Medicare being the most notable one)
will deny payment to a hospital if the admission criteria is not met.
"Hospitals are FORCED to admit anyone who needs health care. That is the
problem. "That legislation is EMTALA. It was signed into law in
1986 by Ronald Reagan
@lost in DC:"Death. Quite the choice, isn’t it? Buy Obamacare or
DIE!!"Everybody dies... at one time or another... of one thing
or another. Those who can't or won't buy health insurance could
possibly die soon than others. But we all die. So, if you think about it, in
the final analysis, Obama care is a waste of money.
Au contraire Terra mon frere. If you look at actuarial tables then you'll
see that probably 98% of people between the ages of 18 to 32 do not need health
insurance. I would recommend that they have at least some major medical coverage
that in a sane world would probably cost them between 20 to 50 dollars a month.
I'm excluding the cost of child birth but if you are young then you have
your whole life to pay that back. Like it or not, now we have Obamacare where
the young and healthy will be forced under penalty of law to pay insurance
premiums with no actuarial relationship to their chance of needing the insurance
to subsidize lower premiums for the old and/or unhealthy. That's our bed
and we will lie in it.
re:MikeRichardsPardon me. I must have you mixed up with someone else--who
told a story once that they didn't have insurance when their child got sick
with cancer but wonderful neighbors and family stepped in to help with medical
bills. From Factcheck, "Death Panels Redux" 2012:"Others have claimed an Independent Payment Advisory Board created by the
law will be charged with rationing care. The 15-member IPAB — made up of
doctors and medical professionals, economists and health care management
experts, and representatives for consumers and seniors — is tasked with
finding ways to reduce the growth in Medicare spending. But as we have noted
before, the law explicitly says that the IPAB’s proposals “shall not
include any recommendation to ration health care, raise revenues or Medicare
beneficiary premiums … increase Medicare beneficiary costsharing
(including deductibles, coinsurance, and copayments), or otherwise restrict
benefits or modify eligibility criteria.”My guess is your
premiums will be going up--but with that you will no longer have the
"mini" coverage and will have much, much better coverage. Already there is evidence that healthcare spending is declining.
Lost in DC -- once again, your second post makes no coherent sense unless you
really are a socialist. And even then, it's a big stretch.
@Truthseeker,I beg your pardon, but did I say that I or my family
was not insured? We have always had insurance. We have always had major
medical. We have paid over $158,000 in premiums for that insurance over the
last 41 years. We have paid our part and have been responsible. We have NEVER
had dental insurance nor have we ever had eye-glass insurance. We
are typical of the self-employed, people who pay the full-size premium for the
mini-size coverage. What Obama offers is so much worse that what I have paid for
all my life. There was no "secretary of health" with Blue-Cross to deny
any service. On those few times that we actually used the insurance, Blue-Cross
was efficient, kind and friendly when it came time for them to pay. Can you
imagine what will happen when the "health secretary" decides that you,
an American citizen, should be given a pat on the head and a pain pill because
it's just not worth the cost to keep you alive? Don't
pretend that Obama cares about you or me. Look what he's done to others.
Re:MikeRichardsYou would really find the March 4th Time magazine
article "Why Medical Bills are Killing Us" interesting. One
would think with your family's experiences of being uninsured--and in one
case having to rely on the largess of assistance from family and friends-- you
would have a different outlook.BTWWe've always had dental
insurance and typically it covers only a portion of crowns and root canals
(unless one has met the deductible). Our dental insurance paid $600-or so to
the dentist and then WE had to pay the remaining $500-600 balance to the
dentist. Crowns and root canals are expensive even with those who have
insurance. On the other hand, routine screenings, cleanings etc are covered at
no cost or a minimal $20 co-pay.Read the article.
Tyler D,I could not have said it any better. Thank you.All,Irrespective of whether we like the ACA or not (I have some
issues with it), the reality is that allowing people to freeload on the system
is foolish. One way or another folks need to have health insurance.I hear folks say that they have sufficient savings to self-insure. Unlikely.
Given the cost of many severe issues, a patient could easily burn through
$100,000 to $250,000 in just a few days. If they have something a little rare,
then the cost can go much higher.Ultimately, I think folks can self
insure for small to moderate amounts if they have a backstop of catastrophic
insurance. But having no insurance is just betting that you won't need
charity. If you lose that bet, we (as taxpayers) lose as well.
old man,no, the only way out of Obamacare is death. you have
no alternative. If you don't want Obamacare, the only way out is to die.
Has nothing to do with needing or receiving health care. If you live the US,
you HAVE to have health insurance, whether you want it or not. no exceptions.
Don't want it, then die, since that is the only way out.There,
I've said it a number of different ways, hope you can understand at least
one of them.I'll say it again - the only way out of
being forced to buy health insurance is to die. You do not have to die to avoid
having to have auto or homeowner's insurance, but to get out of buying
health insureance you have to drop dead. be kaput, exist amongst the living no
more. expire.nice obfuscation, though. Typical of the left; if
they cannot refute what you say, they lie about what you say.
Mike Richards has obviously never heard of in-network volume discounts, a basic
sort of practice nearly every business on this planet engages in. That's
why his son paid full price -- he's not in the network.
What the Left forgets is that health insurance is the result of FDR freezing
wages. When employers lost valuable employees because the GOVERNMENT refused to
allow those employers to pay an acceptable wage, those employers started adding
"benefits" to the pay package. One of those "benefits" was
insurance.Let's look at insurance. There are basically two
types of health insurance, Major Medical and Comprehensive. Major Medical is
designed to pay the "big bills" that are unexpected. That type of
insurance requires the patient to pay for all routine medical expenses.
Comprehensive pays part of all medical costs, including routine visits to a
doctor for sniffles. Doctors bill those who are insured at a lower
rate than those who are not insured. A son and his friend went to the same
dentist at the same time. Each needed a root canal and a crown. We had no
dental insurance. My son paid $1,200 for the procedure. His friend had
insurance. The dentist billed the insurance company $600 for the same
procedure. Obviously, the procedure was worth $600. ObamaCare
solves nothing. It is a patch on top of hundreds of other patches. It solves
Hospitals are required to treat those without insurance or proof of ability to
pay, however, I believe outside of the hospital setting Drs. can decline to see
pts (cash customers) without health insurance (Ethically, Drs. would be expected
to treat pts in a life-death/emergency situation).
Lost in DC, your comment really makes no sense whatsoever. What you are pushing
for is really SOCIALIZED medical care. When the law requires someone to be
treated and they cannot pay for it, who picks up the bill?Let's
revise your last sentence: "Death. Quite the choice, isn’t it? Either
DIE or get the rest of us to pay for your care!!"Gee, I thought
you hated socialism and here you are pushing for it.
The problem is that all we got out of this whole exercise was a veneer on the
current system, which doesn't work. What we really needed was the
elimination of health care as a commodity, removal of the insurance industry and
employers from the health care delivery process, and a single payer system put
Terra,Let’s examine each fallacy in your letter.You disagree
with the following:“Individuals…will now be required to have
adequate health care coverage or pay a penalty”That is the
result of the law, whether you agree with it or not.Your basis for
disagreement is everyone WANTS it. So? Wanting something and being required to
buy it are two different things. And not everyone wants it.You then
say since hospitals have to treat everyone, regardless of ability to pay, that
you should cancel your homeowners insurance or car insurance since somebody else
would pay if your car or home get damaged. Law requires hospitals to treat; no
law exists requiring someone to pay for your house or car if they get
damaged.Also, you are not required to buy a house or a car, so you
have avenues of escape from buying car or homeowner’s insurance. What is
your avenue of escape from buying health insurance or paying the penalty? Death. Quite the choice, isn’t it? Buy Obamacare or DIE!!
Because no one is seriously debating the idea that hospitals should simply let
people die outside their doors, conservatives came up with the ingenious idea of
the individual mandate. At the time it was seen as the antidote to socialized
medicine… a free market approach to ensuring everyone who uses a product
(medical care) pays for that product. And they rightly recognized that everyone
will use this product at some point in their lives and that insurance is the
best business model for providing that care in a predictable and financially
feasible way.And then a funny thing happened – after
recognizing that the country would not pass a single payer system, the president
reluctantly adopted this model perhaps naively believing it would herald a
Kumbaya moment in Washington (Republicans would applaud the president for seeing
the wisdom of conservatism and we would finally bring some sanity to our broken
healthcare system).I guess someone forgot to tell him that
conservative hate the president and are allergic to anything he touches…
and the rest is history.I’ve seen fish on a boat deck flip
flopping less than the Republican Party over the last 5 years…
No Mr. Richards the grocery store is not forced to give away food, but that is
because we have found other ways to deal with the hungry, many ways actually.
There is only one way to treat the sick and injured so a civil society
guarantees they receive some level of care. Here's the real
issue however, "The purpose of government is not to force us to pander to
those who have chosen to ignore their responsibility to care for
themselves." Just what qualifies as ignoring the responsibility to care for
themselves? Is it the person who chooses not to have health insurance, is it
the person who works for a company who doesn't provide health coverage and
can't afford it themselves, is it the person who hasn't taken care of
their health and now needs expensive care, is it the person who has done all of
the right things and still needs care that will cost more than a small country
could afford? And even if you have an answer how do you decide whether to treat
this person when they show up at the ER with a heart attack?
Great letter.Originally, Obamacare was a republican idea which
encouraged folks to be responsible. They were supposed to get health insurance
or face some sort of penalty. Now,because a Democrat took their
idea, they are 100 percent against it. Just like the background check thing,
repubs are going against the President because they don't want to be seen
working with him. The American people should be outraged. How many more times
must "we the people" be used in this political football game?
First, let me say that it is really refreshing to see an occasional sensible
letter like this one.Second, let me ask Mike Richards to explain
what he means when he says: When there is no personal accountability, there is
chaos. ObamaCare supports chaos."Isn't ACA all about
personal accountability?Please turn off the propaganda heard on hate
radio and try to actually learn what is true and what is not.
The only problem with Obamacare is that the idea actually came from republicans.
The problem is not ObamaCare. The problem is not health insurance. Hospitals
are FORCED to admit anyone who needs health care. That is the problem. Is the
grocery store forced to give food to anyone who shows up? Is the gas station
forced to fill the tank of anyone who drives in? Force is the problem. When there is no personal accountability, there is chaos. ObamaCare
supports chaos. The purpose of government is not to force us to
pander to those who have chosen to ignore their responsibility to care for
themselves. The purpose of government is to protect us from those who would
take away our freedoms. ObamaCare takes away our freedom. It panders to those
who are not responsible. It encourages people to be irresponsible.Follow the money. 18% of our nation's wealth will be mixed into the
"general fund" so that government can issue I.O.U.s to the health care
fund, just as it has spent all of the SS money and issued worthless I.O.U.s to
the SS fund.