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Diamond with Oak Clusters Bullet Member
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Clinton to unveil health care proposals

http://news.yahoo.com/s/nm/20070913/pl_nm/usa_politics_clinton_dc


She provided no details about her proposals. Improving the health care system and providing coverage to some 48 million uninsured Americans is a top domestic issue ahead of next year's elections.



I wonder who the 48 million are?? How many illegal aliens are included in the 48 million ??
 

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Clinton to unveil health care proposals

I wonder who the 48 million are?? How many illegal aliens are included in the 48 million ??
That was my exact first thought, Charlie. And guess who's gonna pay for it. You betcha.
 

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Supposedly many of them are young and have decided that they'd rather have the money than coverage (in other words they decided to risk it). Also, that number includes those between jobs. Of course you can always find some pathetic child without coverage to put in your news report.
 

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MSN had a long story on some hapless woman who went bankrupt over health issues even though she had insurance. The point was supposed to be that we can't count on private insurance to cover us. Long bit about how she claimed she would now never be able to retire. She was in her late 40's. Finally at the end of the story, you get the facts - a dispute between Blue Cross and her provider had left her with $15,000 in bills. I hate to be harsh, but if you're pushing 50 and the difference between solvency and insolvency is 15k, you were never going to retire anyway. There's always something wrong with those sob stories whe you dig a bit.
 

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Another problem with it is that the provider usually folds if an insured person really pushes them. Usually they're either satisfied with what they got - usually the case if her insurance has a PPO provision and they're not on the list, or they've tried to charge for something they didn't do or that wasn't justified and will back down eventually.

I've never had a problem that wasn't straightened out quickly in spite of horrendous bills - once the insurance company signed up the provider for their PPO overnight so they could take care of my needs at negligible cost to me.
 

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Diamond with Oak Clusters Bullet Member
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Discussion Starter #6
MSN had a long story on some hapless woman who went bankrupt over health issues even though she had insurance. The point was supposed to be that we can't count on private insurance to cover us. Long bit about how she claimed she would now never be able to retire. She was in her late 40's. Finally at the end of the story, you get the facts - a dispute between Blue Cross and her provider had left her with $15,000 in bills. I hate to be harsh, but if you're pushing 50 and the difference between solvency and insolvency is 15k, you were never going to retire anyway. There's always something wrong with those sob stories whe you dig a bit.

Stop and think of the population in the US as compared to the number of horror stories that you hear about. Actually there are not that many.
 

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That was my exact first thought, Charlie. And guess who's gonna pay for it. You betcha.
Sam,

The so-called crises will explode once the Goobermint nationalizes health care. Think back to your Chair Farce days and recall those clowns, especially their wives, who abused the base hospital's ER because its services were FREE :rolleyes: I experience similar shi'it every night at work - Medicare and Medicaid recipients abusing the ER for pissant, non-life threatening ailments...most need to lose weight, cut back on the booze, quit the cigs/drugs, etc...obvious signs revealed without performing routine CT Scans of their melons :mad:
 

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Discussion Starter #8
Even now some hospitals are closing their emergency rooms becuase of the drain on them by people who are not sick and/or cannot pay. With national insurance, it will be even worse, but probably one of the conditions will be that they cannot close anything, which will mean that other areas will suffer.
 

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And now…….a comment from The Peoples Cube . Com (it’s sort of like the Stalinist version of The Onion) there are some pretty good comments at the link. :D



http://www.thepeoplescube.com/red/viewtopic.php?t=1416

TIPTON IOWA -- Presidential hopeful John Edwards yesterday stated that his state run health care system would be mandatory.

"It requires that everybody be covered. It requires that everybody get preventive care," he told a crowd sitting in lawn chairs in front of the Cedar County Courthouse. "If you are going to be in the system, you can't choose not to go to the doctor for 20 years. You have to go in and be checked and make sure that you are OK."

This prompted an immediate response from the Hillary Clinton campaign.
In a statement issued today Hillary mocked the North Carolina Senator.

"Ha...Twenty years? My health care plan calls for five minutes in the middle of the night. A simple house call by state doctors and a knock on the door at 3AM when you're given five minutes to pack one suitcase before you are taken by health care professionals to the nearest hospital if the state deems you unhealthy and not fit."

"Mammograms? Hell no, euthanasia. Leave it to the professionals to decide whether you are healthy or not. Simple diagnostic tests like if you're able to hold a shovel will determine your general heath."
 

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Senate Healthcare

I'm sure that the House and Senate will give up the plan that they use and use that plan that Hillary wants to sit up, don't you

Rick
 

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Discussion Starter #11
Remember -- do as I say, not as I do.
 

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I'm on the same plan, actually series of plans, the FEHBP (Federal Employees Health Benefits Plan). It covers every federal employee except the military, and has dozens of insurance plans and HMOs under it. It just sets minimum benefits for the level of plan chosen, usually 2 or 3 choices of levels, like "basic" and "standard" under my Blue Cross plan, per insurer, and the feds pay 60% of the average cost of the biggest insurance plans, the rest paid by the employee/retiree.

Even the total price, without the federal contribution, is low, about 2/3 of the best commercial insurance available for an average person. You can change plans once a year, have to wait 5 years if you ever opt out to get back in. No underwriting, cherry-picking or previous condition exclusions. Only options for self only or family.

There's a good guidebook, Washington Checklist, on selecting the plan best for you, and the low cost seems to be because of the brutal competition in cost and services caused by the annual right to switch plans and lack of BS state requirements that add cost. Unlike Hillarycare's thousands of pages of regulations it only has a few dozen in the federal register. It leaves the details to the insurors and competition takes care of the rest. Satisfaction ratings for the FEHBP are extremely high.

Our congressman at the time of Hillarycare got together with a Democrat and introduced a bill for a voluntary national version of the FEHBP. It got nowhere because the Clintons wouldn't compromise on Hillarycare and the Republicans mostly just wanted to beat her up and were afraid that if they got into horse-trading over health insurance with the then majority Democrats it would tend towards a socialized system with the usual politically correct cost increasing features and freebies for the Dem constituents.

Of course Hillary will put in a lot of controlling crap, like a national institute to set treatment standards. If that had been in place I may well have been dead for 10 years now since my doctors have been using a number of medicines on me that do not have FDA approval for that specific purpose. My FEHBP plans have had no problem with that but Hillary does.


WORST BEST PRACTICES

September 16, 2007 Washington Times


Nearly 15 years ago, health insurers opposed Hillary Clinton when she tried to give American health care a makeover in the image of the European and Canadian system. Back then, insurers blasted the Clinton proposal as a government takeover of medical decision-making. Today, they support a new federal agency that would decide what is the most cost-effective or best drug or service, and use that as the benchmark for health-care reimbursement.

Mrs. Clinton and the insurance industry like to call this new bureaucracy a "Best Practice Institute." In fact, it is nothing more than cost-cutting bureaucrats seeking to practice medicine in order to save money, usually at the expense of patient lives and well being.

One could go to Britain or Canada where such government institutes have a small group of underachieving doctors and health economists decide — after a drug has been found to be safe and effective — whether a new product is "worth it." Such institutes curiously wind up rejecting new drug after new drug for cancer, Alzheimer's, multiple sclerosis and osteoporosis in favor of older drugs, ignoring individual differences in response and benefit as irrelevant or wasteful.

But why travel when you can find the same lack of thought and compassion in the Center for Medicare and Medicaid Services? Anyone who thinks leadership doesn't matter should watch as CMS rolls back efforts by its former director, Dr. Mark McClellan, to create a real time system to match the right treatment to the right patient. That visionary enterprise has been shoved aside by bureaucrats all too willing to curry favor with Mrs. Clinton and insurers who see a government "Best Practice Institute" as a great way to sell rationing of breakthrough drugs and devices.

Most recently, CMS issued a best practice decision on the use of drugs known as erythropoiesis stimulating agents (ESAs). These are drugs oncologists have used for 20 years to boost red-blood levels of patients to endure longer, more frequent and stronger doses of chemotherapy. They have made it possible to eliminate repeated blood transfusions in cancer patients, especially elderly and patients who have other illnesses. A study Frank Lichtenberg conducted for the Center for Medicine in the Public Interest found that over the past decade the addition of new chemotherapy agents has extended the life of elderly cancer patients by one year for an additional cost of about $4,600 per person.

It would be nearly impossible to use these new and more powerful cancer drugs in the absence of ESAs. But CMS has used the FDA's manhandling of some safety data from studies investigating the use of ESAs in healthy patients to justify a one-size-fits-all approach.

Congress and insurers want CMS to emulate what "Best Practice Institutes" around the world do in rendering cost or comparative effectiveness judgments.

CMS has applied one hemoglobin level to millions of cancer patients regardless of cancer type, or of secondary illness or of severity of disease or response to treatment should be treated the same: with as little ESA as possible. Moreover, it has suggested that transfusion-first policy is perhaps "best practice" or most cost-effective.

CMS seemingly focuses on cost control to arrive at its decision. ESAs are not only cost-effective in terms of reducing the risk of infections, recipient rejection of transfusions and administrative costs but also boost an individual's quality of life. Without ESAs, many patients would simply not tolerate and therefore respond to newer cancer drugs.

CMS also ignored the cost of paying for and maintaining an increased blood supply and transfusion system. A recent Los Angeles Times article noted that less than 5 percent of all Americans donate blood and that shortages persist.

Congress is already backpedaling on best practice. The Senate unanimously (Mrs. Clinton, too) voted to condemn CMS for its ESA decision. The Congressional Budget Office said a "Best Practice Institute" — through programmed to ignore individual differences in response to care — would cost money. Meanwhile, insurers such as California Blue Shield implemented the CMS restriction immediately after it was announced but dropped the plan after patients and doctors found out.

The CMS coverage decision should be a wake-up call to those who thought that Mrs. Clinton's Best Practice Institute would promote better medicine. Instead, it will create a single reimbursement standard that will be enforced by Medicare and adopted by insurers without regard to patient need or medical progress. Overturning the CMS decision is not enough. Creating a comparative effectiveness board will ensure that patients die waiting for decisions. Best practice? "Katrinacare" is more like it.
 

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As Law Dog points out ( http://thelawdogfiles.blogspot.com/2007/08/this-is-exactly-what-im-talking-about.html ) govt. couldn't keep an established business selling p*$$y running at a profitable rate.

How could anyone want them involved in health care?

I ask every idiot that brings this up (2) questions:

(1) Name something -- ANYTHING -- that is better after Govt. got involved than it was before.

(2) Can you name the basis for the "48 million" number?

Truth is most of them have incomes > $75k. They're (as has been said) choosing to take their chances. For most of us the premiums are more than it would cost us to pay for our own necessary, basic and occasional care.

Idjits.

DD

EDIT: Had to go hunting...

Here's a pretty good pwnage of the "48-million" lie...

http://krusekronicle.typepad.com/kruse_kronicle/2007/07/health-care-lie.html

The highlights:
"...
Of the 47 million without healthcare (According to the US Census Bureau):
8.4 million = $75,000+ but don’t buy insurance
8.3 million = $50,000-75,000 but don’t buy insurance
9.5 million = not citizens
That is 26.2 million out of an estimated 47 million.
About 45% 47 million without insurance will have health insurance within 4 months. They consist mostly of people between jobs.
According to Kaiser Family Foundation, Americans who do not qualify for current government programs and make less than $50,000 a year between 13.9 million and 8.2 million.
The 8.2 million number is the number of chronically uninsured who have been uninsured for two or more years. That comes to about 2.7% by my calculation.
..."
 

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AM - yep, I'm very familiar with the hypocondriacs in the Air Farce who ran to the infirmary every time they got a sniffle. Ditto for the ER's at Charity Hospitals. ER is always full of overweight pregnant sows, wino's with DT's (heh!!), and gunshot/knife wound victims. If you want to see how nationalized health care would work, just take that thought and multiply it times millions.

As for the woman with the $15,000 medical bills, I guarantee you that BCBS was refusing to pay for unsupported charges. The medical provider was turning around and balance-billing the patient. I've seen it happen time and again.

Contracted medical providers have capitation agreements with the insurer and have agreed not to balance bill the patient for the capitated amount. However, if an audit of a hospital bill turns up charges for items that are not documented in doctors' orders, nurses' notes, etc, the insurer will refuse to pay them. If the hospital has not signed a capitation agreement (I don't know of one that ever has), then they very often turn around and send the patient a bill for the charges that the insurer is denying.
 

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Diamond with Oak Clusters Bullet Member
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Discussion Starter #15
Contracted medical providers have capitation agreements with the insurer and have agreed not to balance bill the patient for the capitated amount. However, if an audit of a hospital bill turns up charges for items that are not documented in doctors' orders, nurses' notes, etc, the insurer will refuse to pay them. If the hospital has not signed a capitation agreement (I don't know of one that ever has), then they very often turn around and send the patient a bill for the charges that the insurer is denying.
I have had that happen two times and told them to sue me. Both times, the amount were under $1000. As I told them, we all needed to find out why the insurer (Blue Cross) would not pay.

One time I (as executor) did receive a bill for about $58,000. It was for services rendered to my mother during a long stay in the hospital. She was under Medicare with a BC supplement. I checked with medicare and B and found that the amount was rejected because it was for "unnecessary services".

Then I called the billing department of the hospital and politely (honestly) told the gentleman who was given my call that I was not going to pay the bill. He mentioned that the estate could be sued. At that point I did tell him I had contacted Medicare and BC about their reason for not paying and that he or the hospital did not have the balls to file suit because a major part of the trial would be a discussion on why they provided 'unnecessary' services.

At that point in time he changed course and said that it was an error of the billing department in sending out the bill and hat they would take it up with Medicare.

I know exactly what it was. After my mother left the hospital, she spend over a year in the nursing home before passing away. The hospital sent the bill two months after the estate was created. The hospital thought that because of the circumstances, no one would inquire of Medicare and BC and the bill would be paid.

I wonder how many people the hospital done this to.
 

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I hate to say it but if you're young and have no assets health insurance may well be a waste of money. By law, hospitals must provide treatment for life threatening conditions regardless of a person'a ability to pay. Of course, they'll go after your assets, but if you don't have any to speak of, or maybe only a few thousand dollars, paying more than $1000 a year to protect them doesn't make financial sense. Of course I don't like having to cover the costs of the people who make this decision, but it seems every plan out there would actually raise the cost to my of doing so when compared to the current system.
One thing I absolutely disagree with is this idea that encouraging people to go to the doctor for non-emergency health problems saves money because suppossedly it saves trips to the ER. Every family member I have who ever wound up in the ER was there for something their GP has already looked at, and either it wasn't serious when they looked at it or it was mis-diagnosed. And most doctor visits are totally unnecessary in the first place - people will definately over-use health care if it's covered by insurance and there's little or no cost to them.
 

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So - Hillary annouced her plan.
Whadya all think?
I think it's brilliant, strategically. While pundits are spinning it as socialized medicine, it seems to be little more than tweeking the current system, with relatively modest additional spending and taxes. It's not all that far from what Romney did in MA - actually, it's a plan I might have expected Romney or Guilianni to annouce in a few weeks, only now Hillary has beat them to it.
On the one hand, it makes her more formidable in that she seems willing to tell the moveon.org extremists that no, the unpopularity of the Iraq war is NOT an open invitation to cram European style socialism down America's throat and they can either start playing nice and get thrown a few bones or they can go jump in the lake - they're a liability to the dems, not an asset. Conservative talk show hosts have been saying since 'betray-us" they Hillary can't disown those folks - well, it seems she can - and that puts her closer to the presidency.
On a more positive note, it's a sign that the conservative movement has made some real progress, even if the Republican party hasn't.
 

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Diamond with Oak Clusters Bullet Member
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Discussion Starter #18
Most likely, it is only her first step. The last time showed the reaction when the changes were too great at one time.
 

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AM - yep, I'm very familiar with the hypocondriacs in the Air Farce who ran to the infirmary every time they got a sniffle. Ditto for the ER's at Charity Hospitals. ER is always full of overweight pregnant sows, wino's with DT's (heh!!), and gunshot/knife wound victims. If you want to see how nationalized health care would work, just take that thought and multiply it times millions.
Sam,

My boss (27 yo female with zero management training) counseled me last week for "asking too many questions", per the ER's supervising RN.:rolleyes::cool: I had to contain my temper requesting that my boss clarify the aforementioned (so-called) HIPPA violation so I could prevent future so-called HIPPA F-ups. Well, the boss informs me this evening that my unnecessary questions were directed at a drunk patient which I inquired one of the attending LVNs (LPNs in your State;)). In clinicals, I learned the hard way not to presume, a few times, that patients who appeared to be drunk and unresponsive actually were not soused. In those situations, all of the patients were Type I Diabetics who were experiencing diabetic shock;) Any way, my patient was drunk and fortunate for me at the time, he didn't give me any attitude during the X-ray exams because he was fairly comatose. However, I've been directed to use the acronym/label "ETOH abuse" in future questions directed at the ER nursing staff when inquiring about patients' conditions...this lil tid bit of knowledge was never passed on to me in clinicals or my patient care class:D Go ahead and Google search ETOH abuse
 

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I've seen "ETOH Abuse" numerous times in medical records - it's a polite, politically correct way of saying "chronic alcoholism".

Never could deal with having a female supervisor. The ones I've had were anal and moody. They'd get their pantyhose in a wad over something and hang onto it for days, meanwhile bleeding on ole Moi. Plus, they always wanted to treat me like a 3 year old, like they always knew better than I did. You know - kinda like liberals.

Nope, give me a male supervisor that I can lock horns with, then get over it and have a beer with him.
 
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