Just don't call them "Death Panels"

[Greenbeard]

No asswipe, what he did was steal 960 Billion dollars from the medicare fund.

Well, that's a bit out of the blue. You jump from complaining that doctors have to fill out claims forms after providing services to this?

Your fabricated numbers aside, no money has been "stolen" from Medicare. Cost savings in Medicare are achieved under the reform law in two primary ways: 1) reductions in overpayments to private insurance companies administering Medicare Advantage plans, and 2) slowing the rate of increase of non-physician reimbursements.

So guess fucking what???? There are going to be a LOT MORE DENIALS for care and without that care seniors will DIE. obie lied Seniors DIED. got it now? doyahuh?

"Denials" indicate the insurer isn't going to pay for a procedure. The cost cutting you're referring to simply involved reimbursing less (than projected before this law passed) for a given procedure. These are different concepts.

 

[CrusaderFrank]

When you have certified Eugenicists advising on rationing, it's foolish to think it leads to anything else.

I'm pretty sure eugenics isn't based on killing the elderly. Not big breeders, those folks.

Are you familiar with Eugenicists Ezekiel Emanuel's "Useful Life Years" concept?

"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years"

Principles for allocation of scarce medical interventions : The Lancet

 

[Greenbeard]

Eugenicists

[ame=http://www.youtube.com/watch?v=G2y8Sx4B2Sk]"Eugenics"[/ame]

Are you familiar with Eugenicists Ezekiel Emanuel's "Useful Life Years" concept?

"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years"

What's your point? You're quoting a paper about ethics: if we have one heart and two people in need of a transplant, one 18 years old and one 90 years old, how do we choose who to give it to? Should that question not be explored and discussed? Or should we approach the question the way I assume you do: "assume you have two viable hearts ready for transplant." Wow, that does make it easier.

Does examining the ethical ramifications of questions like that mean we're dissolving Medicare or denying treatment when it's possible to give it? No. Not only is Medicare policy not changing on that front, Ezekiel Emanuel doesn't make policy for CMS. Moreover, in that paper, Emanuel and his coauthors explicitly rejected using their ethical argument on a system-wide basis:

"Accepting the complete lives system for health care as a whole would be premature. We must first reduce waste and increase spending. The complete lives system explicitly rejects waste and corruption, such as multiple listing for transplantation. Although it may be applicable more generally, the complete lives system has been developed to justly allocate persistently scarce life-saving interventions. Hearts for transplant and influenza vaccines, unlike money, cannot be replaced or diverted to non-health goals; denying a heart to one person makes it available to another. Ultimately, the complete lives system does not create “classes of Untermenschen whose lives and well being are deemed not worth spending money on”, but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible."​

 

[RDD_1210]

Greenbeard debating Willow and Frank is just not fair. But the playing field should be leveled a bit since neither Willow or Frank have a job and should be able to craft responses all day long.

 

[G.T.]

So it looks like one side of this argument is presenting facts and supporting evidence, while the other side of the argument is name calling, rejecting ideas without support, and posting cat pictures.

just checking.

It's not surprising.

 

[CrusaderFrank]

Greenbeard debating Willow and Frank is just not fair. But the playing field should be leveled a bit since neither Willow or Frank have a job and should be able to craft responses all day long.

You know Green gets paid to post here, right?

 

[CrusaderFrank]

Eugenicists

[ame=http://www.youtube.com/watch?v=G2y8Sx4B2Sk]"Eugenics"[/ame]

Are you familiar with Eugenicists Ezekiel Emanuel's "Useful Life Years" concept?

"Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years"

What's your point? You're quoting a paper about ethics: if we have one heart and two people in need of a transplant, one 18 years old and one 90 years old, how do we choose who to give it to? Should that question not be explored and discussed? Or should we approach the question the way I assume you do: "assume you have two viable hearts ready for transplant." Wow, that does make it easier.

Does examining the ethical ramifications of questions like that mean we're dissolving Medicare or denying treatment when it's possible to give it? No. Not only is Medicare policy not changing on that front, Ezekiel Emanuel doesn't make policy for CMS. Moreover, in that paper, Emanuel and his coauthors explicitly rejected using their ethical argument on a system-wide basis:

"Accepting the complete lives system for health care as a whole would be premature. We must first reduce waste and increase spending. The complete lives system explicitly rejects waste and corruption, such as multiple listing for transplantation. Although it may be applicable more generally, the complete lives system has been developed to justly allocate persistently scarce life-saving interventions. Hearts for transplant and influenza vaccines, unlike money, cannot be replaced or diverted to non-health goals; denying a heart to one person makes it available to another. Ultimately, the complete lives system does not create “classes of Untermenschen whose lives and well being are deemed not worth spending money on”, but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible."​

What about ObamaCare "reduces waste"?

Spending certainly increase but only because we've added layers and layers of more and bigger government. That won't improve quality or availability. In fact, without increase the supply of doctors and mandating "Free procedures and treatment" you have GUARANTEED Ezekiel's long sought after scarcity.

 

[chanel]

That's what I thought. I do appreciate his knowledge on the subject because it is now the law. Greenbeard's expertise can at least answer the question "how badly are we fucked - bad or really, really bad?" lol

 

[CrusaderFrank]

We need to reform Obamacare to death. Make that first thing on the to do list in November.

We're going to sit on top of Republicans every day, every hour to make sure they understand they are there to undo the damage Progressives have wrought. No more Bush and Delays. Never again.

 

[Greenbeard]

You know Green gets paid to post here, right?

Do you think there's a market for arguing with idiots? Because if there is money to be had there, I actually would like to get in on it. But for now I'm doing this for you pro bono, Frankie.

What about ObamaCare "reduces waste"?

What were they talking about when they talked about waste? Primarily they were referring to overpayments (subsidies) to the privatized fifth of Medicare. Remember when you came up with that brilliant plan to shop Medicare out to the private sector and I told you they actually started doing that 13 years ago? Turns out there's a lot of waste in the Medicare Advantage program:

Payment to MA plans has gone way up since 2003. Did the payment increase largely benefit beneficiaries or not? This is a current political and policy debate, about which much has been written in the media (both traditional and blogospheric). It turns out the answer is known and quantifiable. My work (with Steve Pizer and Roger Feldman) shows that for each additional dollar spent by the federal government (taxpayers) on the program since 2003, just $0.14 of it can be attributed to additional value (consumer surplus) to beneficiaries (see also: findings brief).

What do we make of the other $0.86? That goes to the insurance companies but doesn’t come out “the other end” in the form of value to beneficiaries. In part it is accounted for by the costs of the additional benefits and in part it is captured as additional insurer profit.

So, do higher MA payments produce little value to beneficiaries, as Obama claims, or are the benefits they fund important to maintain, as Republicans would have us believe? The balance of the evidence is on Obama’s side. In fact, it is a landslide: for each dollar spent, 14% of the value reaches beneficiaries and 86% of it goes elsewhere (profit or cost).

Cuts to MA should be a no brainer.​

Under the law, overpayments to Medicare Advantage plans are eliminated, saving about $130 billion over the budget window.

Spending certainly increase but only because we've added layers and layers of more and bigger government. That won't improve quality or availability. In fact, without increase the supply of doctors and mandating "Free procedures and treatment" you have GUARANTEED Ezekiel's long sought after scarcity.

The workforce development provisions of the law are aimed at building the (primary care) workforce. And as for improving quality, we could spend all day going over the quality improvement aspects of the law. The subject is actually intricately related to a separate law--HITECH--and those electronic health records you hate. So I bet you're really going to dislike this fact: quality is, always has been, and always will be data-driven. Data is what allows us to differentiate between high and low quality outcomes and intervene. Data is what allows us to determine how to intervene to promote higher quality. That means comparative effectiveness research, that means EHRs, that means quality reporting of data. All of these things are going to start becoming possible over the next decade.