Why I will not vote for Obama

[Listening]

So that's a "No", huh?

I figured that...

I'm gonna go push an old wheelchair-bound 0bama voter down the stairs...

later, man...

I pushed two of them off a cliff yesterday.

Merry Christmas !!!

Wheres the fun in that? Splat, and it's over...

Down the stairs and you can watch a few bones break and maybe see the chair smack them on the way down too... It's easier to see the life ebb out of them from the top of the stairs rather than the top of a cliff...

Just sayin'... YMMV....

YMMV ????

I've got three lined up for today. I'll try to find some long stairs. The great thing about going over a cliff is listening to them scream all the way down. Otherwise it is just....

oofff
ouch
[crack]
uh
ouch
clang
#$%^

 

[Flopper]

True that the patients are demanding more. The problem is that they are unable or unwilling to pay more for it. I don't think the solution is to make healthcare like the DMV where there is no option to pay a premium for expedited service. Everyone pays the same fee and everyone endures the same wait. Of course there is a "fee for service" there too. It's right there on my receipt, a "service fee."

So how is government healthcare going to be any better again?

The problem with you paying a higher fee for expedited services is that the delivery of service would not be based on medical necessity but rather who pays most. If your doctor feels a service is needed immediately then he will ordered it.

And then the other problem is that the doctors limit options based on their assumptions of what the insurance will and will not cover. We had this happen when my wife went to the hospital with what seemed like a separated shoulder. X-ray didn't show anything so they were about to send her home with some Tylenol 3. I asked if a definite diagnosis had been made. The nurse said yes so I asked to see the x-ray. Just then the doctor walked by and said there was nothing on the x-ray. I asked for an MRI and after 2 hours and a pile of paperwork she got one and it showed pneumonia. I inquired as to why this wasn't presented as an option and was told that my insurance wouldn't cover an MRI.

The healthcare law has little to do with the delivery of healthcare. It addresses how we pay for healthcare, who gets healthcare and regulates insurance companies which is why it will not have a major effect on healthcare cost of the nation.

It will increase costs. More bureaucracy, more services delivered to people removed from the payment process, more one-size-fits-all protocols, and more carve outs for favored organizations.

All insurance should cover MRIs and CT Scans. These are two of the most valuable tools in detecting really serious problems. Also they help doctors in determining treatment options. A chest x-ray should show any pneumonia.

Your story points out one of the problems with private insurance. Health care professional often do not know what is covered and what isn't. Every company and every policy is different. If Medicare is providing your insurance, the chance are very good that your doctor knows just what Medicare pays. 20 to 40 percent of most doctors patients are covered by Medicare. The Medicare claims manual is available online and every insurance clerk knows the patient's financial responsibilities.

 

[asterism]

The problem with you paying a higher fee for expedited services is that the delivery of service would not be based on medical necessity but rather who pays most. If your doctor feels a service is needed immediately then he will ordered it.

And then the other problem is that the doctors limit options based on their assumptions of what the insurance will and will not cover. We had this happen when my wife went to the hospital with what seemed like a separated shoulder. X-ray didn't show anything so they were about to send her home with some Tylenol 3. I asked if a definite diagnosis had been made. The nurse said yes so I asked to see the x-ray. Just then the doctor walked by and said there was nothing on the x-ray. I asked for an MRI and after 2 hours and a pile of paperwork she got one and it showed pneumonia. I inquired as to why this wasn't presented as an option and was told that my insurance wouldn't cover an MRI.

The healthcare law has little to do with the delivery of healthcare. It addresses how we pay for healthcare, who gets healthcare and regulates insurance companies which is why it will not have a major effect on healthcare cost of the nation.

It will increase costs. More bureaucracy, more services delivered to people removed from the payment process, more one-size-fits-all protocols, and more carve outs for favored organizations.

All insurance should cover MRIs and CT Scans. These are two of the most valuable tools in detecting really serious problems. Also they help doctors in determining treatment options.

And that's why costs won't go down. MRIs and CT Scans are not always needed. I didn't need an MRI for my back pain, I needed an x-ray to show my bulging disk. The MRI just confirmed it and was ordered because insurance (car accident) covered it. That was a waste of $2500.

A chest x-ray should show any pneumonia.

But her shoulder was hurting, not her chest. They didn't x-ray her chest (again, a choice based on whether insurance would cover it). She certainly didn't need an x-ray and an MRI to diagnose pneumonia.

Your story points out one of the problems with private insurance.

No, it points out one of the problems with healthcare being conducted based on assumptions and that's a result of micromanaging regulation. If I need a test or a procedure and the regulations allow that procedure to be omitted from an insurance claim I should still be given the option of paying for it myself.

Health care professional often do not know what is covered and what isn't. Every company and every policy is different.

Which is another layer of bureaucracy increasing costs, the administrative folks that dictate what a doctor can and cannot do. That doesn't get fixed with Obamacare, won't get fixed with the insurance exchanges, and certainly wouldn't get fixed with the public option.

If Medicare is providing your insurance, the chance are very good that your doctor knows just what Medicare pays. 20 to 40 percent of most doctors patients are covered by Medicare. The Medicare claims manual is available online and every insurance clerk knows the patient's financial responsibilities.

And that's why my Dad is getting a full battery of tests right now for what his doctor has already said is a pulled muscle. Medicare will cover it the hospital is spending $15,000.

 

[Flopper]

No incentive to reduce costs through efficiency is the primary factor. In fact, there is a huge disincentive to increase administrative overhead.

Payment by private insurance companies provide no more incentive to reduce cost than government. As long as claims are coded correctly and meet the requirements of the claim hand book, which is often based on the Medicare claims handbook, the claim will be paid. In the current system, the more services sold by the provider the more money they make and higher the cost of healthcare.

I agree. In my opinion the problem is the micromanaging regulation. We don't need the government to intrude more into the details, we need the government to step back and provide more oversight.

Here is a real world example. I had a problem with my elbow a few months ago. I saw my doctor and he ordered an X-ray at the clinic, told me to take Aspirin 4 times a day for week and to pick up and elbow band at the drug store and wear it two weeks. If it didn't improve in two weeks make another appointment. It didn't get better so I did. My doctor decided that I should see a specialist at the clinic which I did. The specialist ordered an MRI which showed nothing so he gave me a cortisone shot and sent me to a physical therapist who also worked in the clinic. 6 weeks with the physical therapist and I was back to normal. The total amount they billed my insurance company was almost $3,000. My neighbor had the same problem but she was in a healthcare co-op. She made an appointment with her doctor but saw a physician's assistant who's paid about half what a doctor is paid. She had a cortisone shot, and an x-ray, saw physical therapist, did the same exercise I did and was back to normal in about 6 weeks. I would estimate the cost of handling her problem was about one tenth my cost. This is not usually and it cost us billions of dollars for necessary healthcare services.

I agree with you there also, however this situation could be solved by putting the patient back in the mix as the customer. Health insurance should be like car insurance. Major issues are covered but oil changes and new tires aren't.

In order to put the customer into the mix, you have to put more financial responsibility on the customer. If the customer could do a price and quality comparison of healthcare purchases, I might agree with you for some customers, however you can't compare the purchase of health care as you would a new set of tires. Call a doctor and ask how much to get a diagnosis of a chest pain or how much to treat a cough. You won't get pass the receptionist.

Making the patient responsible for routine healthcare just insures that their will be less early diagnosis of serious diseases which is nearly half of the nation's healthcare cost. For people with adequate financial resources, high deductible insurance makes sense, but for most middle and low income families it would be a disaster both in terms healthcare cost and healthcare outcomes.

 

[Flopper]

And then the other problem is that the doctors limit options based on their assumptions of what the insurance will and will not cover. We had this happen when my wife went to the hospital with what seemed like a separated shoulder. X-ray didn't show anything so they were about to send her home with some Tylenol 3. I asked if a definite diagnosis had been made. The nurse said yes so I asked to see the x-ray. Just then the doctor walked by and said there was nothing on the x-ray. I asked for an MRI and after 2 hours and a pile of paperwork she got one and it showed pneumonia. I inquired as to why this wasn't presented as an option and was told that my insurance wouldn't cover an MRI.



It will increase costs. More bureaucracy, more services delivered to people removed from the payment process, more one-size-fits-all protocols, and more carve outs for favored organizations.

All insurance should cover MRIs and CT Scans. These are two of the most valuable tools in detecting really serious problems. Also they help doctors in determining treatment options.

And that's why costs won't go down. MRIs and CT Scans are not always needed. I didn't need an MRI for my back pain, I needed an x-ray to show my bulging disk. The MRI just confirmed it and was ordered because insurance (car accident) covered it. That was a waste of $2500.



But her shoulder was hurting, not her chest. They didn't x-ray her chest (again, a choice based on whether insurance would cover it). She certainly didn't need an x-ray and an MRI to diagnose pneumonia.



No, it points out one of the problems with healthcare being conducted based on assumptions and that's a result of micromanaging regulation. If I need a test or a procedure and the regulations allow that procedure to be omitted from an insurance claim I should still be given the option of paying for it myself.

Health care professional often do not know what is covered and what isn't. Every company and every policy is different.

Which is another layer of bureaucracy increasing costs, the administrative folks that dictate what a doctor can and cannot do. That doesn't get fixed with Obamacare, won't get fixed with the insurance exchanges, and certainly wouldn't get fixed with the public option.

If Medicare is providing your insurance, the chance are very good that your doctor knows just what Medicare pays. 20 to 40 percent of most doctors patients are covered by Medicare. The Medicare claims manual is available online and every insurance clerk knows the patient's financial responsibilities.

And that's why my Dad is getting a full battery of tests right now for what his doctor has already said is a pulled muscle. Medicare will cover it the hospital is spending $15,000.

More likely he said it could be just a pulled muscle. If a pulled muscle was the actual diagnosis, neither private insurance nor Medicare would pay a claim for additional tests.

Probably some doctors do cheat, but that applies to both private insurance, Medicare, and patient payment. The primary reason for scheduling unneeded tests is simply the inefficiency of our healthcare system. A primary care doctor orders a test. The patient sees a specialist who's not in the same group as the primary and the test doesn't make it to the specialist so he orders another one. The patient goes in the hospital and the surgeon finds the test not to his liking so he orders another one that is only slightly different. Latter if the patient changes doctors, the test is likely to be repeated. Some hospitals will order a series of blood tests routinely when a patient is admitted rather trying to find out if the tests have been run by another doctor or health facility.