The Goat Pen

Professor Tiger wrote:
And when the ultimate goal of Obamacare - single payer - is finally achieved, executives at BCBS, Humana, Kaiser Permanente will all be out of work. Their perks and bonuses will go to HHS managers for providing VA-like care to us schlubs.

Exactly 100% wrong. The overwhelmed VA can't keep up with demand (patient visits increased 30% between 2012 and 2013), so veterans are going to get vouchers toward private healthcare. There's only been one VA hospital built in the last 20 years, in a glaring contrast to the two wars we've undertaken in the last 12 years.

I guarantee you oprama will impose martial law and take over the country with what's left of the military (sequestration, ouch) before he tries to impose single payer. The former would be infinitely easier - and not to mention a whole lot cheaper - than the latter.

No Obama won't do single payer. That's 10-15 years down the road. Even then, there will most likely be a secondary, private service for the 'haves' (similar to Britain).

AlabamAlum wrote:No Obama won't do single payer. That's 10-15 years down the road. Even then, there will most likely be a secondary, private service for the 'haves' (similar to Britain).

Agreed, but I give it 5-7 years. Maybe a platform for Hilary's 2nd term. Two-tiered system is inevitable, as well.

For the Right-Wingers:

Is Obama the new FDR?

Sequestration has been the only positive thing to come out of Washington since 2008.

Johnette's Daddy wrote:For the Right-Wingers:

Is Obama the new FDR?

No, he doesn't need a wheelchair and his wife is fairly attractive.

bluetick wrote:This is worse than 10 Benghazis. Apparently we just traded for Benedict Arnold, while giving up 5 bin ladens in the process. Send money to the RNC commiserate with your level of outrage...$50 if you're pissed, $500 if you can't see straight.

Not Benedict Arnold, more like Eddie Slovik...

http://www.cnn.com/2014/06/01/us/bergda ... ?hpt=hp_t1

JOHN MCCAIN IS MAD!!! DUCK!!!

(of course had GWB made the same call POW Boy would have been calling him a True Leader bringing back our son. No one left behind.

That's why I hate politics. It's all about face time & money.

Wake up America (earl pitts voice)

Even if the American deserted we should be doing everything we can to bring him here; however, the guy ain't no hero.

I wonder how many Mexican drug cartel members the CIC will release to free the captive former Marine seargent. I don't think he deserted.

I just found it funny today watching MCCAIN talking on the subject. He's calling for Obamas head yet had it been GWB he would have been praising him for bringing a fellow POW home. We've exchanged POWS since 1776. Shut the Fuck up already for God's sake.

Pitts off.

"Sequestration has been the only positive thing to come out of Washington since 2008."

You can go back a lot further than 2008....

cogent point

I dont mind trading prisoners

but 1 buck sergeant for 5 high ranking officers is pretty stupid

far as medicare being successful--many specialists/primary doxs dont take it and unless somebody figures out something in the next 20 years its going to consume half of our outlays in the federal budget. social security future is nothing compared to what medicare will do to the budget when the baby boomers all turn 65.

Hospitals take Medicare/Medicaid because it's better than nothing. We're gonna treat the patients anyway. Might as well get something going back. We do not break even with the reimbursements usually, though.

crashcourse wrote:I dont mind trading prisoners

but 1 buck sergeant for 5 high ranking officers is pretty stupid

What is stupid is holding those guys in quasi limbo in perpetuity. We used sophistry to deny them POW status, created a special court to try them - then never tried them. Whatever useful intel they had is 6-7 years out of date, so what do we do? Hold them forever? Scream about human rights abuses in Russia and Iran while detaining prisoners forever without trial? Do we hold them after cessation of hostilities and actually expect hostilities to cease?

At least the Russians and S. Africans (under the Boers) would've conveniently had them die of heart attacks or suicide after a few years. We just held them with no plan.

We had ONE great Arabic ally against Al Qaeda and the Taliban in the region - his name was Saddam Hussein. We took him out, primarily as a favor to Big Energy's slaveholding radical muslim friends (the Emir of Qatar, the King of Saudi Arabia and the Emir of Kuwait) and with him gone, there's no one in the Arab world we can trust (members of the Saudi Royal Family funded the 9-11 attack).

Our puppets in Afghanistan are double-tongued crooks and liars. Our puppets in Iraq are fools and bumblers (along with being double-tongued crooks and liars). Our allies in Pakistan aided and abetted Osama bin Laden in evading capture (along with being fools, bumblers and double-tongued crooks and liars).

The whole thing was a loser from the start 11 years ago. Once we pull out, keeping Gitmo open and/or holding on to those guys would just be a perpetuation of stupidity. I'd be cool if you wanted to give them double taps in the back of the skull instead of releasing them, except we'd just hand the Taliban more PR milage doing that.

AlabamAlum wrote:Hospitals take Medicare/Medicaid because it's better than nothing. We're gonna treat the patients anyway. Might as well get something going back. We do not break even with the reimbursements usually, though.

Healthcare workers in the US are overpaid and Healthcare companies in the US are obscenely overpaid compared to the rest of the world. We should treat healthcare like we treat access to potable water - recognize it as a basic human need, subsidize the hell out of it, make it almost impossible to lose.

Now, if you want frills - hot water, soft water, etc. - that's extra. But safe drinking water is universally available. Similarly, tummy tucks, capped teeth, etc. - is extra. But if I get prostate cancer, my ability to survive shouldn't be tied to my ability to pay.

"But if I get prostate cancer, my ability to survive shouldn't be tied to my ability to pay."

concur but within certain limits. I shouldnt have to pay for your treatment that is only 5 % chance of working. I shouldnt have to pay for your health care to sustain you another day when your condition is "irreversible" if you had inoperable metastatic lung cancer, continued to smoke why should I pay for the chemotherapy to extend your life another month at the costs of thousands.

medicare/medicaid/insurance compaines in general need to do a better job of triaging then stoicking to their guns when somebody is "expectant" unless they pay for it out of theri pown pocket

I disagree that most workers are overpaid. Should a nurse and a CT tech be paid less than a pipefitter. A plumber? Some will even champion raising the minimum wage to $15 an hour while decrying what healthcare workers make. Kinda funny. And as far as being obscenely overpaid, the hospitals that I've worked at over my career average, maybe, a 2% margin. A couple were less than that.

Now, there are luxuries in all hospitals here that are more limited in other countries: CTs MRIs, gamma knives, davinci arms, etc, abound here, and our rooms and common spaces are much nicer. We get extras here that aren't available elsewhere. We're spoiled. Patients pissed because we didn't have HBO was something that I've dealt with. "I want steak for dinner!" "I think you should provide mama a 1-on-1 sitter or nurse."

So, we can cut down on services in an area by allowing only one CT per 500k people in a community, cut the frills and niceties, and we can close some hospitals - and Americans are generally okay with that (as long as it isn't the hospital in their community). Are there positives in doing this? Sure. But make no mistake, there are negatives, too.

Interesting that you mention prostate cancer. In the future, your ability to survive will have less to do with your ability to pay, no doubt; however, variables such as age and comorbidities may exclude you from treatment. There is a give-and-take in the services offered and how quickly you get your ACL tear repaired, and your options for deciding whether you even get surgery (as opposed to being treated by more economical means) might be taken out of your hands (even more than it is now).

I think we needed an intermediate step. We have had the truly poor covered with CMS offerings, and the middle class and above were generally okay (although bolstering catastrophic coverage woulda helped). The working poor - who make too much to qualify for Medicaid, but not enough to pay for BCBS and eat - were the issue. Expanding the CMS umbrella was doable.

Nonetheless, this discussion is nothing but an academic exercise. What is done is done. Our HC trajectory won't be as bad as many believe, but it certainly won't be as positive as others think.