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Just talking with some of my older friends in healthcare. We were trying to think of any changes in heathcare mandated by the federal government that has cut cost and improved care. Most of the mandated changes add at least two layers of workers that do not provide care to the patients but monitor to make sure that the new polices are followed and another layer to provide information to the federal government. We kept going back to decentralized care of the mentally ill. We believe that the increased homeless is a result of the push by the federal government, Another example would be the "fifth vital sign", pain control. The federal goverment decided that all patients had a right to adequate pain control. Now we have a larger number of patients addicted to prescription drugs. We also have the federal government prosecuting doctors for giving patients excess pain control. I hope that the federal government puts some thought into the changes that will be made and how it will actually happen. The latest example is the move to have everyone insured. What has happened thus far. We are seeing people loose the private healthcare but not qualify for federal insurance because they make $1100.00 a month.

 

Ed

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Today in our local paper on the front page. The federal government is investigating our state for lack of oversite in providing adequate housing for the mentally ill. This has been a problem since 2001 when decentralization got underway. The government is involved only because of a lawsuit by Americans with Disabilities. The cost of care has not gone down or away just that more administrative cost and fewer patient contact hours. The sticking point is that 4 paients were beaten to death by other patients in our state over the last 6 months. These deaths are not the only cost. Mentally ill seniors are housed with younger violent patients with little supervision. I have worked in healthcare and have not seen as the norm people turned away unstabilized. The system does have limits. I bet on any given day 40% of all patients seen in any emergency department would be pain related and half would be for dental pain. The ability to care for the emergency patients are decreased by inapproprite use of the system. But legally the patient with whatever complaint has the right to be seen and must be evaluated wheter or not the patient can pay or has paid for the last 100 emergency visits. That same patient can protest to medical boards, state agencies and even take you to court or threaten to do so. These are part of the patient's bill of rights. You must see them , we, federal government may or may not pay for care and at what rate? At some point our system must sift toward the common good and exspect individuals to take some responsibiltity for themselves. The cost of healthcre is being shifted to the working poor. You cannot give people enough to satisfy them. Raising the minimum wage has not brought more people out of poverty. Initative and hard work are good tools. No investment no return.

 

 

Ed

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poster expat is correct....the "savings" were based on assumptions provided to the CBO by Obama's healthcare team.They have now amended their projections up adding even more to the deficit.

 

As Nancy Pelosi said prior to passing the bill: "we won't know exactly what's in this bill until it is passed". That is almost a verbatim quote. The CBO was fed false data to gain enough votes of the "fence sitters"(Blue Dog Democrats) to pass the bill.

 

Health Care reform is an admiral goal and changes must be made. Utopian type care though, cannot and will not work in a country like the US.

 

Ed

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Maybe this will sound like a dumb questions, but who exactly is getting rich off the current state of the US health care system? I know that lawyers and drug companies make a lot, but in what proportion, and how much are others making?

 

A friend of mine is a cardiologist in the US and he pays astounding premiums for mal-practice insurance, even though he's never had a claim against him. He does many, many pacemaker installations for which Medicare pays him a whopping $300-this is all he's paid for initial consult, the operation, and any follow-up work and time needed. Beginning January 1 the rate will drop to $240 and he says he will probably stop doing them because at that price it's not worth it. He says other doc's say the same thing, and that soon the only doc's that will do it for that fee will be doc's who don't have other work to do, i.e. not among the better doc's.

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Maybe this will sound like a dumb questions, but who exactly is getting rich off the current state of the US health care system? I know that lawyers and drug companies make a lot, but in what proportion, and how much are others making?

 

 

A friend of mine is a cardiologist in the US and he pays astounding premiums for mal-practice insurance, even though he's never had a claim against him. He does many, many pacemaker installations for which Medicare pays him a whopping $300-this is all he's paid for initial consult, the operation, and any follow-up work and time needed. Beginning January 1 the rate will drop to $240 and he says he will probably stop doing them because at that price it's not worth it. He says other doc's say the same thing, and that soon the only doc's that will do it for that fee will be doc's who don't have other work to do, i.e. not among the better doc's.

 

 

Trial Lawyers are doing well. Many drug companies do well also. I'm sure there are many others as well.

 

You point out why many Doctors are retiring or will retire as soon as they can. The new plan reduces payments to Doctors for many procedures. Plus the mal-practice premiums are through the roof due to many frivolous lawsuits. Many Drs. are simply fed-up.

 

I am enrolling for my 2011 company plan now and the cost is about $700 higher this year vs. last year. That is very common post Obamacare passage.

 

One of my favorite columnists is Libertarian P.J. O'Rourke. He had a great quote about government expanded health care: "If you think health care is expensive now, just wait until it's free!"

Edited by Art Fern
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What we are seeing on the front line is more people without coverage or coverage with copays or reimbursements that is impossible to use the insurance. Ask people that are working for some of the largest companies in service side about their coverage. Family coverage is too costly if you make minimum wage and if you work full time you do not qualify for Medicaid where I am. If you are given a Rx for Lovenox, Avelox or some inhalers the cost may be $150-$1500. If your coverage is reimbursement after 45 days with the correct paperwork most people cannot afford this. The insurer is betting you cannot afford the out front cost. Yes you have coverage but still no medicine. Will keep you posted when the first group arrives with their new and improved low cost healthcare, Will also continue to forward you the bills for the cost even though you are out of country and have no benefits.

 

Ed

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Art Fern said, in part, "Trial Lawyers are doing well." Can you please explain how this is happening? Surely you are not alluding to malpractice law suits, are you? Because, if you are, then I think you need to check your facts. As I can attest, W pretty much put a stop to malpractice legal actions, with Texas, and then I believe it spread across the nation (kind of like a cancer) when he and his cronies put one over on the citizens of Texas. They passed a law which placed a 'cap' on malpractice settlements. This effectively ended legal recourse for the average person who is injured by a sloppy physician. Attorneys will not take malpractice cases unless there are a lot of dead bodies laying around. So, personally, I just can't see how you can say that Trial Lawyers are doing well, under either the recent healthcare system, or the new one. The only ones who have been doing well are the giant pharmaceutical companies, the huge hospital owning corporations, Insurance Companies, physicians themselves (don't let them fool you; they all make way more than any previous generation of practitioners), and, of course the lobbyists who work for the above.

John, gladly accepting the care provided by our local Caja clinic here in Aguacate, Guanacaste

Personal Blog: http://arenalgrumbles.blogspot.com/

Forum Owner/Moderator: http://groups.yahoo....roup/CRRealists

 

The original post in this thread should answer your primary question. Tort reform is needed nationwide because it is a key element in driving up health care costs (of course there are others).

 

Trail Lawyers will sue you for looking at someone wrong if they sniff $$. Remember a few years back when McDonald's was sued by a woman because her coffee was hot and burned her. She walked away with a big chunk of money cause her coffee was hot...well duh! US TV is is filled with those vultures ads trying to gin up a class action suit and/or promising huge payoffs.

Edited by Art Fern
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Well, the argument would be that McDonald's knowingly and willingly put a dangerous substance in the customer's hands without any forewarning and without taking reasonable measures to protect her. The coffee at McDonald's is served at around 180 degrees F. That's way, way too hot to more than sip off the top. To be sure, it'll be hot when you get to your office or wherever you're headed, but were anyone to gulp it right after leaving the counter, I promise there'd be another noteworthy lawsuit. And while the top on the cup may be typical in the fast food industry, it's hardly a sure way to prevent spills if the cup isn't handled carefully. Remember, this all happened at a drive-thru where there was no good alternative place, like a tabletop, to put the coffee.

 

In the instant case, the judge was pursuaded by the attorneys for McDonald's (those pesky lawyers again) that the victim shared some of the blame for the risk she took by putting the coffee between her legs. That's why the award was so dramatically reduced.

 

Remember, it was McDonald's who chose to serve the coffee dangerously hot. (If it wasn't dangerously hot, it wouldn't have burned her.) It was McDonald's who knowingly served it to an elderly person. (The staff could see her when they served her.) It was McDonald's who failed to secure the container against any reasonable chance of spillage. (The lid just presses into place, and we've all gotten coffee with lids that weren't even completely pressed down.) And it was McDonald's who failed to warn the victim of the risks.

 

Does the victim share some responsibility for her bad judgement? Of course. That's why the award was greatly reduced upon the defense's motion.

 

 

The National Association of Coffee offers that the optimum temperature guideline for serving coffee as between 195-205 degrees. So McDonalds was at a minimum of 15 degrees below industry standards. Plus they had a warning label on the cup. A key contributor to the severe burns were the type of pants she wore, which held the heat against her skin longer than normal. (maybe the pants maker should be sued as well).

 

If you walk into a busy intersection, don't be surprised if you get hit by a vehicle. If you buy and spill a cup of hot coffee, don't be surprised if it burns.

 

I 100% support the ability of the public to sue for damages. My original point was that frivolous lawsuits have driven up the costs in many areas of life in the US.

 

Good discussions. Thanks for your points of view. I respect them. I'm out on this subject.

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