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| If they die, they die. | |
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| Tweet Topic Started: Feb 28 2009, 07:21 PM (312 Views) | |
| Jolly | Feb 28 2009, 07:21 PM Post #1 |
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Geaux Tigers!
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Sat down and had a cup of coffee with a friend of mine, today. Guy's a general surgeon, been practicing over 20 years in a small town hospital. In fact, he's Chief of Staff there. He shut his practice down this week. Reason? Money. The cost of malpractice and the cost of jumping through government billing hoops just got to be too much. He can work as a hospitalist for three days a week, pull 36 hours ER a week and make a better living than keeping an office open and performing surgery. Bottom line...this leaves one general surgeon left in this small town, and nobody can work 24/7. The next closest hospital is about 35 miles away, but if we look at it from a worst case scenario, parts of the parish could be 60 miles from a surgeon, should they need one. So, somebody's going to die, that probably shouldn't. The crisis in healthcare may not be in paying for a physician's care, it may be in finding a physician at all... |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| PattyP | Feb 28 2009, 07:27 PM Post #2 |
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Senior Carp
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It's all going to hell in a hand basket, Jolly. Rolling downhill and picking up speed. (Can I say "hell" here? )
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A tired dog is a good dog. "Dogs' lives are too short...their only fault, really." A.S. Turnbull | |
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| Piano*Dad | Feb 28 2009, 07:42 PM Post #3 |
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Bull-Carp
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This is quite true. The US government responds to pressure from organized groups that want lower medical costs. They respond by reducing insurance payments for various procedures. What they cannot do is force physicians to provide the services at the reduced payment rates. My wife tells a great set of stories about older women who come in for their yearly exams under medicare. Medicare now pays for a basic pap smear, period. The women want to have their meds refilled and to talk about this or that problem. Yet at the desk when they sign in they are told point blank that their visit is for NOTHING but a five minute test, which is all that medicare pays for. If they want stuff that requires a review of history and a discussion of current issues, they are told that they must pay an out-of-pocket fee for this. Many of the women nonetheless try to turn their visit into what they were used to in the dim dark past. They become agitated and angry when they are told that their government isn't funding that. So my wife and her practice become the villain for the government that is reducing ITS spending, as though that reduction has no effect on the quality of care. Bah. Then there are the government cost cutting measures that are truly frustrating. Her practice used to help older women with incontinence problems. They would insert a simple device called a pessary (it holds things in place). The government reduced the reimbursement for that procedure so much that the amount paid is actually less than the cost to the firm of the plastic part, let alone the overhead, nurse, and physician time needed to see the patient. These people are no longer seen. Medical costs are rising for many reasons. There are indeed some inefficiencies in the delivery system, and part of the problem is third party payment that encourages patients to demand too much care (they don't pay) and physicians to prescribe too much (someone else is paying), but the meat axe remedies are creating the potential for some serious declines in the quality of care for a very large number of people. |
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| George K | Feb 28 2009, 07:50 PM Post #4 |
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Finally
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So, Piano*Dad, healthcare costs are going up. Your wife is making less money, I'm taking 60% of the vacation I took 5 years ago, and I'm taking 20% more call. Oh, yeah, I'm making 15% less than I did 5 years ago too. Where's it going? Not in your family's pocket, and not in mine either. |
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A guide to GKSR: Click "Now look here, you Baltic gas passer... " - Mik, 6/14/08 Nothing is as effective as homeopathy. I'd rather listen to an hour of Abba than an hour of The Beatles. - Klaus, 4/29/18 | |
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| TomK | Feb 28 2009, 07:51 PM Post #5 |
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HOLY CARP!!!
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So then what are your thoughts on universal healthcare? Do you think that medical service to patients would decline even further if the government was picking up the entire bill? Would it put an even greater strain on the healthcare provider? |
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| Jolly | Feb 28 2009, 07:53 PM Post #6 |
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Geaux Tigers!
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Universal healthcare? Look at a typical university hospital serving a typical indigent population. That's what I think you're going to get in the long run. Of course, people will always vote with their feet, if they have the money... |
| The main obstacle to a stable and just world order is the United States.- George Soros | |
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| Piano*Dad | Feb 28 2009, 08:02 PM Post #7 |
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Bull-Carp
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Universal health care is is code for "lets start a brawl." The issue is very complex and I resist simple ideological reactions to it. I don't have time now to go into it very thoroughly (gotta shower and go to bed), and I'm not a health care economist. There are pros and cons. The current system of employment-tied insurance is a mess. It produces lock-in that immobilizes many workers. It produces extreme anxiety in workers about job loss because it means so much more than a temporary earnings dip. That anxiety pushes governments to do other things (like subsidize dying industries and erect trade barriers) to preserve jobs that ought to disappear and be replaced by other jobs that offer higher returns. Yet universal health care can suffer from the politicization of health choices even more so than we face at present. Under universal care, governments would be in an even stronger position to dictate all-or-nothing choices to consumers and providers alike. |
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| blondie | Feb 28 2009, 09:52 PM Post #8 |
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Bull-Carp
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Well up here in Canuckistan, IF you're lucky enough to even have a GP, & IF you live long enough to attend that long awaited golden appointment with your doctor, you must schedule separate visits for your hx, your physical, your review of blood work, your meds, and each separate problem. You get about 10 minutes max per visit. This is the only way a doctor can bill the max to the gov't for each visit. Oh, and the patient is billed directly if they cancel an appointment with less than 24 hours notice (some say 48 hours). Docs now post signs about these things in their offices. More & more docs here are seeking contracts & salaries, hospitalist type positions, or working out of "Medi-Clinics". It's so they have a secure income. More & more are simply choosing work part time, like 3 days a week. It's b/c they are stressed to the max b/c of patient loads, political & other reasons. Bottom line here: Doctors' Medical Insurance is fairly cheap. But you're taxed to the hilt. Fact, there are simply not enough doctors for our population. Hospitals & unionized staff are costing the system loads. Not enough of them either. Not enough equipment. Not enough students are chosen for not enough schools. And costs are rising despite the fact we don't have the administrative mayhem generated by insurance companies, these HMOs, etc. We're upset too. |
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| Horace | Mar 1 2009, 12:18 AM Post #9 |
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HOLY CARP!!!
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I suppose the same could be said for almost any cost cutting measure in health care. I have no informed opinion on the specific issues you're talking about, but we can't decide to spend any and every amount of money (apportioned over all of us via health insurance) to optimize health care in every possible way. But our culture is irrational around the issue of life and death (with life, regardless of the quality thereof, being "priceless"), and we can't think clearly about this stuff. |
| As a good person, I implore you to do as I, a good person, do. Be good. Do NOT be bad. If you see bad, end bad. End it in yourself, and end it in others. By any means necessary, the good must conquer the bad. Good people know this. Do you know this? Are you good? | |
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