A sign of the times...

[uniquerabbit]

This disgusts me...

http://www.nytimes.com/2010/12/05/us/05transplant.html?_r=1&hpw

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[Kevin Baker]

This disgusts me...

http://www.nytimes.com/2010/12/05/us/05transplant.html?_r=1&hpw

What in particular disgusts you?

 

[Phlame217]

What in particular disgusts you?

What is disgusting is the fact that a profit margin defines the rule of the road.

 

[Kevin Baker]

What is disgusting is the fact that a profit margin defines the rule of the road.

You can't just throw money at everything and expect a good outcome. From what I read in the previous editorial, '13 of 14 patients under the state’s health system who received bone marrow transplants from nonrelatives over a two-year period died within six months'. If that's the case, I'd say it's less about a profit margin, and more about freeing up cash that at best, prolongs life six months, to help others.

 

[uniquerabbit]

You can't just throw money at everything and expect a good outcome. From what I read in the previous editorial, '13 of 14 patients under the state’s health system who received bone marrow transplants from nonrelatives over a two-year period died within six months'. If that's the case, I'd say it's less about a profit margin, and more about freeing up cash that at best, prolongs life six months, to help others.

It isnt only focused on transplant cuts....but Medicaid cuts in general..

"Arizona reduced Medicaid payments to doctors by 5 percent last year and has frozen payments to hospitals and nursing homes for two years. All providers will undergo another 5 percent cut on April 1, Ms. Carusetta said."

Should have a profound effect on providers continuing to not take Medicaid patients...as well as continuing to overflow our emergency departments...

 

[ShyRem]

If you have a better idea on where the money should come from and how to trim the budgets given the money flow in and the outrageous sums out, please speak up. The bottom line is there is more money flowing out of medicaid and medicare than flowing in. And that is not sustainable.

Like it or not, money DOES matter. What do you think of the proposal there should be limits on medical care for people who smoke, drink themselves to excess, the diabetics that eat bags of candy without regard for the implications later... If you knowingly continue to actively do yourself harm should we work so hard to keep you alive to continue your self-destructive behaviors?

Currently something around 85-90% of all medical health care dollars are spent on 5% of the population. Certainly we need to do something about that. Discuss.

 

[toastedcheese]

What is disgusting is the fact that a profit margin defines the rule of the road.

Haha, profit margin. They're out of money. Everyone is out of money. It's not about profits, it's about bankruptcy.

 

[uniquerabbit]

If you have a better idea on where the money should come from and how to trim the budgets given the money flow in and the outrageous sums out, please speak up. The bottom line is there is more money flowing out of medicaid and medicare than flowing in. And that is not sustainable.

I don't have a better idea of how to trim the budgets..I don't think anybody does, which is precisely why this disgusts me...the fact that it has come to this--money affecting pt care.

Like it or not, money DOES matter. What do you think of the proposal there should be limits on medical care for people who smoke, drink themselves to excess, the diabetics that eat bags of candy without regard for the implications later... If you knowingly continue to actively do yourself harm should we work so hard to keep you alive to continue your self-destructive behaviors?

I agree with your proposal, however, this is a broad generality that cannot be applied to the whole.

Currently something around 85-90% of all medical health care dollars are spent on 5% of the population. Certainly we need to do something about that. Discuss.

I agree.

 

[DbDan]

If you have a better idea on where the money should come from and how to trim the budgets given the money flow in and the outrageous sums out, please speak up. The bottom line is there is more money flowing out of medicaid and medicare than flowing in. And that is not sustainable.

Like it or not, money DOES matter. What do you think of the proposal there should be limits on medical care for people who smoke, drink themselves to excess, the diabetics that eat bags of candy without regard for the implications later... If you knowingly continue to actively do yourself harm should we work so hard to keep you alive to continue your self-destructive behaviors?

Currently something around 85-90% of all medical health care dollars are spent on 5% of the population. Certainly we need to do something about that. Discuss.

Well said and I completely agree.

 

[Phlame217]

Haha, profit margin. They're out of money. Everyone is out of money. It's not about profits, it's about bankruptcy.

Tort reform is always a hot topic, but as long as lawyers run the show...

But really, the Gov't is so damn top heavy it ain't funny. Eliminate the beaurocrats or atleast consolidation would be a big thing. Money changes so many hands from the tax payer to the service provider its almost (rand figure out of my head) like 20 cents on the tax dollar makes it where it should.

Redirect some of the useless subsidies to health care ie alot of the oil and gas subsidies because they profit without them, why give them more?

Theres alot to it, but we need more than politicians doing it. Get the great minds to sit down ie the Warren Buffets and all and have them talk it out.

 

[blinkboy1156]

OP, it is tragic and disgusting, yes.

But what about 50 million uninsured citizens? That, imho, is more disgusting.

 

[Dr Yiot]

If you have a better idea on where the money should come from and how to trim the budgets given the money flow in and the outrageous sums out, please speak up. The bottom line is there is more money flowing out of medicaid and medicare than flowing in. And that is not sustainable.

Like it or not, money DOES matter. What do you think of the proposal there should be limits on medical care for people who smoke, drink themselves to excess, the diabetics that eat bags of candy without regard for the implications later... If you knowingly continue to actively do yourself harm should we work so hard to keep you alive to continue your self-destructive behaviors?

Currently something around 85-90% of all medical health care dollars are spent on 5% of the population. Certainly we need to do something about that. Discuss.

my wife and i work at a nursing and rehab facility. She is a geriatric social worker and i work the activities department on the weekends. this topic is spot on. we are a for profit facility but about 80 percent of our residents are medicaid. they all start out medicare until their private funds run out and then they have to switch to medicaid. it is a very disgusting system. we have so many residents who take their government funded 35 dollars a month and spend it on cigarettes. they are then taken to a hospital for trouble breathing about 5 times a month. these people know they have copd and have been diagnosed for YEARS. yet they spend their government money on CIGGARETTES and are taken via ambulance to the nearest hospital only to be healed, brought back and then shipped out again. some of these residents are under 55 yo with attitudes a mile wide. the question "what are you doing in a nursing home" comes to mind while at work, over and over and over again. dont get me wrong there are some non profit facilities with minimum age requirments and no smoking priveleges. but there are also ones like the facility which i work at that is simply a disgrace. most of these residents where actually homeless or lived in trailer parks prior to bieng admitted. believe it or not, our biggest money maker is our sub acute rehab. and thats only about 25 beds.

Tort reform is always a hot topic, but as long as lawyers run the show...

But really, the Gov't is so damn top heavy it ain't funny. Eliminate the beaurocrats or atleast consolidation would be a big thing. Money changes so many hands from the tax payer to the service provider its almost (rand figure out of my head) like 20 cents on the tax dollar makes it where it should.

Redirect some of the useless subsidies to health care ie alot of the oil and gas subsidies because they profit without them, why give them more?

Theres alot to it, but we need more than politicians doing it. Get the great minds to sit down ie the Warren Buffets and all and have them talk it out.

omg look at how many towns who have populations of 30 people all have mayors making 6 figures. why? i don't know. you cant have 1 mayor for both towns who may have to double his responsibility to 60 people?

 

[Dr Yiot]

OP, it is tragic and disgusting, yes.

But what about 50 million uninsured citizens? That, imho, is more disgusting.

why are they uninsured may i ask? please explain? why are these people uninsured?

 

[blinkboy1156]

why are they uninsured may i ask? please explain? why are these people uninsured?

It is completely asinine to argue about money without first arguing about whether healthcare is an inalienable right.

You're question is unclear: are you asking me to question why we should insure these people for a reason (i.e. healthcare is a privelege) or is it you think these people are "insured"?

 

[kuanileqa]

It is completely asinine to argue about money without first arguing about whether healthcare is an inalienable right.

You're question is unclear: are you asking me to question why we should insure these people for a reason (i.e. healthcare is a privelege) or is it you think these people are "insured"?

Arginine? That is what I saw at first glance. You know you have Biochem on the brain when you try to read interesting threads and Biochem pops up in places that it doesn't belong!

 

[SFO-IST]

If you look at our (humankind's) history, most civilizations collapse due to overspending on the army or destroying their environment.

 

[gatorfann14]

It is completely asinine to argue about money without first arguing about whether healthcare is an inalienable right.

You're question is unclear: are you asking me to question why we should insure these people for a reason (i.e. healthcare is a privelege) or is it you think these people are "insured"?

A very large portion if the "50million" are insured. They self insure their risk of illness is low enough that they don't feel they need to pay thousands of dollars only to never use the insurance, but instead can cover events as they come, another huge chunk are illegal aliens which I really don't give a damn about seeing as how they are not our responsibility. In reality their are only about 10 million people that are truly uninsured and not able to get the insurance they want for any number of reasons. I'd say getting about 97% of the population is a success considering 85% of people are very happy with their insurance.

 

[Dr Yiot]

It is completely asinine to argue about money without first arguing about whether healthcare is an inalienable right.

You're question is unclear: are you asking me to question why we should insure these people for a reason (i.e. healthcare is a privelege) or is it you think these people are "insured"?

my question was very literal. why are these people uninsured? Working at a for profit nursing facility where you see some of the lowest scum of the universe having health insurance, and our tax dollars going to their worthless lives has put a bitter taste in my mouth about this whole thing. Ill admit. I have not spent hours researching the topics of healthcare reform and therefore i do not want to get into a huge conversation regarding it. I will give my view points however incase your interested.

first off let me state, because of the current economy I am working 2 part time jobs not even remotely affiliated with my major and having graduated in may of this past year I am currently....uninsured and have felt the effects to some extent. although thankgod i have not needed immediate medical attention so far, knock on wood.

I will say that I do think there is something wrong with the system, that the laws to get onto medicaid need to be more stringent. I see it everyday cause I work at a primary care physicians office. If your unemployed or make less than a certain salary, you qualify for medicaid and although the new effects have begun and there are so many more questions when filing mds's etc i think its stupid. medicaid is cutting spending but thats just not getting to the route of the problem imo.

On the other side of the coin, you have the people who are uninsured. ok now lets take out the illegal immagrents cause they are counted into the number of people and lets take out the people who can actually afford to have health insurance but choose not too. ok now the pot has gotten about two thirds smaller. now, why do these people not have health insurance? there are so many options out there. I think that the problem is education. people aren't educated enough to have health insurance. that is the source of the problem. go ahead and laugh at me all you want but i believe there are so many programs out there that are readily available to these people but they dont know about them or care less to go out and look for them.

on the whole if you don't have insurance you won't get seen bit that a lot of people tend to boast about. when I shadowed a neurosurgeon he allowed me to watch a surgery. the lady was an alcoholic who had fell, and hit her head while she was drunk. one saturday during rounds with him we saw her. it looked like the hematoma she suffered was small and it looked as if it would dissolve. well, i actually shadowed him the following saturday, things turned for the worst on this patient and she required the subderul hematoma to be removed. during surgery, the anesthesiologist and surgeon where good friends i really loved how lax it really was in the or. they were joking around and we were all talking. so i brought up the idea of health reform. the doctors were totally against it and when i told them the exact words that you just told me "yeah but there are a lot of people who need medical attention who just don't have insurance". They both laughed at me and the surgeon said "you think I am getting paid for this? this lady doesn't have insurance". yup they operated on a person with no insurance. people with no insurance get medical attention in this country. they might get sick and have to fork over cash to go to their primary but the point of the matter is, youll get treatment.

like ive said do i think something needs to be done? yes, but save me the whole "so many people are uninsured bit" this is coming from someone who is uninsured, remember that. reason im uninsured? cause i can't afford it, im out of school and i don't have a job that offers it. What am I doing about it? ill be insured next month when I start school.

bottom line, youll get seen in an er if you don't have insurance. most people who arent insured are illegal aliens, or can actually afford it and choose not too and if you really can't then there are programs out there you can actually qualify for. will there still be some people uninsured, probably but its not a right, its a privelidge. ok thats all i have to say. i hope this doesn't go south.

 

[cbrons]

If you look at our (humankind's) history, most civilizations collapse due to overspending on the army or destroying their environment.

Overspending period - defense, political graft, exploration, downright idiotic monarchs who wanted things (lookup King Ludwig II of Bavaria).

Name 1 major civilization that collapsed because they destroyed their "environment" -- What do you even mean by that?

 

[Dr Yiot]

A very large portion if the "50million" are insured. They self insure their risk of illness is low enough that they don't feel they need to pay thousands of dollars only to never use the insurance, but instead can cover events as they come, another huge chunk are illegal aliens which I really don't give a damn about seeing as how they are not our responsibility. In reality their are only about 10 million people that are truly uninsured and not able to get the insurance they want for any number of reasons. I'd say getting about 97% of the population is a success considering 85% of people are very happy with their insurance.

bingo, as a matter of fact this country actually insures people who don't deserve to be insured and who have never even worked a day in their lives. its disgusting. and people are actually complaining that people are uninsured in this country. holy hell go to a nursing facility and look at some of the scumbags that where homeless who qualified for medicaid and are now living there on your dollar.

 

[Trolking]

First, i would just like to say that anyone who says we need to cut doctor pay, but refuses to consider cutting lawyer pay is a peice of ****. that was aimed at obama for anyone who didnt get it. our government gets an insane amount of money in taxes, we just have to stop all the ridiculous spending. no wellfare, give jobs not handouts, and if there are no jobs have them dig holes. then fill them. free money leads to dependency. we need to stop all foreign aid. we have to stop giving away money we dont have. this new health care reform is not the answer. health care is not a right. people have the right to take care of themselves and to be allowed to do so. no one has some iherent right to anything they havent earned. I'm not saying people shouldnt help the needy, I'm just saying people shouldnt be so generous with other peoples money.

 

[munchymanRX]

First, i would just like to say that anyone who says we need to cut doctor pay, but refuses to consider cutting lawyer pay is a peice of ****. that was aimed at obama for anyone who didnt get it. our government gets an insane amount of money in taxes, we just have to stop all the ridiculous spending. no wellfare, give jobs not handouts, and if there are no jobs have them dig holes. then fill them. free money leads to dependency. we need to stop all foreign aid. we have to stop giving away money we dont have. this new health care reform is not the answer. health care is not a right. people have the right to take care of themselves and to be allowed to do so. no one has some iherent right to anything they havent earned. I'm not saying people shouldnt help the needy, I'm just saying people shouldnt be so generous with other peoples money.

Quoted for truth, except for the part in bold. We largely provide foreign aid to secure our own economic interests.