From a doctor's perspective, is it better to repeal or keep healthcare reform

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She was talking about fellow law students at Georgetown. Tuition: $46,865 per year (full-time)
$33,500 per year (part-time).

I'm sorry, I don't buy the claim that people (generally) in such a situation have anything to complain about regarding contraceptive cost.

So if one is borrowing huge sums of money and working over the summers to make rent and put food on the table one is not in the position to complain regarding increased contraceptive cost.

Impenetrable logic, as always.

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I understood it to be referring to people in positions such as Sandra Fluke's, who are perfectly capable of buying their own contraception, but truly believe that it should be covered by insurance (which is of course nonsensical, because contraception coverage is not "insurance").

You must be using some weird sense of 'their own' if you're calling me a liar.

'So people like Bob, whose mothers are ******... What? How dare you accuse me of calling Bob's mother a *****! I said no such thing!'
 
So if one is borrowing huge sums of money and working over the summers to make rent and put food on the table one is not in the position to complain regarding increased contraceptive cost.

Impenetrable logic, as always.

You DO realize that she could have bought them for $9/month? I don't think $9 is much...just 2 vente lattes at Starbucks.... JUST sayin'....
 
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1) I thought all graduate students (MD and JD) must have their own insurance or buy the school's insurance.

2) ".....contraception can cost a student $3,000 during law school, told CNSNews.com on Tuesday that she did not know that the Target store 3 miles from the Georgetown Law campus sells a month's supply of birth control pills for just $9."

3) "Target advertises the $9-per-month birth control pills on its websitehttp://sites.target.com/site/en/spot/page.jsp?title=pharmacy_generic_drugs_condition, and CNSNews.com confirmed and reconfirmed that the $9 pills were in fact available at the Target near Georgetown Law."

http://cnsnews.com/news/article/sandra-fluke-says-she-didnt-know-target-sells-birth-control-pills-9
 
You DO realize that she could have bought them for $9/month? I don't think $9 is much...just 2 vente lattes at Starbucks.... JUST sayin'....

Isn't this kinda like saying that Benicar must cost $4 a month because HCTZ costs $4 a month and they both treat hypertension? If Sandra's friend needed a pill that Target doesn't sell on the cheap (I thought the whole idea of treating polycystic syndrome was to minimize ovulation which you shouldn't just try with whatever random pill is on the cheapo list) this is kinda irrelevant and fail, innit?

But if you're right and all birth control is cheaper than the ibuprofen that gets handed out like water than WTF is the fuss over? How are the sluts bankrupting America with a $9 generic? Are they taking fistfuls, Limbaugh style? :laugh:
 
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You DO realize that she could have bought them for $9/month? I don't think $9 is much...just 2 vente lattes at Starbucks.... JUST sayin'....

1. Are all means of hormonal birth control the same? Hint: No.

2. Does access to cheap generic birth control impact the argument that Georgetown's insurance should cover it despite the fact that it's a Jesuit institution? Hint: It doesn't.
 
The entire point of the contraception debate is that religiously affiliated institutions shouldn't be able to opt-out of medical care due to their beliefs. No one was debating that the Church itself should be providing contraception care, but groups such as universities, hospitals and other associations cannot opt-out in the same manner.

The way some of these admendments are worded are so vague that an insurance company could theoretically refuse all care due to a belief someone has in the organization. For example, there is nothing stopping an insurance company from declaring itself as a "Christian Scientist" and refusing all care because it goes against their beliefs.
 
1) I thought all graduate students (MD and JD) must have their own insurance or buy the school's insurance.

2) ".....contraception can cost a student $3,000 during law school, told CNSNews.com on Tuesday that she did not know that the Target store 3 miles from the Georgetown Law campus sells a month's supply of birth control pills for just $9."

3) "Target advertises the $9-per-month birth control pills on its websitehttp://sites.target.com/site/en/spot/page.jsp?title=pharmacy_generic_drugs_condition, and CNSNews.com confirmed and reconfirmed that the $9 pills were in fact available at the Target near Georgetown Law."

http://cnsnews.com/news/article/sandra-fluke-says-she-didnt-know-target-sells-birth-control-pills-9

Yeah, scroll down just a little bit further...

On Tuesday, Fluke spoke at an event at the U.S. Capitol in celebration of women's history month. After the event, CNSNews.com asked Fluke: "Were you aware of the Target store that's 3 miles from Georgetown Law that sells a month's supply of birth control pills for $9 a month without insurance coverage? Were you aware of that?"

Fluke said: "So, I'm not familiar with specific department store policies. I know that some generic forms of contraception are less expensive than others and that that has been widely reported. But what has not been widely reported is that many women cannot use those forms of contraception."

"Women have different types of medical needs that require much more expensive forms,"
she said. "One woman contacted me. She was very, very upset that that quote was being emphasized because she has a genetic condition that requires her to use contraception that costs $1,500."

"So, this is medicine," said Fluke. "It's not one-size-fits-all, and while it's great that some women can access more affordable contraception, contraception needs to be accessible and affordable for all of the women who need all of the different kinds."

Frankly, it's rather sad that a law student is expressing a more sound understanding of a medical issue than half the clowns on the allopathic board.
 
Isn't health insurance itself a form of socialism since it involves cost distribution?

We should replace health insurance with health savings accounts
-People would have to change their lifestyle because they are paying directly for their healthcare
-Hospitals would be forced to lower their prices to remain competitive
-Healthy people will have more money to spend
-People who go to the hospital all the time for minor things will have to pay more
-Keep medicaid/medicare to cover the elderly, people living in poverty, and children
 
Read this today...

http://www.theatlanticwire.com/nati...-expect-health-care-law-will-be-upheld/50334/
Poll: Majority of Supreme Court Insiders Expect Health Care Law Will Be Upheld

Survey says … Obamacare will stand. A survey of Supreme Court clerks and lawyers found that most of them expect that at least the central portions of President Obama’s health-care law will stand inspection by the justices. Only 35 percent of insiders surveyed thought it likely that the highest court in the land would nix the individual mandate. According to the roundup, even those who had clerked for the court’s conservative justices said that the chances they’d uphold the mandate topped 50 percent.
 
Isn't health insurance itself a form of socialism since it involves cost distribution?

We should replace health insurance with health savings accounts
-People would have to change their lifestyle because they are paying directly for their healthcare
-Hospitals would be forced to lower their prices to remain competitive
-Healthy people will have more money to spend
-People who go to the hospital all the time for minor things will have to pay more
-Keep medicaid/medicare to cover the elderly, people living in poverty, and children

All business exchanges involve cost distribution. I go to the movies and get popcorn, you just watch the movie. The cost of your ticket essentially was subsidized by my desire for $4.50 popcorn. Some customers pay in more than the costs off what they get out, and vice versa. The difference is insurance and popcorn is voluntary, socialism isn't.

That said, health insurance as we know is a bit of a racket in that it subsists off fear of outrageously inflated costs. Essentially it is a secondary form of socialism, since the same coercive element of socialism is what is driving up costs and necessitating insurance- monopolies, patents, licensing, prohibitions, malpractice, unfunded mandates, etc. By restricting who provides healthcare and how, and raising costs, government has ensured that the only affordable way to get medical care is with insurance, and the idea of even minor emergencies is very scary. So everyone "needs" insurance.
 

Interesting numbers. It does seem to lean towards conventional wisdom and massive jurisprudence precedent since the New Deal.

That 35% does speak to what most people are thinking, the massive politicizing of the court (aka, Gore v Bush, Citizens United) handing down another 5-4 decision. It looks to most people that in the end, the lynchpin is Kennedy, and Roberts for the ride to preserve "court neutrality". 6-3

Here's a live blog of the arguments going down these three days: http://abcnews.go.com/blogs/politics/2012/03/live-blog-obamacare-challenged-at-the-supreme-court/
 
Frankly, it's rather sad that a law student is expressing a more sound understanding of a medical issue than half the clowns on the allopathic board.

I asked an OB/GYN attending today, and she said Fluke is trippin and overestimating the cost.
 
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It baffles me that even those who oppose health care reform by stating that health care is a business, and that no one will forcibly take their money, fail to consider that the system as it stands is NOT sustainable. I had the fortune (or misfortune...depending on your persuasions:)) of working for one of the largest insurers in the country and the medical underwriter who is a registered Republican told me that the current model is not good for business because it is not sustainable in the long term. The hospital I work for also graples with the same issues because they are forced to pass the costs of uninsured patients to other revenue centers to stay afloat. This is bad for business all around. Costs are getting out of control, and the less people there are insured, the less one can spread the overheads associated with providing health services.

Ask yourselves the fundamental question - how can we increase the number of those insured and spread the financial burden associated with providing the services to the most profitable revenue centers in the system? If you are honest in your response to this question, your proposed solution(s) will have no vapid political or ideological skew because none is required..

We need to aspire for viable solutions in place of the simplistic criticism that is rampant on this subject. We should be thinking about how to maximize the bang of our health care bucks, not arguing about whether it is constitutionally guaranteed, optional, socialistic, etc. Stay away from simplistic positions because they never yield any useful arguments for a problem as complex as the one we are currently facing as a profession.
 
It baffles me that even those who oppose health care reform by stating that health care is a business, and that no one will forcibly take their money, fail to consider that the system as it stands is NOT sustainable. I had the fortune (or misfortune...depending on your persuasions:)) of working for one of the largest insurers in the country and the medical underwriter who is a registered Republican told me that the current model is not good for business because it is not sustainable in the long term. The hospital I work for also graples with the same issues because they are forced to pass the costs of uninsured patients to other revenue centers to stay afloat. This is bad for business all around. Costs are getting out of control, and the less people there are insured, the less one can spread the overheads associated with providing health services.

Ask yourselves the fundamental question - how can we increase the number of those insured and spread the financial burden associated with providing the services to the most profitable revenue centers in the system? If you are honest in your response to this question, your proposed solution(s) will have no vapid political or ideological skew because none is required..

We need to aspire for viable solutions in place of the simplistic criticism that is rampant on this subject. We should be thinking about how to maximize the bang of our health care bucks, not arguing about whether it is constitutionally guaranteed, optional, socialistic, etc. Stay away from simplistic positions because they never yield any useful arguments for a problem as complex as the one we are currently facing as a profession.

Great point, it's annoying that staunch Republicans pretend that every business-minded person opposes health care reform. It's simply not true. Many businesses, from small family-owned ones on Main Street to huge corporations, support the ACA through donations and through lobbying for reform. It's outrageously bad for American businesses when the cost of employer-sponsored insurance grows twice as fast as inflation. It's hobbling us in the international marketplace.
 
I guess the word is that it should be a 5-4 vote on the mandate, Kennedy as the swing, and after today he appeared to be leaning towards striking down the mandate.

Interesting to see what happens. If the mandate doesn't hold up, it sounds like the rest of the bill would? Not sure.
 
I guess the word is that it should be a 5-4 vote on the mandate, Kennedy as the swing, and after today he appeared to be leaning towards striking down the mandate.

Interesting to see what happens. If the mandate doesn't hold up, it sounds like the rest of the bill would? Not sure.

Depends if they want to play activist judges and strike down a president's keystone piece of legislation. I guess it would finally put to rest the notion that the Supreme Court is somehow less partisan than our other branches of government. They've already hinted at it with past 5-4 rulings but this would be the final nail in the coffin I think.
 
I asked an OB/GYN attending today, and she said Fluke is trippin and overestimating the cost.

How so? I'm genuinely curious. Even internists know the significant price range of OCPs.

Let's say a female law student can only tolerate the NuvaRing, that's $50 every four weeks = $650 a year. She's part time, so her degree takes 5 years. That comes out to $3,250.
 
How so? I'm genuinely curious. Even internists know the significant price range of OCPs.

Let's say a female law student can only tolerate the NuvaRing, that's $50 every four weeks = $650 a year. She's part time, so her degree takes 5 years. That comes out to $3,250.


oh geezus...condoms are much cheaper....peope are SOOOOOO self-entitled...
 
oh geezus...condoms are much cheaper....peope are SOOOOOO self-entitled...

Are you being sarcastic? Condoms have a significantly higher failure rate, and many women need hormonal control of their periods because of dysmenorrhea, etc.
 
oh geezus...condoms are much cheaper....peope are SOOOOOO self-entitled...

Since the patient in question has polycystic syndrome, I'm not really sure how condoms are indicated for that.

Or are you just blindly throwing out talking points without actually reading anything?
 
oh geezus...condoms are much cheaper....peope are SOOOOOO self-entitled...

If you want savings, you should express this opinion to every woman you meet. Your own birth control needs will quickly drop to zero.
 
How so? I'm genuinely curious. Even internists know the significant price range of OCPs.

Let's say a female law student can only tolerate the NuvaRing, that's $50 every four weeks = $650 a year. She's part time, so her degree takes 5 years. That comes out to $3,250.

Why is the NuvaRing so expensive?
 
Great point, it's annoying that staunch Republicans pretend that every business-minded person opposes health care reform. It's simply not true. Many businesses, from small family-owned ones on Main Street to huge corporations, support the ACA through donations and through lobbying for reform. It's outrageously bad for American businesses when the cost of employer-sponsored insurance grows twice as fast as inflation. It's hobbling us in the international marketplace.

I don't think most Republicans think business-minded people oppose "health care reform." But many think that the way to reform healthcare delivery and availability is through market forces, rather than through government oversight.

To solve employer-sponsored insurance costs, all we need to really to is remove the tax incentive.
 
Since the patient in question has polycystic syndrome, I'm not really sure how condoms are indicated for that.

Or are you just blindly throwing out talking points without actually reading anything?

I am curious about just how many of the students at Georgetown have polycystic syndrome...
 
I am curious about just how many of the students at Georgetown have polycystic syndrome...
~10% of the women, so a decent chunk...
 
A bit less than that, but still a substantial portion.

I've seen a lot of numbers. The PCOS article on eMedicine quotes a range between 4-12% depending on the study. But yeah, somewhere around there. You'd figure that the true prevalence is under reported if anything given how many chicks are on oral birth control for reasons other than PCOS.
 
I've seen a lot of numbers. The PCOS article on eMedicine quotes a range between 4-12% depending on the study. But yeah, somewhere around there. You'd figure that the true prevalence is under reported if anything given how many chicks are on oral birth control for reasons other than PCOS.

True. I'm not disagreeing with you, I personally find it very frustrating to watch oral contraceptive coverage getting swept up in the cultural/economic war of any given political cycle when it's so strongly indicated for many medical conditions other than contraception.
 
Depends if they want to play activist judges and strike down a president's keystone piece of legislation.

Somehow I think striking down a bill requiring people to purchase an optional good or pay a tax/penalty wouldn't be playing activist court.
 
Somehow I think striking down a bill requiring people to purchase an optional good or pay a tax/penalty wouldn't be playing activist court.

Just listened to some of the arguments posed by Verrilli. It's doesn't sound like the judges are buying what he's selling. Mandate looks to be in deep trouble. They made good points, for younger consumers of healthcare, they are basically being forced to subsidize other sicker individuals. Regardless or not if they use healthcare services, their consumption is much less. The only way around this for the democrats will be universal coverage, which is largely an unamerican idea.

If I understand correctly, insurance companies would be in deep trouble if the rest of the bill were to stand while the mandate is struck down.
 
Just listened to some of the arguments posed by Verrilli. It's doesn't sound like the judges are buying what he's selling. Mandate looks to be in deep trouble. They made good points, for younger consumers of healthcare, they are basically being forced to subsidize other sicker individuals. Regardless or not if they use healthcare services, their consumption is much less. The only way around this for the democrats will be universal coverage, which is largely an unamerican idea.

If I understand correctly, insurance companies would be in deep trouble if the rest of the bill were to stand while the mandate is struck down.

yep. You can't really require insurance companies to accept everyone with preexisting conditions without a mandate...no one would buy it before getting sick.

Heck, even with the mandate I still think most people won't purchase insurance, and we'll run into this same problem. After all, the mandate penalties are very, very minimal compared to the cost of a healthcare plan.
 
yep. You can't really require insurance companies to accept everyone with preexisting conditions without a mandate...no one would buy it before getting sick.

Heck, even with the mandate I still think most people won't purchase insurance, and we'll run into this same problem. After all, the mandate penalties are very, very minimal compared to the cost of a healthcare plan.

So replace the mandate with a limited enrollment period for health insurance that only opens up every, say, 3 years. Outside the enrollment period, you could enroll, but premiums would be steeply higher. Boom, free-rider problem solved.

That should keep this creaky system chugging along for another 15 years or so..
 
I'm actually really curious what the Obama team's contingency plan entails if the individual mandate gets struck down. Will they trash the rest of the bill that depends on an individual mandate or will they let it sort itself out? (i.e. insurance companies get kicked between the legs because they can't deny based on pre-existing conditions.)
 
I'm not a Republican or Democrat, but Ryan's budget is sounding better everyday.

We certainly can't continue to work up volumes of debt, Medicare needs some huge cuts. America will be a failed experiment if we don't change our direction.

Found a pretty good summary below:

Health Care:

The plan ensures universal access to affordable health insurance by restructuring the tax code, allowing all Americans to secure affordable health plans that best suit their needs, and shifting the ownership of health coverage away from the government and employers to individuals.

Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.
Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.
Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.
Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.
Addresses health care's growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.
Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.


Medicare/Medicaid:

The Roadmap secures Medicare for current beneficiaries, while making common-sense reforms to save this critical program.

It preserves the existing Medicare program for those currently enrolled or becoming eligible in the next 10 years (those 55 and older today) – So Americans can receive the benefits they planned for throughout their working lives. For those currently under 55 – as they become Medicare-eligible – it creates a Medicare payment, initially averaging $11,000, to be used to purchase a Medicare certified plan. The payment is adjusted to reflect medical inflation, and pegged to income, with low-income individuals receiving greater support. The plan also provides risk adjustment, so those with greater medical needs receive a higher payment.
The proposal also fully funds Medical Savings Accounts [MSAs] for low-income beneficiaries, while continuing to allow all beneficiaries, regardless of income, to set up tax-free MSAs.
Based on consultation with the Office of the Actuary of the Centers for Medicare and Medicaid Services and using Congressional Budget Office [CBO] these reforms will make Medicare permanently solvent
Modernizes Medicaid and strengthens the health care safety net by reforming high-risk pools, giving States maximum flexibility to tailor Medicaid programs to the specific needs of their populations. Allows Medicaid recipients to take part in the same variety of options and high-quality care available to everyone through the tax credit option.
Social Security:

The proposal strengthens this important retirement program and makes it sustainable for the long term.

Preserves the existing Social Security program for those 55 or older.
Offers workers under 55 the option of investing over one third of their current Social Security taxes into personal retirement accounts, similar to the Thrift Savings Plan available to Federal employees. Includes a property right so they can pass on these assets to their heirs, and a guarantee that individuals will not lose a dollar they contribute to their accounts, even after inflation.
Makes the program permanently solvent – according to the Congressional Budget Office [CBO] – by combining a more realistic measure of growth in Social Security's initial benefits, with an eventual modernization of the retirement age.

Tax Reform:

This plan discards a needlessly complex and manipulative tax code, replacing it with a simplified mechanism that promotes work, saving, and investment.

Provides individual income tax payers a choice of how to pay their taxes – through existing law, or through a highly simplified code that fits on a postcard with just two rates and virtually no special tax deductions, credits, or exclusions (except the health care tax credit).
Simplifies tax rates to 10 percent on income up to $100,000 for joint filers, and $50,000 for single filers; and 25 percent on taxable income above these amounts. Also includes a generous standard deduction and personal exemption (totaling $39,000 for a family of four).
Eliminates the alternative minimum tax [AMT].
Promotes saving by eliminating taxes on interest, capital gains, and dividends; also eliminates the death tax.
Replaces the corporate income tax – currently the second highest in the industrialized world – with a border-adjustable business consumption tax of 8.5 percent. This new rate is roughly half that of the rest of the industrialized world.

http://wisconserve.com/2011/05/01/p...h-care-medicare-medicaid-and-social-security/

[YOUTUBE]jwDai5NtXa0[/YOUTUBE]

Not sure how you can argue with the common sense of this plan.


I'm actually really curious what the Obama team's contingency plan entails if the individual mandate gets struck down. Will they trash the rest of the bill that depends on an individual mandate or will they let it sort itself out? (i.e. insurance companies get kicked between the legs because they can't deny based on pre-existing conditions.)

Good question... because it looks like that's where we're headed.
 
If I was an insurance company exec I'd be sweating right now. I don't have that much sympathy for them based on how much they've already milked the system , but they'll still get hit hard if the individual mandate gets struck down. That was a lot of business potentially being sent their way.

If Ryan's going to play fiscal conservative I need to see similar % cuts to defense spending as cuts to education, Medicare, NIH research, and infrastructure investment. Then I'll believe a word he's saying about fiscal responsibility.

Edit: It's easy to find numbers on it because Republicans love to brag that Ryan protects the defense budget while scrapping domestic spending. I find it disgusting. Here's a WSJ article touting the amazing job Ryan did slashing everything but defense spending:
http://online.wsj.com/article/SB10001424052702303816504577305303713789174.html?mod=googlenews_wsj
 
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I do hope they overturn the individual mandate. There's no way the anti-discrimination parts of Obamacare are going to get repealed by a even a Tea Party Congress. Without the premiums from healthy people private insurance will go bankrupt. Medicare for all will be a reality within the next 20 years.
 
I do hope they overturn the individual mandate. There's no way the anti-discrimination parts of Obamacare are going to get repealed by a even a Tea Party Congress. Without the premiums from healthy people private insurance will go bankrupt. Medicare for all will be a reality within the next 20 years.

It sounds completely insane, but there's some truth to this. I don't think it will be Medicare for all, but it will be Medicaid for everyone who isn't old enough for Medicare or who doesn't have the huge amount of money it will take to pay exorbitant insurance premiums for the few remaining luxury private insurance companies. Then you'll have a huge pile of uninsured who aren't poor enough for Medicaid but can't afford luxury private insurance. Oh, and very few employers will be able to afford to provide insurance to employees, that will be an odd relic of the past.

Edit: By exorbitant I mean really insanely crazy expensive, enough money to cover someone with leukemia who signs up for the plan the day after they get their diagnosis. If this happens I wouldn't be surprised if the average physician was uninsured and paying for health care out of pocket in 20 years.
 
If you want savings, you should express this opinion to every woman you meet. Your own birth control needs will quickly drop to zero.

Actually, they like it...:), right after I tell 'em I can Botux them and make them more beautiful....
 
http://www.reuters.com/article/2012/03/28/us-usa-healthcare-court-idUSBRE82L1CJ20120328

Looks like tomorrow they discuss what parts of the law would fall with the individual mandate were it to be struck down. If any of you own stocks in hospitals, managed care organizations, or health insurance companies I would be glued to news reports the next few days. :laugh: It's like March Madness for the future of health care...

I bet they gave Roberts $10 million to uphold it so that their worst nightmare - the indisputably constitutional Medicare For All - stays safely off the table.
 
I bet they gave Roberts $10 million to uphold it so that their worst nightmare - the indisputably constitutional Medicare For All - stays safely off the table.

Yeah, people screaming "Repeal the mandate!" aren't looking very far down the road. It's a bit more nuanced than that - what they want is closer to a legalese version of "Rule that the entire ACA is dependent on the individual mandate, then strike down the mandate!" Aren't we glad we're not in law school? :sleep:

A repeal of the individual mandate along with maintaining the ACA clause that insurance companies can't discriminate based on pre-existing conditions is more of a cause for celebration for those supporting a single-payer system, as you pointed out.

Even Fox can see it coming: http://www.foxnews.com/opinion/2012...-obamacares-individual-mandate-is-thrown-out/
 
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