Health care passage SO what are you going to do?

[mcfaddens]

If the new health care bill is the end of the world or if it gets repealed or reduced in the future, how is that going to change your day to day practice? Is anyone here actually quit and start doing something else? Are you actually gonna start doing procedures? How is this really gonna change your day to day life? If you are not going to do anything about what government is up to why is everyone crying about it? I hate to be the Devil's advocate but its true. Input, comments or any real plans to take action out there?

---

Members don't see this ad.

 

[rollwithit]

If the new health care bill is the end of the world or if it gets repealed or reduced in the future, how is that going to change your day to day practice? Is anyone here actually quit and start doing something else? Are you actually gonna start doing procedures? How is this really gonna change your day to day life? If you are not going to do anything about what government is up to why is everyone crying about it? I hate to be the Devil's advocate but its true. Input, comments or any real plans to take action out there?

We're NOT gonna protest!

We're NOT gonna protest!

We're NOT gonna protest!

 

[LADoc00]

If the new health care bill is the end of the world or if it gets repealed or reduced in the future, how is that going to change your day to day practice? Is anyone here actually quit and start doing something else? Are you actually gonna start doing procedures? How is this really gonna change your day to day life? If you are not going to do anything about what government is up to why is everyone crying about it? I hate to be the Devil's advocate but its true. Input, comments or any real plans to take action out there?

Punch any supporter of the Congressmen and women who passed this bill square in the face. That will be easy where I live due to high concentration of Demofacists but you may have to seek out these scum out if you live in low pop rural areas like Wyoming.

 

[Nilf]

If the new health care bill is the end of the world or if it gets repealed or reduced in the future, how is that going to change your day to day practice? Is anyone here actually quit and start doing something else? Are you actually gonna start doing procedures? How is this really gonna change your day to day life? If you are not going to do anything about what government is up to why is everyone crying about it? I hate to be the Devil's advocate but its true. Input, comments or any real plans to take action out there?

1. Watch the movie '2012'
2. Start building a big boat. Or a hot air balloon. Or a submarine. Or a spaceship.

 

[Substance]

Your new health care bill is, to quote Neil Young, a piece of crap.

If I were a pathologist practicing in the USA, I'd cut the middleman and do my own biopsies. I'd move to a smaller area and set up my own shop. Punch biopsies of moles are about the most monkey-stupid thing anyone could do. There's no reason why a pathologist, who is a physician(people tend to forget that fact), should not be able to do that.

I know a rad onc that does his own GI endoscopies and bronchs. He bills essentially double what his colleagues make. There's no reason why pathologists can't follow his lead and learn dirt-simple, well-paying procedures. Doing so would:

1. Increase the bottom line by billing procedures
2. Decrease the amount of waiting for patients to get a sample taken, which means more referrals to you, which means more money.
3. Decrease the amount of time it takes for a diagnosis between biopsy and reading the slide. You could have a biopsy to diagnosis time of 48 hours.
4. Decrease your dependence on other specialties other than PCPs who must refer to you.

If working for insurance companies and hospitals results in slavery and a lack of respect in the form of monetary compensation, break off and do your own thing en masse.

It's time that everyone, physicians and patients, realize that the pathologists are the Gandalf's of medicine. To do so, path must get out there clinically.

 

[yuz2007]

just curious. How many of u got involved in the big survey by AMA. It was said half of the current physician would choose to leave medicine if the bill is passed. who and When r u going to do that?

 

[BU Pathology]

I am going to welcome 32 million Americans to the ranks of those with health insurance.

 

[mcfaddens]

Punch any supporter of the Congressmen and women who passed this bill square in the face. That will be easy where I live due to high concentration of Demofacists but you may have to seek out these scum out if you live in low pop rural areas like Wyoming.

interesting, search and destroy

keep the ideas coming

 

[mcfaddens]

Your new health care bill is, to quote Neil Young, a piece of crap.

If I were a pathologist practicing in the USA, I'd cut the middleman and do my own biopsies. I'd move to a smaller area and set up my own shop. Punch biopsies of moles are about the most monkey-stupid thing anyone could do. There's no reason why a pathologist, who is a physician(people tend to forget that fact), should not be able to do that.

I know a rad onc that does his own GI endoscopies and bronchs. He bills essentially double what his colleagues make. There's no reason why pathologists can't follow his lead and learn dirt-simple, well-paying procedures. Doing so would:

1. Increase the bottom line by billing procedures
2. Decrease the amount of waiting for patients to get a sample taken, which means more referrals to you, which means more money.
3. Decrease the amount of time it takes for a diagnosis between biopsy and reading the slide. You could have a biopsy to diagnosis time of 48 hours.
4. Decrease your dependence on other specialties other than PCPs who must refer to you.

If working for insurance companies and hospitals results in slavery and a lack of respect in the form of monetary compensation, break off and do your own thing en masse.

It's time that everyone, physicians and patients, realize that the pathologists are the Gandalf's of medicine. To do so, path must get out there clinically.

cut out the middle man, good idea (stop spending $ on marketing and brown eyeing) and invest in equipment

keep the ideas coming

 

[mcfaddens]

We're NOT gonna protest!

We're NOT gonna protest!

We're NOT gonna protest!

PCU reference
Nice

 

[mcfaddens]

just curious. How many of u got involved in the big survey by AMA. It was said half of the current physician would choose to leave medicine if the bill is passed. who and When r u going to do that?

AMA= FAIL

Not just on this issue but in general they do not have our interests and survival as a top priority,but I would love to start an organization charge thousands of members a couple of hundred a year and in return send them a 5 cent certificate a 10 cent plastic card and when problems happen write a letter to a member of government that will never be read.
Wait!! now I know what Im gonna do, just need a catchy name and a professional field I know nothing about.

keep the ideas coming

 

[mcfaddens]

1. Watch the movie '2012'
2. Start building a big boat. Or a hot air balloon. Or a submarine. Or a spaceship.

interesting, id probably go with the hot air balloon option, its got a nice 1800's flair and doesn't require any electronics that may break

 

[mcfaddens]

I am going to welcome 32 million Americans to the ranks of those with health insurance.

The counterpoint, I like

any comments?

 

[pathalot]

i'm probably just going to stand about like Robert #$%*ing Powell

 

[pathstudent]

The counterpoint, I like

any comments?

Completely agree with bu pathology. 20% of medical patients hAd no insurance and didn't pay squat on their pathology. At least now we wil get something. It might bankrupt the country but docs will be better off the next few years. All the "end is nigh" talk proves pathologists are a lot off whiny do nothing whiners. The rest of us will do what we love and figure out how to get a piece of the pie

 

[Nilf]

Completely agree with bu pathology. 20% of medical patients hAd no insurance and didn't pay squat on their pathology. At least now we wil get something. It might bankrupt the country but docs will be better off the next few years. All the "end is nigh" talk proves pathologists are a lot off whiny do nothing whiners. The rest of us will do what we love and figure out how to get a piece of the pie

"We are a nation that does what is hard, what is necessary, what is right", superimposed on 'It might bankrupt the country'.

You just lost all your credibility dude. Your attitude amazes me.

 

[mcfaddens]

Keep going, lets get some more input, this is an open forum lets discuss both sides and prove our points (with opinion or fact or logic)

as an aside everyones comments count, but give your thoughts form your point of view
are you an attending, what setting (private or academic or corporate or other) or a resident or student and your future plans and how the changes effect you (or think they may effect you)

Those who do not post that often (or never before) put your ideas into this thread I want to see what everyones take is on this is.

Bring it X

 

[Thrombus]

I am going to welcome 32 million Americans to the ranks of those with health insurance.

Tens of millions more now have health insurance.

Hundreds of millions more now have a future with decreased access to quality, innovative care.

The entire country is going bankrupt, accelerated by this disaster.

The entitlement class continues to grow and the working class who pays for the entitlement class continues to shrink.

 

[Sulfinator]

The entitlement class continues to grow and the working class who pays for the entitlement class continues to shrink.

This is absolutley the #1 concern I have about our country and its culture.

 

[pathstudent]

Tens of millions more now have health insurance.

Hundreds of millions more now have a future with decreased access to quality, innovative care.

.

How do you draw that conclusion?

This bill is about wealth redistribution more than it is about giving everyone crappy govt run care.

 

[yuz2007]

parasites are more encouraged in this country. Hopeless.

 

[2121115]

parasites are more encouraged in this country. Hopeless.

A child who is born with a debilitating illness and whose parents are bankrupted by health care expenses is not a parasite. A working person who gets sick and their insurance drops coverage is not a parasite. A working person whose covered family member gets sick and then the employer changes insurance carriers solely to make sure that they don't have to pay increased premiums for the sick person is not a parasite.

Surely you would never say this out loud so why post it on the internet?

 

[Thrombus]

A child who is born with a debilitating illness and whose parents are bankrupted by health care expenses is not a parasite. A working person who gets sick and their insurance drops coverage is not a parasite. A working person whose covered family member gets sick and then the employer changes insurance carriers solely to make sure that they don't have to pay increased premiums for the sick person is not a parasite.

Surely you would never say this out loud so why post it on the internet?

Because parasites who work far less than you and choose to spend their money on irresponsibility outnumber the situations you describe by more than 100 fold.

 

[LADoc00]

The counterpoint, I like

any comments?

Only a fool would think that insurance=health care. If no one takes Medicaid or there arent enough Medicaid providers in your area, it isnt worth the paper its printed on.

Im suspecting there will definitely be an outright government take over the medical education system now, which frankly I would be overjoyed with.

Free medical tuition ala Europe (the model everyone loves to point to!) and medical school deans begging to states for funds like elementary school teachers do now in California!

 

[Substance]

Canada is facing a big problem due to universal health care.

Now, I believe that the ill and unfortunate should not be penalized for their being sick. We all fall upon hard times, some harder than others.

The problem is that the majority of illnesses we treat, and spend money on, are preventable lifestyle illnesses. If people lost weight,stopped smoking and drinking, stopped doing drugs, ate well, and tried to accomplish things rather than be self-pitious, we'd be far better off in terms of medical spending. We also as a society have to stop hanging on to life when its clearly time to end. Seeing 99 year olds in the ICU for weeks is just horrid. It won't work. It's expensive. Why do we do it?

What I'd love to see is research into blood or imaging tests that show, with extreme specificity, that your bad habits are most likely the cause of your current illness. A blood test that shows that you've smoked for 50 years should mean you have to pay higher premiums, or out of pocket, to receive care. If you have a BMI of 35 and diabetes, your payment should be more. If you don't keep your a1c down, your payments are even more. If you lose weight, the payments decrease. The savings could go towards better treatment for people who are unfortunately ill due to accident or non-lifestyle illness.

The baby boomers made their nice little bed to lay down in once they get old. They used up all of the resources and made their lives really comfortable. Now that they are getting old, they are absolving themselves of real responsibility. Since they make up the majority of the voting populace, what they say goes. We've all been duped.

 

[Nilf]

Keep going, lets get some more input, this is an open forum lets discuss both sides and prove our points (with opinion or fact or logic)

as an aside everyones comments count, but give your thoughts form your point of view
are you an attending, what setting (private or academic or corporate or other) or a resident or student and your future plans and how the changes effect you (or think they may effect you)

Those who do not post that often (or never before) put your ideas into this thread I want to see what everyones take is on this is.

Bring it X

On a more serious note, the recent developments in healthcare politics made me reevaluate my career goals. Here is my plan:

1. Get best-paying job out there, work my arse off, and save (buy gold, precious stones, and oil, and set up offshore accounts). I don't care much about partnership track etc, because my bet is that many of private pathology groups will fold or devalue.

2. When the tsunami hits us (somewhere around 2015 ballpark), there will be two options:
a. Flight--Get a slow-pace academic position.
b. Fight--bypass the middle man, set up your own shop, charging cash only. There will be moment in time when the reimbursements from the government plans and the private plans will be so low, and the lines to see the doctor so long, that this option will become feasible.

Timeframe: the 'exchanges' and the 'bundled payment' will be implemented around 2014. The extra taxation and cuts will make Medicare viable till circa 2020. So I'm guessing the big changes will occur around 2015-2016.

Caveat: The big question is whether it will be viable to set up the practice that charges cash only or accepts better-paying private plans, and does not accept the pitifully low reimbursements from the government or private insurers regulated via 'exchanges'. Let's face it--people are entitled, and if the gubmint gives them 'free insurance', they might not be willing to pay extra for your service. Admittedly, some specialties are better situated than others. These private practice will likely remain an option for first line clinical specialties (primary care, peds, internists). It might not be possible for pathology, with possible exception of dermatopathology.

 

[LADoc00]

On a more serious note, the recent developments in healthcare politics made me reevaluate my career goals. Here is my plan:

1. Get best-paying job out there, work my arse off, and save (buy gold, precious stones, and oil, and set up offshore accounts). I don't care much about partnership track etc, because my bet is that many of private pathology groups will fold or devalue.

2. When the tsunami hits us (somewhere around 2015 ballpark), there will be two options:
a. Flight--Get a slow-pace academic position.
b. Fight--bypass the middle man, set up your own shop, charging cash only. There will be moment in time when the reimbursements from the government plans and the private plans will be so low, and the lines to see the doctor so long, that this option will become feasible.

Timeframe: the 'exchanges' and the 'bundled payment' will be implemented around 2014. The extra taxation and cuts will make Medicare viable till circa 2020. So I'm guessing the big changes will occur around 2015-2016.

Caveat: The big question is whether it will be viable to set up the practice that charges cash only or accepts better-paying private plans, and does not accept the pitifully low reimbursements from the government or private insurers regulated via 'exchanges'. Let's face it--people are entitled, and if the gubmint gives them 'free insurance', they might not be willing to pay extra for your service. Admittedly, some specialties are better situated than others. These private practice will likely remain an option for first line clinical specialties (primary care, peds, internists). It might not be possible for pathology, with possible exception of dermatopathology.

this is sage advice. I would suggest readers closely examine it.

 

[schrute]

A child who is born with a debilitating illness and whose parents are bankrupted by health care expenses .... A working person who gets sick and their insurance drops coverage .... A working person whose covered family member gets sick and then the employer changes insurance carriers solely to make sure that they don't have to pay increased premiums for the sick person ....

<O</O= fraction of the population&#8230;so rather than deal with them, we overhaul the entire system. Awesome.

Don't give me this "we've been trying for years and haven't gotten anywhere" or "at least they did something" crap. The only thing they did was pass a partisan bill (not one bipartisan vote) with a maxed out credit card without having watched "School House Rock: How a Bill becomes a Law."

<O</ONo one debates that these horrendous situations exist; the question is, is our best option to deal with this minority a multi-trillion $$$ permanent effing behemoth that fundamentally rewrites the relationship bet the people and it's govt?


<O</OI love these pathetically random heart-felt excuses to completely ignore the commerce clause of the Constitution, raise the guillotine to private insurance, and assume the govt. can do a better job managing healthcare (because they have a long track record of efficiency&#8230; &#8230; &#8230; )

If you don't think a single-payer eurofascist system is the long-term goal, you need to read Barry's books & understand the dude's guiding philosophy.

<O</OThen you need to sit down and read some Hayek & von Mises.<O</O

 

[2121115]

<o></o><o></o>If you don't think a single-payer eurofascist system is the long-term goal, you need to read Barry's books & understand the dude's guiding philosophy.

<o></o>Then you need to sit down and read some Hayek & von Mises.<o></o>

I have indeed read Hayek and Von Mises. I suppose next you are going to start quoting Ayn Rand like a freshman English major and referring Howard Roark's when people are all really Peter Keating's. I always have to laugh when I see the tea party enthusiasts and conservative talk show hosts referring to themselves as "the producers" as if working 9-5 at a job makes someone a "producer".

I have read Barry's books. He is a liberal, but he is not the anti-christ and health care reform is not the end of the world. This isn't 1980 and the welfare state that Regan dismantled does not exist today. Obama even agrees in his book that Regan was correct that the welfare system was bloated and inefficient.

Why are people so afraid that more people will have insurance? Because they are going to bump up the tax a little bit on people making more than 250k per year? If you are in academics you don't have to worry about that anyway.

 

[Thrombus]

Why are people so afraid that more people will have insurance? Because they are going to bump up the tax a little bit on people making more than 250k per year? If you are in academics you don't have to worry about that anyway.

Why stop there? How about a free car? Free gas? Free food? Free clothes? Free cigarettes and alcohol? Whats wrong with spending other people's hard earned money?

Liberty, freedom, and self-reliance BE DAMNED.

Lets all get hooked up to the government feeding-tube, get on our knees and beg for the next entitlement/government handout from corrupt mobster politicians and bureaucrats. Why you or anyone would want to give politicians more power over us is beyond me.

People have greater access to QUALITY, innovative healthcare in this country than anywhere else in the history of the world. The very small percentage that cannot afford it (excluding the large percentage the people that CHOOSE not to afford it) -- we can and have always taken care of.

 

[schrute]

I have indeed read Hayek and Von Mises. I suppose next you are going to start quoting Ayn Rand like a freshman English major and referring Howard Roark's when people are all really Peter Keating's. I always have to laugh when I see the tea party enthusiasts and conservative talk show hosts referring to themselves as "the producers" as if working 9-5 at a job makes someone a "producer".
I have read Barry's books. He is a liberal, but he is not the anti-christ and health care reform is not the end of the world. This isn't 1980 and the welfare state that Regan dismantled does not exist today. Obama even agrees in his book that Regan was correct that the welfare system was bloated and inefficient.
Why are people so afraid that more people will have insurance? Because they are going to bump up the tax a little bit on people making more than 250k per year? If you are in academics you don't have to worry about that anyway.

Well, if you’ve read Hayek and von Mises and you’re still more persuaded by Barry’s literary genius, it’s pointless to suggest you read any more books of substance as it clearly goes in one ear and out the other.

People are not “afraid” of everyone having insurance…people are “afraid” the government can claim authority you mandate you PURCHASE something or face a tax as a requisite to live in this country, that the government will assume larger and larger swaths of the economy under the guise of “equality,” and that, in the words of Norman Thomas, “The American people will never knowingly adopt socialism, but under the name of liberalism they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened."

 

[2121115]

Well, if you’ve read Hayek and von Mises and you’re still more persuaded by Barry’s literary genius, it’s pointless to suggest you read any more books of substance as it clearly goes in one ear and out the other.

People are not “afraid” of everyone having insurance…people are “afraid” the government can claim authority you mandate you PURCHASE something or face a tax as a requisite to live in this country, that the government will assume larger and larger swaths of the economy under the guise of “equality,” and that, in the words of Norman Thomas, “The American people will never knowingly adopt socialism, but under the name of liberalism they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened."

Well, I am not suggesting that Obama is in the same league as VM or H but the over-reacting and the doomsday, armageddon, quit medicine, we are turning into Cuba, etc type of talk is just silly. I was not a supporter of healthcare reform but it is certainly not the end of the world and it honestly doesn't look all that different from what McCain proposed during the campaign.

 

[isaishere]

What I'd love to see is research into blood or imaging tests that show, with extreme specificity, that your bad habits are most likely the cause of your current illness. A blood test that shows that you've smoked for 50 years should mean you have to pay higher premiums, or out of pocket, to receive care. If you have a BMI of 35 and diabetes, your payment should be more. If you don't keep your a1c down, your payments are even more. If you lose weight, the payments decrease. The savings could go towards better treatment for people who are unfortunately ill due to accident or non-lifestyle illness.

It would be great!!!

 

[Parts Unknown]

The problem is that the majority of illnesses we treat, and spend money on, are preventable lifestyle illnesses. If people lost weight,stopped smoking and drinking, stopped doing drugs, ate well, and tried to accomplish things rather than be self-pitious, we'd be far better off in terms of medical spending.

Do you have any data to support this?

 

[BrainPathology]

Well, if you've read Hayek and von Mises and you're still more persuaded by Barry's literary genius, it's pointless to suggest you read any more books of substance as it clearly goes in one ear and out the other.

People are not "afraid" of everyone having insurance&#8230;people are "afraid" the government can claim authority you mandate you PURCHASE something or face a tax as a requisite to live in this country, that the government will assume larger and larger swaths of the economy under the guise of "equality," and that, in the words of Norman Thomas, "The American people will never knowingly adopt socialism, but under the name of liberalism they will adopt every fragment of the socialist program until one day America will be a socialist nation without ever knowing how it happened."

I don't really need that much philosophy in this case. This bill pisses off protesters who like using the words N*gg*r and f*gg*t to describe US elected officeholders. No matter what other flaws it has, that alone is reason enough for me to think it's a good enough bill.

EDIT: I'm not saying those of you who vehemently oppose this bill are allied with these *****s. I'm saying that if you're looking for a silver lining to a useless bill (I'm not sure it's useless.. but it's certainly not close to great), making *****s angry is always fun.

 

[2121115]

I don't really need that much philosophy in this case. This bill pisses off protesters who like using the words N*gg*r and f*gg*t to describe US elected officeholders. No matter what other flaws it has, that alone is reason enough for me to think it's a good enough bill.

Good to know that some great, self sufficient Americans still have enough dollar bills to throw at this guy.

http://www.youtube.com/watch?v=EXsRH73Cnw8&feature=related

 

[yuz2007]

you have no idea what you are talking about. Patient contact is essential to give you the whole pic. Hiding in darkness is bad for both of your eyesight and insignt. I am living in a mexican neibourhood. I have not seen anyone paying with other than food stamp. I am sure most of them are on medicaid. They are all young and with working ability. This is still not enough...go bankrupcy american!

 

[yuz2007]

A child who is born with a debilitating illness and whose parents are bankrupted by health care expenses is not a parasite. A working person who gets sick and their insurance drops coverage is not a parasite. A working person whose covered family member gets sick and then the employer changes insurance carriers solely to make sure that they don't have to pay increased premiums for the sick person is not a parasite.

Surely you would never say this out loud so why post it on the internet?

you have no idea what you are talking about. Patient contact is essential to give you the whole pic. Hiding in darkness is bad for both of your eyesight and insignt. I am living in a mexican neibourhood. I have not seen anyone paying with other than food stamp. I am sure most of them are on medicaid. They are all young and with working ability. This is still not enough...go bankrupcy american!

 

[mcfaddens]

alright!! Lets keep this up everyones talking about this topic!! More view points lets get down and dirty!! Like the way the Celtics spanked the Nuggets tonite!

 

[dwil75]

Only a fool would think that insurance=health care. If no one takes Medicaid or there arent enough Medicaid providers in your area, it isnt worth the paper its printed on.

This.

Just attended a speech by a physician last night who is well versed in politics (and who in very up-to-date on all the fine points of the new bill), and I asked his opinion on this very issue.

Trouble, in a nutshell. The way he put it was - those with medicaid/medicare are essentially going to be competing with the new 32 million patients for access to the same shrinking pool of doctors - and everyone's going to be doing a *lot* more calling when it comes time to try and get an appointment.

I hope he's wrong... but I kinda doubt it.

 

[Substance]

Do you have any data to support this?

http://www.ahrq.gov/news/nn/nn012308.htm

Let's go down the list:

1. Heart disease: out of the five major risk factors for this illness(smoking, diabetes, age, family history, and blood pressure), two are preventable and one is easily controllable. There is a LOT of money to be saved here if people were held liable for their bad habits.

2. Trauma: how much of this trauma was due to criminal offense? If so, the perpetrators should be held liable for not only their crime, but also for their victim's medical bills.

3. Cancer: of the major cancers, lifestyle factors are risks for their pathogenesis. If people weren't so fat and didn't smoke all the time, we'd have less breast and lung cancers. These are expensive conditions to treat!

4. Mental disorders including depression: though I do respect psych as a profession, I cannot respect the pushing of the antidepressant-du-jour to generally sad-sack pathetic people with crappy lives, as what the family doctors are taught to do. It's expensive. What they need is to get some personal accountability and lose weight, get a new job, and find purpose in life. That's something medicine can't fix. As Doug Stanhope says, being depressed is a natural reaction to having a crappy life.

5. Asthma and COPD: though I cannot say what one is more expensive, I can say that COPD is usually the result of bad lifestyle habits. If a person wants to smoke, more power to them, but they should have to pay for all of their meds and hospital visits out of pocket or at higher premiums. Health-abiding citizens should not be on the hook for this.

6. HTN: easily controlled with medication. Noncompliance should come with a financial penalty.

7. Type 2 diabetes: again, easily preventable by exercise and not downing 7-11 Big Gulps on a regular basis. If you want to be a slob, pay for the after-effects!

8. Osteoarthritis: usually because you're either old(can't do much about that) or fat(pay up!)

9. Back problems: this is far too vague a description. I can't really comment.

10. Normal childbirth: we need more birth control, government funding to safe-sex programs that ARE NOT ABSTINENCE PROGRAMS, and more access to and LESS STIGMA against abortion. Heck, I'd say that most people should not have children because they just can't hack it, and that option should be readily available. No. Your little angel is not special. If you're lucky, LaSaquashoa will be a factory drone or burger flipper. Crappy people having crappy kids causes crime rates to rise - a secondary cost!

 

[Parts Unknown]

http://www.ahrq.gov/news/nn/nn012308.htm

Let's go down the list:

Those are short term savings. How about the aggregate health care expenditure associated with longer lifespans derived from all this preventive care?

 

[jimbobb23]

http://www.ahrq.gov/news/nn/nn012308.htm

Let's go down the list:

1. Heart disease: out of the five major risk factors for this illness(smoking, diabetes, age, family history, and blood pressure), two are preventable and one is easily controllable. There is a LOT of money to be saved here if people were held liable for their bad habits.

2. Trauma: how much of this trauma was due to criminal offense? If so, the perpetrators should be held liable for not only their crime, but also for their victim's medical bills.

3. Cancer: of the major cancers, lifestyle factors are risks for their pathogenesis. If people weren't so fat and didn't smoke all the time, we'd have less breast and lung cancers. These are expensive conditions to treat!

4. Mental disorders including depression: though I do respect psych as a profession, I cannot respect the pushing of the antidepressant-du-jour to generally sad-sack pathetic people with crappy lives, as what the family doctors are taught to do. It's expensive. What they need is to get some personal accountability and lose weight, get a new job, and find purpose in life. That's something medicine can't fix. As Doug Stanhope says, being depressed is a natural reaction to having a crappy life.

5. Asthma and COPD: though I cannot say what one is more expensive, I can say that COPD is usually the result of bad lifestyle habits. If a person wants to smoke, more power to them, but they should have to pay for all of their meds and hospital visits out of pocket or at higher premiums. Health-abiding citizens should not be on the hook for this.

6. HTN: easily controlled with medication. Noncompliance should come with a financial penalty.

7. Type 2 diabetes: again, easily preventable by exercise and not downing 7-11 Big Gulps on a regular basis. If you want to be a slob, pay for the after-effects!

8. Osteoarthritis: usually because you're either old(can't do much about that) or fat(pay up!)

9. Back problems: this is far too vague a description. I can't really comment.

10. Normal childbirth: we need more birth control, government funding to safe-sex programs that ARE NOT ABSTINENCE PROGRAMS, and more access to and LESS STIGMA against abortion. Heck, I'd say that most people should not have children because they just can't hack it, and that option should be readily available. No. Your little angel is not special. If you're lucky, LaSaquashoa will be a factory drone or burger flipper. Crappy people having crappy kids causes crime rates to rise - a secondary cost!

I don't mean to lately invade this thread, but what you have said above is wrong. You are confusing risk factors with causation. Even if something is a risk factor in the truest sense, it does not mean that it si the onloy cause - that is true only with infectious disease. In extremely healthy populations they still get heart disease, they just get it 5-10 years later but live 5-10 years longer. For health finances that is worse because they are no longer productive.

If all people quit smoking and were of a healthy BMI the impact on breast cancer is completely unknown, but lung cancer would go down. But these people would still eventually die of another disease. You seem to assume without these bad behavior everyone will live perfectly healthy and die in their sleep at age 97. This is rubbish and not borne out by any data. Usually, the best thing for costs is for people to work healthily and die of a massive heart attack the day after they get on Medicare. That is the cheapest.

You are probably right on with COPD, for many people with type 2 diabetes.

 

[Substance]

I don't mean to lately invade this thread, but what you have said above is wrong. You are confusing risk factors with causation. Even if something is a risk factor in the truest sense, it does not mean that it si the onloy cause - that is true only with infectious disease. In extremely healthy populations they still get heart disease, they just get it 5-10 years later but live 5-10 years longer. For health finances that is worse because they are no longer productive.

If all people quit smoking and were of a healthy BMI the impact on breast cancer is completely unknown, but lung cancer would go down. But these people would still eventually die of another disease. You seem to assume without these bad behavior everyone will live perfectly healthy and die in their sleep at age 97. This is rubbish and not borne out by any data. Usually, the best thing for costs is for people to work healthily and die of a massive heart attack the day after they get on Medicare. That is the cheapest.

You are probably right on with COPD, for many people with type 2 diabetes.

You bring up interesting points. Your points make an assumption: that those who are younger than retirement age with unhealthy habits who incur cardiac disease remain productive. I have no idea what the numbers are in this case(if anyone does, please link to them), but it would not be unreasonable to assume that the amount of total production per person would be less in those who have had cardiac disease at a younger age(50s rather than 70s) due to risk factors under their control. Yes, I do understand that risk factors do not imply causation...they can only be correlated and conclusions can only be drawn using theory. But if what we say about said risk factors is accurate, then a population that has less of them will have less total numbers having morbid, and expensive, cardiac disease.

Another issue is that those with poor habits tend to require multiple hospitalizations earlier in life than those without. So even if we all get sick eventually, those with good habits may very well have less inpatient time in total than those with poor habits. The assumption here is that the bad habits do not kill the people too early which would save in hospital costs. I know that there was a study that said that a healthier population is actually more expensive for society. Are there any other studies that investigate this issue?

Other outpatient disorders like OA and depression have links to lifestyle factors and cost the system astronomical amounts. I'd also suggest that the vague "back problems" might also be related to poor lifestyle habits.

Furthermore, if such a system as I suggest were implemented, there is no reason to believe that the public would actually act on the penalties and improve their lives. I'd say that most would either take the cost or just let themselves go until death. Either way, the system would be more financially viable.

 

[Eta Carinae]

No. Your little angel is not special. If you're lucky, LaSaquashoa will be a factory drone or burger flipper. Crappy people having crappy kids causes crime rates to rise - a secondary cost!

OMG!!!!

 

[LADoc00]

interesting quote Eta Carniae. Did you know Eta Carniae's traditional name is Foramen. Foramen.



anyway Chuck Norris round house kicks Obamacare AND this thread!

 

[simplesuture]

chuck norris once got a hard-on while walking down the street.

there were no survivors.

 

[Eta Carinae]

interesting quote Eta Carniae. Did you know Eta Carniae's traditional name is Foramen. Foramen.



anyway Chuck Norris round house kicks Obamacare AND this thread!

Que

If that's not one post written under the influence of either cannabinoids or EtOH, I don't know which others would qualify.

anyway, I don't know what Eta CARNIAE is but Eta Carinae is this;

also called "Tseen She" in Chinese.

Anyway, back to the healthcare issue. What I'm going to do is friggin rally a change of power on capitol Hill-

and send Palin a thank you letter for getting President Handout into the white house.

 

[yaah]

I think we have a lot of Glen Beck fans on SDN.

 

[Euchromatin]

I am a fan of Jon Stewart's mocking of Glenn Beck, is that close enough to fit in? hehehe

Although I was hoping for a "eurofascist" single payer system, I am excited that the health care bill is at least attempting to increase insurance coverage to more Americans and regulate the @sshat insurance companies.

Feel free to discount my opinion using the "Euchromatin is only a lowly med student, and med students lack sufficient real life experience to tell the difference between their @sses and holes in the ground" argument.