The reality is that some of these folks haven't worked in it or around it. Beyond that, there is no limit to the amount of Koolaid some folks are willing to drink.
What are you gonna do?
Is obamacare really bad for doctors?
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The reality is that some of these folks haven't worked in it or around it. Beyond that, there is no limit to the amount of Koolaid some folks are willing to drink.
What are you gonna do?
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Whatever you are smoking sure must be some goooood stuff 😀
You can't compare sports stars and celebrities...they will always make millions for their provided entertainment. There are laypeople that complain they make too much, but it won't change.
You can't compare sports stars and celebrities...they will always make millions for their provided entertainment. There are laypeople that complain they make too much, but it won't change.
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Keep strokin that peen so we can all know what a big bad nurse you really are.
The problem with your posts is that there's so many crazy points you throw out all at once it seems completely disjointed and basically impossible to respond to. One of us would have to write a frickin essay just to address every one-liner you're throwing out there (with little/no evidence to back any of them up I might add). I don't think that many people are dedicated to online forum battles....which is why I think people are just linking off to other sites so you can read papers other people have written already.
If you'd like to have a discussion I'd suggest picking one topic at a time and discussing that. Instead of going (to quote just your most recent posts)
"we're all screwed
what about those sports and hollywood starts who want coverage for everyone?
It's whatever the market will bear and it's gonna bear down hard. It has nowhere to go but down and out.
What kind of healthcare package do you think Congresspeople will have?
Major employers have severely cut down hiring since the last election."
Which basically provokes a response of "Whaaaa...?"
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What is wrong with that comparison? Its simple supply and demand. Celebrities and athletes provide a service people are willing to pay for. Guess what doctors do. The only difference is doctors already are forced to provide at less than market set prices.
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Specialist after fellowship in pain : $500,000 in a private outpt suburb area .. That's my dream. U mad I can do that and still have genuine care for patients? Yea lol u mad.
Obamacare doesn't even apply to Obama lol... How much more blatantly obvious and hypocritical can you be to reform healthcare and give handouts, thereby winning votes, and then continue using your lavish luxury healthcare/ everything. After all , isn't that the fuzzy wuzzy libtard logic? Gotta work for less money so you'll look more sincere! Sounds legit.
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It wasnt an ad hominem. That is my single biggest
sdn pet peeve.
Wut? A moment ago you said that specialists shouldn't make over 200k. Now you think I'm mad that they can make over 5. It is late on a Friday night.... I guess I shouldn't be surprised
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This. For every reasonable statement or good point there are 10 conspiracy theorist ravings. Makes me feel weird on the occasion I find myself agreeing w something
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What am I stroking? Hahahaha. I don't have one, and I don't have penis envy either. hahahah.
Whatever dude. Pick a point then. We've already covered the fact that this is going to be one HUGGGGGGGGGGE TAXATION and cost to everyone. . .and there is only so much cost shifting. . .sigh. . .
Have you really not seen the severe employer pull back over the last several years? We're closer than ever to OC. Guess what? The pull back will continue. Our economics does NOT occur in a vacuum. What happens in one area affects another. It's not my fault if you can't put the pieces together and see the big picture. Betcha you thought the DOW dropping was nothing but a hiccup.
Just state whatever specific point you're miffed about, and I will try to get to it on my next study break.. . but now you've given me other things to think about so. . .😉
Cheers to you!
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That's a good dream but very hard to do 😱 Most med students won't be in a position to come close to that situation.
If you can pull off that feat, more power!
And Specter, that is a good point, I guess I was putting sports star on a big pedestal lol
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Gotcha. 🙂
I'm no conspiracy theorist; but I am insightful realist.
I have to say, it's been quite entertaining. Now back to studying. . .
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It happens. The thing is, people with money are willing to pay a bunch of guys to play with a ball. But that's all it is. As it stands physicians already have some of the most severely artificially restricted salaries per utility and vitality of service provided.
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They cater to entirely different markets is why (to address the simplest point you could make here that doesn't delve into the ethics of this whole situation). Celebrities/Athletes make millions of dollars by selling their product to millions of people for a small(ish) amount. Thousands of people pay a hundred+ bucks to go to a football/basketball/baseball game (depending on the team lol) while millions more "pay" by watching advertising on TV. Millions of people go and pay ten bucks to see a movie starring whatever movie star. They'll roughly get paid based on the amount of people they can draw in to see their latest entertainment.
The "markets" are also entirely different. The information disparity is entirely different. It doesn't take much brainpower to realize you want to watch the Bears v 49ers game on Sunday. It takes quite a bit more to figure out exactly how much that colonoscopy is worth to you and that's taking one of the simplest examples. It has been argued (very successfully I believe) that you cannot have a true "informed consumer" in medicine no matter how hard we try.
Finally, we haven't had a free market in healthcare since the rise of employer sponsored insurance companies in the 1940s, so saying anything about "market set prices" or "what the market will bear" (as old jil lin threw out there) doesn't really apply.
Edit: I just read your post above and I guess you probably weren't arguing what I thought you were...I'll leave this up here just for the hell of it but it might be a nonissue lol.
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Ethics is the only thing that makes it different. That was my point. I wasn't saying salaries are a result of market prices, I was saying they are already well below what market prices would be in a truly free market.
I understand the differences in the markets. The thing is, why attack physician salary? As previously discussed (in this thread?) Physician salary accounts for 6-8% of healthcare costs. If every doc took a 50% cut, putting very many below a point where they could reliably pay off loans, the consumer would at most see a return of 4 cents on the dollar spent. Chump change gained at the expense of financial hardship by the provider. So who are people attacking salary? Honestly I think its a scape goat due to misinformation. Other people just love to tear down those they put on pedestals. Once you inform these people the argument becomes "well there is still no reason for them to make that much"... why the hell not?
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Haha quite but people have written hundreds of essays on the ethics of healthcare so I don't really feel like having a huge discussion about it.
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What am I stroking? Hahahaha. I don't have one, and I don't have penis envy either. hahahah.
Whatever dude. Pick a point then. We've already covered the fact that this is going to be one HUGGGGGGGGGGE TAXATION and cost to everyone. . .and there is only so much cost shifting. . .sigh. . .
Have you really not seen the severe employer pull back over the last several years? We're closer than ever to OC. Guess what? The pull back will continue. Our economics does NOT occur in a vacuum. What happens in one area affects another. It's not my fault if you can't put the pieces together and see the big picture. Betcha you thought the DOW dropping was nothing but a hiccup.
Just state whatever specific point you're miffed about, and I will try to get to it on my next study break.. . but now you've given me other things to think about so. . .😉
Cheers to you!
Sorry what? Why exactly do YOU think the DJIA dropped in 2008? I can't wait to hear this answer...
To quickly address your "employer pullback" point, take a look at the unemployment rate change since the spike in 2008. Hell, take a look at this table (yes I know the rates for government workers are lowest but of course that's fairly typical for any timepoint). If you're going to say "but the unemployment rate jumped in 2008, whassup with that?"...well there's a pretty well accepted explanation for that which I hope you agree has nothing to do with the ACA or I'd have to argue you have no touch with reality at all.
http://www.bls.gov/news.release/empsit.t14.htm
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What am I stroking? Hahahaha. I don't have one, and I don't have penis envy either. hahahah.
Whatever dude. Pick a point then. We've already covered the fact that this is going to be one HUGGGGGGGGGGE TAXATION and cost to everyone. . .and there is only so much cost shifting. . .sigh. . .
Have you really not seen the severe employer pull back over the last several years? We're closer than ever to OC. Guess what? The pull back will continue. Our economics does NOT occur in a vacuum. What happens in one area affects another. It's not my fault if you can't put the pieces together and see the big picture. Betcha you thought the DOW dropping was nothing but a hiccup.
Just state whatever specific point you're miffed about, and I will try to get to it on my next study break.. . but now you've given me other things to think about so. . .😉
Cheers to you!
Nonsense. Penis envy ftw 😀
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I missed the part where he mentioned your nursing "skills?" Nevertheless, I think if you quit with the internal monologue, and the conversational, rambling posts you would have a greater effect on the discussion. Right now I read the thread and your posts are like I suddenly switched to Fox-SDN.
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I'm sure he is mad at a college student who hasn't even taken the MCAT yet but "can" make half a million 🙄
You're right though Obama should not use the benefits that legally come with his job and Romney should not take advantage of legal tax laws that enable him to lower his effective rate way below the average American (sarcasm by the way). You realize that CEO's don't cut their compensation package every-time they lay off workers? Let's see Conservatives in Congress come up with a measure to decrease their own salary and benefits, gotta cut spending or their hypocrites right?
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As it has been pointed out, MEDICARE reimbursements have been going down for more than a decade by 25% (including the massive 5% cut in 2002). Even without Obamacare, that trend would have continued. What PPACA does is redefine the field and attempt to incentivize new things. SGR is a bigger threat to Physician reimbursement than anything in PPACA. PPACA attempts to slow down or reverse cost, but with SGR, Physicians haven't seen a real increase in reimbursements in years.
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I'm sure that Massachusetts will fall apart and float into the sea any day now because they have had something extremely similar to the Affordable Care Act for six years now.
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For all of you who have rotated at a VA, do you think the care there is better than at other institutions?
Many people who have been treated at the VA are not happy with it: but this is the govt healthcare system that is already in place.
People should be ready to wait in a group clinic (from 1-5) for their appts and be only allowed the medications the govt covers as in the VA.
Many people who have been treated at the VA are not happy with it: but this is the govt healthcare system that is already in place.
People should be ready to wait in a group clinic (from 1-5) for their appts and be only allowed the medications the govt covers as in the VA.
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Yeah, and the private market is the paragon of patient satisfaction.
This is a little long in the tooth now, but the VA actually does (did) come out ahead in this measure.
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And the difference is that health care costs are substantially higher than the "cost" to have celebrities roaming around. Correct me if I'm wrong, but that's like comparing paying for insurance/medical procedures versus paying for cable/event tickets. Celebrities make a lot of money individually through privately determined contracts, but there are a lot fewer of them, and their only expenses are their own. For this reason, I can see why the general public is more passionate about cutting costs of healthcare, and the resulting cuts in physician pay, as opposed to cuts in celebrity pay, and I think this is why the comparison really isn't valid.
Furthermore, celebrities are outliers....what about the "up-and-coming", amateur actors/musicians/athletes who make dirt (like, they actually don't make enough money to get by). I can't see anyway to "reform" this industry and retain revenue from them without absolutely screwing over this population, and I don't see this sort of "reform" happening, at least not in the foreseeable future.
Edit: I really don't know enough about this, but I would suppose if the goal is cutting celebrity pay for the good of the economy, I guess the target would have to be the agencies that are extending the outrageous contracts that are making them so wealthy. It is worth mentioning, however, that a lot of modern celebrities did not become wealthy because they are celebrities. Rather, they became celebrities because they are wealthy.
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My short answer:
If you are a money-grubber, then yes.
If not, then no.
If you are a money-grubber, then yes.
If not, then no.
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Wha?!
The public option was taken out of the bill. So I don't know where you are getting this.
Am I mistaken in thinking that making healthcare mandatory is NOT going to wipe out the private insurance market? The government saying, "everyone gets healthcare insurance" does not mean that they are going to micro-manage the thing. Blue Cross will still be around, Cigna is not going anywhere, and Humana is still going to rape everyone on premiums.
Get a grip.
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If anything, it's going to strengthen the private insurer market.
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We'll see.
Wow, this is actually a GREAT example.
Even the best VA hospital in the country is comparatively nightmarish. I know a great number of nurses and docs that have worked there. They admit to this; however, if they are still working in the system, at least for nurses, the pay grading, at least previously, was way superior to private entities. (I have heard that the pension packages are being cut. . .) So, you know, some people want to hold out there for the (at least previously) great pension packages, etc. They had/have to turn their heads away and hold their noses a lot, but the salaries and benefits were superior to the private sector. But boy do they have some wicked stories about substandard care and substandard practices.
Reality is quite different from fairytale land folks.
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[Because Obamacare forces insurers to cover a buffet of benefits that they dont have to today, the cost of insurance will go up. Another driver of higher premiums is the fact that insurers will have to cover everyone, regardless of previous health status, a change that will attract sicker enrollees at the expense of healthier ones.
Some Obamacare defenders try to argue that these cost increases dont matter, because a slice of the low-income population will benefit from the laws subsidies. But if youre not eligible for subsidies, or only partially eligible, you will be exposed to the laws dramatic increases in the cost of insurance. And remember that Obamacare has an individual mandate, which will force most Americans to absorb these higher costs.]
http://www.forbes.com/sites/aroy/20...-insurance-premiums-by-30-says-obama-adviser/
Also wonderfully interesting:
[A multitude of flaws in President Obamas health- care law have been exposed, both prior to its enactment and since it passed on a straight party line vote. They range from tax hikes on small business owners and the middle class, to gutting $716 billion from Medicare, to its punitive individual mandate.
Little attention has been paid, however, to a component of the Affordable Care Act found in section 1311(h), which will prove catastrophic to the doctor-patient relationship. These few lines empower one bureaucratthe Health and Human Services (HHS) Secretaryto determine whether a physician is providing quality health care measures. Based on that finding, the Secretary is empowered to cancel a physicians health insurance provider policy, effectively forcing him out of practice.
Allowing the HHS Secretary, who is not governed by the Hippocratic Oath or a state medical board, to define quality health care measures will have a devastating impact on our health care system. Consider the recent controversy surrounding mammogram guidelines. In 2009, the U.S. Preventative Services Task Force advised mammograms for women over 50, which contradicts the American Cancer Societys typical guideline that screenings begin at 40, and therefore served to divide the medical community.
Under President Obamas health care law, should the HHS Secretary determine that performing mammograms on women younger than 50 violates a standard of care, the provider must comply, regardless of his or her concerns. Failure to do so would allow the Secretary to shut down a medical practice. The powers given to the Secretary are so broad, he or she could literally dictate how all physicians nationwide practice medicine.
This violates the sanctity of the doctor-patient relationship, as physicians are trained to treat patients individually and not with a one-size-fits-all approach. Under this new regulation, patients standard of care may be diminished. This rule also threatens access, driving more doctors from their practices and creating an even greater shortage of medical providers. In turn, patients will face longer wait times in between appointments, and in some cases, it will be time they cant afford to lose. Oftentimes, it is the sickest and poorest Americans access to care that is disproportionately threatened.
The Safeguarding Care of Patients Everywhere (SCOPE) Act repeals this regulation...]
http://www.nationalreview.com/critical-condition#
[An overriding concern was how to make this law work in real life. For example, we were thinking through how a ban on pre-existing conditions really works in practice. You can see that things might happen like insurers evading people who are sick by imposing waiting periods for specific benefits like chemotherapy or autism treatment, or limiting benefits in ways that might make them unattractive to consumers with serious health problems. The secretary of Health and Human Services has said its permissible for insurers to limit the number of visits to certain providers, for example.
If it isnt squarely addressed, some insurer may say, Well, its not expressly prohibited ]
http://gantdaily.com/2012/10/30/con...-state-rules-will-impact-scope-of-health-law/
Lord, this all just scratches the surface of this ghastly overall. Healthcare access and improvement is one thing, this is just a Lernaean Hydra. We have yet to see how far and deep this monster will go.
The devil is in the details when it comes to implementation of the health care overhaul, but a reasonable assumption is that it WILL be a nightmarish windfall of regulations, incompetencies, stonewalling, and net financial loses.
UM no. Government regulations dude. . .they WILL be massive, and continue to be forthcoming.
Government hands in this will cause it to go from a mess to an utter nightmare. Beyond that the burden of costs will seriously hurt many employers and employees for that matter.
I'm sorry but the less of naivete' is mindboggling.
So now, IMHO, we see more of the reason for last Tuesday night.
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Forcing insurers to take on those with pre-existing conditions is a good thing, and I'm sure they will benefit greatly from the millions of new customers forced to buy their product.
And people, government regulations on healthcare are already massive, and they've been increasing for more than a decade. What PPACA adds on is minor compared to what's already there. Once again, SGR, which is a policy implemented in 1997 is a bigger threat to Physicians than anything in PPACA.
And people, government regulations on healthcare are already massive, and they've been increasing for more than a decade. What PPACA adds on is minor compared to what's already there. Once again, SGR, which is a policy implemented in 1997 is a bigger threat to Physicians than anything in PPACA.
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If that were true the savvy business men who run those companies wouldn't have been turning those people away
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Turning who away? Those with pre-existing conditions? Yes, it may hurt health insurance companies, but I don't care. It's good policy.
The millions of new customers, however, aren't people the health insurance companies have been turning away. They just chose not to pay for private health insurance. Now, they will have no choice but to buy coverage.
I am thinking you don't know how insurance works.
? Is your employer self-insured? Where does the money come from?
What is it that you think actuaries do?
And do you think that government controlled healthcare will not include actuarial work--or that people's treatments will NOT be denied based on statistical analyses?
Do you not think major limitations will occur? Sure more people MAY be "seen," but will folks be as effectively treated with the same standard of care or better than what exists now under most systems?
Talk about ethics. . .hospitals have already been going to court to supplant the will of family over loved ones in ICUs. Now I'm not arguing for allowing the cost of care to go up and the quality of life and death go down. But there is this whole sphere of ethics concerning overriding family or even the individual patient's rights when things get too costly or burdensome. OK, so then, how do you moderate that???? Previously it has been on a case-by-case basis. Dude that will be lost. Certain days and points on a quality of life scale will be given, and neither the doc nor the family or patient will have any say. That's just reality. And before you go all hog wild on the craziness of "death panels," know that in some form they are already in existence.
These things have been on PBS and Discovery, etc. The hard choices will have to made from a financial standpoint.
And know this. While you can appeal turndowns from your current insurance carrier, often with good success (I know. Done it and been there! ), you will not,by anything near to the same means or degree, if at all, be able to effectively appeal the government appointees when they make their "final" decisons. And in a nation of > 300 million people, they and all with whom they work will have to make a lot of these decisions. There is only so much money to go around.
Wow. I wish I had someone to do my studies and go to work for me, so I could argue on SDN all day, but no such luck.
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It sucks majorly for people to be turned away for pre-existing conditions
No doubt. The issue I raised was whether or not, within the realm of government directed and regulated healthcare, necessity will also dictate limitations on treatment--very akin to turning people away for pre-existing conditions--its all in the wording--semantics. But, as of today, you can go up against Joe Private insurer and appeal, a number of times.
This will not be the case when government fully regulates it. Their word will be final. They will not have the time or money to go head to head with all the folks. As the lines of need get longer, less and less will have to be doled out. This is just basic mathematics.
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You said just a minute ago it would make them money. It won't. Good policy: yes. Make money: no. That is what I was responding to
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OO, a post I agree with. Regardless, I think this is irrelevant to the Obama vs. Romney debate, cause "romneycare" is not much different (I am from Mass and work in a hospital in MA, and for all intents and purposes, they are the same.) and I think this was destined to happen anyway. Either way, This is one of the extremely concerning issues I have with universal care and lack of funding to increase the number of doctors to keep pace with the number of patients. A lot of this lack of funding could be solved by raising more awareness about the costs/benefits of end-of-life care and futile critical care, both of which are so outrageously expensive. If health-care is going to sustain itself, something NEEDS to be done about this black hole in medical spending.
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You misunderstood me. I said the mandate will make them money. The millions of people (who don't have pre-existing conditions) who now have to have private insurance will make them money.
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Dude, I'm sorry, and I mean no disrespect, but your writing style is very hard to follow. I honestly can't understand a lot of what you're saying.
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deleted303591
From what I can tell, the healthcare bill will require us to ration care.
My healthcare costs are very expensive right now.
I am ok with my healthcare being rationed. More is not better in a lot of circumstances.
Better education and preventative medicine would solve a lot of problems in the majority of the population in the first place. This is why the bill is only a starting point. Further legislation will be needed to compensate for deficiencies.
For example, if I knew my rare autoimmune disease (a form of autoimmune autonomic neuropathy) was not a degenerative disease when I was diagnosed, I would have been better off. I actually had to confirm with one of my doctors that my disease was not degenerative (based on my understanding) about 8 months after being diagnosed with the disease.
Anyways, if I knew my disease was not degenerative in the first place, I would have been able to make better decisions regarding my care. I also would have been a much more informed patient and I could have figured out better resources to help me recover and regain functioning from this disease.
My healthcare costs are very expensive right now.
I am ok with my healthcare being rationed. More is not better in a lot of circumstances.
Better education and preventative medicine would solve a lot of problems in the majority of the population in the first place. This is why the bill is only a starting point. Further legislation will be needed to compensate for deficiencies.
For example, if I knew my rare autoimmune disease (a form of autoimmune autonomic neuropathy) was not a degenerative disease when I was diagnosed, I would have been better off. I actually had to confirm with one of my doctors that my disease was not degenerative (based on my understanding) about 8 months after being diagnosed with the disease.
Anyways, if I knew my disease was not degenerative in the first place, I would have been able to make better decisions regarding my care. I also would have been a much more informed patient and I could have figured out better resources to help me recover and regain functioning from this disease.
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deleted451730
There will be more financial incentive for people to get on government healthcare. As more people do so, the fewer people still with private insurance will see their costs skyrocket even more, indirectly forcing them to also get on govt healthcare instead. It's a cycle.
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Not everybody qualifies for Medicaid.
Those without any insurance are only guaranteed to have emergency care to stabilize the situation. After that you are on your own. Of course there might the doctors who do pro bono. Not too many of those that I know of.
Those without any insurance are only guaranteed to have emergency care to stabilize the situation. After that you are on your own. Of course there might the doctors who do pro bono. Not too many of those that I know of.
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What "government healthcare"? The only thing you're talking about is medicaid, and the people that qualify for that can't afford private health insurance anyway.
At the very least, this will help reduce lost income by physicians who treat patients that have no coverage and can't afford to pay at all.
Ok. State what you are confused about, or is this avoidance b/c you honestly don't know what actuaries do or our insurance coverage works? Seriously. No disrespect here either.
Also, I am not a guy. And b., I type fast and on the fly---have trouble at times sitting on that multitask propensity gene. So I truly apologize where things aren't clear. Plus right now I am typing on my iPad, which sucks, in terns of typing, without the right kind of accessory keyboard.
Name what confuses you the most.
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I know what actuaries do, I just feel that you're jumping from point to point, without much cohesion.
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