So the House bill has been unveiled...

[Nilf]

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Members do not see this ad.

'Affordable Healthcare for America Act.' AHAA. That's the worse that the socialists, otherwise known as 'liberals' can do to this industry and this country. Two hundred years from now, the event that took place on 10/29/2009 will be likened to events like Battle of Adrianople, Battle of Manzikert, and assassination of archduke Ferdinand.

In your opinion, how will this affect pathology as (1) business, and (2) field in next 20 years. If you are an attending, your opinion is especially valuable.

 

[dfafda]

I'm sorry but you just became one of the worst people on SDN. I can see how getting health care to millions of people and allowing them a basic human right would be a bad thing... prick.

 

[Pingu]

I'm sorry but you just became one of the worst people on SDN. I can see how getting health care to millions of people and allowing them a basic human right would be a bad thing... prick.

Please explain how healthcare is a basic human right. Thanks in advance.

 

[tncekm]

I'm sorry but you just became one of the worst people on SDN. I can see how getting health care to millions of people and allowing them a basic human right would be a bad thing... prick.

Why not "socialized water"? Food? Housing? I mean, not just for "some people", but everybody. Why doesn't the government control those things? Ultimately, they're far more important to a persons lives than anything we can do to them in a hospital.

In addition, he didn't say people don't deserve healthcare. The position of many people critical of the proposed universal healthcare system is that it will essentially give the government full control. Even if it doesn't up-front, it will over time. What states do you think will "opt-out" when they're already paying taxes for it? What chance do private insurers have against a goverment that can regulate against them at the drop of a hat and put them out of business after they've developed the infrastructure for it?

What happens to medical innovation when America's capitalist health system dies? Is getting antibiotics to every kid with a runny nose or paxil to all the stressed out soccer mom more important than the medical advances that will save lives? Right now, sick people are taken care of. We need to streamline the process, make it more efficient and affordable, and make sure there are no "stragglers" or people "forcibly excluded", but we can do that without a government takeover and we can focus on just those people in need while we take a calculated approach to solving many of the problems with the healthcare system, one step at a time, over a period of time, safely.

This is an invitation for abuse by the government and will defintely result in an abuse of the medical system by the ignorant masses (not blaming them).

 

[dfafda]

well considering there are housing projects (which suck but better than being homeless), and things like foodstamps... i guess there is socialized food and housing... and i'm sure the people who get those things will agree they're not perfect but better than no food and no housing. Also you're fitting into this American idea that the whole purpose of the medical profession is to only treat the very sick. what about preventing disease?? the people who are lacking healthcare are the ones who suck most of the healthcare dollars right now because they're the ones not getting screening and not getting education regarding diet and proper preventative care. The vast majority of medical expense is in the final year of life.... how is that even remotely a smart way to spend healthcare dollars. I agree that changing the health insurance plan won't solve our problem but opening affordable health care to the those who don't have it will ultimately bring down the cost of healthcare for everyone because it will ultimately decrease the financial burden of chronic diseases like diabetes, asthma (getting kids in to doctors with URI and getting proper education and treatment will greatly decrease costs of admitting those kids for asthma exacerbations). And the people who are getting their paxil are the middle-upper class people who already have healthcare....

 

[Granular]

Please explain how healthcare is a basic human right. Thanks in advance.

It seems that everyone you know, or have ever known, and everyone you will see, meet, encounter in your life, has a RIGHT to be treated by you as a doctor. Thanks for all your commitment to the field of medicine: the work you did in school, the stress you encountered taking tests, getting s*it on by surgeons, nurses, senior residents and others, borrowing tons of money, etc. All this so the fruits of your labor can be claimed by your comrades. But don't worry, the government will decide how much your effort is worth, and you will accept whatever that is. Hopefully enough to cover the malpractice insurance.
Health care for all would be nice. But until US citizens start sneaking across the border to live in Canada, or swimming to Cuba, for the "free" healthcare (and thus exercise their basic human rights), I think dfafda has a tough argument to make.

 

[Thrombus]

My right to receive the H1N1 vaccine is being denied! Someone call the ACLU!

My right to see Dr. James Andrews is denied! I have a sore ankle and he can't get me in today!

"Health care" is a relative term and therefore not a human right. A settler in the West 150 years ago had no access to healthcare and still had all his/her rights don't you think?

Get a grip you leftist socialists. You impose socialized medicine and NO ONE except for those politically connected will get good healthcare. Capitalism/Free enterprise/Free market sytems are the only truely compassionate system as anyone can start out with nothing and achieve anything. It also produces FREE PEOPLE riches who build NICE hospitals with QUALITY care that CARES FOR THE POOR WITH COMPASSION.

Socialism builds dumps with mold and the citizenry goes to the back of the line. Compassion my arse!

 

[Thrombus]

2000 pages of bureaucracy with countless regulations and rules which will no doubt end up in overhead for physicians.

Less quality physicians will go into medicine to put up with this BS; many of those who are in will no doubt retire; those of us already in will work longer and see families less to deal with it.

The end result: Reduced patient access and poorer quality of care.

Shame on you would be physicians for supporting this calamity!

 

[Pingu]

the people who are lacking healthcare are the ones who suck most of the healthcare dollars right now because they're the ones not getting screening and not getting education regarding diet and proper preventative care.

I'm recalling my days as a medical student, when I had to work with an family practice doctor down at a clinic for low income people. They had subsidized medications for approximately 5 dollars a month. I'll let you guess the number of people who came in saying they weren't taking their blood pressure or diabetes medication because they 'couldn't afford 5 dollars' who had a pack of cigarettes, a cell phone, and some form of designer clothes or shoes.

It's called priorities and the majority of Americans have theirs skewed.

I have absolute sympathy for those people who cannot afford insurance...but if you say you can't afford insurance and you have a cell phone, cable or satellite TV, are smoking and have no plans to quit, eat out regularly, or have been on a vacation in the last year, then chances are you could have bought insurance for yourself.

 

[tncekm]

well considering there are housing projects (which suck but better than being homeless), and things like foodstamps... i guess there is socialized food and housing...

Then why are there homeless and hungry people? Not everybody is qualified to get housing/food/etc. Those are "assistance programs", not programs applied to every soul in the US.

and i'm sure the people who get those things will agree they're not perfect but better than no food and no housing.

Yeah, and currently we take care of TONS of people who can't afford insurance. (This needs fixing, but it's not like everyone who needs help is left wanting as you suggest)

Also you're fitting into this American idea that the whole purpose of the medical profession is to only treat the very sick. what about preventing disease??

disease prevention comes by lifestyle and education. That's largely out of the hands of the physician, as their influence will only go so far. And, please don't tell me that a physician should be relegated to a full time dietician/counselor.

the people who are lacking healthcare are the ones who suck most of the healthcare dollars right now because they're the ones not getting screening and not getting education regarding diet and proper preventative care.

Okay, so does that mean the governent needs to take over? Or are you just happy to accept anything that claims to fix that problem without giving though to the consequences.

I agree that changing the health insurance plan won't solve our problem but opening affordable health care to the those who don't have it will ultimately bring down the cost of healthcare for everyone because it will ultimately decrease the financial burden of chronic diseases like diabetes, asthma (getting kids in to doctors with URI and getting proper education and treatment will greatly decrease costs of admitting those kids for asthma exacerbations). And the people who are getting their paxil are the middle-upper class people who already have healthcare....

Healthcare legislation affects more than just the people receiving the healthcare. You need to also think in terms of federal power, freedoms, and economic impact.

And, simply "opening affordable health care to those who don't have it" (from the government, aka tax payer money) won't simply bring down the cost of healthcare because they're insured now. All that happens is that the money comes from a different avenue.

Things need to be done to lower the costs of healthcare for everyone and make it possible for everyone to purchase insurance. And the stragglers who literally "can't" get it should be assisted by the government.

(1) increase competition, allow people to buy insurance across state lines
(1a) make sure insurance companies aren't exempt from anti-trust laws
(2) tort reform
(3) decrease the paperwork trail
(4) have requirements that every capable american have catastrophic insurance (cheap)

Do those things and the costs will go down. decrease the costs, increase the pool. Increase the pool, high risk patients can get insurance. Reduce all of our costs, make sure everyone capable and willing to cover themselves is doing so, and then we can single out the people who want/need healthcare access but can't get it (i.e. disabled, etc, come to mind).

 

[tncekm]

"Health care" is a relative term and therefore not a human right.

I think the only "true" human right is, like all other animals, the right to attempt do your best at life.

Other than that, we're talking people agreeing with one another about what they're willing to given up in order for some level of protection/security/luxury/etc.

Luckily, humans are sympathetic and altruistic creatures, so we help each other out.

 

[Nilf]

Whoa, let's not digress here. Let's stay on the topic how the bill IN ITS CURRENT VERSION, proposed by Pelosi, that is moving through the legislative process will affect pathology as business. Business is defined as a way to earn living.

 

[phillystudent]

I'm recalling my days as a medical student, when I had to work with an family practice doctor down at a clinic for low income people. They had subsidized medications for approximately 5 dollars a month. I'll let you guess the number of people who came in saying they weren't taking their blood pressure or diabetes medication because they 'couldn't afford 5 dollars' who had a pack of cigarettes, a cell phone, and some form of designer clothes or shoes.

I've had the same experience, and it really pisses me off.

I have absolute sympathy for those people who cannot afford insurance...but if you say you can't afford insurance and you have a cell phone, cable or satellite TV, are smoking and have no plans to quit, eat out regularly, or have been on a vacation in the last year, then chances are you could have bought insurance for yourself.

This is one of the of the smartest comments I've ever seen on this site.

 

[Path or bust]

Whoa, let's not digress here. Let's stay on the topic how the bill IN ITS CURRENT VERSION, proposed by Pelosi, that is moving through the legislative process will affect pathology as business. Business is defined as a way to earn living.

Oh come on guys, who are you trying to kid? It's all about the money for some of you. 👎

Well and while I'm not opposed to making money or others for that matter, this process is simply unsustainable in the long run. Nobody here as well as the republicans has proposed a better solution, they just shoot down what solutions are presented.

 

[yaah]

If you want to talk about "reform" and how it relates to pathology, fine. But if we are going to keep posting about basic tenets of healthcare and politics, the thread is going to be closed and someone can try again. There are other forums (Topics in healthcare, sociopolitical) where you can discuss this until you are blue in the face (or fingers).

Personally, I haven't read the bill. But I heard that the bill to increase medicare payments to MDs was separated out of the AHAA bill, mainly so that the price tag of the main bill would be under $1 trillion. There is also an asinine earmark aimed at helping out reference labs with molecular test billing (Wyden amendment, I think) at the expense of hospitals and smaller labs. CAP has been trying to knock that one down but no luck.

 

[pathstudent]

If you want to talk about "reform" and how it relates to pathology, fine. But if we are going to keep posting about basic tenets of healthcare and politics, the thread is going to be closed and someone can try again. There are other forums (Topics in healthcare, sociopolitical) where you can discuss this until you are blue in the face (or fingers).

Personally, I haven't read the bill. But I heard that the bill to increase medicare payments to MDs was separated out of the AHAA bill, mainly so that the price tag of the main bill would be under $1 trillion. There is also an asinine earmark aimed at helping out reference labs with molecular test billing (Wyden amendment, I think) at the expense of hospitals and smaller labs. CAP has been trying to knock that one down but no luck.

It will be great for academic and hospital based community pathologists. We treat a lot of people that don't have insurance and aren't going to pay a penny of their pathology bill.

But physicians in general especially ones starting out today need to come to grips with the fact that medicine will no longer be a ticket to wealth. It will go back to being a secure profession with a good living but not with the mega
salaries that private practice types were able to pull durring the nineties.

Lastly healthcare coverage is a human right if the govt legislates it.

 

[MOHS_01]

It will be great for academic and hospital based community pathologists. We treat a lot of people that don't have insurance and aren't going to pay a penny of their pathology bill.

But physicians in general especially ones starting out today need to come to grips with the fact that medicine will no longer be a ticket to wealth. It will go back to being a secure profession with a good living but not with the mega
salaries that private practice types were able to pull durring the nineties.

Lastly healthcare coverage is a human right if the govt legislates it.

Unbelievable. Wow.😱

 

[pathstudent]

Unbelievable. Wow.😱

It is true. There is no such thing As an unalienable right. They are all mam made

 

[earmuff]

Finland recently passed a law that makes broadband internet access a basic human right.


We can't handle health care. Worthless.

 

[earmuff]

http://healthcare.procon.org/

1. 62.1% of all US bankruptcies in 2007 were related to medical expenses. Approximately 78% of medical bankruptcies were filed by people who had health insurance.
2. The United States is one of the few, if not the only developed nation in the world that does not guarantee health coverage for its citizens.

 

[Euchromatin]

I have absolute sympathy for those people who cannot afford insurance...but if you say you can't afford insurance and you have a cell phone, cable or satellite TV, are smoking and have no plans to quit, eat out regularly, or have been on a vacation in the last year, then chances are you could have bought insurance for yourself.

Although I am sure some individuals deserve your lack of sympathy, I have several family members who are in the unfortunate position of making too much money to qualify for Medicaid, but there is no way they could afford their own insurance. They already can't afford to go on vacation or eat out very much, and even if they did cancel the basic cell phone and cable service they have now, they wouldn't be able to afford the rent on their apartment if they had to pay for insurance too.

Also, since there is no large group or employer plan available to them, the health care plans my relatives get to choose from are all very expensive (huge premiums, copays, and deductibles) and offer crappy coverage.

Some people seem to think that people who genuinely can't afford insurance are a myth, or that it would be easily available if they just gave up a few little luxuries. I can assure you from my personal experience that this is not the case.

 

[gbwillner]

http://healthcare.procon.org/

1. 62.1% of all US bankruptcies in 2007 were related to medical expenses. Approximately 78% of medical bankruptcies were filed by people who had health insurance.
2. The United States is one of the few, if not the only developed nation in the world that does not guarantee health coverage for its citizens.

Nice. How DARE you LIBERALS throw out such PROPAGANDA. It is obvious that we need to get rid of all the regulation that is hindering the benevolent insurance companies, who seek not to reap wealth from not truly providing any services, but give access to health care to millions who could not otherwise afford it. The markets will always regulate themselves!

And while we are at it, we need to keep the government from from TAKING OVER the internet! Once the "net neutrality" bill is passed, the government will tell us what to think with direct propaganda to our brains, passed through a series of tubes. It will be just like the Nazis!

 

[Path or bust]

Nice. How DARE you LIBERALS throw out such PROPAGANDA. It is obvious that we need to get rid of all the regulation that is hindering the benevolent insurance companies, who seek not to reap wealth from not truly providing any services, but give access to health care to millions who could not otherwise afford it. The markets will always regulate themselves!

And while we are at it, we need to keep the government from from TAKING OVER the internet! Once the "net neutrality" bill is passed, the government will tell us what to think with direct propaganda to our brains, passed through a series of tubes. It will be just like the Nazis!

my my, someone woke up on the wrong side of the bed. 😉

 

[Thrombus]

Although I am sure some individuals deserve your lack of sympathy, I have several family members who are in the unfortunate position of making too much money to qualify for Medicaid, but there is no way they could afford their own insurance. They already can't afford to go on vacation or eat out very much, and even if they did cancel the basic cell phone and cable service they have now, they wouldn't be able to afford the rent on their apartment if they had to pay for insurance too.

Also, since there is no large group or employer plan available to them, the health care plans my relatives get to choose from are all very expensive (huge premiums, copays, and deductibles) and offer crappy coverage.

Some people seem to think that people who genuinely can't afford insurance are a myth, or that it would be easily available if they just gave up a few little luxuries. I can assure you from my personal experience that this is not the case.

Do they work a 35-40 hour work week?

Seems like I have busted my tail for many 80+ hour work weeks and have sacrificed a lot more of my personal life studynig my tail off to get where I am at eating peanut butter and bologna sandwiches, sans a nice television/furniture; given up the cell phone, drive a pos car, taken on extraordinary debt, etc. etc. during my life. I would say 99% of the people in this country are perfectly capable of taking care of their own selves with STRONG WORK ETHIC....something that has been bred out of this country unfortunately.

The other <1%, we can take care of them with charity (as physicians) or with our money that we can donate and we will do so happily.

Health care in socialized countries has led to next to ZERO innovation, and almost ZERO charity (look at what the US has done in fighting disease in the 3rd world both in the gov't and from charity). You get put in a line and you must do what the gov't says to do in these nanny states that seem like paradise to some of you utopians. If you want experimental treatment you cannot get that. Here in the US, even if your insurance wont pay for it, you are free to do so.

Long live FREEDOM and DOWN WITH TYRRANY!

 

[Adrian Cocot]

'Affordable Healthcare for America Act.' AHAA. That's the worse that the socialists, otherwise known as 'liberals' can do to this industry and this country. Two hundred years from now, the event that took place on 10/29/2009 will be likened to events like Battle of Adrianople, Battle of Manzikert, and assassination of archduke Ferdinand.

---------------
YOU LIE!

Whoa, let's not digress here. Let's stay on the topic how the bill IN ITS CURRENT VERSION, proposed by Pelosi, that is moving through the legislative process will affect pathology as business. Business is defined as a way to earn living.

"I had no idea I could derail a thread with flamebait. DURRRRRR."

 

[Thrombus]

http://healthcare.procon.org/

1. 62.1% of all US bankruptcies in 2007 were related to medical expenses. Approximately 78% of medical bankruptcies were filed by people who had health insurance.
2. The United States is one of the few, if not the only developed nation in the world that does not guarantee health coverage for its citizens.

My out of pocket maximum is like 3K per year.

I would venture to guess that these folks spent indiscriminantly and paid the price when something bad happened.

Not sure about you, but this isn't the kind of financial discipline that should be rewarded by our nanny government.

 

[gbwillner]

My out of pocket maximum is like 3K per year.

I would venture to guess that these folks spent indiscriminantly and paid the price when something bad happened.

Not sure about you, but this isn't the kind of financial discipline that should be rewarded by our nanny government.

Your mistake is assuming everyone's situation is like yours. Having an out-of-pocket maximum of 3K is pretty good, and of course assumes that you are entirely covered.

Let me give you an example to show you how F'ed up the current system is. My own mother practices the most sound fiscal responsibility possible. She is also 50 years old, and has a uterine fibroid. Totally benign, right? Well, she needed to change health insurance providers. Because she has an existing medical condition- a uterine fibroid- she is not covered in ANY GYN procedure. That means all paps/pelvic exams are out of pocket. Her out-of-pocket covered maximums are similar to yours, but she pays probably 3K/Yr just on paps/GYN visits out of pocket in addition.

Now, let's say something terrible happened, and she developed endomtrial CA. No procedures are covered, meaning testing/diagnosing/treatment are all out-of-pocket. If this were to occur she would accrue debt of hundreds of thousands of dollars. Not only that, her insurance premiums are over $1K/ month. Wouldn't it be worth considering stopping insurance alltogether in her case? She pays roughly $20K in medical expenses per year to NOT get health care... if she just saved that money per year, in five years of saving she could possibly pay those ridiculous hospital bills entirely out-of-pocket.


I think the above is true for most of the aging population, but many are not aware of the true nature of the problem since they are not directly responsible for their own health care (it is provided by work). One day, their workplace will realize that health care is just too expensive and stop providing it- and then people will all realize how bad it is.

 

[earmuff]

Health care in socialized countries has led to next to ZERO innovation, and almost ZERO charity (look at what the US has done in fighting disease in the 3rd world both in the gov't and from charity). You get put in a line and you must do what the gov't says to do in these nanny states that seem like paradise to some of you utopians. If you want experimental treatment you cannot get that. Here in the US, even if your insurance wont pay for it, you are free to do so.

Long live FREEDOM and DOWN WITH TYRRANY!

Untrue. Research conducted in Europe and Australia (not to mention Asia)has contributed IMMENSELY to our current medical knowledge base.

This quote just demonstrates a basic lack of understanding of health care as it operates in other countries and perpetuates the stereotype of Americans knowing nothing about any other people. You are the typical "Ugly American". Please, never travel abroad (I don't like people knowing you exist).

We can actually learn things from others. Crazy thought, I know.

 

[Thrombus]

knowing nothing about any other people. You are the typical "Ugly American". Please, never travel abroad (I don't like people knowing you exist).

Get back to me when you have graduated the 4th grade.

America is the last bastion of freedom and you people are trying to destroy it. We have done more good in this last century than the rest of the world combined. Get over it and go back to your hole with your American-hating friends in their ivory towers.

 

[Thrombus]

Your mistake is assuming everyone's situation is like yours. Having an out-of-pocket maximum of 3K is pretty good, and of course assumes that you are entirely covered.

Let me give you an example to show you how F'ed up the current system is. My own mother practices the most sound fiscal responsibility possible. She is also 50 years old, and has a uterine fibroid. Totally benign, right? Well, she needed to change health insurance providers. Because she has an existing medical condition- a uterine fibroid- she is not covered in ANY GYN procedure. That means all paps/pelvic exams are out of pocket. Her out-of-pocket covered maximums are similar to yours, but she pays probably 3K/Yr just on paps/GYN visits out of pocket in addition.

Now, let's say something terrible happened, and she developed endomtrial CA. No procedures are covered, meaning testing/diagnosing/treatment are all out-of-pocket. If this were to occur she would accrue debt of hundreds of thousands of dollars. Not only that, her insurance premiums are over $1K/ month. Wouldn't it be worth considering stopping insurance alltogether in her case? She pays roughly $20K in medical expenses per year to NOT get health care... if she just saved that money per year, in five years of saving she could possibly pay those ridiculous hospital bills entirely out-of-pocket.


I think the above is true for most of the aging population, but many are not aware of the true nature of the problem since they are not directly responsible for their own health care (it is provided by work). One day, their workplace will realize that health care is just too expensive and stop providing it- and then people will all realize how bad it is.

Soudns like the insurance company is completely unreasonable and I would be on the phone until I am blue in the face and have gotten coverage. Denial for a uterine fibroid is absolutely lunacy.

THe real problem you seem to have missed is underlying cost. It should not cost thousands for a pap smear and yearly appointments. Legal issues and intense, overbearing regulation are responsible for this and aer NOT being addressed by the Obamaphiles and until they do doctors should BOYCOTT all health care reform if we have any spine whatsoever.

Another optino is to get catastrophic hospitalization insurance which is what my parents had when I grew up for not a whole lot of money. If it does cost too much, then as said the solution to reduce costs such as a 10$ tylenol in the hospital and the rest of the outrageousness through reduced regulation is the answer...not this Obamination of a plan.

 

[earmuff]

Get over it and go back to your hole with your American-hating friends in their ivory towers.

:troll:

 

[Path or bust]

I sense a thread closing....

 

[gbwillner]

Soudns like the insurance company is completely unreasonable and I would be on the phone until I am blue in the face and have gotten coverage. Denial for a uterine fibroid is absolutely lunacy.

THe real problem you seem to have missed is underlying cost. It should not cost thousands for a pap smear and yearly appointments. Legal issues and intense, overbearing regulation are responsible for this and aer NOT being addressed by the Obamaphiles and until they do doctors should BOYCOTT all health care reform if we have any spine whatsoever.

Another optino is to get catastrophic hospitalization insurance which is what my parents had when I grew up for not a whole lot of money. If it does cost too much, then as said the solution to reduce costs such as a 10$ tylenol in the hospital and the rest of the outrageousness through reduced regulation is the answer...not this Obamination of a plan.

Yes, the insurance company is completely unreasonable. But there is ABSOLUTELY NOTHING that can be done about it. Since my mother developed a uterine fibroid some 7 years ago and changed providers, she has since developed HTN. The HTN managment is covered. She has screamed about her treatment for the GYN coverage, but they said no. Now, if health care was any other enterprise in a free market system, as a consumer, my mother's recourse would be to find another provider that would be more reasonable. Unfortunately, health care is not any other commodity. Every single "consumer" is signing contracts under duress, in a way. If my mother would walk away for her current provider for one that may cover her GYN issues, she would risk losing coverage of her HTN, and therefore any CVS issue. That is way too big of a gamble to take, and she is pretty much locked into the current set-up, or else risk more massive expenses.

It is FOOLISH to reject a plan that will help the system because it is not perfect. If the current proposals help more than they hurt they should be accepted- work out fine-tuning later.

 

[lipomas]

'Affordable Healthcare for America Act.' AHAA. That's the worse that the socialists, otherwise known as 'liberals' can do to this industry and this country. Two hundred years from now, the event that took place on 10/29/2009 will be likened to events like Battle of Adrianople, Battle of Manzikert, and assassination of archduke Ferdinand.

Might be better if you used more hyperbole. I bet both Hitler and Stalin would have voted for this bill.

 

[dfafda]

Might be better if you used more hyperbole. I bet both Hitler and Stalin would have voted for this bill.

I'm glad you think so little of the innocent human life that was lost at their hands to even think about comparing them to people fighting for healthcare for more americans. I applaud how big of a ****** you are. For an attending you really aren't worth a **** are you... jackass

 

[earmuff]

I think he was being sarcastic...

 

[gbwillner]

I think he was being sarcastic...

Sarcasm meter is broken in many in this thread...

 

[Thrombus]

Yes, the insurance company is completely unreasonable. But there is ABSOLUTELY NOTHING that can be done about it. Since my mother developed a uterine fibroid some 7 years ago and changed providers, she has since developed HTN. The HTN managment is covered. She has screamed about her treatment for the GYN coverage, but they said no. Now, if health care was any other enterprise in a free market system, as a consumer, my mother's recourse would be to find another provider that would be more reasonable. Unfortunately, health care is not any other commodity. Every single "consumer" is signing contracts under duress, in a way. If my mother would walk away for her current provider for one that may cover her GYN issues, she would risk losing coverage of her HTN, and therefore any CVS issue. That is way too big of a gamble to take, and she is pretty much locked into the current set-up, or else risk more massive expenses.

It is FOOLISH to reject a plan that will help the system because it is not perfect. If the current proposals help more than they hurt they should be accepted- work out fine-tuning later.

I am not sure what is going on in your part of the country, but in my part of the country this stuff does not happen. No one would be denied for high blood pressure and/or a uterine fibroid at my work or anyone else's work that I know of.

That is the biggest problem with this is it FORCES a select population's plan of GOVERNMENT BUREAUCRACY, INEFFICIENCY, TAXATION, and REGULATION on others. That is completely UNAMERICAN and is why these types of decisions should be in the hands of states. It is TYRANNICAL to force everyone including providers to succumb to these mandates and rules.

You will lose many a good man and woman who will look at a career of medicine and laugh as AUTONOMY is has been RIPPED AWAY and government servitude with some bureaucrat with their social studies degree making rules over them as a HUGE DISINCENTIVE to enter this field.

You make the system more inefficient, you have longer lines and reduced access to care. You try arguing with the government over a proposed therapy or test and you might as well bang your head against the wall. At least insurers are reasonable -- in my experience.

 

[lipomas]

I'm glad you think so little of the innocent human life that was lost at their hands to even think about comparing them to people fighting for healthcare for more americans. I applaud how big of a ****** you are. For an attending you really aren't worth a **** are you... jackass

lol. Way to completely miss the point of my post. Do you watch Glen Beck or something?

 

[Pingu]

Although I am sure some individuals deserve your lack of sympathy, I have several family members who are in the unfortunate position of making too much money to qualify for Medicaid, but there is no way they could afford their own insurance. They already can't afford to go on vacation or eat out very much, and even if they did cancel the basic cell phone and cable service they have now, they wouldn't be able to afford the rent on their apartment if they had to pay for insurance too.

Also, since there is no large group or employer plan available to them, the health care plans my relatives get to choose from are all very expensive (huge premiums, copays, and deductibles) and offer crappy coverage.

For every person like your family members, there are at least one (or more) people out there who have zero concept of fiscal responsibility. And "little luxuries" can add up very quickly.

Some people seem to think that people who genuinely can't afford insurance are a myth, or that it would be easily available if they just gave up a few little luxuries. I can assure you from my personal experience that this is not the case.

Well, that's not the first time I've been referred to as 'some people'

I know that people who genuinely can't afford insurance are NOT a myth.

But I guarantee that a fairly decent percentage of the 36 million (or whatever number they've decided it is at) uninsured people out there are uninsured because they choose to spend their income on something other than insurance, not because they absolutely can't afford it. I've also known many self-employed people who made 6 to 7 figure incomes who didn't have insurance.

For every sob story there is a shiftless loser sitting on their butt watching a 50 inch flat screen HDTV.

 

[Thrombus]

Pelosi Health Care Bill Blows a Kiss to Trial Lawyers
by Capitol Confidential
The health care bill recently unveiled by Speaker Nancy Pelosi is over 1,900 pages for a reason. It is much easier to dispense goodies to favored interest groups if they are surrounded by a lot of legislative legalese. For example, check out this juicy morsel to the trial lawyers (page 1431-1433 of the bill):
Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.
So, you can’t try to seek alternatives to lawsuits if you’ve actually done something to implement alternatives to lawsuits. Brilliant! The trial lawyers must be very happy today!
While there is debate over the details, it is clear that medical malpractive lawsuits have some impact on driving health care costs higher. There are likely a number of procedures that are done simply as a defense against future possible litigation. Recall this from the Washington Post:
“Lawmakers could save as much as $54 billion over the next decade by imposing an array of new limits on medical malpractice lawsuits, congressional budget analysts said today — a substantial sum that could help cover the cost of President Obama’s overhaul of the nation’s health system. New research shows that legal reforms would not only lower malpractice insurance premiums for medical providers, but would also spur providers to save money by ordering fewer tests and procedures aimed primarily at defending their decisions in court, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, wrote in a letter to Sen. Orrin Hatch (R-Utah).”
Stay tuned. There are certainly many more terrible, horrible, no-good, very bad provisions in this massive bill.

--------------------

So states that actually have done something to limit torts will now be PENALIZED by this bill........

and the AMA is SILENT!!!!!

 

[BrainPathology]

'Affordable Healthcare for America Act.' AHAA. That's the worse that the socialists, otherwise known as 'liberals' can do to this industry and this country. Two hundred years from now, the event that took place on 10/29/2009 will be likened to events like Battle of Adrianople, Battle of Manzikert, and assassination of archduke Ferdinand.

In your opinion, how will this affect pathology as (1) business, and (2) field in next 20 years. If you are an attending, your opinion is especially valuable.

The five simple steps offered earlier would be way better than 1900 pages of new rules and debt. But to compare one bill to those three events, unless the entire world is at war in 2 months because of it, is a little wild.

The GOP had unrestricted, uncontrolled, unquestioned power for 8 years and didn't do anything about this, and the GOP quite possibly could have made the simpler things happen, maybe. Obviously they didn't. A carnival house of mirrors is the only appropriate place for anyone who is furious over this bill now and wants to blame someone.

As for pathology, most people here that seem to lean GOP swear that the specialty is already a rotting corpse without the sense to realize its already dead. I doubt this bill can do much to make it worse.

 

[yaah]

Don't make me close this thread. Redirect to pathology (or at least business of medicine) or else!

 

[poutsara]

yaah, i say close it.

 

[pathstudent]

Yaah. Please closenthis thread I can't stand these rants by these anti-academic pro-private practice capitalist pigs who care more about their bmws and McMansions than the uninsured who get bills for tens of thousands of dollars just because their baby got the flu and they has to go to the er.

 

[tncekm]

Yaah. Please closenthis thread I can't stand these rants by these anti-academic pro-private practice capitalist pigs who care more about their bmws and McMansions than the uninsured who get bills for tens of thousands of dollars just because their baby got the flu and they has to go to the er.

I care more about economic/personal freedom allowing for massively beneficial technological innovations that will benefit the entire world's population much more than I do about passing a bill, without regard for it's contents and subsequent negative affects on innovation, freedom, etc, simply because 95% of the country would be covered vs. 85% (especially considering our health care system can't actually reject treatment for anybody at the moment). / run-on-sentence

edit: PS: I still want reform that streamlines healthcare and covers more people.

 

[KluverB]

This is why we can't have nice things.

 

[Pingu]

Yaah. Please closenthis thread I can't stand these rants by these anti-academic pro-private practice capitalist pigs who care more about their bmws and McMansions than the uninsured who get bills for tens of thousands of dollars just because their baby got the flu and they has to go to the er.

I realize things are different in your happy academic world but in my anti-academic pro-private practice capitalistic pig world, the purchase of things like food, clothing, and shelter requires these greenish colored rectangular pieces of paper called money. For some unknown reason, my husband and children decline to sit naked and hungry in a cardboard box.

But I would love to hear how you pay your mechanic in the intangible joy of working with residents. Mine seems to only want cash.

 

[Ziehl-Neelsen]

Your mistake is assuming everyone's situation is like yours. Having an out-of-pocket maximum of 3K is pretty good, and of course assumes that you are entirely covered.

Let me give you an example to show you how F'ed up the current system is. My own mother practices the most sound fiscal responsibility possible. She is also 50 years old, and has a uterine fibroid. Totally benign, right? Well, she needed to change health insurance providers. Because she has an existing medical condition- a uterine fibroid- she is not covered in ANY GYN procedure. That means all paps/pelvic exams are out of pocket. Her out-of-pocket covered maximums are similar to yours, but she pays probably 3K/Yr just on paps/GYN visits out of pocket in addition.

Now, let's say something terrible happened, and she developed endomtrial CA. No procedures are covered, meaning testing/diagnosing/treatment are all out-of-pocket. If this were to occur she would accrue debt of hundreds of thousands of dollars. Not only that, her insurance premiums are over $1K/ month. Wouldn't it be worth considering stopping insurance alltogether in her case? She pays roughly $20K in medical expenses per year to NOT get health care... if she just saved that money per year, in five years of saving she could possibly pay those ridiculous hospital bills entirely out-of-pocket.


I think the above is true for most of the aging population, but many are not aware of the true nature of the problem since they are not directly responsible for their own health care (it is provided by work). One day, their workplace will realize that health care is just too expensive and stop providing it- and then people will all realize how bad it is.

I'm not trying to be crass...

Why doesn't your mom just have a total hysterectomy. I would bet that it would cost <20k, which is what you say she pays per year in gynecologic visits/procedures.

 

[pathstudent]

I realize things are different in your happy academic world but in my anti-academic pro-private practice capitalistic pig world, the purchase of things like food, clothing, and shelter requires these greenish colored rectangular pieces of paper called money. For some unknown reason, my husband and children decline to sit naked and hungry in a cardboard box.

But I would love to hear how you pay your mechanic in the intangible joy of working with residents. Mine seems to only want cash.

You will be naked living in a box if there was a public option and everyone was insured? The low end of private practice partner salaries can't be any lower than 300K. Even if that was cut in half it would still be 150K. The median household income in this country is 50K. You will be OK. Maybe spend less time being the imelda marcos of pathology get out of Neiman Marcus and buy your kids some clothes at Target.

To buy insurance for a family costs about 1000 a month, if they will even insure you. If you have a job that pays 30K a year and no insurance, if your one year-old get a high fever and you take her to the ER, you will get a bill for around 5000. If your kid gets admitted, it will be a bill for 10-15K. That is just one kid getting a fever. Now if your kid gets leukemia. Your forever ruined financially. This needs to be addressed.

The average reimbursement might drop a little the next few years for pathologists. But there will be more patients with insurance and more specimens. So it will probably average out. You will just have to work a little harder.

It is time to embrace reform. Get on the Obamatrain and support Obamacare.

And stop this absurd rant about how you are going to go from being the imelda marcos of pathology shopping in Neiman Marcus to being naked in a box because there is healthcare for all Americans.