The truth about Obamacare

  • Posted by a hidden member.
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    Jul 01, 2012 2:53 AM GMT
    Here’s what I want to know. Why are conservatives so pissed off about the Affordable Care Act? I thought they were all about personal responsibility. At least that was the whole point of the originally Republican idea of imposing an insurance mandate. I know that’s what they’re angry about because all you can hear echoing through the empty corridors of their tiny little minds is, “I don’t want to be forced to buy something by the government! It’s unconstitutional!”

    Well, actually, it IS constitutional and so says your until recently much lauded Chief Justice, John Roberts. And while we’re on that subject, if it’s so unconstitutional for government to mandate you purchase health insurance, why haven’t you filed suit against all those states that mandate auto insurance? And they’re not even offering to help you out if the cost of auto insurance is a bit too steep for your wallet.

    I want to know what is so terrible about:

    Keeping your kids on your policy until they reach the age of 26.
    Eliminating the lifetime cap on benefits.
    Stopping insurance companies from canceling your policy if you get sick.
    Lowering the cost of care and medication for Medicare recipients.
    Covering preventative care at no charge.
    Strengthening fraud protections by increasing penalties.
    Stopping insurance companies from denying coverage to children with pre-existing conditions.
    Stopping insurance companies from arbitrarily jacking up rates.
    Getting a rebate if your insurance company spent too much on ads and CEO bonuses.
    Tax credits to small businesses so they can afford quality health coverage for their employees.
    Building and improving community health centers.
    Giving working Americans a tax credit so they can afford insurance (begins in 2014).
    Also in 2014, ending discrimination against adults with pre-exiting conditions.
    Preventing insurance companies from charging higher prices to women based solely on their gender (2014).
    Creating insurance exchanges where people can shop and compare and get the most for their health insurance dollars (2014).
    We get all this with Obamacare—and I’ll be honest, I don’t think it’s enough but it’s a great place to start—AND the insurance companies have to compete. That’s another conservative argument always being put forward: competition in the marketplace and how that’s good for the country and the economy.
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    Jul 01, 2012 3:13 AM GMT
    CrankySpice said
    David4985 saidHere’s what I want to know. Why are conservatives so pissed off about the Affordable Care Act?

    Because Obama is black.
    Next?


    Hahahaha!

    I know right?

    The thing is I don't even consider Obama a liberal. He is more like a conservative democrat or a moderate Republican. He has all but bent over backwards for these ass holes trying to be diplomatic at the risk of loosing the ones who voted for him to begin with and they still think he he is a socialist communist who was not born in this country. Morons! icon_neutral.gif
  • maxferguson

    Posts: 321

    Jul 01, 2012 3:17 AM GMT
    I know there are a few posters who write off the Canadian posters who comment on news topics pertaining more to the U.S. than Canada, but here I will willingly admit that "Obamacare" is beyond me.

    Frankly, I see a population that (at least as far as I know...) champions the fact that everyone will have health insurance and can subsequently receive care.

    Just trying to see the difference between our health care system (public, single payer - no Canadian citizen is refused for non-elective care). Personally, I enjoy it. I would contract (for a fixed fee) a business process consultant to continually monitor infrastructure needs (i.e., MRI machines are only $1M, but for some reason, the wait is quite lengthy. Perhaps limited specialists?).

    Because all the health facilities are owned by the Canadian government, practitioners wishing to use them are subject to government salaries, which aren't shy of global counterparts. This is also a variable cap. I.e., the rates charged for procedures are determined by the government, but the more efficieint you are, well, there you go. That's why walk in clinic physicians make a killing.

    Where I see Obamacare differing is the single payer bit. Canadian doctors are capped by the procedure. On the other hand, private practice as far as I know, you are free to set your prices and anyone who is willing and able to pay them (either through insurance or personal funds) can receive your services.

    If health insurance is mandated, then price is of little concern to the patient. They register their insurance filings, the doctor does their thing, the office manager handles the paperwork. The insurer pays the bill, the bill is then reflected in the patients insurance premiums. In the short run, the patients minimal concern over cost (rather than care quality) creates an incentive to increase treatment prices, which are then passed along to the insurer. Since the insurer sets the patient's premium based on historical health costs and health condition, this should *in theory* drive insurnace premiums up, while the insurer makes the same profit before and after, and the doctor makes a killing. Eventually, patients/employers won't be able to afford their own premiums. I might be nuts, but my question is this: Is Obamacare a certain failure on the affordability side of things?
  • Posted by a hidden member.
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    Jul 01, 2012 3:26 AM GMT
    CrankySpice said
    David4985 saidHere’s what I want to know. Why are conservatives so pissed off about the Affordable Care Act?

    Because Obama is black.
    Next?


    When you see it, you'll trip balls!
    elephant.jpg
  • KissTheSky

    Posts: 1981

    Jul 01, 2012 5:02 AM GMT
    David4985 saidHere’s what I want to know. Why are conservatives so pissed off about the Affordable Care Act? I thought they were all about personal responsibility. At least that was the whole point of the originally Republican idea of imposing an insurance mandate. I know that’s what they’re angry about because all you can hear echoing through the empty corridors of their tiny little minds is, “I don’t want to be forced to buy something by the government! It’s unconstitutional!”

    Well, actually, it IS constitutional and so says your until recently much lauded Chief Justice, John Roberts. And while we’re on that subject, if it’s so unconstitutional for government to mandate you purchase health insurance, why haven’t you filed suit against all those states that mandate auto insurance? And they’re not even offering to help you out if the cost of auto insurance is a bit too steep for your wallet.

    I want to know what is so terrible about:

    Keeping your kids on your policy until they reach the age of 26.
    Eliminating the lifetime cap on benefits.
    Stopping insurance companies from canceling your policy if you get sick.
    Lowering the cost of care and medication for Medicare recipients.
    Covering preventative care at no charge.
    Strengthening fraud protections by increasing penalties.
    Stopping insurance companies from denying coverage to children with pre-existing conditions.
    Stopping insurance companies from arbitrarily jacking up rates.
    Getting a rebate if your insurance company spent too much on ads and CEO bonuses.
    Tax credits to small businesses so they can afford quality health coverage for their employees.
    Building and improving community health centers.
    Giving working Americans a tax credit so they can afford insurance (begins in 2014).
    Also in 2014, ending discrimination against adults with pre-exiting conditions.
    Preventing insurance companies from charging higher prices to women based solely on their gender (2014).
    Creating insurance exchanges where people can shop and compare and get the most for their health insurance dollars (2014).
    We get all this with Obamacare—and I’ll be honest, I don’t think it’s enough but it’s a great place to start—AND the insurance companies have to compete. That’s another conservative argument always being put forward: competition in the marketplace and how that’s good for the country and the economy.


    I agree with your post 100%.
    You cannot apply rational thought to Republican politicians.
    They automatically reject everything Obama proposes -- even when it was an idea they had first. "Obamacare" was basically developed by the Heritage Foundation and Romney. But now it's the "end of freedom" according to the drama queens in the GOP.
    And the main thing they're objecting to is the idea that everyone contributes to the cost of their own health care. What a RADICAL, dangerous idea!
    The good news is that the voting public is catching on to the GOP, which reflexively blocks any progress on the economy in hopes of destroying Obama -- if they have to ruin the country in the process, so be it.
    That's why Romney is continuing to sink in the polls.
  • musclmed

    Posts: 3284

    Jul 01, 2012 6:26 AM GMT
    maxferguson saidI know there are a few posters who write off the Canadian posters who comment on news topics pertaining more to the U.S. than Canada, but here I will willingly admit that "Obamacare" is beyond me.



    If health insurance is mandated, then price is of little concern to the patient. They register their insurance filings, the doctor does their thing, the office manager handles the paperwork. The insurer pays the bill, the bill is then reflected in the patients insurance premiums. In the short run, the patients minimal concern over cost (rather than care quality) creates an incentive to increase treatment prices, which are then passed along to the insurer. Since the insurer sets the patient's premium based on historical health costs and health condition, this should *in theory* drive insurnace premiums up, while the insurer makes the same profit before and after, and the doctor makes a killing. Eventually, patients/employers won't be able to afford their own premiums. I might be nuts, but my question is this: Is Obamacare a certain failure on the affordability side of things?



    To address one point of a larger problem, simply giving people coverage without addressing the physician shortage dooms this program.
    One example we can use now is Medicaid, at least in California it is nearly impossible for patients to actually get a primary care doctor who takes medicaid. The reason is the significant under-market reimbursement.

    There is no Presidential medal of honor for taking care of Medicaid patients. What is likely to happen is that you will not be able to pay your electric bill as a physician. So unless we have a clone army of doctors, adding 17-30 million patients to the "insured category " will turn finding a doctor like trying to find the right line at the DMV.


    The history of the US government and physician payment is horrible. Every year there is a mandatory 20% price reduction in medicare payments that have to be "fixed" by the congress.
    Medicare falsely looks solvent in the future by having these fake built in price reductions going forward. The assumption was that somehow things would be cheaper as time goes on.

    The OP's heart is in the right place. But the law makes so many assumptions for it to work properly it is likely to break the system we have currently and make things worse.

    Some of the ideas such as pre-existing conditions make alot of sense.
    In hindsight instead of forcing people to buy things they do not want. A national health service may have made more sense. In that case as we see in the Roberts decision. Congress has a right to levy a tax, and create a agency. It does not have a right to " mandate activity under the commerce clause" A tax to pay for a national health service would have been constitutional.

    FYI - the auto insurance analogy just doesn't pass as a legitimate argument for the mandate. You are not born driving a car. A drivers license is a privilege. If you lose your license you dont have to buy auto insurance.
  • maxferguson

    Posts: 321

    Jul 01, 2012 10:38 AM GMT
    musclmed said
    maxferguson saidI know there are a few posters who write off the Canadian posters who comment on news topics pertaining more to the U.S. than Canada, but here I will willingly admit that "Obamacare" is beyond me.



    If health insurance is mandated, then price is of little concern to the patient. They register their insurance filings, the doctor does their thing, the office manager handles the paperwork. The insurer pays the bill, the bill is then reflected in the patients insurance premiums. In the short run, the patients minimal concern over cost (rather than care quality) creates an incentive to increase treatment prices, which are then passed along to the insurer. Since the insurer sets the patient's premium based on historical health costs and health condition, this should *in theory* drive insurnace premiums up, while the insurer makes the same profit before and after, and the doctor makes a killing. Eventually, patients/employers won't be able to afford their own premiums. I might be nuts, but my question is this: Is Obamacare a certain failure on the affordability side of things?



    To address one point of a larger problem, simply giving people coverage without addressing the physician shortage dooms this program.
    One example we can use now is Medicaid, at least in California it is nearly impossible for patients to actually get a primary care doctor who takes medicaid. The reason is the significant under-market reimbursement.

    There is no Presidential medal of honor for taking care of Medicaid patients. What is likely to happen is that you will not be able to pay your electric bill as a physician. So unless we have a clone army of doctors, adding 17-30 million patients to the "insured category " will turn finding a doctor like trying to find the right line at the DMV.


    The history of the US government and physician payment is horrible. Every year there is a mandatory 20% price reduction in medicare payments that have to be "fixed" by the congress.
    Medicare falsely looks solvent in the future by having these fake built in price reductions going forward. The assumption was that somehow things would be cheaper as time goes on.

    The OP's heart is in the right place. But the law makes so many assumptions for it to work properly it is likely to break the system we have currently and make things worse.

    Some of the ideas such as pre-existing conditions make alot of sense.
    In hindsight instead of forcing people to buy things they do not want. A national health service may have made more sense. In that case as we see in the Roberts decision. Congress has a right to levy a tax, and create a agency. It does not have a right to " mandate activity under the commerce clause" A tax to pay for a national health service would have been constitutional.

    FYI - the auto insurance analogy just doesn't pass as a legitimate argument for the mandate. You are not born driving a car. A drivers license is a privilege. If you lose your license you dont have to buy auto insurance.


    Thanks! Lol, the only thing I hear on the news is literally the word "Obamacare," so any details on what people actually think of it is appreciated. Although I'm not sure where the car insurance analogy plays in. I think you're getting at what an individual carries with them as a person that mandates the purchase of health insurance vs holding a licence and requiring auto insurance with the license. The auto license is obviously an optional thing
    (a privilege), but you can take the insurance and the associated costs (financial and opportunity costs) into consideration when deciding about whether to obtain an auto license. Mandated health insurance on the other hand, there is no such choice. I could be completely off the mark on that, but is that how such an argument would typically be made?
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    Jul 01, 2012 11:36 AM GMT
    musclmed said
    To address one point of a larger problem, simply giving people coverage without addressing the physician shortage dooms this program.
    One example we can use now is Medicaid, at least in California it is nearly impossible for patients to actually get a primary care doctor who takes medicaid. The reason is the significant under-market reimbursement.

    Just because you don't know about it, doesn't mean it's not there. icon_lol.gif
    The ACA addresses multiple areas of PCP shortage, including Medicaid reimbursement and PCP training:

    http://www.healthreformgps.org/resources/primary-care-physician-workforce/

    For a quick summary:

    http://www.kaiseredu.org/Issue-Modules/Primary-Care-Shortage/Background-Brief.aspxTraining
    ACA is expected to add 15,000 new providers to the workforce by 2015.The 2009 Economic Stimulus package included $300 million for the National Health Service Corps which recruits the primary care workforce in underserved areas. An additional $230 million in award grants will go to “teaching health centers” to start primary care residency programs.

    Financial incentives
    ACA includes 10% bonuses for primary care providers under the Medicare fee schedule starting in 2011. Primary care service reimbursements will increase at the state level from Medicaid rates to Medicare rates by 2014.

    ACOs
    ACA legislation highlights the potential of Accountable Care Organizations (ACO), patient-centered, integrated services, to improve coordination in the healthcare system. ACOs include central “medical homes’ where primary care is accessed, and coordination takes place between specialists. The ACO’s patient-focused approach is thought to both curb costs and improve quality of care, with outcomes monitored by cost-effective outcomes criteria and patient assessments and financial incentives for multi-specialty providers to collaborate and coordinate patient care. [13]

    CHCs
    ACA increases the number of community health centers (CHCs), which provide continuous health care, coordination of care, and a large variety of health and welfare services. CHCs have been associated with a host of positive health outcomes and focus on primary care to underserved populations.

    Prevention
    New universal coverage of recommended preventive care will improve patient need for and access to primary care providers on a regular basis. With a number of preventive services covered without cost sharing in all insurance plans (in the “essentials benefit package”) primary care will be sought more regularly.
  • GQjock

    Posts: 11649

    Jul 01, 2012 12:20 PM GMT
    486633_428181310556066_43256319_n.jpg
  • Posted by a hidden member.
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    Jul 01, 2012 6:52 PM GMT
    maxferguson saidI know there are a few posters who write off the Canadian posters who comment on news topics pertaining more to the U.S. than Canada, but here I will willingly admit that "Obamacare" is beyond me.



    To be honest and fair I know Obamacare is not perfect and there are some things that need improvement and I believe now that it is constitutional just like with medicaid and medicare and all other programs with time we will work out the kinks but it is a hell of a lot better then what we have now (which is an EPIC FAIL) and I do not see any solutions coming from the GOP besides Romeny's plan which Obama used and they are still bitching b/c it came from Obama.

    Honestly I wish we had Canada's healthcare plan. It works. It has shown to work. It is not risky b/c we are not reinventing the wheel by doing it by being the first (so many other countries have done it and it works). You guys have it and most of Europe has it. Its only here in America where we have to suffer b/c of the the fanatical extremist right wing Fox news watching nuts here who believes any improvement to the public's life through government is somehow linked to communism or socialism. icon_rolleyes.gif

    But b/c Obama (as much as I love our Preisent and am voting for him again) wants to please these nut jobs and find some middle ground with their craziness he decided to settle on a plan that was reasonable considering the other option of doing nothing (something the GOP is great at) and that they they themselves came up with and they are still not happy b/c he was the one to implement it. icon_neutral.gif

    Obama can't win even when he does what they want him to do. Republicans are literally like stubborn bratty children who b/c it was not done by them and someone who they don't like did something they rather they ruin it for all. They are going to be the death of this country. The fall of Rome. Watch and see.icon_neutral.gif
  • jock_1

    Posts: 1492

    Jul 01, 2012 7:29 PM GMT
    southbeach1500 said
    David4985 saidRepublicans are literally like stubborn bratty children who b/c it was not done by them and someone who they don't like did something they rather they ruin it for all. They are going to be the death of this country. The fall of Rome. Watch and see.icon_neutral.gif


    Really? Did you miss the mass walkout of the Democrats this past week when the House voted on the Holder contempt issue? The adult and responsible thing to do would be to do your job - and vote "No" on it instead of theatrics and a public tantrum.

    Did you also miss the Wisconsin Democrat state Senators fleeing the state and going into hiding in Illinois when the election didn't go their way in an attempt to bring the Wisconsin legislature to a halt? Not to mention that whole recall mess up there.

    I don't recall any such actions by Republicans during those first two years of the Obama administration when Democrats had control of the House, Senate and Presidency, do you?



    +1
  • musclmed2

    Posts: 4

    Jul 01, 2012 9:08 PM GMT
    q1w2e3 said
    musclmed said
    To address one point of a larger problem, simply giving people coverage without addressing the physician shortage dooms this program.
    One example we can use now is Medicaid, at least in California it is nearly impossible for patients to actually get a primary care doctor who takes medicaid. The reason is the significant under-market reimbursement.

    Just because you don't know about it, doesn't mean it's not there. icon_lol.gif
    The ACA addresses multiple areas of PCP shortage, including Medicaid reimbursement and PCP training:

    http://www.healthreformgps.org/resources/primary-care-physician-workforce/

    For a quick summary:

    http://www.kaiseredu.org/Issue-Modules/Primary-Care-Shortage/Background-Brief.aspxTraining
    ACA is expected to add 15,000 new providers to the workforce by 2015.The 2009 Economic Stimulus package included $300 million for the National Health Service Corps which recruits the primary care workforce in underserved areas. An additional $230 million in award grants will go to “teaching health centers” to start primary care residency programs.

    Financial incentives
    ACA includes 10% bonuses for primary care providers under the Medicare fee schedule starting in 2011. Primary care service reimbursements will increase at the state level from Medicaid rates to Medicare rates by 2014.

    ACOs
    ACA legislation highlights the potential of Accountable Care Organizations (ACO), patient-centered, integrated services, to improve coordination in the healthcare system. ACOs include central “medical homes’ where primary care is accessed, and coordination takes place between specialists. The ACO’s patient-focused approach is thought to both curb costs and improve quality of care, with outcomes monitored by cost-effective outcomes criteria and patient assessments and financial incentives for multi-specialty providers to collaborate and coordinate patient care. [13]

    CHCs
    ACA increases the number of community health centers (CHCs), which provide continuous health care, coordination of care, and a large variety of health and welfare services. CHCs have been associated with a host of positive health outcomes and focus on primary care to underserved populations.

    Prevention
    New universal coverage of recommended preventive care will improve patient need for and access to primary care providers on a regular basis. With a number of preventive services covered without cost sharing in all insurance plans (in the “essentials benefit package”) primary care will be sought more regularly.


    They have tried that sort of thing for about 20 years. It really has not changed the amount of PCP's generated.

    We both know even if every new doctor became a generalist, it would not be enough.
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    Jul 01, 2012 9:48 PM GMT
    Well, they have not really tried to give PCPs a 10% bonus before. Medicaid parity with Medicare is new. Creating new primary care residencies is worthwhile regardless. And the trend in cutting specialty reimbursement has just recently started.
    Since 2009 there has been more med students who chose FP, reversing the trend from 2000-2009:
    http://www.aafp.org/online/en/home/residents/match/table1.html
    Unfortunately, after increases in IM from 2010 and 2011, this year had the same number of med students for IM:
    http://www.acponline.org/pressroom/match_day_2012.htm

    And as you said, the problem with lacking enough PCPs predates the ACA, and the measures in it attempt at least to tackle the problem.
    I'm all for PAs and NPs to take up the slack.
    What would you have done otherwise?
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    Jul 01, 2012 9:56 PM GMT
    CrankySpice said
    David4985 saidHere’s what I want to know. Why are conservatives so pissed off about the Affordable Care Act?

    Because Obama is black.
    Next?
    Best. Answer. Ever.

    And truest.
  • musclmed2

    Posts: 4

    Jul 01, 2012 10:01 PM GMT
    q1w2e3 saidWell, they have not really tried to give PCPs a 10% bonus before. Medicaid parity with Medicare is new. Creating new primary care residencies is worthwhile regardless. And the trend in cutting specialty reimbursement has just recently started.
    Since 2009 there has been more med students who chose FP, reversing the trend from 2000-2009:
    http://www.aafp.org/online/en/home/residents/match/table1.html
    Unfortunately, after increases in IM from 2010 and 2011, this year had the same number of med students for IM:
    http://www.acponline.org/pressroom/match_day_2012.htm

    And as you said, the problem with lacking enough PCPs predates the ACA, and the measures in it attempt at least to tackle the problem.
    I'm all for PAs and NPs to take up the slack.
    What would you have done otherwise?


    Well in retrospect. A national health service at least would give a medstudent job/financial security and be cost saving . Say if you promised 10 years you had your medical school for free.

    Or a compromise, forgive stafford loans of Md's completing IM/FP residencies

    10% is a start. We both know however that rising costs for overhead because of ACA may approach that. Because it always takes your own time or a paid experts time to wade through what is required to be reimbursed correctly.

    How about address the inequities in Medicare?
    We both know of the medicare inequities against the non specialty docs.
    Example Surgeons can get more for placement of the same dialysis catheter.

  • Posted by a hidden member.
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    Jul 01, 2012 10:04 PM GMT
    Well, compromise is compromise. A national health service would be labeled socialism, I'm sure. icon_lol.gif
    And if you look at Medicare reimbursement for the last few years (I do since RPA routinely publishes them on their newsletter), the specialties have been where the majority of cuts have been, while nephrology reimbursement has not really been majorly cut.
  • maxferguson

    Posts: 321

    Jul 02, 2012 5:47 AM GMT
    David4985 said
    maxferguson saidI know there are a few posters who write off the Canadian posters who comment on news topics pertaining more to the U.S. than Canada, but here I will willingly admit that "Obamacare" is beyond me.



    To be honest and fair I know Obamacare is not perfect and there are some things that need improvement and I believe now that it is constitutional just like with medicaid and medicare and all other programs with time we will work out the kinks but it is a hell of a lot better then what we have now (which is an EPIC FAIL) and I do not see any solutions coming from the GOP besides Romeny's plan which Obama used and they are still bitching b/c it came from Obama.

    Honestly I wish we had Canada's healthcare plan. It works. It has shown to work. It is not risky b/c we are not reinventing the wheel by doing it by being the first (so many other countries have done it and it works). You guys have it and most of Europe has it. Its only here in America where we have to suffer b/c of the the fanatical extremist right wing Fox news watching nuts here who believes any improvement to the public's life through government is somehow linked to communism or socialism. icon_rolleyes.gif

    But b/c Obama (as much as I love our Preisent and am voting for him again) wants to please these nut jobs and find some middle ground with their craziness he decided to settle on a plan that was reasonable considering the other option of doing nothing (something the GOP is great at) and that they they themselves came up with and they are still not happy b/c he was the one to implement it. icon_neutral.gif

    Obama can't win even when he does what they want him to do. Republicans are literally like stubborn bratty children who b/c it was not done by them and someone who they don't like did something they rather they ruin it for all. They are going to be the death of this country. The fall of Rome. Watch and see.icon_neutral.gif


    Lol, I like Obama because he is setting precedents as each potential precedent poses as an opportunity. As a quick example (and without the intent of opening this category), being the first to openly agree and say that gays ought to have equal marriage rights (well, some might say that Ron Paul said "well why not?" ... but followed with "leave it to the states").

    Given that, I have to confess, I think Bill Maher nailed it when he said "I'd be a Republican if Republicans were still Republican!"

    As for Canadian Healthcare, there aren't any major debates about how best to support it financially; most people agree that a public health system has met their needs. That said, my own family (myself included) has sought private care in the U.S. on multiple occasions. Not out of distrust, but out of the availability of the newest care and compassionate grounds. Having being diagnosed as terminally ill, my Mom, whose prognosis was under 60 days, would not be first in line to exhaust any options on the table in front of her. This is understandable as a terminal patient (who will obviously receive palliative care and treatment) should not use the resources which could be used by someone with a better chance at survival. This is the difference between a single payer and patient payer system; the patient drives the care in a patient payer system, and collective need for resources and best use drives it in a single payer (gov't payer).

    After being diagnosed, my Mom had to digest what she had just learned. Being only 50 and a very (very, very) strong woman, she could not leave her family knowing there were some (few, but not zero) options on the table. Exhausting those options required that the patient be able to decide when they could not continue (with the obvious exception of medical and ethical limits and our own family decisions). Having been several times to the Mayo Clinic in Rochester for my dad's kindeys, we were very comfortable and familiar with the care process there and we decided to pursue major surgery at the Rochester clinic despite having to foot the bill privately. The surgery was successful and extended her prognosis enough to open up a tool box of additional treatment options, including different chemotherapies, gamma-ray knife radiation, new and un-marketed drugs (Dichloroacetate specifically, which had not been used on a large scale to treat deep, inner body cancers, but showed good promise for the research stage the drug was at), and dietary consultation for cancer patients.

    In Canada, at least at public clinics, you go in, the doctor decides what's best or presents you with options of similar effectiveness for you to choose given your comfort level.

    In the end, she far outlived her prognosis of 60 days, living for 7 months. Having the full pallet of options available also let her do this in personal comfort; those 7 months were not all miserable, but an extra 7 months to spend with her family and to teach us what she needed to teach us.

    Summary: for routine care, surgical procedures, emergencies, child and adolescent care, and general public health concerns, the Canadian system has performed just fined (IMO). But for situations like cancers with very poor prognoses, rare diseases and things that don't fit the ordinary, private care lets the patient and their family take the wheel with the advice of medical professionals who will guide you through the complete set of options given the newest resources (which aren't being constrained by the equal right for all to have access to -- this is a great thing, but not for situations that have unique challenges and risks). Ron Paul described American care (as it was in his time of practice) accurately when he said "You don't have the right to someone else's services, and they don't have the obligation to provide them." In Canada, because those services are technically government services, you do have the right to them and those practitioners have the obligation to provide them. Since healthy persons' right to those services should be placed above an equally healthy individual with the same, and likely unknown, chance of needing them, the health facilities, professionals, moneys, beds, everything has to be made equally accessible, and this doesn't particularly cater to cases with unique risks and challenges; how does one rank them objectively enough to maximize patient welfare and use of resources?

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    Jul 02, 2012 12:38 PM GMT
    southbeach1500 said
    David4985 saidRepublicans are literally like stubborn bratty children who b/c it was not done by them and someone who they don't like did something they rather they ruin it for all. They are going to be the death of this country. The fall of Rome. Watch and see.icon_neutral.gif


    Really? Did you miss the mass walkout of the Democrats this past week when the House voted on the Holder contempt issue? The adult and responsible thing to do would be to do your job - and vote "No" on it instead of theatrics and a public tantrum.

    Did you also miss the Wisconsin Democrat state Senators fleeing the state and going into hiding in Illinois when the election didn't go their way in an attempt to bring the Wisconsin legislature to a halt? Not to mention that whole recall mess up there.

    I don't recall any such actions by Republicans during those first two years of the Obama administration when Democrats had control of the House, Senate and Presidency, do you?



    The GOP made the contempt of Holder vote a show - no contempt vote has been done with such haste and little thought.

    Boehner has the authority under Reed's Rules (Jan 1890) to lock members of the House in the chamber to force a vote. He wanted the drama of a walkout as much as the dems.

    Republicans walked out of the House on August 3, 2007

    Walk outs on the state level go back to 1839 when the Whigs walked out of the IL House.

    There is nothing wrong with a recall; it is how some states have drawn up their constitutions.
  • Posted by a hidden member.
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    Jul 02, 2012 2:45 PM GMT
    TMW2012-07-04colorKOS.png
  • Posted by a hidden member.
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    Jul 02, 2012 3:09 PM GMT
    Here, for you Maxferguson, right here in Canada.
    http://www.medicorcancer.com/aboutUS.html

    Medicor Cancer Centres’ is the first clinic in the world to use dicholoroacetate (DCA) as an “off-label” cancer treatment, and the first to use the ChemoFit assay to predict a patient’s response to DCA alone or combined with chemotherapy. We have also treated many patients with ammonium tetrathiomolybdate (TM), low dose naltrexone (LDN) and noscapine. We are constantly adding newer promising treatments (such a photodynamic therapy and immunotherapy) so that our patients can have access to options that are not readily available elsewhere. "


    Personally I like the current system, as out here in BC we've found the public system means private systems have competitive pricing to compete for patients.

    An example: in the US knee replacement can often cost up to $35,000.
    Here in BC? Up to $18,000 in a private clinic.
    If you use the public system the cost to the medical services plan is $8,000, as they're not trying to make profit on top of paying for skills and equipment, facilities etc.

    What I also enjoy about the public system is that they don't want to see you back again; they want you cured, and also push preventative medicine. We found a few of the private clinics would LOVE to see you back again, and all that that entails.
    I'm very much enjoying and admiring the balance in your posts, and careful consideration of the merits of both systems.

    Thanks!

    -Doug
  • maxferguson

    Posts: 321

    Jul 02, 2012 10:57 PM GMT
    You're welcome!

    My Mom actually had "great" (I'll call it great) success with dichloracetate. We did the surgery at Mayo, but we went to a different private clinic in Toronto called "Immune Recovery Clinic." If you know someone who is running through that table of options and running out, pass the name a long.

    It's very comprehensive care; dietary consultation, radiation, surgery, clinical trials, and chemo. It's not alternative care, but rather a small group of doctors who research and employ very, very calculated care. For instance, they used a low-grade chemo on my Mom. Most doctors would have raised an eyebrow at that. This group of doctors found eachother because of the way they think; they wouldn't have raised that eyebrow, but asked more and more open ended questions. The low-grade chemo is accompanied with insulin injections as the insulin causes the cancer cells to "open up" (I'm not sure in what way, perhaps cell membranes diffuse larger molecules? I'm no biologist :S) and the chemo can act on the cancer with greater concentration, and dramatically reduce the unpleasant side effects. I believe there is a clinic in Atlanta too

    http://www.immunerecovery.com/
  • GQjock

    Posts: 11649

    Jul 02, 2012 11:05 PM GMT
    Why The Affordable Healthcare Act won't be repealed

    Because Bozo's like this one HAVEN'T GOT A F**KIN CLUE
  • maxferguson

    Posts: 321

    Jul 02, 2012 11:45 PM GMT
    I should also clarify a position on something before it's falsely assumed:

    Think of society like dodge ball for a moment; we all walk into the gym and we haven't picked teams yet. There we are, just human beings, ungrouped and unorganized, and undifferentiated (again...for example). To play the game of life (dodge ball), we start picking teams. Say there's 5 people on each team. One team get's labelled government, a team for each business, each household, each school and each group in society. But the game gets complicated; people play on more than one team and don't necessarily stick on one team for a known amount of time. Rather than being divided into two, the gym is divided into as many slices as there are groups. But if people can change teams at any moment, play for more than one team,

    Sometimes, as I hope we've all experienced at some point in life, dodge ball can get a little heated and competitive. Some people keep throwing the balls, playing and ejoying the game, while others hold their balls (yup, I meant that ;) ) and start pointing, yelling and standing at the middle of the gym where all the pieces meet. Those people soon find that they all have at least one team in common, except government; only a few are on that team. Even then, each person standing at the crossection of each slice realizes that the set of teams they play for is entirely unique to them -- they group their teams into one category called ME. Government is just a team of people, each playing for their own team. This doesn't mean that teams of more than one person aren't effective teams; teams could have common enemies and all be going for the same opponents, your family members probably have a very similar set of teams as you (I'd say the best families have the exact same set of teams, excepting that each member has their own human self as their private team).

    In the end, government is the single biggest team playing. Not a qualified majority (50% + 1 of the game), but there is no one team that is larger -- a simple majority. Eventually, it's big enough that it becomes an easy target and some of the players get hit and are out for a while. How big does it have to be so that if every individual player in the game breaks roughly the same number of rules, that government is the one making the game hardest to play (and not for the private sector, just for society in its entirety)? How big does it have to be before the consequences of half of Team Government getting tagged out are that the Government players who are out realize they are still in the game of life on other teams and keep playing anyway? Perhaps even against the government?

    The best question of all is, who the hell is refereeing this game? Government? Wait... it's playing too. It's the player who is supposed to catch the stray balls and pass them to all the other players. But eventually, there are no stray balls and people aren't sure whether to play or to roll the balls back to others.

    Using that analogy, I'd say Canadian healthcare rolls the balls back as best as it can. Sometimes there aren't enough balls, but it's not unfair (for the better part). Private care is like someone who says "Do you want to make a new team until we knock this illness out or we decide it's not worthwhile to play against it?" I don't see how Obamacare can, in various capacities (and ignoring the economic faculties of it for now), roll the balls back without people getting mixed up about who is on what team. Lol too much?