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 Why emergency rooms don't close the health care gap 
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Post Re: Why emergency rooms don't close the health care gap
regularjoe12 wrote:
TheRealWags wrote:
I now need to ask assistance from other forum members here. Can anyone, please point out where I have been partisan in any manner? I do strive to stay middle of the road. I do want to keep an open mind and if I have someone misrepresented that, I would like to know so that I may work on rectifying it.

Thanks,
Wags


Im guessing here...but i think that perception has a bit to do with stereotyping. You got a lil hippy in ya....that can lead people to think your a lil more left leaning than you actually are.

IMO you do a better job of finding out all sides of a story before making judgments....thats a good thing....and very hippy like! hat36.gif laughing7.gif



RJ - when you advocate for an insurance company to accept $10k a year, and knowingly have to payout $1,000,000 a year, and blame a lack of "business model evolution" or ingenuity as the culprit of the impossibility of any business surviving under that climate, you're not "open-minded" or "searching for all sides of a story." You're flat out blind.


May 14th, 2012, 4:14 pm
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
TheRealWags wrote:
wjb21ndtown wrote:
How about you borrow the "crystal ball" of the thousands of experts that have read the bill? Or, better yet, how about you look at what is actually in the legislation and read the public option part. Employers are going to choose to pay the penalty because it is cheaper, that's going to force people onto the public option, creating a single payer system. I'm sorry if you can't see it, but that's what is going to happen, period.
Care to point me in the direction of one or two of those experts? Thx

wjb21ndtown wrote:
Again, no discussion of issues, problems, or solutions out of you, just more of the same.
Feeling is mutual; its seems as though we are at an impasse.

Peace to you and yours.



I love how we're at an impasse when you've NEVER ONCE offered a solution, discussed a problem, or brought up any issue. ALL you have done is say that the Rep idea is bad, and Obama Care is good. Nice "free thinking" you have going on there.
Actually, I've listed several of my opinions, that you immediately dismissed.
Also, from page 1 of this thread, in case you might have forgotten:
TheRealWags wrote:
Do I know what exactly needs to be done? No.
Do I claim to know more about how to resolve this issue than anyone else? Again, no.
Are there parts of the PPACA that I like? Yes.
Are there parts I don't? Again, yes.
Never once did I even attempt to say I knew the answer, you on the other hand....

Thx, I'll read those over.

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May 14th, 2012, 4:18 pm
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Post Re: Why emergency rooms don't close the health care gap
Something that may have been passed over during the discussion, but I don't recall discussing this (though it possible it may have gotten lost in the mix):
Quote:
Perhaps we should be asking why is it 'a million dollar' disease to begin with? Why does it cost so much? Why not work on bringing said cost down? Make it more affordable for both the insurer and the insured
For the record, yes, we know that the PPACA does NOT bring down the cost of health care. (Yet another thing I dislike about it)

So again, let me ask, what could be done to actually reduce the cost of health CARE?

Options I have heard discussed here and elsewhere:
    Sell insurance across state lines
    Transparent pricing for services
    Tort reform
Is there more? Certainly there has to be, right?

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May 14th, 2012, 4:31 pm
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Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
Actually, I've listed several of my opinions, that you immediately dismissed.
Also, from page 1 of this thread, in case you might have forgotten:
TheRealWags wrote:
Do I know what exactly needs to be done? No.
Do I claim to know more about how to resolve this issue than anyone else? Again, no.
Are there parts of the PPACA that I like? Yes.
Are there parts I don't? Again, yes.
Never once did I even attempt to say I knew the answer, you on the other hand....


Ok, to be fair, I guess you did list very generic ideas like "people shouldn't have to file bankruptcy over a health problem" and "preventative care is cheaper than fixing a disease later."

What parts of the PPACA do you like? And more importantly, do you really think they outweigh to disastrous consequences, trillions of dollars the "new" system will cost, and the sacrifice we will all have to make via waiting in lines and people DYING doing so? Personally, I don't.


May 14th, 2012, 4:41 pm
Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
Something that may have been passed over during the discussion, but I don't recall discussing this (though it possible it may have gotten lost in the mix):
Quote:
Perhaps we should be asking why is it 'a million dollar' disease to begin with? Why does it cost so much? Why not work on bringing said cost down? Make it more affordable for both the insurer and the insured
For the record, yes, we know that the PPACA does NOT bring down the cost of health care. (Yet another thing I dislike about it)

So again, let me ask, what could be done to actually reduce the cost of health CARE?

Options I have heard discussed here and elsewhere:
    Sell insurance across state lines
    Transparent pricing for services
    Tort reform
Is there more? Certainly there has to be, right?


Covering everyone at some modicum level WILL reduce costs. It will take pressure off of our emergency system (where people DO receive massive amounts of unnecessary, EXTREMELY expensive care), it will ensure that people going to small clinics and other places that cover their care get paid (instead of passing on the costs to everyone else), and it will insure more healthy people adequately spreading the burden of the sick throughout the system (which is NECESSARY in any true form of insurance).

All of these things should be done, and done incrementally in a manner that reduces costs (another HUGE cost right now is the bureaucracy that is the industry and inefficiencies that need to be eliminated). The current "whole-sale" garbage can method that is being attempted right now is grossly wrong and does more to exasperate the problem than to correct it.


May 14th, 2012, 4:45 pm
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Post Re: Why emergency rooms don't close the health care gap
Quote:
"preventative care is cheaper than fixing a disease later."


broad generalization that is not always true. you have to look at the number of people you need to screen and how much that will cost. for example you could have a great screening test for a very rare cancer but you d have to test millions of people to find one case of the disease and factor in the cost of the unnecessary screening.


May 15th, 2012, 9:39 pm
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Post Re: Why emergency rooms don't close the health care gap
The Legend wrote:
Quote:
"preventative care is cheaper than fixing a disease later."


broad generalization that is not always true. you have to look at the number of people you need to screen and how much that will cost. for example you could have a great screening test for a very rare cancer but you d have to test millions of people to find one case of the disease and factor in the cost of the unnecessary screening.



Good point Legend. I do, however, think that if we had a preventative care system in place it would reduce net costs. Like I said, it would greatly reduce the stress on hospitals and emergency rooms. You are right though, the sheer numbers have to be factored when you're talking about "saving money."


May 16th, 2012, 5:08 pm
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
What parts of the PPACA do you like?

Parts I like or at least sound good on the surface(many listed from ):
    Removal pre-existing conditions as a reason to deny coverage: If 'affordable' health insurance was not tied w/employment, then I don't know that we would need to maintain this. (Though I can see where it may need to be maintained during an 'implementation' phase to ensure the opportunity to obtain 'new' coverage.)

    Preventative medicine practices

    No lifetime dollar limits

    Insurers are prohibited from dropping policyholders when they get sick

    Transparency aspects: Time will tell how transparent & accurate this turns out to be, but transparency in general is good IMO

    Insurers are required to implement an appeals process for coverage determination and claims on all new plans: So, there wasn't any appeal process before? Or perhaps this makes it consistent throughout all plans / insurers.

    Employers must disclose the value of the benefits they provide

    Expand Medicaid eligibility - all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children

    Establish health insurance exchanges, and subsidization of insurance premiums for individuals in households with income up to 400% of the poverty line. (Section 1401(36B) of PPACA explains that the subsidy will be provided as an advanceable, refundable tax credit[95] and gives a formula for its calculation.[96] Refundable tax credit is a way to provide government benefit to people even with no tax liability[97] (example: Earned Income Credit))

    Members of Congress and their staff will only be offered health care plans through the exchange or plans otherwise established by the bill (instead of the Federal Employees Health Benefits Program that they currently use)

    A state may apply to the Secretary of Health & Human Services for a "waiver for state innovation" provided that the state passes legislation implementing an alternative health care plan meeting certain criteria.

    Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, and vending machines

Parts I don't like:
    Mandate

    Flexible spending accounts, Health reimbursement accounts and health savings accounts cannot be used to pay for over-the-counter drugs, purchased without a prescription, except insulin

    Does not reduce health care costs

    Does not appear to be deficit neutral, as was 'promised'

    The entire way it was 'debated' behind closed doors. Anything that affects Americans this much should be discussed & debated in a public forum.

wjb21ndtown wrote:
And more importantly, do you really think they outweigh to disastrous consequences, trillions of dollars the "new" system will cost
If the PPACA is implemented in its current form, only time will tell what the consequences are, disastrous or not.
wjb21ndtown wrote:
and the sacrifice we will all have to make via waiting in lines and people DYING doing so? Personally, I don't.
Don't people wait in line currently? And don't some of those die while waiting? This sounds an awful lot like hyperbole.

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May 18th, 2012, 11:40 am
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Post Re: Why emergency rooms don't close the health care gap
Now, with all that being said, for those who are in favor of repealing the PPACA, how do you suggest we do that? Do you think it would be as simple as just overturning the law and reversing every provision it has already implemented? I don't think it would be that easy. As much as I might not want to admit it, I think Rep Bachman was correct in that it would be a long, drawn out process even trying to repeal it. If, as Romney has stated, he were to sign an Executive Order on Day 1 of his Presidency repealing PPACA / ObamaCare, what then? What about all the young adults under 26 that are on their parents plans? Do they all just get kicked off and have no insurance? And what of those that have pre-exisiting conditions? With that provision removed and them no longer on their parents plans, how do they obtain insurance?

(I realize some of this may sound like hyperbole, however it is not my intention for it to be that way, I am trying to 'brain storm' if you will, what might happen in the above scenario and how might we resolve the aforementioned potential issues)

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May 18th, 2012, 11:47 am
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
Covering everyone at some modicum level WILL reduce costs. It will take pressure off of our emergency system (where people DO receive massive amounts of unnecessary, EXTREMELY expensive care), it will ensure that people going to small clinics and other places that cover their care get paid (instead of passing on the costs to everyone else), and it will insure more healthy people adequately spreading the burden of the sick throughout the system (which is NECESSARY in any true form of insurance).

All of these things should be done, and done incrementally in a manner that reduces costs (another HUGE cost right now is the bureaucracy that is the industry and inefficiencies that need to be eliminated). The current "whole-sale" garbage can method that is being attempted right now is grossly wrong and does more to exasperate the problem than to correct it.

After a couple days away, I think I might have a better understanding or idea of what your proposed plan might look like.

    Very basic coverage available to the public:
      Preventative medicine
      Annual check-ups / physical and associated tests (blood work)
      Common outpatient services (ex: broken arm, stitches, flu, etc)

    Make available tiered private plans which would cover all other ailments, procedures, diseases with varying degrees of our of pocket expenses

Is this correct or at least closer to what you're suggesting?

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May 18th, 2012, 12:25 pm
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Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
wjb21ndtown wrote:
Covering everyone at some modicum level WILL reduce costs. It will take pressure off of our emergency system (where people DO receive massive amounts of unnecessary, EXTREMELY expensive care), it will ensure that people going to small clinics and other places that cover their care get paid (instead of passing on the costs to everyone else), and it will insure more healthy people adequately spreading the burden of the sick throughout the system (which is NECESSARY in any true form of insurance).

All of these things should be done, and done incrementally in a manner that reduces costs (another HUGE cost right now is the bureaucracy that is the industry and inefficiencies that need to be eliminated). The current "whole-sale" garbage can method that is being attempted right now is grossly wrong and does more to exasperate the problem than to correct it.

After a couple days away, I think I might have a better understanding or idea of what your proposed plan might look like.

    Very basic coverage available to the public:
      Preventative medicine
      Annual check-ups / physical and associated tests (blood work)
      Common outpatient services (ex: broken arm, stitches, flu, etc)

    Make available tiered private plans which would cover all other ailments, procedures, diseases with varying degrees of our of pocket expenses

Is this correct or at least closer to what you're suggesting?



Definitely. I think we need to at least immediately get people covered under plans that take care of basic needs. The majority of the problems of covering everyone come by way of super expensive diseases that take years and lengthy hospital visits to cure. Those diseases literally cost millions of dollars to treat/cure and cripple the insurance/medical industry. However, I think even these basic plans should be written through the private sector and funded at some percentage (100% for impoverished people) by tax credits.

That said, i do think hospitals should be more creative with administering care. I find it ridiculous that it's near impossible to walk out of a hospital for under $2k ish. I also find it ridiculous that it costs so much to over-night at a hospital, and I think stays are over-requested. I think there's a lot of "padding" going on by hospitals with their billing. Would it really cost that much to have a private nurse go to someone's house to administer chemo for one night? Sure, there CAN be complications, but they are generally minimal, they could be over-seen by a doctor (phone call, what do I do?), and I'm sure a general manual could be written that would cover 90% of the possible issues that could come up. Things like that drive me nuts.

But yea, I would like that general basic coverage for everyone, and I would like a tiered system of coverages over and beyond that. It allows an immediate expansion of HC, and allows for the industry to grow organically (once doctors and clinics realize that they will actually get paid for the visits of the lower cost stuff, private clinics will pop up all over the place), and incrementally (we could slowly and much more predictably add or delete coverages).


May 18th, 2012, 1:08 pm
Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
Now, with all that being said, for those who are in favor of repealing the PPACA, how do you suggest we do that? Do you think it would be as simple as just overturning the law and reversing every provision it has already implemented? I don't think it would be that easy. As much as I might not want to admit it, I think Rep Bachman was correct in that it would be a long, drawn out process even trying to repeal it. If, as Romney has stated, he were to sign an Executive Order on Day 1 of his Presidency repealing PPACA / ObamaCare, what then? What about all the young adults under 26 that are on their parents plans? Do they all just get kicked off and have no insurance? And what of those that have pre-exisiting conditions? With that provision removed and them no longer on their parents plans, how do they obtain insurance?

(I realize some of this may sound like hyperbole, however it is not my intention for it to be that way, I am trying to 'brain storm' if you will, what might happen in the above scenario and how might we resolve the aforementioned potential issues)


Hopefully the Sup. Court rules that the mandate is unconstitutional. If that happens the entire bill will likely be ruled null and void, and repealing it won't be necessary.


May 18th, 2012, 1:29 pm
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Post Re: Why emergency rooms don't close the health care gap
I just noticed that I haven't responded to this...I apologize its been crazy busy lately (which is a good thing)
wjb21ndtown wrote:
TheRealWags wrote:
wjb21ndtown wrote:
Covering everyone at some modicum level WILL reduce costs. It will take pressure off of our emergency system (where people DO receive massive amounts of unnecessary, EXTREMELY expensive care), it will ensure that people going to small clinics and other places that cover their care get paid (instead of passing on the costs to everyone else), and it will insure more healthy people adequately spreading the burden of the sick throughout the system (which is NECESSARY in any true form of insurance).

All of these things should be done, and done incrementally in a manner that reduces costs (another HUGE cost right now is the bureaucracy that is the industry and inefficiencies that need to be eliminated). The current "whole-sale" garbage can method that is being attempted right now is grossly wrong and does more to exasperate the problem than to correct it.
After a couple days away, I think I might have a better understanding or idea of what your proposed plan might look like.

    Very basic coverage available to the public:
      Preventative medicine
      Annual check-ups / physical and associated tests (blood work)
      Common outpatient services (ex: broken arm, stitches, flu, etc)

    Make available tiered private plans which would cover all other ailments, procedures, diseases with varying degrees of our of pocket expenses

Is this correct or at least closer to what you're suggesting?
Definitely. I think we need to at least immediately get people covered under plans that take care of basic needs. The majority of the problems of covering everyone come by way of super expensive diseases that take years and lengthy hospital visits to cure. Those diseases literally cost millions of dollars to treat/cure and cripple the insurance/medical industry. However, I think even these basic plans should be written through the private sector and funded at some percentage (100% for impoverished people) by tax credits.

But yea, I would like that general basic coverage for everyone, and I would like a tiered system of coverages over and beyond that. It allows an immediate expansion of HC, and allows for the industry to grow organically (once doctors and clinics realize that they will actually get paid for the visits of the lower cost stuff, private clinics will pop up all over the place), and incrementally (we could slowly and much more predictably add or delete coverages).
Obviously the specifics would need to be ironed out, but me thinks I could support a plan like this, now if only one of the Pres candidates supported something like this....
One thing I would add would be to state clearly that in the event of a chemical and/or biological agent 'situation' (attack, spill, etc) then the US Govt should be responsible for making any and all antidotes available to the each and every American. However, if these antidotes were to be made public (over the counter) then we should be responsible for ourselves. (Disclaimer: I have no idea if something like this is already in place or how it would be handled in our current environment)

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May 30th, 2012, 2:00 pm
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
TheRealWags wrote:
Now, with all that being said, for those who are in favor of repealing the PPACA, how do you suggest we do that? Do you think it would be as simple as just overturning the law and reversing every provision it has already implemented? I don't think it would be that easy. As much as I might not want to admit it, I think Rep Bachman was correct in that it would be a long, drawn out process even trying to repeal it. If, as Romney has stated, he were to sign an Executive Order on Day 1 of his Presidency repealing PPACA / ObamaCare, what then? What about all the young adults under 26 that are on their parents plans? Do they all just get kicked off and have no insurance? And what of those that have pre-exisiting conditions? With that provision removed and them no longer on their parents plans, how do they obtain insurance?

(I realize some of this may sound like hyperbole, however it is not my intention for it to be that way, I am trying to 'brain storm' if you will, what might happen in the above scenario and how might we resolve the aforementioned potential issues)
Hopefully the Sup. Court rules that the mandate is unconstitutional. If that happens the entire bill will likely be ruled null and void, and repealing it won't be necessary.
From what I've heard, this could actually be two separate things in that the SCOTUS could rule the mandate unconstitutional, but that doesn't necessarily mean the entire bill / law would be struck down. It could get very messy....for example: If the PPACA were to be struck down, then what? I ask again, What about all the young adults under 26 that are on their parents plans? Are they somehow 'grandfathered' in? Are they kicked off their current plans? And what of those with pre-exisiting conditions? With that provision removed, how do they obtain insurance?

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May 30th, 2012, 2:09 pm
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Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
wjb21ndtown wrote:
TheRealWags wrote:
Now, with all that being said, for those who are in favor of repealing the PPACA, how do you suggest we do that? Do you think it would be as simple as just overturning the law and reversing every provision it has already implemented? I don't think it would be that easy. As much as I might not want to admit it, I think Rep Bachman was correct in that it would be a long, drawn out process even trying to repeal it. If, as Romney has stated, he were to sign an Executive Order on Day 1 of his Presidency repealing PPACA / ObamaCare, what then? What about all the young adults under 26 that are on their parents plans? Do they all just get kicked off and have no insurance? And what of those that have pre-exisiting conditions? With that provision removed and them no longer on their parents plans, how do they obtain insurance?

(I realize some of this may sound like hyperbole, however it is not my intention for it to be that way, I am trying to 'brain storm' if you will, what might happen in the above scenario and how might we resolve the aforementioned potential issues)
Hopefully the Sup. Court rules that the mandate is unconstitutional. If that happens the entire bill will likely be ruled null and void, and repealing it won't be necessary.
From what I've heard, this could actually be two separate things in that the SCOTUS could rule the mandate unconstitutional, but that doesn't necessarily mean the entire bill / law would be struck down. It could get very messy....for example: If the PPACA were to be struck down, then what? I ask again, What about all the young adults under 26 that are on their parents plans? Are they somehow 'grandfathered' in? Are they kicked off their current plans? And what of those with pre-exisiting conditions? With that provision removed, how do they obtain insurance?


Wags, I could get into a bunch of legal jargon, but I've studied Con Law at two schools now (WSU and UofD). Basically, the SCOTUS could strike down a portion of the law, or the whole law. The deciding factor being whether or not the unconstitutional portion "was so integral to the stated purpose of the bill as to unravel the whole thing." There is a three part test, and blah blah blah, but that's the jist of it. IMO, if the "mandate" is struck down the entire bill is likely dead.


May 30th, 2012, 2:19 pm
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