Neil Boortz - republicans blowing it on Obamacare

[Conan71]

Oh, don't get your balls in an uproar. I was thinking in terms of the lad desire for giving care and later on regretting his decision to go for the money.

How old was your vet when she retired?

No uproar here, there's always time to go back.  I know two engineers who both turned in their slide rule in their 30's go to to med school.

My vet.  Cute.  She was 51 or 52 when she left Omni.  Last I heard she's doing "industrial medicine a few days a week" which I believe is doing employment physicals.   

"Turn your head and cough."

[Gaspar]

Why do you guys hate medicare and refuse to offer up any amendments to redirect it's scope to include everyone or even just those who can't get insurance?

1. It's essentially bankrupt. Paying out far more than it takes in.

2. It pays physicians 20% less than the typical cost of their services, so they shift that cost to the rest of us.

3. It only covers a portion of necessary services. Most smart patients also choose to add a supplement.

4. It requires a medicare coding system with tens of thousands of codes for each procedure/treatment/exam/medication that requires a full time staff for physicians and clinics to manage.

5. Any error in coding results in delayed payment, audits, and challenges, the majority of which are settled but only after significant administrative expense.

6. It only offers a strict formulary of treatments and medications and is slow to adopt new treatments (having worked in a hospital, I know that Medicare patients are given a lower priority because they are not candidates for the most advanced treatments or procedures unless they have a supplemental plan).

7. . .and finally, medicine, pharma, therapy, and biochemistry, and biotechnology are driven, like any other industry, by profit.  

Remove the profit, or regulate it heavily, and you remove the incentive.  If it costs you $780 million dollars to produce your new cancer drug, but you know that it can't go to market because it's only 15% more effective than chemotherapy and the government will only pay for chemotherapy, why bother?  Most medical breakthroughs are not Earth shattering, they are baby steps.  One drug leads to another drug that may only work 10% better or may work 100% in only 5% of the affected patients.  Insurance companies have to compete for accounts and contracts.  At least that offers some competition.  It used to be they had to compete for individual families.  If your insurance company pissed you off because they wouldn't pay for your BP medicine, you said "good bye" and went to another carrier willing to compete for your business.

What you are proposing is not going FORWARD, it's going AWAY!

[Teatownclown]

1. It's essentially bankrupt. Paying out far more than it takes in.

2. It pays physicians 20% less than the typical cost of their services, so they shift that cost to the rest of us.

3. It only covers a portion of necessary services. Most smart patients also choose to add a supplement.

4. It requires a medicare coding system with tens of thousands of codes for each procedure/treatment/exam/medication that requires a full time staff for physicians and clinics to manage.

5. Any error in coding results in delayed payment, audits, and challenges, the majority of which are settled but only after significant administrative expense.

6. It only offers a strict formulary of treatments and medications and is slow to adopt new treatments (having worked in a hospital, I know that Medicare patients are given a lower priority because they are not candidates for the most advanced treatments or procedures unless they have a supplemental plan).

7. . .and finally, medicine, pharma, therapy, and biochemistry, and biotechnology are driven, like any other industry, by profit.  

Remove the profit, or regulate it heavily, and you remove the incentive.  If it costs you $780 million dollars to produce your new cancer drug, but you know that it can't go to market because it's only 15% more effective than chemotherapy and the government will only pay for chemotherapy, why bother?  Most medical breakthroughs are not Earth shattering, they are baby steps.  One drug leads to another drug that may only work 10% better or may work 100% in only 5% of the affected patients.  Insurance companies have to compete for accounts and contracts.  At least that offers some competition.  It used to be they had to compete for individual families.  If your insurance company pissed you off because they wouldn't pay for your BP medicine, you said "good bye" and went to another carrier willing to compete for your business.

What you are proposing is not going FORWARD, it's going AWAY!

Great example of lazy right wing thinking. More a whine than an idea about what to do. I want to remind you we are far from first in health care compared to the rest the world.

How about means testing?...how about setting new standards for qualification as well as establishing new actuarial tables for care. There's much room for flexibility, re-balancing, and calibration to Medicare. If only there wasn't obstinacy at every turn.... The only thing going away is gouging the middle class.

[Conan71]

Great example of lazy right wing thinking. More a whine than an idea about what to do. I want to remind you we are far from first in health care compared to the rest the world.

How about means testing?...how about setting new standards for qualification as well as establishing new actuarial tables for care. There's much room for flexibility, re-balancing, and calibration to Medicare. If only there wasn't obstinacy at every turn.... The only thing going away is gouging the middle class.

It's lazier to simply say: "Let's put everyone on Medicare!"

First, we do have one of the the best if not the best healthcare system in the world.  The problem is, not enough people take a pro-active approach to their health nor do they prioritize it.  People who sit around eating poison-laden crap, drinking a 12 pack a night, and smoking a carton of cigs a week either are or will be a drag on the system and will add to the "poor outcomes" tally every time because they wait until their body is so broken there's little you can do other than pump it full of one drug after another.

When I worked for a company too small to afford health benefits and even when I had my own business, I felt it was a priority to have health insurance for my family.  I paid out of pocket and did without new cars, big screen TV's, and eating out seven nights a week.  I really have no pity for people who are making very good income but cannot "afford" health insurance.  It's simply a bigger priority to them to drive a new Mustang GT, live in a newer home, and have a large balance on their Best Buy card.  Sure there are people who do need publicly-funded health insurance, but do understand there's a decent percentage of young Americans who simply don't buy health insurance because they have materialistic priorities greater than health insurance.

It's no secret that obesity stats run inverse to longevity stats.  Pick any country with a "better" health care system than the U.S. and I guarantee you will find their obesity rates are far lower, their diets are far healthier, and people don't smoke and drink as heavily as we do here in America.

Let's say we do go single payer, there will still be two tiers of healthcare in this country: those who can afford to pay cash for their care and those who will get the care with a government-mandated discount.  Guess who is still going to get preferential treatment? It's not going to be the person on Medicare.

Just because the government dictates procedures should cost a certain amount doesn't mean they can be done profitably.  Yes, I understand that medicine should ascribe to the higher calling of helping our fellow man, however, it can't run at a break-even or a loss.

One thing I believe really drove up the cost of care in the last 20 years or so is all the specialty hospitals.  Our health care system has become so far flung and there are so many facilities to maintain and operate, I suspect that alone could account for as much as 25 to 30% of the rise in costs in the last two decades.  Doctors are becoming partners in these hospitals as another profit base.  I don't fault them for this, but it's something the government could have taken a long look at and attempted to regulate before it got out of hand.  Take a look at how many specialty hospitals we had in 1992 in the Tulsa Metro and how many we have today, it's pretty amazing the growth we've seen.  Great for the construction industries and it's no doubt created new support staff, PT, and nursing jobs but it's definitely added to the costs.

Hospice and home healthcare have also exploded in that time, all feeding off the teat of Medicare and Medicaid.  What's sad is watching a nursing home, a hospital, a hospice, and a home healthcare company all fighting over the same patient in the days immediately preceding their death so they can get their government-funded billing.  Medicare and Medicaid are just as much to blame as the providers for the explosion in HC expenditures simply because they have allowed such an expansion of hospice and home healthcare.  Sure there's a need for both services but the bar is set so low for eligibility, there are people who end up on hospice long before it's really needed, and who stay on home health care long after it's no longer needed.  

Single payer isn't the panacea you think it is.  All parties need to come to the table instead of a bunch of legislators who understand no more about healthcare than their lobbyists tell them to think trying to overtake the entire system.

As a country, we also need to take a much more proactive approach to our health instead of a reactive one.