The Supreme Court decision on ObamaCare

[TheArtist]

Optometry practice defined by Oklahoma statute:

http://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=439178

Interestingly, this is the definition of the practice of allopathic medicine:
[Emphasis added].
http://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=95745

My only "dispute", if you want to call it that, is an optometrist (or chiropractor) calling themselves "doctor" can be misleading to the everyday consumer/patient. These professionals are trained no question, but in my opinion are not a professional equal to an MD, DO, Dentist (except in Thailand). To flip Artist's point, an optometrist who would attempt to draw that comparison would be, in his words, elevating themselves by tearing down the skills of the others.

Basically, if an optometrist is not allowed to be called a physician, they can't bill medicare and medicaid or any other health insurance for any of their services, forcing patients to go to an opthamologist for something like say, glaucoma management and treatment (where they would mostly then work with a technician who is not required to have ANY formal training, not the surgeon).  They won't likely do the little "eye puff" thing anymore, or look for other signs of illnesses and refer the person to a specialist like an Opthamologist, because they cant bill insurance for doing those tests.  

There are real world consequences for not allowing them to be called doctors or physicians beyond what you might think.

Say you had a condition that caused you to have dry eyes or eye allergies that was not treatable by over the counter medications, or over the counter medications werent working for you and you needed a prescription medication for it.  The optometrist diagnoses the condition,(btw, optometrists have more training than Dentists) but since he is no longer allowed to be called a doctor (physician) he or she can't prescribe the medication.  So what your saying is that if some rural person has a dry eye condition that needs presciption medication for that, they have to drive perhaps hundreds of miles to see a SURGEON who (probably interned under an optometrist to learn about eyes) and who apparently has nothing better to do with his "high surgical" skills than pluck eyelashes and prescribe dry eye medication?  

[RecycleMichael]

I can't believe this thread turned into a conversation about eye surgery.

I didn't see that coming.

[guido911]

The optometrist diagnoses the condition,(btw, optometrists have more training than Dentists) but since he is no longer allowed to be called a doctor (physician) he or she can't prescribe the medication.   

Wow, you sure about that?

Optometrist:

Education

Optometrists need a Doctor of Optometry (O.D.) degree. In 2011, there were 20 accredited Doctor of Optometry programs in the United States, one of which was in Puerto Rico. Applicants to O.D. programs must have completed at least 3 years of postsecondary education, including coursework in biology, chemistry, physics, English, and mathematics. In practice, most students get a bachelor's degree before enrolling in a Doctor of Optometry program. Applicants must also take the Optometry Admission Test (OAT) to apply to O.D. programs.

Doctor of Optometry programs take 4 years to complete. They combine classroom learning and supervised clinical experience. Coursework includes anatomy, physiology, biochemistry, optics and visual science, and the diagnosis and treatment of diseases and disorders of the visual system. After finishing the O.D., some optometrists do a 1-year residency program to get advanced clinical training in a specialty. Specialty areas for residency programs include family practice, primary eye care, pediatric or geriatric optometry, vision therapy and rehabilitation, cornea and contact lenses, refractive and ocular surgery, low vision rehabilitation, ocular disease, and community health optometry.

http://www.bls.gov/ooh/Healthcare/Optometrists.htm#tab-4

Dentistry

e U.S. Bureau of Labor Statistics reports that more than 85% of dental students obtain a bachelor's degree prior to entering dental school (www.bls.gov). While no specific undergraduate degree is required, students commonly take science courses in biology, anatomy, chemistry and microbiology.
Dental School

Aspiring dentists enroll in a dental school accredited by the American Dental Association. Dental colleges offer either a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD). Prospective students must submit Dental Admission Test (DAT) scores with their application.

DDS degree programs cover four years of in-class, pre-clinical and clinical instruction. The first two years are devoted to lab and class instruction. Courses may include oral pathology, dental diagnosis and dental treatment techniques. In the last two years, students typically complete a dental rotation externship, which is usually conducted in dental clinics and allow students to treat patients under supervision.

In addition to general dentistry, dental schools typically offer specialized areas of study, such as oral and maxillofacial surgery, orthodontics or pediatric dentistry.These postgraduate programs generally take an additional 2-6 years to complete, depending on the chose specialty, and may include a residency.

http://education-portal.com/dentist_education_requirements.html

I do know dentists can write hardcore pain meds and administer anesthesia. Not sure if optometrists can. As for me, I have always gone to the ophthalmologist for eye issues, mainly because I am too lazy to schedule my own appointments and I follow instructions from SWMBO.

[guido911]

I can't believe this thread turned into a conversation about eye surgery.

I didn't see that coming.

[AquaMan]

I am trying to show that taxing us for not buying something isn't new.  They just take it from a different pocket.

I see what you're saying. The tax code is often used to encourage or discourage behaviors that are deemed to benefit the country or private interests.

[Cats Cats Cats]

I see what you're saying. The tax code is often used to encourage or discourage behaviors that are deemed to benefit the country or private interests.

They could have increased taxes by $2,100 per family and then given a deduction up to $2,100 per family and nobody would have blinked.  But just have a tax of up to $2,100 based on not doing something and everybody flips because it has never been done before.  since they didn't raise and then give a credit to offset the raised taxes.  Anyway, if this bill doesn't work as indented I hope they repeal it.  If it does work (as intended) then I'm for it.  There are unforeseen consequences to almost all bills passed.

[Teatownclown]

Are these taxes annual or monthly?

I recall when tax rates were over %50 but you could deduct interest paid on investments against income from those investments which served to encourage development in all types of business.

The GOP is the definition of "give em enough rope and they will hang themselves. Newt did it in the 90's, Bush in the 2000's.

I see the militia guy behind "fast and furious" is calling for armed revolution over health care.  Stay away from federal buildings.

[Teatownclown]

Why would you say something like that? I get it. You are a dick.

Admin: do something about RM's slander. Wait....never mind. That's like asking the GOP to police their own.

You DO NOT get it....

[Red Arrow]

That's got nothing to do with it. I'm not comparing rack rate that nobody who has insurance pays, but the actual price paid by the insurer to the doctor, hospital, and the rest, on average.
We pay more for basically everything. Hospital stays are the worst, which is why we send people home sooner than almost any other developed country (and many developing nations). This pushes the cost of nursing onto family members, who may well not be able to afford the loss of income from taking leave from work to nurse their sick relative. Few insurance plans pay (much) for home health aides these days.
It might be tolerable if we got measurably better outcomes for our extra healthcare dollars, but we don't. We pay more and get nothing.

The "list" (rack?) price is relevant to the thread.  High prices which can be negotiated down by insurance companies make it nearly impossible for the non-insured to pay for health care.  Therefore, you have to have health care insurance.  Nice racket for the insurance companies.  Get the medical community to jack up prices to the point where insurance is necessary for all but the wealthiest among us.  

More specifically to your point though is what expenses are we imposing on the medical community that other countries in that report do not.  The perennial favorite is malpractice insurance.  Staffing requirements now are much more than when I was a kid.  Back then, our family doctor had his office in part of his home.  He had one nurse on staff and I believe his wife was the accountant.  When I go to the doctor now at St. John Medical Center, there are at least 3 office personnel, a physician's assistant, and a couple of nurses.  There are several patient areas.  I am getting good care but I don't know that it's any better than when I was a kid.   Do our high costs help subsidize the rest of the world?  Does the price of a MRI Scanner in the US keep the price of the same machine lower in another country?  Is the wealthy USA is paying a higher tax price so the middle class countries rest of the world don't have to?  It's only fair that the (formerly?) wealthiest nation in the world should pay its fair share.

[Teatownclown]

Admin: do something about RM's slander. Wait....never mind. That's like asking the GOP to police their own.

You DO NOT get it....

What do they call somebody who runs from the violence they bestow on others (in this case erasing their hateful posts)?

Chicken smile!

[RecycleMichael]

I was wrong to use such language and deleted my slander.

This forum should not be besmirched by my contempt for you. I do think it is irresponsible for you to say such ridiculous and clearly stupid things. I have no clue as to what happened in your life to make you think and write such things, but trying to make people afraid to go to federal buildings because you think there will be a bombing is really low. I believe such an attack would make you happy.

If that makes you feel that I am a chicken smile, fine. But remember, I post my thoughts here with people having clear knowledge of who I am. You hide behind a fake name with no reponsibility. Look in the mirror, chicken smile.

[guido911]

What do they call somebody who runs from the violence they bestow on others (in this case erasing their hateful posts)?

Chicken smile!

Funny, that's what I call little punk wastes of sperm who send these sorts of things via pm (NSFW):

http://www.philzone.org/discus/messages/36579/759342.jpg

[nathanm]

The "list" (rack?) price is relevant to the thread.  High prices which can be negotiated down by insurance companies make it nearly impossible for the non-insured to pay for health care.  Therefore, you have to have health care insurance.  Nice racket for the insurance companies.  Get the medical community to jack up prices to the point where insurance is necessary for all but the wealthiest among us.  

If this is true, why is it that doctors who don't accept insurance also charge exorbitant (by global standards) amounts? Because they can, I guess.

More specifically to your point though is what expenses are we imposing on the medical community that other countries in that report do not.  The perennial favorite is malpractice insurance.  Staffing requirements now are much more than when I was a kid.  Back then, our family doctor had his office in part of his home.  He had one nurse on staff and I believe his wife was the accountant.  When I go to the doctor now at St. John Medical Center, there are at least 3 office personnel, a physician's assistant, and a couple of nurses.  

Based on the days back when I had some doctors as clients, I'd say a large part of the issue is that they have to employ half as many billing specialists as medical personnel. I once did some work for an eye clinic with 3 doctors and around 10 medical staff, plus a couple of receptionists, and an accountant. And another 5 people to deal with making the insurance companies pay up. It's definitely a good racket for the insurers. Med mal has less to do with it than you'd think. The cost simply pales in comparison, IME. Maybe guido can ask his wife how the numbers work out for her. They may be different in different practice areas. My dentist manages to get by with himself, a dental assistant, a hygenist, and his wife. I gather dental insurance isn't as bad as some others at frivolously denying claims and withholding payments for inordinately long periods of time.

There are several patient areas.  I am getting good care but I don't know that it's any better than when I was a kid.   Do our high costs help subsidize the rest of the world?  Does the price of a MRI Scanner in the US keep the price of the same machine lower in another country?  Is the wealthy USA is paying a higher tax price so the middle class countries rest of the world don't have to?  It's only fair that the (formerly?) wealthiest nation in the world should pay its fair share.

I seriously doubt GE is selling MRI machines to other countries at below cost.

[Conan71]

You just mentioned the fallacy - how costs could come down adding 10 million to the care pool... They are already IN the care pool.  Hospitals are required to treat, so, instead of going to a doctor in what most of us would consider the 'normal' way - make an appointment for yearly checkup - they go to the ER.  Your costs today, including the insured part includes 30% or so extra to cover those expenses.  If those 10 million get into the pool, costs may still actually go up, but it won't be because of that 30% contribution today.  (It will be price gouging, fixing, and collusion....)

We have a classic example of how this SHOULD work (but, granted, may not) in EMSA.  What does it cost to take an ambulance ride?  And what does it cost to take an ambulance ride if you subscribe to the Totalcare plan for EMSA rides?  EXACTLY the same principle.  (And anyone who lives in the coverage area and does not subscribe is an idiot.)  Now, will reality be hijacked?  We will just have to wait and see.

Not everyone realizes they can simply show up at Tulsa Regional with a raging case of the herps at 2am.  There are millions who don't go because they think they are on the hook for hundreds, if not thousands in medical bills awaiting them if they do. 

Let 10 million people think Obama is personally going to pay the tab for having someone else to put a Band Aid on that boo boo on their elbow and you will see how fast the outlays add up.  If you think people who were irresponsible about their health before this pile passed will use insurance judiciously, there's a spillway up on highway 88 I'd love to sell you.

[Teatownclown]

I was wrong to use such language and deleted my slander.

This forum should not be besmirched by my contempt for you. I do think it is irresponsible for you to say such ridiculous and clearly stupid things. I have no clue as to what happened in your life to make you think and write such things, but trying to make people afraid to go to federal buildings because you think there will be a bombing is really low. I believe such an attack would make you happy.

If that makes you feel that I am a chicken smile, fine. But remember, I post my thoughts here with people having clear knowledge of who I am. You hide behind a fake name with no reponsibility. Look in the mirror, chicken smile.

Bull....the federal building comment was a sarcastic commentary in retaliation for all the years of righties laying blame for such threats at the feet of liberals. You MP are the type of chicken smile that allows righties to run all over the progressives in this country. You are a loserman who fails to see how satire works. It was pure and simple gonzo journalism.   You are basically the type who fakes critical thinking with cuteness. I guess you can't always have it your way. Do you control this forum? You evidently think you do....