If the best value and quality of medical care is obtained with FREEDOM! in the marketplace, why is it that every nation with universal health care has much lower per capita spending on health care than we do? No, it's not that these countries all have lower costs of living. Some have higher.

For all the yelling about the individual mandate, I'm predicting that the most important long-term impact of Obamacare will be the creation of these ACO's. If they function even remotely as intended they will save us a staggering sum of money and result in better care for many, many Americans. And I'd be willing to bet that your average voter (not just the derpfest at the extreme edges) doesn't have the foggiest idea what an ACO is (or will be), why its necessary, or how they'll work. People who want to shout and scream about repealing Obamacare because they disagree with one of it's many provisions are not just throwing the baby out with the bathwater, they're throwing out the washtub, the soap, the hose and the house the hose is attached to.

I'm in favor of ACO's; however, it will only work if politicians don't start meddling in the best-care recommendation process. Remember the hullbaloo when CMS wanted to change the recommended age for annual mammograms from 40 to 50? MASS PANIC!

Now multiply that by 100 million screaming old people.

Wow....even the headline is tl;dr.

So ACO's are the death panels, right?

Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Suppose President Obama declared he would tackle rising food prices by forcing everyone to eat at government-supervised restaurant chains. Small restaurants would be nudged to merge with national ones. Bureaucrats would monitor menu items and prices. Restaurants would record orders in a central database to ensure meals adhered to federal nutrition guidelines.

Health Care does not work that way.

PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

I am convinced the republican party will not be happy until they give a filibuster proof senate to the democrats.

I have nothing against the goal, but has the government ever succeeded at improving efficiency?

PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Things like cancer that happen to only a few before Medicare age cost a hell of a lot more than the sore throats that happen to everyone.

Oh, there's right-wing outrage? First I've heard of it. I must not have received my daily talking points, yet.

Rest assured I will display the correct amount of righteous indignation when Fark tells me to.

gerrychampoux: I have nothing against the goal, but has the government ever succeeded at improving efficiency?

There are no guidelines for how these are supposed to work. I've talked to senators and house reps who don't have the slightest idea and CMS has yet to offer specific guidelines......because they have no clue how to take an academic concept and implement it nationally. ACO type models work in a few very highly managed markets where one prividor contraols all the hospitals and employs the docs, but that is a fraction of the market.

Only a full federal takeover (which the majority of farkers on this board would support) this cannot work.

xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

I plan to go out in a blaze of glory when I get to that age with serious health issues.
/has his zombie apocalypse gear ready in case it comes early

Real Women Drink Akvavit: So, it's like the poor, old person's version of a HMO, right? I belong to a HMO and they haven't killed or bankrupted me yet.

Yet.

Far more controlling than an HMO (in theory as no real plan has been advanced) and most people chafe under the unresponsiveness of HMOs.

rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

But how much can you really afford for certain situations? Is it worth spending $25,000 per day for your last week to live on life support, barely cognizant of the world around you? That could have been enough money to send your child to college and a down payment on their home. That much for a week in which you can't even communicate with them.

We should care for the elderly, but we should also be realistic about it. At some point you are going to die.

Molavian: Better than 10% of the population being responsible for 50% of the murders.

Let's not ever address that, though.

Now if those 10% can find those 5%...
/i keed...
//don't taze me bro

rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

Dunno. I had an uncle die a few months ago where the doctors spent probably a quarter of a million dollars or so doing procedure after procedure and keeping him hospitalized for weeks after he had any observable signs of consciousness. They put the family through hell with the hope that each new thing might produce some positive change, and the only thing that was accomplished was putting the family members through weeks of horror. Toward the end he had tubes coming out of his body all over the place, they were pumping so many fluids into him that his body was almost squirting water from every pore, etc. My father was driving back and forth from NY to FL multiple times because each time it looked like it was time to pull the plug the doctors would come up with something new they wanted to try for week. My dad was under so much stress that he started forgetting things, getting weak, and I was afraid that he might not outlive his brother.

The only good thing was that my uncle never regained consciousness so he never knew what his doctors put his family through.

IamKaiserSoze!!!: Far more controlling than an HMO (in theory as no real plan has been advanced) and most people chafe under the unresponsiveness of HMOs.

People may not like having restrictions placed on them, but they also don't like their insurance costs going up by double digits every year. Something has to change, and I don't think this is a bad way to go. We do need to do something to reduce overutilization of healthcare services, and better manage chronic diseases which account for a huge portion of costs.

Molavian: Better than 10% of the population being responsible for 50% of the murders.

Let's not ever address that, though.

What exactly do you propose that we can do more to stop it?

I heard the GOP is trying to pass a bill that says the elderly who die from poor healthcare will be called "permanent nappers" instead of victims. After all, how can we know if they're asleep if we can't get a doctor to look at them? Everyone knows old people nap a lot. It's just a common sense solution.

Helios1182: rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

But how much can you really afford for certain situations? Is it worth spending $25,000 per day for your last week to live on life support, barely cognizant of the world around you? That could have been enough money to send your child to college and a down payment on their home. That much for a week in which you can't even communicate with them.

We should care for the elderly, but we should also be realistic about it. At some point you are going to die.

This is where the Repubs really got this wrong. As much as hospitals try to provide social workers/chaplains/etc to assist family with end of life decisions they are still hamstrung by doctors who may want to keep treating a patient, or can't deliver the tough message to the family or the family member who arrives at the last minute and fights making the correct decisions.

A federal mandate on how this process should work would be exceptionally helpful.

Helios1182: rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

But how much can you really afford for certain situations? Is it worth spending $25,000 per day for your last week to live on life support, barely cognizant of the world around you? That could have been enough money to send your child to college and a down payment on their home. That much for a week in which you can't even communicate with them.

We should care for the elderly, but we should also be realistic about it. At some point you are going to die.


By your cold, hard logic they should have pulled the plug on my sister when she was in a medically induced coma during chemo. They thought she had no chance of surviving it, but she did. She did die months later, but not from the pneumonia that they put in her a coma for. Months in the life of a 24 year old who got to spend with her friends and family.

So why don't you get off your computer, step outside, find the tallest tree in your neighborhood, and shove that puppy right up your ass, pal.

You know tho, we DID have a provision for this sort of thing but it got taken out. Called "end of life counseling." But you know, Death Panels, lolololoSaraPalin111.

rhondajeremy: xhorder: PsyLord: Wait, 5% of Medicaid recipients are responsible for 50% of Medicaid costs?!?!

Sounds about right...Gotta spend half a million dollars to keep grandma alive for a few more days, right?!!!!!

Cannot WAIT until you are old and your family is waiting in line to pull the plug.

//makes me sick how the eldery are de-valued in this society; can only hope Karma will kick some serious ass when those people get old

If keeping me alive for a week will cost hundreds of thousands of dollars, I'll gladly pull the plug myself. Just because you CAN keep someone alive doesn't mean you SHOULD.

Molavian: lockers: Molavian: Better than 10% of the population being responsible for 50% of the murders.

Let's not ever address that, though.

What exactly do you propose that we can do more to stop it?

Revolution. Break the government, and change how politicians do business. Republican, Democrat, it really doesn't matter. It's us vs. them, and we need to stop letting them make it us vs. us.

Your solution to stop murder is to kill more people? I guess that is one way to do it.

You know who esle liked to coordinate services?


/

Excuse me Cap'n, I think the right wing (or fiscally responsible) outrage is related to the fact that we have trillions of dollars in unfunded health care costs.

Trillions.

Glad Obamacare fixes that. Whoops. I guess Obama was SO busy focusing on jobs he didn't fix healthcare for us. Whoops.

why are they going after the kinds of people that otherwise would vote for them? talk about spiting your own constituents.

Public or Private insurance doesn't matter, thanks to the drug companies we're all screwed.

/How much does the cost of your pill actually cover the R&D costs and how much goes to CEOs, lobbying, and advertising?

Snarcoleptic_Hoosier: Part me out like an old Camaro.

I've asked for this as well to troll the poor mortician who gets me.

Mortician cutting me open looking for spare parts: "Nope, can't use that, umm the lungs look like charcoal, the liver is melting, what the FARK is that!?"

I'm trying to get it so they'll video tape it and send to my loved ones.

rinasaunce: Excuse me Cap'n, I think the right wing (or fiscally responsible) outrage is related to the fact that we have trillions of dollars in unfunded health care costs.

No, I think the right wing outrage is related to the public finding their policies repugnant.

wozzeck: They put the family through hell with the hope that each new thing might produce some positive change, and the only thing that was accomplished was putting the family members through weeks of horror.

Oh, they accomplished something else. They made a shiatload of money. And they can all sleep at night because they buy in to the idea they were trying to save his life even though they likely knew themselves there was little or no chance of that happening, and even if it did his quality of life would largely suck.