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(Reuters)   As "Obamacare" marks its third anniversary, it's becoming increasingly clear who the real winners are under this law: healthcare lobbyists, of course   (reuters.com) divider line 299
    More: Obvious, obamacare, Amy Klobuchar, National Coalition Party, America's Health Insurance Plans, National Federation of Independent Business, Medtronic, lobbying, medical device  
•       •       •

1418 clicks; posted to Politics » on 25 Mar 2013 at 11:30 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-03-25 11:48:52 AM

Jackson Herring: HawaiiE: I've given up arguing about Obamacare. Three years of reading fark threads & Facebook posts have taught me that conservatives have no idea what the ACA does, and don't want to learn.

It's very odd behavior to me, if anyone has ever had a success story I'd love to hear it.

government

takeover


of


healthcare


best part


forever
 
2013-03-25 11:49:09 AM

Jackson Herring: ahh ok I get the joke now, you are literally sarah palin


Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.
 
2013-03-25 11:49:09 AM

kiwimoogle84: Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


Oh shiat, the death panels!!  OoooOOOoooOO~~~!!!!
 
2013-03-25 11:49:22 AM

The Stealth Hippopotamus: In other news: People who are good at playing the game will continue to be good at the game no matter what rule changes you make.

Obamacare or ACA was an unfunny joke played on the American people; can't afford healthcare? No worries we'll just fine you (dont worry you can cover that right?) and give you medicare. 'cause we all know medicare is great and is the model of efficiency. And then ACA will make things more affordable by increasing costs!! Cause that's how economies works!


That's not how anything works.  Go spout your insanity elsewhere.
 
2013-03-25 11:49:26 AM

Masta Kronix: Yeah another Obamacare thread!

Did a paper on The Patient Protection and Affordable Care Act in College.

Here ya go for people who actually want to educate themselves!! Coming in 3 parts because it's looooonnnngggggg.


May the Bird of Paradise fly up your nose, AW.
 
2013-03-25 11:49:53 AM

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Ah, and a BSABSVR into the mix. Awesome.
 
2013-03-25 11:50:02 AM

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


Well right now that call is made by a group of middle managers on a "recission Committee" who hope to get a promotion by showing the company how much money they've saved it by coming up with loopholes to deny claims and care to subscribers that the company would otherwise be legally obligated to pay for.

You might think that having the government do the same thing isn;t much of an improvement, but consider this: at least you get some say in who is running your government, unless you have the money to become its majority shareholder, you can't say the same thing about your insurance company.
 
2013-03-25 11:50:30 AM

FlashHarry: "thrid?"


www.thrid.com
 
2013-03-25 11:51:28 AM

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


both sides are bad, therefore death panels exist
 
2013-03-25 11:51:49 AM

A Dark Evil Omen: kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.

DEATH PANELS!!!


ZOMGZ!!!! Socializms gonna kills da Stephen Hawkings!!!!!
 
2013-03-25 11:51:58 AM
Part 2 of 3


Currently in Effect


Pre-Existing Conditions Insurance Plans (PCIP)



Before the passage of PPACA insurance companies were able to deny an individual health insurance based on whether or not a pre-existing condition was a factor. What this means is that if a condition requiring medical attention is discovered before an individual purchases health insurance, insurance companies can then deny that individual health insurance due to already requiring medical care, i.e. having a pre-existing condition. The premise behind this is that it would be too costly to provide insurance for those who already require medical care. Individuals should purchase medical insurance before they require medical attention adding funds into the insurance pool before they take from it. This practice had a very serious consequence, it meant millions of Americans being unable to purchase health insurance and causing countless more to file for bankruptcy due to medical bills. In 2011 more than 60% of all bankruptcy filed were for outstanding medical bills according to The American Journal of Medicine (AJM).

               
Section 1101 of The Patient Protection and Care Act is aimed at providing what is called a "High-Risk Pool" health insurance program to individual with pre-existing conditions so that they are able to purchase health insurance. In order for an individual to be eligible to take part in this new "High-Risk Pool" they must have an established pre-existing condition and are not currently covered by any health insurance plans. This "High-Risk Pool" will be in effect until January 1, 2014 at which point health insurance companies will no longer be able to deny insurance coverage to those with pre-existing conditions and the rates charged as well as the type of coverage cannot be determined by whether or not a pre-existing condition is a factor. This is done in 2014 so that the initial shock of pre-existing condition patients being covered under private insurance companies will be softened. Individuals with pre-existing conditions will have already started their treatments or possibly completed their treatments under the High-Risk Pool program thereby absorbing the initial costs of treating them.


Patient-Centered Outcomes Research Institute (PCORI)


                Section 1181 (b) establishes the non-profit, independent health research organization The Patient-Centered Outcomes Research Institute (PCORI). Their goal will be to assist patients and physicians obtain the most up to date and efficient treatments available as well as conduct research to determine which treatments are the most cost effective. PCORI follows a "comparative clinical effectiveness" research protocol that compares for preventing disease and providing treatment and care. They aim to accomplish this by focusing on 4 goals:


Identifying national priorities for research

Creating research agenda based on identified priorities

Funding research consistent with these priorities and agendas.

Providing Patients and their caregivers with useful research information.


The first two goals will be the main focus of the final section for PCORI as it gives a brief but general understanding of how PCORI plans on achieving their stated goals.


Identifying National Priorities for Research


PCORI has created 5 national priorities that focus on providing patients and health care givers with as much information as possible.


1. Assessment of Prevention, Diagnosis, and Treatment Options

ØDetermine which option(s) work most efficiently for distinct populations with specific health issues.

2. Improving the Health Care System

ØDetermine and establish effective and realistic programs that can help improve health care services.

3. Communication and Dissemination

ØDetermine the most effective way to provide reliable and accurate information to the patient.

4. Addressing Disparities

ØEnsure programs and methods of treatment are considered for all manner of patient populations. Certain treatments are not as effective on certain populations and needs to be taken into account.

5. Accelerating Patient-Centered and Methodological Research

ØDesign and create a way for patients and caregivers to be part of the research project in a quick, safe and efficient manner.


Creating research agenda based on identified priorities

PCORI has established their research agenda will not designate any specific disease or treatment criteria at first but reserves theright to do so in the future. Their first wave of research is aimed at improving any and all aspects of the Health Care System and their available treatments. There 5 focuses of research focus on the national priorities and can be described as follows:


1. Assessment of Treatment, Diagnosis and Treatment Options

ØClinical options with emphasis on patient-preference and decision-making.

ØBiological, clinical, social, economical, and geographic factors that may affect patient outcomes.

2. Improving the Health Care System

  ØUse of non-physician health-care providers, such as nurse and physician assistants, and the impact on patient   outcomes.

ØSystem-level changes that impact all populations, diseases, and health conditions.

3. Communication and Dissemination

ØStrategies to improve patient and clinical knowledge about prevention, diagnosis, and treatment options.

ØMethods increase patient participation in care and decisions-making and the impact of health outcomes.

ØCommunications tools that enhance decision-making and achieve desired outcomes.

ØEnable the use of digital records ("e-health records") to support decision-making.

ØDetermine best practices for sharing research information.

4. Addressing Disparities

ØWays to reduce disparities in health outcomes

ØBenefits and risks of health options available across the population.

ØStrategies that address health care barriers that can affect patient preference and/or outcome.

5. Accelerated Patient-Centered and Methodological Research

ØImprove the usefulness and quality of clinical data in follow up studies.

ØMethods of combining analyzed critical data that follows patients over time.

ØUse of registries and clinical data networks to support research and patient-centered outcomes.

{ØStrategies to train researchers and enable patients and care givers to participate in patient-centered outcome research.


Removal of Life-Time Limit Insurance Caps


Section 2711 establishes new guidelines requiring all new insurance policies after January 1, 2014 to not have a life-time cap on health care expenditure. All plans, including those in affect prior to January 1, 2014 that have life-time spending caps, are to instead establish annual spending caps that set a limit on the dollar value of benefits the patient can receive.


Free Services for Preventative Care


Section 2713 is entitled "Coverage of Preventative Health Services" and outlines 4 new categories in preventative care that must be provided free of charge under insurance plans if they are deemed necessary by a care provider and patient, they are as follows with a few brief examples:


1. Evidence-based services and/or treatments outlined as Type 'A' or 'B' in the current recommendation of the United States Preventative Task Force.

ØDiabetes screening

ØDepression screening in adults and adolescence

ØBreast cancer screening and preventive care

ØCervical cancer screening

2.Immunizations recommended from the Advisory Committee on Immunization Practices of the Center for Disease Control and Prevention.

ØPneumonia

Ø
 
2013-03-25 11:52:08 AM

kiwimoogle84: paying claims for the gov


do you even have any idea what "Obamacare" actually is i mean holy shiat
 
2013-03-25 11:52:18 AM

kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


Like private insurers do.

A law requiring insurers to spend a certain percentage (80, I believe) of their spending on actual medical care is a good thing.  Making it harder for insurers to drop people when they get sick (wtf is that) is a good thing.

Oh no, it's the government!  Who the fark cares?  Millions of people in this country die or go bankrupt because we're failing to provide them even the most basic care that EVERY OTHER CIVILIZED COUNTRY provides.

As to penalties for not being covered, those only kick in for single income earners if they're making 50k or more.  There aren't that many people making over 50k who don't have some sort of coverage in the first place.  Not that 50k is a whole lot of money or anything, but the majority of people who can't afford coverage and don't get it through work are under that bar.
 
2013-03-25 11:52:20 AM

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Oh, You're so adorable! I just want to snuggle you!
i3.kym-cdn.com
 
2013-03-25 11:52:45 AM

kiwimoogle84: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

I'm not ok with THE GOVERNMENT deciding whether I live or die.


*facepalm*

/no, that didn't even warrant a GIS
//no Picard for you
 
2013-03-25 11:53:33 AM

verbaltoxin: Medical device makers, health insurers, retailers and restaurants are waging what lobbyists call a coordinated effort to gain Senate Democratic support for overturning $130 billion in taxes that will be used to fund the new law, and repealing a mandate requiring employers to provide insurance coverage for full-time workers or pay a fine.

This right here is only feeding the oncoming demand for single-payer. The President couldn't wrangle single payer from blue dogs and teabaggers, so this was put into place. I said it once, and I'll say it again: PPACA was designed to suck just enough to make Americans finally cave and implement single payer.


Please be right. Please be right. Please be right.
 
2013-03-25 11:53:34 AM
I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.
 
2013-03-25 11:53:48 AM
In 2 years, how many on the TF left will still claim to have always supported Obama care? How many will somehow blame the right for it?
 
2013-03-25 11:54:52 AM
Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left
 
2013-03-25 11:55:11 AM

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


You must suck at business.
 
2013-03-25 11:56:06 AM

macadamnut: FlashHarry: "thrid?"

[www.thrid.com image 288x232]


Ring Kichard the Thrid?

/a shroe, a shroe, my dinkgom for a shroe
 
2013-03-25 11:56:11 AM

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


If you don't want healthy employees, then good riddance.
 
2013-03-25 11:56:22 AM

Sorry for the poor formatting of 2 of 3, trying best to transfer from Word to Forumn.

Part 3 of 3

Effective January 1, 2014

Maintenance of Minimum Essential Coverage


Chapter 48 Section 5000A begins the most controversial and most debated aspect of the Patient Protection and Affordable Care Act and is entitled "Maintenance of Minimum Essential Coverage". The Maintenance of Minimum Essential Coverage in essence declares that any "eligible" individual must purchase and possess "minimum" essential coverage for every "eligible" month that individual can afford to purchase said insurance as defined by PPACA starting January 1, 2013. If an "eligible" individual does not purchase the "minimum" level of required health insurance, that individual will then have a "tax penalty" placed on their yearly tax returns for every "eligible" month he or she has gone without purchasing "minimum" essential coverage. In order to better understand exactly how this process will work, the key aspects of the Maintenance of Minimum Essential Coverage will be broken down into three specific sections: Applicable Individuals, Applicable Minimum Essential Coverage Programs, and Tax Penalty.

Applicable Individuals

Any individuals who don't meet a PPACA Exemption will be required to purchase a Minimum Essential Coverage Program. The following regulations and guidelines have been set by the PPACA in order to determine exempt individuals with a brief description explaining the exceptions:

Religious Exemptions
Any recognized Religious sect or division with tenets and established teachings that would conflict with PPACA regulations and care.

Individuals Not Lawfully Present
Individuals who are not legal residents of the United States of America will not be required to participate in the program nor will they be able to participate if they choose to.

Incarcerated Individuals
Individuals who are incarcerated and/or detained by the state will have their medical care provided for them by the Prison System and will not be required to purchase insurance during the months of their incarceration.

Individuals Who Cannot Afford Coverage
Any individuals who falls below the 113th Poverty Line (~$18,000/annual income) will not be required to purchase Minimum Essential Coverage and will have their medical needs covered under Medicaid

Individuals Related To Employees
Individuals who are eligible and acquire a Minimum Essential Coverage Plan through their employer.

Members of Indian Tribes
As Religious Exemptions but relating to Indian Tribal Customs and Native Americans living on reserves.

Applicable Minimum Essential Coverage Plans

As defined by Section 5000A, Sub-section (b), Minimum Essential Coverage is any Health Insurance Plan that meets a Bronze Level of coverage. A Health Insurance Plan that meets the Bronze level of coverage is one in which the insurance company covers an average of 60% of the annual cost of average care and 40% covered by the individual.  These plans can be private, employer-sponsored, government sponsored, grandfathered health care plans and/or any other coverage that meets the Bronze level of coverage.

Tax Penalty for Non-Compliance

"Eligible" individuals who do not purchase a Minimum Essential Coverage Plan for "eligible" months will have a Tax Penalty attached to their tax returns for every "eligible" month they did not have the necessary plan for a given year. The Tax Penalty is a specific progressive tax over the next 3 years starting with a 1% tax for every month in the year 2014 (~$95), 2% tax for every month in the year 2015 (~$325), and a 2.5% tax for every month in the year 2016 (~695).  An individual will be required to pay 1/12 of the flat dollar amount for every month "eligible" insurance wasn't purchased. As an example, John Smith didn't purchase an "eligible" plan until May 2015 for himself and 2 other dependents. This mean Mr. Smith and 2 dependents were not covered by an "eligible" plan for a total of 4 "eligible" months during the year 2015. Mr. Smith would be charged ~ $27.08 (325/12) per individual not covered per month for a total of ~ $324.96 ([{325 / 12}*3]*4) at the end of the year. In doing this, PPACA hopes to curb the cost of care by taxing those who will eventually need Medical Services at some point in their life but choose not to purchase health insurance until they need it. For those calendar years beginning after 2016, the flat amount used will be $695 multiplied by the cost-of-living adjustment. If the amount increased is not a multiple of $50, such increase will be rounded to the next lowest multiple of $50.

Effective January 1, 2017

State Sponsored Health Care Systems


                Waiver for State Innovation is the title of Section 1332 of the PPACA and provides for States to implement their own Health Care Plan for individuals of the State as long as it meets or exceeds the standards set forth by the PPACA.

Conclusion

The Patient Protection and Affordable Health Care Act has many more provisions and regulations that are currently affecting and will continue to affect the Health Care Industry. Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time. At the very least, the PPACA is a start in the direction of Health Care Reform in the United States. With the cost of care at ~ $7,000 per Capita (Annual Cost of Health Care / Population), the United States has the highest cost of care of all nations belonging to the Organization for Economic Co-Operation and Development (OECD). If the United States hopes to gain control of its exponential growth of health care cost, Health Care Reform will need to be a continuous and concentrated effort; constantly monitoring and adjusting regulations and procedures in order to ensure best practices, cost efficient treatments and access to quality care will be accessible to all citizens of the United States.

Ressource and Reference

Economic History Association - "Health Insurance in the United States" (Melissa Thomasson, Miami University)
http://eh.net/encyclopedia/article/thomasson.insurance.health.us

Yale Journal of Medicine - "The History of Medical Insurance in the United States" (Katherine Zhou)
http://www.yalemedlaw.com/2009/11/the-history-of-medical-insurance -in- the-united-states/

The Library of Congress - 111th Congress H.R. 3950 (PPACA) Full Text
http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3590:/

Urban Institute - "How Will PPACA Impact Individuals and Small Group Premiums in the Short and Long Term?"
http://www.urban.org/uploadedpdf/412128-PPACA-impact.pdf

The Health Policy Monitor (Bertelsmann Stiftung) - "Pre-Existing Condition Coverage Post-Health Reform"
http://www.hpm.org/us/b16/1.pdf

U.S. Preventative Services Task Force - USPSTF A and B Recommendations
http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm

Healthcare.gov - Comprehensive Guidelines Supported by the Health Resources and Services Administration (HRSA)
http://www.healthcare.gov/law/resources/regulations/prevention/rec omme ndations.html

Healthcare.gov - Health Resources and Services Administration-Supported Women's Preventive Services
http://www.healthcare.gov/law/resources/regulations/womenspr evention.h tml

Bright Future - Recommendations for Preventative Pediatric Health Care
http://brightfutures.aap.org/pdfs/AAP%20Bright%20Futures%20Periodi city %20Sched%20101107.pdf

American Cancer Society - Plan Levels and Standardization of Coverage
http://www.acscan.org/pdf/healthcare/implementation/background/Pla nLev elsStandardizationofCoverage.pdf
 
2013-03-25 11:56:26 AM

kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left


We'll all come and ask you for your totally expert and not at all ignorant as shiat opinion when there is any government health plan to speak of instead of a massive private insurance expansion. Also DEATH PANELS.
 
2013-03-25 11:56:46 AM

kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left


Good riddance!
 
2013-03-25 11:57:20 AM

Dusk-You-n-Me: kiwimoogle84: I'm against it because I don't want to be dependent upon the government

So...don't become dependent on the government.


The line of reasoning people use in not wanting to become "dependent on government" is so silly because EVERYONE in a modern society is dependent on government. There's no way NOT to be. Businesses use the money issued by governments and the public infrastructure to make a profit. FARKING WELFARE QUEENS
 
2013-03-25 11:57:31 AM

kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left


How can we ignore something that only exists in your imagination?
 
2013-03-25 11:58:00 AM

kiwimoogle84: /exits stage left


Try not to become dependent on the government on your way out.
 
2013-03-25 11:58:23 AM

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


Having also wrked in healthcare, my experience was that private insurers like to dick around, but government likes to get people treated. I had a kid whose private insurance would rather pay for a MONTH in an acute care facility (about 4-10x more expensive than long-term care, depending; typical stay with us was 4-7 DAYS) than a year somewhere else - "somewhere else" having the caregivers better situated for him than us - because they were bickering with some OTHER entity (or entities) over who footed the bill and who was on whose network. Talk about coming between you and your doctor.

Also, "end of life consultations" = a conversation my dad had with my granddad's doctor (my grandfather had been living on machines for 4 months, had some advance directives and also a girlfriend, but had just taken a very serious turn) about their options:
1) Keep him alive indefinitely. It's expensive as hell and there's little hope, but yay he's alive.
2) Keep him on just those machines that do X, but not Y. No pain, and he stays around longer, but he gets to go in peace.
3) Shut down everything. It's not like he's suddenly going to wake up and dance the hora.

I won't bore you with the details, but that should be an hours-long conversation with a doctor (or two). Who pays for their time?
 
2013-03-25 11:58:42 AM

kiwimoogle84: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Then explain to me the clause about "end of life" counseling if you're over a certain age and have a serious ailment. Grandma has cancer? Instead of treating her, we'll just counsel her about her upcoming demise.

That's IN THE BILL.

I'm not a foil hat wearer or anything, but I've worked in government healthcare (Medicare and Medi-Cal claims) long enough to know that if you get too expensive to insure, they'll cut you off.


You work in health care and don't understand what end of life counseling is?

1) It's optional.  Health insurers are required to cover it, you aren't required to have it.
2) It's informational. You meet with a doctor and a nurse to talk about your treatment options, which includes but is not limited to stopping treatment if you don't want it.
3) I don't even think it made it to the final bill because idiots thought it was a bad thing.
 
2013-03-25 11:59:06 AM

thurstonxhowell: kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left

How can we ignore something that only exists in your imagination?


don't you get it? with Obamacare everyone is going to be on government health insurance therefore death panels and reimbursing hospitals pennies on the dollar! also my little pony is a documentary
 
2013-03-25 12:00:25 PM

Masta Kronix: Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time.


You post all that for a conclusion that says "eh, who knows." I hope you got an F on that project.
 
2013-03-25 12:00:37 PM

BarkingUnicorn: verbaltoxin: At issue are a 2.3 percent tax on medical devices valued at $30 billion over the next 10 years, a $100 billion health insurance premium tax and the employer mandate, which opponents say could cripple many small business with costly fines.

*Sighs* That's because your ability to see a doctor shouldn't be dependent upon your boss' ability to buy an insurance plan! People cry "Socialism!" but are seriously okay with actuaries, shareholders, and their own f*cking boss deciding whether you live or die?

Isn't it really your health care providers who decide whether you live or die?


That depends. Can you get coverage in the first place? If the answer's "no," then you're pretty much f*cked if you have any condition requiring long term care. You're doubly f*cked if it's an emergency that requires additional, in-patient treatment. If you can't pay, a health care provider might never even see you.

Suffice to say, at this point it's insane to say the UK, Canada, New Zealand, Australia, Sweden, Norway, Denmark, Germany, France and a whole host of other nations can run a single payer healthcare program, and we can't. The largest economy in the world with the planet's reserve currency can't operate and fund single payer?

Really?

Really?

Really?
 
2013-03-25 12:00:50 PM

kiwimoogle84: Fine. You know what? Go ahead and ignore all of my experience in a field that I know like the back of my hand. But it's not going to be pretty.

/exits stage left


The government has statutes in place making sure that the stage is structurally sound, you damn socialist.
 
2013-03-25 12:01:16 PM
I honestly had forgotten that there are people in the real world who earnestly believe that Obamacare is some sort of government health insurance
 
2013-03-25 12:01:16 PM

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


www.mountainside-medical.com
 
2013-03-25 12:02:42 PM
I'm not too worried. I have an insider tip that the House of Representatives is going to repeal the whole thing anyways.
 
2013-03-25 12:02:49 PM
What's at "thrid"?

heystupid.files.wordpress.com
 
2013-03-25 12:03:03 PM

kiwimoogle84: verbaltoxin: Jackson Herring: kiwimoogle84: I'm not ok with THE GOVERNMENT deciding whether I live or die.

oh my god are you for real

like really really for real

Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.

That's not my argument at all. This will kill more people than it helps, and quality of care drops dramatically when reimbursement rates drop through the floor.


Yes that's why people in Canada are dying by the thousands each day, because of no access to healthcare.

Wait a sec....that's not how it's happening at all!
 
2013-03-25 12:03:20 PM

Cletus C.: Masta Kronix: Whether or not these changes will result in more efficient and lower cost of care is something that will be determined in time.

You post all that for a conclusion that says "eh, who knows." I hope you got an F on that project.


Until you realize the point of the paper was to inform the reader as to what the bill actually did.
 
2013-03-25 12:05:03 PM
I'd like to add that I don't want to be dependent on the government to ensure the safety of the food that I buy. If you don't inspect and slaughter the animal yourself, that's pure, unadulterated, Maoist, communism.
 
2013-03-25 12:05:04 PM

pinual: I work for a small business with many VH employees and a small staff of salaried employees.

We are just going to end up paying the fines because it works out cheaper then trying to ensure everyone. At least for the first few years. The fact that they tied the fine to insurance premium cost probably means in a few years the fine will be three or four times as high. Then we will just close out doors.


One more reason we should have single payer. I'm going to keep repeating it, because it's f*cking true.
 
2013-03-25 12:05:04 PM

verbaltoxin: The largest economy in the world with the planet's reserve currency can't operate and fund single payer?

Really?


THE US IS SOOOOO DIFFERENT FROM THOSE GUYS!  We're at least 3 tiems larger!
 
2013-03-25 12:06:09 PM

kiwimoogle84: IN THE BILL


Why is that in there?  Because A) a REPUBLICAN congressman asked for it and B) its a very good idea.  People die, you see, and Modern American medicine is very good at treating and alleviating symptoms, but sucks at helping a patient manage their life, in particular, the end of it.  As my very soon to be 75-year old mother the nurse has been known to snap at young interns who order whole batteries of tests to determine "what is wrong" witht he 90-year old man admitted with congestive heart failure  "what's wrong with him is that he is dying, and it's your job to make that as comfortable and dignifed as possible, not  to make his reamining hours a living hell as you poke and prod him to treat things that won't matter in a week anyway"
 
2013-03-25 12:06:21 PM

kiwimoogle84: Jackson Herring: ahh ok I get the joke now, you are literally sarah palin

Oh dear christ. Look, I'm neither republican nor democrat. I see the flaws in both sides. BUT I WORK IN HEALTHCARE. I have SEEN firsthand what happens when it comes to paying claims for the gov. It's a mess, it's cheap since so many people have it, and the reibmursement rates absolutely blow.


I'm a nurse and I've seen about 10 of my patients die this year. Never did the government intervene. Most of these people were on Medicare. The choice is up to patients or family or the result of being too poor/uneducated to manage illness so they get too sick at home and come to us unfixable.

TL;DR: you are full of shiat
 
2013-03-25 12:06:32 PM

Dr Dreidel: Having also wrked in healthcare, my experience was that private insurers like to dick around, but government likes to get people treated. I had a kid whose private insurance would rather pay for a MONTH in an acute care facility (about 4-10x more expensive than long-term care, depending; typical stay with us was 4-7 DAYS) than a year somewhere else - "somewhere else" having the caregivers better situated for him than us - because they were bickering with some OTHER entity (or entities) over who footed the bill and who was on whose network. Talk about coming between you and your doctor.


I actually worked for a while (admittedly, tangentially, but up to my neck in the financials) in the Yukon Territory health care system. A mostly-socialized system (government-owned hospitals and clinics as well as insurance) with some private clinics. Neither the doctors nor the patients were anything but happy with the system as presented - something like an 80% public approval rate, higher than the Canadian average and even higher among healthcare workers - and there were more than adequate facilities, equipment and supplies available. Wait times lower than the American average.

By every metric I can think of, the Yukon health care system (not Canadian, Canadian health care is managed differently by province and territory, and unsurprisingly the more heavily-privatized systems are rated most poorly) is vastly superior to anything in the US. But we probably had to make Eagle Jesus cry to do it, so there is that.
 
2013-03-25 12:08:21 PM

Jackson Herring: I honestly had forgotten that there are people in the real world who earnestly believe that Obamacare is some sort of government health insurance


Where do I sign up for this Obamacare? Because farking Premera sucks.
 
2013-03-25 12:09:36 PM

verbaltoxin: Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.


You mean that the reality that people don't give a shiat about each other and are just as much driven by survival of the fittest as any other beast on this planet? And people will generally look out for themselves and their closest niche and ignore everyone else? *Gasp* say it ain't so! Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.
 
2013-03-25 12:10:31 PM

Bravo Two: verbaltoxin: Probably not, but who cares? Either way it sums up the opposition to single payer: f*ck you, got mine.

You mean that the reality that people don't give a shiat about each other and are just as much driven by survival of the fittest as any other beast on this planet? And people will generally look out for themselves and their closest niche and ignore everyone else? *Gasp* say it ain't so! Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


You've got some drool on your chin.
 
2013-03-25 12:10:33 PM

Bravo Two: Now, if you'll excuse me, I've got work to do because ain't no one else going to come along and pay my bills for me.


Be sure to stay off our roads.
 
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