Except for the elite specialists and surgeons, doctors are terrible and SHOULD be shit on

YEA, I SAID IT - the interwebs lets me do the same god damn thing a GP does only i'm not allowed to write a prescription.

[Edited on October 30, 2012 at 10:55 PM. Reason : I'm PARLY joking]

10/30/2012 10:55:42 PM

A certain "alternative" health care center I visited made a curious argument. They made the claim that the 3 leading causes of preventable death in America are:

1. hospital errors
2. heart disease
3. cancer

Now, I understand how many grains of salt have to come with this. They took one study that did a ballpark estimate of the number of deaths due to hospital errors and then extrapolated to the entire nation at all times. Still, it's instructive.

Public health programs have helped us immensely. Unfortunately, we've chronically over-estimated the degree of service that health care provides us individually. Most of the benefit we get are from services we mastered 50 years ago. That is, stitching up lacerations, treating the illnesses like childhood pneumonia, and most of all, nutrition.

The delivery of almost every one of these useful things have been undermined by the recent trends of rising costs. Those ballooning costs come from these and more:
- extremely advanced heart surgery, ultimately treating obesity
- prolonged life services for a small number afflicted with severe cancer and at end of life
- liability defense measures that demand 3 workers when we needed 1 before
- brand name prescriptions given to healthy people that NEVER stop

Liberals have a case that we should provide basic health care services. How about we start by socializing the cost of a pregnancy? Let's keep the assistance to the stuff that makes modern life good. Instead, liberal reforms cost lives by attaching the cost of the 50-year-old stuff with the stuff that Big Pharma just sold us, and actually makes life more miserable even when handed over for free.

Obamacare is a conservative program. It doesn't give health care to the 45 million people who needed it, it will probably pick up 10 million of them, and it imposes more taxes on living through indirect means that we've already been swallowing by the boatload. It is clearly right-wing, and clearly totalitarian. If heath care is a right, it's one of the many that won't be respected by our federal government in this century.

10/30/2012 11:10:31 PM

10/30/2012 11:10:52 PM

-I don't believe healthcare is a right
- I believe that government at various levels is as much to blame as the many other private players in healthcare that drive prices up.

-Around 49 Million Americans have no health insurance.
-Another 50 million people are on Medicaid
-Around 48 Million on Medicare

that's a little south of half of the country either without insurance or on insurance for poor/old people.

I don't think that universal healthcare provided by the federal government is necessarily THE answer. I definitely believe that a profit driven model that incentivizes insurance companies to increase profits by denying health care coverage is a fundamentally broken model to deliver care to patients who are sick. I believe that overreaching regulations that require onerous process and paperwork drive costs up, as well as the multiple payer model that we have today. Most patients have no idea what anything costs, and neither patients nor doctors have any incentive to design a care strategy with costs in mind. Doctors practice defensive medicine and perform expensive, unnecessary tests in order to avoid lawsuits. Medical device manufacturers and pharmaceutical companies price gouge hospitals. There are many more examples but ultimately all of these costs get obfuscated and spread around in a system so complex, it's nearly impossible to determine what's what. At the end of the day, you have the worst of both worlds in terms of the private/public hybrid shitbag healthcare system we have today.

The right-wing folks have a simple, lazy solution. get rid of medicare and medicaid, and the private sector will solve the problem. Magically, the poor will be able to pay for their own healthcare, because it will suddenly become dirt cheap because

I don't pretend to know of a solution that's the panacea for our healthcare problem. However, I will say that "fixing" it by cutting access to healthcare from the people that need it the most is a completely heartless, fucked up way to address it.

10/30/2012 11:16:41 PM

I like how hospitals can send you a bill for any fucking amount they want and you are just supposed to assume you are being billed fairly.

There is absolutely no transparency in medical billing whatsoever.

10/30/2012 11:20:03 PM

Quote :

"I like how hospitals can send you a bill for any fucking amount they want and you are just supposed to assume you are being billed fairly. "

False. Hospitals send you a bill for the absolute maximum amount that the highest insurer is willing to pay out.

They do this because if they charge you anything less, they are committing insurance fraud.

Quote :

"There is absolutely no transparency in medical billing whatsoever.""

Absolutely true for getting a price before the operation/procedure

10/30/2012 11:23:22 PM

Wrong - hospitals are more than legally capable of haggling on a patient by patient basis for the uninsured.

[Edited on October 30, 2012 at 11:34 PM. Reason : ]

10/30/2012 11:34:13 PM

Quote :

"Wrong - hospitals are more than legally capable of haggling on a patient by patient basis for the uninsured."

Wrong - hospitals are able to give you uninsured discounts, but they only apply if you ask for them.

10/30/2012 11:36:03 PM

You said I was wrong and then make a statement that agrees with me.

Cool story bro.

10/30/2012 11:37:42 PM

You are oblivious to technicalities and how they work.


See "Obamacare: Tax versus Mandate"

10/30/2012 11:38:32 PM

You are oblivious to being a complete fucking moron.

10/30/2012 11:39:06 PM

beatsunc, can you post more information on Gary Thompson? Your enthusiasm has piqued my interested in said candidate.

thx in advance.

nobody

[Edited on October 30, 2012 at 11:58 PM. Reason : yadig?]

10/30/2012 11:57:50 PM

Quote :

"You are oblivious to being a complete fucking moron. "

when JaZon arrives, the conversation devolves into a poo-slinging circus.

10/31/2012 12:20:32 AM

Last year I had chest pains that wouldn't go away, I tried getting a hold of my regular doctor but he was busy with his usual overbooked visits. So went to the hospital and the ER doc took x-rays and checked my heart beat and said everything looked ok, this all took half an hour or less and this particular hospital was almost empty. They sent me home...

Months later, I received a bill from a billing company (not directly from the hospital since I guess they send all their bills to a 3rd party automatically) for roughly $5,000, of which my insurance paid roughly $4,000 so I owed $1,000. So I called them up and told them they were overcharging me for services that weren't worth $5,000 let alone $1000. So I said I would pay 60% right away if they would drop the rest of the bill. They automatically agreed and I made the payment although I knew I was getting ripped off.

The insured are already paying for the uninsured through cost-shifting so I probably paid for 2-3 uninsured emergency visits. Is this the bloated, convoluted healthcare system that some people want to preserve.

Why don't we just make it official and more efficient by providing healthcare for everyone??

10/31/2012 12:49:16 AM

Quote :

"The insured are already paying for the uninsured through cost-shifting so I probably paid for 2-3 uninsured emergency visits. Is this the bloated, convoluted healthcare system that some people want to preserve. Why don't we just make it official and more efficient by providing healthcare for everyone?? "

Not only does Obamacare not stop this insanity, it adds fuel to the fire.

Now do you believe me that they are purposely trying to fuck the country up?

10/31/2012 12:52:31 AM

Also a ridiculous amount of medical bills just go unpaid by anyone, that obviously inflates the cost of care for everyone else.

See this article for examples: http://www.huffingtonpost.com/2012/04/27/north-carolina-hospitals-debt-collection_n_1459324.html (states 39 billion went uncollected in 2010)

The rest of society is paying for that one way or another.

10/31/2012 12:55:18 AM

i haven't been keeping up with this argument, but i wanted to comment on BobbyDigital's:

Quote :

"I don't believe healthcare is a right"

i agree wholeheartedly...if we're talking about "natural" rights

the thing is, no one is entitled to ANYTHING...you are not entitled to happiness, safety, education, healthcare, fair treatment, etc...if you want to boil it down, we're only left to our best effort and if we happen to get happiness, safety, education, healthcare, fair treatment, etc, then we're lucky

the moment you establish a government, though, you're establishing a baseline by which our "rights" are redefined and measured differently...suddenly these things that we were not entitled to become "rights" and the argument of which of these many things should be included in that set of basic rights comes to the forefront as points of contention

and as a result, to say healthcare isn't a "right" is just plain stupid...it's as much a right as being treated equally regardless of sex, religion, or race

no one is OWED fair treatment just because they're alive...but when you establish a government to oversee the most fundamental equalities, basic healthcare should be included

10/31/2012 8:10:36 AM

Quote :

"basic healthcare should be included"

Medical costs are projected to reach 25% of GDP by 2021. This is "basic"?

What if someone comes up with a way to extend lives to live beyond 120? I would love to live longer, so am I entitled to receive that service? And we should throw the working class under the bus in order to provide extreme outliers their heath care they want/need?

10/31/2012 8:39:41 AM

Quote :

"Not only does Obamacare not stop this insanity, it adds fuel to the fire. Now do you believe me that they are purposely trying to fuck the country up?"

If I try to solve a complex engineering problem and come up with a solution that doesn't work, did I get there because I was purposely trying to fuck up the problem?

10/31/2012 8:40:07 AM

Quote :

"False. Hospitals send you a bill for the absolute maximum amount that the highest insurer is willing to pay out. They do this because if they charge you anything less, they are committing insurance fraud. "

I cannot speak for hospitals but this is exactly how we do it. As a medicare provider you are not allowed to bill people different charges for the same service, they classify that as insurance fraud. Since you have to deal with well over 40 insurance plans these days this becomes a huge accounting issue and paperwork nightmare. I do know that hospitals get reimbursed MORE from medicare than private practices for the same code. That is why you are seeing hospitals buying up private practices. Yet another example of the govt skewing the market and making things more expensive.

In fact you actually charge a bit above your max reimbursement plan. Helps keep you from getting cut. Didnt take long for doctors to pick up on what medicare was doing. Taking the average charge for a code then cutting it by some percent. So they simply raised the charge. You want more transparency in billing with healthcare? You have to bring introduce the consumer to the costs of goods and services they are consuming. It works in every other industry.

You can offer a cash discount, but there is actually a code for that in our profession.

To the guy who went to the ER for chest pain. A cheaper alternative would have been an urgent care facility vs the ER. Much cheaper

10/31/2012 8:46:12 AM

Quote :

"If I try to solve a complex engineering problem and come up with a solution that doesn't work, did I get there because I was purposely trying to fuck up the problem?"

Typically, the problem exists before they call the engineer to work on it. Not so in this case. The more government has got involved in health care, the more expensive it became.

This isn't entirely surprising in light of the history of medicine (although it would be for engineering). Before we had germ theory the net sum effect of medical interventions was doubtfully positive. I mean, we were still prescribing lobotomies through the 1970s. That's not even saying our problems were witch doctors and whatnot back in the day, medical institutions and doctors (who were science based at that time) resisted things like germ theory.

Walmart can't offer me a health care alternative that uses welll-educated people who aren't doctors. I can't self-perscribe myself a prescription. 23andme is innovating genetic testing and is constantly weathering legal shots from states because they don't have doctors on staff and they don't like that.

Government isn't trying to fix the problem. That's what you had in mind when you elected the politicians. Doesn't mean that's what the politicians had in mind when they passed a new bill drafted largely by industry and helping you isn't necessarily what the regulators have in mind when they inspect a facility.

The engineer has a clear metrics and the company has clear options if he/she doesn't meet them. If your politicians screw it all up, you're just going to advocate to vote more Democratic because we need to fix it more.

10/31/2012 8:54:56 AM

You read way more into that analogy than you should.

Geniusboy suffers from a paranoia and anti-social disorder and as such actually believes that the ACA was actively designed for the purpose of damaging the country. Not that it is a bad solution by people why are trying or that it won't work, he thinks it was created on purpose to destroy people. The point of the analogy was to show how its a huge jump (and not a logical one) to go from "this is a bad solution" to "this solution was purposely created to destroy us".

10/31/2012 8:58:48 AM

True, I don't think it was intentionally created to crash the economy.

But still, you can't speak for every person involved. I'm sure the president had good intentions, I'm sure plenty of lawmakers had good intentions. But a small minority could hold the entire thing at hostage (and did) by threatening to withdraw their vote.

The Democrats supposedly had something like 1 month in which it was possible to pass it (due to Senate head count). They openly recognized that it sucked, but we need the bill to get the foot in the door. We need to first recognize this as a national responsibility, and then we'll be able to adjust things as we go.

I will support the progressives, but only conditionally. I felt like Obamacare was stabbing me in the back for voting them in in 2008. The argument is ideologically driven, this is the way the Republicans are supposed to work. They didn't care too much about the details, they wanted to push the state of existing legislation to their idea that health care is a right on the national level.

It's complicated. Obama isn't sitting there sucking his pinky, in delight at how much he screwed the world up, but these individual actors in Washington aren't taking the action that is best for the nation, because they think it'll just give the other side more rope.

If you can't work together and be coherent as a government, you should just not do anything.
(except balance the budget, you should do that)

[Edited on October 31, 2012 at 9:08 AM. Reason : ]

10/31/2012 9:07:18 AM

That comment was not for every person involved. Most people against ACA don't think it was created to bad things on purpose. That comment was only for the crazy, paranoid Geniusboy.

When the conservative Heritage Foundation created ACA, they thought it would be a great example of privatization. In fact, before Obama put his stamp on it, most other conservatives agreed.

10/31/2012 9:16:24 AM

Quote :

"When the conservative Heritage Foundation created ACA"

So in other words, I don't like it, you don't like it, we all don't like it!

Ignoring everything else about Romney, the fact that he wants to repeal Obamacare would be a valid reason to vote for him. Of course we lack details of what, if any, reform would replace it but it's not like our expectations for specificity were high to begin with.

10/31/2012 10:40:49 AM

Quote :

"and as a result, to say healthcare isn't a "right" is just plain stupid...it's as much a right as being treated equally regardless of sex, religion, or race no one is OWED fair treatment just because they're alive...but when you establish a government to oversee the most fundamental equalities, basic healthcare should be included"

meh, at this point it's a matter of semantics.

10/31/2012 10:52:53 AM

No insurance to anyone. Government mandates the price of treatments. Its only fair.

10/31/2012 11:05:06 AM

10/31/2012 11:08:00 AM

Quote :

"Ignoring everything else about Romney, the fact that he wants to repeal Obamacare would be a valid reason to vote for him."

No, because

Quote :

"we lack details of what, if any, reform would replace it "

And also there is basically no way he would be successful at repealing ACA
And also what we do know about the Romney/Ryan plan involves just cutting things and replacing it with vouchers.

So, no.

10/31/2012 11:29:08 AM

^ true, but you're forgetting that he would turn over more control to the states, because states are better at managing these programs... just like states are better at managing budgets and pensions.

10/31/2012 11:38:56 AM

neither of those claims is true

Also, lets be clear that when we talk about using vouchers and such to have people use the existing private healthcare industry... that is not really different from how it is now except in a voucher system you would no longer have the government able to negotiate lower rates. What we had before ACA and what we have with ACA are all private healthcare getting government money at negotiated rates.


[Edited on October 31, 2012 at 12:35 PM. Reason : .]

10/31/2012 12:32:08 PM

my sarcasm apparently isn't obvious enough.

After the budget and pension part I thought to myself "they can't possibly think I'm serious now".

[Edited on October 31, 2012 at 12:36 PM. Reason : ]

10/31/2012 12:35:17 PM

Some conservatives and Tea Party people really want everything at the state level because they are under the impression it works better there, I couldn't be certain

10/31/2012 12:51:08 PM

from a scalability standpoint, government provided healthcare does make more sense at the state level. This is one thing that Romney said that makes sense in explaining being against obamacare, even though it's very similar to Romneycare.

Now, the issue you get into there is that depending on the demographics of various states, it may not be feasible for said state to reasonably fund such a program, whereas for others, it would be relatively easy.

There's no proven model to follow for the US. There's no other country that offers universal healthcare that scales comparably to the US. This is a case where economies of scale work against efficiency.

10/31/2012 1:32:34 PM

Quote :

"Some conservatives and Tea Party people really want everything at the state level because they are under the impression it works better there, I couldn't be certain "

You are missing their point. If Virginia passes a bunch of crap laws that cause damage to the people of virginia it doesnt affect the people in other states. Also the people of virginia are free to leave if they dislike the new laws so much. If the federal govt passes the same crap law well everyone is screwed and has to suffer. You are also ignorning the constitution's limits on federal govt. It is ok, everyone does it these days.

Have you noticed how much cheaper gas is in SC and Virginia compared to NC? The gas taxes NC passed didnt affect these states. Kind of how the republic is supposed to work.

10/31/2012 1:40:28 PM

it baffles me that so few people advocate for the states to have more control.

10/31/2012 1:47:05 PM

the tradeoff for us in virginia is that our roads are absolute shit.

I'd gladly pay a few cents more per gallon if our roads would be as well maintained as those in NC.

now that said, NC's method of automatically adjusting taxes twice a year based on gasoline costs is overly aggressive. each increase should be voted on by the state house and senate.

[Edited on October 31, 2012 at 1:50 PM. Reason : point being is that there's another side to every good/bad thing. ]

10/31/2012 1:49:50 PM

Quote :

"If you respect individual rights and properties then it shouldnt matter if you have more money than I do."

i don't.

10/31/2012 2:01:39 PM

^that is opposite to your statement

"the people who live in a level of luxury that is frankly irresponsible should have to give that back to everyone so that they can do things like eat, get a checkup, not live on the street."

Clearly you DO CARE what people with more money do. In fact you think they should HAVE to give it back.

10/31/2012 2:08:04 PM

Quote :

"Medical costs are projected to reach 25% of GDP by 2021. This is "basic"? What if someone comes up with a way to extend lives to live beyond 120? I would love to live longer, so am I entitled to receive that service? And we should throw the working class under the bus in order to provide extreme outliers their heath care they want/need?"

to pretend that i have the answer (or, rather, that it's so simple) would be presumptuous...because i don't

but i don't think there's much argument that there is a clear difference between giving new lungs to a smoker who needs them at age 80 and a child who needs to have their broken arm set

there is a inescapable moral component to deciding what healthcare covers and what it doesn't...as morals vary from person to person, there will always be debate and outrage over ANY level of taxpayer-subsidized healthcare, so the best that can be hoped for is that the majority picks the leader that most closely supports their personal moral code

Quote :

"meh, at this point it's a matter of semantics."

no more than everything else...we might disagree, but the vast majority of our government-given and government-protected rights rely heavily on semantics to define their limits (and these same semantics are argued and debated by the judicial branch with great regularity)...to write off an opposing view as "semantics" is to say that you disagree but are too lazy to defend your view and too unwilling to consider another

10/31/2012 2:08:04 PM

^^ i meant i don't respect individual property.

10/31/2012 2:20:08 PM

Ah ok. Good luck with that.

10/31/2012 2:34:25 PM

I completely agree that we need to have a sort of "sacred cow" to defend with healthcare. We should have a set of fundamental services that everyone has access to. The most important thing is to not damage the affordability to these basic services, and we have completely failed.

If someone brings in their sick kid with something fairly typical and curable to Rex hospital and stays the night they will be saddled with $1000s of charges with no recourse even if they fully have insurance. In many cases, such a basic thing can cost literally several months of income. Am I the only one who sees a problem with this?

Insurance wouldn't be such a problem if it weren't for the fact that we inflated costs so much to begin with! What really drives me nuts is when people have policies that will at best pay 80% of the costs. Well, the system inflated the costs several fold to begin with.

And yet the goal of Obamacare was to get everyone covered. That is such horse dung. Working class people would be literally safer from the high cost of medical emergencies completely uninsured in a free market than "covered" with what we have now.

It's modern slavery I tell you!

10/31/2012 2:39:19 PM

prices are crazy because of privatization

10/31/2012 2:40:20 PM

That makes no sense to me.

Many hospitals aren't private.
You're implying that the system used to be less private than it is now. How? When?
Doctors are inherently self-employed. Even if they work for someone else their neck on on the line for malpractice.

10/31/2012 2:45:39 PM

^^that view is not consistant with reality. The two most heavily subsidized insdustries in the US have the highest cost growth. Education and Healthcare

You know what procedures have gotten better and cheaper over time? Non covered services. Wow, ones where the market can behave just like every other market we have and gives us the same results.

Also the govt dictates what insurances and hospitals HAVE to provide, also while restricting their prices and competition. (like shopping for insurance over state lines)

[Edited on October 31, 2012 at 2:47 PM. Reason : .]

10/31/2012 2:46:30 PM

you know what subsidized private industries is? privatization

10/31/2012 2:50:26 PM

seems to me that if healthcare and education were no longer subsidized in any way (ie. privatized), you'd find that poor people could only afford shitty, poor schools and shitty, poor healthcare

10/31/2012 2:56:45 PM

you act like the free market, capitalist world is a wonderful one, but that's just not the case. the evidence is bountiful. the global economy is collapsing thanks to bank regulators that didn't believe in regulation. we've markedly elongated and amplified the hurricane season, increased temperatures around the world and melted the arctic thanks to a total lack of respect for the environment (#sandy). we have some very serious problems, most of which have been caused by right wing, anti-government ideals. this is an unacceptable model for society.

10/31/2012 2:58:38 PM

poor healthcare is better than sewing wounds shut at home.

10/31/2012 3:00:43 PM