D.C. Circuit guts ObamaCare

[Timsup2nothin]

These statements all show a clear bias against aging Americans who unlike young people paid into the system and yet you all want to limit their ability to take back out the money they invested into the system.

What's next, firing squads?

Guess what Sherlock? Dementia is not about overliving your mental capacity, but it's about any number of diverse pathology states that happen to everyone. Is Cancer about overliving our usefulness too? What a novel concept! We can cut costs to the bone by a cheap bullet for anyone who has a major illness who's outlived their mental capacity as Americans. You have schizophrenia. Bang! You have major depression. Bang! You have autism. Bang!

Nuts!

No, in fact they don't. They point to a very real and unavoidable reality of healthcare cost...the population is going to age, and that is going to be expensive. There is absolutely nothing there that supports your false claim that anyone "can't wait 'til they croak."

Just like the republican "budget genius" that Rmoney took on as a running mate, you want to 'solve the problem' without acknowledging that it exists. He was going to 'level social security costs' while denying the reality that as the number of eligible people grows (which it will at an easily predictable rate) if you hold the aggregate cost level per capita payout has to go down due to nothing more 'malicious' than simple arithmetic.

You come in here spouting about 'Obamacare is broken look at healthcare costs going up' and when people point out that there are implacable reasons that healthcare costs are going to go up and the objective of the ACA is just to keep them from going up so fast they break us you fly off on this weird tangent about 'wanting the elderly to just die' and start calling names. There's nothing malicious about mathematics or demographics, they are just the reality that has to be dealt with.

You are not only not dealing with it you are taking offense that other people won't take you seriously if you don't. You may not be cut out for engaging in this form of communication. Clearly you really want to be in some form where you can just bluster and huff and puff to put down disagreement. That won't happen here, you will just end up looking silly. Exclamation points just aren't all that intimidating.

 

[Crackerbox]

I stated numerous genuine reasons why healthcare costs were going up: lack of personal responsibility to do preventative maintenance, padding the bill because of the deep discounts demanded by Medicaid, Medicare, and Managed Care, outrageous statements by Obama that the average family would save $2500 and everyone could get coverage for less than a cellphone bill when in actuality it cost $3500 more. I stated the effects of malpractice.

I'm not just ranting in a general statement that it's broken by rising costs but explaining WHY it was rising. It's really going to go up simply if we hire 45,000 more physicians and 46,000 more surgeons because we need that many just to keep our head above water, but EVEN MORESO because of millions of new people on the rolls.

This topic is really nutty because it's full of unquestioned liberal rhetoric and badmouthing anyone who criticizes Obamacare, and then full of posters who presume that a critic must be a Republican conservative. Great people, run off anyone who doesn't parrot your words. Then it no longer is a discussion, but becomes a pity party.

 

[El_Machinae]

Yeah, there's no doubt demand-side inflation will drive up prices (which will be caused by more people having access to healthcare money). It's a bit of a bad thing, since you could prevent that price rise by just preventing poor people from having access to purchasing power. In sum, it's a subsidy. They distort markets.

Most of the analyses I see suggest that Adversarial Paperwork and Overtesting are the reasons why it costs Americans so much more than elsewhere. The economic incentives on both problems are wonky, which is why The Market is destabilizing towards decreased efficiency.

I'll never disagree that 'bad lifestyles' drive costs higher than they need to be! But it's not like other developed nations don't have that problem ...

IIRC, some States are running the liability experiment. We'll see if increased protection from torts beings down over testing.

 

[Timsup2nothin]

Guess what. The only one taking a pitiable position is you.

"Woe is us! Healthcare is broken!!! Ashes and sackcloth!!!"

I stated numerous genuine reasons why healthcare costs were going up: lack of personal responsibility to do preventative maintenance, padding the bill because of the deep discounts demanded by Medicaid, Medicare, and Managed Care, outrageous statements by Obama that the average family would save $2500 and everyone could get coverage for less than a cellphone bill when in actuality it cost $3500 more. I stated the effects of malpractice.

I'm not just ranting in a general statement that it's broken by rising costs but explaining WHY it was rising. It's really going to go up simply if we hire 45,000 more physicians and 46,000 more surgeons because we need that many just to keep our head above water, but EVEN MORESO because of millions of new people on the rolls.

This topic is really nutty because it's full of unquestioned liberal rhetoric and badmouthing anyone who criticizes Obamacare, and then full of posters who presume that a critic must be a Republican conservative. Great people, run off anyone who doesn't parrot your words. Then it no longer is a discussion, but becomes a pity party.

Previously addressed.

Meanwhile, there are numerous disagreements in this thread, between numerous posters. The only one who seems to be playing the 'disagreement means you are running me off' card is you.

Your willingness to keep digging the hole no matter how much dirt gets thrown in on you is impressive, but the only reason dirt is falling on you is because you keep digging. Wild and groundless hyperbole like "the country is imploding", "you want to just kill the old people and the baby boomers", "blah blah blah" is not going to make a point. It is going to get challenged, and to have any shot at making a point you will have to defend it.

Playing the 'you intolerant liberals' card isn't going to make any difference. Claiming you aren't a conservative won't either, because truthfully no one cares if you are or aren't. You tried to make your point by using links to arch conservative ditto tanks, and took it personally when most people didn't even look past seeing where the link went before blowing it off. If you don't make an argument that makes sense and just toss up links that's what happens.

You keep flinging further and further afield; now into some one man debate about the deservedness of payouts based on payment in to social security. It's a one man debate because no one is disputing your wild tangents, because who really wants to bother? You don't make any point, you just toss some sort of wild statement in the air and run off to your next tangent...then get mad because your previous unsupported wildness hasn't been accepted as part of the foundation for the ongoing conversation.

You complain that people are judging you without even knowing you, which isn't true. They are judging what you post and how you post it, which is mostly getting disregarded. The one judging people appears to be you, and part of the reason it appears that way is that it seems like you aren't even reading what anyone else posts. You see 'aging population' somewhere in the text and fly off into some wild blue yonder of 'death squads for old people you must be a monster' rather than considering the real world demographics being pointed out. It was hilarious, but has become tiresome.

 

[Crackerbox]

I heartily disagree about overtesting. That's a gross oversimplification. The reality is we need better and less expensive testing in order to do routine testing of some ailments like Breast Cancer. What we have now is lots of people getting breast cancer due to poor diagnostic methods, stigma for preventative breast exams, and people slip through the cracks. Likewise we need a less expensive test for the BRCA gene so that we can use genomics to tailor pick which cancer drugs to use to get the best outcome.

There's some new work that's happening with testing the breath of patients as it's apparent that at least some dogs can detect cancer from the patient's breath, and this could significantly improve diagnosis. Early detection means catching before it's spread and become a largely expensive losing battle.

Testicular cancer is waved away with a wink and a nod, even though it's very serious and any guy can check for lumps, but the stigma of feeling ridiculous results in young men getting it.

The amount of young people with STDs is entirely too high. There's no reason that every sexually active young person should avoid screening. As secondary and tertiary spread of STDs continue, then extremely expensive treatment and poorer outcomes result. Worse it's spreading the disease(s) to unsuspecting people who often are very naive, prone to shame and guilt, and results in increasing the amount of infections.

Yes, a lot of testing is ridiculous because it's applying a broadcast method of unnecessary tests to CYA for the physican and their practice. But by the same token something like Hyperthyroid testing for women is entirely too low, is inexpensive, can be treated with very inexpensive generic drugs, and yet we have lots of undiagnosed cases.

Why? Because many female patients are not taken seriously as the symptoms could be the result of anxiety as well. The flipside of the issue is that same female patient might cycle into Hypothyroid disease, and as a result then get very depressed and lethargic. The whole thing is preventable and inexpensive, but only if the patient is taken seriously and not dismissed as well as the physician not being too busy to order it.

As Obamacare will lead to shortages of physicians due to all of the extra people signing up for it, then we can expect less time with the physician as a logical outcome. Which means a lot of responsibility on the RN to do a thourough workup, and that's far from ideal.

Because of electronic records and Informatics (the transfer of written patient records into an electronics databased for searches) then many mistakes will occur with proper transfer of those records as data. Not only this, but many RNs have elected to transfer into the Informatics department, and they're the seasoned ones, so you have yet another brain drain from RNs exacerbating a now 40 year shortage.

Quit whining Tim, you're boring me with your mantra about conservative links when you'll accept a liberal one.

 

[Timsup2nothin]

Quit whining Tim, you're boring me with your mantra about conservative links when you'll accept a liberal one.

Once again, if you are going to toss off wild accusations, please provide some indication where this happened other than in your fertile imagination...which seems to be your primary source on all things.

 

[Crackerbox]

I may be the only person who's been actually involved with healthcare. Who knows how many people have been run off by the extreme bias in this topic?

 

[Timsup2nothin]

I may be the only person who's been actually involved with healthcare.

Or you may not. You may also not know thing one about economics. Or you may be the ghost of John Maynard Keynes. No one asked you, or anyone else, for a resume. If your posts make no sense your qualifications are irrelevant.

For the record, I recognized your 'involvement in healthcare' when you started whining about how the ACA was impoverishing our poor doctors. The genuine source of your concern with limiting healthcare costs is clearly because to you healthcare isn't cost, it is income, so you of course resist limitations being imposed. Your 'involvement in healthcare' gives you an obvious personal stake that lessens the weight of your arguments...or it would if you weren't already just blowing soap bubbles anyway.

 

[Crackerbox]

Or you may not. You may also not know thing one about economics. Or you may be the ghost of John Maynard Keynes. No one asked you, or anyone else, for a resume. If your posts make no sense your qualifications are irrelevant.

For the record, I recognized your 'involvement in healthcare' when you started whining about how the ACA was impoverishing our poor doctors. The genuine source of your concern with limiting healthcare costs is clearly because to you healthcare isn't cost, it is income, so you of course resist limitations being imposed. Your 'involvement in healthcare' gives you an obvious personal stake that lessens the weight of your arguments...or it would if you weren't already just blowing soap bubbles anyway.

Right, because docs need to bend over so the very people who would get Medicaid before will now still get Medicaid due to meddling while also making private health insurance more expensive. Great, how very logical. Stellar job. It's about demonizing docs. They're so rotten because they're out to steal from poor patients and deny them coverage.

What malarkey. It couldn't have anything to do with demanding people have more insurance than they want. It couldn't have anything to do with actually requiring people to live healthier instead of, "Doc, can you just get off my butt about my weight and give me a pill. What about approving my bariatric surgery? What about writing me a note so I can stay home a couple of extra days?"

Yeah, it's the doc's fault. He/She's the one who missed a diagnosis because of incompetence, not managed care that's trimmed down the amount of time he can see patients due to getting slammed with them and spending 9 minutes of face time with the patient.

 

[Timsup2nothin]

Does this "woe woe woe us poor doctors" whining have any relevance to the topic or offer any support to one or more of the wild diversity of unsupported positions you have already littered the thread with?

 

[Crackerbox]

It has everything to do with the massive waste in American healthcare due to a detached idea that a pill will fix a decade of abusing one's body and/or mind. Why do you think that instead of getting real counseling about say getting a job that fulfils you, the patient comes in, "Doc, I saw a great advertisement for ____. The woman looked so happy afterwards. Can we try that med because my depression isn't getting any better?"

Can you imagine with all of these undocumented workers from diverse Central American countries and Mexico, who lack basic public health protection with clean water, who have all manner of issues like scabies, lice, impetigo, and parasites...that we'd just let them in carte blanche? Or we belly ache because Americans won't get vaccinated because they found that the rate of Autism skyrocketed and perhaps because of Thimerosol in those vaccinations...and then let in the undocumented (that no country in the world would allow in) who lack the very same vaccinations. And that actually have contagion.

Right, makes perfect sense to me. Don't listen to the physicians and medical staff because you see they have a vested interest to maintain the status quo. What a bold face falsehood for over and over the very same workers have worked to help improve healthcare in America, stayed over hour upon hour, check on patients, consulted, worked tirelessly by staying on the phone to argue with the patient's insurance companies.

And people want them to bend over and cut salaries. Wow. I wonder if you'd volunteer to cut your income even a penny.

 

[JollyRoger]

When you medical professionals lobby for tort "reform", what you really are asking for is for trial lawyers to take a cut in income.

 

[Farm Boy]

They're overpaid and cause cancer like agriculturalists anyways. Maybe they should cut back to subsistence practices because randos find the idea romantic for other people.

 

[hobbsyoyo]

What does 'I'm the only one involved with healthcare' even mean?

 

[JollyRoger]

No patients

 

[ArneHD]

They're overpaid and cause cancer like agriculturalists anyways. Maybe they should cut back to subsistence practices because randos find the idea romantic for other people.

What is an agriculturalist and why are they a cancer? When I wiki the term it redirects to farmer.

 

[Farm Boy]

Oh, I'm just being snide about trial lawyers and doctors. Then maybe a little bit about myself. Everyone thinks they're important. A lot of careers could do with pay cuts for the common good. But nobody's own poo smells.

 

[hobbsyoyo]

What is an agriculturalist and why are they a cancer? When I wiki the term it redirects to farmer.

He was making an obtuse reference to the fact that some poster or other essentially stated that farmers grow cancer causing foods or some other garbage.

You can find some really weird accusations about nearly every group, be they farmers, lawyers or doctors here in OT if you dig deep enough.

 

[Timsup2nothin]

It has everything to do with the massive waste in American healthcare due to a detached idea that a pill will fix a decade of abusing one's body and/or mind. Why do you think that instead of getting real counseling about say getting a job that fulfils you, the patient comes in, "Doc, I saw a great advertisement for ____. The woman looked so happy afterwards. Can we try that med because my depression isn't getting any better?"

The hilarious thing is that if you ever bothered to read for understanding instead of skimming other posts for something to fly off on a tangent about you would realize that the most likely source of agreement with this line of reasoning that you are likely to find here is me. Unfortunately for you I'm not willing to make the leap into "oh look how those evil pharmaceutical companies are driving people into paying the poor downtrodden doctors...woe for the poor doctors, woe, woe, woe." If you had made an effort to identify our common ground you could have made an advantage of it, instead you had to follow the greedy little woe is me path and undermine what little position you had.

Can you imagine with all of these undocumented workers from diverse Central American countries and Mexico, who lack basic public health protection with clean water, who have all manner of issues like scabies, lice, impetigo, and parasites...that we'd just let them in carte blanche? Or we belly ache because Americans won't get vaccinated because they found that the rate of Autism skyrocketed and perhaps because of Thimerosol in those vaccinations...and then let in the undocumented (that no country in the world would allow in) who lack the very same vaccinations. And that actually have contagion.

Then, while getting your butt handed to you on the favorite conservative issue "healthcare is broken because Obama " you try to widen the field by repeated sorties into immigration. Not that this really "makes you a conservative", but you do seem to focus on their hot button issues.

Right, makes perfect sense to me. Don't listen to the physicians and medical staff because you see they have a vested interest to maintain the status quo. What a bold face falsehood for over and over the very same workers have worked to help improve healthcare in America, stayed over hour upon hour, check on patients, consulted, worked tirelessly by staying on the phone to argue with the patient's insurance companies.

Bold face falsehood? Are you saying that doctors did not have a vested interest in maintaining a system in which their fees rose at a substantially higher rate than inflation? Apparently your medical school did not offer courses in economics, and you are not the ghost of John Maynard Keynes. There is nothing false about that at all. You could try to say that you personally are not driven by that interest. You could try to overcome the reality that you do have such an interest in the making of your arguments. But just pretending it doesn't exist and calling me a liar for pointing it out indicates that either you are trying to hide it or are too disconnected from economic reality to recognize the basics.

And people want them to bend over and cut salaries. Wow. I wonder if you'd volunteer to cut your income even a penny.

I volunteered to cut my income entirely. The attempt to manage your ethical position based on 'well I'm no worse than you' has failed miserably, because you tried it on what may be the only guy here who could bust it in the snout that solidly.

Doctors against the ACA is basically like the union that makes such aggressive demands that they drive their company out of business. The healthcare payment system was going to shift payments from the payers to the doctors until the payers broke (and it still might)...and the single biggest payer was the US government. When the US government breaks because of that it will leave people like me unchecked, and my solution to the collapse of civil order in that circumstance is to eat all the doctors first. GR would be happy with that, because under most circumstances my first meals are lawyers.

I have to note that in either event I choose Farm Boy the Agriculturalist for king.

 

[El_Machinae]

It's very hard to increase people's health habits at the government level. I'm not so sure that Americans are that much less healthy than other developed nations, though it's not a checkmark in the way people handle the society.