Discussion in 'Politics & Religion' started by misterno, Mar 22, 2010.
The bill means "leftist radicals will now be making your health care decisions, instead of your doctor,' warned Limbaugh.
"... and it will be much harder to get the drugs that make you feel real good" - he added off the record.
Doctor's don't practice medicine. They practice insurance billings and CYA procedures. They are bound to the terms and conditions imposed by their medical malpractice insurer. If they deviate they get dropped and the same goes with providing services. If they have no procedure code or pre-approval they can't do it.
Exactly how does HIPPA come into play when your medical info is transmitted to the insurer by your doctor so he can get paid?
Most doctors I know practice the best medicine they can. Some may focus upon maximizing billings, but in my experience, they are the exceptions.
About a fourth of the tests I order are to CYA in order to prevent missing something obscure that may lead to a malpractice suit. Patients like that I am thorough, but I would order fewer tests if we did not live in such a litigious society. Our lawyer friends who run the country do not think that the threat of malpractice increases medical costs, but it does.
I try to practice quality medicine. I have malpractice insurance, but there are no terms and conditions imposed upon me. I have never heard of a doctor deviating from these conditions and getting terminated. I have no doubt that there are some terms in the policy that allow for revocation in the case of gross misconduct or repeated incompetence, but they would apply to extreme circumstances rather than daily practice.
Every charge must have a procedure code, but only expensive tests and surgical procedures need pre-approval.
Patients sign a form waiving HIPPA confidentiality rules allowing doctors to provide relevant information to insurance companies to allow payment for appropriate services.
Regarding the video, I have no sympathy for specialists complaining that they are receiving less money. Doctors in general and specialists in particular are among the top wage earners in the country. Doctors keep their numbers low by limiting the number of medical schools. If more medical students could be trained, we would not have a doctor shortage and physcian pay would decrease.
Actually your not far off the mark.
VA doctors often can not prescribe non generic drugs because of the costs. The doctors have to get authorization in many cases and show that they first tried other less expensive drugs first without results even though the more expensive one may be better for the patient.
There is no such thing as a free lunch and there is no way you can provide more service to more people at a lower cost. Costs can include other things besides money, like time (think waiting) and health problems that take longer to figure out as tests that may be given now by your doctor are not given until others prove negative.
All that wasted money on all the needless tests do come back once in a while with an unlikely cause.
Some of the money goes towards R&D and improving the quality. What happens to improvements to medicine if the ability to make a profit is gone.
Lastly, When was the last time the CBO was able to get a budget prediction right? I mean even by 10 or 15% within the mark?
I know many don't agree with me but I don't think the people that run the post office (running large deficit), Amtrak (running large deficit), and of course who can forget what a bang up job they are doing keeping tuition costs down in government run colleges from sea to sea. Of course we would be forgetting the one area where we already have government run health care. medicare, that great program where people are already getting a feel for the "sorry we are not taking any more medicare clients"
Its going to be interesting when the baby boomers go into full speed retirement wanting all that social security money and medicare and find out there is not enough money to pay for it. Of course they will also be the largest voting block. What is going to happen to America when there is not enough people to pay for all the things that the boomers want and no one is stupid enough to loan us more money around 2020?
It is not hard to imagine in 2020 that 15-20%+ of the budget going towards interest payments to service the debt load. Or home loans at 12% or more. Gas at $15 a gallon since the dollar was devalued or that standard of livings are going down compared to those in Asia. 60% effective income tax (fed, state, local) on income alone before you add in property or sales tax. How do I explain this to my kids?
I am not saying mad max or anything like that but I think we are going to have some serious rude shocks to peoples understanding of what type of quality of life we may end up having. This credit card bill our uncle Sam seems to be running up will have to get paid at some point even if no one in DC knows what a due date is
I don't think anyone's talking about the government taking over medicine, just the payment mechanisms for it.
I'm not taking a pop shot at Doctors. I believe they have their hands tied because of the litigious nature of our society and the mechanisms in place for them to get paid.
What if patients refused to provide the HIPPA release? Is there a procedure code for "Confidential" treatment? I'm sure such code would make both patients and doctors happy.
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Whoah, stop the bus right here.
Don't write me off as being a cynical ass, but when somebody controls the purse strings, they control the whole shootin' match.
Name me one instance about anything at anytime in history anywhere in the world where the one who controls the funding didn't have a heavy influence over the outcome of events, if not run the entire show.
Over the last 30 years, the Congressional Budget Office (CBO), which assesses the costs of health reform and other legislation as it moves through Congress and is widely respected for its competence and integrity, has underestimated the amount of savings and overestimated the costs that major changes in the health care system would bring.
CBO underestimated savings from reforms Congress made in the way Medicare paid hospitals by $11 billion.
Savings from the Balanced Budget Act of 1997, which changed the way skilled nursing facilities and home health services were reimbursed under Medicare, turned out to be 50 percent greater in 1998 and 113 percent greater in 1999 than the budget office forecast. And, CBO predicted that drug prices would rise following the Medicare Modernization Act of 2003, which added prescription drug benefits to Medicare, estimating that spending on the drug benefit would be $206 billion. Actual spending was nearly 40 percent less than that, Gabel found.
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