Jenks's Journal
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08/27/2009 17:25 #49641
this is probably wrong but I don't care08/17/2009 17:07 #49558
good health care plan?But I'd love to hear other opinions... DCoffee? Larsons?
Sounds a lot better than an Obamacare card to me...
The ideas here barely scratch the surface, and would not fix our healthcare problems.
I Agree:
What we eat and do with our lives greatly effects our health. But I don't see what the government can do to make tofu and cabbage more appealing than KFC, except maybe taxing unhealthy foods and subsidizing healthy ones to change cost incentives, but I don't think people would go for that. I can't even get into America's insane food culture, but I think it's mostly up to parents to teach good eating habits to their children.
Tort Reform - This is a big issue, I don't think it will save much money, but it cripples private practices. Doctors have to buy some kind of lawsuit insurance, and the cost is going up just as bad as healthcare in general.
Buying Insurance over state lines - the only reason we can't is because Insurance companies don't want competition. Try to change it and you'll see the insurance companies fighting it.
Equalize tax laws so insurance is tax deductible - Hell yea, this is one of the things that bugs me. I spend money out of pocket all year on health bills, weather it's insurance or actual doctors bills to see the dentist or whatever. Add it up, maybe it's $2,500 for the year, take it to the accountant "thanks, but it doesn't matter because it's not more than your standard deductible of $8,000." This standard deductable thing is bullshit, what is it supposed to accomplish? does it just make me think that my accountant is a magician for giving me a big writeoff? All it does is ignore essential expenses that come out of some people's income like mine. These expenses should either be added on top, or get rid of the $8,000 standard deductible and just change the tax brackets.
Tax form donation - like people said, this isn't going to generate much revenue.
Disagree:
The high deductable + HSA thing - They just did this at my mom's work, everyone's pissed because all of their copays literally doubled, for surgeries, overnights and emergencies you pay between $150-$1,500, and for a specialist you pay $75. Regular doctor $50. All this says to me is that they want to keep you out of the hospital, $50 for a regular checkup, what ever happened to preventing illness so we're keeping people healthy instead of waiting till someone has a heart attack and trying to save their life?
Does anyone actually like going to the hospital? Personally, I don't really enjoy waiting rooms, or sitting in my undies on a paper sheet waiting for a doctor to surprise me. I don't think there are that many individuals overusing the system. How about hospitals who bill for things they never preform, I'll bet there is a lot more money to be saved there.
Repeal government mandates regarding what insurance companies must cover - ?!?! this is a stupid and dangerous idea, but I'll bet the insurance companies are glad someone suggested it. My insurance company doesn't cover ambulance rides, or if I get hurt in another state. I'm supposed to sift through legal/medical language to find insurance that covers everything I will ever need? This is just legalizing denials.
Go ahead, tell America that that's your solution, you're going to double people's copays, then repeal government mandates so Insurance Companies are allowed to opt out of covering more illnesses and treatments. That's the plan to bring the cost of healthcare down. You think that will fly? hell no. That's probably why the republicans haven't even offered a proposal, cause it would sound something like that.
I still think Medicare for all is the way to go.
link
There's a little extra in that bill, like no copays, includes hearing, vision, dental coverage, but that's how it goes, you compromise throughout the process. You don't start with some complex middleground BS like the president and congress are doing now.
Sadly, it doesn't breach the topic of medical malpractice and the effect on health care costs. I don't think that's what the paper was meant to do any way. I'd be willing to check out a liberal perspective. Other than Daschle, et al, who supported this kind of reform earlier in the year.
To completely hijack the topic - this article on "tort reform" really is necessary reading if you want to develop an informed opinion on the subject:
:::link::: (PDF)
Mackey is in trouble for this with his customers. For some reason people who shop at Whole Foods expect the company to adhere to every political and social whim of the far left. I guess it's your prerogative as a customer. I guess I really don't care, they can get their food where they want.
I definitely agree that we should be able to buy health insurance from any state. The way I see things, we have a couple of regional choices and that's it. There isn't as much competition for our dollar as there could be. I don't understand why laws are put into place to restrict this.
Agree about equalizing the tax laws.
Government mandates - I don't have a problem philosophically with the government setting rules for the market place. I'm going to read more about the mandates. Mackey doesn't get too much into it. I don't have much to say about this.
I agree with everyone who says that we shouldn't be denied coverage because of pre-existing conditions. As a healthy person I already end up essentially helping to cover the risk of paying for someone who is sick. The healthy pay for the sick and it won't change. I'm okay with this.
Tort reform - this is something that has long been needed. It's so bizarre to me that someone wouldn't want this part of the mix to be cleaned up like the rest. Really, really bizarre. We have to be the most sue-happy nation ever.
Enact Medicare reform - okay. Tell me how. I already know they pay fractions on the dollar for services. I know it's abused. Tell me how it's going to be fixed.
Charity - this isn't going to cover a ton of people, but I don't have a problem with making it easier for people to make a donation. Nothing wrong with it at all. I don't foresee a flood of people taking advantage of this, after all part of the problem people have with the government solution is.....they have to pay for the slackers. Why would they pay now? It's a feel good proposition and that's all.
Regarding the rest, obviously I can't comment on everything. When Mackey talks about the root of the issue, the fact that we are a nation of unhealthy overweight folks, and we need a cultural change, I say HELL YEAH but changing food culture is hard enough in a family home, let alone a country. He's right that people should be responsible for their own health, but a lot of people just want their bills to be paid for and aren't interested. I do believe we need to change the food culture in the United States.
High deductible plan with HSA - I have one of these. You still have to pay for the health care you use, which some people are going to have a problem with. Premiums are lower. Catastrophic stuff is covered. I know that maximum I will spend X dollars on health care if something bad happens to me. I'm not abusing the system or nickel and diming the insurance company for copays for every little sniffle.
It forces you to be smarter about how you use health care, and think about preventative maintenance. $10 copays or $0 copays just invite people to take the easy route. Mackey's company gives 1800 bucks which is very, very generous. Presumably his employees may use that towards the deductible. My company gives nothing close to that amount, but I do get a pittance every 6 months.
If you're healthy at Whole Foods it's great, it's like an 1800 bonus every year that is YOURS and will accumulate interest, and it rolls over. If you aren't healthy...you get to still have your deductible subsidized. The employee also may contribute something out of their pocket towards the HSA. I do I think 500 a year.
The problem I DO have is this - why was my 20 minute doctor visit 65 bucks, and even worse, why was my GENERIC prescription 45?? WHY? It was worth 110 for me to get rid of my bronchitis, because I could afford it, but it seems brutally excessive and too expensive, especially for the less fortunate among us. I still have a problem with how expensive things are, and just paying fractions on the dollar to the providers doesn't solve the problem, it shifts ownership of it.
Of course, neither Mackey's ideas nor Obamacare answer one fundamental issue some people have, and that's making sure everyone is covered. We have finite resources and infinite wants. It kills me that some people think there is this infinite pool of dollars available. It's an ugly truth we have to swallow, that not everyone is going to get everything they want or need.
That's an interesting article.
One of the missing items is "pre-existing conditions". Insurance companies should not be allowed to exclude people based on their pre-existing conditions. Health insurance is not like auto insurance.
He says, "Repeal government mandates regarding what insurance companies must cover". I'm sorry, but I don't think this is a good idea. There are a zillion medical conditions, each of them known by a dozen different names in multiple languages. There is no way that a layman can understand a lethal mix of legal and medical terms.
I would suggest an FDIC-like federal insurance agency that comes in in extreme cases, and insures expenses over, say, 100K. All insurance companies pool money into this pot, just like banks put money into FDIC.
I'm all for limits on patient lawsuits. This is a uniquely American phenomenon.
Lastly: donations to cover the millions of uninsured people? Ain't gonna happen.
I firmly believe that any civilized society must have safety nets like decent, affordable healthcare for all; just like we have education, transportation, and other infrastructure. Not to mention Defence, which soaks up a large chunk of the budget anyways.
I like the high-deductible plan in conjunction with an employer-funded HSA, although the employer-funded HSA would probably not be very popular with many employers. A $2,500 deductible is out of reach of too many people (10% of a $25K income... way too much). This also doesn't address those who are self-employed or not employed (covering those who are unemployed - seeking work, unemployed - not seeking, disabled, etc.)
Totally agree on equal tax treatment of individual and employer-sponsored plans - it should all be pre-tax dollars.
I'm pretty sure I agree on plans being able to cross state lines - it's not particularly rational to have 51 versions of the same thing, but we do the same state-controlled but federally funded thing in so many other fields, it's also probably easy to make an argument in the other direction that is rational and fact-based.
I do have big issues with "Repeal government mandates regarding what insurance companies must cover." Health and illness aren't predictable - what if your plan doesn't cover exactly what happens to you in a car accident? Or you develop a mental illness but your plan doesn't cover it? Stuff needs to be covered and insurance companies cannot be allowed to wiggle out of coverage. I read a case in contract law last semester about a break-in at a warehouse that the insurance company didn't want to cover because there weren't sufficient signs of forceable entry, even though that how the perpetrators had gotten into the building. The insurance company lost, but it shouldn't have been an issue at all - does this policy cover burglaries? Yes. Okay, all burglaries are covered, duh. I'm pretty passionate about this because I have one of those medical issues that insurance companies love to shaft on coverage. I would hate hate hate to see people get shafted by greedy nasty insurance companies crafting policies that no one understands and no one can get coverage for actual problems. Does anyone actually read the policy manuals they get from their employer or health insurance company? How much is the copay on that appendectomy? Oh, it's not covered! Only spleenectomies are covered. The idea that insurance companies can offer some kind of a la carte plan is also silly - if they make a cheaper version that doesn't cover ob/gyn care, it discriminates against women - but that's legal (Gudeldig v. Aiello :::link:::). So fucked up.
"Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year." My tort law class touched on medical malpractice tort law for about 10 minutes, so I don't feel like I have enough data to be emphatic about this, but I'm pretty sure this is an exaggeration propagated by the folks related to other "tort reform" - which is incredibly bogus and pro-biz ideological when you look at the data of who sues, how much they get and why.
I'm all for clarity and truth in fees and billing but the current system is pretty broken. The retail fee schedule is way higher than the fees that are paid by insurance companies or medicare. A rather intense, personal look at that issue in Alaska: Mired in the Health Care Morass :::link:::
"Enact Medicare reform." I don't have the time at the moment to analyze/deconstruct that, hopefully someone else will.
"Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation ..." Laughably naive. We cannot run a health care system on charity.
Didn't we deal with the "rationing" canard last week?
08/16/2009 08:37 #49548
Rebirth!!But I have to say- I'm sure the band kept thinking "wow, we are not in new orleans". These guys are a fixture down there. Everyone knows and loves them. Then they come here and get a bunch of white people, all sitting down- haha. They kept saying "come on people, MOVE!"
Heh. Eventually people got into it and were dancing. But so fun.
I don't know how people can listen to this music and NOT 1: instantly feel happy and 2: shake that ass!
Gotta love those horns!!
haha, yeah- last night they segued into TLC's Waterfalls. It was pretty funny.
sounds like fun!
Sweet! I saw Rebirth in NYC a few years ago, and they were awesome. They did a hysterical version of Let's Get It On.
I saw them at B.B. King's Blues Bar, and it struck me that I'd never seen so many blonde Eurowaif cocktail waitresses at a blues club.
- Z
08/13/2009 13:57 #49525
WTF????!!!!!!!!!!That's a little frightening. Because I can't tell who it's from (just comes up as one of those 5 digit codes).
But it was some text message telling me to go to some dating website.
I do NOT like this. How the fuck did they get my cell phone number? Who are they? I don't like that I can't respond/block them.
This is not cool. Spam email is one thing. But spam texts??!!
Has anyone else had this happen??
If it came from 36245, somebody emailed your phone and you'll never find them [36245 spells 'EMAIL']. That's bogus and cheap [and also how (e:strip) sends mobile messages]. Your phone's email address would be something like 7168771932@txt.att.net, depending on your carrier.
Occasionally, carriers will sell 'legitimate spam' messages, which usually spend half the allotted space explaining that you're not getting charged for it. I haven't gotten one of those in a while, but I doubt they've stopped doing it.
- Z
I HATE text spam! I don't even use my phone much and my balance keeps dwindling because all these random spammy texts AND texts from drunk teenagers sending 6 messages at a time. I absolutely hate it. :/
I've gotten a couple. I think it's part of cell phone numbers being telemarketed. I'm confident that Sprint is treating their numbers like a regular old list database and the random something gets through.
08/13/2009 13:24 #49523
more healthcare stuff, blah blah blahI just finished taking my general surgery boards. Fingers crossed that I passed- because it's not something I'd like to do again.
So now I am catching up with email- got this from the American College of Surgeons the other day.
Now, when I don't have my facts straight, I try to stay out of a conversation- or at least admit that I may well be talking out of my ass. Apparently our president does not do the same thing?
This is distressing, if you ask me...
Statement from the American College of Surgeons Regarding Recent Comments from President Obama
CHICAGO--The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people at a time when they want clear, understandable facts about health care reform. We want to set the record straight.
Yesterday during a town hall meeting, President Obama got his facts completely wrong. He stated that a surgeon gets paid $50,000 for a leg amputation when, in fact, Medicare pays a surgeon between $740 and $1,140 for a leg amputation. This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation. Private insurers pay some variation of the Medicare reimbursement for this service.
Three weeks ago, the President suggested that a surgeon's decision to remove a child's tonsils is based on the desire to make a lot of money. That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what's right for the patient.
We agree with the President that the best thing for patients with diabetes is to manage the disease proactively to avoid the bad consequences that can occur, including blindness, stroke, and amputation. But as is the case for a person who has been treated for cancer and still needs to have a tumor removed, or a person who is in a terrible car crash and needs access to a trauma surgeon, there are times when even a perfectly managed diabetic patient needs a surgeon. The President's remarks are truly alarming and run the risk of damaging the all-important trust between surgeons and their patients.
We assume that the President made these mistakes unintentionally, but we would urge him to have his facts correct before making another inflammatory and incorrect statement about surgeons and surgical care.
Wait, where are these doctors who think all you do is cut? And that it's only about money?
I know people seem to think these guys are out there... and maybe they are... but, I certainly don't know any...
I mean, there is a certain code of ethics and moral behavior in medicine...
You lose your license over stuff like that... Hippocratic oath and all that...
I mean maybe I'm naive- but I think these hacks are more urban legend than real.
But that's all beside the point.
If you're the freaking president of the United States- you should at least sort of have your facts right before speaking. Saying that something that costs $1000 costs $50,000 is a pretty big error.
Though James certainly has a point- I don't know the context of the comments. Just the statement from the ACS. Who is of course protecting their own interests.
And- an amputation is not as basic a procedure as you may think...
To be honest I have no idea how much surgical procedures cost- as residents we are completely sheltered from the 'business' side of it. But considering that that 750-1000 includes 3 months of postop care- it's not all that much.
He Said the wrong thing but I know what he was getting at. What he means is that there are some doctors who think that when ever there is a problem you cut. They are Cut happy and they lean that way and don't give their patients all the facts. Surgery shouldn't be the only option. I'm sure he thinks these doctors prefer this because of the money factor.
Just out of curiousity... How is $1000 for a leg amputation not a lot?
It really does seem like a bit much for what is apparently, to me, a pretty basic procedure.
I had no idea that Obama could fib.
I would be interested to see the President's comment in context.
Interesting. The President shouldn't be pulling numbers out of his ass to make a point.
I think doctors should get paid better. I'm worried that too much money is being skimmed off the top before the surgeon gets paid. $1,000 for a leg amputation doesn't seem like a lot to me, I wonder how much the hospital gets paid for the room the surgeon uses.
It is true that Ted was a deeply flawed man, and that he showed the part of his character during that event that wasn't very flattering.
I've been doing some more reading since his death and I learned he actually spoke at Falwell's Liberty Baptist College back some time ago. He was someone that even if he disagreed politically with you he could still show you respect and get along quite well. That part of his character is entirely ignored by people, but I admire him for it.
I also think, despite me saying "what the hell does someone like him know about what the poor needs", that he was not a faker when it comes to helping the poor and the sick. When he says that having UHC represents the kind of just society he believes in, I have no reason to doubt him.
Also I've learned more of his personal warmth towards his employees and colleagues. Handwritten letters. Gifts. Nobody does that anymore.
So I think he had some traits that are worthy of taking a second look. He had his very bad, he had his very good.
It was 1969, so no, you probably weren't watching the news then. ;)
Here's more info-
:::link:::
It's argued that that's a large part of the reason he never ran for president.
There are a lot of questions I guess surrounding it all, but presumably he was drunk, crashed, she died, and he fled the scene. It wasn't reported to the cops til the next day, but was somehow all swept under the rug because he's a Kennedy.
Thanks for explaining that, some how I never heard of that. Well I can admit it is easy to miss a big news story like that, I'm not sure when it happened so Maybe I didn't follow the news then.
That's pretty funny. Peter, it is a Chappaquidick reference, where Teddy drove off a bridge with an aid and the aid didn't make it out
Help Me out here. Is that because he is a Drunk and being a Drunk is little drowning? Or is that because two Kennedy's where Murdered? Or is it because one crashed into a Tree? What Am I Missing?