Originally Posted by Justin '77

That's all bundled into what gets called 'overhead'. I gave you a 33% markup for it.

... and all I said was that you're low. It's trivial, so let's skip it.

Originally Posted by Justin '77 ...

True. So as I've been saying for a fair chunk here, the 'fix' being offered not only doesn't fix a thing (since it doesn't even begin to address the actual problem or provision of actual solutions), but it accepts the broken status quo as a foundation and makes it that much less assailable. I've never tried to claim that it was a short or easy road from here to a better place.

Here's where the problem lies. We have systems of medical institutions, providers and insurers. If we cut the insurers loose, we get some minor chaos, but the system still provides health services. For my money, the insurance industry has no claim on healthcare. Kick then to the curb. But at that point, you still have real issues that need to be resolved.

The providers have big investments in being providers ... some more than others. Now, I'm not one to believe that MD after ones name (or any other letter combo for that matter) automatically entitles anyone to big bucks, but I do believe that 8-years of college and 2 or more in clinical rotations needs to be recognized and rewarded – assuming it’s more than just a rite of passage to the gravy train, of course. The same is true for other specialties. Some specialties are pushing the envelope, and may need to back-down a bit. Do we need Physical Therapists with PhDs, when the standard requirement was a BS as recently as 10 years ago? This has all the signs of puffery.

In any case, most of these services would probably be better handled through clinical practice than through the traditional stand-alone medical practices, with their interwoven relationships and consultation deals. Good personnel in adequate numbers are still going to be expensive ... and should be. It just doesn't need to be confiscatory. And there are alternatives to MDs and DOs. NPs and PAs are often exactly the right level of primary care, and even support some specialty services. In any case, the correct mix of providers can be established as time goes along.

Then we have the institutions. Yes, hospitals try to bill until you drop, and they are notorious for buying gadgets, using gadgets and billing for using gadgets. It's what they do. Because they are fee-for-service, they can and do gouge. They argue, with some justification, that they are being forced to provide free care to the indigent, so they pass the cost to other payers when they can. The fix for that is to eliminate the category "indigent non-paying patient", but that only fixes the excuse, not the problem.

Hospitals and out-patient facilities are the toughest nut to crack, because they have real costs just to exist, and we can't do without them. I think it's worth considering the UK model of direct ownership and staffing of these places. What we have is terrible, so anything should be better.

http://www.washingtonpost.com/blogs/...-and-medicaid/

The ranks of the uninsured are shrinking, and it’s thanks to Obamacare and Medicaid

About 1.4 million more Americans have health insurance than did one year ago, according to new data out Wednesday morning from the United States Census Bureau.

That reverses a three-year trend of rising uninsured rates, with the number growing from 16.3 percent in 2010 to 15.7 percent in 2011. That means there are 48.6 million Americans without coverage, down from 50 million in 2010.

Census data also shows 2011 to be the first year in a decade where the rate of private insurance did not fall.....

....The other driver has to do with a growth of Americans using public insurance programs, like Medicaid. When you break down the insurance numbers by income, you see that the biggest gains have been made among the lowest-income Americans, most likely to be eligible for those programs....

Ye-haw!

And yet the quality of care for which they are spending their money has not increased a whit, nor has its cost even begun to stop moving further and further from rational and just.

Good job, guys. Those CEOs really appreciate the big bonuses your Insurer Guaranteed Profitability Act garnered them. That lobbying money they spent really paid off... I'm sure you'll be getting thank-you cards any minute from them.

Originally Posted by Justin '77

And yet the quality of care for which they are spending their money has not increased a whit, nor has its cost even begun to stop moving further and further from rational and just.

Good job, guys. Those CEOs really appreciate the big bonuses your Insurer Guaranteed Profitability Act garnered them. That lobbying money they spent really paid off... I'm sure you'll be getting thank-you cards any minute from them.

I think you may have had a brain fart or something because that's about the silliest thing I've ever read in the health care debates, and there have been some pretty silly ones.

I recognize that there's an argument to be made about the quality of care provided, but it is little silly to suggest that a few million people who did not have insurance before but do now will not be getting care, regardless of quality, than they didn’t get before.

It is a little like sniffing at a McDonalds hamburger because it’s not on par with top sirloin from a 5 star restaurant, and then concluding that someone who hadn't eaten much in a few days would therefore not benefit from getting a McDonalds hamburger. Just silly.

Not your usual level of thinking. If you want to delete it; I’ll be kind and delete this response. Who needs a record of their brain fart?

Originally Posted by playwrite

I think you may have had a brain fart or something because that's about the silliest thing I've ever read in the health care debates, and there have been some pretty silly ones.

I recognize that there's an argument to be made about the quality of care provided, but it is little silly to suggest that a few million people who did not have insurance before but do now will not be getting care, regardless of quality, than they didn’t get before.

It is a little like sniffing at a McDonalds hamburger because it’s not on par with top sirloin from a 5 star restaurant, and then concluding that someone who hadn't eaten much in a few days would therefore not benefit from getting a McDonalds hamburger. Just silly.

Not your usual level of thinking. If you want to delete it; I’ll be kind and delete this response. Who needs a record of their brain fart?

I'd say it is more like locking up the dumpster out back, where poor people used to get free big mac scraps, and taking down the no shirt/no shoes sign as a tradeoff.

So, the new policy says those with no money have to come in the store and buy their big mac like everyone else. After paying for the monthly membership fee that allows you a chance to buy french fries, of course.

Oh and sure, there are a few places like Mayo and Sinai that are serving prime steaks, but for most people the line at McDonald's just got longer and the same old crappy food just got more expensive.

Originally Posted by Justin '77

And yet the quality of care for which they are spending their money has not increased a whit, nor has its cost even begun to stop moving further and further from rational and just.

Good job, guys. Those CEOs really appreciate the big bonuses your Insurer Guaranteed Profitability Act garnered them. That lobbying money they spent really paid off... I'm sure you'll be getting thank-you cards any minute from them.

OK, this "new system" is really the old system with a new paint job, but the real question is: is the overall system under ACA better or worse than the old CF system? As a major critic of ACA, I have a hard time evaulating it any higher than a high 'F' ... but that's better than a low 'F' the older model rated

That's where we are: sucky progress. But even sucky progress is still progress.

Originally Posted by playwrite

http://www.washingtonpost.com/blogs/...-and-medicaid/




Ye-haw!

Comment from Doctor Don McCanne:

The numbers of uninsured decreased from 50.0 million in 2010 to
48.6 million in 2011. That might be good news for the net 1.4 million newly
insured, but it is terrible news for the 48.6 million who remain without
health insurance.

These numbers, of course, are transitional since new private coverage
through the state insurance exchanges and the greater expansion of coverage
under Medicaid will not take place until 2014. Even then, the new coverage
will be either with private underinsurance plans (low actuarial value and
inadequate subsidies) or with the chronically underfunded Medicaid program,
with even greater impairment of health care access likely. Worse, 30
million will still have no coverage at all (CBO).

Perhaps even more shocking is that 31.2% of families with a female
householder live in poverty - right here in the United States!

And income inequality? The aggregate share of household income has
decreased for the middle and fourth quintiles. The middle class is being
wiped out!

Of course we knew all this. So why aren't we doing something about it?
Howling in the wind doesn't seem to be getting us very far.

Originally Posted by JohnMc82

I'd say it is more like locking up the dumpster out back, where poor people used to get free big mac scraps, and taking down the no shirt/no shoes sign as a tradeoff.

So, the new policy says those with no money have to come in the store and buy their big mac like everyone else. After paying for the monthly membership fee that allows you a chance to buy french fries, of course.

Oh and sure, there are a few places like Mayo and Sinai that are serving prime steaks, but for most people the line at McDonald's just got longer and the same old crappy food just got more expensive.

Very good comparison.

Originally Posted by JohnMc82

I'd say it is more like locking up the dumpster out back, where poor people used to get free big mac scraps, and taking down the no shirt/no shoes sign as a tradeoff.

So, the new policy says those with no money have to come in the store and buy their big mac like everyone else. After paying for the monthly membership fee that allows you a chance to buy french fries, of course.

Oh and sure, there are a few places like Mayo and Sinai that are serving prime steaks, but for most people the line at McDonald's just got longer and the same old crappy food just got more expensive.

Tell that to the woman who has ovarian cancer and can now actually get contraceptives for free to help mitigate that.

Light a candle, nitwit, instead of cursing the darkness.

The Affordable Care Act and You
The health care law protects women by providing insurance options, covering preventive services, and lowering costs:

Insurance Companies Can’t Deny Coverage to Women. Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and having been pregnant. Under the law, insurance companies are already banned from denying coverage to children because of a pre-existing condition. In 2014, it will be illegal for insurance companies to discriminate against anyone with a pre-existing condition.

Women Have a Choice of Doctor. Thanks to the Affordable Care Act, all Americans joining new insurance plans have the freedom to choose from any primary care provider, OB-GYN, or pediatrician in their health plan’s network, or emergency care outside of the plan’s network, without a referral.

Women Can Receive Preventive Care Without Copays. Thanks to the Affordable Care Act, all Americans joining a new health care plan can receive recommended preventive services, like mammograms, new baby care and well-child visits, with no out-of-pocket costs. See a list of preventive services for women. (Preventive services benefits apply if you’re in a new health plan that you joined after March 23, 2010.) Learn about new women's preventive care guidelines issued August 1, 2011.

Women Pay Lower Health Care Costs. Before the law, women could be charged more for individual insurance policies simply because of their gender. A 22-year-old woman could be charged 150% the premium that a 22-year-old man paid. In 2014, insurers will not be able to charge women higher premiums than they charge men. The law takes strong action to control health care costs, including helping states crack down on excessive premium increases and making sure most of your premium dollars go for your health care.

The Affordable Care Act and Your Family
Women often make health care decisions for their families, and the law enhances their ability to make the best choices by:

Delivering New Coverage Options for Americans with Pre-existing Conditions. Health plans that cover children can no longer exclude, limit or deny coverage to your child (under age 19) based on a pre-existing condition. In addition, the law created a new program called the Pre-Existing Condition Insurance Plan (PCIP) to help provide coverage for uninsured people with pre‑existing conditions until new insurance market rules that prohibit discriminating against anyone with a pre-existing condition go into effect in 2014.


Providing Consumers with New Rights and Protections: The Patient’s Bill of Rights. The Affordable Care Act frees Americans from worrying about losing their insurance, or having it capped unexpectedly if someone is in an accident or becomes sick, giving you greater control over your health insurance and care. It also places tough restrictions on health insurance companies to make them more accountable to you.

Requiring Plans to Cover Preventive Services Without Out-of-Pocket Costs. The law requires new health plans to cover recommended preventive services, including vaccinations, cost-free. Regular well-baby and well-child visits are also covered from birth through age 21. These services do not require a copay or co-insurance when offered by providers in your insurer’s network. See a list of preventive services for women and children. (Preventive services benefits apply if you’re in a new health plan that was created after March 23, 2010.)

Allowing Kids Under 26 to Stay on Their Parents’ Plan. If your plan covers children, you can now add or keep your children on your health insurance policy until they turn 26 (except, in some cases, when your child’s employer offers health coverage). It doesn’t matter whether your child is married, living with you, in school, or financially dependent on you.

Help for Family Members on Medicare. If your parents or other loved ones are on Medicare, it’s good to know the Affordable Care Act protects current benefits, strengthens Medicare for the future, and offers new benefits that will help cut costs. The gap in drug coverage known as the “donut hole” is being closed, reducing seniors’ out-of-pocket costs. In addition, people on Medicare may receive recommended preventive care like mammograms and colonoscopies for free. Read more in our Medicare & Long-Term Care section, where you can find out about Medicare, long-term care, and other options for seniors.

I'm keeping an open mind on Obamacare, seeing if the "Insurance Companies must use at least 80% of money coming in for healthcare" clause is enforced. If it is we will starting going down the path towards the Swiss system.

Originally Posted by The Rani

Wait ... what? BCPs now treat ovarian cancer?
This Obamacare thing truly is a miracle.

Didn't you hear? The Dear Leader has all sorts of miraculous powers. We mere mortals can only hope his brilliant and charitable gaze falls our way.

Originally Posted by playwrite

Tell that to the woman who has ovarian cancer and can now actually get contraceptives for free to help mitigate that.

"For free", huh? Except for the money she's gotta pony up every month to keep the insurance CEO bonuses rolling in. And copays and so on. All for a treatment that costs a fraction of the amount of money she's being forced to shell out even if she doesn't get treated.

But yeah, whatever it takes to keep the fucked-up system rolling along as much unchanged in its fundamentals as possible. Call it a victory and maybe people will stop bugging you about making actual improvements.

Originally Posted by Justin '77

"For free", huh? Except for the money she's gotta pony up every month to keep the insurance CEO bonuses rolling in. And copays and so on. All for a treatment that costs a fraction of the amount of money she's being forced to shell out even if she doesn't get treated.

But yeah, whatever it takes to keep the fucked-up system rolling along as much unchanged in its fundamentals as possible. Call it a victory and maybe people will stop bugging you about making actual improvements.

It's a little more complicated than that - usually is with you.

If the women is in a household earning up to 400% poverty line (over $90K per year for a family of 4), the feds subsidize her insurance. Something she never had before.

silly you!

Originally Posted by The Rani

Wait ... what? BCPs now treat ovarian cancer?
This Obamacare thing truly is a miracle.

splitting hairs, hey?

http://www.mayoclinic.com/health/ova...ents-and-drugs

Ovarian cysts - Treatments and drugs
By Mayo Clinic staff

Treatment depends on your age, the type and size of your cyst, and your symptoms. Your doctor may suggest:

Watchful waiting. In many cases you can wait and be re-examined to see if the cyst goes away on its own within a few months. This is typically an option — regardless of your age — if you have no symptoms and an ultrasound shows you have a small, fluid-filled cyst. Your doctor will likely recommend that you get follow-up pelvic ultrasounds at periodic intervals to see if your cyst has changed in size.

Birth control pills. Your doctor may recommend birth control pills to reduce the chance of new cysts developing in future menstrual cycles. Oral contraceptives offer the added benefit of significantly reducing your risk of ovarian cancer — the risk decreases the longer you take birth control pills.

Surgery. Your doctor may suggest removal of a cyst if it is large, doesn't look like a functional cyst, is growing, or persists through two or three menstrual cycles. Cysts that cause pain or other symptoms may be removed.

Some cysts can be removed without removing the ovary in a procedure known as a cystectomy. In some circumstances, your doctor may suggest removing the affected ovary and leaving the other intact in a procedure known as oophorectomy.

If a cystic mass is cancerous, however, your doctor will likely advise a hysterectomy to remove both ovaries and your uterus. Your doctor is also likely to recommend surgery when a cystic mass develops on the ovaries after menopause.

My understanding is once cysts of concern are identified, it is nearly standard to put the woman on contraceptives (or equivalent) to reduce the likelihood of more. I think most docs see preventing further development as key to responding to a condition. For example, with a gunshot wound, while they put you on a sack of plasma, they do tend to try to stop further bleeding - it's generally been shown to be helpful.

I think I'll go with the Mayo Clinic. But, maybe that's just me.

Let's dispel some myths about the "mandate":

1. People will be forced to buy insurance or pay the penalty even if they can't afford it. Truth: If you don't have enough income to file a tax return, or the cheapest available insurance costs more than 8% of your income, you're exempt from the penalty. In addition, through some combination of Medicaid and/or government subsidies, those who can't afford the insurance will be given assistance. It's only the rich and upper-middle-class "freeloaders" that have anything to worry about.

2. You will go to jail and/or be considered a criminal for not paying the penalty. Truth: Under the ACA as it's written the IRS cannot criminalize you or enforce the usual lien policy it does to collect taxes. If failure to comply did have criminal penalties the SCOTUS ruling would've most likely been different.

Since the populace (and to some extend the MSM) fail to know/mention the full truth that will likely fuel Republican turnout this November with people wanting to gut the law. Admittedly, that is why I wanted the SCOTUS ruling to go the other way, since if they blocked the law there would've likely be little effect along party lines this election; with the law being upheld that will most likely bring conservatives out to vote for candidates that back the repealing of the ACA (that's probably also one of the main reasons for the Republican shift back in 2010). Due to that, although by no means certain, I'm predicting we could very well end up with Republicans holding the House, taking back the Senate (the Dems have more than twice the number of incumbent seats at stake than the GOP, favoring the latter in a shift), and a Romney win (despite his questionable position on the Obamacare issue). Also, since the mandate was upheld as a tax, that means that for repeal from the Senate all that is needed is a simple majority under the reconciliation rule (which exempts certain budget-related issues from a filibuster).

One change I would support to the mandate is to make a "catastrophe" plan sufficient, since the fundamental purpose for the mandate (and the one that Republicans once supported) is to ensure that large medical bills don't burden others. Requiring people to buy a complete insurance package does resemble back-door socialism.

Originally Posted by The Rani

I guess all I can say is that I hope the PAs and NPs who will be treating everyone in the coming decades will know the difference between cancer and cysts.

More than most, oncology is a team effort. Just the lab work alone requires a fair share of skill sets ... not the least being cell differentiation. Most of that work is not done by physicians today ... unless they are pahologists. When my prostate biopsies were read, the report was signed by a PhD from a central lab; allowing my urologist and radiation oncologist to keep to their knitting ... me.

Originally Posted by Justin '77

"For free", huh? Except for the money she's gotta pony up every month to keep the insurance CEO bonuses rolling in. And copays and so on. All for a treatment that costs a fraction of the amount of money she's being forced to shell out even if she doesn't get treated.

But yeah, whatever it takes to keep the fucked-up system rolling along as much unchanged in its fundamentals as possible. Call it a victory and maybe people will stop bugging you about making actual improvements.

How is this for a health care/insurance system anecdote?

Some time ago my health insurance spontaneously decided that all employees of our wonderful Corp. would need to make an appointment with our personal doctors for health tests and blood work to include blood sugar, cholesterol, etc. Everyone. This data was then to be transmitted directly to the insurance company for review. Failure to comply with this order meant financial penalties.

Now just to note, my particular health insurance is actually pretty good (compared to other plans). It is very cheap, has a good deductible (again comparatively speaking) and covers a high percentage of care cost.

Something else to note. I am probably in the best shape of my entire life.

So I swallow my disgust at this particular mandate, make an appointment and go in to see my doctor. My last visit to my doctor? 8 years ago.

I go to the same small, rural clinic that handled all of my health care needs over my entire life including my vaccinations as a baby. They have a folder on me 8 inches thick. It's very Doc Hollywood. The waiting room contains 4 or 5 elderly people who are obviously not doing as well as I am. The nurses are clearly confused when they see a healthy person walk in. I am asked why I am there and so I explain that my insurance company requires this testing. The nurse shakes her head. Height, weight and blood pressure are normal. My doctor walks in. It has been so long since my last visit she barely recognizes me. My doctor is clearly confused why I am there. She asks me how often I exercise. I tell her, "5 to 7 hours of cardio a week and 2 hours in the weight room." She chuckles and asks if I am feeling okay, which I am. She asks why I am even there. I hand her the memo from the insurance company asking for the battery of tests. She shrugs, sends me down the hall to get my blood drawn in the lab. They kick me out maybe 20 minutes after I walk through the doors.

Several days later I get the results of all of this testing ordered by some scumbag bureaucrat to be reported and later reviewed by businessmen. My numbers are not only good, they are phenomenal. The doctor already knew it just by looking at me. I already knew it because I feel great. Short of the ridiculous threat of financial penalty I would never have made the visit.

Now as I leave, I walk past the sick and/or elderly in the waiting room and it occurs to me, all of the medical resources (time, equipment, supplies) that have been wasted on testing a very healthy man could have instead been used to treat... You know... People who are actually sick.

All of this on top of the violation of my privacy (all legal) with my "biological data" being reported to the surplus humanity bureaucratic arm of my insurance company.

And government behavior? Even worse. My father, retired and now on Medicare, also happens to be a type 1 diabetic and has been since he was 40. He has an insulin pump that so successfully treats his condition, his doctor of 20 years (a highly trained and experienced professional) determined that he only needed to see my father once a year. The bureaucrats at Medicare however freaked the fuck out and mandated not two or three, but several needless (according to the only medical professional involved here) visits to the doctor each and every year.

It is laughable to assume that a government mandated health system (on top of a health system already run by bureaucrats) that rewards this behavior is somehow any improvement. It will not cut costs, it will not reduce complexity and it will not improve individual levels of care. It is guaranteed to take more and more control from people and more and more control from their doctors. It is just another in a long series of giant dicks in the ass and that sort of damage my friends, is not covered.

How is private insurance any better?

Originally Posted by Copperfield

How is this for a health care/insurance system anecdote?

Some time ago my health insurance spontaneously decided that all employees of our wonderful Corp. would need to make an appointment with our personal doctors for health tests and blood work to include blood sugar, cholesterol, etc. Everyone. This data was then to be transmitted directly to the insurance company for review. Failure to comply with this order meant financial penalties.

Now just to note, my particular health insurance is actually pretty good (compared to other plans). It is very cheap, has a good deductible (again comparatively speaking) and covers a high percentage of care cost.

Something else to note. I am probably in the best shape of my entire life.

So I swallow my disgust at this particular mandate, make an appointment and go in to see my doctor. My last visit to my doctor? 8 years ago.

I go to the same small, rural clinic that handled all of my health care needs over my entire life including my vaccinations as a baby. They have a folder on me 8 inches thick. It's very Doc Hollywood. The waiting room contains 4 or 5 elderly people who are obviously not doing as well as I am. The nurses are clearly confused when they see a healthy person walk in. I am asked why I am there and so I explain that my insurance company requires this testing. The nurse shakes her head. Height, weight and blood pressure are normal. My doctor walks in. It has been so long since my last visit she barely recognizes me. My doctor is clearly confused why I am there. She asks me how often I exercise. I tell her, "5 to 7 hours of cardio a week and 2 hours in the weight room." She chuckles and asks if I am feeling okay, which I am. She asks why I am even there. I hand her the memo from the insurance company asking for the battery of tests. She shrugs, sends me down the hall to get my blood drawn in the lab. They kick me out maybe 20 minutes after I walk through the doors.

Several days later I get the results of all of this testing ordered by some scumbag bureaucrat to be reported and later reviewed by businessmen. My numbers are not only good, they are phenomenal. The doctor already knew it just by looking at me. I already knew it because I feel great. Short of the ridiculous threat of financial penalty I would never have made the visit.

Now as I leave, I walk past the sick and/or elderly in the waiting room and it occurs to me, all of the medical resources (time, equipment, supplies) that have been wasted on testing a very healthy man could have instead been used to treat... You know... People who are actually sick.

All of this on top of the violation of my privacy (all legal) with my "biological data" being reported to the surplus humanity bureaucratic arm of my insurance company.

And government behavior? Even worse. My father, retired and now on Medicare, also happens to be a type 1 diabetic and has been since he was 40. He has an insulin pump that so successfully treats his condition, his doctor of 20 years (a highly trained and experienced professional) determined that he only needed to see my father once a year. The bureaucrats at Medicare however freaked the fuck out and mandated not two or three, but several needless (according to the only medical professional involved here) visits to the doctor each and every year.

It is laughable to assume that a government mandated health system (on top of a health system already run by bureaucrats) that rewards this behavior is somehow any improvement. It will not cut costs, it will not reduce complexity and it will not improve individual levels of care. It is guaranteed to take more and more control from people and more and more control from their doctors. It is just another in a long series of giant dicks in the ass and that sort of damage my friends, is not covered.

Originally Posted by annla899

How is private insurance any better?

Neither is preferable. That is exactly the point. Indeed, the bureacratic system is the problem.

Originally Posted by annla899

How is private insurance any better?

Not by much, to be honest. But at least a private insurer bears the costs in some way of its own waste. A government bears none of the costs for what it does. So in theory, there'd be at least a bit of system feedback against waste in the private case.

But since you're probably talking not about private insurance, but "private" insurance of the sort that monopolizes the corporatist American system, even that difference probably doesn't hold.

Originally Posted by Copperfield

How is this for a health care/insurance system anecdote?

Some time ago my health insurance spontaneously decided that all employees of our wonderful Corp. would need to make an appointment with our personal doctors for health tests and blood work to include blood sugar, cholesterol, etc. Everyone. This data was then to be transmitted directly to the insurance company for review. Failure to comply with this order meant financial penalties.

Now just to note, my particular health insurance is actually pretty good (compared to other plans). It is very cheap, has a good deductible (again comparatively speaking) and covers a high percentage of care cost.

Something else to note. I am probably in the best shape of my entire life.

So I swallow my disgust at this particular mandate, make an appointment and go in to see my doctor. My last visit to my doctor? 8 years ago.

I go to the same small, rural clinic that handled all of my health care needs over my entire life including my vaccinations as a baby. They have a folder on me 8 inches thick. It's very Doc Hollywood. The waiting room contains 4 or 5 elderly people who are obviously not doing as well as I am. The nurses are clearly confused when they see a healthy person walk in. I am asked why I am there and so I explain that my insurance company requires this testing. The nurse shakes her head. Height, weight and blood pressure are normal. My doctor walks in. It has been so long since my last visit she barely recognizes me. My doctor is clearly confused why I am there. She asks me how often I exercise. I tell her, "5 to 7 hours of cardio a week and 2 hours in the weight room." She chuckles and asks if I am feeling okay, which I am. She asks why I am even there. I hand her the memo from the insurance company asking for the battery of tests. She shrugs, sends me down the hall to get my blood drawn in the lab. They kick me out maybe 20 minutes after I walk through the doors.

Several days later I get the results of all of this testing ordered by some scumbag bureaucrat to be reported and later reviewed by businessmen. My numbers are not only good, they are phenomenal. The doctor already knew it just by looking at me. I already knew it because I feel great. Short of the ridiculous threat of financial penalty I would never have made the visit.

Now as I leave, I walk past the sick and/or elderly in the waiting room and it occurs to me, all of the medical resources (time, equipment, supplies) that have been wasted on testing a very healthy man could have instead been used to treat... You know... People who are actually sick.

All of this on top of the violation of my privacy (all legal) with my "biological data" being reported to the surplus humanity bureaucratic arm of my insurance company.

And government behavior? Even worse. My father, retired and now on Medicare, also happens to be a type 1 diabetic and has been since he was 40. He has an insulin pump that so successfully treats his condition, his doctor of 20 years (a highly trained and experienced professional) determined that he only needed to see my father once a year. The bureaucrats at Medicare however freaked the fuck out and mandated not two or three, but several needless (according to the only medical professional involved here) visits to the doctor each and every year.

It is laughable to assume that a government mandated health system (on top of a health system already run by bureaucrats) that rewards this behavior is somehow any improvement. It will not cut costs, it will not reduce complexity and it will not improve individual levels of care. It is guaranteed to take more and more control from people and more and more control from their doctors. It is just another in a long series of giant dicks in the ass and that sort of damage my friends, is not covered.

For your first issue of going to get a check up, you do realize what that was about don't you? If not, the insurance company was trying to determine if there was enough high-risk people at your place of employment to justify dropping you and your co-workers, en mass. Once out, those dropped would have pre-existing conditions and no longer eligible. The insurer would then tell you employer who they would and would not cover. The combined results would be available to every other insurer so your employer would be over a barrel. Given that the ACA stops preclusion based on pre-existing conditions, the situation you describe will likely never happen again - what would be the point?

Second issue - do you have any idea what an insulin pump and catheters costs let alone the costs of all the strips etc? That all gets paid for under Medicare and you're complaining that your dad has to go for a check up a few more times a year? Something that most people in the world can't even dream as a possibility. Also, diabetes in middle to late stages of life and his doctor says come around once a year??? I think if you want your dad around for a few more years, you might want to explore some alternatives.

Given what the ACA is bringing to millions of people for the first time, sorry, your complaints are some pretty silly self-centered carpola.

Originally Posted by Copperfield

Neither is preferable. That is exactly the point. Indeed, the bureacratic system is the problem.

Yes, the health care system in that Libertarian paradise on the outskirts of Mogadishu is much more efficient. If they have a good supply of bullets that day, they just shoot you in the head. If not, you're left to die in the gutter. If you complain, they feed you your own tongue or gonads.

Very efficient system.

Originally Posted by Justin '77

Not by much, to be honest. But at least a private insurer bears the costs in some way of its own waste. A government bears none of the costs for what it does. So in theory, there'd be at least a bit of system feedback against waste in the private case.

But since you're probably talking not about private insurance, but "private" insurance of the sort that monopolizes the corporatist American system, even that difference probably doesn't hold.

Complete utter bullshit.

Reality -

http://news.firedoglake.com/2012/08/...ate-insurance/

Medicare, Medicaid Far More Cost-Efficient Than Private Insurance