Re: Health care plan.....I'm confused

On Sat, 12 Sep 2009 10:05:54 -0700, "Bruce S" <bruce.snell@xxxxxxxxx>
wrote:

nothermark wrote:
On Fri, 11 Sep 2009 16:29:57 -0700, "Bruce S" <bruce.snell@xxxxxxxxx>
wrote:

nothermark wrote:

Cost is an issue but is often used to obfuscate underlying
objectives. Folks rant about cost but do not factor in that we are
usually paying the bill now in some way. Unifying they system
would potentially provide a way to track what is really paid out
and who gets it. Once tracking becomes possible the expectation is
that much money can be saved simply by providing cheaper higher
quality preventive care up front instead of high cost emergency
care for many folks.

We've been over this before, so pay attention this time.
1. Preventive medicine does not save money - it adds to the overall
cost.

Wrong on this one as most folks will go to a Doctor they can afford
before they getthe ambulance ride. Many chronic conditions are very
treatable at a much lower cost than stabilizing somebody that goes
into a life threatening condition.

I'm not sure why I am responding to you, since we had this very conversation
less than a month ago (see: "OT - Appreciation for a broken medical system"
from about August 15.) And, you WERE a participant in that conversation.
If you are unable to remember a discussion from a month ago, you really
aren't smart enough to be worth wasting my time on again. If you want to
have the discussion, go to Google groups and do a search, you now have the
time of the discussion, and the subject.

Either way, here is a link to a page debunking the whole stupid idea that
preventive medicine is a cost saver.
http://www.cbo.gov/ftpdocs/104xx/doc10492/08-07-Prevention.pdf


Read your own page. It is an apples and oranges arguement. Testing
everybody every x number of years is more expensive. The only one's
arguing otherwise are the testing labs. OTOH testing folks who walk
in with a problem before they end up in the emergency room in critical
condition is cheaper than treating them before they become critical.
Nobody who understands argues that either. The controlling parameter
is volume of patients. Relatively few folks develop a medical problem
in a given year.



Just a hint, it may be cheaper for one person, who really does have a
problem, to find that problem early, but it is not cheaper to test the
multitudes for various problems, and learn that they are problem free.

See above. The only folks who are pushing the test everybody
prevention arguement are the scaremongering right wing assholes trying
to kill the legislation.


2. People will not stop going to the emergency rooms instead of
making (and keeping) doctor's appointments just because they have
insurance. In fact, since the insurance will cover those visits,
even more lazy and worthless people will burden the system, rather
than show the responsibility required to make and keep those
appointments.

Wrong again. In many, if not all, states requiire an Emergency Room
to treat and at least stabilize anybody carried through the door. It
does not matter if they have insurance or not. Many folks with no
insurance ignore conditions that get them the ambulance ride and free
treatment.

This is another discussion we have had in the past - you were wrong then,
and you are still wrong. For this one, I can only provide an example that I
am familiar with (and I believe I told this story the last time we had this
discussion too). When my worked for the copper mine, they had great
insurance - full coverage for almost everything, including doctor's visits.
There was even an insurance run clinic in town, so people could get medical
care with minimal effort. However, the number of people failing to make
appointments, and choosing to go to the emergency room instead, was so great
that in the next contract, emergency room visits were no longer covered
unless the doctor certified that it was really an emergency and required an
emergency room visit. If it was the type of issue that could have been
handled with a doctor's appointment, the person was sent a bill for every
cent of the emergency room visit. It was only when the insured were forced
to be responsible for their own actions that they finally stopped abusing
the system.

Read your own example. It took a change in the insurance contract so
it only worked with folks who had insurance from the company. It
probably worked with a captive population like that. The problem is
that leaves out all the folks without insurance and all the folks not
insured under that contract. In most places that is almost everybody.
The major problem in emergency rooms today really is the uninsured who
are usually also mostly working poor and you can bill until the cows
come home but you won't get much or change much.




If they had insurance it is reasonable to assume most would go to the
Doctor before the free ride. Many get pretty sick before they call
the ambulance.

BTW. It also provides a way to control the costs to other patients.
One reason the folks do not go is that private pay patients often pay
several times what insured patients do for the same treatment. That
is how many Hospitals try to recover the cost of uninsured patents who
also have no money.

You really should research some of this instead of depending on Glenn.

And you really should pay attention, and possibly do some research of your
own.

I do.

This is a couple of years old but you might find it interesting:

http://www3.acep.org/patients.aspx?id=25932

It is part of a larger resource site but this answers one of you
rissues:

"Emergency departments have the only legal mandate to provide health
care ¾ the Emergency Medical Treatment and Labor Act (EMTALA). This
law ensures that anyone who comes to an emergency department,
regardless of their insurance status or ability to pay, must receive a
medical screening exam and be stabilized. According to an ACEP survey
released March 2003, emergency physicians estimate that one out of
every three patients they personally treat are uninsured. They say
one-fourth of their uninsured patients are children under age 18."
.