Ok, Republicans. We give up!!!

[Cain]

i haven't heard him in a while....
Hasn't he got a better speech synthesizer yet?  there's no reason he couldn't have the accent and voice inflection of his choice now, right?

Apparently he sees the computery voice as his voice now, and goes to great lengths to make sure his new computers keep the old voice.

you're shitting me.
serious? he has decided that Dr. Sbaitso is his true voice?!

I've heard that too.  I suppose after a while, you would get used to it.

A long while.

[Elder Iptuous]

Medicaid and Medicare are only in financial trouble for the same reason the rest of the country is, healthcare costs have doubled in the last 10 years, and will likely double again if not checked, supposedly one of the key things Omaba is trying to do is put price controls on health care to prevent this, my inclination is to call him a liar, but the medical lobby seems to believe he'll do it.

I have never heard of a doctor that won't accept medicare, though I've been to one who was rejected by medicare (his services were primarily non vital, I was in to track down a digestive issue that turned out to be a food allergy).  There might be a few libertarian type ones who refuse to accept it on principle i suppose.  But in general people don't turn down money.

a google of 'doctors opting out medicare' give plenty of articles...
such as this WSJ article that says:
http://online.wsj.com/article/SB123993462778328019.html

Consider that the Medicare Payment Advisory Commission reported in 2008 that 28% of Medicare beneficiaries looking for a primary care physician had trouble finding one, up from 24% the year before. The reasons are clear: A 2008 survey by the Texas Medical Association, for example, found that only 38% of primary-care doctors in Texas took new Medicare patients. The statistics are similar in New York state, where I practice medicine.

More and more of my fellow doctors are turning away Medicare patients because of the diminished reimbursements and the growing delay in payments. I've had several new Medicare patients come to my office in the last few months with multiple diseases and long lists of medications simply because their longtime provider -- who they liked -- abruptly stopped taking Medicare. One of the top mammographers in New York City works in my office building, but she no longer accepts Medicare and charges patients more than $300 cash for each procedure. I continue to send my elderly women patients downstairs for the test because she is so good, but no one is happy about paying.

[Jenne]

  So yeah, the docs who can count on richer patients making up the shortfall are going to refuse Medicare patients (or ONLY medicare--several elderly are now medicare PLUS private), because they know they can.

There are a lot of docs (in fact, probably most in the US) who'd be out of business if they tried that.

[Elder Iptuous]

so the statistic that only "38% of primary-care doctors in Texas took new Medicare patients" is incorrect?  or are we wealthy enough here that 62% or the primary doctors don't have to worry about it?

[Jenne]

You'd have to compare that to how many ALREADY WERE Medicare patients..."new" medicare patients just means they weren't this doctor's patients before.  And I don't know what state-run programs there are in TX, either.

I need more data on what TX is doing and where it's going, private vs. public on this issue.

I don't deny, eta, that Medicare is doesn't have problems.  BUT and BUT even the TOP health care insurance policies HAVE problems.

The only guarantees right now are if you WORK for the GOVERNMENT.  That...oughtta say something for gov't-run healthcare.

[Requia ☣]

so the statistic that only "38% of primary-care doctors in Texas took new Medicare patients" is incorrect?  or are we wealthy enough here that 62% or the primary doctors don't have to worry about it?

Yes, those doctors are high class types, where you see the same doctor every month.  Successful ones usually have nearly as many patients as they can handle, so why would they take less money?  The only reason to accept Medicare would be if you're still getting a private practice going, and getting more work is more important than getting highly paid work.  Primary care doctors are pretty rare outside of pediatrics too, you'd have a hard time finding one even if you pay cash.

Clinics and hospitals almost all still take Medicare.

[Elder Iptuous]

The only guarantees right now are if you WORK for the GOVERNMENT.  That...oughtta say something for gov't-run healthcare.

...wait....
are you implying that healthcare to .gov workers is not a net drain on all the other taxpayers?

[Requia ☣]

God forbid that they don't drop dead because they were denied coverage.

[Jenne]

The only guarantees right now are if you WORK for the GOVERNMENT.  That...oughtta say something for gov't-run healthcare.

...wait....
are you implying that healthcare to .gov workers is not a net drain on all the other taxpayers?

O jesus.  Are you SERIOUS?

I'm also talking about vets as well.

[Elder Iptuous]

 
forgive me for being such a dimbulb, here. perhaps i didn't articulate well enough.
my question was whether you were implying that the health care that the gov provides to their workers is fully funded by the payments that they deduct from what they pay them...  that is to say, does that system fund itself, or does it rely on taxes from non govt workers to support it?

i'd also like to point out that i'm not intending to come across as combative here, and have clearly stated that i really don't know the details of the problems facing our system.  if i'm making you impatient, i can stfu.... 

[Jenne]

Oh, ok, I took your tone wrong then.  Sorry. 

Ok, I'm going to get some facts for you tonight.  I'm very serious when I say my husband's a pretty good expert on all this.  He flies up to Sacramento to sit on a panel about all these things for the gov't of CA.  So let me ask him your questions so I can be lazy and not have to dig shit up that may or may not satisfy or apply.

[Requia ☣]

forgive me for being such a dimbulb, here. perhaps i didn't articulate well enough.
my question was whether you were implying that the health care that the gov provides to their workers is fully funded by the payments that they deduct from what they pay them...  that is to say, does that system fund itself, or does it rely on taxes from non govt workers to support it?

i'd also like to point out that i'm not intending to come across as combative here, and have clearly stated that i really don't know the details of the problems facing our system.  if i'm making you impatient, i can stfu.... 

Its a drain on taxes either way (patent office and post office not included).

[Elder Iptuous]

that's true.
i guess i would have to make the (baseless) assumption that the wages the gov worker are making (including health benefits) would have to be comparable to non gov workers for that to be meaningful at all....
of course, it still stands, that just because gov workers are receiving health care that doesn't cost them an arm and a leg, doesn't mean that .gov health care for everybody would be a viable solution...

[Requia ☣]

At this point neither is the private system.  I will admit I'll admit I don't hold out hope that this will turn out to be more than government pork for medical supply companies, but we are frankly, fucked if we don't, we may as well try for something else.

[Jenne]

Jenne:  So, is Medicare "broken"?

Dr. Mr. Jenne:  Well, its cost projections need to be raised.  Everything in medical care is becoming more pricey, as everything in medicine is just costing more.  Procedures are more complex, technology is more expensive and more advanced, and everything in general is just more expensive. 

Not only that, but more and more people are using it.  There are more older people, people are living longer, and this means it is just used way more than projected.

Jenne:  So what happens with the doctors who refuse Medicare?  Can they do that?

Dr. Mr. Jenne:  Yes, they can, because they are private businessmen.  But if they are a doctor who sees patients over the age of 65, then they HAVE to accept Medicare, like my dad [aside: he's a cardiologist, sees 99.99% elderly patients].  Otherwise they won't see patients at all.

Jenne:  So what about the 40m who don't have medical care?  Why should that be on the backs of the rest of us who do?

Dr. Mr. Jenne:  Because it's already on our backs.  Because the hospitals and clinics are being crippled by those who don't have medical care, the costs are already carried by those of us who do, and so all our costs are rising.

You see, right now in America, all health care is the same.  Everyone gets a Mercedes.  In order for everyone to have affordable health care, we'll have to give less.  A basic program for everyone at the outset.

Jenne:  But what about those who say they don't want the socialized medical care the government would bring?

Dr. Mr. Jenne:  We already have that.  If you don't want socialized medicine, then you need to let people die in the streets.  When you call 9-1-1, that's socialized medicine.  If they call 9-1-1, they aren't billed, and emergency rooms MUST treat them.

So if you don't want socialization, then you need to come to their home after a 9-1-1 call, look for their insurance card, and if they don't have one, give them a cross and say, "Good luck" and be on your way down the road.

The thing is, people are using the emergency room as their stopgap measure for health care, and this also creates larger costs.  Because someone is billed--sometimes they are, sometimes it's the state or the federal government.  Either way, someone's paying, and it's the law.

So the point is to get a basic policy on everyone, so that the people who are naturally opting out, like your brothers, who don't have to get private medical insurance because they are young and healthy, end up helping to broker the costs of people like your parents, the middle aged ones who need health care and would have to pay for it whether it's $1000 a month or not.

But you get a basic plan that everyone can afford, and it evens out.


***********************************************************************

Hopefully that clears up why I have some of the positions I do.  Any more questions?