A practical application of socialist ideas (Read 1168 times)


Fat butt on couch

    Well, federal and state governments, and Department of Defense divisions such as the VA already do this now, and they do it well.

     

    Well, that's a matter of opinion.  I worked for a physician who refused to round at the local VA as he felt their behavior was unethical.  He's not the only one I know with such experience, who arrived at the same conclusion.  

     

    If the gov't is so good at making decisions related to medical care and expenses, I assume you support the "doc fix" and determining how much physicians will be compensated through a formula meant to cut costs and maintain solvency of the program, rather than one that fairly accounts for the cost to provide service and compensate doctors for the years of training it took them to enter the profession?

    "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

     


    A Dance with Monkeys

      Medicare decides about coverage.

      Congress decides about Medicare payments to providers.

       

      I was advocating for the former (over opaque private commercial insurance companies), not the latter.

       

      I am really not sure what this means, and it is fairly vague and anecdotal: "I worked for a physician who refused to round at the local VA as he felt their behavior was unethical." I will say this: I too refuse to round at the VA. Not because the healthcare delivery or decision-making is bad (it is NOT, VA healthcare is generally excellent), but instead because the federally-mandated security procedures are so onerous, it is impossible to use the medical record systems there. And yeah, apparently much of that comes from Executive branch mandates. I have been fingerprinted and had full federal background checks several times to care for patients at the VA. But none of that has anything to do with the VA's decisions about where resources can and cannot be spent in treating or preventing disease.


      A Saucy Wench

        Medicare decides about coverage.

        Congress decides about Medicare payments to providers.

         

         

        Yeah and half the providers around here either wont accept medicare patients or require up front payment for services.  You are on your own for billing and getting payment for medicare.  

        I have become Death, the destroyer of electronic gadgets

         

        "When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7


        Fat butt on couch

          Medicare decides about coverage.

          Congress decides about Medicare payments to providers.

           

          I was advocating for the former (over opaque private commercial insurance companies), not the latter.

           

          I am really not sure what this means, and it is fairly vague and anecdotal: "I worked for a physician who refused to round at the local VA as he felt their behavior was unethical." I will say this: I too refuse to round at the VA. Not because the healthcare delivery or decision-making is bad (it is NOT, VA healthcare is generally excellent), but instead because the federally-mandated security procedures are so onerous, it is impossible to use the medical record systems there. And yeah, apparently much of that comes from Executive branch mandates. I have been fingerprinted and had full federal background checks several times to care for patients at the VA. But none of that has anything to do with the VA's decisions about where resources can and cannot be spent in treating or preventing disease.

           

          My reference to issues with the VA are directly related to their rationing of care.  I know several physicians who have worked in that system and completely disagree with your assessment of their ability to do this well.  In particular, an oncologist who was not allowed to deliver standard-of-care in accordance with established guidelines because the VA administrator would not allow it.  I have no personal experience with this, only what they relate second-hand and a relative who they nearly killed through clear negligence (military waited until 6mo before he was due full retirement then forced him out with partial retirement due to the medical problems their doctors created, nice way to pay a guy back for decades of military service).

           

          My point was, do you trust the gov't to set your reimbursement/compensation?  If you do not, why should they be trusted to have final say what care we have access to?

           

          Personally I would rather see a hybrid system.  Gov't has no incentive to be efficient and I do not trust them to be as transparent as you think them to be.  However they could set regulations which would allow private enterprise to innovate and drive for efficient care while following transparency guidelines or possibly having to meet certain standards for access/coverage.

           

          M

          "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

           


          Fat butt on couch

            Yeah and half the providers around here either wont accept medicare patients or require up front payment for services.  You are on your own for billing and getting payment for medicare.  

             

            Only the tip of the iceberg.

             

            I work with a lot of specialty physicians on a regular basis....sometimes I regret the decision not to be a doctor, until I talk to them.  

            "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

             


            A Dance with Monkeys

              Only the tip of the iceberg.

               

              Yep.  Medicare is not the only one limiting payments to medical practices.


              Dave

                Yeah and half the providers around here either wont accept medicare patients or require up front payment for services.  You are on your own for billing and getting payment for medicare.  

                 

                The number of physicians accepting Tricare (the HMO most military families get as health coverage), is very low indeed.  

                 

                Everything requires a referral and by the time you get into a physician who accepts your coverage, it can be weeks.  One of my soldier's had his son break his leg.  He received emergency treatment but the run around to get the right referral to the right physician to set it properly may take weeks.

                 

                And we're pretty grateful to have the health coverage but the rationing through inconvenience and bureaucracy sucks.

                I ran a mile and I liked it, liked it, liked it.

                dgb2n@yahoo.com

                  2 cents worth of political speculation:

                   

                  These threads are always about the economy, but I think that the main difference between Democrats and Republicans has nothing to do with the economy or with big government or small government, spending or taxing. Everyone wants a streamlined, pragmatic, effective government. Everyone agrees that a brisk private sector is the foundation of our economic success.

                   

                  Everyone on both sides of the aisle recognize that the system is corrupt and that both Dems and Repubs exploit taxpayer money for special interest gain. But this is not a problem of parties--this is a problem of the corruption of big $$ in politics. Neither side is effective at fighting it, both sides are fundamentally entrenched in it and beholden to it, so it shouldn't determine your choice of parties.

                   

                  The difference between Dems and Republicans boil down to the social issues. The reason I'm a Democrat is that Republican support in the South (where I am from) is drawn from people who opposed the civil rights movement. Republicans oppose to extending marriage to gays. Republicans pander to xenophobia at the borders. Republicans threaten to make abortions illegal, even in the case of rape and incest. Republicans refuse decent and reasonable gun control plans. Republicans have a history of making war. Republicans pander to global warming deniers. Republicans attack the teaching of science in schools.

                   

                  Those are the main reasons I vote Democratic. By the way, this is also the reason Republicans will not win the presidency in 2012--the old "Southern Strategy" of pandering to retrograde fear and hate has now alienated too many people in our increasingly secular and tolerant culture. The alliance of fiscal conservatism and social conservatism never made any sense; it was a convenient strategy for success 20-30 years ago, and the current republican primary proves the strategy is dead--in order to win the primary, you basically have to show that you are unelectable.

                   

                  Until the right figures this out, get used to having a Democratic president. Smile

                    The difference between Dems and Republicans boil down to the social issues. The reason I'm a Democrat is that Republican support in the South (where I am from) is drawn from people who opposed the civil rights movement. Republicans oppose to extending marriage to gays. Republicans pander to xenophobia at the borders. Republicans threaten to make abortions illegal, even in the case of rape and incest. Republicans refuse decent and reasonable gun control plans. Republicans have a history of making war. Republicans pander to global warming deniers. Republicans attack the teaching of science in schools.

                     

                    Those are the main reasons I vote Democratic. By the way, this is also the reason Republicans will not win the presidency in 2012--the old "Southern Strategy" of pandering to retrograde fear and hate has now alienated too many people in our increasingly secular and tolerant culture. The alliance of fiscal conservatism and social conservatism never made any sense; it was a convenient strategy for success 20-30 years ago, and the current republican primary proves the strategy is dead--in order to win the primary, you basically have to show that you are unelectable.

                     

                    Until the right figures this out, get used to having a Democratic president. Smile

                     

                    (I thought this thread was dead...)

                     

                    But, in some ways I agree, but in most ways I disagree (and think you may have re-stirred a hornets nest). 

                     

                    I think Ron Paul answered the abortion issue spot on the other night in the debate.  He's Pro-Life, but since he believes that it's a high crime, then it should be a state issue.  I also happened to find it odd that the moderator had the other 3 answer the issue and discuss it for about 3 or 4 minutes, and he was going to move on to the next question without giving Paul the opportunity to discuss his thoughts.  And, he happens to be a obstetritian and gynecologist?!?  The moderator looked very bad and biased on that issue by not including Paul in the discussion.

                     

                    As it relates to the other subjects (science in schools, gun control, gay marriage, global warming), I believe that the Republicans are wrong on many fronts, but so are the Democrats on those same issues (with opposite views). 

                     

                    It's not a question as to what the answer to those issue are.  The question is what the Federal Government should legislate. 

                    I believe that's the fundamental difference between the two, and quite honestly, I don't believe the Republican party (and their supporters) fully understand the role of the Federal Government. 

                     

                    Cheers,

                    (The northern immigrant).

                    Brian

                    2014 Goals:

                    #1: Do what I can do. <DOING>

                    #2: 365 Hours training

                     

                      Thanks, Brian, for the response. I don't expect that many will agree with me, but I think that the economic issues get overplayed, as frankly I do not see much difference between the two parties on economics (we quibble about whether a 3% tax on some rich people should or should not be rolled back, as if it made a difference.)

                       

                      I guess the thread just made me reflect: why do I have such strong Democratic leanings? To me, it's the social issues. 

                       

                      MTA: Just to address your Ron Paul example. The whole "states rights" thing has a very different ring to these Southern ears. And to discuss abortion as violence and "high crime" doesn't resonate with me. To me abortion is a difficult and complex decision left to individuals. I wouldn't trust the State of Tennessee with it, are you kidding me. 

                       

                      See--this is the where the meaty disagreement is, seems to me. Not splitting hairs over the economy. 

                      juniordo1


                        There are ways to help fund an education.  Military for one.  Scholarships for another.

                         

                         

                        Get a job is another.

                         

                        My job doesn't pay the best but my company offers $8K a year in tuition reimbursement which is pretty generous.

                         

                        I paid for about half  of my bachelor's degree out of my own pocket and my company forked over the rest. No, I wasn't able to graduate in four years and it took me four years to finish the second half alone but I graduated with ZERO student loan debt.

                        2013 -Sub 2:00 for 1/2 marathon

                          Get a job is another.

                           

                          My job doesn't pay the best but my company offers $8K a year in tuition reimbursement which is pretty generous.

                           

                          I paid for about half  of my bachelor's degree out of my own pocket and my company forked over the rest. No, I wasn't able to graduate in four years and it took me four years to finish the second half alone but I graduated with ZERO student loan debt.

                           

                          If you notice, almost all of the conservative responses on this thread are backed by an anecdote either from their own life, a friend, or family member who did something exceptional or praise-worthy. It's a very strange mode of political argument to me, and it's totally unconvincing (to me) because it makes an appeal to private experience. What is it about being a conservative that makes one think this sort of argumentation would be successful?

                           

                          Really, this baffles me. I'm not trying to be contrary here.


                          A Dance with Monkeys

                            [1-n] x anecdote ≠ evidence.

                               

                              MTA: Just to address your Ron Paul example. The whole "states rights" thing has a very different ring to these Southern ears. And to discuss abortion as violence and "high crime" doesn't resonate with me. To me abortion is a difficult and complex decision left to individuals. I wouldn't trust the State of Tennessee with it, are you kidding me. 

                               

                               

                              Didn't say that was my opinion.  I was stating how Ron Paul addressed the issue.

                               

                              We naturally think left vs. right because that's what our moms, dads, media, government, etc. have taught us.

                              Eventually, we need to understand that there's another axis that matters.


                              Through all of the discussion regarding politics, we go back to left vs. right.

                              We need to think up vs. down (or north vs. south and I don't mean northern states vs. southern states).

                               

                              and to respond to "I wouldn't trust the State of Tennessee with it, are you kidding me."... Why would it be better to trust the federal government????  Are you kidding me????

                              2014 Goals:

                              #1: Do what I can do. <DOING>

                              #2: 365 Hours training

                               

                                Didn't say that was my opinion.  I was stating how Ron Paul addressed the issue.

                                 

                                We naturally think left vs. right because that's what our moms, dads, media, government, etc. have taught us.

                                Eventually, we need to understand that there's another access that matters.


                                Through all of the discussion regarding politics, we go back to left vs. right.

                                We need to think up vs. down (or north vs. south and I don't mean northern states vs. southern states).

                                 

                                and to respond to "I wouldn't trust the State of Tennessee with it, are you kidding me."... Why would it be better to trust the federal government????  Are you kidding me????

                                 

                                On abortion: I'm a choice guy, so I want to trust it to individuals, not the federal gov. or the state gov.

                                 

                                I like your thinking about up vs. down. But it's also true that we are in the process of making a choice about the president, and that choice is, for better or worse (probably worse), left or right, dem or repub.