Supreme Court Ruling on Health Care

[PaulinVA]

I think the Doctor is mistaken on the worth of his service. “All the market will bear?”

It’s hard to tell, but I think you are saying that medicare/medicaid reimbursement rates are fair, Not very many people hold that position.

There are areas with a glut of physicians. Just like there are specialties with the same. Always, there are areas which could use an influx of skilled physicians. Urban centers, and rural areas, generally head up that list. This is where a doctor will do the most good.

I would like to know where there is a glut of physicians.

Though granted, he may have to drive a Chevy. Just like me.

Once again, you seem to be indicating that the education and training that a doctor undergoes isn’t worth that much. would you like to explain why you hold that position?

 

[Mickey_Finn]

It’s hard to tell, but I think you are saying that medicare/medicaid reimbursement rates are fair, Not very many people hold that position.

I would like to know where there is a glut of physicians.

Once again, you seem to be indicating that the education and training that a doctor undergoes isn’t worth that much. would you like to explain why you hold that position?

1. Thats is the fundemental driver of our entire economy. What is the payer willing to pay?
2. chartsbin.com/view/gcu ncbi.nlm.nih.gov/pmc/articles/PMC1361233/ You’ll see that the highest concentrations of physicians is in the termed “super centers”. The weakest distribution continues to be in lower income, and rural areas. Both
   nationally, and worldwide. Please keep in mind. The Medical profession, (Universities, organizations, and associations) and the Doctors themselves. Have been aware of this issue since the fifties. Another example of their inability to “own” the problem.
3. I’m sure the education and training a physician undertakes is very useful. Just like a Chevy is useful. Like I said before. The wealth that some physicians may expect. May no longer be available. Not unlike the rock stars wealth, or the auto workers, and police officers pension.

ATB

 

[PaulinVA]

1. Thats is the fundemental driver of our entire economy. What is the payer willing to pay?

Please, please, just answer the question. Are medicare reimbursement rates adequate? If you think they are, why?

1. chartsbin.com/view/gcu ncbi.nlm.nih.gov/pmc/articles/PMC1361233/ You’ll see that the highest concentrations of physicians is in the termed “super centers”. The weakest distribution continues to be in lower income, and rural areas. Both
   nationally, and worldwide. Please keep in mind. The Medical profession, (Universities, organizations, and associations) and the Doctors themselves. Have been aware of this issue since the fifties. Another example of their inability to “own” the problem.

The nih report actually says that it’s getting better, the distribution of docs into the rural areas.

Conclusion

Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas. While substantial variation in the supply of physicians across communities remains, current measures of geographic access to physicians overstate the extent of maldistribution and yield an incorrect ranking of areas according to geographic accessibility of physicians.

Having some of the more complicated specialties clustered in "Centers of Excellence is actually a good idea. You might have to travel a little, but the physician performing the service is experienced.

1. I’m sure the education and training a physician undertakes is very useful. Just like a Chevy is useful. Like I said before. The wealth that some physicians may expect. May no longer be available. Not unlike the rock stars wealth, or the auto workers, and police officers pension.

You are mixing apples, oranges, and hyperbole. It’s actually a little frustrating. You are advocating that doctors accept reimbursement rates that do not allow them to keep their businesses open, much less make a decent living. You are comparing that the police officers having their pensions cut or auto workers who have demanded benefits that have almost killed the car companies. They are not the same.

 

[Jeffrey]

Well… looks like Maine is going to fight obamatax altho I would’ve chose a better word than gestapo… altho thats where it looks like its heading:

onlinesentinel.com/news/Governor-says-IRS-new-gestapo-in-radio-address.html

 

[LisaA]

Lisa, that figure was from the BLS. It’s income, not intake. 25 years ago, I would charge $45.00 to come to your home to look at your phone. That was quite a bit more than I was paid. Do you see the difference?

Also, the tort/malpractice scare tactic doesn’t hold much in the way of water. The number of cases heard, and decided, by either bench, or jury. Are actually very low. The percent of cases awarded to the plaintiff? Even lower. bjs.ojp.usdoj.gov/index.cfm?ty=tp&tid=4511

One well known law firm suggests that over 200,00 people die each year from medical malpractice. I don’t know where they got that figure. But, they site among other causes mis-prescribed drugs, and overdoses. Whether that is the fault of the physician, a pharmacist, or the patient themselves is anyone guess. Or, for a judge/jury to decide. But, taking away, a citizens right to seek damages. Or to dictate the amount of damages, is very wrong headed. About what we’ve come to expect from the pro-business/ anti worker Republicans.

ATB

Once again you do not understand the point. Indeed there are very few cases that ever go to trial and once tried, even fewer that have the megamillion dollar payments. However the cost of MALPRACTICE is directly related to the POTENTIAL for suits and the reality that as one person posted, if a patient sues or threatens to sue, it is often settled out of court.

A doctor sued, even if COMPLETELY without merit must defend himself. This is done via the malpractice company. So hopefully you realize that while the million dollar payouts are rare, there are many suits or threats of suits that a) must be defended and b) increase premiums paid by the doctors. This is all behind the scenes so to speak.

Now from my actual experience (as opposed to your speculation) my docs have performed thousands of surgeries (one has 13000 surgeries so far in his career). In the 25 years I’ve been with the group we have never lost or paid out anything in damages. We have been sued although certainly not frequently, my docs are the best! But there are more than a few patients and more than a few lawyers who like to play what we call litigation roulette. They hope if they are enough of a PITA the insurance company will weigh the cost of continuing vis a vis a small settlement. Unfortunately this trend just inspired MORE suits but thankfully the insurance companies are now coming out swinging and will not capitulate.

That being said, in states where there IS tort reform, malpractice rates have dropped and doctors are storming the gates to get in. In states with high malpractice rates, no tort reform, there are fewer and fewer specialy providers particularly in ob-gyn and neurosurgery.

Again the attorneys have a stranglehold over the Democrat party and as a result those states with Democrat legislators are not able to push through tort reform or other cost saving measures.

Lisa

 

[jsk]

In 1919, when the sale of alcohol was banned, a Constitutional Amendment was required to give the federal government the authority regulate alcoholic drinks. At that time, the federal government did not assume any powers not very specifically designated to it. That view has changed over time to one where the Supreme Court sees if there is any way to find a reason to uphold any power the Congress tries to assume. I consider this to be dangerous, but now that the Supreme Court has spoken, it is law until it is overturned by a future Supreme Court decision.

 

[Scott_Lafrance]

I think the Doctor is mistaken on the worth of his service. “All the market will bear?”

There are areas with a glut of physicians. Just like there are specialties with the same. Always, there are areas which could use an influx of skilled physicians. Urban centers, and rural areas, generally head up that list. This is where a doctor will do the most good.

Though granted, he may have to drive a Chevy. Just like me.

ATB

p.s. Even with your dancing around the ring. I think I’m landing a few good one.

HAve you given up 24 years of your life in schooling? Please stop equating the practice of medicine to an apprentice electrician, particularly for a profession that literally saves lives. Its worth more than you are giving it.

 

[Mickey_Finn]

Please, please, just answer the question. Are medicare reimbursement rates adequate? If you think they are, why?

The nih report actually says that it’s getting better, the distribution of docs into the rural areas.

Conclusion

Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas. While substantial variation in the supply of physicians across communities remains, current measures of geographic access to physicians overstate the extent of maldistribution and yield an incorrect ranking of areas according to geographic accessibility of physicians.

Having some of the more complicated specialties clustered in "Centers of Excellence is actually a good idea. You might have to travel a little, but the physician performing the service is experienced.

You are mixing apples, oranges, and hyperbole. It’s actually a little frustrating. You are advocating that doctors accept reimbursement rates that do not allow them to keep their businesses open, much less make a decent living. You are comparing that the police officers having their pensions cut or auto workers who have demanded benefits that have almost killed the car companies. They are not the same.

Man you like to dance around. The point was the problem exists. It’s been known to exist for many years. (That NIH says it’s not as bad as some say it is. Is completely irrelevant. It’s bad!) Yet, they have failed to come up with a solution. That this problem is world wide. Leaves no doubt that there must be another authority to see to adequate distribution of this valued resource.

For the wealth you are so fixated on. That point was, things are changing. You can change with them. or you can go under. The choice is yours.

ATB

 

[Mickey_Finn]

Once again you do not understand the point. Indeed there are very few cases that ever go to trial and once tried, even fewer that have the megamillion dollar payments. However the cost of MALPRACTICE is directly related to the POTENTIAL for suits and the reality that as one person posted, if a patient sues or threatens to sue, it is often settled out of court.

A doctor sued, even if COMPLETELY without merit must defend himself. This is done via the malpractice company. So hopefully you realize that while the million dollar payouts are rare, there are many suits or threats of suits that a) must be defended and b) increase premiums paid by the doctors. This is all behind the scenes so to speak.

Now from my actual experience (as opposed to your speculation) my docs have performed thousands of surgeries (one has 13000 surgeries so far in his career). In the 25 years I’ve been with the group we have never lost or paid out anything in damages. We have been sued although certainly not frequently, my docs are the best! But there are more than a few patients and more than a few lawyers who like to play what we call litigation roulette. They hope if they are enough of a PITA the insurance company will weigh the cost of continuing vis a vis a small settlement. Unfortunately this trend just inspired MORE suits but thankfully the insurance companies are now coming out swinging and will not capitulate.

That being said, in states where there IS tort reform, malpractice rates have dropped and doctors are storming the gates to get in. In states with high malpractice rates, no tort reform, there are fewer and fewer specialy providers particularly in ob-gyn and neurosurgery.

Again the attorneys have a stranglehold over the Democrat party and as a result those states with Democrat legislators are not able to push through tort reform or other cost saving measures.

Lisa

We have to deal with the numbers we can prove. Not the numbers we think are real. I assume there are no numbers to support a set amount of out of court settlements? As there are no numbers to support the number of people who choose not to sue. Even if they have suffered harm. I don’t recall any speculation. I think I posted what actual numbers I could find.

As for missing the point. There seems to be a lot of that going around.

ATB

 

[Mickey_Finn]

HAve you given up 24 years of your life in schooling? Please stop equating the practice of medicine to an apprentice electrician, particularly for a profession that literally saves lives. Its worth more than you are giving it.

It’s important to remember your audience. My education ends the day I retire. Assuming I’m able to let it go.

ATB

 

[Mickey_Finn]

In 1919, when the sale of alcohol was banned, a Constitutional Amendment was required to give the federal government the authority regulate alcoholic drinks. At that time, the federal government did not assume any powers not very specifically designated to it. That view has changed over time to one where the Supreme Court sees if there is any way to find a reason to uphold any power the Congress tries to assume. I consider this to be dangerous, but now that the Supreme Court has spoken, it is law until it is overturned by a future Supreme Court decision.

I think you’d have to go back to the Whiskey rebellion. Many then, thought the government had no right to build roads.

ATB

 

[Scott_Lafrance]

It’s important to remember your audience. My education ends the day I retire. Assuming I’m able to let it go.

ATB

I’m not interested in cute platitudes. It takes 24 years of formal and very expensive education to become a doctor. And that doesn’t include residency training.

 

[Dawnia]

We have to deal with the numbers we can prove. Not the numbers we think are real. I assume there are no numbers to support a set amount of out of court settlements? As there are no numbers to support the number of people who choose not to sue. Even if they have suffered harm. I don’t recall any speculation. I think I posted what actual numbers I could find.

As for missing the point. There seems to be a lot of that going around.

ATB

Ummm…you might want to do a simple search before making assumptions. There is a considerable amount of stats & studies regarding medmal cases. With the huge dollar figures involved neither insurance companies nor lawyers are going into these without that info.

 

[LisaA]

Ummm…you might want to do a simple search before making assumptions. There is a considerable amount of stats & studies regarding medmal cases. With the huge dollar figures involved neither insurance companies nor lawyers are going into these without that info.

Thank you Dawnia. I like dealing with facts instead of wild speculation, pontificating and assumptions.

There are also numbers supporting the migration of doctors to states like Texas which has passed tort reform.

Lisa

 

[Mickey_Finn]

I’m not interested in cute platitudes. It takes 24 years of formal and very expensive education to become a doctor. And that doesn’t include residency training.

Your interests are very important! I think it’s something like eleven years including their residency, post H.S. I find it interesting that a would be revolutionary puts so much stock in formal education.

ATB

 

[Mickey_Finn]

Ummm…you might want to do a simple search before making assumptions. There is a considerable amount of stats & studies regarding medmal cases. With the huge dollar figures involved neither insurance companies nor lawyers are going into these without that info.

Link away Dawnia.

 

[Mickey_Finn]

Thank you Dawnia. I like dealing with facts instead of wild speculation, pontificating and assumptions.

There are also numbers supporting the migration of doctors to states like Texas which has passed tort reform.

Lisa

People going to places where they won’t be held accountable for their actions.

 

[_Abyssinia]

Discord at Supreme Court is deep, and personal

Conservatives feel a sense of betrayal. They feel that Roberts changed his mind for the wrong reasons.

If Roberts had been with the liberals from the beginning, sources tell me that would have been one thing; but switching his position – and relatively late in the process – infuriated the conservatives.

Of course it’s unclear why he switched. He may have been focused solely on the law. But that is not what some of his colleagues believe.

.

Liberal justices thought Roberts had signaled he would be open to compromise and be more moderate. But he sided with conservatives that year, making the liberals feel misled. They were furious. As one said at the time: “He talks the talk, but won’t walk the walk.”

Conservatives were angry at Roberts, too – they thought he gave the liberals false hope. He ended up just pushing them further away

That tension eased over the summer of 2007. But this conflict among conservatives – after Roberts “walked the walk” with liberals – may take much longer to resolve

.

They set out writing their own opinion – they wrote it to look like a majority decision, according to sources, because they hoped Roberts would rejoin them to strike down the mandate. Kennedy relentlessly lobbied Roberts until the end to come back. Of course he did not, and the conservatives’ decision became a dissent

.

It’s not unheard of for the Court to erupt into conflict; Bush v. Gore in 2000 was a famous example. But some people say you would have to go back nearly 70 years to see this kind of tension, and almost bitterness, that now exists among the justices

cbsnews.com/8301-3460_162-57468202/discord-at-supreme-court-is-deep-and-personal

 

[Scott_Lafrance]

Your interests are very important! I think it’s something like eleven years including their residency, post H.S. I find it interesting that a would be revolutionary puts so much stock in formal education.

ATB

I like my doctors professionally trained.

 

[_Abyssinia]

Perry: Texas will not expand Medicaid or set up a state run exchange

In a critical decision that will impact uninsured Texans, health providers and those who will buy insurance under the new health care law, Governor Rick Perry early today decided Texas will not expand Medicaid or set up a state run exchange.
His decision also has wide ranging political implications.

In a statement Perry will release at midmorning he says, “Neither a ‘state’ exchange nor the expansion of Medicaid under this program would result in better “patient protection” or in more “affordable care.” They would only make Texas a mere appendage of the federal government when it comes to health care.”

The U.S. Supreme Court decison upholding most of the law gave Texas the choice of whether to expand Medicaid, the joint federal-state program that provides health care for the poor, when the Affordable Care Act becomes fully effective in 2014.

The state can also set up its own health insurance exchange or marketplace where coverage can be bought competitively or let the federal government do it.

Perry says the state should opt out of both, “I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government.”

wfaa.com/news/Perry–161782615.html