Its over, the Dems win

[jshel1]

"... hangin's too good for em..."

In the mean time, "Ten for Tark."
http://tark2010.org/

[Excaliber]

Did you miss the part where the OMB issued a correction and it will now do little to reduce the deficit?

No I didn't miss that, it's another example of Republican spin, sustained, altered and further twisted by the radical right. The OMB estimate, and granted it is only an estimate, was only SLIGHTLY reduced from it's original number. The projection is the deficit will STILL be substantially reduced.

SPO1715, if you don't believe the estimate it is likely you don't understand how the calculations were made. A more reasonable approach would be to question the math than to dismiss the calculations.

[Anthony]

Originally Posted by Excaliber

No I didn't miss that, it's another example of Republican spin, sustained, altered and further twisted by the radical right. The OMB estimate, and granted it is only an estimate, was only SLIGHTLY reduced from it's original number. The projection is the deficit will STILL be substantially reduced.

SPO1715, if you don't believe the estimate it is likely you don't understand how the calculations were made. A more reasonable approach would be to question the math than to dismiss the calculations.

From what I have seen, read, heard, I don't think the OMB, and maybe even you, understand the numbers or calculations.

Currently, there are 40,000,000+ on Medicare, and 60,000,000 on Medicaid.

And the governmment wants to insure another 47,000,000 - That's a 50% increase.

Currently, Medicaid (the cheapest government insurance) pays about $3000/yr/person, or about $250 month/person, or about $1000/month for a family of four, close to what private insurances charge.

Of the money spent on Government healthcare, Medicare and Medicaid, I can tell you there definitely is not a 33% waste factor, unless you cut out screening for mammograms, colon cancer, "unnecessary" heart bypass operations, etc. There really is virtually no waste. It's all really limiting health care services to a much greater degree than they already are, that is, to a level that they limited to in other countries, what OBAMA considers to be waste. No more brand name drugs, just generics, you won't have a choice. The only way to make the numbers come out not adding to the deficit is to cut medical benefits/services by 33% to pay for the extra 47,000,000.

You're clueless.

Unfortunately for us, those are the numbers, and those are the facts.

[Excaliber]

Anthony it sounds like you are saying the OMB are clueless, it's their numbers, their math, not mine.

Fair enough, you don't believe the numbers or the calculations. Myself, I won't dismiss them out of hand. But as the OMB has made clear, it is extremely difficult to forecast these numbers so far into the future. So there is reason for doubt. Savings on Medicare is only a part of the overall calculations. Increased taxes also play a roll. As well as a larger number of people buying into the system.

Personally I think the best way to save money on Medicare is to more aggresively go after fraud, which is rampant. Factoring in fraud would constitute a HUGE inefficency within Health Care. I would say more than the proposed 33%.

[Excaliber]

I am well versed in the generic drug vs brand name drugs. That particular argument has been raging around my house for about 20 years now! You could make a solid case for SOME brand name drugs, I don't believe you could make that case for ALL of them. Forced to choose one OR the other, I'd have to lean toward generic on a cost benefit analysis.

I think we screwed up by disallowing drug's from Canada into the health care system.

[Anthony]

Originally Posted by Excaliber

Anthony it sounds like you are saying the OMB are clueless, it's their numbers, their math, not mine.

The government seems to use "fresh out of school" PhD's to write the rules, like they did with the auto bailout, people who probably donlt understand the relative importance of different factors playing into the equation.

One who blindly agrees with anybody/anything, without a good understanding of the specifics in question, makes me believe they are clueless.

Originally Posted by Excaliber

Fair enough, you don't believe the numbers or the calculations. Myself, I won't dismiss them out of hand. But as the OMB has made clear, it is extremely difficult to forecast these numbers so far into the future. So there is reason for doubt. Savings on Medicare is only a part of the overall calculations. Increased taxes also play a roll.

Personally I think the best way to save money on Medicare is to more aggresively go after fraud, which is rampant. Factoring in fraud would constitute a HUGE inefficency within Health Care. I would say more than the proposed 33%.

There you go, believeing in facts that in my opinion are clearly unsubstantiated, the waste thing, fraud thing, inefficiency thing. I can tell you, I know alot of doctors/hospital systems, and there rarely is fraud, I mean rarely. There are some fly by night companies that bill for ficticious patients, that are clearly fraud, but that is really rare. It just doesn't occur to nearly the level you and the rest of the country is led to believe. The money is not there to save. It will have to be funded by reducing services offered, increasing taxes, or more likely both. I'm already thinking about hiring some PA's to take care of my Medicare patients, so I don;t have to, and I will still get payed the same. Just think of it, patients will now be treated by PA's, NP's instead of doctors. The medical industry is alot more efficient than what people think, and definitely alot more efficient than the government. You have good ideals, but that is all they are, ideals that really don't make any good sense on how to implement.

[bomelia]

Does anybody hav a link to that article about the OMB I was referring to (and Excal answered). Please? I cannot find it.

Thanks!

Mike

[Excaliber]

My position on fraud remains unchanged, I fear you are grossly under estimating it. In addition I believe waste is also grossly under estimated. To many legal, ethical and PAYABLE procedures are performed because hospitals and doctors feel the need based on CYA more than patient need. Tort reform would go along way toward getting a handle on it. Perhaps you are to close to the forest to see the tree's on that issue...

Went to school for about a year working toward becoming a PA. Decided it wasn't my cup of tea, took another direction. Nothing wrong with a PA seeing the patients, good idea, saves money, can be more efficient.

[Anthony]

Originally Posted by Excaliber

My position on fraud remains unchanged, I fear you are grossly under estimating it. In addition I believe waste is also grossly under estimated. To many legal, ethical and PAYABLE procedures are performed because hospitals and doctors feel the need based on CYA more than patient need. Tort reform would go along way toward getting a handle on it. Perhaps you are to close to the forest to see the tree's on that issue...

I eat, drink, and sleep medical issues 10 hrs/day, 6 days a week. Listen to my patients complain not only about healthcare they receive, limited by their insurance companies ( esp W.Comp) and by other providers and healthcare systems, but also about their socio-economic issues that impact their medical care. I prescribe generic as well as brand name drugs (usually with coupon cards) all the time, 200-300 prescriptions/day. I watch as well as sometimes play in the politics of healthcare systems (i.e. money). I think I have a pretty good picture of what goes on, behind the headlights if you say so. Although there is some money to be saved from not ordering cya tests/labs, I and I know alot of other doctor's donlt practice that way. What is much more of a problem is the frivilous lawsuit crap. Just today, an ex patient of mine threatened to sue me because I discharged her out of my clinic, to a rehab center, because she tested positive for THC and Cocaine use, when she obvioulsy wasn't supposed to be using illegal drugs. If she does file a claim against me, then I got to pay for my defense, and she never has anything to lose. What BS.

If you take the opinion that anything ever spewed out of a politician is first propoganda, unless later proven otherwise, you will probably have a better understanding of what really is going on.

[Stentor]

Originally Posted by Excaliber

I am well versed in the generic drug vs brand name drugs. That particular argument has been raging around my house for about 20 years now! You could make a solid case for SOME brand name drugs, I don't believe you could make that case for ALL of them. Forced to choose one OR the other, I'd have to lean toward generic on a cost benefit analysis.

I think we screwed up by disallowing drug's from Canada into the health care system.

Sure, it makes sense to use a generic drug when one's available. Generic drugs account for upwards of 60% of drug utilization in the US already (and this proportion will increase over the next few years as tens of billions of dollars of branded drugs face patent expiration). However, in a lot of cases, there are not direct generic substitutes available.

Regarding importation of drugs from Canada--we would exhaust Canada's supply of drugs very quickly if we were to try and implement widespread importation from Canada. Furthermore, the FDA has already repeatedly indicated that it cannot guarantee the safety of our drug supply if importation is pursued (there’s already a sizeable grey market for fake/counterfeit drugs—which would likely dramatically increase under any importation scenario).

[Excaliber]

FDA has already repeatedly indicated that it cannot guarantee the safety of our drug supply

That is a good point, certainly one of the issues debated before the final decision to delete that section from the Health Care bill. I have a sneaky hunch the REAL reason it was deleted came from the powerful drug lobby though! I would like to think the FDA would have been able to rise to the challenge, but maybe not...

[Ralphy]

Ex the other day you were praising our abilities with checks and balances. Now you're *****in about excesive fraud. Are you up for election?

Originally Posted by Excaliber

My position on fraud remains unchanged, I fear you are grossly under estimating it. In addition I believe waste is also grossly under estimated. To many legal, ethical and PAYABLE procedures are performed because hospitals and doctors feel the need based on CYA more than patient need. Tort reform would go along way toward getting a handle on it. Perhaps you are to close to the forest to see the tree's on that issue...

Went to school for about a year working toward becoming a PA. Decided it wasn't my cup of tea, took another direction. Nothing wrong with a PA seeing the patients, good idea, saves money, can be more efficient.

[Ralphy]

Bomelia I read that article maybe 2 days ago. Also hows about paying for healthcare 4 years in advance so they could fudge the numbers by the CBO. Ex, it's all an illusionnn......

Originally Posted by bomelia

Does anybody hav a link to that article about the OMB I was referring to (and Excal answered). Please? I cannot find it.

Thanks!

Mike

[Anthony]

Originally Posted by Excaliber

Went to school for about a year working toward becoming a PA. Decided it wasn't my cup of tea, took another direction. Nothing wrong with a PA seeing the patients, good idea, saves money, can be more efficient.

I agree exactly, for the most part, but it doesn't save money from the patient's perspective. Patients will tell you, if they got to keep making that same $20-$40 co-pay with every visit, to see the PA, the same co-pay they would have to pay to see the doc, although it wouldn't matter to some, many of the patients would not be pleased, with some leaving the practice, thinking they are getting ripped off. That is what goes on.

[Excaliber]

Checks and balances aren't perfect, but aren't you glad we have them?

Interesting observation on the PA issue Anthony. We will need to address that soon, I see PA's as the wave of the future. Perhaps I missed the boat on my education priorities?

[Cobrabill]

[Ralphy]

Ex seems your playing both sides maybe?

Gasp! You mean some folks are abusing welfare and food stamps? How about Social Security, Medicare, Medicaid? Should we end all these programs immediately because of this abuse of the system? Because were tired of supporting these "bottom feeders"? Should we cut them all off right now? Let them starve then, including any homeless Veterans! Let them freeze in their house during this blizzard, no more heat subsidies for you bottom feeders. No more homeless shelters, they made their bed, let them lay in their own filth.

I don't know man, that sounds a little bit "facist" to me. Maybe our concern about socialism is a bit skewed here...

Or maybe, just maybe, some of these programs and some future programs actually have merit and are worth considering?

[Ralphy]

There could be better checks. However when you get the ACLU and Lawyers (Democrats) involved. These checks are shut down.

[Tom Kirkham]

She hasn't sung yet. The abortion issue may just kill this bill.

http://apnews.myway.com/article/20091222/D9CO403G0.html

[Excaliber]

I'm afraid I don't see your point Ralphy? We should not end all the various Federal programs without serious consideration given to each one, THAT was my point. Always has been.

However, my views are wide ranging and don't follow a particular party. Being an independant thinker I make a rational choice on what to support, or not. I guess that could be interpreted as "playing both sides". You'll find me in the middle aisle, looking for my seat. I'm the guy scratching his head...

I do see Cobrabill's pointed point though.

Indeed Tom, I too doubt that it will pass because there is NO WAY the politicians will be able to resist "tinkering" with it again!