TrophyHusband 0 #151 August 14, 2009 QuoteQuotethis is wrong on multiple levels. first, and most relevant to this discussion, obama clearly doesn't even have a general picture of heathcare costs. second, to suggest that physicians let conditions that they could treat get worse so they could make more money down the road is downright rediculous. and third, the surgeon is not going to share his income with the family practice doc. i ask again, how can you fix a money problem without first knowing where all of the money is going? obama's idea of healthcare reform will cause far more problems than it solves. he and congress need to back the hell up and do this health care reform right. I don't think his implication is that the physician is intentionally letting the problem get worse so that the hospital will make more in the long run. The idea is that an overworked doctor who does not get paid for spending time on follow-up, monitoring, or preventative medicine in general is not going to do those things as a practical matter. The physician who gets reimbursed for preventative medicine will be able to take more time to help the patient maintain health. That saves everybody money, including the patient, the patient's employer, the insurance company, and even the hospital. i think that is his implication, and it's not the first time he's said it. what about this? “You come in and you’ve got a bad sore throat, or your child has a bad sore throat or has repeated sore throats. The doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out.’” obama has a low opinion of doctors. he really has no clue what he's talking about when it comes to healthcare and needs to pull back, study up on it, and take the time to do this right instead of pushing for it to happen now. "Your scrotum is quite nice" - Skymama www.kjandmegan.com Quote Share this post Link to post Share on other sites
DanG 1 #152 August 14, 2009 I think its the overall health payment system that pressures doctors to perform the more expensive treatment. Currently doctors get paid for performing procedures, but don't get paid for having a nurse call patients to remind them to take their medicine, or make sure they are exercising, etc. Eventually even doctors with the highest moral standards are going to be forced to tend toward the treatments they get paid for. I'm not saying that the current bills being discussed are going to fix everything, but there needs to be a change in the way healthcare is perceived and compensated for in order to make the system both economically and medically more effective. - Dan G Quote Share this post Link to post Share on other sites
idrankwhat 0 #153 August 14, 2009 Ouch! Another two sentence volley! "UNCLE"! You win! I give up. You win the argument that you never made. Congratulations on a non fight poorly fought. I bow to your superior fallaciousness brave sir knight of the round and round and round table. Quote Share this post Link to post Share on other sites
mnealtx 0 #154 August 14, 2009 QuoteOuch! Another two sentence volley! "UNCLE"! You win! I give up. You win the argument that you never made. Congratulations on a non fight poorly fought. I bow to your superior fallaciousness brave sir knight of the round and round and round table. And you, in turn, win the Kallend Cup for idiotic semantics games...congratulations.Mike I love you, Shannon and Jim. POPS 9708 , SCR 14706 Quote Share this post Link to post Share on other sites
nerdgirl 0 #155 August 14, 2009 QuoteQuoteQuotethis is wrong on multiple levels. first, and most relevant to this discussion, obama clearly doesn't even have a general picture of heathcare costs. second, to suggest that physicians let conditions that they could treat get worse so they could make more money down the road is downright rediculous. and third, the surgeon is not going to share his income with the family practice doc. i ask again, how can you fix a money problem without first knowing where all of the money is going? obama's idea of healthcare reform will cause far more problems than it solves. he and congress need to back the hell up and do this health care reform right. I don't think his implication is that the physician is intentionally letting the problem get worse so that the hospital will make more in the long run. The idea is that an overworked doctor who does not get paid for spending time on follow-up, monitoring, or preventative medicine in general is not going to do those things as a practical matter. The physician who gets reimbursed for preventative medicine will be able to take more time to help the patient maintain health. That saves everybody money, including the patient, the patient's employer, the insurance company, and even the hospital. i think that is his implication, and it's not the first time he's said it. what about this? “You come in and you’ve got a bad sore throat, or your child has a bad sore throat or has repeated sore throats. The doctor may look at the reimbursement system and say to himself, ‘You know what? I make a lot more money if I take this kid’s tonsils out.’” Part of what sounds like is being described in non-specifics (so I’m not confident of how many different filters it’s gone through and what distortion level pro- &/or con-) was described in an investigative article linked by someone a couple months ago … may have been Matt [idrankwhat] or [DanG] (?). “The Cost Conundrum” describes why one small town in Texas has the most expensive healthcare in America (highest Medicare reimbursement rates) and does _not_ have higher effectiveness of care. It’s actually lower. The cost, in that case, is largely driven by the business model that has come to dominate in that specific city that does reward monetarily more tests and procedures. As the article discusses, with every additional test and procedure there is risk. Small, in many cases, but over time and lots of cases, risk increases, which is what decreases effectiveness. It also describes localities and facilities (such as Mayo Clinic) that have lower healthcare cost, higher effectiveness, and different business models. /Marg Act as if everything you do matters, while laughing at yourself for thinking anything you do matters. Tibetan Buddhist saying Quote Share this post Link to post Share on other sites
idrankwhat 0 #156 August 14, 2009 Quote And you, in turn, win the Kallend Cup for idiotic semantics games...congratulations. Cool! At least we're now in agreement about what we were talking about.Actually, what were we talking about? Palin drones or have we drifted too far? Quote Share this post Link to post Share on other sites
mnealtx 0 #157 August 14, 2009 QuoteActually, what were we talking about? Palin drones or have we drifted too far? Political bullying.Mike I love you, Shannon and Jim. POPS 9708 , SCR 14706 Quote Share this post Link to post Share on other sites
billvon 2,991 #158 August 14, 2009 > first, and most relevant to this discussion, obama clearly doesn't even > have a general picture of heathcare costs. What in his example do you disagree with, that makes you think that he doesn't even have a general picture of healthcare costs? >second, to suggest that physicians let conditions that they could treat get >worse so they could make more money down the road is downright rediculous. Of course they do. If a doctor is going to get no money to perform a procedure, schedule a consult or write for another test, they often won't do it. Not because they want Granny to die, but because when presented with more patients than they can see, they will take the ones who can pay, and schedule tests/treatments that their insurance company (or Medicare) will pay for. >and third, the surgeon is not going to share his income with the family practice doc. Right. He's going to get the check, and so will be perfectly willing to do the surgery. Quote Share this post Link to post Share on other sites
kallend 2,027 #159 August 14, 2009 QuoteQuoteOuch! Another two sentence volley! "UNCLE"! You win! I give up. You win the argument that you never made. Congratulations on a non fight poorly fought. I bow to your superior fallaciousness brave sir knight of the round and round and round table. And you, in turn, win the Kallend Cup for idiotic semantics games...congratulations. Words have meanings. The GOP lies about Bill in the House only work because people like you are sloppy in their use of words. When you buy a dictionary you will understand.... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
idrankwhat 0 #160 August 14, 2009 Quote Part of what sounds like is being described in non-specifics (so I’m not confident of how many different filters it’s gone through and what distortion level pro- &/or con-) was described in an investigative article linked by someone a couple months ago … may have been Matt [idrankwhat] or [DanG] (?). “The Cost Conundrum” It wasn't me but thanks for the link. I'm reading it now and some of it reminded me of an interview I heard, (yesterday?) on NPR. The doctor in the interview was mentioning that Dr's are being paid better to "do" than to "think". Essentially that the procedures that she performs are more lucrative than diagnosis. As an example she mentioned (seriously paraphrasing here) that she would see maybe nine patients a day for various pains and conditions and she'd prescribe various remedies. But then the 10th patient shows up with an ingrown toenail, and even though he only received the same allotted 20 minute session that all the others did, his procedure would bring in more money to her practice than the preceding nine patients combined. Quote Share this post Link to post Share on other sites
mnealtx 0 #161 August 15, 2009 Quote When you buy a dictionary you will understand. Did I hit a nerve there, Doc? Boy, you really DON'T like it when someone plays your little word games back against you, do you? As for the dictionary, I picked up the Merriam-Webster "Chicago College Professor" edition - it has one page saying "You already know EVERYTHING", so I figure I'm good. Mike I love you, Shannon and Jim. POPS 9708 , SCR 14706 Quote Share this post Link to post Share on other sites
kallend 2,027 #162 August 16, 2009 Quote Quote When you buy a dictionary you will understand. Did I hit a nerve there, Doc? Boy, you really DON'T like it when someone plays your little word games back against you, do you? As for the dictionary, I picked up the Merriam-Webster "Chicago College Professor" edition - it has one page saying "You already know EVERYTHING", so I figure I'm good. You share the "2009 Self Congratulation Cup" with rushmc... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
rushmc 23 #163 August 16, 2009 Quote Quote Quote When you buy a dictionary you will understand. Did I hit a nerve there, Doc? Boy, you really DON'T like it when someone plays your little word games back against you, do you? As for the dictionary, I picked up the Merriam-Webster "Chicago College Professor" edition - it has one page saying "You already know EVERYTHING", so I figure I'm good. You share the "2009 Self Congratulation Cup" with rushmc As compared to what? Your "2009 Flatulation Cup"? By comparison the congratulation cup looks great! "America will never be destroyed from the outside, if we falter and lose our freedoms, it will be because we destroyed ourselves." Abraham Lincoln Quote Share this post Link to post Share on other sites
christelsabine 1 #164 August 16, 2009 Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? dudeist skydiver # 3105 Quote Share this post Link to post Share on other sites
rushmc 23 #165 August 16, 2009 Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"?"America will never be destroyed from the outside, if we falter and lose our freedoms, it will be because we destroyed ourselves." Abraham Lincoln Quote Share this post Link to post Share on other sites
christelsabine 1 #166 August 16, 2009 Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? dudeist skydiver # 3105 Quote Share this post Link to post Share on other sites
rushmc 23 #167 August 16, 2009 Quote Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? it is, but to create the correct award a play on words was required"America will never be destroyed from the outside, if we falter and lose our freedoms, it will be because we destroyed ourselves." Abraham Lincoln Quote Share this post Link to post Share on other sites
kallend 2,027 #168 August 17, 2009 Quote Quote Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? it is, but to create the correct award a play on words was required Only if the RATS have poor language skills.... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
rushmc 23 #169 August 17, 2009 Quote Quote Quote Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? it is, but to create the correct award a play on words was required Only if the RATS have poor language skills. Maybe I should have "Flatulation Bag" award"America will never be destroyed from the outside, if we falter and lose our freedoms, it will be because we destroyed ourselves." Abraham Lincoln Quote Share this post Link to post Share on other sites
turtlespeed 220 #170 August 17, 2009 Quote Quote Quote Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? it is, but to create the correct award a play on words was required Only if the RATS have poor language skills. And this is only because in the book of Kallend - it doesn't matter how epically wrong you are - as long as you spell it correctly.I'm not usually into the whole 3-way thing, but you got me a little excited with that. - Skymama BTR #1 / OTB^5 Official #2 / Hellfish #408 / VSCR #108/Tortuga/Orfun Quote Share this post Link to post Share on other sites
kallend 2,027 #171 August 17, 2009 Quote Quote Quote Quote Quote Quote Quote .... As compared to what? Your "2009 Flatulation Cup"? .... "Your what ...." ??? You have heard of being "flatulent"? Of course, as far as I know the noun is flatulence. ? it is, but to create the correct award a play on words was required Only if the RATS have poor language skills. And this is only because in the book of Kallend - it doesn't matter how epically wrong you are - as long as you spell it correctly. A self-referential post that proves itself epically wrong.... The only sure way to survive a canopy collision is not to have one. Quote Share this post Link to post Share on other sites
TrophyHusband 0 #172 August 18, 2009 QuoteCurrently doctors get paid for performing procedures, but don't get paid for having a nurse call patients to remind them to take their medicine, or make sure they are exercising, etc it is not the doctor's or anyone else's job to call and remind people to take their meds and tell them to excercise. "Your scrotum is quite nice" - Skymama www.kjandmegan.com Quote Share this post Link to post Share on other sites
wmw999 2,447 #173 August 18, 2009 There was an interesting commentary from an internist on NPR the other day. She said that out of all of the patients that she saw all day, with problems from diabetes to whatever, the one she got paid for most was the ingrown toenail. Because she did a procedure. Her take was that diagnosis and management just aren't valued as much as doing stuff right now, and that maybe that's not the right allocation of importance. Wendy P.There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown) Quote Share this post Link to post Share on other sites
TrophyHusband 0 #174 August 18, 2009 Quote> first, and most relevant to this discussion, obama clearly doesn't even > have a general picture of heathcare costs. What in his example do you disagree with, that makes you think that he doesn't even have a general picture of healthcare costs? he said that a surgeon gets $30,000-$50,000 to do a foot amputation. Quote >second, to suggest that physicians let conditions that they could treat get >worse so they could make more money down the road is downright rediculous. Of course they do. If a doctor is going to get no money to perform a procedure, schedule a consult or write for another test, they often won't do it. Not because they want Granny to die, but because when presented with more patients than they can see, they will take the ones who can pay, and schedule tests/treatments that their insurance company (or Medicare) will pay for. you know goddamn well that there is a difference between accepting a patient with insurance, and making sure the patient's insurance company will cover what the tests and procedures and mismanaging a patients illness so they get sicker in order to make more money down the road. you are bordering on kallendism here. Quote >and third, the surgeon is not going to share his income with the family practice doc. Right. He's going to get the check, and so will be perfectly willing to do the surgery. so why the hell would the fp doc intentionally mismanage his patient's illness just so the surgeon can get paid? "Your scrotum is quite nice" - Skymama www.kjandmegan.com Quote Share this post Link to post Share on other sites
DanG 1 #175 August 18, 2009 Quoteso why the hell would the fp doc intentionally mismanage his patient's illness just so the surgeon can get paid? NO ONE SAID THE MISMANAGEMENT IS AN INTENTIONAL PLOY TO MAKE MORE MONEY! Except you. Sorry for the shouting, but if you're going to base your argument on your own interpretations, even when everyone else is using the correct interpretation, then just have it privately with yourself. And you're right, it is not the doctor's job to follow up with patients to ensure they are following orders. But studies have shown that hospitals that do that reduce costs and have healthier patients. Of course, why would we want that? That's just silly. - Dan G Quote Share this post Link to post Share on other sites
