[N0help4u]

I agree with J_9 and Tomder
Also the doctors will be paid on a different basis such as flat rate opposed to commission so they could easily end up choosing the golf course over the delivery room when they choose to.

[inthebox]

To Obama:

Involve the doctors, or like Hillary care it will fail.

Do not lower reimbursements - doctors will reduce or not see medicare or medicaid patients, because the reimbursements do not cover the costs.

Malpractice reform : LOSER PAYS will cut down on frivolus lawsuits. Limit lawyer fees to either an absolute amount 500 k or a fixed % [ 10 ] of award

Malpractice and tax deduction for charity care

[BABRAM]

To Obama:

Involve the doctors, or like Hillary care it will fail.

Do not lower reimbursements - doctors will reduce or not see medicare or medicaid patients, because the reimbursements do not cover the costs.

Malpractice reform : LOSER PAYS will cut down on frivolus lawsuits. Limit lawyer fees to either an absolute amount 500 k or a fixed % [ 10 ] of award

Malpractice and tax deduction for charity care

Americans are divided on whether medical malpractice lawsuits should be... | Public Agenda


You make some good points here. More specifically though physicians to the exclusion of admin wages, and the insurance companies to the exclusion of humanity (our costs), have been overly involved and neglectful to others for their own benefit. As for the malpractice lawsuits I support a cap being put in place similar to how some states currently have determined partial and full disability rewarding once a injury case is proven.

[twinkiedooter]

Wondergirl - this country is not like Chicago. You are so narrow minded and besotted by what your Ocommie is going to supposedly do with medical care for everyone. Just how do think he'll solve this problem nationwide? Just supposedly solving Chicago's problem isn't enough. Didn't his wife used to be the Hospital Administrator for the Chicago University Hospitals (monied by the Rockefellers)?

The regular doctors practicing medicine today are so hesitant to treat patients due to the litigious populace expecting miracles such as J-9 pointed out that a lot of doctors and hospitals are not going to be open much longer in this country. Awards in the millions of dollars makes me ill to even think about. The PI attorneys really have jacked up the awards out of this world to collect huge fees.

Short of having clinics open with foreign born and foreign speaking doctors there will be no other choice at present should his health care program actually get made into legislation. I seriously doubt if it will either.

[kp2171]

A new "report" said that over half of current physicians would seriously consider getting out of practice within three years because of the red tape involved with insurance procedures. When a provider who wants to heal is bogged down with all of this other BS noise, its so damn sad.

I don't give a damn if you are a rabid gop'er or extreme bleeding heart liberal. Both extremes p!ss me off to no end, with both sides seeking little good but to sustain their own political machines.

Trickle down health care doesn't work. The poorest of the poor, the ones with no real advocates or lobbyist are always left with the least, the worst. We have evil social systems in place. Likewise, dolling out more dollars through taxes to a government system that is inept, inefficient, and unable isn't an answer.

If you've never read Three Cups of Tea, do it. It isn't about health care, its about education. But it's a story of how one person, acting with intent and integrity can change the world. If more people acted like this, it would be a better place.

Republicans who claim a moral superiority, yet state an attempt at helping those most in desperate need (usually children and women) as communism, socialism are a disgrace to their "faith"... im a registered (R) by the way... democrats who pander to every social ill without a reasonable understanding of how standard of living is raised through job creation are economic idiots.

I'm sick of both extremes. They should be locked in a room together.

Those who b!tch and moan... ask yourself this. What have you done today to make your world better outside of your job/paycheck? How far out of your comfort zone are you? If you are Christian, how much stock do you place in your biblical calling to tend to the least of you first? Likewise, do you understand that social justice and personal growth, security, and wealth are not separate, conflicting positions?

You can demand social justice and not be a flipping socialist/communist. Highly centralized power (communism) fails. But you are kidding yourself if you think the US has free trade. Why do we subsidize crops we cannot grow at competitive prices when they can be grown in developing nations cheaper? Do we believe in free trade or not? Why do unions, who supposedly want to seek a better standard of living for their members, desire to abolish the "secret ballot" and to intimidate workers with home visits?

Yes... med school training takes time. What? Supply and demand no longer applies or does it only apply when its convenient?

I don't think nationalized health care is necessarily going to fix a damn thing. I also don't think the free market does anything but take care of the most successful and those employed by them, but does little for the people with no voice, no lobbyist.

Working through my church, I've seen way to many people on both sides b!tch and moan without doing a damn thing themselves to act locally. It's a crock.

If you are not your brothers keeper, then don't talk like you are. If you don't sacrifice something of your life for people who are in awful positions, who live in places that we would flee from, abandoning children with no voice to the wolves, I have no time for you.

I'm already sick of the partisan BS talk, and I'm tired of the hyposcisy on both sides of the aisle.

*rant over* man, I'm in a mood today...

[kp2171]

*sigh* back after my rant. I'm sorry. I'm in the middle of a "paradigm shift" where I'm trying to find a way to balance being financially successful and being socially moral... and its not easy right now. I think I'm called to do more than I am doing, and I'm doing more than I was. Just wish more would step up and help. I'm seeing too many willing to donate a buck or two to charity, but who won't act directly to those in need... and we all know the more hands that money passes through, the less there is in the end. We need action on many levels, not more money, or more government. We need funding, we need structure, and we need a public who believes and acts in social justice and the power and responsibility we each have to meet that end personally.

So back on topic...

OK... there is a lag time connected to the numbers of physicians and the potential number of patients...

What about nurse practitioners, physician assistants, physical therapists, and certified midwives? Each can fill roles that can tend to the needs of many. Since 1990 the numbers and roles of nurse practitioners has dramatically increased with corresponding changes in how they were regulated.

We have talented people in health care. Nurses are one of the most important resources we have. Enabling them to do more with attainable certification is one great way to expand the care for any additional patients. Of course, that would mean the powers that be relinquish some power.

They didn't like it when DO's pushed to be on a level playing field. Today, a DO can teach right alongside MDs at med schools.

[NeedKarma]

Good posts kp, thank you.

[kp2171]

well... I'm not the moral police here. Make noise back at me at what will work.

for ex... foreign aid is a farce. When we give aid to other nations its often part of a sham. How much of that aid goes toward real development? You don't know... how much of foreign aid goes toward building up the military complex? Lots. Yet its packaged under the seemingly charitable title of foreign aid.

the "communism" that we fought in El Salvador... one of our most wretched lies, and I still am enamored by the spirit of hope reagan had in the US. The poorest people of the nation simply wanted some land. An ability to make a living. Instead we trained the opposition to kill... ever hear the phrase "be a patriot, kill a priest"? Those are the people we backed in the name of staving off "communism".

go there and meet the children. One in five will die before they are five years old.

so if working through the BS government noise doesn't work, what can?

this year I'm cutting my church tithe in half. I'm increasing my giving, but the rest will probably go through micro loans, directly to those in need without the layers and layers of sticky fingers.

if we want to provide primary health care, we need to pay for it. That might mean a change in how we allocate funds. Even well meaning agencies with good intentions can really screw things up. When HUD tried to eliminate slums through tearing down projects and relocating the poor to lower class suburbs, all they did was move the slums. The poorest still were unemployable, without systems of support.

our "bootstrap" mentality is too simplistic. Yes... I believe in the power and opportunity of the individual. But when you work with a person who has grown up in a terrible environment, you begin to see what systemic problems there are. A young person who has never lived in a clean home doesn't understand hygiene. Doesn't understand financial planning. Doesn't value what most of us value.

so how do you pull someone out of that mess? Individuals are saved one moment at a time, often by people making meager livings themselves. I just talked to a guy who applies for grants for three local homes... one tends to teens who are homeless, one is for young, pregnant mothers, another is for women. All aim to give them a place of security while teaching them about sustainable living. The guy who writes the grant work has done a great job. But I could see the stress in his face... he said "well, you are only as good as your last grant"... meaning he knew the whole house of cards could fall down, especially when people are giving less now in times of economic turmoil.

I talk to a woman who teaches as a PT at a local med school. She states one of the biggest problems with the poorest patients is they don't come back for checkups. That its not something that's been taught to them... so when they finally do come back its usually because some minor problem has developed into a major trainwreck.

is society to blame for this issue? No and yes.

obviously I teach my child skills and structure that I know will help him succeed in life. Others should do the same.

but its not that simple. There's a boy, labelled as a "problem" child in a tutoring class that I volunteer for. We never have enough tutors to match the number of kids in need. This "problem child" comes every week. Week after week. He has yet to be assigned a tutor and usually works with the bus driver who brought the kids there.

this is a case where the government is not needed. A person is needed. Two hours once a week is needed.

so... while it sounds like I'm off topic, I don't think I am. If we want to provide quality health care, especially to those who need help, it isn't enough to say "opportunity is there... this is the US"... and giving the govt more cash to burn isn't the answer either.

until you look locally at what's happening in your town, and start directly supporting those programs with many fewer layers of red tape, until you actually do something yourself, things will not change.

if we need medical providers like CNM's and nurse practitioners to be able to fill in the gaps, fine. Cut back the red tape. Provide funding for education for service to needing communities.

the education of poor women should be paramount. It clearly reduces pregnancy and increases standard of living, which pulls another name off the govt roster.

but it takes individuals to make a difference. Screw the DNC or GOP. I'm done wasting dollars on ad campaigns. If healthcare is really important, fine. Invest personal time being an advocate for an elderly person in need. Support a local clinic that helps those most at risk.

I'm angry because I've done all the wrong things myself. I've blamed the govt. blamed the poor. Blamed the politicians. Blamed the system.

nope.

its me.

until I get off my arse and actually do something that directly, positively affects someone else, I'm the problem.

[J_9]

KP, your arguments make perfect sense. I would like to add though, and going way down to the perverbial root of the problem... Why don't we pay our teachers more? All the way from elementary to secondary schools and above.

We can't have an intelligent society without good teachers who care. There are many people who qualify as wonderful teachers, yet after graduation go into other businesses because they pay more. My neighbor is an example. He has his Masters Degree in elementary and secondary education, but because of the pay scale, he works at a local tobacco barn where he gets paid three times as much as a teacher.

Without teachers, we can't have doctors or nurses. We farm out to other countries who value their educational system and their teachers.

No Child Left Behind is a comedy. My MIL has a child in her class who she is required to pass because the child has Down's Syndrome, and another that has ADHD. They don't have to do their homework, they don't have to take tests, they just have to show up.

While I believe we need to start with our legal system, we should also focus on our education system

Okay, off my soap box now.

[inthebox]

Health care does cost money - there is no such thing as "free" healthcare, unless it is by healthcare professionals that cannot even deduct the loss.

In this country - those uninsured - are able to go to an ER and be seen - which is very expensive.

The cost of unreimbursed care gets spread out into less insurance benefits or higher out of pocket costs or higher premiums.

What is not addressed is rationing:
30 % of medicare $ goes to the last 6 months of care: there has to be a discussion whether 3-5 thousand dollars a day for an 80 year on a ventilator with no good prognosis - can that resource be better used for vaccinations or screening tests or prevention or treatment for chronic diseases such as diabetes or heart failure etc...

Another thing -
After high school
4 years college
4 years medical school
3- 12 years residency and or fellowship depending on specialty
- 100s of thousands in debt and at the very least you are 28 if not into your mid 30s
- then in the real world your working > 40 hours - if not double that - then you could lose it all in a malpractice suit.

Tell me what high school kid wants to be a doctor - go through all that and be exected to provide "free " care?

If you ratchet the salary's down to say under 100 k - only the independently wealthy could afford to be a doctor.

[kp2171]

Oh I'm lock in step with you j_9... if you want to really improve the living conditions of a people, especially the poor, educating women is one of the key factors. You see dramatic decreases in pregnancy when women are afforded an honorable education. The book I mentioned, Three Cups of Tea... is about a nurse who was a mountain climber. He got lost trying to summet and was separated from his group on the way down. A local village basically saved his life. When he asked how he could repay them, they said they needed to be able to school their children and didn't have a school.

This guy, Greg Mortenson, was a nurse. Yes, making a wage more than some, but by no means raking in the cash. It took him two years to get the money to build that first school. He never stopped. His organization has built over 50+ schools in pakistan and afghanistan, working with local leaders to provide an education for women, in particular, and ensuring that these schools hold no political agenda or ideological training, all the while doing this in the middle of taliban country.

Quality education is critical. Preventative medicine is critical. I don't have the numbers at all, but I recently read about some plans that encouraged doctors to do follow up calls to make sure their patients were still on track. After running through this program it was estimated that over a five year period over 5K would be saved per patient in health care costs. I don't know enough to say more than I've said.. but clearly its easier and cheaper to provide much needed preventative care than it is to solve the much bigger problems that come with delayed or denied care.

Why am I no longer teaching? The wages in industry were far superior to what I got teaching, and I was at a university teaching science majors. I liked what I did, but to make numbers work theyd just cram more and more students into classes, and at some point good teaching falls away with heavy courseloads.

The simple truth is when the pay isn't there, many go elsewhere. Some have the heart and desire to fight through the noise. Bless them. But its pretty maddening when the people with whom we entrust our kids education have to choose between a better wage and a great calling. My cousin, a teacher, has to pay continually out of pocket for teaching supplies, and she's been teaching for years and years... her classroom is established. Yet she doesn't get the basic classroom supply support that shed get were she working in an office someplace... or without the fundraising of the parenting group.

Education and health care are two big pillars upon which stability and prosperity are built.

[J_9]

I am going to HAVE to get that book. I have a feeling it will become one of my favorites! How can I join him in his mission!!

[inthebox]

If you really want to help prevent poverty - support the traditional two p[arent family - census statistics bear this out.

And it is true - a dollar spent on education is more effective [ at maintaining good health ] than a dollar spent on health care.

[twinkiedooter]

Lately there has been a huge demand for field surgery kits and field medical kits. They are in short supply. The folks over in England have even posted videos on YouTube on how to pull out your own teeth. The reason the British are pulling their own teeth is due to lack of dentists on the National Health Care System. The ones that are not on the system cost a fortune. A regular Brit cannot afford dental care or can't wait who knows how long to see a dentist if he can even find one on the system. A few years ago this would have been unthinkable. But now with everyone poor and/or broke due to the high cost of everything at least they are taking the initiative to do what is necessary. Ever have an abscessed tooth? Hurts like hell.

I notice that it's always health care but they neglect to add dental care which sometimes is MORE important than health care. Tooth decay and resultant abcesses has a lot to do with brain infections and possibly can prove fatal.

I got myself a field medical kit and if necessary I can use it due to not having to go to a foreign speaking doctor sometime in the future and being misdiagnosed. Or for an emergency in case there is no doctor around. You never know. Good thing to have.

I really pity the people who are hooked on the lower my cholesteral or diabetes drugs. What are they going to do when they have to get refills or see a doctor?

I was also wondering should America actually get this national health care. Will they stop putting MSG (and other ingredients) in our prepackaged food? Will they stop selling aspertame (insect poison) disguised as artificial sweeteners? Will they actually help people eat healthier and eliminate the obese people now walking around on our streets by having them go on good diets and teaching them good dietary health? I am appalled at the huge fatties walking around (or trying to walk I should say) and even the marshmallow children struggling to keep up with hugely overweight mama or daddy.

No, I am not making fun of these people as I am sure it is not pleasant being that huge. It does have something to do with the additives to our food that makes normal people just gain and gain more weight. The overweight people and the resultant expensive medical problems they incurr will vastly drain any kind of medical monies allocated for a national health plan. The fast food restaurants will literally have to be shut down or really overhauled and banned from adding the "obese" making ingredients they now add to the food along with irrational oversized portions. Supersize? Humongus obese size? Omega giantic heart attack size with extra cholestral?

I don't think that a national health care plan would really work if we don't stop poisoning our populace with the "obese" ingredients. When a person is obese they have health problems such as diabetes, lupus, heart problems, high cholesteral, arthritis, liver and kidney problems. Most of these people end up on the disability lottery due to being obese/overweight and not being a productive member of society and relegated to staying at home doing diddly.

[liz28]

KP, I have to agree with everything you said. I recently read in the newspaper about a lady in Long Island that is a school bus driver opening up a school in Haiti for kids to learn because there was no schools, not even one, in the town. She started with one classroom and one teacher. Now she is able to teach 1st through 5 and hope to keep expanding.

She paids for everything herself while maintaing her home and bills. She even have a lunch program in place and the kids depends on it.

Nobody knew she was doing this but after her town found out about it and her employer they started helping her by donating money. She even got donations from a private organization that heard her story.

It is great that there are people out there with big hearts. I will look for the story and post it if you want to read it.

[kp2171]

Twinkie... loved most of your post, except the part about the foreign speaking doctor. I just spent a ton of cash to have my eyes worked on by a doctor whose last name is hussein. He is the best in town. Period. I don't give a damn about his accent. He trained in the US, did his fellowship here, and if you understand ANYTHING about the health and physical sciences... it is common to see that foreigners are often the best educated in theoretical issues... then they come, and often stay, in the US for clinical and laboratory training.

One of the best chemists I know is an iranian who worked in the petrol industry until he came to the US for graduate work. Today, he is one of the best teachers of our young doctors, scientists, and physicians.

Don't assume that a foreign dialect begets diminished care.

[N0help4u]

Exactly right Twink
I tell people how Canada, England, New Zealand and other countries with socialized medicine how bad off they have it and they think I am believing a bunch of lies, but I hear the stories from the people in the countries and my one friends friend died waiting for surgery.

I guess maybe we will have to get Doctors without Borders and those types of organizations involved with American patients.

[NeedKarma]

NOhelp,
Do you see Canadians posting here about how terrible their system is?

[N0help4u]

No I do not but have any of you needed surgery to save your life?
Or to see a specialist for a life endangering problem.
It seems to me that it is easy for you to get to the family doctor but from what I have heard once you have a really serious problem you then see the problem.

I have heard many Canadians that said they came to Pittsburgh and other places in the USA for surgery because they were told they could not have their surgery in the necessary time to save their life.

[NeedKarma]

I guess we'll have to take your word for it instead of the opinion from actual Canadians.