The never-ending POTUS Election thread....

[Hoofbite]

This is true with almost every insurance company but still I get your point.
The guy who did my knee replacement in January told me he just does more surgeries.This is not exactly comforting.He's the head of a clinic that has four other full time surgeons.They take over the ORs in their hospital Monday and Wednesday every week except Thanksgiving and the two weeks at the end of the year.
My doc did over 250 surgeries last year,that's how he makes up for cut fees.
Think how many the whole team knocked out.
He's doing my other knee in August lol

Your doc did over 250 surgeries last year because he can make a fucking killing.

Local newspaper publishes the top salaries for the 2 main healthcare systems in the area. Orthopedic surgeon came in at #2 on the list and pulled over $1.1M.

These guys have control over multiple ORs at a time. While 1 person is currently under the knife in 1 room, another person is getting prepped and being put under anesthesia in another room. The ortho doc does what he's there to do, hands off wound closure to someone else, and then goes over and starts working on the other patient. When the 1st patient is done, they're wheeled out and someone else comes in and starts getting prepped.

Ortho doc just bounces back and forth and knocks out a handful of people in a single day.

 

[Hoofbite]

The money part I only mentioned as motivation for why some of the brightest people become doctors, not all but a significant portion. If that isn't there, they'll look towards different career options.

Most doctors are paid fee for service. When there is less competition, fees for those services are reduced. More and more physicians everyday refuse to accept Medicare and Medicaid because government reimbursements are too low and admin costs are too high. In areas of the country where there is one dominant carrier (think Anthem/BCBS in many states) the carrier greatly slashes fees paid to providers, but providers don't have much choice to accept or not because if they drop out of that network thy lose access to market share. This is why government run healthcare/single payer systems suck. Once they are implemented, fees will go down. All the while physician costs (especially for things like medical malpractice coverage) have gone through the roof.

And just so we're clear here, a large part of why fees are slashed is because the FFS model allows doctors to be reimbursed for everything they do regardless of whether or not it was medically appropriate.

Doctors bill excessively. Some shit necessary, but a lot is not.

Insurance companies cannot make an argument that they know what was necessary because they weren't there in the room so the only recourse insurance companies have is to cut reimbursement. Without reducing rates, the insurance companies wouldn't be able to operate because runaway testing would bankrupt them.

 

[TheZoneSucks]

Fee for service is a shitty model that won't last regardless of whether or not the United States goes to a single payer system. It's largely part of the problem with runaway costs. It incentives volume rather than outcomes, which means that malpractice is a product of FFS by pushing people out the door sooner than necessary and subjecting them to unnecessary testing and procedures.

FFS isn't going to last. If single payer would give the system a kick in the ass towards finding a better pay model then single payer is absolutely needed.

Yeah, lets take away the profit motive for highly skilled people because that is going to work out just great into the future. Fee for service is the ONLY way it can work. When you get government involved you get the problems we have today and single payer... you've got to be one stupid motherfucker to want and advocate for that in the US. You socialist assholes have already fucked up the system with this Obamacare fascist crap, so of course after it fails you want to emulate Venezuela and go for fucking up the whole thing beyond repair. How about you socialists stop fucking shit up so much? It's not like history provides many great examples of where your bullshit leads.

 

[Hoofbite]

Yeah, lets take away the profit motive for highly skilled people because that is going to work out just great into the future. Fee for service is the ONLY way it can work. When you get government involved you get the problems we have today and single payer... you've got to be one stupid motherfucker to want and advocate for that in the US. You socialist assholes have already fucked up the system with this Obamacare fascist crap, so of course after it fails you want to emulate Venezuela and go for fucking up the whole thing beyond repair. How about you socialists stop fucking shit up so much? It's not like history provides many great examples of where your bullshit leads.

1. That's flat out bullshit because there are other payment models. If FFS was the ONLY way, other models wouldn't exist here in the US now would they?

2. You should probably either check your emotions at the door or stay on the sidelines. This is big boy talk. No need for emotionally charged rants that are barely comprehendible.

 

[SixisBetter]

Ortho doc just bounces back and forth and knocks out a handful of people in a single day.

Hmm except I had a spinal and talked to him some,and could see him from the shoulders up over the drape the whole time.
Well not when they fired up the jigsaw,then I averted my eyes and turned up the music.Couldn't really see the operating field,but I could see stuff slinging off the saw blade.My stuff.
I'm assuming he didn't run off to another theatre during those 3 or 4 minutes,those couple or 3 times.

 

[Hoofbite]

Hmm except I had a spinal and talked to him some,and could see him from the shoulders up over the drape the whole time.
Well not when they fired up the jigsaw,then I averted my eyes and turned up the music.Couldn't really see the operating field,but I could see stuff slinging off the saw blade.My stuff.
I'm assuming he didn't run off to another theatre during those 3 or 4 minutes,those couple or 3 times.

I'm not saying they run off in the middle of the procedure. They finish the procedure and move on to the next one that's ready and waiting for them.

I'm saying they have the ability to schedule more patients on a given a day and because they can make a shit ton, that's what they do.

I don't believe that any increase in the number of procedures is a consequence of getting reimbursed too little. It requires the assumption that they wouldn't maximize their earning potential. If you can take on more cases and make more money, why wouldn't they?

 

[dbair1967]

And just so we're clear here, a large part of why fees are slashed is because the FFS model allows doctors to be reimbursed for everything they do regardless of whether or not it was medically appropriate.

Most managed care companies still make doctors prove medical necessity, so no, this is not true.

Insurance companies cannot make an argument that they know what was necessary because they weren't there in the room so the only recourse insurance companies have is to cut reimbursement. Without reducing rates, the insurance companies wouldn't be able to operate because runaway testing would bankrupt them.

They make that argument all the time.

 

[Hoofbite]

Most managed care companies still make doctors prove medical necessity, so no, this is not true.

They make that argument all the time.

Which entails what, asking the provider to justify his decision? Okay, easy enough. All you have to do is document a sufficient level of uncertainty for a diagnosis and who can question that?

As for proving medical necessity, I doubt that. They may retain the right to "ask" for rationale regarding medical necessity but they damn sure don't have a standing order that requires doctors to provide anything in regards to medical necessity for every prescription or lab test ordered. They literally could not process that quantify of information. They may have policies written, but I'd say they are so rarely applied that they may as well not even exist.

Look the volume of prescription opioids that are prescribed in this country and tell me that any standard of proof was applied for their medical necessity. Now, I will concede that pain management is largely subjective and is an area where nobody wants to feel like they aren't doing the best they can so things may be a bit different in these instances. That said, the sheer volume is undeniably NOT a justified medically necessity. You look the number of prescription opioids compared to the rest of the world and the US is either full of junkies, or sometime over the past 20 years we've largely become a nation entirely intolerant to any sort of physical pain at all.

More than just narcotics, there are other drugs that are worthless yet somehow pass the medical necessity test. Zetia is still in the Top 20 or Top 30 drugs sold in the USA, depending on source. This drug has absolutely zero evidence for use either by itself, or in combination with other drugs. There is none. You telling me this drug is medically necessary? There may be 1 instance in which this is true and that would be when someone cannot tolerate all the other options available. Top 20 to Top 30. Couple notches below Viagra. $2.5B in sales last year and doesn't have the evidence to back it up. Insurance companies paid for it. Did they ask for proof? If they did, here's all the proof they could possibly get, "Patient reports adverse effects to preferred first-line therapies".

You can't tell me that the system isn't ripe with excessive billing and unnecessary treatment, testing, and procedures. If it wasn't, the cost of healthcare wouldn't even be worth discussing because the costs WOULD NOT have grown at the rate that they have over the past 2 decades.

 

[VTA]

So let them take some of that weight of providing security. That still doesn't address the fact that they pay less for healthcare. They wouldn't pay any more if they had to divert funds to national defense.



A private healthcare system doesn't mean that non-contributing members actually contribute or are excluded if they don't. You have non-contributing members either way and under both circumstances they receive healthcare. Either through Medicaid or through a Universal System, you have not done anything to satisfy whatever desire there might be to arrive at the point where people have "earned" their healthcare.



How so? They have less people so they probably have less people working in this area to manage their system. They also have smaller economies. The UK has about 1/6th the population of the US. Their GDP is right along the same ratio.



It does, you're right. Read the chart incorrectly. My bad.



Insurance companies currently profit, which means they could charge less in premiums to break even. Without them, those profits would become taxpayer savings.



You get lower drug costs because the entire population of the US would be up for grabs. There are countless alternatives to nearly every medication, both within a single class of drugs and when considering moving to another class of drugs. Hospitals do not carry every medication, they have a formulary. You might take drug X but the hospital only has drug Y from that particular drug class. They automatically substitute it to the drug they have because they are almost exactly the same in terms of efficacy.

Rather than having 5 groups of 60 million all coming to separate agreements for drug pricing (that's what the major insurance companies do), you would have 1 large group 300+ million people. There isn't a drug company in the world that wants to lose access to the one of the wealthiest and largest populations. They'll either compete to gain these contracts, or the healthcare system will simply use another product from the same class.



Healthcare shouldn't be viewed as a commodity. If you're willing to grant that people have a right to life, then it shouldn't be a big leap to say that people have a right to immunizations and antibiotics because they unquestionably add decades to a person's life.



That's not backed up by the outcomes across the world.



Medicaid works. In my state, it's a $0 copay on all medications. Medicaid isn't the problem. The problem is that we still have a large number of people who are uninsured and even for those who are insured, the costs are still obscene. The entire system is set up in such a way where prices and reimbursements are entirely independent of each other, nobody actually knows what a particular procedure or service should cost, and ultimately the people of this country are getting fucked over.

More agencies may be required, but when we aren't funneling 1 trillion dollars through insurance companies, that's not really a problem. Insurance companies are simply a middleman who also acts as a gatekeeper on both ends. They make the system less efficient and there isn't even a question about this aspect. Every pharmacy in America would be significantly more productive if they didn't have to deal with the minefield of 3rd party reimbursement. That's a fucking fact.

The reasons they pay less have nothing to do with who’s providing the care, unless of course these governments are intentionally short changing their people. The U.S leads the world in R&D and Specialized healthcare and the use of technology, as noted above. All of these charts and lists have the U.S. system rated low because of costs and availabilities which is misleading. The quality of care in the U.S. is world class; we have 16 of the 30 most technologically advanced hospitals in the world.

To put it crassly, you can’t get an Audi for the price of a Corolla.

Also misleading in these articles and editorials are the averages not being mentioned. 58 countries in the world have some form of Universal Healthcare. How many of them would make the grade? You get the same 10-13 nations mentioned. What about the rest? As it stood before goofy ObamaCare, the U.S. had 75%+ coverage rate. That’s far from a losing percentage, warranting any kind of overhaul.

And yes, if the nations in question would have to scramble for funding if and when the U.S. gravy train dwindles, I can’t see how it wouldn’t effect every part of their economy, including healthcare funding. And I’m saying it again: the migrant crisis is going to tax their systems severely. It’s un-sustainable.

The sheer number differentials are enough to see that it can’t work here. We can’t postulate how many people would be involved in administration based on what smaller nations do and expect to come to a conclusion that it would function the same. 330 million people, with God knows how many not even on board with this idea is going to be a disaster. Another goofy attempt will be imposed, with the same and probably various other short-comings involved accomplishing nothing but higher insurance costs and higher taxes for those of us still working. At it's best, it should be a states' rights issue, not a federal imposition. If the people-states on board with this idea were smart, they’d handle it locally to prove that it works, instead of demanding everybody monkey along with their ideas. Trying to impose things on people is a sure-fire way to meet resistance.

Why wouldn’t health care be a commodity? Food and shelter are far more immediate needs and we wisely accept them as commodities. Do you want to share your house or the cost of your neighbors? Healthcare and medical science are specialized areas, why would we expect quality service when it gets relegated to the level of postal carrier?

The outcomes across the world, in terms of quality care and advancement are evidence of cost/quality ratio.

 

[dbair1967]

Which entails what, asking the provider to justify his decision? Okay, easy enough. All you have to do is document a sufficient level of uncertainty for a diagnosis and who can question that?

As for proving medical necessity, I doubt that. They may retain the right to "ask" for rationale regarding medical necessity but they damn sure don't have a standing order that requires doctors to provide anything in regards to medical necessity for every prescription or lab test ordered. They literally could not process that quantify of information. They may have policies written, but I'd say they are so rarely applied that they may as well not even exist.

Look the volume of prescription opioids that are prescribed in this country and tell me that any standard of proof was applied for their medical necessity. Now, I will concede that pain management is largely subjective and is an area where nobody wants to feel like they aren't doing the best they can so things may be a bit different in these instances. That said, the sheer volume is undeniably NOT a justified medically necessity. You look the number of prescription opioids compared to the rest of the world and the US is either full of junkies, or sometime over the past 20 years we've largely become a nation entirely intolerant to any sort of physical pain at all.

More than just narcotics, there are other drugs that are worthless yet somehow pass the medical necessity test. Zetia is still in the Top 20 or Top 30 drugs sold in the USA, depending on source. This drug has absolutely zero evidence for use either by itself, or in combination with other drugs. There is none. You telling me this drug is medically necessary? There may be 1 instance in which this is true and that would be when someone cannot tolerate all the other options available. Top 20 to Top 30. Couple notches below Viagra. $2.5B in sales last year and doesn't have the evidence to back it up. Insurance companies paid for it. Did they ask for proof? If they did, here's all the proof they could possibly get, "Patient reports adverse effects to preferred first-line therapies".

You can't tell me that the system isn't ripe with excessive billing and unnecessary treatment, testing, and procedures. If it wasn't, the cost of healthcare wouldn't even be worth discussing because the costs WOULD NOT have grown at the rate that they have over the past 2 decades.

Hoof, you seem to have the idea that all healthcare that's non government delivered is somehow wasteful and ineffective, and this is simply not true.

Is the system perfect, no it isn't. Too many patients still "doctor shop" looking for someone who will help them get pain killers, or go to their doctors and want to have the drug they just saw on TV or read about in a magazine. There are doctors who own x ray, MRI/CT centers that will routinely order those tests when maybe there isn't enough evidence to warrant having it. When I got into the healthcare business, pre authorization was routine for MRI/CT, now many insurance companies no longer require it. Do you know why? Because their research found the vast majority (well over 95%) were in fact, warranted. It was costing more administratively to review it than it was saving in denials for those not needed. Further, consumers WIDELY and LOUDLY complained about managed care/HMO companies being FAR too restrictive, especially in the early to mid 90's.

In contrast to what you insinuate above, unless people are paying out of pocket then they cant just get whatever drug they want. Almost every healthcare insurance company I know has physician and clinical pharmacists consulting on what drugs should or should not be on their formularies. Many of the "designer" type drugs require pre approval or have prescribing limitations which again, is something consumers complain about. While many companies have 3 or 4 tier drug copays, some still have 2 tier (its either on and covered or not on and not).

I mention above that in some ways, consumer complaints led to less restrictive managed care. The reason I did is because you are promoting a system which would ultimately be VASTLY more restrictive than anything in place currently, even beyond such disasters like the VA, Medicare and Medicaid. People only support the ridiculous idea because they somehow believe it will be "free" or "cheap", and again those system do nothing to save money other than to severely ration or even avoid much needed care. It isn't because they can deliver it for "less" or are somehow improving the health of those people.

The health problems in this country have little to do with people not being able to access or even afford good care. The problems are people (our population in general) have become incredibly fat & lazy. Kids sit in front TV's for hours watching shows or playing video games every day when the norm in the past to go out and run, ride bikes, play sports etc etc. They get a very early start on being unhealthy and it continues throughout their life. Many spend hours on their smart phones or I pads now. Many have very poor eating habits.

The best research in the world is done here in this country. The best complex care is delivered in this country. The best doctors in the world are in this country. There's a reason so many from outside the US want to come here to get care, if they can.

 

[Sheik]

Healthcare debate is boring as fuck.

 

[dbair1967]

Healthcare debate is boring as fuck.

Welcome to the offseason

 

[Hoofbite]

The reasons they pay less have nothing to do with who’s providing the care, unless of course these governments are intentionally short changing their people. The U.S leads the world in R&D and Specialized healthcare and the use of technology, as noted above. All of these charts and lists have the U.S. system rated low because of costs and availabilities which is misleading. The quality of care in the U.S. is world class; we have 16 of the 30 most technologically advanced hospitals in the world.

To put it crassly, you can’t get an Audi for the price of a Corolla.

Yet in spite of all that technology and world class ability, we have worse outcomes in key measure. We're paying for the Audi and getting something slightly better than a Corolla.

Also misleading in these articles and editorials are the averages not being mentioned. 58 countries in the world have some form of Universal Healthcare. How many of them would make the grade? You get the same 10-13 nations mentioned. What about the rest? As it stood before goofy ObamaCare, the U.S. had 75%+ coverage rate. That’s far from a losing percentage, warranting any kind of overhaul.

Because those are the most comparable countries in terms of standard of living. It wouldn't make sense to compare to countries with a shittier standard of living.

And yes, if the nations in question would have to scramble for funding if and when the U.S. gravy train dwindles, I can’t see how it wouldn’t effect every part of their economy, including healthcare funding. And I’m saying it again: the migrant crisis is going to tax their systems severely. It’s un-sustainable.

It may impact their funding but the average spending per capita will not go up because of a lack of funding.

Why wouldn’t health care be a commodity? Food and shelter are far more immediate needs and we wisely accept them as commodities. Do you want to share your house or the cost of your neighbors?

Because unlike food and shelter you have absolutely no ability to forgo healthcare in the event that you need it. Many people go without food and/or shelter everyday. Find yourself with bacteremia and it doesn't matter where you planned on sleeping that week because if it's not in a hospital you're probably going to die. Get drilled by a car and Sunday dinner doesn't matter. Food and shelter are generally not even an immediate need unless you've gone without food for a long time or find yourself in a the middle of a natural disaster. When you have an immediate need for healthcare (which unlike food or shelter, could happen at any moment), you have no bargaining power or ability to defer until tomorrow. Furthermore, hospitals are required by law to treat people with medical emergencies. During a medical emergency healthcare is neither bought nor sold, it is only provided without regard to the person's ability to pay.

Healthcare and medical science are specialized areas, why would we expect quality service when it gets relegated to the level of postal carrier?

So don't relegate it to the level of the Post Office.

The outcomes across the world, in terms of quality care and advancement are evidence of cost/quality ratio.

And quality-wise, the US doesn't get what it pays for. That's why the whole discussion exists.

 

[Doomsday]

Number 3 killer of Americans? Medical mistakes.

 

[Hoofbite]

Hoof, you seem to have the idea that all healthcare that's non government delivered is somehow wasteful and ineffective, and this is simply not true.

Is the system perfect, no it isn't. Too many patients still "doctor shop" looking for someone who will help them get pain killers, or go to their doctors and want to have the drug they just saw on TV or read about in a magazine. There are doctors who own x ray, MRI/CT centers that will routinely order those tests when maybe there isn't enough evidence to warrant having it. When I got into the healthcare business, pre authorization was routine for MRI/CT, now many insurance companies no longer require it. Do you know why? Because their research found the vast majority (well over 95%) were in fact, warranted. It was costing more administratively to review it than it was saving in denials for those not needed. Further, consumers WIDELY and LOUDLY complained about managed care/HMO companies being FAR too restrictive, especially in the early to mid 90's.

And providers inevitably give it to them. Thank you for pointing that out. It's a perfect example of waste.

As far the MRI issue, if the issue was made based on whether or not it was cost-effective to require prior authorization then it doesn't matter if the MRI was warranted or if it wasn't. So long as it's cheaper to provide a test, procedure, or medication than it is to review it's use, it's cost-effective. Essentially, the door is now open for any test, procedure, or medication to be excluded from the prior authorization process regardless of whether or not is is indicated so long as the cost of reviewing it's use is greater than the cost of permitting the test, procedure, or medication. This is how you get waste. You accept a smaller loss than you would incur through administrative bullshit and whether or not the order makes medical sense is irrelevant.

In contrast to what you insinuate above, unless people are paying out of pocket then they cant just get whatever drug they want. Almost every healthcare insurance company I know has physician and clinical pharmacists consulting on what drugs should or should not be on their formularies. Many of the "designer" type drugs require pre approval or have prescribing limitations which again, is something consumers complain about. While many companies have 3 or 4 tier drug copays, some still have 2 tier (its either on and covered or not on and not).

Of course they can't get whatever they want but they don't need to be able to get whatever they want to make my example true. You won't find an advertisement for Zetia anywhere anymore because it's garbage. It just does not have the data to support it's use in almost any fashion. Nobody is doctor shopping for a shitty cholesterol med, and yet it is still being prescribed.

I mention above that in some ways, consumer complaints led to less restrictive managed care. The reason I did is because you are promoting a system which would ultimately be VASTLY more restrictive than anything in place currently, even beyond such disasters like the VA, Medicare and Medicaid. People only support the ridiculous idea because they somehow believe it will be "free" or "cheap", and again those system do nothing to save money other than to severely ration or even avoid much needed care. It isn't because they can deliver it for "less" or are somehow improving the health of those people.

I'm not sure about your state but where I live Medicaid's $0 copays are pretty fucking hard to beat. The VA, well of course it's a mess. They are funded appropriately and they're supposed to care exclusively for the people who are much worse off both physically and psychologically than the rest of the country?

The health problems in this country have little to do with people not being able to access or even afford good care. The problems are people (our population in general) have become incredibly fat & lazy. Kids sit in front TV's for hours watching shows or playing video games every day when the norm in the past to go out and run, ride bikes, play sports etc etc. They get a very early start on being unhealthy and it continues throughout their life. Many spend hours on their smart phones or I pads now. Many have very poor eating habits.

That my be what you think but that's far form reality. Old people struggle with their prescription costs a great deal. Ask just about anyone who's on an auto-immune drug that ends in "-mab" how their costs are doing as they hit the out of pocket maximum ever year. Ask any type 2 diabetic what percentage of their income goes to their basal and mealtime insulins.

Shit, 60 to 70 million people are beneficiaries of Medicaid. They definitely couldn't afford it if the were forced to purchase it. That's almost 20% of the country right there.

 

[Hoofbite]

Number 3 killer of Americans? Medical mistakes.

That study included therapy failure as a "drug mistakes".

Not sure how anyone would assume that's rational. You get a multi-resistant pneumonia and die, how was any of that a mistake?

 

[Doomsday]

That study included therapy failure as a "drug mistakes".

Not sure how anyone would assume that's rational. You get a multi-resistant pneumonia and die, how was any of that a mistake?

If true, that skews the results how much? Maybe then medical mistakes are only the number 4 killer of Americans? C'mon now.

I was bolstering YOUR point.

Yet in spite of all that technology and world class ability, we have worse outcomes in key measure.

 

[dbair1967]

Hoof on the warpath against waste fraud and abuse in healthcare, but props up Medicare, Medicaid and VA.

All among the most glaring examples in the world of waste, fraud and abuse.

 

[VTA]

Yet in spite of all that technology and world class ability, we have worse outcomes in key measure. We're paying for the Audi and getting something slightly better than a Corolla.



Because those are the most comparable countries in terms of standard of living. It wouldn't make sense to compare to countries with a shittier standard of living.



It may impact their funding but the average spending per capita will not go up because of a lack of funding.



Because unlike food and shelter you have absolutely no ability to forgo healthcare in the event that you need it. Many people go without food and/or shelter everyday. Find yourself with bacteremia and it doesn't matter where you planned on sleeping that week because if it's not in a hospital you're probably going to die. Get drilled by a car and Sunday dinner doesn't matter. Food and shelter are generally not even an immediate need unless you've gone without food for a long time or find yourself in a the middle of a natural disaster. When you have an immediate need for healthcare (which unlike food or shelter, could happen at any moment), you have no bargaining power or ability to defer until tomorrow. Furthermore, hospitals are required by law to treat people with medical emergencies. During a medical emergency healthcare is neither bought nor sold, it is only provided without regard to the person's ability to pay.



So don't relegate it to the level of the Post Office.



And quality-wise, the US doesn't get what it pays for. That's why the whole discussion exists.

You’re making it sound as if we’re functioning like a banana republic. If the high quality/High Tech capabilities we have weren’t being used to good effect, the costs would not be high. Laparoscopic procedures, nuclear medicine, PET Scans, etc, these things are being put to good use very day and you’re painting a picture of some bombed out third world clinic.

If I’m not mistaken, you work in a hospital, correct? Is this hospital withholding the use of it’s resources while people suffer? You don’t witness the success of years of research and development?

Personal anecdotes: A co-worker was diagnosed with prostate cancer in Dec. By March he was cancer free and back to where he was, working, back on his Harley, back in the gym.

My sister had brain tumor 8-10 years ago. The CorollaCare at Memorial Sloan Kettering has given her a completely clean bill of health with every successive re-evaluation. Let’s get Obama involved, surely he can make it better. Somehow.

Good point on the comparable standard of living reasoning.

I think you’re confusing immediate need with urgency. The average persons immediate needs are food and shelter; it’s why we work and generally what our lives center around: these basic necessities. Urgent care is something different and not in every body’s line of sight, moment by moment. We have Medical Centers, with Call Centers who can respond to almost any health catastrophe as it happens. As you’ve already stated, it’s provided for. What exactly is the discussion in terms of forcing us to pay more for routine medical coverage?

I wouldn’t dream of denigrating our great success in terms of healthcare by making it another inept government agency. Unfortunately I’m not in control and no amount if sound reason will convince the people in control to keep their hands off of it. If I have any complaint, it’s with the almost total rejection of some alternative medicines and therapies and the insurance companies refusal to participate in them.

We’re having this discussion because these very same people are interested in greater and greater in-roads into our very day lives and making excuses to raise taxes. There’s no altruism in these attempts to drag down our health care system.

 

[Hoofbite]

Hoof on the warpath against waste fraud and abuse in healthcare, but props up Medicare, Medicaid and VA.

All among the most glaring examples in the world of waste, fraud and abuse.

Not propping anything up. The VA covers people who require specialized care for things that normal people don't usually have to deal with.

It is what it is. The VA is massively underfunded in terms of healthcare. You can find their healthcare budget online at $65B. 10 million enrolled, IIRC. That's $6,500 per person, which is $2,000 less than the per capita for the entirety of the US, and 10 to 12% of the population isn't even covered by any plan.