No-Bama Care ?????

[Ronkh]

I remember and the general public and politicians had more common sense. Hillary care did not go far, since then the idiots have taken over.

Dave

If I recall correctly, didn`t she herself say it wasn`t workable?

[davidc]

If I recall correctly, didn`t she herself say it wasn`t workable?

Yes, apparently she lost her common sense since then. But>>>>>>>>>>>>>>> I already knew that

Dave

[Bunky]

The GOP at the federal level always want to blame liberals for all that is wrong and never address the issues.

The GOP had plenty of opportunities to get free market reforms but they would rather blame than do anything about it. They even passed an unfunded prescription benefit program under Bush..a win for Big Pharma.

I was taxing recipients of employer provided health care -- not employers and agree it had problems from the start since it had to go through the political sausage machine. Another big win for Big Pharma. They spend a fortune direct marketing drugs most do not need and Americans should not be subsidizing drug prices when other countries pay less. I think it should be honestly funded plus addressing free market improvements that can be done no matter what "care" you like.

[Bunky]

I sure liked the VA exec comments associated waiting for VA wait times with Disney World/Disney land.

The oversight committees seemed to surprised at all the issues at the VA.

[Ronkh]

The GOP at the federal level always want to blame liberals for all that is wrong and never address the issues.

The GOP had plenty of opportunities to get free market reforms but they would rather blame than do anything about it.

Ummmmmmmmmmmm

When did the GOP have a majority that could pass it ??

Remember the dems were in charge except the oval office......................

You`re just making this way too easy.

[Ronkh]

I sure liked the VA exec comments associated waiting for VA wait times with Disney World/Disney land.

The oversight committees seemed to surprised at all the issues at the VA.

And this is the same government you want in charge of all our healthcare..............

[tenblade2001]

Start with a "free education" for doctors, as in you get a degree you work for x amount of dollars for x amount of years. It works in the military for doctors and lawyers. Then figure out a way to control the price of drugs. The same drugs we buy in the US are sold in other parts of the world at very low prices. Set limits on payouts on malpractice suits. Control the doctors, control the meds, and control the patients. This is not a great answer, but the whole medical system needs to be reformed. I believe most doctors start out wanting to help people and if we can get more people involved in helping people we might get somewhere as a society. In Cuba it costs nothing to go to med school. In the US your father just about has to be a doctor before you can get into med school. We also need a bigger Physicians Assistant program. A good PA knows what he can treat and when to pass the patient on to a doctor.

There are some very erroneous assumptions and conclusions in this statement, which I`ll address each:
(1) There are already programs in place, non-military, that do exactly what you propose. The problem: they discriminate against specialist. They are only for primary care (Family Practice, Internal Medicine, Pediatrics, Geriatrics). You go to an "underserved" community and work, and your loans are forgiven at 10K/year. The irony is this: those same "underserved communities are the ones that DESPERATELY need specialist. However, specialist are not represented well in the AMA, who was a MAJOR backer of this plan. Also, it only re-affirms my prior point that government run healthcare only works when you`re not REALLY sick i.e. the young and healthy. Regarding the military, they tightly control the residencies (training after med school) that you can do. For example, if you want to be a plastic surgeon, there are ZERO residencies...before you say "who needs plastic surgery in the military", it is plastic surgeons that do all limb-salvage procedures and complex reconstructions on the soldiers. Orthopedic surgery is another example...only 19 positions in the entire country. Worse, those chosen are not always the best candidates. It is riddled with nepotism. Lastly, the training in the military residencies is not as a rigorous, as a whole, compared to non-military residencies. How do I know this? b/c I did my general surgery training in Norfolk and worked with Navy residents and attending surgeons. There were some good ones, a lot of mediocre ones and some REALLY bad ones but, as a whole, they were not on the same level. They just didn`t get the same level of training. So, the government paying for school, as shown, is hampered by political shenanigans and doesn`t meet the needs of the population.
(2) Controlling the price of drugs- this is a tough topic b/c there are MANY factors to take into account. The average cost to bring a drug to market is between 4 and 11 million, depending on the number of trials. There are R&D cost...researchers don`t always hit pay dirt but their experiments cost money. The companies have to recoup their cost. So why are the drugs cheaper in other countries? In developed countries like Canada and the UK, there is a single-payer...the government. So if the manufacteur wants to sell their drug there, they have to lower the price but they will make it up by charging those that can pay, more. Second, there are not the same rules for making generics, so the drugs the generics go to market faster than they do here. Also, in less developed countries, knock-off or counterfeit drugs are big business (so much so that 60min did a segment on it). You may think you`re getting a beta-blocker for your hypertension, but you`re getting a sugar pill (not really, but close to it). The FDA tightly controls the quality of the drugs produced and manufactures have to go through MULTIPLE EXPENSIVE trials to show that they are safe. Those same safeguards are not present in other countries to the same degree they are here. How do I know this? b/c I`ve done A LOT of research.( go on pubmed and search S Becker AND breast cancer or S Becker and Proteomics)..everything from bench work to devices (not drugs) and I can tell you the process is long and expensive. So, you can have cheap and unsafe/unregulated vs. expensive and safe.
(3) Control the docotrs-?????? what do you mean? dictate care? you want a bureaucrat deciding what treatment you need? There are already controls in place...its called precertification and predetermination....AND PATIENTS HATE IT. So what control are you speaking of?
(4) Most doctors still want to help people and helped people LONG before the ACA. We treat indigent patients, medical missions, and perform MILLIONS of dollars in free surgery every year. We get no reward for doing so: a lawyer does a pro-bono case, he can get continuing education credit. A surgeon does a free surgery on an indigent patient...NOTHING and we are the hook for millions if there is a negative outcome. But, this is a calling and its what we signed up for. However, physician "burnout" is at an all-time high..why? b/c we are working harder for less AND being made into villains by this administration and the media (part of their media push to pass the ACA). Remember when Barry made the comment about 50,000 dollars for an amputation during a press conference...there isn`t a single surgeon in the US that gets ANYWHERE close (maybe 600-1200, depending on the insurance) for an amputation. It was a bold face lie to gin up contempt for physicians.
(5) Cuba-Where to start... (1) when was the last medical breakthrough that came out of Cuba? 1990-never..there is zero innovation. I can name at least 10 from the US. Are they doing nerve sparing prostetectomies in Cuba? Nope. What about DIEP flaps for breast reconstruction? Nope. Single-site gallbladder removal? Nope. Minimally invasive, anterior approach for hip replacement? Nope. Cuba is at least 20yrs behind the US. So whuy is Cuba`s health system touted by the media and idiot hypocrites like Michael Moore? The look at stats like "lower infant mortality rate"...that`s great, until you look deeper. The US has a higher infant mortality rate b/c of how we define and infant i.e. a lot of countries don`t define a 23-24wk live birth as an "infant", but we do OR the baby has to live beyond X amount of days to be counted. In the US, we will try to save a 23wk baby alive vs. other countries in which being born that premature is a death sentence.

[Bunky]

Since 1995 (11 2 yr terms), the GOP has controlled the House all terms except for 2 (last 2 yrs of Bush, 1st 2 yrs of Obama). The GOP has controlled the Senate 6 terms against the Dems 5.

The president was a Democrat for 7 2 year terms and 4 were Republican.

The GOP has ample opportunity to support legislation that has even a remote chance of passing rather than political votes on planned parenthood. The dems have not lead either in Congress but where is the leadership from those that claim they are better. The House is usually the key on initiating funding.

The leadership decides what comes to the floor for votes and everyone seems to be dodging the real votes.

The GOP could propose a simple bill to allow companies to work across state lines and allow importation of cheaper drugs and not tie to some silly side issue.

The party of responsibility, integrity, family values, and conservative ideas has chosen Donald Trump who has changed his position very often and sometimes in mid-conversation.

[Accumulator]

tenblade2001- Belated thanks for posting that, good to see an MD`s view (yours is in agreement with the MDs I know). Oh, and Welcome to Autopia!

What I as a patient/consumer find frustrating is that the fear of a Malpractice Suit dissuades MDs (who don`t know me pesonally) from having frank discussions for fear of some "gotcha!". E.g., I ask about [post-op conditions] and the answer is "I didn`t do anything wrong!". Uhm..OK, understood, where do I sign a hold-blameless or something..I`m a happy customer, I just want a better understanding of [whatever]. MD literally just repeats "I didn`t do anything wrong!" as a response to numerous specific questions which call for detailed explanations. It was like a [freakin`] comedy sketch! Sigh...had to go to another Doc to get the explanation. This is becoming the norm, not like it only happened once or twice, and it`s frustrating besides being a waste of everyone`s time and my money.

[tenblade2001]

Since 1995 (11 2 yr terms), the GOP has controlled the House all terms except for 2 (last 2 yrs of Bush, 1st 2 yrs of Obama). The GOP has controlled the Senate 6 terms against the Dems 5.

The president was a Democrat for 7 2 year terms and 4 were Republican.

The GOP has ample opportunity to support legislation that has even a remote chance of passing rather than political votes on planned parenthood. The dems have not lead either in Congress but where is the leadership from those that claim they are better. The House is usually the key on initiating funding.

The leadership decides what comes to the floor for votes and everyone seems to be dodging the real votes.

The GOP could propose a simple bill to allow companies to work across state lines and allow importation of cheaper drugs and not tie to some silly side issue.

The party of responsibility, integrity, family values, and conservative ideas has chosen Donald Trump who has changed his position very often and sometimes in mid-conversation.

Several things to address:
(1) the healthcare system has not been in crisis since 1995. Were there problems...sure. BUT Washington (Dems AND Republicans) put band-aides on the problems and kicked the can down the road; typical. MULTIPLE factors are responsible for the healthcare system being in the state that it is in. (PRE- ACA) (a) increasing numbers of elderly and the increased cost of care (b) increased "end of life" cost...we are keeping people "alive" longer without a change in outcome. I`m not talking about elderly, I`m speaking of those in the ICU and late-stage terminal illness (c) more indigent care; Liberals like to paint the picture of the "working poor" but this is a minority. The majority is composed of the young who choose not buy insurance, illegals (especially true in border states) and the rest being those who are out of work/part-time. The rest, a small number, are the full-time employed, working poor. BUT, they are the poster children for the program.(d) increasing cost business i.e. higher insurance rates (malicious lawsuits has become its own industry), more employees for billing/collection (see prior post on the difficulty of dealing with insurance companies).
(2) Yes, the house has the power of the purse, but they can not act alone. A Dem controlled Senate can kill a bill (Reid was a pro at this) or the Pres. can veto.
(3) All the reforms I mentioned where put in front of Barry and he basically gave the finger to any opposition to the ACA.
(4) You can call Trump out on a lot of things (I`m no fan of DJT) BUT flip-flopping? vs. Shillary?? REALLY?? She has reversed nearly all of her "convictions" from the Iraq War, ``` Marriage, Drug policy, etc... When you live in a glass house, you can`t throw stones.

[Ronkh]

<----- getting ready to hear the liberal "talking points" rebuttal.

In 5,4,3,2............

[tenblade2001]

tenblade2001- Belated thanks for posting that, good to see an MD`s view (yours is in agreement with the MDs I know). Oh, and Welcome to Autopia!

What I as a patient/consumer find frustrating is that the fear of a Malpractice Suit dissuades MDs (who don`t know me pesonally) from having frank discussions for fear of some "gotcha!". E.g., I ask about [post-op conditions] and the answer is "I didn`t do anything wrong!". Uhm..OK, understood, where do I sign a hold-blameless or something..I`m a happy customer, I just want a better understanding of [whatever]. MD literally just repeats "I didn`t do anything wrong!" as a response to numerous specific questions which call for detailed explanations. It was like a [freakin`] comedy sketch! Sigh...had to go to another Doc to get the explanation. This is becoming the norm, not like it only happened once or twice, and it`s frustrating besides being a waste of everyone`s time and my money.

I`m shocked that someone would reply that way. One of the first things ANY continuing education class on med-mal will discuss is the importance of communication. Frivolous lawsuits are a real fear and some doctors let that fear get the best of them....we`re only human.

[Swanicyouth]

Start with a "free education" for doctors, as in you get a degree you work for x amount of dollars for x amount of years. It works in the military for doctors and lawyers. Then figure out a way to control the price of drugs. The same drugs we buy in the US are sold in other parts of the world at very low prices. Set limits on payouts on malpractice suits. Control the doctors, control the meds, and control the patients. This is not a great answer, but the whole medical system needs to be reformed. I believe most doctors start out wanting to help people and if we can get more people involved in helping people we might get somewhere as a society. In Cuba it costs nothing to go to med school. In the US your father just about has to be a doctor before you can get into med school. We also need a bigger Physicians Assistant program. A good PA knows what he can treat and when to pass the patient on to a doctor.

Some thoughts....

One thing I think a lot of people don`t understand, regarding "drugs" purchased from other countries is - they are not necessarily the "same"..

Any medication sold in the good `ol USA is manufactured in an FDA approved facility; packaged and distributed by organizations held to the highest standard in the world. Sadly, for generic medications today - this location is often in India, China, or some other foreign land.

Regardless, the cheap medicine people are ordering from Canada, India, etc... Is not the same medicine you are getting at your local pharmacy....

Basically, the difference can be can be compared to buying real Rupes 15 (FDA drug) here, or buying a Chinese knock off 15mm throw polisher (overseas market drug)...

Rupes invented the technology and makes the best large throw DA. Their machines are are also the most expensive. But, you know what you are getting is quality. With Chinese knock off polisher, they don`t have to spend the R & D - just do their best to reverse engineer the machine and manufacture it using cheap labor. Material and Quality is a crap shoot. You want that for our drug supply?

In the "US your father just about has to be a Dr before you can get into med school" ???????

Wha???? This is simply nowhere near true. In fact, look around, most of our younger physicians weren`t even born in the USA.

Look to Cuba as a model because it`s free to go to med school??? Seriously??? Do you think that free Cuban medical school is anywhere near as good as even our worse medical school here?

Unfortunately, it costs money to educate Drs and bring quality medications to market. The problem is - nobody wants to pay for it. People expect to see like the top specialist in the land and pay like a $10 copay. Dr dude trains for like 16 years for some speciality - and people here think it`s their Good given right to be treated by him for almost nothing. It`s crazy.

Same thing for drugs...I spend like $115 a month for medicine for my cat (transdermal methimazole)... But, tell someone their Rx is $115 for their sick kid and they look at you like you are crazy. Some people think it is their God given or constitutional right to free medical care.

Americans jumped on 3rd parties in the 1980s because they thought they were going to save money. Now the system is screwed and lawyers and insurance companies are blood sucking major dollars out of the health care system. Drug prices are out of control, because the 3rd party payer system is out of control.





Sent from my iPad using Tapatalk

[Accumulator]

I`m shocked that someone would reply that way..

And isn`t it downright sad that I`ve come to consider this normal? It`s not like I`ve had a lot of Medical Procedures, but when I do that`s how it usually goes and my wife experienced the same after her [recent Medical Procedure]. I even get the feeling that some (?most?) MDs *dislike* that I`m a, uhm....knowledgeable consumer...when it comes to this stuff; the vibe is "just don`t inquire about that, let us Medical Professionals do all the thinking". Gee, it`s not like I`m trying to be a know-it-all or Armchair Physician, I just want to know what to expect and/or explanations regarding the apparent "new normal" that just *magically/coincidentally* manifested itself after the procedure. Ya know, the MDs I subsequently consult for the "straight answer", the ones who don`t have to worry about a malpractice claim, seem to *enjoy* discussing this stuff with me and are able to easily satisfy my curiosity. Sigh...

[rlmccarty2000]

I may be the only one here that has been treated by Cuban doctors and Cuban trained doctors and all I can say is they are way better than the doctors that have treated me here in the US. They spoke English, wow! I go to the VA and I get Patel, Patel, and Patel and if it is English they are speaking coulda fooled me. Two doctors I had were from Haiti, couldn`t figure out what they were even trying to do. I got sent to a gastroenterologist and he was from Peru, I talked to him in Spanish. The neurologist I went to was Russian and I am still trying to figure out what he said. None of these doctors went to med school in the US. Some did a residency in a US hospital and then got their board cert. If you have time check out what med school costs in Peru, damn near nothing. We have to find a way to open more medical schools in the US, period. Free med school for everyone! Lol. But really we don`t need to have doctors paying off million dollar med school loans. You have to wake up the emergency room doctor here in my home town. Have you ever tried to talk to a doctor that was half asleep? Painful. Close to useless, and yes I got a very large bill.

While I was in the military and a military brat I lived in and visited too many countries to count, so I may not have the opinion that the USA is the best country in the world, some people think it is the only country in the world. There are good and bad doctors in every country. The doctors in other countries do not always have the latest and greatest machine to play with, but a good one can get the job done better than the idiot that just runs tests to run your bill up.

The FDA blocks innovation. Other countries do have innovative techniques in medicine. The US still does not do spinal disc replacement that is normal in many other countries. I don`t even want to get into the misuse of antibiotics. Here, take this, if it doesn`t work we will give you some more until none of them work and you die.

I was referring to US medical schools and who they accept. It is much easier to get into med school if your father graduated from a med school. Just what my doctor friends tell me. I`ve got no numbers to back me up.

The end.