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Started by sophist, August 06, 2009, 09:48:07 AM

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mistercharlie

Quote from: slslbs on February 28, 2017, 03:44:54 PM
The Donald, in his address to the Governor's Association

Quote"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."

Anyone with any form of experience would have know.  :shakehead:
"I used to be 'with it', but then they changed what 'it' was and now what I'm with isn't 'it' and what's 'it' seems weird and scary to me"
Quote from: kellerb on August 02, 2009, 02:29:05 AM
You haven't lived until you've had a robot shart in your ear and followed along in the live setlist thread while it happens. 

gah

Quote from: slslbs on February 28, 2017, 03:44:54 PM
The Donald, in his address to the Governor's Association

Quote"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."

And by nobody, he meant himself.

:shakehead:
Sometimes we live no particular way but our own.

sls.stormyrider

http://time.com/4690837/donald-trump-seema-verma/?xid=newsletter-brief
QuoteIf Trump's Medicare Chief Is Approved, You'll Need to Be on Your Best Behavior

Jauhar is a cardiologist and the author of Doctored: The Disillusionment of an American Physician.
Some years ago, surgeons in Australia were refusing to provide heart and lung surgeries to smokers, even those who needed the operations to stay alive. "Why should taxpayers pay for it?" one surgeon argued in the policy's defense. "It is consuming resources for someone who is contributing to their own demise."
Though some were outraged — the Australian Medical Association called it "unconscionable" to ration services based on personal habits — many agreed with this stance. They saw nothing wrong with patients paying for the consequences of their actions.
Seema Verma, President Trump's pick to lead the Centers for Medicare and Medicaid Service, sees things the same way. Verma, a health policy consultant, helped to reform Indiana's Medicaid program, working with then-Gov. Mike Pence. With an eye toward competition and personal responsibility, her program, known as Healthy Indiana Plan, mandated monthly contributions from beneficiaries, even individuals at the federal poverty line. There were stiff penalties for missed payments: termination of coverage or transfer to a pared-down plan that offered limited services.




Donald Trump Promises 'Insurance for Everybody' With Obamacare Replacement Plan
President-elect Donald Trump says his plan to replace the nation's health care law will include "insurance for everybody."
Verma has written that personal contributions are a way for Medicaid recipients to have "skin in the game." She has said that traditional Medicaid regulations "disempower individuals from taking responsibility for their health, allow utilization of services without regard for the public cost, and foster dependency."
Verma's views are in line with those of many Americans. A majority say it is fair to ask people with unhealthy habits, like smoking and overeating, to pay more for health insurance. Even President Obama has said that Americans should be "doing something about their own care."
At some level, this makes sense. People should be agents of their own wellbeing. I myself am sometimes put off by patients who don't seem to care about their health and then demand a quick fix.
HEALTH CARE
Republicans' Health Care Bill Unlikely to Quell National Debate
But personal responsibility is a complex notion when it comes to health. Individual choices always take place within a broader, untidy context. Demanding personal accountability often ignores that context and can lead to discrimination against the people least equipped to defend themselves.
I once took care of a young man with severe congestive heart failure who had a toddler at home but no reliable child care. We were supposed to start him on a blood thinner early in his hospitalization, but it got overlooked. Then, rushing to get his blood thinned, we overshot and had to stop the drug completely, leading to frustrating delays in getting him home. In the end he signed out of the hospital against medical advice. He told me he had to care of his baby.
He came to the clinic a week later looking embarrassed. He had left without prescriptions, so he had been taking no medications since discharge, leaving him short of breath. But the attending physician I was working with refused to give him prescriptions. She said he had to go to a walk-in clinic. She said he had to learn "personal responsibility."
Patients should be encouraged to make healthy choices, but punitive measures to force those choices can backfire. They also presuppose more control over health and sickness than really exists.
Representative Roger Marshall, a Kansas Republican, said in a recent interview: "Just like Jesus said, 'The poor will always be with us.' There is a group of people that just don't want health care and aren't going to take care of themselves." When the interviewer asked him to elaborate, he said, " I think just morally, spiritually, socially, [some people] just don't want health care. The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising."
Consistent with Marshall's views, under Verma's program in Indiana, missing two payments can get you kicked out of Medicaid for six months. We don't know why some patients in Indiana are delinquent on their payments, in part because little data has been made publicly available. (The Center on Budget and Policy Priorities, a left-leaning organization, says Indiana has not cooperated with attempts to assess the program independently.) But a Medicaid experiment in West Virginia in the late 2000s suggests people often fail to comply with such requirements because of mundane, if no less demanding, life pressures.
In the West Virginia program, Medicaid patients who signed pledges to enroll in a wellness plan and follow their doctors' orders were rewarded with special benefits, including unlimited prescription-drug coverage, diabetes care, and nutritional counseling. Even so, many patients still did not sign up. Those with limited transportation options or childcare responsibilities could not commit to regular office visits. Sadly, patients who could benefit most from the additional services were often least able to comply with the requirements, rendering them ineligible.
Irresponsibility can lead to unhealthy habits and thus poor health. But so can social status, income, family dynamics, education, access to healthy foods and genetics. It is reasonable to demand personal responsibility, but patient noncompliance is as much a function of poor communication, medication costs, cultural barriers, psychiatric illness and inadequate resources as it is of willful disregard of medical advice.
Americans are right to worry about rising health insurance premiums, and there is no denying that the relatively healthy majority will continue to pick up the tab for the sick minority, even those whose misfortune appears to derive from lifestyle choices. That is the nature of insurance: The fortunate among us subsidize care for those less fortunate.
But punitive measures like the kind Verma espouses will not improve the health of the vulnerable populations she is supposed to help. They will also probably lead to higher costs in the long run. Championing personal responsibility is fine, but punishing patients who make poor choices will only worsen this country's health.Jauhar is a cardiologist and the author of Doctored: The Disillusionment of an American Physician and Intern: A Doctor's Initiation
"toss away stuff you don't need in the end
but keep what's important, and know who's your friend"
"It's a 106 miles to Chicago. We got a full tank of gas, half a pack of cigarettes, it's dark and we're wearing sunglasses."

ytowndan

http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."

It doesn't exactly feel like a "victory."  More like "catastrophe temporarily avoided."  But it's something.

Quote from: nab on July 27, 2007, 12:20:24 AM
You never drink alone when you have something good to listen to.

Hicks

Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended. 
Quote from: Trey Anastasio
But, I don't think our fans do happily lap it up, I think they go online and talk about how it was a bad show.

rowjimmy

Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

Hicks

Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

100% serious. 
Quote from: Trey Anastasio
But, I don't think our fans do happily lap it up, I think they go online and talk about how it was a bad show.

rowjimmy

Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

100% serious.
Yeah, I know.

pcr3

Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

100% serious.
Yeah, I know.

It's fun to dream.

I am happy to report that I completed my employer's ACA reporting requirements for 2016 today. I gotta say it was a good day.  8-)
"I'm singlehandedly responsible for poisoning the entire local ecosystem with all my fluids spilling onto the ground." -birdman, while plowing

"Mushrooms were a good idea!" -wtu

http://phish.net/myshows/prizzi3

mopper_smurf

Here Comes The Flood - a weblog about music
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As a roadie for the Jimi Hendrix Experience, I learned that I should give up being a guitar player. - Lemmy

runawayjimbo

Thank God for those obstructionist wing nuts in the House Freedom Caucus, amirite?!?!

Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

100% serious.
Yeah, I know.

Serious question:  what haven't they funded? I don't mean like what you would like gov't to pay for, I mean what funding has been stripped from the law that was passed that is preventing it from working as intended?
Quote from: DoW on October 26, 2013, 09:06:17 PM
I'm drunk but that was epuc

Quote from: mehead on June 22, 2016, 11:52:42 PM
The Line still sucks. Hard.

Quote from: Gumbo72203 on July 25, 2017, 08:21:56 PM
well boys, we fucked up by not being there.

mbw

Quote from: runawayjimbo on March 28, 2017, 10:36:02 AM
Thank God for those obstructionist wing nuts in the House Freedom Caucus, amirite?!?!

Quote from: rowjimmy on March 24, 2017, 10:35:05 PM
Quote from: Hicks on March 24, 2017, 08:05:39 PM
Quote from: rowjimmy on March 24, 2017, 07:32:52 PM
Quote from: Hicks on March 24, 2017, 07:24:03 PM
Quote from: ytowndan on March 24, 2017, 05:54:29 PM
http://www.npr.org/2017/03/24/521395060/ryan-trump-meet-as-more-republicans-defect-from-health-care-bill

Quote"I will not sugarcoat this — this is a disappointing day for us," the House Speaker conceded.

The way forward for Republicans on exactly how to replace Obamacare remains murky — or if they even will try again.

"Obamacare is the law of the land. It is going to remain the law of the land," Ryan admitted. "We're going to be living with Obamacare for the foreseeable future. I don't know how long it's going to take us to replace this law."


Good, now that you haven't been able to replace it, fund it so it can work as intended.

I'd laugh at your funny joke but it's depressingly true.

100% serious.
Yeah, I know.

Serious question:  what haven't they funded? I don't mean like what you would like gov't to pay for, I mean what funding has been stripped from the law that was passed that is preventing it from working as intended?

well, risk corridors for one.

runawayjimbo

Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.

Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.
Quote from: DoW on October 26, 2013, 09:06:17 PM
I'm drunk but that was epuc

Quote from: mehead on June 22, 2016, 11:52:42 PM
The Line still sucks. Hard.

Quote from: Gumbo72203 on July 25, 2017, 08:21:56 PM
well boys, we fucked up by not being there.

mbw

Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.

Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.

Well, i certainly dont support that, but if that is that is the way it is... for now, it should have been funded as intended.
Little Marco, however, slipped a provision in a spending bill that ultimately only funded the corridors to the tune of about 13 cents on the dollar.  That way the repubs could go on the campaign trail and scream, "Look, premiums have gone up!  What a disaster!"

In addition to funding it properly, they could have also put an extention on them until they were more solvent, but, you know, politics.

Hicks

Quote from: runawayjimbo on March 28, 2017, 12:51:12 PM
Woah. Never thought I'd see the day when you'd support sending taxpayer money to the already overstuffed coffers of the greedy health insurance companies. You've changed, dude.

Snark aside, the risk corridor program ended (as scheduled) in 2016, so there's nothing left to fund going forward to make the law work as intended. I swear I'm not trying to be a dick, but I legit cannot think of anything Congress choked off that would have resulted any different outcome than what we are seeing.

It may have "ended" in 2016, but there were many not for profit co-ops, and regular insurance companies, that were promised millions that never arrived last year.  If the money had been disbursed as planned, I might still have my $1000 deductible plan that I had at this time last year. 

If the money is passed on to policy holders in the form of benefit rich plans for sick people, then I'm all for it.  Who wouldn't be?
Quote from: Trey Anastasio
But, I don't think our fans do happily lap it up, I think they go online and talk about how it was a bad show.