The Health Care Bill has passed...

[DaemonSeid]

So now what?


Thoughts?

[DrPhil]

Now it's Christmas Eve.

This won't register on many people's radars until after the New Year.

Surprise.

[DaemonSeid]

Ha!

[AKA_Monet]

DS, IDK? A lot of people are like frazzled and we'll probably see what happens in 2010, possibly February. I'm not sure, but I think since it is approved, it goes through House & Senate reconciliation, and voted upon by the entire Congress the large bill. Then is sent to the POTUS for signature.

[honeychile]

Forget about the Bill itself - Nebraska Senator Ben Nelson has set a new political low by selling his vote. The chutzpah of this act amazes me - and Arlen Specter (Mr. Magic Bullet theory!) has been one of my senators for decades!

[AGDee]

I think that without a public option, the whole thing is useless. I will still have no choice. In my perfect world, health insurance being provided by an employer would be completely eliminated. They don't cover my car insurance, life insurance or home owners insurance. I don't want them handling my health insurance either. I would like an opportunity to opt out of my insane HMO and get some real insurance where I can have the doctors of my choosing. Right now, if we are covered by a spouse, we can opt out and we get $500. They PAY around $11K for each employee. I want to be able to opt out and get that whole amount from them to buy my own insurance. This bill is not "reform".

[Kevin]

Originally Posted by AGDee

I think that without a public option, the whole thing is useless..

Don't worry. If these for-profit companies do what for-profit companies have done lately (focus on the short-term gains), then a public option won't be far off. If they do what I suspect they'll do and take us all to the cleaners, Congress is going to have to step in and do something. The only thing I can see hindering them in that regard is the 15% cap on administrative costs.

I don't think it's a question if 'if,' though, but rather 'when' the private companies wear out their welcome.

[AXiDTrish]

I work for a health insurance company, albeit a smaller one (not an Aetna or United), and believe me we are NOT rolling in dough. Our benefits are less then many of the groups we cover and we as employees have the same concerns about our employment as other companies. Insurance companies aren't innocent by any means, but they aren't all bad either.

What infurates me:

1. Ambulance chasing lawyers and their frivolous, ridulous law suits!
2. Collections agencies that buy accounts from doctors who have left their practice and then collect inappropriately! Seriously, I really hate collectors!
3. Doctor's and hospitals who think they should be paid astronomical amounts. I definitely think they should be paid fairly, but for Pete's sake, just because you went to medical school doesn't mean your entitled to a fortune! DISCLAIMER: This does not apply to every doctor, but there are some doozies out there who have enormous ego's and are total a$$holes!

[AOII Angel]

Originally Posted by AXiDTrish

I work for a health insurance company, albeit a smaller one (not an Aetna or United), and believe me we are NOT rolling in dough. Our benefits are less then many of the groups we cover and we as employees have the same concerns about our employment as other companies. Insurance companies aren't innocent by any means, but they aren't all bad either.

What infurates me:

1. Ambulance chasing lawyers and their frivolous, ridulous law suits!
2. Collections agencies that buy accounts from doctors who have left their practice and then collect inappropriately! Seriously, I really hate collectors!
3. Doctor's and hospitals who think they should be paid astronomical amounts. I definitely think they should be paid fairly, but for Pete's sake, just because you went to medical school doesn't mean your entitled to a fortune! DISCLAIMER: This does not apply to every doctor, but there are some doozies out there who have enormous ego's and are total a$$holes!

I think this is a rarity. Doctors are generally paid an average across an area. We can bill whatever we want, but the insurance companies pay what they have set as the fee for service. Don't forget that the amount that is collected by a physician doesn't all go to the physician, also. For most physicians, this pays for their overhead, including office space, staff, insurance for their staff, medical liability insurance, etc. before it goes towards a physician's salary. For example, a surgeon can spend three hours doing a sigmoid colectomy for colon cancer. He/she will be reimbursed less than $3000 for the procedure which includes the surgery and 3 months of follow-up care including any complications. That is very little money for the time involved, not to mention the education or the 6 years of residency at 100+ hours/week of near slave labor. There are very few specialties in medicine where a doctor can make a fortune anymore....most don't involve insurance companies! Before you blame your doctor for the state of medicine, stop and ask yourself how much you'd want to be compensated for 20 years of education and a minimum of 3 years of post-graduation apprenticeship with up to 80 hours/wk (now regulated by the federal government) work hours for about $6 an hour just to work 70-90 hour work weeks when you go into private practice? Some physicians barely make $90,000 a year and have over $100,000 in student loans. I'm lucky to have picked a field with a shortage of physicians that has a growing need and good reimbursement, but who knows how long that will last. I'm compensated because no one else can do the job I do.

[AXiDTrish]

I'm not placing a blame game on all doctors. This healthcare mess is not a fault of theirs. They are a cog in a very large wheel. Like I said in m,y disclaimer, a FEW doctor's think they should be paid above and beyond all others. Most do not. Certainly every office manager/administrator believes their doctor is the absolute best in the state!

You are correct, doctors do get paid a percentage based on their area. Medicare reimbursement is generally used as the base (which is a scary place to start considering how they pay!) and a doctor's fee's are dependant upon how they negotiate with the insurance company. Usually, the more providers in a group, the more negotiating strength they have.

[Kevin]

Originally Posted by AXiDTrish

1. Ambulance chasing lawyers and their frivolous, ridulous law suits!

As an 'ambulance chasing lawyer,' (yes I do personal injury, but not medical malpractice), I cannot actually recall even hearing about a so-called frivolous lawsuit anywhere but in the national media; and even then, I can't recall a story which was in my opinion actually frivolous other than the lawsuit filed by that former Administrative Law Judge in D.C. regarding his alleged lost pants.. (and his case was dismissed with prejudice, he was disbarred and a judgment was granted against him for attorneys fees).

Other than that, there is simply no basis for saying that if frivolous lawsuits do exist, that said lawsuits are actually a serious problem in the grand scheme of things.

And if you're really looking for the culprit in all of this, look at the doctors. Depending on the study you're looking at, medical errors account for between 98,000 and 195,000 deaths per year. And no one, not even the insurance companies which deny claims for malpractice and subsequently force and lose a lot of trials would tell you (unless they were telling lies) that the majority or even close to a significant number of lawsuits are frivolous.

[AOII Angel]

Originally Posted by Kevin

As an 'ambulance chasing lawyer,' (yes I do personal injury, but not medical malpractice), I cannot actually recall even hearing about a so-called frivolous lawsuit anywhere but in the national media; and even then, I can't recall a story which was in my opinion actually frivolous other than the lawsuit filed by that former Administrative Law Judge in D.C. regarding his alleged lost pants.. (and his case was dismissed with prejudice, he was disbarred and a judgment was granted against him for attorneys fees).

Other than that, there is simply no basis for saying that if frivolous lawsuits do exist, that said lawsuits are actually a serious problem in the grand scheme of things.

And if you're really looking for the culprit in all of this, look at the doctors. Depending on the study you're looking at, medical errors account for between 98,000 and 195,000 deaths per year. And no one, not even the insurance companies which deny claims for malpractice and subsequently force and lose a lot of trials would tell you (unless they were telling lies) that the majority or even close to a significant number of lawsuits are frivolous.

From personal experience, I can say that there are frivilous lawsuits. I think there are lawyers who do NOT cross their "T"s and dot their "I"s. Doctors aren't the only ones who make mistakes. Medical errors do occur because doctors are humans, nurses are humans, information is misinterpreted, but not all medical errors are malpractice. Unlike doctors, though, we can't sue lawyers for malpractice.

I was sued for malpractice for a case which did involve malpractice by another set of physicians. I was said to be incapable of performing cataract surgery, providing anesthesia and a whole host of medical procedures that I do NOT perform simply because my name was on a chart. It took two years and a lot of money to get my name removed from the lawsuit that should never have included my name in the first place. I can also name at least three other people at the same institution named in the same case who were also not involved in the inciting incident. Multiple other people have been named in cases inappropriately. You multiply this by every malpractice suit in the nation, and you can't convince me that this does not influence the cost of malpractice insurance which most definitely does increase the cost of health care.

Malpractice suits definitely have their place. I can think of a number of cases off the top of my head from residency that I could even testify for the patient. The case above had merit and settled for an undisclosed amount. I just wish all lawyers would practice due diligence before filing these cases.

That being said, lawsuits are NOT the problem with health care, but they do drive doctors to practice "cover your ass" medicine which has driven up the cost of health care significantly.

[AOII Angel]

It's less about reform for people who already have insurance and more about people who cannot afford to buy insurance and do not get insurance from their employers. It's about time. We already pay for these people to get very poor medical care through ERs all across the US. They do not get turned away, and we pay through our taxes and higher insurance premiums. In return, we have a whole class of citizens who get horrible medical care with no follow up and only catastrophic care. They tweaked a few things with the insurance companies, but this is a first step. Congress can't make huge changes all at once....hell, look what they had to go through to do this little!

[AGDee]

I do realize that, I just think it's a band-aid though, not a fix for what is wrong with the system. I work for a health care system in Detroit, I truly understand the need for insurance for the uninsured. Our system provides hundreds of millions of unreimbursed care annually.

The health care system is so much more broken than just the unreimbursed care though. I know he had to battle just to get this, and hopefully, in the future, people will accept that there are more changes that need to be made. Most insurance companies are in the business of making money. Most are not non-profits. None of the companies that make money off of hospitals/health care are non-profits yet most of the hospitals are (all of them are, in Michigan). A model where you have all these profit organizations having a feeding frenzy off of a non-profit entity is simply wrong. It can't work no matter what.

The only entities that insurance companies have to please are our employers. Our employers are only happy with those insurance companies who offer lower premiums. The only way that insurers can do that is to deny as much care as they can. Most people who don't work in health care do not understand that insurance companies dictate their treatment almost completely. Most do not understand that, if your primary care physician KNOWS that a certain treatment is not right for you, they cannot skip that step and move to a more expensive treatment because they will get points from the insurance company if they don't try things in a specified order. Critical pathways, managed care.. all attempts by the insurance companies to make more money, not truly ways to better manage your illness. There is no real competition among insurance companies for the users of the system. The users of the system are bound to use whatever insurance their employer chooses to provide for them. I don't see much changing until THAT changes.

[ThetaPrincess24]

I say boo! I am one of the Americans who enjoys my health insurance that I have.

Real reform should start with competition across state lines for the best deals/coverage and caps on medical malpractice lawsuit awards.


Polls show most Americans dissapprove of this bill. I think the democrats have shot themselves in the foot with this one proving it isnt about the folks they claim to represent but about power. If Congress truly cared about the folks then put healthcare aside for now and concentrate on what matters to most presently (myself included) : JOBS and the ECONOMY.