House passes health care bill on 219-212 vote

[33girl]

The thing that is driving health care costs sky high is marketing particular meds to the general public. They see the commercials and decide they want to get them whether they need them or not. We should have gotten rid of that before effing around with universal health care.

[DaemonSeid]

Originally Posted by 33girl

The thing that is driving health care costs sky high is marketing particular meds to the general public. They see the commercials and decide they want to get them whether they need them or not. We should have gotten rid of that before effing around with universal health care.

Speaking of ads...after this weekend, come mid term elections, the best ads the DNC could do would be to mix Joe Wilson's 'Liar', with Randy Neugebauer's 'Baby Killer', some Tea Party Protesters,(especially the spitting ones) etc. into one montage, then ask 'Is this who you want to give more power to in Washington?'

[AOII Angel]

Originally Posted by PeppyGPhiB

I will tell you that my sophomore year in college I gained 40 lbs in one year despite eating better and getting a great workout every day on my hilly campus. I was pre-med at the time and noticed that I had a number of symptoms of hypothyroidism (we were studying the endocrine system at the time). So when I went home at the end of the year, I went to the doctor. And she wouldn't test me. Told me I was too young to have hypothyroidism and that I just needed to exercise more. By the time I came home from winter break of my junior year, I had gained another 20 pounds. I went to the doctor, crying, and she finally tested me. My TSH test came back at a 45 - but she still didn't want to treat me! So I asked for a referral to an endocrinologist and I've been treated ever since. Through REALLY hard work, and medication, I've been able to lose 20 of the pounds, but not all 60. My TSH is still around 10.

Some doctors who are more recent graduates and know all of the latest research on this stuff may know better than their patients, but not all doctors keep up on current research and treatments. Any patient who has had to change doctors due to new insurance or lack of "chemistry" with a given doctor knows that there is a huge variety of doctors out there, all with different methods. My doctor was old school, about five years out from retiring, and though she was a smart lady, she used old-fashioned approaches that were not appropriate for an unusual case like myself. She needed to recognize her areas of weakness and refer me to someone who knew more about my condition than she did.

I agree, which is what I told her in the beginning.

[AOII Angel]

Originally Posted by Beryana

And what is not very quickly in your eyes? A clear mammogram the end of April and a large lump and a diagnosis of breast cancer the end of September? Is that not quickly? In my book 5 months is rather quickly. . .
Healthy people go to the doctor and use the insurance for preventative purposes typically. And some of us attempt to use our insurance for preventative purposes (or to establish a baseline due to family histories of diseases) and deal with doctors that won't even do that.

Oh and I DO understand how insurance and insurance companies work very well, thank you - and not just health insurance companies. Once again, insurance companies aren't here to make their customers happy, they answer to the stockholders who like those dividend checks.

You are making very little sense and yes I agree that insurance companies are there to make money. No, breast cancer doesn't grow de novo in 5 months. Cancer grows from a single cell. Most cancers when found have been present for 10-15 years but can't be detected. I'm not going to argue medicine with you because you are not armed, but your experience is your experience. I don't have your mother's films to see if something was missed. Mammography is not perfect. Just because a cancer was not seen on one mammogram doesn't mean it was not there. In fact, by definition, it was a false negative mammogram. But as I said before, cancer rates are fairly static. If you enroll all healthy people, a certain percentage will be diagnosed with cancer. It isn't magical. Statistics actually aren't made up. We actually can rely on them. Insurance companies use them all the time, that's how they decide how much your rate should be with your history if you went to buy a policy on your own. They don't just randomly assign a number.

[DrPhil]

Originally Posted by DaemonSeid

Amazing, people are being investigated because of death threats they made via twitter after the bill passed.

link

Yeah, you didn't need a crystal ball to know that was coming.

There have been racial slurs and spitting at Black politicians; and homosexual slurs at the openly gay politician. That's how it goes when otherwise "nice people who aren't prejudiced, bigoted, or even homophobic or racist" perceive some sense of threat to group status and positioning. Hence, the "-isms" aren't about "bad people" or just about prejudice and bigotry.

So, I knew when I heard about the slurs yesterday that death threats were next. These people are attempting the social control/constraint mechanisms that have been attempted during every social change (perceived crisis).

[MysticCat]

Originally Posted by Ghostwriter

Oh and SAKO. Shut the hell up and leave this discussion. If you are who I think you are you have been banned a kajillion times.

Which is why we should all ignore him and not feed him.

Originally Posted by Ghostwriter

I am not so sure our Army and Navy are that well run from an efficiency stand point. Do you not believe there are billions upon billions of dollars in waste and fraud within the services?

I'm quite sure there's inefficiency. That wasn't the point. At all.

The point is: there can be inefficieny in the public sector and in the private sector. Nevertheless, there are some things more appropriately entrusted to the government to run, some things more appropriately left to the private sector and some things about which people can reasonably disagree (without being socialists, totalitarianists, hyper-free market capitalists, etc.). The claim that if the government runs it, it is automatically worse or more inefficient is a dodge that avoids dealing with the real issues.

If the military is beset with waste and fraud, is the answer to address that waste and fraud and try to stop it or to privatize the military on the assumption that the waste and fraud will disappear? Which is in the country's best interests?

To your point on private insurance carriers they are just that, private. If they can justify to their stockholders the Executives pay then so be it. I am not pleased about the disparity between what the person at the top makes versus the person at the bottom but that is for the companies and their stock holders to sort through.

Call me crazy, but I have a real problem with that business model when it affects the premiums I have to pay and the health care I and my family receive.

Originally Posted by Gatorbaby

Ladies..and gentlemen...please, please trust Federalism. Already, 37 (or 39?) states have filed suit against the national government. The balance between the national and state powers has not been struck and many states are upset (rightfully so) concerning the passage of this bill and the powers given to the national government under it.

Just because they sue doesn't mean they'll win. Anyone can sue. While I'll readily admit I haven't looked at all the issues that might be raised, I have a gut sense that these lawsuits are going to be a waste of state dollars at a time most states don't have too many dollars to waste.

ETA: Any legal challenges will be to specific aspects of the bill, not to the bill as a whole. Those states that have announced that they may sue have mainly indicated that they will attack the mandate that each person have insurance or be fined; that is the aspect of the bill the pundits and think tanks/legal foundations seem to be attacking and encouraging suit on. Perhaps ironically, the individual mandate aspect of the bill is quite similar to Republican proposals from the 1990s and to Mitt Romney's Masschusett's plan.

Meanwhile, this is a good read: Anti-Health Care Reform Suits Face Steep Hurdles: Not All Opponents Confident of Repeal, by David Weigel.

Originally Posted by moe.ron

David Frum's take on the political fall out:

I saw that earlier and thought it was interesting.

[AOII Angel]

Originally Posted by VandalSquirrel

Seriously, I've had some not great doctors and I think what we need people to do is to learn to advocate for themselves and do some research. I don't mean spending hours on WebMD, but keeping track of changes/norms so when something comes up there is a baseline and a time line. If I go to the doctor and my blood pressure is high and I ate a high salt meal or was running late, that would make sense. If I just drank coffee, that could account for an elevated temp. So much of that behavior for me is left over from having to keep track for health issues I just kept doing it and I always bring that to an appointment, as well as writing down my concerns. I want to make the most of my time and the doctor's time.

I was dismissed once for breast cancer and I was so fortunate the ENT surgeon (huge a-hole, but good surgeon) refused to operate until a doctor he trusted ruled out cancer as the person I normally saw was on maternity leave and the other doctor didn't find my concerns important (that person is no longer in the practice). I have the option of a second opinion but it is so annoying when office #1 will not send your records in a timely manner to office #2. If I had cancer and they blew me off I'd have considered filing a law suit because it shouldn't take three months to send records. I go to the biggest practice in town and thankfully they also run the Urgent Care but one practitioner doesn't get butt hurt if you see someone else because they aren't available, nor is there drama if they consider different treatments. Living in a rural area makes it hard at times, and many people make the 1.5 hour drive to Spokane for specialists.

My time in Alaska is always a crap shoot because the clinic is either 30-100 miles away and because I'm an outsider the med student who is doing a rotation always wants to see me because I'm less likely to object (I don't have tinfoil underpants and believe in conspiracy theories) and have some strange shizz in my medical history. I've only been cranky once when one young woman was telling me I should be concerned about osteoporosis, when my only risk factor is being female. No one in my family has had it, I've never broken a bone, my bone affected surgeries healed freakishly fast, I'm not lactose intolerant, and I'm Norwegian so eating cheese on the daily.

My temp is low though, constantly, about 97.5-97.9 but allegedly it is genetic. I'm willing to have my thyroid checked though because I tolerate cold too well for some people's liking.

First bold- YES! I am a doctor, but first I am a patient. You have to be your own advocate. Doctors are human. We make mistakes. We have biases. Don't take it if a doctor gets "butt hurt" if you see someone else if they weren't available. My neurologist did that to me and actually YELLED at me while I had a migraine. I never went back to him again. It was unprofessional, and I can find a new neurologist that will treat me with respect. Even physicians get the run around when they become patients. It is hard to be a patient...even harder when you don't know what you are getting yourself into, so educate yourself!

Second bold...ahhh, Alaska!

[Munchkin03]

Originally Posted by AGDee

The other advantage to those who are already insured that I don't believe has been mentioned, is the ability for parents to keep their kids on their insurance until the age of 26. This means I can actually insure my kids until they finish grad school, which is a wonderful bonus.

But, don't insurance policies in most states cover dependents as long as they are students? It's not as if you get dropped the minute you turn 18 or 22. Even so, colleges offer insurance for students. When I was in grad school, I think it was something like $1400 for a full year of insurance with Aetna, which happened to be the insurer my father's company had when I was dropped at 25.

The 26 cut-off doesn't impress me that much because so many states offer it until 25 even if you're not a student and if you are, you can get lower cost insurance through your school.

[DaemonSeid]

Originally Posted by Munchkin03

But, don't insurance policies in most states cover dependents as long as they are students? It's not as if you get dropped the minute you turn 18 or 22. Even so, colleges offer insurance for students. When I was in grad school, I think it was something like $1400 for a full year of insurance with Aetna, which happened to be the insurer my father's company had when I was dropped at 25.

The 26 cut-off doesn't impress me that much because so many states offer it until 25 even if you're not a student and if you are, you can get lower cost insurance through your school.

Right..as long as they are a dependent AND a student.

Some places and some insurances have a stipulation that the moment the sudent is making an income, they are no longer considered a 'covered dependent'.

[Alumiyum]

Originally Posted by Munchkin03

But, don't insurance policies in most states cover dependents as long as they are students? It's not as if you get dropped the minute you turn 18 or 22. Even so, colleges offer insurance for students. When I was in grad school, I think it was something like $1400 for a full year of insurance with Aetna, which happened to be the insurer my father's company had when I was dropped at 25.

The 26 cut-off doesn't impress me that much because so many states offer it until 25 even if you're not a student and if you are, you can get lower cost insurance through your school.

Fully agree. I am getting another degree and can be on my parents' insurance until I'm 25. And the school does offer low cost insurance plans for students...in fact part of our student facilities fees go towards a plan that covers the basics for every student. The only advantage I see would be for a recent grad school graduate who needed a little extra time to afford the insurance or find a job that provided it.

[Alumiyum]

Originally Posted by AOII Angel

The problem with this is that physicians are not paid to spend time with patients. Primary care physicians have been slowly cut down over the years to such minimal reimbursements so that they have to see patients every ten minutes. In order to see enough patients to pay their rent, office staff and make a reasonable salary, they have to see patients that frequently. Thank the medicare cuts. It's frustrating for physicians, as well, even though you think it's not. Doctors really do want to spend more time with their patients. That's why some doctors have started concierge services where they limit their patient load and charge a set fee for all you want medical service. It's expensive, but you get impeccable care.

Maybe you should stop taking it so personally. No one ever said all doctors don't care and I in fact did acknowledge the fact that things get difficult sometimes. But things get difficult in EVERY profession and there are a LOT of people in careers for the job and not the money. The difference is many of those careers aren't involved directly in the medical health of clients. None of what you've said rules out the suggestion that doctors try to touch the bases the first time around saving time and money for both doctor and patient. Some do and will, but it's so difficult to find them while wading through those that have decided most of us aren't worth their time.

My hometown includes many, many doctors, lawyers, CEO's, etc. Several family friends have switched to a pay to be a patient system. All of them admitted it was because they wanted to work three days a week but keep their same lifestyle. No, that's certainly not the motivation for every doctor who goes this route, but it isn't all about scraping by.

Is anyone else excited about the tanning bed tax? As a former tanorexic who three years ago had a come to jesus meeting with the dermatologist I am glad their starting to acknowledge just exactly how dangerous tanning is.

[Munchkin03]

Originally Posted by Alumiyum

Fully agree. I am getting another degree and can be on my parents' insurance until I'm 25. And the school does offer low cost insurance plans for students...in fact part of our student facilities fees go towards a plan that covers the basics for every student. The only advantage I see would be for a recent grad school graduate who needed a little extra time to afford the insurance or find a job that provided it.

Most of the student insurance plans cover you for 12 months so you're covered from September 1-August 31. Assuming a mid-May graduation, that gives you at least a few months to find a job and get coverage (this is what happened to me). Even if you do need temporary coverage at the end of that time, you can usually get it through the school (or your alumni association) for a higher cost than if you were still a student, but for far less than going on the open market.

Does anyone actually think that the bill as it stands now will be implemented any time soon? I certainly don't, other than some of the immediate changes. We're (on both sides) getting all excited over something that's going to be very different in practice than in action.

[MysticCat]

Originally Posted by Munchkin03

Does anyone actually think that the bill as it stands now will be implemented any time soon? I certainly don't, other than some of the immediate changes. We're (on both sides) getting all excited over something that's going to be very different in practice than in action.

Everything that I have seen/read has been very clear that some provisions (like those concerning pre-existing conditions and children staying covered until 26) will be effective within 6 months, while others will not go into effect until 2014 or later.

[Munchkin03]

Originally Posted by MysticCat

Everything that I have seen/read has been very clear that some provisions (like those concerning pre-existing conditions and children staying covered until 26) will be effective within 6 months, while others will not go into effect until 2014 or later.

I think that most people who are freaking out about this one way or the other expect changes to be made right away, other than the ones that we were discussing up thread (like the lifetime caps and age limits). A lot of people, unless they actually read, don't understand that it takes a while for laws to go into effect. It's kind of like how a certain contingent expected the economy to improve on January 21 of last year.

[MysticCat]

Originally Posted by Munchkin03

I think that most people who are freaking out about this one way or the other expect changes to be made right away, other than the ones that we were discussing up thread (like the lifetime caps and age limits). A lot of people, unless they actually read, don't understand that it takes a while for laws to go into effect. It's kind of like how a certain contingent expected the economy to improve on January 21 of last year.

So true. Sometimes people (on all sides of many issues) are so busy reacting and complaining as loudly as possible that they don't take to time to pay attention.