House passes health care bill on 219-212 vote

[AOII Angel]

Originally Posted by Alumiyum

This is the problem. We all know there are hypochondriacs in the doctor's office every day, but that's life. On the other hand I've been brushed off repeatedly by doctors who refuse to believe I'm anything but a hypochondriac. Muscle and joint pain so bad I sometimes cannot leave bed, fatigue so severe I sometimes can't get out of bed (yes I have a regular sleep schedule, have cut out all caffeine, etc.), and bouts of hair loss (which, yes, is a cosmetic issue and fortunately because my hair is thick in my case not a noticeable one, but is also a symptom of a problem elsewhere in the body) make it obvious there is something wrong with me. But again, because I don't appear to be dying, I have not gotten a diagnosis. I have no problem doing my own research on these and my many other symptoms to come up with some possibilities, but I am not a health care professional and obviously cannot diagnose or treat myself. Your average person, myself included, does know the difference between normal and not when it comes to their body. When something changes rapidly and radically (like totally healthy to daily moderate to severe pain) a patient can be reasonably certain there is something up and just because one or two tests don't present an immediate answer doesn't mean that one doesn't exist. I think if doctors would treat everyone the same-pay attention to them, order only necessary tests, and follow up quickly, those of us with a disorder or disease could be diagnosed and sent on our way with the correct treatment, and the hypochondriacs could be reassured that they are very healthy and could be sent on their way as well.

And I wouldn't call you a hypochondriac, but a lot of vague illnesses also are difficult to diagnose. The problem with our current health care system is that primary care physicians are NOT reimbursed to spend 20 minutes or more with a patient to figure out what is wrong with them if it isn't run of the mill hypertension or diabetes. That being said, you can get a referral to a specialist...I would recommend a rheumatologist given the symptoms you are complaining of. They even have research physicians at places like the NIH that specialize in hard to diagnose cases (kinda like House but not fake.) That being said, not everything is a sign of a disease. I think that losing hair may or may not be a problem. Joint pain/swelling for over 6 months is a problem and may be a sign of a serious disease. I wouldn't take no for an answer.

As for Beryana...If I am the reason you don't go to doctors, you are a fool.

[Alumiyum]

Originally Posted by AOII Angel

And I wouldn't call you a hypochondriac, but a lot of vague illnesses also are difficult to diagnose. The problem with our current health care system is that primary care physicians are NOT reimbursed to spend 20 minutes or more with a patient to figure out what is wrong with them if it isn't run of the mill hypertension or diabetes. That being said, you can get a referral to a specialist...I would recommend a rheumatologist given the symptoms you are complaining of. They even have research physicians at places like the NIH that specialize in hard to diagnose cases (kinda like House but not fake.) That being said, not everything is a sign of a disease. I think that losing hair may or may not be a problem. Joint pain/swelling for over 6 months is a problem and may be a sign of a serious disease. I wouldn't take no for an answer.

As for Beryana...If I am the reason you don't go to doctors, you are a fool.

My point is spending a little more time to figure it out in the first place would decrease repeated visits and a lot of irritation on both ends. I realize a few people are going to come through with true mystery illnesses, but surely those are minority cases. Specialists that I have been referred to have been no more helpful than the two doctors I've been to before. Not taking no for an answer is easier said than done when doctors simply don't want to take the time to find the problem. I'll eventually find the right doctor but in the meantime it's frustrating to spend copious amounts of time and money shopping around, especially since I know it would be easier for a doctor that has already seen me to get a read on the problem than a new one who has to review my file and start from scratch. (For the record the only helpful hint I've gotten is actually from a family friend who is a doctor and suggested an autoimmune disease, and as the only disease in that category that can be ruled out in my case is HIV my next step is to present this theory to my doctor...we'll see how it goes this time.)

[AOII Angel]

Originally Posted by Alumiyum

My point is spending a little more time to figure it out in the first place would decrease repeated visits and a lot of irritation on both ends. I realize a few people are going to come through with true mystery illnesses, but surely those are minority cases. Specialists that I have been referred to have been no more helpful than the two doctors I've been to before. Not taking no for an answer is easier said than done when doctors simply don't want to take the time to find the problem. I'll eventually find the right doctor but in the meantime it's frustrating to spend copious amounts of time and money shopping around, especially since I know it would be easier for a doctor that has already seen me to get a read on the problem than a new one who has to review my file and start from scratch. (For the record the only helpful hint I've gotten is actually from a family friend who is a doctor and suggested an autoimmune disease, and as the only disease in that category that can be ruled out in my case is HIV my next step is to present this theory to my doctor...we'll see how it goes this time.)

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.

[Beryana]

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.

Which is why some of us are leaving the broken system and finding a doctor with whom we can actually build a relationship. Doctors CAN fix the broken system as well, insurance is not the be all end all solution to this country's medical problems.

[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.

[AOII Angel]

Originally Posted by Alumiyum

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.

I'm not taking it personally. I'm not a primary care physician. I'm just telling you why they don't spend more time with patients. It's the way things are. I know a lot of primary care physicians, and they all say the same thing. I personally spend LOTS of time with my patients, but I have that option because I read very fast and am not limited by reimbursement patterns. Also, there is no reason a physician who has gone to school a minimum of 9 years with an average of $100,000 of school loans should have to scrape by. Look at the reimbursement codes if you don't believe me. Primary care physicians are by no means rich physicians. That's why there is a shortage, and medical students can't be persuaded to go into those fields.

[Beryana]

Originally Posted by AOII Angel

As for Beryana...If I am the reason you don't go to doctors, you are a fool.

Umm...I don't go to doctors because I'm typically not sick. . . I just don't like your attitude that people can't know their own bodies or do their own research and bring some intelligence to the table. I also don't put doctors up on a pedestal as you are also human and don't necessarily know everything about everything.

I've had bad experiences with Family Practitioners as well as specialists. Not spending more than a few minutes with a patient missed a MAJOR diagnosis (a STROKE!!). Why bother going in to see a doctor if they don't care about a patient?

And I really don't care what you think about me because I'll never be coming to see you or your husband in any capacity, professional or otherwise.

[moe.ron]

David Frum's take on the political fall out:

Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s.

It’s hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections. But:

(1) It’s a good bet that conservatives are over-optimistic about November – by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs.

(2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now.

So far, I think a lot of conservatives will agree with me. Now comes the hard lesson:

A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

Barack Obama badly wanted Republican votes for his plan. Could we have leveraged his desire to align the plan more closely with conservative views? To finance it without redistributive taxes on productive enterprise – without weighing so heavily on small business – without expanding Medicaid? Too late now. They are all the law.

No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?

We followed the most radical voices in the party and the movement, and they led us to abject and irreversible defeat.

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

I’ve been on a soapbox for months now about the harm that our overheated talk is doing to us. Yes it mobilizes supporters – but by mobilizing them with hysterical accusations and pseudo-information, overheated talk has made it impossible for representatives to represent and elected leaders to lead. The real leaders are on TV and radio, and they have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

So today’s defeat for free-market economics and Republican values is a huge win for the conservative entertainment industry. Their listeners and viewers will now be even more enraged, even more frustrated, even more disappointed in everybody except the responsibility-free talkers on television and radio. For them, it’s mission accomplished. For the cause they purport to represent, it’s Waterloo all right: ours.

[Kappamd]

Originally Posted by Beryana

Umm...I don't go to doctors because I'm typically not sick. . . I just don't like your attitude that people can't know their own bodies or do their own research and bring some intelligence to the table. I also don't put doctors up on a pedestal as you are also human and don't necessarily know everything about everything.

I've had bad experiences with Family Practitioners as well as specialists. Not spending more than a few minutes with a patient missed a MAJOR diagnosis (a STROKE!!). Why bother going in to see a doctor if they don't care about a patient?

And I really don't care what you think about me because I'll never be coming to see you or your husband in any capacity, professional or otherwise.

You have no clue.

And your responses to AOII Angel are getting a little out of hand considering how cordial she has been to you.


Anyways, I am super happy to see the tanning tax included in the bill. Disappointed about a lot more (lack of tort reform, medicare spending, etc.) There are a lot of major problems that are not being addressed with this bill.

[Beryana]

Originally Posted by Kappamd

And your responses to AOII Angel are getting a little out of hand considering how cordial she has been to you.

And since when is calling someone a fool 'cordial'?

And I do know plenty about what is going on in the insurance industry as well as with healthcare (from a patient perspective as I am not and do not want to be in the medical profession). Oh, and I also understand socialized medical care from a political perspective as well as the Constitution, etc - where is it that I have no clue?

[Kappamd]

Originally Posted by Beryana

And since when is calling someone a fool 'cordial'?

And I do know plenty about what is going on in the insurance industry as well as with healthcare (from a patient perspective as I am not and do not want to be in the medical profession). Oh, and I also understand socialized medical care from a political perspective as well as the Constitution, etc - where is it that I have no clue?

Her calling you a fool was generous considering some of the disparaging remarks you have made.

And your having no clue refers to some of the completely naive comments you have made about healthcare delivery.