The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.
The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.
In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.
Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.
The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Starfall1969
Frequent Contributor (1K+ posts)
Member # 17353
posted
I hope people are happy with the changes they all wanted. Cuz I sure ain't happy with a lot of what's going on....
Posts: 1682 | From Dillsburg, PA | Registered: Sep 2008
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You still have the chance to pick your doctor and to still stay with your current health care provider.
This is better for people like ME who in Sept, I will lose my health insurance in Sept due to divorce.
My mom is on medicare (medicaid?) She is on SSDI.
She has gotten THE BEST CARE for SERIOUS conditions, heart problems, neck problems (SERIOUS) and she was sent to the top specialist here in Tampa. They have taken SUCH good care of her successfully without a dime out of her pocket. She has more freedoms than she did without insurance.
Open your eyes a little bit. Our OWN insurance doesn't even cover our Lyme, usually.
The program that people CAN OPT INTO OR OPT OUT OF has taken the best care of my mom for serious LIFE THREATENING CONDITIONS. If anyone wants to know what they were, let me know. They put her Hep C into remission....EXPENSIVE DRUGS FOR A YEAR (PART OF WHICH WAS CHEMO DRUG), they went into her heart and found that she was SO close to having a heart attack. They monitor her closely. Also, she has spots on her breast which they take very seriously. They biopsy, ultrasound them (or whatever) or a regular basis. OMG, there is so much more but she was treated better than on insurance when she had it. There's so much more to this story.
She was sent to the TOP neurosurgeon for her neck condition which her OWN doctor couldn't figure out. It could have paralyzed her at any minute.
They have taken such good care of her.
As for Lyme....there's really not help anywhere. Paid for by insurance. So, what's the diff? The state pays for my mom in FULL. and she gets the best of care. Better than I've EVER seen. I could go on and on like I usually do. But I won't. Feel free to ask me anything.....here or PM.
Thanks for listening. Sometimes we have to think of others than ourselves. Lyme is different than almost any other disease out there.
Posts: 63 | From Hell - Or at least it feels like it, Oh, I mean Tampa, FL. OOOps! :D | Registered: May 2009
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dmc
Frequent Contributor (1K+ posts)
Member # 5102
posted
Excellent find luvs. People are so niave thinking it's gonna help or solve their own troubles but I say again look at the VA healthcare (I am a part of).
I think the IDSA is gonna be the absolute RULE for treating Lyme and other TBDs.
Posts: 2675 | From ct, usa | Registered: Jan 2004
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
I for one am not happy to see our choices limited for any medical condition.
Nessa - I'm glad to hear that your mom had a good experience with medicare. I have medicare and my dad had medicare and I know a number of elderly patients who have medicare. I can tell you that many have not had the great experience that your mother has had.
Medicare will not be left as is with these upcoming changes. I expect it to get much worse.
Currently, a lot of my prescriptions are covered and a portion of my doctor bills for lyme. I'm very concerned that will change but even more concerning are limitiation that will likely be put on my ability to choose which doctor I want to see for a particular condition and I'm not talking about lyme disease.
I DO NOT want HMO style medicine to dominate. That would be a disaster.
Terry
Posts: 6286 | From Oregon | Registered: Jan 2006
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TerryK
Frequent Contributor (5K+ posts)
Member # 8552
posted
dmc - I was thinking about the VA health care system when I saw luvs post. My brother has VA health care and it is horrible.
He has NO CHOICE of doctors. His current doctor is clearly letting him die of hepatitis C. Even some of his other doctors have made comments about her lack of care and yet there is NOTHING that we can do though the VA.
I've been thinking lately of writing to some of my elected officials to see if we can get some help before it's too late.
The VA is a good example of HMO style care gone mad.
Terry
Posts: 6286 | From Oregon | Registered: Jan 2006
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Geneal
Frequent Contributor (5K+ posts)
Member # 10375
posted
Medicaire does pay for serious things.
For the first 20 days it is 100% covered.
Then you'd better have a secondary insurance,
Because it becomes 80% covered and 20% not covered.
My Mom can't get the medicine she does well on as
There is no generic. No generic....Medicaire doesn't pay.
Of course she appealed with doctor letter and such.
Denied.
I still will admit that Medicaire is better than some
Of the other organizations out there.
Yet...I think that someone who has paid into the system her whole
Life and worked hard to earn it, should have a say so
In her choices for medical care.
Hugs,
Geneal
Posts: 6250 | From Louisiana | Registered: Oct 2006
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posted
I dunno guys you paint it all black . I am sure there still will be private care.
Accessible medicine for everybody is not bad - I know I couldn't visit doctor for 5 years cause I had no insurance .
What is bad usually is that care might be substandard. But it is better than having absolutely nothing at all. I know as bad as socialized care is (and it was very bad in Russia in 90's ) it still treated you , I had appendectomy done and stayed in hospital for 7 days with absolutely no charges (my mom had to pay for abx out of pocket though)
And you could still go visit private doctors
What I see in US is extremely inflated prices for everything -from drugs to doctor visits. If prices dropped I bet that would solve 70% of problems. I mean I knew a guy collapsed on a street, he had work up done in ER (MRI/CT/ECG) it cost him $10k ! WTF? I mean same exact work up in poorer countries is done for free and here you pay insane amounts
Posts: 856 | From MA | Registered: Jul 2009
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posted
I was in an HMO and a serious disease, not Lyme, was missed because I had no choice of doctors. Then follow up post surgery was poor due to the HMO dicatating where I could go for treatment.
I DO NOT WANT TO GO BACK TO THAT TYPE OF CARE AGAIN
Now in a PPO I have choice, not all free care, but a choice of the care I do receive
If Medicare pays for everything then why do you need Medicare supplimental insurance?
Also these reform bills count on cost cutting of Medicare/Medicaid to pay for the public plan
Do some actual reading instead of parroting what is said by those in favor...it is disturbing stuff.
Posts: 130 | From Central NY | Registered: Jul 2009
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quote:Originally posted by coltman: [QB] I am sure there still will be private care.
Millions of Americans will lose their current health care coverage. The nonpartisan Congressional Budget Office estimates up to 20 million Americans would remain uninsured, even after spending more than $1 trillion.
Private insurance companies will go out of business because they can't compete without new customers coming in to offset their aging policyholders.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
Coltman,
You are one of the rare few I have heard talk about the true problem with health care in America. The cost of the medical care.
Everyone seems focused on the insurance premium. No one seems to understand that medical costs have skyrocketed ever since insurance expanded into wellness care.
Greed is driving everything into the ground.
I have no problem with expanding medicare and medicaid to cover all people who can't get insurance elsewhere or can't afford insurance elsewhere.
But all you people who point out how great medicare is, you must not be listening to our president because reducing the number of claims paid under medicare is his biggest way he is going to save tax dollars to pay for the new public plan. He keeps saying this loud and clear.
And even though his lips promise we will get to keep our private plan, the healthcare bill currently on the table will eliminate private insurance.
Just read the article I posted at the start of this thread. Losing private insurance is #1. Losing your LLMD is #5.
Do you guys honestly think the government is going to pay for longterm lyme treatment? The government won't even acknowledge that chronic lyme exists.
The democrats are dragging their feet on the bill right now because they can't find a way to pay for it. President Obama, in his news conference last Wednesday night, blatantly lied to us when he said it is going to save 2 trillion dollars.
His financial advisors who are analysing the anticipated costs actual predict it wil COST 2 trillion dollars. That is HIS advisors.
With that kind of deficit, you think they are going to be generous in medical care?
I predict they are going to make insurance companies look like santa claus. And the care available to you will be determined by how productive you are and how many productive years you have left to contribute to the tax base.
That doesn't bode well for the elderly or the disabled.
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Everyone seems focused on the insurance premium. No one seems to understand that medical costs have skyrocketed ever since insurance expanded into wellness care.
Greed is driving everything into the ground.
I think there are 4 main factors behind US healthcare costs:
1. Corporate Greed -everything is and only for profit
2. Law - big pharma patents , ambulance chasing lawyers . Lawsuit happy population
3. Inequality of healthcare burden.Hospitals have to treat everybody because of emtala, add "defensive" medicine practice with expensive tests (because of 2) and you get skyrocketing costs for those who still pay
4. Administrative costs, driven by 2 and 3. I mean medical billing ,coding and money collection is a whole industry in itself. Which servers absolutely no one interests
I think reigning in 2 and 3 and reducing 4 trough nation wide standards and electronic database would go a long way. You can reduce 1 by putting regulation in place making it harder for insurance companies to refuse coverage at reasonable rates.
Medicare for everybody with all the rest staying the same does not really sound like a good solution - I agree.
Posts: 856 | From MA | Registered: Jul 2009
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luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
Coltman,
U R hired. Accept, there already is a ton of regulation on the insurance industry. Literally, the states dictate coverage and premium.
Of course, just like the Securities Exchange Commission, the regulators may be looking the other way.
We can cut lawsuits dramatically if we would stop the practice of lawyers getting a percentage of the spoils. That just encourages fraudulent inflation of claims. Pay the attorney a set fee, win, lose or draw and he/she will stop exaggerating the claims.
But that will never happen because most of the lawmakers are.......attorneys.
I don't know about #3. I really do want everyone in America to get medical attention when they need it.
I don't mind paying taxes for that kind of assistance.
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
"Do you guys honestly think the government is going to pay for longterm lyme treatment? The government won't even acknowledge that chronic lyme exists."
Actually it is the IDSA- a PRIVATE organization- that is stating that garbage.
Medical guidelines.
Supported mainly by private insurance companies to reduce costs.
No one is relying on the IDSA's guidelines more than private insurance.
Even doctors who know little about Lyme are not following them much anymore.
It is the insurance companies holding tight to their $$ that keeps us from being properly treated.
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Tutu said.. "Private insurance companies will go out of business because they can't compete without new customers coming in to offset their aging policyholders."
luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
TC,
I don't buy that for one minute.
Why? Because my insurance company is paying without argument.
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Hey luvs...
Not to sound stupid but...
If we all worked for the insurance companies like you do, we would have an "in" with them too.
Kinda like when I worked in the park. If I had to trap and transport a bad bear, the folks I worked with would help me out and be there for me.
If we had to try to get someone who isn't working with us to be there when we needed help.. well...
The CDC and NIH buy the IDSA guidelines and they are government agencies with great influence over how our doctors treat us
Posts: 130 | From Central NY | Registered: Jul 2009
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
BTW- The President sent me a letter earlier today.
Thought you might want to see it. Here is a quote that refers to what is going on in the media right now...
"Over the next month there is going to be an avalanche of misinformation and scare tactics from those seeking to perpetuate the status quo."
Dear Tincup,
If you're like most Americans, there's nothing more important to you about health care than peace of mind.
Given the status quo, that's understandable. The current system often denies insurance due to pre-existing conditions, charges steep out-of-pocket fees - and sometimes isn't there at all if you become seriously ill.
It's time to fix our unsustainable insurance system and create a new foundation for health care security.
That means guaranteeing your health care security and stability with eight basic consumer protections:
No discrimination for pre-existing conditions
No exorbitant out-of-pocket expenses, deductibles or co-pays
No cost-sharing for preventive care
No dropping of coverage if you become seriously ill
No gender discrimination
No annual or lifetime caps on coverage
Extended coverage for young adults
Guaranteed insurance renewal so long as premiums are paid
Learn more about these consumer protections at Whitehouse.gov.
Over the next month there is going to be an avalanche of misinformation and scare tactics from those seeking to perpetuate the status quo.
But we know the cost of doing nothing is too high.
Health care costs will double over the next decade, millions more will become uninsured, and state and local governments will go bankrupt.
It's time to act and reform health insurance, drive down costs and guarantee the health care security and stability of every American family.
You can help by putting these core principles of reform in the hands of your friends, your family, and the rest of your social network.
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Renee...
Just saw your comment as I was shutting down.
You said.. "The CDC and NIH buy the IDSA guidelines and they are government agencies with great influence over how our doctors treat us."
I can't speak to the fact if that is true or not ("buy"- literally or figuratively?) ... wouldn't surprise me if they were... and I'll take your word on it...
But what I can say is that is why we are busting our humps every day to make changes...
And are working as fast and as best we can with the government agencies and everyone else so we can get rid of the IDIOT guidelines and the ones causing this problem.
Stay tuned for tomorrows presentation on the IDSA website.
And if you believe in prayer...
Please pray our combined efforts will help those who are suffering at the hands of the IDSA and their guidelines.
posted
Well, I am tired of arguing this point, so folks are just never going to get it, so here is part of the bill itself.
July 23, 2009: 48 Important Things to Know About Obama's Healthcare Plan
Page 22: Mandates audits of all employers that self-insure!
Page 29: Admission: your health care will be rationed!
Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services. Page 58: Every person will be issued a National ID Healthcard.
Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
Page 65: Taxpayers will subsidize all union retiree and community organizer health plans(read: SEIU, UAW and ACORN)
Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
Page 127: The AMA sold doctors out: the government will set wages.
Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
Page 167: Any individual who doesnt' have acceptable healthcare (according to the government) will be taxed 2.5% of income.
Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that.
Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."
Page 241: Doctors: no matter what speciality you have, you'll all be paid the same (thanks, AMA!)
Page 253: Government sets value of doctors' time, their professional judgment, etc.
Page 265: Government mandates and controls productivity for private healthcare industries.
Page 268: Government regulates rental and purchase of power-driven wheelchairs.
Page 272: Cancer patients: welcome to the wonderful world of rationing!
Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.
Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens,assisted suicide, euthanasia?
Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
Page 430: Government will decide what level of treatments you may have at end-of-life.
Page 469: Community-based Home Medical Services: more payoffs for ACORN.
Page 472: Payments to Community-based organizations: more payoffs for ACORN.
Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
Page 494: Government will cover mental health services: defining, creating and rationing those services.
You can download the complete bill text [ here ]
Incidentally, if you haven't watched Soylent Green yet, you should at least see the future of our country's end-of-life plans: [ Part 1 | Part 2 ]. So ethically immoral, and yet this is where our country is headed. Thanks AARP and AMA for your support of such an immoral bill that so egregiously violates doctors' Hippocratic oath:
"I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art."
Excerpt from the original Hippocratic Oath
In the meantime, if you care anything whatsoever about your right to privacy and do not want to live in a second-rate society where the value of life itself is degraded, contact your state reps and beg them for state legislation to prevent hospitals and practices from submitting any of your medical records into any national database system. If residents want to opt-in, that's their business, but your state should be asserting their rights in protecting its citizens from such a demoralizing system.
Posts: 893 | From Florida | Registered: Dec 2008
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kam
Honored Contributor (10K+ posts)
Member # 3410
posted
Not able to read what other posted. But, I was watching a bit of the View this am. Not sure if it was a current one or a rerun.
The doctor they had on said that we don't know what the plan is.
There are several plans in Congress right now being discussed.
And from what I know about Congress. They don't look for solutions but they look for faults.
Posts: 15927 | From Became too sick to work or do household chores in 2001. | Registered: Dec 2002
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
Medical home is not like the negative aspects of an HMO.
A medical home is having a primary care doctor who takes care of you and is a "home" to all of your medical information so one doctor knows everything going on and helps you get the regular care you need. They are not designed to be gatekeepers to keep down cost.
They are actually designed to encourage people to get health care. They help people make appointments for preventive tests like mammograms. They follow up with patients to make sure they are taking their prescribed medications.
I worked on setting up a medical home and the patients are going to the ER less, they are having fewer complications from their chronic illnesses, and they are getting their mammograms.
Personally, I wouldn't support health reform that didn't encourage a medical home.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
No offense tincup, but politicains tell you what they want and then do something else.
Do you think that if Pres Obama doesn't stick to his word, in this case your letter, that you will be able to take your letter to him and hold him accountable.
How do you think he will respond.
He is for GLOBAL LEADERSHIP thats why he has a SOCIALIST agenda. At least 11 of his cabinet members belong to the Tri-Lateral commission. It is not to benefit the people,but to make us dependent on a gov't. THIS IS BEYOND HEALTHCARE!!!!!
Posts: 262 | From ohio | Registered: Jul 2008
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posted
What you just stated about the medical home is exactly what we in the medical profession were told the HMOs would be in the 1980s.
The primary was to be the gatekeeper, to use specialists on consult only, that is why the need to be referred by the primary, so they would know everything that was going on with the patient and communicate with the specialists.
Turned out different didn't it?
Everything sounds great in theory but READ THE BILL
Obama keeps on talking about what it is and isn't going to do but he hasn't even read it or put one proposal in it yet. Yes ultimately he signs it but he signed the stimulus bill without reading it, how's that working out for you?
Need Lots of Help posted actual statement from the actual bill, did not make it all up.
And go to the CDC site, what guidelines do they recommend?
I worked in healthcare as an RN until last year. I was woefully uniformed about Lyme by the CDC recommendations and our state and local health departments. Weren't we all?
Posts: 130 | From Central NY | Registered: Jul 2009
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posted
VA hospitals seem to vary in US. My husband gets excellent care in San Jose, CA. He sees a number of specialists.
His primary doc is wonderful. She checks him out carefully. All tests, etc. are on computer so everyone kept in the loop.
His free care keeps us afloat since mine is so $$$
-------------------- DOCTOR: "I don't think you are sick." PATIENT: "We are all entitled to our opinions. I don't think you are a doctor." Posts: 697 | From Northern California | Registered: Jul 2009
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sometimesdilly
Frequent Contributor (1K+ posts)
Member # 9982
posted
FROM THE PEANUT GALLERY--
SCARING FOLKS ON LYMENET WITHOUT BASIS IN FACT THAT OBAMA WILL COST THEM THEIR LLMDS IS NOT JUST OK.
AS FOR MORE OF THAT O IS A SOCIALIST STUFF..
pfffffffffffft. get a grip.
Posts: 2507 | From lost in the maze | Registered: Aug 2006
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posted
No, its not about getting a grip. You can look it up yourself his advisors and mentors etc.
Have you read Obamas book. It was not meant to offend - I thought it was common knowlegde.
Posts: 262 | From ohio | Registered: Jul 2008
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posted
Anyways, its just a political opinion. One thing we have in common is the reason why we even come on this site - Lyme and co. That said - Peace.
Posts: 262 | From ohio | Registered: Jul 2008
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
c3 said... "No offense tincup, but politicains tell you what they want and then do something else."
No offense taken at al.
And you are right C3... that often happens. I've trusted folks and have been slapped in the head later for it.
And I know... I really do... that possibly...
I am looking at this situation through blinders in some ways... and maybe I am totally wrong...
But I believe the system we have now sucks so badly that unless we have drastic changes made soon...
We will be in BIG trouble... worse trouble.
I know change has been promised for the better many times in the past but no one has made the changes.
I believe no one person has the power to make all the needed changes... and no one will make changes that will please all of the people all of the time.
I believe the President is only as strong as the Congress that is working with him .... and that what he wants he won't always get.
I believe our President has good intentions and he has a good heart.
Do I think he is perfect? No.
Do I think he will solve all of our problems. No.
But I do think he will try and he will go to the limits doing so.
That is all I can ask of any man.
BTW- Sincere questions here...
Why isn't anyone kicking Congress over the bill?
Why are all the nasties and things going wrong being blamed on the President?
He has been in office 6 months.. and already he has taken the blame for all the nations ills as if he were single-handedly the cause.
luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
TC,
I totally agree with you.
Obama is trying to do what he believes is best and at the very least, the man is shaking the tree hard enough to get some actual action. That alone is a good thing.
Obama is only one person and does not have all the control. That is the beauty of our system.
I do not think any previous administration has helped us either.
Again and again and again I ask
Why isn't everyone focused on the true cost of healthcare? Insurance premiums are NOT THE COST OF HEALTHCARE. The premium is the result of the cost of healthcare.
The cost of medicine and medical tests and doctor care is the true cost of healthcare.
If those items were affordable, we would not need an insurance company to buy our medical treatments for us.
Does a for profit company buy your groceries, your clothes, etc?
We have our focus and our blame aimed in the wrong direction. We also have our solution aimed in the wrong direction.
I personally do not believe this is by accident. I believe many in government and business and even the so-called medical associations are focusing us in the wrong direction on purpose.
Haven't any of you noticed the ads for Obama's plans are paid for by the pharmacutical industry. Don't you wonder why insurance companies are sitting so silent? Think they are scared?
There is SO MUCH PROFIT IN MEDICAL TREATMENTS. Pres Obama keeps talking about the necessity of "everyone" having insurance so that it keeps costs down.
He is right about that. It really does keep costs down when the insured group gets larger and larger. That is a normal, natural and factual "for profit fact".
The government taking over our healthcare and charging us dearly for it through taxes is just another "for profit" scheme. Only you and I will not be the beneficiaries of the profits anymore than our schools have actually benefited from lottery profits as they were promised.
The money will magically disappear, the service will be restrictive and goverment will plead broke. More committees will be formed to figure out what is wrong which will require more money.
What a ponzi scheme.
Let's demand fair pricing of drugs and surgery based upon actual costs to produce the drug plus overhead and profit. Much the way contractors bid their jobs.
Let's demand the FDA actually protect us and stop protecting Big Pharma or lets close it down.
Let's watchdog the extortionist practices going on in our medical world that demand highway robbery for medications we need to live. In other words, stop pricing the drug according to how important it is to life.
Why is one chemotherapy dose $20,000.? Why aren't the consumers up in arms about that?
Doesn't that make sense?
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
You want to talk about Lyme disease, talk about Lyme disease. If you have facts about how health reform proposals will impact Lyme treatment, please share that treatment.
But we all have enough to worry with sorting through people lying to us about supposed miracle cures for Lyme, or the lack of chronic Lyme. We don't need more lies.
We don't need anymore propaganda and lies. There is no proposal actually moving in Congress for the government to take over our health care.
I work in this area. I have studied this area. Medical homes are not the HMO model and are not gatekeepers. There is no proposal that has any possibility of passing that has government taking over our healthcare.
The reform proposals moving are not my ideal. But my ideal will not get the support necessary to pass. The reform proposals moving will allow more people to access health care and there is a good possibility they will help people afford to manage chronic diseases.
I don't know what will happen to Lyme patients under reform because there is a separate Lyme controversy. Most likely, some insurance plans will cover treatment and others won't, just like now. And as Lyme patients continue to advocate, as they continue to pressure their state legislators, Congess and IDSA, we will change the way the medical community looks at Lyme and that will be incorporated into insurance coverage for Lyme - both private and public.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
Aniek,
Again you duck the true issue. The cost of healthcare.
Why is that?
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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posted
Any change in healthcare will change lyme treatment. If today during this webcast, ISDA doesn't admit there is Chronic Lyme Disease that requires long term treatment, and this medical bill comes through, we will not get long term antiboitics.
It will be deemed unnecessary and even dangerous. Right now, my insurance is paying for my meds....I am scared that will change.
Shalome
Posts: 893 | From Florida | Registered: Dec 2008
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luvs2ride
Frequent Contributor (1K+ posts)
Member # 8090
posted
Need
My insurance is paying too. I'm sorry everyone doesn't have insurance as good as mine. Maybe we should just make it available to everyone.
I don't pay higher than anyone else to get this coverage either. But I do belong to a group plan, so not available for individuals.
People for the current plan being considered should consider this. Congress rejected a provision that would mandate congress be on this plan. They opted to keep their private coverage.
Now that should tell us something.
-------------------- When the Power of Love overcomes the Love of Power, there will be Peace. Posts: 3038 | From america | Registered: Oct 2005
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
luvs2ride,
I'm not ducking anything. My post wasn't about specifics about reform, it was about pointing out that there are people posting information that is including lies, like continuing to say that medical homes are gatekeepers or that what is moving through Congress is government controlled health care.
You want me to talk about cost? How about reducing preventable illnesses and complications that cost billions of dollars and don't ever need to happen. With a good primary care system that provides affordable access to preventive treatments and chronic disease maintenance, health costs will drop.
As Lyme patients, we advocate for proper treatment of Lyme when a patient goes to the doctor with a bulls eye rash because we know that may prevent chronic Lyme. Think about the millions of dollars in health care spending that would be saved if every acute Lyme case was treated properly.
Now imagine if every asthmatic, every diabetic, every person with hypertension, etc. was treated properly. Less people in hospitals. Less people ending up on disability. Less money spent in health care. That is the goal of the medical home.
You started a thread about the medical home that included mistruths. I tried to correct them because I happen to have experience with the medical home model, I have read detailed information about the concept, I have attended conferences discussing the concept.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
What is most frightening is the amount of energy that people will put into frightening others.
We spent the last eight years being frightened by an administration, only to wake up and realize that the lies, deceit, corrupt greed etc...were running amuck. Hence, the country voted for change.
This spewing of deceit and lies must stop. we have become a fear based society, believing anything that is thrown our way. And, making up anything that we think will strengthen our position.
This plan is about spending less money and finding ways to make a more efficiently run business.
What amazes me is that the same people that complain about this newly proposed health plan are the same ones that would never want to pay a penny more in taxes for anything. They want the best of the best, but don't ever want to pay more for it.
This attitude has put us trillions of dollars into debt with China and is ruining our country.
People deserve and will get affordable health care under this plan.
-------------------- aka: Lyme Warrior
In order to do "real" science, you have to have a "real" conversation with nature.
Well Behaved Women Rarely Make History!
"Just Demand your Rights" Posts: 869 | From nor - cal | Registered: Apr 2008
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quote:Originally posted by Tincup: Tutu said.. "Private insurance companies will go out of business because they can't compete without new customers coming in to offset their aging policyholders."
Because I'd like to have my own insurance with a choice! So would a lot of others!
We're not going to get adequate treatment under the new plan. Period.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
Lymetoo,
People will have choice. Private insurance companies will only go out of business if people and employers choose the public option over the private insurers.
Right now, a lot of people don't have choice because they get care through their employer that their employer chose. Having an exchange actually increases choice because it provides a way for people to purchase private insurance who otherwise couldn't.
The exchange is not public insurance. It is private companies offering health care plans along with a public option.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
Oh, jez, are we on the Bush train again... Bush bashing?
Like it was said in another post, we (America) is in debt so much that it doesn't matter who is President...that person is owned. We do not vote anymore by the majority of the public's vote.
Votes based on who owns who's A&& and who is scratching who's back and Congress is running bills through quicker than we can read, comprehend, and take a stance on.
While we are arguing about Healthcare reform everything is going to pot.......cap and trade...the livestock bill....
We are in trouble and it isn't just about Healthcare anymore. America will not be home of the free for long.
And it is simple, you can't be free if the governement is in control of everything and that is where the governement is going.
WAKE UP AMERICA!!
Shalome
Posts: 893 | From Florida | Registered: Dec 2008
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posted
[QUOTE]Originally posted by Aniek: [QB] Lymetoo,
People will have choice. Private insurance companies will only go out of business if people and employers choose the public option over the private insurers. [QUOTE]
The companies won't be able to compete with the government. No way.
I think there's a better way to do this than what is being planned.
But maybe I'd be better off bowing out of this discussion. I don't want to lose any friends here. Hugs to all.
PS .. Who's going to pay for all the new hospitals we'll need ( right away! ) {{we are}}........
and how are we going to find twice as many drs as we now have since they KNOW they won't get paid good wages in the future.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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posted
"The companies won't be able to compete with the government. No way."
I don't get it. I thought that the government was bloatedf and inefficient, and made a mess out of everything, and that the private sector was superior. If that is the case then the insurance companies, with their lean hustle, should run circles around any gov't plan. No?
Posts: 845 | From Eastern USA | Registered: Jul 2006
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posted
"Why isn't everyone focused on the true cost of healthcare? Insurance premiums are NOT THE COST OF HEALTHCARE. The premium is the result of the cost of healthcare."
I don't know about this, either. Hartford is filled with giant shiny buildings paid for by our premiums. And inside those buildings are thousands of people in suits and dresses, and they're filing papers and sending memos and typing on computers and holding video conferences and collecting premiums and dunking doughnuts into coffee cups while stamping denied on our claims in bold red letters.
The last I checked, those insurance buildings were not filled with people with white coats and stethoscopes and tongue depressors.
So why is it a good idea to have that level of waste, a giant pay toll really, standing between the average citizen and their health care.
I say cut out the middleman.
Big business is THE problem.
How do we make a system that affords access to medical care, without this giant toll booth in between?? That's the hard part. That part is where you need someone way-way-way smarter than me.
PS -- I had a great policy too, that paid for everything, within reason, no questions asked. (I never understood what people here were talking about.) Until one day they decided not to. Then they stopped.
Posts: 845 | From Eastern USA | Registered: Jul 2006
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
Lymetoo,
I hope you wouldn't lose any friends from this discussion. I for one don't mind a good debate, as I appreciate hearing other people's thoughts. Of course, I'll still speak up if I think people are wrong
-Aniek
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
It's Guidelines to jump up and down about.. and the insurance companies promotion and use of them.
Example:
``The [Insurance] Department and the Board [Compensation Insurance]... encourage Insurers to institute voluntary programs that reinforce the use of the treatment guidelines.
For example, Insurers could institute an expedited bill payment program for those Health Care Providers that have a track record of successfully using the treatment guidelines.
An expedited bill payment program would add a further incentive for Health Care Providers to use the treatment guidelines...''
Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
The issue with guidelines is an important issue for Lyme treatment. But we have to understand why it is in the legislation.
It is not there because of Lyme. It is there because there are conditions like diabetes and asthma that have clear, conflict free guidelines. There are doctors not following those guidelines and have their patients on out of date treatments that are really detrimental to their health. This can result in blindness, loss of a limb and even death. It also increases health care costs.
Instead of just trying to kill reform because of this inclusion, we should be lobbying to make sure that there is a distinction if there are competing guidelines or a conflict around the guidelines.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Yo, A...
I was meaning to say for Lyme we need to be concerned.
This is an example of OUR problems... and how insurance gets away with not paying for our care.
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