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Old 07-24-2011, 01:23 PM   #57
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AND what is the alternative, what we have now?
Insurance companies put all our records into computer databases now. Too bad the doctor treating me in an ER somewhere can't access it. Right now, believe me, our medical records are "out there in cyberland" but the doctor trying to save my life may not be able to access it."

We need changes in our healthcare system in this country. I don't have the answers, but I'm glad we are at least trying to do something besides starting wars & feeding big oil.

I agree with those of you who noted that the present prohibitive cost for insurance and copays, deductibles, etc. can well mean that many of us won't be able to afford to use our Airstreams to travel as we dream!
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Old 07-24-2011, 01:34 PM   #58
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OK since we are already off topic here is how the Insurance companies work.

- Doctors bill different codes for different visits Thus you get different amounts of money for different visits.

- Each insurance company pays a different amount for the same code.

- Each insurance company contracts with each individual doctor for a set amount for each code. (so one doctor could get paid more or less money for the same code as a doctor down the street) makes sense so far right.

- If you don't have a contract with set insurance company you get paid even less.

- This is why doctors take some insurances and not others.

- Medicaid and Medicare pay pretty low. (half or less than a regular insurance company) Sometimes not even covering the cost of the visit. This is why some doctors don't take them or limit the amount they see in a practice.

- Our healthcare system is fine. It's the Insurance system that is screwed up..
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Old 07-24-2011, 01:58 PM   #59
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Did I just enter the Fox News Website?
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Old 07-24-2011, 02:06 PM   #60
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Did I just enter the Fox News Website?
No, this is news not opinion
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Old 07-24-2011, 03:03 PM   #61
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Did I just enter the MSNBC website?
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Old 07-24-2011, 03:04 PM   #62
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No, this is news not opinion.
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Old 07-24-2011, 03:08 PM   #63
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The health care system in this country is great if you have a lot of money, have a premium insurance coverage, or have a doctor in the family. I got treated a lot better by docs when my father was alive.

A lot has changed in my lifetime. Docs were once respected, now not so. Everyone I know when they are talking about the health care system has mostly bad things to say. A lot say they diagnose themselves, do research on the internet and chose treatment. The doc often agrees, but they are always in a hurry. Even though I am prepared, I sometimes forget to ask something. I haven't found one who uses e-mail, so there's no follow up. Docs are powerless, rushed, disliked (a lot of narcissists in my generation) and think about early retirement. Need dental work—it's even worse though I usually have found good dentists who do listen and we can discuss treatment. No coverage for dental work for me.

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Old 07-24-2011, 03:26 PM   #64
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That's why we go to our PA, Gene. Same price, of course, but generous with time and care.

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...A lot say they diagnose themselves, do research on the internet and chose treatment. The doc often agrees, but they are always in a hurry. Even though I am prepared, I sometimes forget to ask something. I haven't found one who uses e-mail, so there's no follow up. Docs are powerless, rushed, disliked (a lot of narcissists in my generation) and think about early retirement... Gene
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Old 07-24-2011, 03:43 PM   #65
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While we are on the subject of health care; I'm suprised that no one has brought up how lawyer and lawsuites affect the cost of health care.
Oh; drugs (legal) the same drug made in europe costs less in Canada than in the USA. We can thank the FDA for that and import taxes for that.
Than there are the federal, state and local regulations; and the Joint Commission on Hospital Accrediation.
We have equipment manufacturers; X-ray cat scanners, MRI etc.these $$$ also have to be included. Each time a NEW piece of equipment is brought out the hospital, clinic or doctor is forced to keep updated and the old is shipped off or "junked"
This list could go on and on, but I'm getting tired typing.

Let's get off the health care and talk about cars, houses, oil, food etc.
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Old 07-24-2011, 04:14 PM   #66
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While we are on the subject of health care; I'm suprised that no one has brought up how lawyer and lawsuites affect the cost of health care.
Actually very little, if any cost, is from lawsuits. Medical malpractice insurers claim they do to get recoveries limited, but when they are, premiums do not go down and the insurers make more money. People should be able to sue when a doc does a bad job. State medical boards, often controlled by docs, do not discipline docs often and only malpractice suits do so. If someone you loved was messed up by a careless doc, would you want a recovery limit that is far below what decades of extra care would cost?

To get back to the original post, sloppy record keeping and difficulty of obtaining records in an emergency, contriobute to malpractice and increase costs.

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Old 07-24-2011, 04:47 PM   #67
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Problem is Gene: People in this country our sue happy. We had a friend that delivered a perfect baby. (by c-section) 12 years later when the kid was slow in school they sued; "saying they didn't do the c-section fast enough. " Look at all the adds on tv for people being able to sue. Our malpractice insurance is over $10,000 a year. it was over $20,000 when Michelle did OB. It cost the doctors more than anyone. It's not like you can charge more. The insurance companies only pay what they pay.

Funny thing is Vets make more than most family docs do. People seem to want to pay when their animal is sick. But don't when they are. Going to your doctor is a service just like going to auto shop. When the service is done you need to pay.
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Old 07-24-2011, 04:55 PM   #68
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Going to your doctor is a service just like going to auto shop. When the service is done you need to pay.
When the car is fixed, the customer either may not pay, or will try to chisel you down. But that's a topic for another thread, this one is going far enough astray as it is.
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Old 07-24-2011, 05:02 PM   #69
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Jason, there are always going to be stupid lawsuits. I have been sued in a case that had no merit. The lawyer for the plaintiff was later suspended for getting a DUI and not reporting it to the supreme court. My homeowners insurance paid all my expenses, so it was not a monetary drain, but an emotional one. These stories are anecdotal and don't indicate a lot. I can say the Colorado supreme court is very aggressive in disciplining bad lawyers and the medical board is not.

A doctor once asked me why doctors got sued more than chiropractors. I told him personality had a lot to do with it. I will agree some lawyers have bad personalities also. Chiropractors get lots of training in handling patients in a positive way and it seems to pay off. One medical specialty, anesthesiologists, as a group, have taken strong efforts to weed out the bad ones, and it has paid off in lower insurance premiums and better care.

Dentists make more than all of us. No one wants to pay any of us. People rarely have legal insurance, so sometimes we get stiffed.

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Old 07-24-2011, 05:41 PM   #70
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Medical costs are in large part driven by the American consumers " I want it right now attitude."
I am an Internist, and I make a good deal off the "worried well."
Also, those with lousy life styles.

If you have a respiratory tract infection, 95% of the time it is viral.
Yet invariably every season I see 5-6 people day who want an antibiotic. Very disaapointed if they hear "no."
The general rule is wait 7 days and then come in only if you still have a fever or colored mucous. Doesn't matter if tomorrow is Thanksgiving and you need to "nip it in the bud."

That low back pain or swollen knee does not need an MRI until enough time has passed to allow for nature, anti-inflammatories, and physical therapy to work their magic.

Your headache is likely not a stroke or tumor or aneurysm. Despite what your neighbor may have had.

As for comparisons to Canada, there is the good and the bad. Routine and preventitive care is easily found there. Other things, I remember sending a Snow Bird back from Florida to have her atrial fibrillation cardioverted. Later she told me that she was denied the procedure as it was not deemed necessary. Despite her wishes. She was told to live with it and take coumadin.

And, who's premier went to Miami for heart valve surgery?

In reality, the USA and Canada are very different countries. I don't see them with the crime, gun, drug, ghetto problems etc. on near the scale we have. Poverty drives down the life expectancy rate no matter what the health care system.

We have had an EMR in place for 1 1/2 years now. Working it adds two hours to my day. Lots of data entry. Tons of scrolling and clicking. I must enter my security password at least 100/times per day. Our whole office hates it.

The difficulty is great enough that most ER's now hire scribes to accompany the Dr.
He/She can't see patients and run a complete computer record on each one too.

Despite what you may have heard, there is no hard data to support that EMR's improve outcomes. And, very few hospitals, specialists, and other Drs can communicate via their respective EMR's. Someday yes, but it's years away.
When data is all in the "cloud."

To meet meaningful use criteria and be very partially reimbursed for the costs associated with going electronic, I have to jump through all kinds of hoops.
Most of it is designed to control the way I practice. Make sure I do it in the government's correct way.
I have to prove that I send patients reminders whether they want them or not. Prove that I am printing out some mundane education material and handing it to them.
Things like another diet for that 10 yr diabetic. Seems to be a big push that everyone leaves with a piece of paper in hand.

Less than 3% of medical students want to become Internists now. We are a dying breed. I love what I do. My patients and their families become my friends. I am very satisfied. I was blessed to have been mentored by strong and independent thinking physicians. Those not afraid to tell a hospital CEO to stick it. My patients do well and my practice is full because I care. You cannot legislate that quality.

Yet, I would not wish my children or grandchildren this. The managed care and Medicare controls are relentless.

Tom W
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