REAL health care reform.

[Capt. Nemo]

I wonder if Al Gore championed that suit...

... he invented lawsuits

 

[djwright4341]

1) Tort reform. Reduce the number of frivolous malpractise suits, you reduce the costs of malpractise insurance. Reduce the cost, reduce the premium. Reduce the premium, and the doctor doesn't need to charge as much. There's something wrong with a psychiatrist (can't prescribe anything, can't do surgery) needing to carry malpractise coverage to the tune of $150K per annum.

How about a "loser pays" system? If you want to sue someone, fine; but if you lose, you have to pay all of your lawyer fees AND their lawyer fees plus court costs and everything else. It would make some people think twice before dragging someone to court at the drop of a hat.

I think people overusing health care is driving up the cost more than malpractice insurance, but the insurance costs going down certainly wouldn't hurt.

 

[kastein]

How about a "loser pays" system? If you want to sue someone, fine; but if you lose, you have to pay all of your lawyer fees AND their lawyer fees plus court costs and everything else. It would make some people think twice before dragging someone to court at the drop of a hat.

I think people overusing health care is driving up the cost more than malpractice insurance, but the insurance costs going down certainly wouldn't hurt.

This would really suck for, say, college kids brought to court by the RIAA/MPAA. "Hey, here's four million more in lawyer fees on top of that billion dollar fine. Ha!" I see where you're coming from though - maybe "if you sue someone and lose, you pay their fees"? Also, sometimes the judge will award fees and such I think, I'm pretty sure I've heard of it happening.

 

[bigalpha]

Turns out Public option would have higher premiums than private plans:
http://www.politico.com/livepulse/1009/CBO_Public_option_premiums_higher_than_private_plans.html

 

[5-90]

How about a "loser pays" system? If you want to sue someone, fine; but if you lose, you have to pay all of your lawyer fees AND their lawyer fees plus court costs and everything else. It would make some people think twice before dragging someone to court at the drop of a hat.

I think people overusing health care is driving up the cost more than malpractice insurance, but the insurance costs going down certainly wouldn't hurt.

As mentioned above, that could be problematic.

However, the "Grand Jury" setup I'd like to see put in place (to decide whether there is enough merit for the case to proceed) could have such a mechanism put in place - say, a fine for frivolity? If you can't provide a case with enough merit to move forward, a nominal fine (for most people, $5,000-$10,000 would be plenty!) for wasting the time of the Court could be sharp enough to make sure you've got something.

Question: How do you define "overuse" of health care? Are you referring to healthy people going in when they get a sniffle? Or people like my wife and myself with some medical issues, who actually have to go see MDs at fairly regular intervals? Due to post-physical-trauma effects, I see a cardiologist twice a year, a neurologist 2-4 times a year, an internist twice a year, a pain management specialist four times a year, and I'm about to start a series with a physical rehab specialist after the first of the year. My wife has to see the internist about four times a year, has a series with the asthma specialist about twice a year, and assorted "if and when" appointments.

Note that most of these appointments are because they want to see us, not the other way about.

Could be germane to the discussion, y'know...

 

[XJEEPER]

$1,500,000,000,000,000 (that's $1.5 Trillion) is all it going to cost to reform healthcare?

http://blog.heritage.org/2009/11/03/the-true-cost-of-the-house-health-bill-15-trillion/


So let me get this straight...... our government created Medicare and Medicaid, then mis-managed it and bankrupted it. Now We the People are supposed to trust them to fix it, by adding another 111 government agencies?


1. Retiree Reserve Trust Fund (Section 111(d), p. 61)
2. Grant program for wellness programs to small employers (Section 112, p. 62)
3. Grant program for State health access programs (Section 114, p. 72)
4. Program of administrative simplification (Section 115, p. 76)
5. Health Benefits Advisory Committee (Section 223, p. 111)
6. Health Choices Administration (Section 241, p. 131)
7. Qualified Health Benefits Plan Ombudsman (Section 244, p. 138)
8. Health Insurance Exchange (Section 201, p. 155)
9. Program for technical assistance to employees of small businesses buying Exchange coverage (Section 305(h), p. 191)
10. Mechanism for insurance risk pooling to be established by Health Choices Commissioner (Section 306(b), p. 194)
11. Health Insurance Exchange Trust Fund (Section 307, p. 195)
12. State-based Health Insurance Exchanges (Section 308, p. 197)
13. Grant program for health insurance cooperatives (Section 310, p. 206)
14. "Public Health Insurance Option" (Section 321, p. 211)
15. Ombudsman for "Public Health Insurance Option" (Section 321(d), p. 213)
16. Account for receipts and disbursements for "Public Health Insurance Option" (Section 322(b), p. 215)
17. Telehealth Advisory Committee (Section 1191 (b), p. 589)
18. Demonstration program providing reimbursement for "culturally and linguistically appropriate services" (Section 1222, p. 617)
19. Demonstration program for shared decision making using patient decision aids (Section 1236, p. 648)
20. Accountable Care Organization pilot program under Medicare (Section 1301, p. 653)
21. Independent patient-centered medical home pilot program under Medicare (Section 1302, p. 672)
22. Community-based medical home pilot program under Medicare (Section 1302(d), p. 681)
23. Independence at home demonstration program (Section 1312, p. 718)
24. Center for Comparative Effectiveness Research (Section 1401(a), p. 734)
25. Comparative Effectiveness Research Commission (Section 1401(a), p. 738)
26. Patient ombudsman for comparative effectiveness research (Section 1401(a), p. 753)
27. Quality assurance and performance improvement program for skilled nursing facilities (Section 1412(b)(1), p. 784)
28. Quality assurance and performance improvement program for nursing facilities (Section 1412 (b)(2), p. 786)
29. Special focus facility program for skilled nursing facilities (Section 1413(a)(3), p. 796)
30. Special focus facility program for nursing facilities (Section 1413(b)(3), p. 804)
31. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 1422, p. 859)
32. Demonstration program for approved teaching health centers with respect to Medicare GME (Section 1502(d), p. 933)
33. Pilot program to develop anti-fraud compliance systems for Medicare providers (Section 1635, p. 978)
34. Special Inspector General for the Health Insurance Exchange (Section 1647, p. 1000)
35. Medical home pilot program under Medicaid (Section 1722, p. 1058)
36. Accountable Care Organization pilot program under Medicaid (Section 1730A, p. 1073)
37. Nursing facility supplemental payment program (Section 1745, p. 1106)
38. Demonstration program for Medicaid coverage to stabilize emergency medical conditions in institutions for mental diseases (Section 1787, p. 1149)
39. Comparative Effectiveness Research Trust Fund (Section 1802, p. 1162)
40. "Identifiable office or program" within CMS to "provide for improved coordination between Medicare and Medicaid in the case of dual eligibles" (Section 1905, p. 1191)
41. Center for Medicare and Medicaid Innovation (Section 1907, p. 1198)
42. Public Health Investment Fund (Section 2002, p. 1214)
43. Scholarships for service in health professional needs areas (Section 2211, p. 1224)
44. Program for training medical residents in community-based settings (Section 2214, p. 1236)
45. Grant program for training in dentistry programs (Section 2215, p. 1240)
46. Public Health Workforce Corps (Section 2231, p. 1253)
47. Public health workforce scholarship program (Section 2231, p. 1254)
48. Public health workforce loan forgiveness program (Section 2231, p. 1258)
49. Grant program for innovations in interdisciplinary care (Section 2252, p. 1272)
50. Advisory Committee on Health Workforce Evaluation and Assessment (Section 2261, p. 1275)
51. Prevention and Wellness Trust (Section 2301, p. 1286)
52. Clinical Prevention Stakeholders Board (Section 2301, p. 1295)
53. Community Prevention Stakeholders Board (Section 2301, p. 1301)
54. Grant program for community prevention and wellness research (Section 2301, p. 1305)
55. Grant program for research and demonstration projects related to wellness incentives (Section 2301, p. 1305)
56. Grant program for community prevention and wellness services (Section 2301, p. 1308)
57. Grant program for public health infrastructure (Section 2301, p. 1313)
58. Center for Quality Improvement (Section 2401, p. 1322)
59. Assistant Secretary for Health Information (Section 2402, p. 1330)
60. Grant program to support the operation of school-based health clinics (Section 2511, p. 1352)
61. Grant program for nurse-managed health centers (Section 2512, p. 1361)
62. Grants for labor-management programs for nursing training (Section 2521, p. 1372)
63. Grant program for interdisciplinary mental and behavioral health training (Section 2522, p. 1382)
64. "No Child Left Unimmunized Against Influenza" demonstration grant program (Section 2524, p. 1391)
65. Healthy Teen Initiative grant program regarding teen pregnancy (Section 2526, p. 1398)
66. Grant program for interdisciplinary training, education, and services for individuals with autism (Section 2527(a), p. 1402)
67. University centers for excellence in developmental disabilities education (Section 2527(b), p. 1410)
68. Grant program to implement medication therapy management services (Section 2528, p. 1412)
69. Grant program to promote positive health behaviors in underserved communities (Section 2530, p. 1422)
70. Grant program for State alternative medical liability laws (Section 2531, p. 1431)
71. Grant program to develop infant mortality programs (Section 2532, p. 1433)
72. Grant program to prepare secondary school students for careers in health professions (Section 2533, p. 1437)
73. Grant program for community-based collaborative care (Section 2534, p. 1440)
74. Grant program for community-based overweight and obesity prevention (Section 2535, p. 1457)
75. Grant program for reducing the student-to-school nurse ratio in primary and secondary schools (Section 2536, p. 1462)
76. Demonstration project of grants to medical-legal partnerships (Section 2537, p. 1464)
77. Center for Emergency Care under the Assistant Secretary for Preparedness and Response (Section 2552, p. 1478)
78. Council for Emergency Care (Section 2552, p 1479)
79. Grant program to support demonstration programs that design and implement regionalized emergency care systems (Section 2553, p. 1480)
80. Grant program to assist veterans who wish to become emergency medical technicians upon discharge (Section 2554, p. 1487)
81. Interagency Pain Research Coordinating Committee (Section 2562, p. 1494)
82. National Medical Device Registry (Section 2571, p. 1501)
83. CLASS Independence Fund (Section 2581, p. 1597)
84. CLASS Independence Fund Board of Trustees (Section 2581, p. 1598)
85. CLASS Independence Advisory Council (Section 2581, p. 1602)
86. Health and Human Services Coordinating Committee on Women's Health (Section 2588, p. 1610)
87. National Women's Health Information Center (Section 2588, p. 1611)
88. Centers for Disease Control Office of Women's Health (Section 2588, p. 1614)
89. Agency for Healthcare Research and Quality Office of Women's Health and Gender-Based Research (Section 2588, p. 1617)
90. Health Resources and Services Administration Office of Women's Health (Section 2588, p. 1618)
91. Food and Drug Administration Office of Women's Health (Section 2588, p. 1621)
92. Personal Care Attendant Workforce Advisory Panel (Section 2589(a)(2), p. 1624)
93. Grant program for national health workforce online training (Section 2591, p. 1629)
94. Grant program to disseminate best practices on implementing health workforce investment programs (Section 2591, p. 1632)
95. Demonstration program for chronic shortages of health professionals (Section 3101, p. 1717)
96. Demonstration program for substance abuse counselor educational curricula (Section 3101, p. 1719)
97. Program of Indian community education on mental illness (Section 3101, p. 1722)
98. Intergovernmental Task Force on Indian environmental and nuclear hazards (Section 3101, p. 1754)
99. Office of Indian Men's Health (Section 3101, p. 1765)
100. Indian Health facilities appropriation advisory board (Section 3101, p. 1774)
101. Indian Health facilities needs assessment workgroup (Section 3101, p. 1775)
102. Indian Health Service tribal facilities joint venture demonstration projects (Section 3101, p. 1809)
103. Urban youth treatment center demonstration project (Section 3101, p. 1873)
104. Grants to Urban Indian Organizations for diabetes prevention (Section 3101, p. 1874)
105. Grants to Urban Indian Organizations for health IT adoption (Section 3101, p. 1877)
106. Mental health technician training program (Section 3101, p. 1898)
107. Indian youth telemental health demonstration project (Section 3101, p. 1909)
108. Program for treatment of child sexual abuse victims and perpetrators (Section 3101, p. 1925)
109. Program for treatment of domestic violence and sexual abuse (Section 3101, p. 1927)
110. Native American Health and Wellness Foundation (Section 3103, p. 1966)
111. Committee for the Establishment of the Native American Health and Wellness Foundation (Section 3103, p. 1968)


This bill in not about healthcare reform, it's about expanding our government and stripping away our Freedoms.

Are we really that stupid folks? :doh: Our Government has no business attempting to be in business, period. That's why it's called "government", not the US Corporation of America LCC. History has proven that they suck at it, greed and corruption are the only outcome.

 

[5-90]

So let me get this straight...... our government created Medicare and Medicaid, then mis-managed it and bankrupted it. Now We the People are supposed to trust them to fix it, by adding another 111 government agencies?

I knew it was going to be a problem as soon as I saw the page count. And, what would you care to bet that no-one on the Hill is going to read the entire damned thing before they vote on it?

Write Congress, write the Senate. Write early, write often! There are plenty of ways to find out who your "representatives" are (if you don't already know,) so I shan't go into that.

We're going to have to snow them under with letters. And, as I recall, the entire House is up for replacement in the next election...

 

[RichP]

I knew it was going to be a problem as soon as I saw the page count. And, what would you care to bet that no-one on the Hill is going to read the entire damned thing before they vote on it?

Write Congress, write the Senate. Write early, write often! There are plenty of ways to find out who your "representatives" are (if you don't already know,) so I shan't go into that.

We're going to have to snow them under with letters. And, as I recall, the entire House is up for replacement in the next election...

Showing up and bracing them in their office works well too, I'm hoping the guy who had his video camera rolling when we visited ours releases it so people can see what an azzhimer he is.

 

[djwright4341]

As mentioned above, that could be problematic.

However, the "Grand Jury" setup I'd like to see put in place (to decide whether there is enough merit for the case to proceed) could have such a mechanism put in place - say, a fine for frivolity? If you can't provide a case with enough merit to move forward, a nominal fine (for most people, $5,000-$10,000 would be plenty!) for wasting the time of the Court could be sharp enough to make sure you've got something.

Interesting... I like it.

Question: How do you define "overuse" of health care? Are you referring to healthy people going in when they get a sniffle? Or people like my wife and myself with some medical issues, who actually have to go see MDs at fairly regular intervals? Due to post-physical-trauma effects, I see a cardiologist twice a year, a neurologist 2-4 times a year, an internist twice a year, a pain management specialist four times a year, and I'm about to start a series with a physical rehab specialist after the first of the year. My wife has to see the internist about four times a year, has a series with the asthma specialist about twice a year, and assorted "if and when" appointments.

Note that most of these appointments are because they want to see us, not the other way about.

Could be germane to the discussion, y'know...

If you need health care, you need it and there's no way to change that. I was referring to the people who show up at the emergency room with stuffy noses. My daughter had pyloric stenosis when she was 6 months old and my wife and I took her to the e-room. My wife told the girl at the check-in that we were there because our 6 month-old wouldn't stop crying. The girl rolled her eyes at us until I explained a few more symptoms. Apparently babies crying are frequent emergency room visitors too.

 

[JNickel101]

http://www.foxnews.com/politics/2009/11/14/report-government-paid-b-medicare-claims/?test=latestnews

Yet more proof that Socialized medicine will be a disaster.....

 

[5-90]

Interesting... I like it.



If you need health care, you need it and there's no way to change that. I was referring to the people who show up at the emergency room with stuffy noses. My daughter had pyloric stenosis when she was 6 months old and my wife and I took her to the e-room. My wife told the girl at the check-in that we were there because our 6 month-old wouldn't stop crying. The girl rolled her eyes at us until I explained a few more symptoms. Apparently babies crying are frequent emergency room visitors too.

Just checking.

Ya go in with a sniffle and no relevant Hx, you get stuck in triage for 18 hours (or until you walk out and go to a clinic. Which is why I think neighbourhood clinics aren't a bad idea - takes a load off of the ER.)

I wanted to see what you considered "overuse" - and it sounds like we're in agreement. The very few times I've been able to get right in I've been a trauma case (got hauled in by a DocWagon...) and I could usually get my MIL in quickly because she had a respiratory/cardiac Hx (and she was fairly often a direct admit because we'd just come from a doctor's office anyhow. They caught something that I didn't know how to check - so I'd have them explain it to me so I could save the trip next time. I can count on the fingers of one nose how many times I was wrong - I just didn't have access to as much information as they do.)

"Pyloric stenosis" - constriction of the stomach exit into the small intestine? As I recall, that's the "pyloric junction" - but I'm a medic, not a surgeon...

 

[djwright4341]

"Pyloric stenosis" - constriction of the stomach exit into the small intestine? As I recall, that's the "pyloric junction" - but I'm a medic, not a surgeon...

You're right. The pyloric junction is where the stomach meets the small intestine. Pyloric stenosis is a hardening of the muscle that lets stuff flow out of the stomach.

The clinics are good. I've still seen people sitting in the clinics who would be better served by going to Walgreen's, picking up some cold/flu medicine of their choice, and sitting on the couch for the weekend. We have a friend who does have some medical issues, but also runs to the doctor for every sneeze and sniffle.

Now that I'm in the military again, I avoid the doctor like the plague. If I'm well enough to drive 45 mins to the MTF, see my primary care physician, possible get referred to someone else, spend most of my day (in uniform anyway) dealing with Navy "medical professionals", then drive home with whatever over-the-counter medicine they gave me and sit on the couch, then I'll just go to work sick. Anyone who wants socialized health care should spend some time in the military and deal with Tricare Prime.

 

[5-90]

You're right. The pyloric junction is where the stomach meets the small intestine. Pyloric stenosis is a hardening of the muscle that lets stuff flow out of the stomach.

If it's a hardening of the muscle, wouldn't it be "pyloric sclerosis?" Just wondering - I know a lot of medical terminology sounds like something they just made up five minutes ago, but there's some logic to it if you can sort it out. What causes/caused it? I hope everything better now (and that it was/is treatable...)