Obama Care

[FRPLG]

Originally Posted by Schneed10

PS, I'm in healthcare finance. The bolded statement is woefully off the mark when compared to the general consensus of the financial professionals within the industry. The model for care delivery will no doubt change, but those ill-prepared to adapt will go extinct, while the providers who remain standing will deliver care in a more cost effective manner with greater efficiency and quality.

How so?

[Schneed10]

Originally Posted by FRPLG

How so?

I'm not quite sure which portion of my comment your question is directed at, but...

The biggest change with healthcare reform is that eventually providers will be reimbursed for episodes of care, rather than for encounters or procedures performed.

Let's say you fall and break your leg. Right now, every time you come to the hospital for an X-Ray we get $90, every time you come for an outpatient surgery we get $1500, every time you come for an inpatient admission we get $7000. I'm making up numbers and oversimplifying, but you get the picture. You can clearly see that the more we see you, the more we get paid. So there's an incentive to see you over and over. Lots of doctors order unnecessary tests because of this.

Under healthcare reform though, if you fall and break your leg we'll get paid a lump sum $8000 to take complete care of you, from the first time you see us to when you're either healed or the year ends. So then it's up to the doctor to decide when ordering a test is really necessary, which he'll be incented to do to watch his bottom line.

Now, before you freak out about a doctor withholding tests in the name of his (or his hospital's) bottom line, malpractice and licensing issues still are strong incentives to keep them from rationing care.

But it's easy to see; why order 4 x-rays on the leg when all you need is 2? It will reduce redundant tests, which reduces costs to the consumer in the long run.

So clearly testing volume will drop at hospitals, so competition will become more fierce. If testing levels drop enough, some hospitals may not be able to support themselves and may have to close. But that just speaks to the excess capacity of healthcare facilities and equipment that we have in SOME parts of the country. Closing those facilities will be a good thing in the long run, it's a market force that will bring capacity more in line with patient demand.

[firstdown]

Originally Posted by Schneed10

I'm not quite sure which portion of my comment your question is directed at, but...

The biggest change with healthcare reform is that eventually providers will be reimbursed for episodes of care, rather than for encounters or procedures performed.

Let's say you fall and break your leg. Right now, every time you come to the hospital for an X-Ray we get $90, every time you come for an outpatient surgery we get $1500, every time you come for an inpatient admission we get $7000. I'm making up numbers and oversimplifying, but you get the picture. You can clearly see that the more we see you, the more we get paid. So there's an incentive to see you over and over. Lots of doctors order unnecessary tests because of this.

Under healthcare reform though, if you fall and break your leg we'll get paid a lump sum $8000 to take complete care of you, from the first time you see us to when you're either healed or the year ends. So then it's up to the doctor to decide when ordering a test is really necessary, which he'll be incented to do to watch his bottom line.

Now, before you freak out about a doctor withholding tests in the name of his (or his hospital's) bottom line, malpractice and licensing issues still are strong incentives to keep them from rationing care.

But it's easy to see; why order 4 x-rays on the leg when all you need is 2? It will reduce redundant tests, which reduces costs to the consumer in the long run.

So clearly testing volume will drop at hospitals, so competition will become more fierce. If testing levels drop enough, some hospitals may not be able to support themselves and may have to close. But that just speaks to the excess capacity of healthcare facilities and equipment that we have in SOME parts of the country. Closing those facilities will be a good thing in the long run, it's a market force that will bring capacity more in line with patient demand.

Lots of doctors order unnessary test so they don't get sued. A good portion of those test are done by specialist and the doctor ordering them makes nothing of them.

[Schneed10]

Originally Posted by firstdown

Lots of doctors order unnessary test so they don't get sued. A good portion of those test are done by specialist and the doctor ordering them makes nothing of them.

Right, which is why they'd institute the new methodology. One payment to cover everything, and then it's up to the providers to figure out a way to share that payment.

Then there's a downward pressure on ordering extra tests to counterbalance the risk of getting sued. It makes them walk the line.

[firstdown]

Originally Posted by Schneed10

Right, which is why they'd institute the new methodology. One payment to cover everything, and then it's up to the providers to figure out a way to share that payment.

Then there's a downward pressure on ordering extra tests to counterbalance the risk of getting sued. It makes them walk the line.

Makes no sense without ourt reform. What will happen is doctors will still have to order the test but now he will start eating the cost. DR. tells Obama care to Fu^% Off because they can make more money doing something else.

[Tiggwin]

Originally Posted by firstdown

Lots of doctors order unnessary test so they don't get sued. A good portion of those test are done by specialist and the doctor ordering them makes nothing of them.

Very good point... and when it comes to rationing care... who's going to sue the Federal Government? Back to the same old debate... allow marketing of healthcare plans across state lines.. crack down on frivilous lawsuits that jack up the rates of medical malpractice (also known as tort reform) cut out some of the costly Federal Regulations that also increase rates... there are a number of options available without a Government take over of healthcare.

Look prior to this whole healthcare problem was created by this administration... there were 275 Million people insured. How is there a crisis when 85% of the population was insured and "liked" their coverage? Infamous words of Rahm Emanuel... never let a good crisis go to waste.. in the words of Sal Aliniski.. the ends justify the means... in other words... since there wasnt any real crisis.... we make one up and then use it to our advantage.

How come there hadnt been a healthcare problem in this country since HillaryCare was blown up in 1993... until Obama was elected? The something for nothing crowd... screams again.

Now the most ridiculous thing I have ever heard is I can keep my dependent on my healthcare LOOOOONNNNGGGG after the Federal Government stops allowing me to claim them as a dependent for tax purposes. Do people realize this also includes "Married" dependents up to age 26? How can someone 25 years old.. married and maybe even with a child of their own... still legally able to be on their "Parents" policy?? makes absolutely no sense to me at all. I could understand if they were in grad school or something where their focus is supposed to be on their studies.. but damn this is more than ridiculous... and the Prez has the nerve to speak about self responsiblity during the State of the Union? I hate someone who talks out of both sides of their neck

[firstdown]

Originally Posted by Tiggwin

Very good point... and when it comes to rationing care... who's going to sue the Federal Government? Back to the same old debate... allow marketing of healthcare plans across state lines.. crack down on frivilous lawsuits that jack up the rates of medical malpractice (also known as tort reform) cut out some of the costly Federal Regulations that also increase rates... there are a number of options available without a Government take over of healthcare.

Look prior to this whole healthcare problem was created by this administration... there were 275 Million people insured. How is there a crisis when 85% of the population was insured and "liked" their coverage? Infamous words of Rahm Emanuel... never let a good crisis go to waste.. in the words of Sal Aliniski.. the ends justify the means... in other words... since there wasnt any real crisis.... we make one up and then use it to our advantage.

How come there hadnt been a healthcare problem in this country since HillaryCare was blown up in 1993... until Obama was elected? The something for nothing crowd... screams again.

Now the most ridiculous thing I have ever heard is I can keep my dependent on my healthcare LOOOOONNNNGGGG after the Federal Government stops allowing me to claim them as a dependent for tax purposes. Do people realize this also includes "Married" dependents up to age 26? How can someone 25 years old.. married and maybe even with a child of their own... still legally able to be on their "Parents" policy?? makes absolutely no sense to me at all. I could understand if they were in grad school or something where their focus is supposed to be on their studies.. but damn this is more than ridiculous... and the Prez has the nerve to speak about self responsiblity during the State of the Union? I hate someone who talks out of both sides of their neck

I think at some point to control cost we will have to ration care. We spend billions to keep people alive just a few days or weeks that could be spent on long healthy people and lower cost. I know that sounds cruel but we have to find away to say that it time to stop treatment on some people.

[Tiggwin]

Originally Posted by firstdown

I think at some point to control cost we will have to ration care. We spend billions to keep people alive just a few days or weeks that could be spent on long healthy people and lower cost. I know that sounds cruel but we have to find away to say that it time to stop treatment on some people.

Firstdown keep in mind Dr. Kavorkian (? sorry if I have brutalized his name) was tried and convicted of performing assisted suicides back in 1999... I didnt feel it was wrong then because it was a decision made between a patient and their Dr. If someone realizes they are terminal and they want to go out on their own terms I dont have an issue with that... but before I would agree to leave the rationing up to some bureaucrat in DC Id rather they create legislation to ration care to all of the 12,000,000 illegal aliens in this country.. Id rather they create legislation to limit care to people who choose to do nothing but game the system... People that arent even supposed to be here coming across the boarder to have their anchor babies.. They come here illegally and can get welfare and public assistance in times when our own citizens cant... that is where the majority of the spending is coming from. If Hospitals werent required to provide coverage to people who are in this country illegally (people who use the ER as their primary care physician) they would be able to charge less for services.. they have to make up for the loss somewhere. If we rationed their services we wouldnt have to ration services to a Senior Citizen who has most likely and most probably been a fairly productive member of our society.

And if costs were able to go down for services because of responsible rationing such as that... well then the services to Grandma might not be so expensive...

I aint saying.... Im just saying.... haha

[GMScud]

No bueno for Obamacare....

Judge rules healthcare reform unconstitutional | Reuters