Blue Dogs Barking Up the Wrong Tree

"Poor people would get subsidies to help them buy care after spending 12% of their income on premiums, instead of 11% in the current bill."


The reformed reform plan is that an individual with a 50k income would need to come up with $5200 in premiums, no mention of deductibles, lowest tier in the exchange currently at 25% with out of pocket max of how much? Who can afford this? Why aren't HSA's considered?

I'm ready to get well now.

Daddy always used to say when I got hurt, "Think about how good it will feel when you get better." There is no getting better with this disease. It's not so much than any particular ache or inconvenience can't be handled, it's the day after day after day relentless nature of it that is like Chinese water torture.

Global payment = global pain in the butt?

Looks like fee for service didn't control costs in Massachusetts so they want to switch to paying docs per patient. If the doctor keeps the patient healthy he makes some money. Polticians must imagine that physicians have some kind of voodoo magic to make patients lose weight and quit smoking. Will they be able to fire a noncompliant patient? Will they be able to say that difficult cases are beyond the scope of their practice? Will they be able to turn down a patient's 732,930th request for an appointment for pain killers, loneliness, or that disturbing ache in the pinky finger?

This brings to mind the schemes that are put in place in prisons to keep food budgets under control. If a warden keeps the budget down he's allowed to personally pocket some money.

In Alabama earlier this year, a federal judge ordered the Morgan County sheriff locked up in his own jail for contempt for failing to adequately feed his inmates. Alabama allows sheriffs to keep food money they do not spend, and the sheriff reportedly pocketed more than $200,000 over three years.

Well, I'm not going to be one of those people that a doc can keep healthy. I'm not sick because I'm fat, I don't have hypertension or diabetes or any other "lifestyle" disease, I have Crohn's and I'm going to be a big pain in the butt to treat for any doctor who is rewarded for healthy patients. Perhaps one of the ways that a GI will be able to save a little money from me is to not use conscious sedation during a colonoscopy , an oft repeated event in the life of a Crohn's patient.

Colonoscopy without sedation is common in Europe and Asia, and efficacy is
comparable."There have been several studies that show that if you have motivated patients, a significant fraction of them can have a colonoscopy without sedation," said Douglas Rex, MD, past president of the American College of Gastroenterology

That's right, folks, lack of sedation is one way to keep costs down. We might quite literally take this one up the ass if it becomes national policy.

Enjoy those govt provided "free" well baby check ups.

Don't bother with doc says NHS.

I make the rounds to various international newspapers and saw this advice in today's Telegraph on how to handle swine flu:

Official advice is stay at home and log on to the NHS Direct website, consult
the Swine Flu Information Line (08001 513 513) or your GP for advice by phone.

If swine flu is confirmed as a phone diagnosis, then
you will be given an authorisation voucher - this means someone who can act as
your 'flu friend' can collect it from your GP's surgery and take it to a chemist
to pick up Tamiflu (or the alternative anti-viral relenza, if you cannot take
Tamiflu, for example because you are pregnant).
'Avoid going to your GP surgery.There may be people in the waiting room with underlying health issues for whom swine flu could be very dangerous,' says Dr Baker.


Read more:
http://www.dailymail.co.uk/news/article-1199760/SWINE-FLU-Your-vital-questions-answered.html#ixzz0LQzM0YON

Is it even legal in the US to make diagnosis by phone? I have a low level UTI right now and I'm pretty sure I'm going to have to pay the $150 for the doctor visit that is required so that I can get the $4 cipro from WalMart. Just seems like there is a lot we could do to lower costs in the US without disrputing the lives of patients and the livelihoods of providers.

Govt should pay my bills so that I can have fun!

Tim Egan's opinion piece in the New York Times informs us that we wouldn't have to work in unfun jobs if it weren't for those pesky bills.

We all know somebody who is sticking with a lousy job because of the health care. Economists call this “job lock,” and it stifles entrepreneurship and mobility, among other things.

We may also know someone who has remained married to the wrong person for the same reason. Call this “marriage lock.”

http://egan.blogs.nytimes.com/2009/07/15/health-cares-historic-moment/

No worry about high taxes preventing financial independence, all this health coverage will be free or a "small increase in taxes." Once we get rid of those high salaried CEOs helath care will only cost $1 per member per month, don't you know?

Humira ceases to work?

Daily I've been getting more fatigue and more joint pain. Yesterday I felt aches and pains as if I had been beaten up and I wonder what the game plan is if the Humira stops working altogether. My usual modus operandi is to let everything get intolerably bad then call up the nurse at the office.

Meanwhile at the national level the health care coverage debate rages on and as a patient I have no idea what fate befalls me a few years from now.

An enlightened comment

Sometimes the comments are more interesting than the articles. This one is to a WSJ article:

In my opinion, we should go to a "single payer" model where people pay for their primary care, much the way you might pay for a haircut or an oil change. For more expensive procedures, people should pay for at least some of the cost. Eventually, comparison shopping and the sheer pressure of people choosing to die rather than be bankrupted will force the prices down to a more rational level once again.

I got $100,000 in the bank, but I think I'll choose to die rather than spend it on medical care. Is that what would motivate the "choice"? A single payer system isn't needed for this scheme. As it is there are a few people forgo insurance and die, doesn't bring costs down.