Ok, that's it; nobody else move to Utah

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I personally don't know what the answer is reguarding the health care issue. I think it is a big quagmire without a simple solution, like a political thread.

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Well, for one it needs to be streamlined. Family doctor visits shouldn't be covered. Same with a trip to the ER for stitches once every five years. You KNOW you're going to go on average once a year (probably none some years and maybe two or three times on a bad year). So, why should you pay insurance for something you know you're going to pay for?

Insurance should be for catastrophes. You're supposed to purchase insurance for situations that you don't expect to occur, but can't handle by yourself if they do.

What we've essentially done is forced ourselves to pay the insurance companies a fee to see the family doctor, just so we can cover ourselves in case we need major surgery.

Insurance companies have a right to do this, it is a free market after all; but because of the regulation within the industry, the barriers of entry are so high, that competition is stifled and better plans aren't available.

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Originally Posted by shmerham

Well, for one it needs to be streamlined. Family doctor visits shouldn't be covered. Same with a trip to the ER for stitches once every five years. You KNOW you're going to go on average once a year (probably none some years and maybe two or three times on a bad year). So, why should you pay insurance for something you know you're going to pay for?

Insurance should be for catastrophes. You're supposed to purchase insurance for situations that you don't expect to occur, but can't handle by yourself if they do.

What we've essentially done is forced ourselves to pay the insurance companies a fee to see the family doctor, just so we can cover ourselves in case we need major surgery.

Insurance companies have a right to do this, it is a free market after all; but because of the regulation within the industry, the barriers of entry are so high, that competition is stifled and better plans aren't available.

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Totally agree Shmerm. Why the F can't I find any decent catastrophic care insurance (even with a high deductable)? I haven't been to anything more than the free clinic in 5 years and I feel fine.

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Originally Posted by Buzzworthy

I blame Bagtagley. He is now a Utarded one! Anyone got a job for him??

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Hey, 2 of us moved into a house that had 4 people living in it. So, the population decreased in Sugar House.

Also, most of my clothes are still boxed up. I've been wearing the same pair of pants and few shirts for over a week now, so I'm doing my part to conserve water. :D

Kiss Ass. Wash yer jeans....

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Originally Posted by mountainbored

I was thinking of Ogden, so that doesn't count right? :D

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Right, Ogden is a different country. Speak spanish?

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Originally Posted by Dexter Rutecki

If we had national health care costs for everyone would go down, and the only losers might be some doctors/administrators who wouldn't see the six and seven figure paychecks they currently do.

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Dex,

IMHO Docs need the salaries they get to pay the liability insurance premiums they have. The docs up here in the ER in little Logan, UT pay an average of 25 to 30 THOUSAND dollars a year for liability insurance. And they go to school for four years after college, and 3-4 years of residency, perhaps even a fellowship. They incur huge debt obtaining their education, so I think there salaries are justified. Reduce there pay to sub 100k/year and who is ever going to want to give there life up for med school, only to get paid shit and be struggling to pay student loans in excess of 100k.

Andministrators..........that's another issue. I'm with you on that.

The cost of health care is much more related to modern medicine than it is to salaries. New MRI's, new CT scanners, new monitors, all this is the price of our health care. We want the best, and we are paying for it.

This brings us to another quagmire, litigation. There are states that are hurting for OB/GYN docs because they can't afford to practice there because the litigation rates are so high and hence the malpractice insurance is unaffordable.

Remember John Edwards? Talk to him about his pursuits.

Not to mention many Docs work rediculous hours doing the noblest of work, they deserve lots of cash to throw around if that is what will help relieve the stress. I have no problem rewarding life savers like that.

I'm really tired of hearing about how hard it is for doctors to make a living because they have to pay something in the low five figures for malpractice. For a guy right out of residency who's making 250k+ (and will soon make much more), that argument just doesn't wash. There are MD's all over New York (and elsewhere) who are actually opting out of insurance altogether because they can make more money that way--I don't see many of these guys living in housing projects or driving cars that aren't new Range Rovers/Lexus type cars. And this pattern leaves even those with insurance with fewer choices.
I'm not arguing that doctors should be impoverished, just that they shouldn't see it as a right to make obscene amounts of money. We should pay for the schooling of doctors who specialize in needed fields, and give all med students a break on tuitions as long as they're not going to contribute to the explosion of health care costs (actually, I believe all higher education should be largely government financed). I don't think we need too many MD's who are primarily motivated by greed, anyway--and I don't think we'd lose too many med school students if doctors made more reasonable amounts of money. Most good doctors would still be doctors even if they didn't get rich doing it.
As for the whole damage awards question, I see that as another red-herring thrown out by GW and co. While there may be some ambulance chasers profiting excessively (like some MD's do), it's tough to say that people (and the families of those) who have been maimed or killed by malpractice shouldn't receive compensation. John Edwards' representation of malpractice victims is not what I see as a real cause of our health care crisis--it's the insurance companies and their pursuit of profit that's to blame.

If you were a doc, would you volunteer 25% of your salary to lower the cost of healthcare? I bet not.

Don't you think 25-30k a year in malpractice insurance is excessive? Cause it sure as hell is.

We agree on one point, insurance companies are crooks. That is for sure.

I would blame the cost of malpractice insurance on the insurance companies and sloppy doctors/hospitals etc., before blaming attorneys (maybe stupid juries can share some blame). As I said, compared to many doctors' salaries, I don't see that insurance costs are proportionately too much. If they were making 75k a year, that would be a different story.

Sloppy doctors, I have worked with docs for 9 years. Haven't seen a sloppy ER doc yet. Or IM, Pulm, Onc, etc. Perhaphs I haven't been doing it long enough. I'm sure they exist, but I haven't seen them yet.

It's like charging the snot out of a 25 year old male for his car insurance, even though he has a perfect driving record. He could screw up, but hasn't.

But remember, he IS a 25 year old male....

I can't personally say I've come across 'sloppy' doctors, but off the top of my head I can remember at least three times here in NYC during the past 5 years that I've heard reports of surgeons operating on the wrong limb--in one case amputating it (which of course meant the patient lost both legs). You think that person should have a damage award of less than 250k, or whatever the limit is supposed to be?

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Originally Posted by Dexter Rutecki

But remember, he IS a 25 year old male....

I can't personally say I've come across 'sloppy' doctors, but off the top of my head I can remember at least three times here in NYC during the past 5 years that I've heard reports of surgeons operating on the wrong limb--in one case amputating it (which of course meant the patient lost both legs). You think that person should have a damage award of less than 250k, or whatever the limit is supposed to be?

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Of course not, the patient should own the doctor as their personal bitch in that type of situation. I agree. But OR's have what is called a 'time out'. Right patient, right limb, right procedure, etc.

Atleast half of the tests we order in the ER are what we call 'cover your ass' orders. Even if it isn't medically necessary, we order them to cover our ass. This fear of litigation costs the patients, insurance companies, and ultimately the public, more money and higher costs of health care.

It's unfortunate that medicine is ultimately ruled by insurance providers (health and malpractice) and fear.

Good information on medical malpractice issues.

boy did this thread take a detour!


P.S. - John Edwards is the worlds biggest douche.

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Originally Posted by shamrockpow

Totally agree Shmerm. Why the F can't I find any decent catastrophic care insurance (even with a high deductable)? I haven't been to anything more than the free clinic in 5 years and I feel fine.

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When I was contracting, I looked into catastrophic insurance...something like a $5k deductible. It ended up costing almost as much as the Blue Cross Blue Shield HMO, so I went with that. I just didn't see the upside given the cost.

I know that nobody is reading this thread now except for a few people, but, regressing just a bit to the conversation about water rights........There is an extremely interesting book called CADILLAC DESERT by Marc Reisner which is a history of water in the West. It's more exciting than you can imagine and very well-written. Anybody that lives west of the Mississippi should check it out. It talks all about the schemes to bring water from Canada and Alaska down to the lush deserts of the American southwest.

The late 1800's were one of the wettest periods of the west, this coincided with the first large scale western expansion. This led many of the local Mexicans to believe that the white man brought the rain, and there were many whites who believed this as well. They believed that God would bring rain to the people as the population grew no matter where, this belief lead to more westward expansion and continues to this day.

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Originally Posted by Ireallyliketoski

The problem is the intelligent people that realize that overpopulation is the source of all the worlds ills take steps to have a small number of children, while the idiots who don't see the big picture have 10 kids.

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In some ways this is true. However, I don't think it;s intelligence as much as education and, probably being a little better off. In other words, if you are raised in a fairly good situation, you don;t want tto screw it up so you get an education, a good job, and then have kids, and are careful not to have too many because too many kids dilutes your personal resources and your quality of life. People raised in a bad situation don't feel like they have as much to lose and therefore don't worry about how many offspring they create.

I agree with whoever said that no one gets to tell you when you can and cannot reproduce, but I do think it is irresponsible of certain churches to encourage abundant reproduction in this day and age. Obviously their pro-reproduction ideas are from a time when the church was tryign to create more members. In today's world they need to realize that society needs fewer people.

That is obviously a problem for Utah. THe other problem is, of course, that it's a really nice place. I'm thinking about moving there myself.

Edit after reading the rest of the thread.

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Originally Posted by two_planks

Pardon my french, But who the fuck are you to tell people when they can and can't have a family? I know I would never have quailified to have a kid under your fuckwit plan. No drugs. But, I was unemployed and did not have a consitent emplyment history. I didn't mean that I was not ready for the responsibility and that I didn't buck up and do what had to be done immediatly after I found it (because I did). I just chose to live my life around different principles that making dough. So I never worked more than I had to becdause I wanted to spend my time skiing, climbing and doing other things I love. That doesn't give you the right to dictate my right to my daughter. It may not have happened under ideal circumstances, but I can honestly tell you that it is the best thing to ever happen in my life and if some fucking asshole who thinks he's better than every body else had been able to say I couldn't have her I'd be missing out on the greatest chapter of my life. I know maybe your clinic should also do a DNA check to make sure that there are no undesirable genetic "defects" that could possibly surface too, that way you can create a race of genetically superior people. It would be like Hitler without the killing.

FUCK YOU, YOU FUCKING FUCK

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Back to remedial reading comp for you. :nonono2: :nonono2: :rolleyes: :rolleyes: :nonono2: :rolleyes: :rolleyes:

here's a plan, read, digest; then smoke crack.

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Originally Posted by Bud Green

I know that nobody is reading this thread now except for a few people, but, regressing just a bit to the conversation about water rights........There is an extremely interesting book called CADILLAC DESERT by Marc Reisner which is a history of water in the West. It's more exciting than you can imagine and very well-written. Anybody that lives west of the Mississippi should check it out. It talks all about the schemes to bring water from Canada and Alaska down to the lush deserts of the American southwest.

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I'd also include books by Wallace Stegner, The man himself..Powell, Gary Snyder, Terry Tempest-Williams, and one other which the author slips my mind..Hell or High water..concerning water in the SW.

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Originally Posted by bagtagley

Hey, 2 of us moved into a house that had 4 people living in it. So, the population decreased in Sugar House.

Also, most of my clothes are still boxed up. I've been wearing the same pair of pants and few shirts for over a week now, so I'm doing my part to conserve water. :D

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OK you hick, you are not in WestByGodVirginia no more. Wash yer damn clothes!


I agree and disagree with all or some of you. That is my story and I am sticking with it.


Edit: and I would like to add that my parents have a yard full of rocks and cacti in Tucson. 50 feet out the back though is the 8th Tee Box for the REALLY GREEN 18 hole course. :rolleyes:


And where the hell does all the irrigation water go that flows down my damn street???

Here's what I would do with the health care issue:

The medical profession should not be socialized. If a doctor wants to do lipo and facelifts on aging LA society women, go ahead.

The government should provide for basic preventative and emergency care for all citizens. Routine physical? Covered. Routine dental exams, tooth cleaning, and fillings? Covered. Break a leg, burn yourself, blow a knee, car wreck? Covered. Vaccines, flu shots? Covered. Antibiotics and wound care? Covered. Childhood asthma and ear infections? Covered.

What the government can't afford to cover: end-of-life care, self-neglect, cosmetic, or elaborate/expensive treatments. Bypass surgery? Not covered. Need machines to breathe or pump your heart? Not covered. Stomach stapling? Not covered. Organ transplants? Not covered. And so on.

That does *NOT* mean doctors can't perform these operations, or that you can't purchase insurance covering them -- just that the *government* doesn't cover it.

This would be many times cheaper to administrate than the nightmare we have now, and improve the quality of most people's life tremendously.

I don't know, Spats, but I think what you propose would have the effect of leaving most people who need things like organ transplants and end of life care uninsured, as there would be few insurers charging reasonable premiums for care that was limited to the most expensive treatments. Favoring government coverage of blown knees over organ transplants? Doesn't sound right to me.

I'm with spats on this one - have been for years.
If I actually tought the govt could do a basic insurance plan without it growing to ridiculous bloated coverage and cost I would be more in favor.

With basic coverage included, insurers could charge $25 a month for the extreme organ transplants, etc (assuming of course that enough people are paying into that insurance pool). What makes insurance so expensive are the regular checkups, visits, prescriptions, treatments, etc. for the average guy with a medical condition.

Now the real question is do you still have a Medicaid or provider of last resort government program??
If so, then the insurance program will only be used by folks with enough money. Any normal schmo will realize that if he needs a kidney, all he has to do is give/spend all his money to become poor, and Medicaid will take care of him.
OTOH, to not have Medicaid leaves a world of images of sick and dying elderly and poor organ failures without insurance. Any politician would immediately fund a new program to take care of these folks. So I think you do have Medicaid also.

So now, the only point of a "basic national health care plan" is to have cost savings from 1) efficiency (one provider versus thousands of insurance cos) and 2) preventive care (e.g. seeing the doc earlier at the first symptom versus waiting for the tumor to grow cause you cant afford the office visit and xray expense).
I dont know how much money would be saved by #2, but #1 is questionable if this is a govt program. US Govt is never more efficient than private sector.
Maybe if this were a program run by a private co chosen as the low bidder? Even so, with the govt writing the rules and regulations and doing the oversight, it would still be a fiasco.



Insurance is totally screwed no matter how you look at it.

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Originally Posted by Core Shot

I dont know how much money would be saved by #2, but #1 is questionable if this is a govt program. US Govt is never more efficient than private sector.
Maybe if this were a program run by a private co chosen as the low bidder? Even so, with the govt writing the rules and regulations and doing the oversight, it would still be a fiasco.



Insurance is totally screwed no matter how you look at it.

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Yesterday's Paul Krugman column:

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Passing the Buck
By PAUL KRUGMAN

The United States spends far more on health care than other advanced countries. Yet we don't appear to receive more medical services. And we have lower life-expectancy and higher infant-mortality rates than countries that spend less than half as much per person. How do we do it?

An important part of the answer is that much of our health care spending is devoted to passing the buck: trying to get someone else to pay the bills.

According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs, which consist mainly of Medicare and Medicaid. The numbers for both public and private insurance are similar in other countries - but because we rely much more heavily than anyone else on private insurance, our total administrative costs are much higher.

According to the health organization, the higher costs of private insurers are "mainly due to the extensive bureaucracy required to assess risk, rate premiums, design benefit packages and review, pay or refuse claims." Public insurance plans have far less bureaucracy because they don't try to screen out high-risk clients or charge them higher fees.

And the costs directly incurred by insurers are only half the story. Doctors "must hire office personnel just to deal with the insurance companies," Dr. Atul Gawande, a practicing physician, wrote in The New Yorker. "A well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That's how a doctor makes money. ... It's a war with insurance, every step of the way."

Isn't competition supposed to make the private sector more efficient than the public sector? Well, as the World Health Organization put it in a discussion of Western Europe, private insurers generally don't compete by delivering care at lower cost. Instead, they "compete on the basis of risk selection" - that is, by turning away people who are likely to have high medical bills and by refusing or delaying any payment they can.

Yet the cost of providing medical care to those denied private insurance doesn't go away. If individuals are poor, or if medical expenses impoverish them, they are covered by Medicaid. Otherwise, they pay out of pocket or rely on the charity of public hospitals.

So we've created a vast and hugely expensive insurance bureaucracy that accomplishes nothing. The resources spent by private insurers don't reduce overall costs; they simply shift those costs to other people and institutions. It's perverse but true that this system, which insures only 85 percent of the population, costs much more than we would pay for a system that covered everyone.

And the costs go beyond wasted money.

First, in the U.S. system, medical costs act as a tax on employment. For example, General Motors is losing money on every car it makes because of the burden of health care costs. As a result, it may be forced to lay off thousands of workers, or may even go out of business. Yet the insurance premiums saved by firing workers are no saving at all to society as a whole: somebody still ends up paying the bills.

Second, Americans without insurance eventually receive medical care - but the operative word is "eventually." According to Kaiser Family Foundation data, the uninsured are about three times as likely as the insured to postpone seeking care, fail to get needed care, leave prescriptions unfilled or skip recommended treatment. And many end up disabled - or die - because of these delays.

Think about how crazy all of this is. At a rough guess, between two million and three million Americans are employed by insurers and health care providers not to deliver health care, but to pass the buck for that care to someone else. And the result of all their exertions is to make the nation poorer and sicker.

Why do we put up with such an expensive, counterproductive health care system? Vested interests play an important role. But we also suffer from ideological blinders: decades of indoctrination in the virtues of market competition and the evils of big government have left many Americans unable to comprehend the idea that sometimes competition is the problem, not the solution.

In the next column in this series, I'll talk about how ideology leads to "reforms" that make things worse.

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Say what you want about Krugman, but he was an excellent economist at one time and this column does not go too far into his foaming at the mouth attacks on GWB and co.

Nice find shamrockpow! Good read.

The depth of this issue is staggering.

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Originally Posted by Trackhead

Good information on medical malpractice issues.

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If you believe this is a credible source, I'm not sure how you believe insurance companies are crooks. It (and all their other med mal material) clearly states that insurance companies have left the industry because of poor performance. If it were such a scam, wouldn't more companies be doing just the opposite - - flooding in? Since 2000, insurance companies have been paying in excess of $1 for every dollar of med mal premium they have collected. Do the math and you'll quickly see why more companies have left and and the few that have stayed have increased their premiums.

I know we all like to think of the big bad insurance companies, but in this case, that's an excuse. What is the cause? I'll give you a hint - - it starts w/ a C and ends with an M.

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Originally Posted by shamrockpow

Totally agree Shmerm. Why the F can't I find any decent catastrophic care insurance (even with a high deductable)? I haven't been to anything more than the free clinic in 5 years and I feel fine.

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Check Kristen's post in this thread, she's paying $35 a month w/ a $1k deductible. Don't know much about the coverage, but it's a place to start:
http://www.tetongravity.com/forums/s...ad.php?t=28988

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Posted by Followme:
Do the math and you'll quickly see why more companies have left and and the few that have stayed have increased their premiums.

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EXACTLY! I never said malpractice insurance providers were making money. My point was that their increase in premiums is affecting and dictating your health care. The premiums are rising because of our litigious society.

First hand info on malpractice prices for a PA and a Doc in our ER.

PA yearly premium:$5,000, raising $1500 dollars per year.
Doc:$30,000 this year, $35,000 next year.

We just had a class put on my malpractice insurance providers. When a complaint is filed, they typically just fork out $50,000 dollars to the plaintiff to avoid having to go to court, etc. Like a pacifier. And this is about illegit complaints, not wrongful amputations of limbs.

If you don't think expensive malpractice insurance premiums is affecting your health care costs, your mistaken. I see this every day at work. Every day.

When you go to the doctor, you are being treated by a lawyer and an insurance company, not an MD. How does that make you feel? The doctor is just a puppet for the attorney/insurance company behind the scene.

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Originally Posted by Trackhead

When you go to the doctor, you are being treated by a lawyer and an insurance company, not an MD. How does that make you feel? The doctor is just a puppet for the attorney/insurance company behind the scene.

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I think that is a really scary thought. And, I think that's why you pick one primary care providor and stick w/ him/her over the long term to develop a trustworthy relationship that would alow you and the doc to throw all the BS out the window and get back to the issue at hand - - your health. There is some sort of misconception out there that doctors are perfect. We as patients have to accept that there are inherant risks involved w/ medical treatment. In some cases there has to be some moral high ground to be taken by the patient and/or family if a mistake is made by a doctor. Wouldn't that be refreshing (although highly unlikely)?

I love it -- a thread SLC's population ballooning has turned into a debate about health care.

I think in the Primary care side of practice, there is good honesty, etc.

But I have to be honest, in the ER up here in Logan, we order tests and do procedures that are in some part "cover your ass" and part because the doc can bill for them.

At Cottonwood ER in SLC where I use to work, the doctors starting doing splint application and not having the other staff do them. They said that way they could bill it as a doc procedure. Guess what, we still put them on in most cases, they just billed that they put them on. They didn't want to be tied up with the time it takes to put them on. But they wanted the bucks for it.

Like when an ER bills that a nurse did the blood draw, vs. the tech. You can bill more for when a nurse does it vs. the tech.

Quagmire.

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Originally Posted by 13

I love it -- a thread SLC's population ballooning has turned into a debate about health care.

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Seems to happen in 50% of the threads. They go to shit quickly.

Maybe it happened in this thread because health care costs are more easily discussed than ethical issues concerning limiting population growth.

TH -- I've been around long enough to expect this sort of thing to happen.

I was making an amusing observation -- better to debate health care instead of debate how to kill 'em all off, eh? ;)

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Originally Posted by 13

TH -- I've been around long enough to expect this sort of thing to happen.

I was making an amusing observation -- better to debate health care instead of debate how to kill 'em all off, eh? ;)

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It's more fun to talk about killing 'em off though. Beaurcratic issues are stale by nature. :rolleyes2

Ok, since we're off topic, how about this tidbit from the news today?

LEWD BEHAVIOR -- A 20-year-old Orem resident was cited for lewdness around 6 p.m. Thursday after wearing thong underwear with a pair of jeans with the rear end cut out on State Street in Orem, according to police. The man was stopped at 50 S. State by an officer and cited for lewdness after passersby called police.

He was then given a trash bag to cover himself until he got home. However, he refused to wear bag and asked the officer to give him a ride. The officer declined on the basis of having just cleaned the seats in his car and called for a ride for the man instead. The officer then instructed the young man that he was to stay seated on the ground until his ride arrived or the officer would arrest the man for lewdness and book him into jail. The man apparently complied.

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Originally Posted by Red Baron

Ok, since we're off topic, how about this tidbit from the news today?

LEWD BEHAVIOR -- A 20-year-old Orem resident was cited for lewdness around 6 p.m. Thursday after wearing thong underwear with a pair of jeans with the rear end cut out on State Street in Orem, according to police. The man was stopped at 50 S. State by an officer and cited for lewdness after passersby called police.

He was then given a trash bag to cover himself until he got home. However, he refused to wear bag and asked the officer to give him a ride. The officer declined on the basis of having just cleaned the seats in his car and called for a ride for the man instead. The officer then instructed the young man that he was to stay seated on the ground until his ride arrived or the officer would arrest the man for lewdness and book him into jail. The man apparently complied.

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Disgusting. But much more entertaining.

Your state frightens me. that is the only thing preventing me from moving there.

perhaps the Nazi police are part of the plan to keep no new people from moving to Yew-tahhh