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Change is here!!!


HAOLE

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Don't insurance companies ALREADY make judgement calls about if they'll pay for certain surgeries that aren't necessary for survival? Aren't there lots of people RIGHT NOW hobbling around because their insurance company told them to get bent?

 

no, they don't. the surgeon makes the call. the insurance company decides how much they will pay you to do the surgery. the insurance company is at least assuming that the surgeon is not doing unnecessary surgery.

 

in canada, surgeons are limited as to the number of elective surgeries they can do. that's why there's such a long wait for an elective surgery. 'elective' can be anything from a knee replacement, to acl surgery in a young athlete, to a hernia repair, etc. etc. these surgeries greatly improve quality of life, but aren't absolutely necessary for survival. imagine tearing your acl, having your knee give out on you every other step, and then obamacare coming in and telling you there's a 2 year wait for your surgery--that's what happens in candida, and that's what's coming here.

 

some canadian total knee surgeons work 6 months in canada (fulfill their allowed quota of joint replacements), and then go to the US, or the caribbean and work the other 6 months there.

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no, they don't. the surgeon makes the call. the insurance company decides how much they will pay you to do the surgery. the insurance company is at least assuming that the surgeon is not doing unnecessary surgery.

 

in canada, surgeons are limited as to the number of elective surgeries they can do. that's why there's such a long wait for an elective surgery. 'elective' can be anything from a knee replacement, to acl surgery in a young athlete, to a hernia repair, etc. etc. these surgeries greatly improve quality of life, but aren't absolutely necessary for survival. imagine tearing your acl, having your knee give out on you every other step, and then obamacare coming in and telling you there's a 2 year wait for your surgery--that's what happens in candida, and that's what's coming here.

 

some canadian total knee surgeons work 6 months in canada (fulfill their allowed quota of joint replacements), and then go to the US, or the caribbean and work the other 6 months there.

 

So this guy here who's saying that his insurance company was trying to avoid paying for his ACL surgery is lying?

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So this guy here who's saying that his insurance company was trying to avoid paying for his ACL surgery is lying?

 

no, he's not lying. insurance companies play all kinds of games---they will send you a bill, and you have to argue with them to get them to pay--this happens all the time, its nothing new. tons of insurance companies will withhold payment to the surgeon until the surgeon's office nags them. even if its 20-30 days, the fact that the insurance company has kept that money for that extra time, and earned interest on it, is one way insurance companies make money

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I see. And is there anything in the new health care bill about quotas?

 

Of course not, but a federal mandate to own private insurance now somehow equals a socialized single payer system.

 

So Kirk, is it the system that was enacted you fear... or what you think it will lead to. (i.e. a single payer system)

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Of course not, but a federal mandate to own private insurance now somehow equals a socialized single payer system.

 

So Kirk, is it the system that was enacted you fear... or what you think it will lead to. (i.e. a single payer system)

 

i don't think there will ever be a single payer system. but keep in mind, i do surgery on patients with many different types of insurance, and some without insurance. every one of these companies pays different rates for the same work---medicare pays the least amount, and presumably the gov't plan would pay close to medicare. that means my office gets flooded with gov't plan patients, and i end up operating on less patients with favorable insurance. right now i operate on everyone who needs it without considering insurance, but it might not always be like that, which is a sad truth.

 

as far as quotas, who knows what will happen. my surgeries do not directly extend someone's lifespan, or save someone's life. so, financially speaking, the government could save tons on healthcare by puting a limit to how many of these surgeries i do. that's fine, people will be suffering so much, they will pay cash for the surgery---i won't suffer. but those unable to pay will suffer. the bottom line is that patient care will be compromised in the name of (trying) to save money---surely, the gov't will piss away any potential savings on making the system extremely inefficient

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So when you said, "that's what's coming here," you were lying? Exaggerating? Speculating?

 

Whatever you want to call it, it's not helping.

 

everything is speculative at this point, and that's part of the problem. i can guarantee you that the plan has no intention on paying specialists (like me) more. obama has specifically said he's looking to decrease the number of specialists, and their role in medicine, and increase primary prevention, eliminating the need for more specialized care---there's no speculation in that statement.

 

what he hasn't figured out is that people are not interested in primary prevention----people will not become healthier if they are given free insurance. it won't happen. people don't like going to the doctor, because they are told they're fat and unhealthy. so they wait until they're beyond primary prevention. that's what i've learned in over 10 years of seeing patients.

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Psst, the bill passed. If you're wondering what's in it, go look. No reason to speculate anymore.

 

psst, if you think that things will run and work out exactly as the bill outlines, you're retarded. until you see how the american public utilizes their new 'gift' you can't possibly begin to understand how this will impact the system as a whole. for every action there's a reaction, and we'll see how physicians react to being told what to do by the gov't.

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Psst, the bill passed. If you're wondering what's in it, go look. No reason to speculate anymore.

 

Did you read it? Did you understand it? I will assume the answer to both questions is no judging from your responses in this thread.

 

Come back and post once you have finished reading the bill. Then someone might care about what you have to say.

 

kthnxbye.

-Marc

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psst, if you think that things will run and work out exactly as the bill outlines, you're retarded. until you see how the american public utilizes their new 'gift' you can't possibly begin to understand how this will impact the system as a whole. for every action there's a reaction, and we'll see how physicians react to being told what to do by the gov't.

 

So you're saying it's fair to say that this bill will implement a quota system like Canada because we don't know how it will work out in practice? Even though the bill mentions nothing about quotas, can't possibly implement quotas (without a single payer system), and has nothing to do with Canada? Hashing out some details once this thing goes live is one thing, using that tiny bit of uncertainty to claim that Obama is going to tell me I can't have my ACL fixed is another. It's completely disingenuous.

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Did you read it? Did you understand it? I will assume the answer to both questions is no judging from your responses in this thread.

 

Come back and post once you have finished reading the bill. Then someone might care about what you have to say.

 

kthnxbye.

-Marc

 

All I know is what Fox News is telling me about it. I figure if anyone is going to find anything super alarming in there, it's them. Fortunately, I'm somewhat immune to fear-mongering.

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So you're saying it's fair to say that this bill will implement a quota system like Canada because we don't know how it will work out in practice? Even though the bill mentions nothing about quotas, can't possibly implement quotas (without a single payer system), and has nothing to do with Canada? Hashing out some details once this thing goes live is one thing, using that tiny bit of uncertainty to claim that Obama is going to tell me I can't have my ACL fixed is another. It's completely disingenuous.

 

if you have the gov't plan, the gov't will have some say in what you can and can't have----period. they don't need a single payer system to do that. right now different insurance companies cover completely different amounts for different things----

 

suppose you can't have a kid, and are looking at invitro fertilization. many insurance companies won't pay one bit of that---its not medically necessary for survival. some will cover the cost of medications, some will cover more than that. you don't need your acl to live a healthy life. if you want to play sports, be active, and run, that's a different story. if the gov't is paying for your surgery, they can tell you that you have to wait for them to cover it, or you'll have to pay out of pocket for this 'non-medically' necessary surgery. they'll save tons of money by you not having the surgery, you'll be miserable-but live.

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All I know is what Fox News is telling me about it. I figure if anyone is going to find anything super alarming in there, it's them. Fortunately, I'm somewhat immune to fear-mongering.

 

you'd be more concerned if it affected your livelihood.

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you'd be more concerned if it affected your livelihood.

 

No doubt. There's a difference between a surgeon having his bottom line affected by this bill and "Obama will get to decide whether or not you get your ACL surgery." If the pundits, talking heads, and loudmouths were out there talking about how bad this bill will be for doctors, I wouldn't have much input. But the shit that's being said is way out of line and is very far removed from "it affects my livelihood."

 

In fact, what it sounds like is that you have a vested interest in people hating this bill, and you're using exaggeration, speculation, and other deceitful statements to drum up support for your side.

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No doubt. There's a difference between a surgeon having his bottom line affected by this bill and "Obama will get to decide whether or not you get your ACL surgery." If the pundits, talking heads, and loudmouths were out there talking about how bad this bill will be for doctors, I wouldn't have much input. But the shit that's being said is way out of line and is very far removed from "it affects my livelihood."

 

In fact, what it sounds like is that you have a vested interest in people hating this bill, and you're using exaggeration, speculation, and other deceitful statements to drum up support for your side.

 

what part of "it won't affect every physician equally" don't you understand??

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All I know is what Fox News is telling me about it. I figure if anyone is going to find anything super alarming in there, it's them. Fortunately, I'm somewhat immune to fear-mongering.

 

What is this "Fox News" you speak of?

-Marc

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what he hasn't figured out is that people are not interested in primary prevention----people will not become healthier if they are given free insurance. it won't happen. people don't like going to the doctor, because they are told they're fat and unhealthy. so they wait until they're beyond primary prevention. that's what i've learned in over 10 years of seeing patients.

 

or they will go to the doctor as often as they can to treat everything under the sun without ever changing the habits that got them there to begin with....and the rest of us who actually do care for ourselves and pay our own way will end up paying the price for Johnny hillbilly and is overweight wife to continue to smoke and drink and eat McD's every day as they play video games and collect unemployment and disability. Fuck this bullshit....let Darwin take over.

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