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September 6, 2008 at 10:17:57
Modification of Medicare to give Universal Healthcare by Mark Green Page 1 of 1 page(s) |
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Rational Health Care Reform I believe Medicare can be expanded and improved and can serve as a base for the development of a universal healthcare system for the United Stated. Please consider the following. The first step in health care reform is to issue to every person 65 years and older a unique healthcare ID number that is not their social security number. Except for the unique ID number, all cards would be identical and independent of financial status. Including those issued to Congress, etc. Then improve Medicare to make it an adequate product. Start by making a Medicare sponsored "Medicare Supplement"- available directly from Medicare for those current Medicare patients who want a supplement as part of their plan. Not everyone will want to pay for full coverage. Alternately, the supplement could just be rolled into the basic Medicare plan available to everyone. A Medicare Part D drug benefit would be part of the standard offering. Then to dismantle all of the Medicare Advantage plans and roll their existing patients back into Medicare, as expanded above. Fees currently being paid into those plans would be scrutinized for fairness, adjusted as needed, and paid directly into Medicare. Standard fees would have to be reasonable for everyone, though there will need to be a declining "co-pay"- schedule for those in lower economic classes. With this in mind, however, everyone needs to have to pay something to help them feel vested in the system and to help prevent over-utilization. In the process, we need to ensure we have the infrastructure in place to handle the increasing administrative load. This might be a way to utilize some of the existing claims processing capacity of the current private plans, allowing many of their employees to transition into Medicare based employment, as opposed to losing their jobs as the private market contracts. 
The next step is to organize the second most expensive segment of society, one that is in large part supported by a huge and inefficient patchwork of governmental agencies and programs, as well as private insurance. All persons under age 18 would be enrolled into the Medicare plan as expanded above. Each enrollee would have benefits specific for them, as opposed to being a member of a "family plan". Monies currently utilized for the current coverage could be consolidated and used to defer the cost of the new system. Costs would be further reduced by establishment of a reasonable resource based premium assessed to all. These monies would be collected from the parents or guardians, much as their current insurance premiums are at present. Again, time would be allowed for the consolidation of the infrastructure required to run the system.
Once the two most expensive age groups above are fully incorporated, we could then incorporate the remaining, and more "profitable" age groups into this expanded Medicare plan. Perhaps starting at age 64 and working backward till all are incorporated. The speed of this enrollment would only be limited by the expansion of the required infrastructure. As each age group is enrolled, they would begin paying their health care premiums directly into Medicare, as mentioned above.
One of the many downfalls of the current system is the inability of persons with heath risks to obtain insurance. Accordingly, premiums would be built on a much more rational consideration. A child born with a defect or an adult who develops leukemia have done nothing wrong and should not be penalized for the rest of their lives by doing without health insurance or by paying exorbitant rates for it. Accordingly, premiums would be established by age and would be independent of uncontrollable risks, as exampled above. We could elect to modify premiums upward in relation to controllable risks. Examples would be smoking, excessive alcohol use, and obesity. We could also consider charging some amount extra to persons for medical noncompliance. Examples are in not controlling their blood sugars, blood pressures, or cholesterol. These extra amounts need not be excessive. It is likely that many patients could be steered toward improving their health simply by getting their premium statement each month showing their basic premium and optional supplement plus the extra assessments for their controllable risks that are not currently controlled, each itemized with the related small extra charge. Those 65 and over would be assessed a flat age related rate modified as above for controllable risk factors. Correspondingly, we could consider reducing the premiums some amount for those people who successfully control their risks. Obviously, the monies need to be fully evaluated before the exact possibilities can be determined.
Provisions will have to be made for the collection of monies due to be paid to the Medicare system, such as premium payments. Industries/corporations currently play a role in supplying health care and they still would in the new system. Industry would benefit from controlled costs and protection from rampant heath care inflation. Payments for individual premiums would have to be collected. These payments could be deducted from payroll checks, as is currently done for persons who get their health insurance through work. For persons getting their support from the government, insurance premiums could be deducted directly from their checks as well. Self employed persons could pay monthly or have their premiums added to their income tax indebtedness. No matter what payment arrangements we try to make, there will always be people who show up needing health care, but who have sidestepped the system. These people will have to have care and access will have to be available. Additionally, foreign visitors would have to be covered. Their healthcare number could be printed on their visa, or similar ID.
This type of approach would allow a step-wise implementation. Funding and infrastructure would have time to grow and would avoid the calamity of whole country implementation of an all or nothing approach.Any laws that need to be changed to accommodate this reform can be passed through congress. There are, of course, many aspects and possibilities that need to be fleshed out as the current legal restrictions reveal themselves. It will be up to the American voter to force our elected officials to do what is right, and to enact any legislation that needs to be in place to see is done.
Mark Green
6Sept2008
OurHealthReform.com
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| 24 comments |
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Mostly Agree, mostly...
I am sure you are aware of the fraud perpetrated by the Bush administation in inacting the Medicare Part D fiasco. The stated goal was to ensure that drugs for the elderly would be made available. Well they're available alright, at about three times what they were prior to Part D. Part D has become a Party for the huge pharmaceutical companies. So, we need to renegotiate with the pharmaceutical companies and slash and burn Part D... in my opinion. Then you wrote, "... Accordingly, premiums would be established by age and would be independent of uncontrollable risks..." "...We could elect to modify premiums upward in relation to controllable risks. Examples would be smoking, excessive alcohol use, and obesity. We could also consider charging some amount extra to persons for medical noncompliance..." I got to tell you, I like this part. But you went on to suggest that the fee increase might be sufficient to modify behavior. While I agree that it will be a factor, I have to point out that insurance companies already charge more for smokers, overweight people or Democrats. These extra fees have probably made some people modify their behavior but by and large the greatest influence on behavior has been social pressures. When it comes to obesity we have an immense, I mean huge, er... I mean great problem heaped on us by the fast food industry as well a concomittant reduction in physical exercise in our schools. Could there be something included in a reworking of MediCare for all that reduces fees or provides extra benefits to those who demonstrate a reduction in visits to The Crap Shack or The Cholesterol Bullet? What encouragement could be legislated for those who adopt an exercise program? Could personal trainers be subsidized by medicare for the morbidly obese? Should schools PE programs be subsidized by MediCare? Could Cheney buy his own private health insurance and reduce the loss to the federal deficit? Just a thought. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Saturday, Sep 6, 2008 at 12:27:32 PM  (0+)
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Reply: Cheneys' Health Premium and Other Issues
InsuranceTease, Part D, as it was enacted, is very expensive, industry protecting, and grandstanding joke of a plan. The politics was to get something out there to shore up the political façade of the administration and its supporters. So as not to anger the pharmaceutical industry, no price reductions could be negotiated for 5 years. Knowing that the cost of the program could not be supported, they concocted the “doughnut hole”. What a joke! My mention of part D was only to address the need for a medication plan. I probably need to change the wording. Modifying human behavior is a challenge. When an extra charge for a service is buried or concealed in contract small print, I feel it is simply forgotten. In any event, most people functionally ignore it. I am hoping that a small extra premium charged to them directly each month, on the premium statement, and therefore in their face, would at least keep it in their mind. When contracting, I keep my liberal views hidden, and am sure I’ve saved a ton. Probably better than shopping at Geico. I wonder if it would be possible to set a standard “nutrition to calorie” ratio and to require restaurants to make a contribution the health fund for each serving sold of products exceeding that number. It is certainly reasonable to require the posting of nutritional information in each restaurant. Do you think we could put a scales in the seat of each chair and an eject function that would automatically activate if…..I guess not. I thought the increase in the national debt in the last 7 years was due to Cheney’s health insurance. I will give things more thought. Mark Green 6Sept2008 by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Saturday, Sep 6, 2008 at 9:26:22 PM (0+)
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Expanding Medicare has been proposed
Expanding Medicare and creating an equitable health care system is possible - funding the program in a fair and equitable way is the problem. HR676 the Single Payer initiative is probably the best solution to our nations health care woes. Unfortunately, tell that to our politicians that all receive money from the Big Pharma lobbyists and the Health Insurance Industry. They have a Cash Cow - and it's OUR money. Of course once a system is "privatized" like our health insurance, pharmaceutical companies and Hospitals then you're battling entrenched wealthy status quo organizations that have the power and ability to lobby the people's representatives 24/7/365. And they do it with our money. We pay these overly inflated premiums and in return we get some of the highest priced lack of health care of any industrialized nation. The facts and the statistics are there for anyone to search. We have allowed these companies to become legal monopolies - check out United Health Care and Wellpoint, Inc. They are bigger than General Motors and they are somehow counted in our GNP (can't export health care) so if it were factored correctly, our GNP would be showing year over year declines. (Instead of the "modest" growth those in power continue to claim). Big Pharma slaps a few million in research where the people through the NIH and the University system have spent 100's of millions and they are entitled to patent protection. That needs to be overhauled as well. If it's 90/10 public private financing, then the patent rights should go to the people, not the private corporations. Why do the people have to bear the expenses and the corporations get to reap the profits? We need to keep growing the national movement for health care for all and a single payer system and keep eroding the entrenched power base - but that takes long term sustained grassroots growth until their is a national movement that does not give up. The health care reforms being proposed by the current selected candidates are both awful. Big Pharma stays. Insurance actually grows stronger - with everyone required to participate. Our current health care system has so many inequities it is riduculous. The largest employers opt out by becoming self insured shifting the expense and a competitive disadvantage to smaller employers. Insurance companies cherry pick healthy people and do not insure those with a phone book long list of "pre-existing" conditions. Those that are the most expensive, serious injuries and life long disabilities are shifted to public programs. Insurance companies are in the business of collecting premiums, not paying out claims. Every part of the current insurance formula is wrong. Allowing the insurance industry to continue to collect premiums off the healthy, while excluding the sick, should be ended permanently. by August Adams (11 articles, 0 quicklinks, 1 diaries, 585 comments [12 recommended, 0 rejected]) on Saturday, Sep 6, 2008 at 6:37:22 PM (0+)
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Reply: Medicare metamorphosis and Funding
Mr. Adams, Thank you, and excellent synopsis of insurance and healthcare. It is an embarrassing joke of a system, and I’ve been in it and frustrated by it for 26 years. No matter how much universal healthcare will cost, there is enough money currently being spent to fund it. This money comes from personal premiums, corporate contributions, government programs, and cost shifting of the uninsured costs to the insured. This funding is reduced by excessive fees by some providers, waste, fraud, legal industry fees, the cost of defensive medicine (astronomical), the cost of the hopelessly redundant systems and functions across the industry, and especially the loss of the “profit” pillaged from the system by the “for profit” systems. If we could do the following, I believe we can fund universal coverage. 1. Establish a one payer system to allow use of one information system so as to could track waste and fraud across all suppliers and providers. 2. Free healthcare from the malpractice legal insult by the establishment of 3 member arbitration panels, as I have discussed elsewhere, thereby allowing the true practice of clinical medicine. 3. Dispense with the cost of all of the “compliance lawyers” by having one system with one set of rules and regulations. 4. Completely ditch the “for profit” insurance industry allowing the recapture of the monies meant to go to patient care in the first place. 5. Review provider fees to ensure they are appropriate for the work done (currently a very lopsided affair). 6. Encourage patient compliance. 7. Discourage over utilization 8. Establish programs to teach health in the schools and to encourage adults to live healthy lives. 9. Preserving and consolidating most of the current funding sources, though establishing premiums at scalable affordable rates, and then using general tax monies as needed. I personally do not feel we have the resources to fund everything from tax money without HUGE tax increases for everyone. Also, we need a system that can perfect itself in a set population segment (as with 65 and older), then expand incrementally to avoid dumping a huge, new, and unperfected program on the taxpayers. Fortunately, Medicare is in place, and though imperfect, is a very reasonable platform on which to build. Starting from scratch would be a huge undertaking (discussed further elsewhere). There is a brighter future in relation to drug costs. Patents have run out on many excellent medications and are running out on many more. Though many important drugs are yet to go generic, I can now manage a great deal of my patients perfectly well on inexpensive generic medications. A little reform of the pharmaceutical industry would help as well. My hope, Mr. Adams, is to collaborate as citizens and to pen a bill for universal healthcare that is as near perfect and fundable as possible, and to mobilize enough voters to MAKE congress pass it as “We the People” see fit. I agree that our legislators are too lobbied and too protectionist of themselves and their friends to enact meaningful legislation on their own. Ideas and suggestions? Most Sincerely, Mark Green 6Sept2008 OurhealthReform.com PS i may post this as an artical, depending on comments by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Saturday, Sep 6, 2008 at 10:45:47 PM (0+)
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Speachless
Dear August, With an attitude like that you should pay a visit our URL. HINT... its my name. Okay, so I'm not good at subtle. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Saturday, Sep 6, 2008 at 9:02:05 PM (0+)
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Reply: OK, So I got there
Let's see, Tired, sleepy, inattentive, fumble-fingered, exc. In any event , I typed it right. Nice site and tees. Mark Green by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Saturday, Sep 6, 2008 at 10:56:24 PM (0+)
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Taxation = theft
Remember that the government cannot “give” anything that is has not first stolen. by M. Bennett (0 articles, 0 quicklinks, 0 diaries, 109 comments [7 recommended, 0 rejected]) on Sunday, Sep 7, 2008 at 12:44:03 PM (0+)
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Reply: Taxes as theft
Well I'v got to give it to you there Mr. Bennet. According to some people in the know our federal income tax is an illegal tax because it is not an apportioned tax. However, that arguement aside, any taxes taken from ones income for MediCare For All (AKA HR 676) would be an apportioned tax, and therefore legal. Not stealing. Now if you want to discuss whether the 16th amendment was properly ratified or not please take that discussion to the proper forum. I believe you will find them three dooors down on the right, just passed the cool aid stand. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Sunday, Sep 7, 2008 at 1:09:37 PM (0+)
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Reply: Taxes and Healthcare
Dear Mr. Bennett, My biggest issue with taxes is they are disproportionate assessed and then needlessly and wastefully spent. That aside, I’m not sure how you can have a community of any size without them. I am trying to find a way to set up universal healthcare without over taxation, but at the same time, affordably available to all. Please help us come up with a way to do this, and join in the crafting of a suitable bill and with the mobilization of the voters to make it happen. Sincerely, Mark Green OurHealthReform.com 6Sept2008 by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Sunday, Sep 7, 2008 at 3:26:36 PM (0+)
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Reply: Re: Mr. Bennett
Mark, Aren't you the politically correct one. Better you than me. ;-) by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Sunday, Sep 7, 2008 at 4:41:09 PM (0+)
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Reply: Surprise
Dear Tease, Consensus building, you know. Ever Onward, Mark by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Sunday, Sep 7, 2008 at 7:38:16 PM (0+)
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yet another one....
Yet another siren song....ever so sweetly articulated...for government control and managment of the ART and SCIENCE of medicine. Socialism has destroyed most of the world....private property, individual responsibility selfgovernment and the LEGAL FRAMEWORK required to maintain that has either been erased, not allowed to exist or redefined in a majoritarian guilttrip Marxian class warfare mantra quite ablely exhibited by this article. Government CONTROL of the means of production...as well as government CONTROL of art, science and individual livelihood has been the goal of megalomaniacs and tyrants for centuries....look at the 20th Century. The installation of DEMOCRACY ie majoritarian rule ON THE BLEEDING AND KICKED AND WOUNDED America with its REPUBLICAN FORM OF GOVERNMENT is the goal of the same sundry list of schemers.....for over a hundred years....the centralization of decision, power and authority with the Federal Government along with the economic and cultural leveling by the 2 sided coin of fiat currency and income tax and the FedGov takeover of education...ALL DIRECTLY used to torpedo our form of government. The Ministry of Health HHS in DC.......an Orwellian nitemare of unelected bureaucrats backed by administrative law and the club of government...in addition to the largess of the government created BioChem monopolies... to the detriment of all of us and our freedom. Calls for government takeover of insurance and "management" of providers is glossed over Mussolini...takeover and regimentation. When socialism in England captured healthcare in '47 doctors who refused to be government employees fled in droves.....today you have 2 year waiting lists to be seen for a foot ailment....and in proposed ROLEMODEL Canada!?!?! there are more MRI machines in the CITY of Detroit than in the ENTIRE SOCIALIST NATION of Canada...good role model. Calls for government takeover of health is unfortunatley bipartisan. Other than Ron Paul, the rest of the shills for government/Biochem lobby candidates all sold the wares of state intervention of the health industry quite effectively. The voters are waiting for the "bread" of "free" health care and the 'circuses" of more stimulus checks...and now football.... How much longer can the Ship of State America stay afloat? your guess is not as good as mine. by Chris Bieber (1 articles, 0 quicklinks, 0 diaries, 69 comments [2 recommended, 0 rejected]) on Sunday, Sep 7, 2008 at 6:01:27 PM (0+)
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Reply: What Else Can We Do?
Dear Mr. Bieber, I appreciate your perspective, though I am now sure I have made you aware of what I really want to happen. First I offer a few observations. What I want, Mr. Bieber, is for you, me, and many others to refine a universal healthcare bill and to force our do-nothing congress to stop bickering and pass the damn thing. We can build a single payer plan and make the administrators accountable to the people. The slate is nearly blank at this point and we can build it any way that makes sense, is effective, and that can be paid for. Please respond to this. All criticism is welcome. Respectfully, Mark Green OurHealthReform.com by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Sunday, Sep 7, 2008 at 7:43:23 PM (0+)
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Chris Bieber
Dear Chris, I understand your fears. You don't understand reality. The FACTS are that some form of universal health care system is used by every industrialized county and all but the good ol' U.S. of A. has better health statistics, lower cost for health care and a slimmer populace, (though the export of our fast food frenzy is fixing that). You are stuck in the idea of the cold war, where every concept that is not capitalistic is evil and wrong. Well then, let's do away with our socialist fire department, police station, and libraries. I want you to know that we at InsuranceteaseDOTcom do not believe that socialism is the way to go in every aspect of economics. But, as it has been demonstrated in over 36 other countries, it is THE way to go for health care. Besides I like the color red. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Sunday, Sep 7, 2008 at 10:46:48 PM (0+)
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Universal Healthcare
Mark, I am fascinated that you have put so much thought and good work into this health care plan. Although I think that holding restaurants responsible for calorie counts (other than publishing them) is slightly over complicating things, I very much like the way you have things laid out. The idea of no family plans but that everyone would have an account and would pay a co-pay I think is great. It would help to promote responsibility and ownership. American industry, although they would still have to contribute, would be in a much more advantageous position in regard to global competition. I hope that you can get this plan to people who are in a position to carry it forward because it would clearly help the U.S. join the other advanced nations of the world in the 21st Century. A free market economy is not suited to the delivery of every essential service that should be provided and that would include health care, defense and other strategic services or essentials. by Bryan Emmel (0 articles, 0 quicklinks, 0 diaries, 418 comments [32 recommended, 0 rejected]) on Monday, Sep 8, 2008 at 3:28:53 AM (0+)
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Reply: Free Market Economy
Dear Bryan, I couldn't agree with you more. To quote you; "...A free market economy is not suited to the delivery of every essential service that should be provided and that would include health care, defense and other strategic services or essentials." The reason I believe that health care, or more specifically, health insurance does not lend itself to a free market economy is in the fact that we as consumers do not have a way to judge the product. The product is often foisted on us by employers, or some representative who shows us a bunch of health care options. These options always leave something out when they include another. You never get a complete package, unless you are willing to pay through the nose. So in being made to choose some "plan to meet your needs" you are in fact being made to guess at what form of health care you will need in the future, and you can't know. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Monday, Sep 8, 2008 at 5:48:53 PM (0+)
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Reply: Insurers Bag of Tricks.
InsuranceTease, Correct again. There is a reason that there are so many difference insurance plans, rates and premiums. They cleverly word the coverage and rates, coupled with this drug plan or that co-pay all to one end; to confuse the buyer. Their resellers pretend it all makes sense in order to convince the shopper of what “they need”. It’s up to him to give them a fair shake. He only makes money if he sells the policy. . . The policies and plans are so confusing that there is no way an average person can compare them one to the other. It’s smoke and mirrors. Agree also, healthcare delivery is not appropriate for free market profiteering. Mark Green 8Sept2008 by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Monday, Sep 8, 2008 at 8:31:25 PM (0+)
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Reply: Thanks and Agree
Dear Bryan, Thank you for the pat on the back. Who knows what the right answer is, but I want each of us to evaluate the options and to help push reform as hard as possible. I have lived inside the system long enough to be thoroughly disgusted on the one hand, and thoroughly enthusiastic for the potential, on the other. Yah, we were kind of horsing around on the restaurant tax thing. I have written so many things in so many places that it is hard to keep up with what I have put where. Fundable reform will require maintaining many of the current funding streams, and that includes employee contributions. I believe it would be a mistake to dump it all on the tax base (some folks completely sidestep the tax system, believe it or not) or to completely turn it into an entitlement program. Americans do well with a level of personal responsibility. I want the average American to have a feeling of ownership of the system, and not to take it for granted. In any event, reallocating the contributions coming from the current funding streams would allow a quicker start for the program. That is if we can get Congress off their collective arses. We do not need a government run system, and could set it up like FannieMae. Sorry, bad choice, though if we screwed it up we could get a bail out. In any event, I do not favor socializing the system. Help as you can and I look forward to hearing from you. Sincerely, Mark Green Sept2008 OurHealthReform.com by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Monday, Sep 8, 2008 at 6:30:26 PM (0+)
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People taking ownership.
I've got to tell you, this is the one place I'm not so sure I agree with you, Mark. I mean, you expect people to feel that because they pay some trivial amount for an office visist that this will engender some sense of ownership to the new American health care system? I don't buy it. People pay for car insurance and feel nothing more than irritated, and people pay for health insurance now and feel only outrage. I don't see the difference. But on the other hand IFF (from algebra meaning "If and ONLY if") the new system is actually revolutionary will they WANT to feel that they are a part of it. A sense that their health care system is something to be proud of will create that feeling without the need to pry their money fom them any more than is done through taxes. Just Ask the French. People take ownership because of pride, not because they were charged for something. PS. Nice curtains. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Monday, Sep 8, 2008 at 10:25:15 PM (0+)
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Reply: Co-pays and Ownerships
Dear ITease, Sorry to take so long. I had my guitar lesson last night. Not sure it helped. It is hard to say what would motivate any one person and I can only tell your what I have observed in my practice. I have a good practice with a good mix of payers, including non-payers and TennCare / Medicaid. Of the uninsured, the people that seem the most vested in my practice are the ones I charge at least 10-20 dollars. If I see them for free they seem to feel they are imposing on me or the staff when they need something. On the other hand, that small charge seems to make them feel they are a part of the practice and not taking charity. Obviously the 10-20 dollars is not much to the practice, but it seems to mean a measure of respectability for them. Similarly, patients whose insurance requires no co-pay, call for everything. No matter how small a problem it is. Tests are no object and seem to think nothing of asking for a $3000 MRI series “just to be sure”. There may be other ways to get the desired effects and I am open to suggestions. I still want to avoid the likelihood of a huge expansion of spending when we do get universal coverage, if at all possible. It has to be fundable and sustainable. Now I better practice for a while. My instructor is in his seventies and I can’t afford to stress him any more than I do already. Mark 10Sept2008 by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Wednesday, Sep 10, 2008 at 6:23:31 PM (0+)
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Reply: Glad you're back
I hear what you are saying, and to an extent I agree, but the one who authorizes the expensive test (regardless of the patient's desire to have one) is the doctor. But the opposite, I believe, is far more often the case. I have just come across a situation that I would like to share. This patient of a well known HMO has been seen for at least eight years with a primary complaint of headaches (HA). These HA have been getting progressively worse over time, and are associated with a numbness accross half the face and the eye on that side looses vision. In addition the effected eye has a slight ptosis (eyelid is drooping). Now with JUST these symptoms a good doctor would have asked for an MRI a long time ago, but when we add in a family history of brain tumor I have to ask "WHAT ARE THEY WAITING FOR?" So, having a patient ask for a test is one thing. The doctor doesn't have to authorize it. But NOT to request or authorize a needed exam when it is OBVIOUSLY needed is quite another. The system that is in place right now is the problem. HR 676 will no doubt NOT be perfect but it will be a far cry better than what we have. Furthermore, I understand your desire to "...get it right the first time..." but it will evolve over time and the language in the bill allows for periods of adaptation. I would rather do a test run now, rather than let the patient to die waiting for a miracle. by InsuranceTeaseDOTcom (0 articles, 0 quicklinks, 0 diaries, 43 comments [3 recommended, 0 rejected]) on Wednesday, Sep 10, 2008 at 6:52:51 PM (0+)
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Reply: Testing and Stuff
Dear ITease When we get a one party payer, and therefore one information system, it will be much easier to track who is competent and who is not. No matter how we do it, we have to have good folks. Of coarse no one can make a long distance diagnosis, but I would at least consider an atypical migraine headache with a stroke equivalent. i.e.- has she ever tried imitrex or similar. If no response, scanning would be indicated. You are right, practitioners order the tests and hopefully they do so appropriately. There is no substitute for competence in any field of work of study. I stand by the “lets get it right the first time’ thing. Take care, Mark by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Wednesday, Sep 10, 2008 at 9:09:59 PM (0+)
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Of course this is the way it should be.
Thank you Mr. Green. This plan is basically what Dennis Kucinich has been advocating for his whole career in Congress-" Medicare for all". His idea has always been for a not for profit health care plan that covered every person in the country. He and Ted Kennedy have fought for this a long time. Kennedy wrote a book decades ago called In Critical Condition that called for a national health care plan. Isn't it sad that it has taken so many years for this subject to be taken seriously? I guess it had to be totally broken for the country to think about fixing it. And it has been echoed by so many of us. Michael Moore said on the Larry King show the other night, " There should never be a profit where there is illness." I think that's it in a nutshell. It's obscene that the richest country in the world allows the insurance companies to hold us all ransom for health care. Even the doctors I know are in favor of a national care plan now that the whole profession has been destroyed. I know several doctors who will only accept Medicare, probably because they receive their payments in a more timely fashion. Isn't that heart warming? by Caronome (0 articles, 0 quicklinks, 1 diaries, 327 comments [15 recommended, 0 rejected]) on Thursday, Sep 11, 2008 at 12:47:13 AM (0+)
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Reply: Thanks
Dear Caronome, Thank you for your time and interest. Ted Kennedy and others have fought long and hard and, due to the times, have had little success. I hope that we can force something soon, though it will have to be through the voter’s efforts. I have little faith in congress. Just look at Medicare Part D! The profit margin is even more obscene when it has become the primary reason to do business in healthcare. We have let our country become ruled by millionaires and attorneys. Maybe the internet will level the playing field, somewhat. Take Care, Mark Green OurHealthReform.com by Mark Green (9 articles, 0 quicklinks, 1 diaries, 35 comments) on Friday, Sep 12, 2008 at 10:45:26 PM (0+)
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