- oden
- 03-20-2011, 09:35 PM
I heard Obama are includes veterinary care. Any truth to that?
- WTF
- 03-20-2011, 09:37 PM
- atlcomedy
- 03-20-2011, 10:17 PM
- goodtiminme
- 03-20-2011, 10:56 PM
Nope, Obama care mostly targets the inaccessibility of health insurance for low income citizens particularly children. It was fairly well gutted by the republicans though... Two things that were taken out that really piss me off are the public option and the end of life care advising for the elderly (aka by plain as "death panels". Actualy idk that she started that lie but she did take it up pretty early on).
The end of life care advising would have made end of life decisions (I.e. Obtaining a do not resuscitate or DNR order in certain situations before those situations occur and the family has to guess). End of life care is often taken to extreams so doctors are not sued when there is a question about what the patient wants. This is not only expensive for the system, but often leaves patients in debilitated states who would rather have died from the original disease or incident ( such as a masive stroke). No where in there is the patient advised to die or have that descision taken from them, all this would have done is paid from those patients to have the conversation with their doctors that gets their wishes put into their medical records. In the end that ensures better patient care and better cost effectiveness of the medical system.
The public insurance option would have provided a minimal service medical insurance option that citizens could buy through the government. The expensive part of the bill was that some people with low incomes and pretty much all children would be subsidized so they could afford it. As it was originally written it would probably have been an expensive bill, but the bill wouldn't have gone into full effect until 2014 I think it was, which left plenty of time to trim it down as needed. And in MHO isn't it worth it to have an affordable insurance option for all the kids in the country?
The other issue that's frequently brought up is that this would provide coverage to illegals. Illegals are a whole noter issue, but pretty much every benefit the Obama care bill outlined stipulated citizenship had to be proven for the benefits to be received.
The end of life care advising would have made end of life decisions (I.e. Obtaining a do not resuscitate or DNR order in certain situations before those situations occur and the family has to guess). End of life care is often taken to extreams so doctors are not sued when there is a question about what the patient wants. This is not only expensive for the system, but often leaves patients in debilitated states who would rather have died from the original disease or incident ( such as a masive stroke). No where in there is the patient advised to die or have that descision taken from them, all this would have done is paid from those patients to have the conversation with their doctors that gets their wishes put into their medical records. In the end that ensures better patient care and better cost effectiveness of the medical system.
The public insurance option would have provided a minimal service medical insurance option that citizens could buy through the government. The expensive part of the bill was that some people with low incomes and pretty much all children would be subsidized so they could afford it. As it was originally written it would probably have been an expensive bill, but the bill wouldn't have gone into full effect until 2014 I think it was, which left plenty of time to trim it down as needed. And in MHO isn't it worth it to have an affordable insurance option for all the kids in the country?
The other issue that's frequently brought up is that this would provide coverage to illegals. Illegals are a whole noter issue, but pretty much every benefit the Obama care bill outlined stipulated citizenship had to be proven for the benefits to be received.
- goodtiminme
- 03-20-2011, 10:57 PM
Because my first post got a bit off topic, no Obama care does not in any way shape or form cover your pets... Especially if theyer from Mexico lol
- TexTushHog
- 03-21-2011, 01:22 AM
Amazing what people will say, or believe.
- pjorourke
- 03-21-2011, 08:47 AM
- Marshall
- 03-21-2011, 08:58 AM
- Marshall
- 03-23-2011, 03:55 AM
Cancer operations are denied to thousands of elderly patients 'because of ageism'
By Jenny Hope
Last updated at 2:05 AM on 19th March 2011
Bad news: Thousands of elderly patients are being denied life-saving surgery because of ageism in the NHS (Picture posed by models)
Thousands of older cancer patients are being denied potentially life-saving surgery because of ageism in the NHS.
The chances of being operated on start falling in middle-age and plummet for those in their 70s and older, an official study shows.
Experts blame age discrimination and poor access to specialist opinion in some areas.
This may explain why older people in Britain are less likely to survive than elsewhere.
Surgery rates vary greatly, from 80 per cent of breast and uterine cancer cases to just 6 per cent of those with liver cancer, researchers found.
Surgery rates drop for all cancers with age, but in many cancers this started from patients in their late 40s.
For cervical cancer, 58 per cent of patients in their 40s had surgery compared with 42 per cent in their 50s. For women in their 80s, however, this dropped to 10 per cent.
The figures come from the National Cancer Intelligence Network, which was set up by the Department of Health.
They reinforce evidence showing older people still get a raw deal from the ‘institutionally ageist’ NHS despite official policies to stamp it out.
Lead researcher Mick Peake, of Glenfield Hospital, Leicester, said the decline in operating rates among the middle-aged is particularly worrying as surgery has the biggest benefit in long-term survival.
More...
Some patients are not referred to specialists even though their local hospital lacks the expertise, he added.
‘There are places where the teams are just looking at the patients and saying “no”,’ he said. ‘They sit there like in the arena in the Colosseum and it’s thumbs up or thumbs down.’ There are places ‘where I wouldn’t send my cat’ because they do not offer the same level of surgical skills, he added.
The figures cover operations between 2004 and 2006, but there have been just marginal improvements since, he said.
Dr Peake, a lung specialist, said just 9 per cent of lung cancer patients had surgery five years ago, now up to 13 per cent. In other countries, 20 per cent are being operated on.
More operations could save 1,500 lives a year, with similar savings in other cancers.
‘We know that internationally our biggest gap in terms of survival is in the elderly,’ he said. ‘While you might argue that your resources could be spent on younger age groups, if you can give a seventysomething-year-old ten or 15 years of active life, you should certainly offer it to them.’
Worrying statistics: The chances of being operated on start falling in middle-age and plummet for those in their 70s and older
A report last year found women over 80 with breast cancer are up to 40 times less likely than young women to get a diagnosis and treatment.
Care Services Minister Paul Burstow said: ‘There can be no place for age discrimination in the NHS. We made this clear by not seeking any exceptions to the Equality Act.’
Campaigner Michelle Mitchell, of Age UK, said: ‘It is outrageous that ageist attitudes are condemning older patients to an early, preventable death.
‘The NHS was set up to provide healthcare for all.’
Meanwhile, 9,000 pensioners are missing out on potentially life-saving cancer tests because staff cannot cope with the workload.
Routine bowel cancer screening for 70 to 75-year-olds should have been introduced nationwide last April, but has been delayed until the autumn at the University Hospital of North Staffordshire.
By Jenny Hope
Last updated at 2:05 AM on 19th March 2011
Bad news: Thousands of elderly patients are being denied life-saving surgery because of ageism in the NHS (Picture posed by models)Thousands of older cancer patients are being denied potentially life-saving surgery because of ageism in the NHS.
The chances of being operated on start falling in middle-age and plummet for those in their 70s and older, an official study shows.
Experts blame age discrimination and poor access to specialist opinion in some areas.
This may explain why older people in Britain are less likely to survive than elsewhere.
Surgery rates vary greatly, from 80 per cent of breast and uterine cancer cases to just 6 per cent of those with liver cancer, researchers found.
Surgery rates drop for all cancers with age, but in many cancers this started from patients in their late 40s.
For cervical cancer, 58 per cent of patients in their 40s had surgery compared with 42 per cent in their 50s. For women in their 80s, however, this dropped to 10 per cent.
The figures come from the National Cancer Intelligence Network, which was set up by the Department of Health.
They reinforce evidence showing older people still get a raw deal from the ‘institutionally ageist’ NHS despite official policies to stamp it out.
Lead researcher Mick Peake, of Glenfield Hospital, Leicester, said the decline in operating rates among the middle-aged is particularly worrying as surgery has the biggest benefit in long-term survival.
More...
Some patients are not referred to specialists even though their local hospital lacks the expertise, he added.
‘There are places where the teams are just looking at the patients and saying “no”,’ he said. ‘They sit there like in the arena in the Colosseum and it’s thumbs up or thumbs down.’ There are places ‘where I wouldn’t send my cat’ because they do not offer the same level of surgical skills, he added.
The figures cover operations between 2004 and 2006, but there have been just marginal improvements since, he said.
Dr Peake, a lung specialist, said just 9 per cent of lung cancer patients had surgery five years ago, now up to 13 per cent. In other countries, 20 per cent are being operated on.
More operations could save 1,500 lives a year, with similar savings in other cancers.
‘We know that internationally our biggest gap in terms of survival is in the elderly,’ he said. ‘While you might argue that your resources could be spent on younger age groups, if you can give a seventysomething-year-old ten or 15 years of active life, you should certainly offer it to them.’
Worrying statistics: The chances of being operated on start falling in middle-age and plummet for those in their 70s and olderA report last year found women over 80 with breast cancer are up to 40 times less likely than young women to get a diagnosis and treatment.
Care Services Minister Paul Burstow said: ‘There can be no place for age discrimination in the NHS. We made this clear by not seeking any exceptions to the Equality Act.’
Campaigner Michelle Mitchell, of Age UK, said: ‘It is outrageous that ageist attitudes are condemning older patients to an early, preventable death.
‘The NHS was set up to provide healthcare for all.’
Meanwhile, 9,000 pensioners are missing out on potentially life-saving cancer tests because staff cannot cope with the workload.
Routine bowel cancer screening for 70 to 75-year-olds should have been introduced nationwide last April, but has been delayed until the autumn at the University Hospital of North Staffordshire.
- Marshall
- 03-23-2011, 03:57 AM
Obama's health care reform is unhealthy for hospitals
Trying to squeeze productivity gains out of hospitals will force many to close
By John D. Hartigan
8:00 AM EDT, March 19, 2011
Many of these hospitals are already struggling to make ends meet because Medicare only reimburses them for 90 percent of what it costs them to take care of Medicare patients. But, instead of helping them out, this rule change does the opposite. In a misguided effort to pressure them to become more efficient, it arbitrarily assumes that they can achieve the same productivity savings as the economy at large and decrees that these hypothetical cost savings must be deducted from any Medicare reimbursements they receive after September.
The trouble with this is that it lumps hospitals in with manufacturers like IBM and General Electric and takes it for granted that they can ultimately save almost $30 billion per year by replacing their workers with equipment or by squeezing their operations into tighter quarters. Nothing could be further from the truth.
First of all, hospitals are far too labor intensive to be able to slash payrolls as easily as manufacturers. They can automate functions like lab work and record keeping, but there's no way they can substitute equipment for nurses, orderlies, housekeepers, nurses' aides, kitchen workers or maintenance men. Moreover, hospitals can't downsize as readily as manufacturers either. Hospitals that close floors have to uproot the patients on those floors and crowd them in with patients on other floors, and there are obvious safety and tolerability limits to how far that kind of doubling up can be pushed.
Given these constraints, very few of the 4,686 U.S. hospitals providing patients with Medicare Part A services are going to be able to boost their productivity enough to make up for the new reimbursement reductions. To quote Medicare's own chief actuary, Richard Foster: "While such payment update reductions will create a strong incentive for providers to maximize productivity, it is doubtful that many will be able to improve their own productivity to the degree achieved by the economy at large. ... Thus, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable. ... Simulations by the Office of the Actuary suggest roughly 15 percent of Part A providers would become unprofitable within the ten year projection period."
That's a shocker. What Mr. Foster is telling us is that deducting the legislatively presumed productivity savings from Medicare reimbursements would gradually turn more than 700 of our hospitals into chronic money losers. And — while he doesn't spell out what would happen when those hospitals eventually had to shut down — there's no doubt that the impact would be devastating. Patients in rural areas would have to travel long hours to get to the nearest hospital still open for business, and patients everywhere would have to put up with critical shortages of beds, operating rooms and ICUs, as well as badly overcrowded clinics and emergency rooms.
Not only that, care would almost certainly have to be rationed. Grandpa might not get his heart bypass. His daughter might not get her mammogram. And his grandson would probably have to wait months for surgery to repair a sports injury.
Despite all this, HHS has no plans to intervene. Brushing off Mr. Foster's warnings, his superiors insist that the new Medicare reimbursement reductions won't cause any harm to hospitals or the communities they serve because hospitals can "become more productive" if they "invest in system changes." But that's just bureaucratic posturing. In order to survive the reductions, a typical 200-bed hospital would have to achieve long-term productivity savings of about $7 million per year, and investing in "system changes" couldn't possibly cut payroll costs by that large an amount.
So let's hope the new productivity mandate is either eliminated or scaled down to a level that's reasonable. Otherwise, our hospitals risk becoming an endangered species.
John D. Hartigan, a Chevy Chase resident, is a former vice president and general counsel of Technicon Corp., developer of the first fully computerized hospital information system. His e-mail is hartlex@comcast.net.
Trying to squeeze productivity gains out of hospitals will force many to close
By John D. Hartigan
8:00 AM EDT, March 19, 2011
Advertisement
Over the last few months, the U.S. Department of Health and Human Services has exempted a long list of unions and employers from an Affordable Care Act provision that would have made it too costly for them to continue some of their health care insurance plans. But, in sharp contrast, HHS apparently doesn't intend to do anything at all about a new health reform mandate that could eventually force hundreds of badly needed U.S. hospitals to shut their doors.Many of these hospitals are already struggling to make ends meet because Medicare only reimburses them for 90 percent of what it costs them to take care of Medicare patients. But, instead of helping them out, this rule change does the opposite. In a misguided effort to pressure them to become more efficient, it arbitrarily assumes that they can achieve the same productivity savings as the economy at large and decrees that these hypothetical cost savings must be deducted from any Medicare reimbursements they receive after September.
The trouble with this is that it lumps hospitals in with manufacturers like IBM and General Electric and takes it for granted that they can ultimately save almost $30 billion per year by replacing their workers with equipment or by squeezing their operations into tighter quarters. Nothing could be further from the truth.
First of all, hospitals are far too labor intensive to be able to slash payrolls as easily as manufacturers. They can automate functions like lab work and record keeping, but there's no way they can substitute equipment for nurses, orderlies, housekeepers, nurses' aides, kitchen workers or maintenance men. Moreover, hospitals can't downsize as readily as manufacturers either. Hospitals that close floors have to uproot the patients on those floors and crowd them in with patients on other floors, and there are obvious safety and tolerability limits to how far that kind of doubling up can be pushed.
Given these constraints, very few of the 4,686 U.S. hospitals providing patients with Medicare Part A services are going to be able to boost their productivity enough to make up for the new reimbursement reductions. To quote Medicare's own chief actuary, Richard Foster: "While such payment update reductions will create a strong incentive for providers to maximize productivity, it is doubtful that many will be able to improve their own productivity to the degree achieved by the economy at large. ... Thus, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable. ... Simulations by the Office of the Actuary suggest roughly 15 percent of Part A providers would become unprofitable within the ten year projection period."
That's a shocker. What Mr. Foster is telling us is that deducting the legislatively presumed productivity savings from Medicare reimbursements would gradually turn more than 700 of our hospitals into chronic money losers. And — while he doesn't spell out what would happen when those hospitals eventually had to shut down — there's no doubt that the impact would be devastating. Patients in rural areas would have to travel long hours to get to the nearest hospital still open for business, and patients everywhere would have to put up with critical shortages of beds, operating rooms and ICUs, as well as badly overcrowded clinics and emergency rooms.
Not only that, care would almost certainly have to be rationed. Grandpa might not get his heart bypass. His daughter might not get her mammogram. And his grandson would probably have to wait months for surgery to repair a sports injury.
Despite all this, HHS has no plans to intervene. Brushing off Mr. Foster's warnings, his superiors insist that the new Medicare reimbursement reductions won't cause any harm to hospitals or the communities they serve because hospitals can "become more productive" if they "invest in system changes." But that's just bureaucratic posturing. In order to survive the reductions, a typical 200-bed hospital would have to achieve long-term productivity savings of about $7 million per year, and investing in "system changes" couldn't possibly cut payroll costs by that large an amount.
So let's hope the new productivity mandate is either eliminated or scaled down to a level that's reasonable. Otherwise, our hospitals risk becoming an endangered species.
John D. Hartigan, a Chevy Chase resident, is a former vice president and general counsel of Technicon Corp., developer of the first fully computerized hospital information system. His e-mail is hartlex@comcast.net.