Health Insurance

6/2/2016 2:21pm
I haven't seen this posted yet, maybe they don't pay enough in Texas?

"Blue Cross and Blue Shield of Texas, the state's largest insurer, has asked for rate hikes of nearly 60 percent for next year in three popular HMO plans, filings with federal regulators show."

http://www.houstonchronicle.com/news/houston-texas/texas/article/Blue-C…
6/3/2016 6:57am Edited Date/Time 6/3/2016 7:00am
There's so much crap you can't shovel it all. A patient has the right to refuse treatment. If that patient refuses to be turned because of...
There's so much crap you can't shovel it all.


A patient has the right to refuse treatment. If that patient refuses to be turned because of any reason the worker is to respect the patients wishes. If they develop a pressure sore because of it, in the hospital (even though they refused to be turned off pressure points) the hospital can bill Medicare for it. Medicare won't pay for it. So the hospital eats the cost.

Same with 30 day heart failure readmissions. If they're readmitted in 30 days or less from a past admission of heart failure. MEDICARE WONT REIMBURSE THE HOSPITAL for services provided.

We teach patients they can't keep eating high sodium diet, and they must still take their water pill even though it makes them have to pee In the middle of the night. We use dumb terms. Water pill not diuretic. How much more can healthcare workers do to make people take accountability for their disease process ?! But the patients go home and slump right back into poor habits: smoking, drugs, Burger King daily...skipping their diuretics. And before you know it within 30 days they're back in the ED with swollen feet and respiratory distress. Admitted for "blah blah " secondary to heart failure. So now the hospital eats the cost of that patient. And to make up for it they bill geezer $13,000 for a kidney stone.

These are just two cases of not getting reimbursed. There are hundreds of tiny stipulations that aren't reimbursable. And it's ludicrous to punish the hospital for the ignorant patients sucking the system dry.

People going to the ER for their child's runny nose. Drives healthcare costs up. Because you can't turn people away. When they walk in the ER the hospital is stuck with them. And most won't pay for any of it.

Seperate the entities. You want government healthcare ?? Go to a govt hospital. You want private care go to a private hospital. But once you can't pay, stabilize them and transport to the govt hospital. Guaranteed the private hospitals will be more innovative and the quality of care will be better. You get what you pay for.
motogrady wrote:
Georgie might be on to something. And the answer might already be in place, and has been for years. How about just rename the VA, to...

Georgie might be on to something.

And the answer might already be in place, and has been for years.

How about just rename the VA, to the HA, and open that to all US citizens, Veterans and visitors?

Keep the private sector private, you wanna pay, so be it.

You can't pay, head over to the Health Administration and get fixed up.

Why not?
That would be amazing. I don't know if it could happen though. It would mean that hospitals would have to refuse to participate in Medicaid and Medicare. At this point it seems like Medicaid and Medicare have taken over a really large segment of the population because they are expanding every day.

Georgie is completely right though. The majority of the patients we see are on Medicaid and could either have to pay out of pocket to simply fix themselves by going to Walgreens, or they could go to the ER for free and waste thousands of tax payer dollars. These patients have no incentive to take care of themselves because they have free access to a doctor 24/7. They usually either come in for silly stuff or they have chronic conditions that they don't take care of.

The shitty part is that patients who have private insurance are less likely to seek medical attention when they need it because they're scared of their huge bill even though they are the ones paying for all the Medicaid waste. Ouch

I alway joke that we should take down the ER sign and just call it the Medicaid clinic because that's all we do. I work on Tuesday. I will try to remember to keep a tally of how many patients I see that are on Medicaid compared to how many people with private insurance.
Spartacus
Posts
2269
Joined
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Location
PW US
6/3/2016 5:57pm Edited Date/Time 6/3/2016 7:06pm
American health in general REALLY sucks. Fat is the new normal. Business lobby government to let us eat crap and keep people in the dark about food choice/health.

American health care underserves and is over priced.

Rx prices are the highest in the developed world. Again, the fox is hanging out with the guard dogs in Washington.

The entire discussion on affordable care was misguided. It should have been about health care costs, not who pays.

That said why the fuk is America the only developed country without health care? Because the leaches selling it want to make every damm cent they can no matter what and buy their way into having their way.

Ban lobbying. Period. No corporate donations to politicians. Boo fuking hoo for them.

Opinions from someone with 4 doctors in family.



6/3/2016 8:50pm Edited Date/Time 6/3/2016 9:07pm
kkawboy14 wrote:
Has Obamacare helped or hurt you? I provide group for my company and it keeps going thru the roof but it is easier to get good...
Has Obamacare helped or hurt you?

I provide group for my company and it keeps going thru the roof but it is easier to get good coverage
This guy is probably excellent at playing chess.


You can be as efficient as you want. My hospital is doing "cost repositioning" that's what they call so the nurses won't organize a union and go on strike.

The hospitals are desperately cutting costs, even refusing to do certain tests that CMS has deemed not to pay for. They won't pay for a bladder infection. So that means, no more urine cultures because we know that creamy shit is infected why put it on paper so CMS can say nope! Was your fault they got infected in your hospital. Not that their comorbidities actually can't prevent infection because some are so sick.

If people would take accountability for themselves the system would fix itself. These people refuse to help themselves. The people that do it right, like go to urgent care instead of an Ed if their doctor can't see them reduce overall costs. BUT THERE ARENT MANY OF US.

Watch the videos on obesity in America. If you get sick. Septic sick and you're normal weight, you still have a hard time recovering. If you're obese. Morbidly obese. Good luck because sepsis will be your least worry. After that's fixed it will be a plethora of problems.

Unnecessary surgeries don't help either. Like gastric bypass. What a great way to sentence someone to years and years of admissions for gastric obstructions. Which leads to sepsis. Leads to confusion. Leads to bed sores. Leads to tracheostomies....all because of an unnecessary surgery.

I should write a book about all the shit that goes on. Not from an evil hospital stand point, but from the victimized, unaccountable patient.

And it pisses me off when you got a good person trying to do it right that avoids the hospital until they got stage 4 cancer and it's too late. But you got shitheads in the ED every day for a runny nose and rash because--hey it's free!!

It comes down to the leaches Ruin it for everyone. They suck the industry dry so the industry has to charge more for services. Can't fix that until you fix the people. Get them off fraudulentlent assistance. Please!!!!!!! Or make them do something. SOMETHING.

The Shop

6/3/2016 10:22pm
kkawboy14 wrote:
Has Obamacare helped or hurt you? I provide group for my company and it keeps going thru the roof but it is easier to get good...
Has Obamacare helped or hurt you?

I provide group for my company and it keeps going thru the roof but it is easier to get good coverage
No offense man, but that's why some of us paid for insurance BEFORE we needed it; so we wouldn't have a "preexisting " problem that wouldn't be covered. Every single person who complain about "How expensive insurance was before obamacare" always seemed to have a house full of flatscreens, I phones, ps4's, etc. If the luxuries of daily life are more important to you then protecting yourself from catastrophic hospital bills, then I'm not understanding why it "the Republicans fault" that an insurance company doesn't want to foot the bill for your preexisting fuck ups. I'm glad you got sorted out, but a whole lot of people either lost their perfectly fine coverage or had their rates skyrocket so that people who didn't plan ahead get their shit covered.
Niloz
Posts
225
Joined
4/1/2008
Location
Ayala Alabang, Muntinlupa City PH
6/4/2016 1:56am
Our country's medical and insurance system is a travesty.

I've been living and working in the Philippines for the last 5 years. On Easter this year I had a pretty bad get-off coming up short on a double. Beat me up pretty bad.

Went to the emergency room of one of the finest hospitals in metro Manila (compares to ANY hospital I've seen in the US). Because of the fact I hurt literally everywhere I was X-ray'd from head to toe, probably 40+ images. X-rays revealed a broken arm (Ulna) about 3" down from the elbow and a broken wrist (scaphoid). Everything else was just contusions, hematomas, bruising etc.

To get a better look at the broken bones I was given a CT scan and then was admitted to a private room in the hospital that was like a really nice hotel room with a couch and table for visitors and of course the hospital bed.

Spent 4 days and three nights in the hospital. Had reconstructive surgery including two pins, two screws and some wire to fix the Ulna. Cast for the wrist. All necessary meds, IV's, anesthesia for the surgery etc.

Total cost = 261,000 PESOS.....thats about $5300 USD before insurance coverage.

How much ya think this little adventure would have cost me back home in Ohio?
APLMAN99
Posts
12474
Joined
4/1/2008
Location
Tualatin, OR US
Fantasy
6/4/2016 9:17am
There's so much crap you can't shovel it all. A patient has the right to refuse treatment. If that patient refuses to be turned because of...
There's so much crap you can't shovel it all.


A patient has the right to refuse treatment. If that patient refuses to be turned because of any reason the worker is to respect the patients wishes. If they develop a pressure sore because of it, in the hospital (even though they refused to be turned off pressure points) the hospital can bill Medicare for it. Medicare won't pay for it. So the hospital eats the cost.

Same with 30 day heart failure readmissions. If they're readmitted in 30 days or less from a past admission of heart failure. MEDICARE WONT REIMBURSE THE HOSPITAL for services provided.

We teach patients they can't keep eating high sodium diet, and they must still take their water pill even though it makes them have to pee In the middle of the night. We use dumb terms. Water pill not diuretic. How much more can healthcare workers do to make people take accountability for their disease process ?! But the patients go home and slump right back into poor habits: smoking, drugs, Burger King daily...skipping their diuretics. And before you know it within 30 days they're back in the ED with swollen feet and respiratory distress. Admitted for "blah blah " secondary to heart failure. So now the hospital eats the cost of that patient. And to make up for it they bill geezer $13,000 for a kidney stone.

These are just two cases of not getting reimbursed. There are hundreds of tiny stipulations that aren't reimbursable. And it's ludicrous to punish the hospital for the ignorant patients sucking the system dry.

People going to the ER for their child's runny nose. Drives healthcare costs up. Because you can't turn people away. When they walk in the ER the hospital is stuck with them. And most won't pay for any of it.

Seperate the entities. You want government healthcare ?? Go to a govt hospital. You want private care go to a private hospital. But once you can't pay, stabilize them and transport to the govt hospital. Guaranteed the private hospitals will be more innovative and the quality of care will be better. You get what you pay for.
motogrady wrote:
Georgie might be on to something. And the answer might already be in place, and has been for years. How about just rename the VA, to...

Georgie might be on to something.

And the answer might already be in place, and has been for years.

How about just rename the VA, to the HA, and open that to all US citizens, Veterans and visitors?

Keep the private sector private, you wanna pay, so be it.

You can't pay, head over to the Health Administration and get fixed up.

Why not?
That would be amazing. I don't know if it could happen though. It would mean that hospitals would have to refuse to participate in Medicaid and...
That would be amazing. I don't know if it could happen though. It would mean that hospitals would have to refuse to participate in Medicaid and Medicare. At this point it seems like Medicaid and Medicare have taken over a really large segment of the population because they are expanding every day.

Georgie is completely right though. The majority of the patients we see are on Medicaid and could either have to pay out of pocket to simply fix themselves by going to Walgreens, or they could go to the ER for free and waste thousands of tax payer dollars. These patients have no incentive to take care of themselves because they have free access to a doctor 24/7. They usually either come in for silly stuff or they have chronic conditions that they don't take care of.

The shitty part is that patients who have private insurance are less likely to seek medical attention when they need it because they're scared of their huge bill even though they are the ones paying for all the Medicaid waste. Ouch

I alway joke that we should take down the ER sign and just call it the Medicaid clinic because that's all we do. I work on Tuesday. I will try to remember to keep a tally of how many patients I see that are on Medicaid compared to how many people with private insurance.
I thought that you were an ER nurse. No?
APLMAN99
Posts
12474
Joined
4/1/2008
Location
Tualatin, OR US
Fantasy
6/4/2016 9:39am
APLMAN99 wrote:
I thought that you were an ER nurse. No?
Yea I am.
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting rep it seems.

Are you digging into their financial information because you alter your level of care based on their ability to pay or their levels of insurance? Are you determining how they came about having that insurance?

I find your level of involvement in your patients' financial affairs a bit strange.
6/4/2016 9:55am
APLMAN99 wrote:
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting...
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting rep it seems.

Are you digging into their financial information because you alter your level of care based on their ability to pay or their levels of insurance? Are you determining how they came about having that insurance?

I find your level of involvement in your patients' financial affairs a bit strange.
Absolutely not, we have to print their face sheets all the time for the ems crews and insurance info is on there.

I don't care what the doctor orders for anyone. I follow orders, I dont decide what their plan of care will be. The only thing I have a problem with is when someone has had 40 cat scans in a year because it is a waste of time and resources, and greatly increases the patients risk of cancer. They get scanned every time they come in to the ER because the doctor has to rule out conditions that threaten their life.

They are supposed to follow up with a primary doctor but so many of them don't because it is easier to just come to us when they run out of pain medication.
6/4/2016 11:10am Edited Date/Time 6/4/2016 11:44am
APLMAN99 wrote:
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting...
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting rep it seems.

Are you digging into their financial information because you alter your level of care based on their ability to pay or their levels of insurance? Are you determining how they came about having that insurance?

I find your level of involvement in your patients' financial affairs a bit strange.
Absolutely not, we have to print their face sheets all the time for the ems crews and insurance info is on there. I don't care what...
Absolutely not, we have to print their face sheets all the time for the ems crews and insurance info is on there.

I don't care what the doctor orders for anyone. I follow orders, I dont decide what their plan of care will be. The only thing I have a problem with is when someone has had 40 cat scans in a year because it is a waste of time and resources, and greatly increases the patients risk of cancer. They get scanned every time they come in to the ER because the doctor has to rule out conditions that threaten their life.

They are supposed to follow up with a primary doctor but so many of them don't because it is easier to just come to us when they run out of pain medication.
Aha. Trying to demonize nurses are we APL?? Yes we provide excellent care ONLY to the insured. Becuse--as you know we are paid in commission!!!! Those that aren't insured we let writhe in pain on a 10/10 scale. And by writhe in pain , I mean they're finger-Fn their $1100 iPhone with the most stable vital signs you've ever read in a textbook.

That's a load of shit. We provide the same care to everyone. We can't refuse it. The patient can. But we cannot refuse to treat patients. We could care less if they have insurance or not. We still get paid. But every year we know our benefits and raises will be moderately adjusted to off set the costs of Mr. 40-cat-scans-in-one-year. Who didn't pay for any of it.

Can you see why we get pissed off ? The healthcare worker gets screwed twice. We provide care for free. Then we get our wages and benefits cut because the hospital is crying about their doctors, nurses and environmental service people not making money for the hospital. So the freeloaders getting us coming in. And the suits in hospital systems get us going out. The suits "cost-reposition" (A clever PC term used that really means "take it from the docs and nurses" but that's ok it sounds nice and nobody thinks twice about it) and the Suits...CEO, chief nursing officer, chief finance officer etc wtc still get their huge raises and bonuses by repositioning costs to the largest employer demographics (doctors and nurses) But at the bedside, We are the worlds largest bitch that can't compete when the government intervenes with all the bogus regulation. The nurse and staff physicians pay the most because they're the majority of the employees in the hospital. So you take some from the doctors and nurses you're saving millions upon millions a year. This profession sucks. Takes a special person to continue to do it, we actually do care about people but can you blame us for getting disgruntled ?!


Easiest way to explain what bedside Nurses and staff doctors are:

They are the "middle class" in hospitals. As in America the middle class pays for everything. We pay for the CEOs bonuses and we pay for the FREE care through cost repositioning, decreased staffing and other things to name a few.

Maybe what's worse is hospitals eliminating positions that aren't bedside. They can't figure out how to stay out of the red. So they're forced to fire people. How in the hell has the ACA helped us as a country ?! It didn't create jobs. It eliminated them. It didn't get cheaper. It got insanely expensive. Still people aren't insured. But now everyone gets to pay more taxes to the government if they're not insured. It's all a ploy to get us dependent on the government. And when single payer goes full bore into effect and Uncle Sam tells me I'm only worth $15 an hour. Just like the burger flippers, I'm done. I'm out. Done. As will most of the other qualified and experienced healthcare workers.

You think it's bad now ? You wait. The healthcare employees aren't the demons, the citizen cheating the system are the demons. The untold demon. The unreported on demon. Yet the media will try to crucify Prince's doctor for prescribing. Well prince consumed. He's a prime example of the PROBLEM as it relates to patients


Niloz: in Ohio they might not of scanned you in a ct. Radiation isn't the best for you. But who knows. Room and board probably would of been around $4000. The surgery $6,000. The scans $1200. X rays: $200x40 $8000. Meds: who knows. Anesthesia bill: 1500-3000ish?These are rough guesstimates. Why are hospital rooms made to look like 5 star hotel rooms ? To attract people that can pay. But those that don't pay still get the same rooms.....

Did you have your own nurse anesthetist or was there one doctor floating between 7 cases in the philipeans ? I'm not sure but what do you think is safer? That's rhetorical. It's hard to compare different countries, impossible really. How many philipeans die from reduced access to care in their country ? The poor philipeaneans....etc. probably ten fold over the poor that die here related to access of care. I'm just speculating though. I bet more die of heroin here than all those combined in philipeans that actually get to a hospital. And the heroin abusers have stand alone ERs all over the United States to hit. Aha, look where that brings us...back to accountability of the most devastating factor in the American human existence! The citizens self destruct themselves and ruin it for those that are truly sick and get dealt a bad hand.
APLMAN99
Posts
12474
Joined
4/1/2008
Location
Tualatin, OR US
Fantasy
6/4/2016 1:47pm
APLMAN99 wrote:
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting...
I don't think I've ever had a nurse, especially an ER nurse, ask me about my insurance or financial info at all. That's generally the admitting rep it seems.

Are you digging into their financial information because you alter your level of care based on their ability to pay or their levels of insurance? Are you determining how they came about having that insurance?

I find your level of involvement in your patients' financial affairs a bit strange.
Absolutely not, we have to print their face sheets all the time for the ems crews and insurance info is on there. I don't care what...
Absolutely not, we have to print their face sheets all the time for the ems crews and insurance info is on there.

I don't care what the doctor orders for anyone. I follow orders, I dont decide what their plan of care will be. The only thing I have a problem with is when someone has had 40 cat scans in a year because it is a waste of time and resources, and greatly increases the patients risk of cancer. They get scanned every time they come in to the ER because the doctor has to rule out conditions that threaten their life.

They are supposed to follow up with a primary doctor but so many of them don't because it is easier to just come to us when they run out of pain medication.
Aha. Trying to demonize nurses are we APL?? Yes we provide excellent care ONLY to the insured. Becuse--as you know we are paid in commission!!!! Those...
Aha. Trying to demonize nurses are we APL?? Yes we provide excellent care ONLY to the insured. Becuse--as you know we are paid in commission!!!! Those that aren't insured we let writhe in pain on a 10/10 scale. And by writhe in pain , I mean they're finger-Fn their $1100 iPhone with the most stable vital signs you've ever read in a textbook.

That's a load of shit. We provide the same care to everyone. We can't refuse it. The patient can. But we cannot refuse to treat patients. We could care less if they have insurance or not. We still get paid. But every year we know our benefits and raises will be moderately adjusted to off set the costs of Mr. 40-cat-scans-in-one-year. Who didn't pay for any of it.

Can you see why we get pissed off ? The healthcare worker gets screwed twice. We provide care for free. Then we get our wages and benefits cut because the hospital is crying about their doctors, nurses and environmental service people not making money for the hospital. So the freeloaders getting us coming in. And the suits in hospital systems get us going out. The suits "cost-reposition" (A clever PC term used that really means "take it from the docs and nurses" but that's ok it sounds nice and nobody thinks twice about it) and the Suits...CEO, chief nursing officer, chief finance officer etc wtc still get their huge raises and bonuses by repositioning costs to the largest employer demographics (doctors and nurses) But at the bedside, We are the worlds largest bitch that can't compete when the government intervenes with all the bogus regulation. The nurse and staff physicians pay the most because they're the majority of the employees in the hospital. So you take some from the doctors and nurses you're saving millions upon millions a year. This profession sucks. Takes a special person to continue to do it, we actually do care about people but can you blame us for getting disgruntled ?!


Easiest way to explain what bedside Nurses and staff doctors are:

They are the "middle class" in hospitals. As in America the middle class pays for everything. We pay for the CEOs bonuses and we pay for the FREE care through cost repositioning, decreased staffing and other things to name a few.

Maybe what's worse is hospitals eliminating positions that aren't bedside. They can't figure out how to stay out of the red. So they're forced to fire people. How in the hell has the ACA helped us as a country ?! It didn't create jobs. It eliminated them. It didn't get cheaper. It got insanely expensive. Still people aren't insured. But now everyone gets to pay more taxes to the government if they're not insured. It's all a ploy to get us dependent on the government. And when single payer goes full bore into effect and Uncle Sam tells me I'm only worth $15 an hour. Just like the burger flippers, I'm done. I'm out. Done. As will most of the other qualified and experienced healthcare workers.

You think it's bad now ? You wait. The healthcare employees aren't the demons, the citizen cheating the system are the demons. The untold demon. The unreported on demon. Yet the media will try to crucify Prince's doctor for prescribing. Well prince consumed. He's a prime example of the PROBLEM as it relates to patients


Niloz: in Ohio they might not of scanned you in a ct. Radiation isn't the best for you. But who knows. Room and board probably would of been around $4000. The surgery $6,000. The scans $1200. X rays: $200x40 $8000. Meds: who knows. Anesthesia bill: 1500-3000ish?These are rough guesstimates. Why are hospital rooms made to look like 5 star hotel rooms ? To attract people that can pay. But those that don't pay still get the same rooms.....

Did you have your own nurse anesthetist or was there one doctor floating between 7 cases in the philipeans ? I'm not sure but what do you think is safer? That's rhetorical. It's hard to compare different countries, impossible really. How many philipeans die from reduced access to care in their country ? The poor philipeaneans....etc. probably ten fold over the poor that die here related to access of care. I'm just speculating though. I bet more die of heroin here than all those combined in philipeans that actually get to a hospital. And the heroin abusers have stand alone ERs all over the United States to hit. Aha, look where that brings us...back to accountability of the most devastating factor in the American human existence! The citizens self destruct themselves and ruin it for those that are truly sick and get dealt a bad hand.
Obviously you completely misread my post. Nowhere was I demonizing nurses in general. One particular nurse, however, causes me a little bit of concern based on his posting history and the attitudes he has shown about his patients based on classifications he puts them into. If you happen to fall into the same views as him, then I understand your feelings of being demonized. If you don't, then my post had nothing to do with you and certainly didn't have anything to do with nursing as a profession in general.
6/4/2016 3:09pm Edited Date/Time 6/4/2016 3:22pm
Didnt mean for it to be a personal attack. But nurses work closely with case managers and all have input on how to successfully move the patient to the next step in the process. If we know they don't have insurance why waste the time and resources to try to find them a long term care facility ? We wouldn't, we would gear our time to trying to figure out how to qualify them for Medicare or Medicaid.

Nurses and doctors do way more than Just bedside care. They're very involved with MANY MANY MANY aspects of care that go unnoticed. Without us, the patient would notice REAL fast. And so would the bottom line in hospitals.

However, anytime something happens the nurse or doc is blamed. like Ebola. If you think for one second hospitals were ready for Ebola the you're stupid. If you think the nurses had the right equipment. You're naive. If you think they were trained properly--yea right.

My point is the first people to care are at the bedside. Yet they're the first ones to get burned by the media, executives....and the public. Like the nurse that got Ebola caring for a patient. Oh it's her fault! That rotten nurse. She didn't care she just went in there and blatantly did everything in her power to not provide care safely. Not the case. It's all the Unknown bullshit that put us at risk. And we keep dealing with it. Adding more responsibility year after year after year. There's a bubble blowing up. It's gonna pop. But....when it does let's Blame the nurse and staff doctor ! Not the terrible liberal policies that caused it. They cut corners in the name of reimbursement! Burn those healthcare bedside workers!!!!


If I woke up 19 years old again I think I'd get into a trade. Wouldn't even deal with college or healthcare knowing now what I didn't know then. Most Everything that is taught to kids in high school and college is a blatant lie. I had one great professor who had a NOBAMA sticker on his podium. I hated him because of it. But the guy was right. And his conservative teaching was scoffed at. But now it makes sense to me. But when I was 20 I thought he was a stingy bastard with a cold heart.
SCR
Posts
1107
Joined
12/10/2009
Location
CA US
6/4/2016 7:54pm
Didnt mean for it to be a personal attack. But nurses work closely with case managers and all have input on how to successfully move the...
Didnt mean for it to be a personal attack. But nurses work closely with case managers and all have input on how to successfully move the patient to the next step in the process. If we know they don't have insurance why waste the time and resources to try to find them a long term care facility ? We wouldn't, we would gear our time to trying to figure out how to qualify them for Medicare or Medicaid.

Nurses and doctors do way more than Just bedside care. They're very involved with MANY MANY MANY aspects of care that go unnoticed. Without us, the patient would notice REAL fast. And so would the bottom line in hospitals.

However, anytime something happens the nurse or doc is blamed. like Ebola. If you think for one second hospitals were ready for Ebola the you're stupid. If you think the nurses had the right equipment. You're naive. If you think they were trained properly--yea right.

My point is the first people to care are at the bedside. Yet they're the first ones to get burned by the media, executives....and the public. Like the nurse that got Ebola caring for a patient. Oh it's her fault! That rotten nurse. She didn't care she just went in there and blatantly did everything in her power to not provide care safely. Not the case. It's all the Unknown bullshit that put us at risk. And we keep dealing with it. Adding more responsibility year after year after year. There's a bubble blowing up. It's gonna pop. But....when it does let's Blame the nurse and staff doctor ! Not the terrible liberal policies that caused it. They cut corners in the name of reimbursement! Burn those healthcare bedside workers!!!!


If I woke up 19 years old again I think I'd get into a trade. Wouldn't even deal with college or healthcare knowing now what I didn't know then. Most Everything that is taught to kids in high school and college is a blatant lie. I had one great professor who had a NOBAMA sticker on his podium. I hated him because of it. But the guy was right. And his conservative teaching was scoffed at. But now it makes sense to me. But when I was 20 I thought he was a stingy bastard with a cold heart.
When people don't have responsibility of paying for or managing their own health insurance or get it free. Or have limited choice thru their work they tend to abuse it or not understand the costs of it. I hear people all the time say how they have great health insurance because they only had to make a 10 dollar copay to see their doctor. But they don't realize the real cost their employer or Medicare is making. Or what is really coming out of their paycheck. Likely if their employer didn't provide health insurance they would see that money on their paycheck and be able to purchase more affordable insurance. At least that is how it used to be. Not sure anymore.

I have talked with a few doctors and hear them saying similar things to what you are saying.

These are things I think would make a better system. I am curious what you think because what your saying makes sense to me.

Regulation: Limit, get a hold of out of control class action lawsuits against Hospitals and Physicians. Allow Insurance Companies to sell in any state and compete more easily. Allow Insurance to sell catastrophic policies with high deductibles and allow unlimited tax deductible HSA accounts to cover the deductibles and medical bills out of pocket.
I don't know all the regulation on Insurance Companies but my guess is that the large Companies lobby for regulation that they can absorb easily and that prevents smaller start up Companies from entering the market and competing. The free market is very flexible and innovative and provides great service when its not regulated and manipulated to death by Govt.

Do away with laws that require any Company regardless of size to have to provide insurance to employees. This would put more money in peoples pocket and allow them to shop for there own insurance that fits there needs, and allow them to take that policy wherever they want. This would put people in the position to have make choices and understand there insurance and force the Insurance market to be more competitive. This would be a huge cost and burden off the backs of Business. It would be an instant boost to the economy and Jobs.

I also don't know all the regulation of Doctors, Nurses, Hospitals, etc. but I hear what you are saying, and from what I understand there are a lot of politics in Medicine with the AMA, Unions, etc. that don't help costs or to provide better healthcare.

As far as people that cant afford Insurance or costs for care. There are many ways that could be worked out. But right now there are lots of people that think they should not have to pay for their own medical care. The most important thing in life if you want to be around for awhile is to take care of your health. But many people will make a 400 dollar a month car payment, pay for tattoos, concert tickets, dirt bikes, whatever. But then they have a fit when once every few years they have to pay a few thousand dollars for health services for what is supposed to be the most important thing.

If most people had something more like a catastrophic policy with a high deductible like 5, 10, even 20K . And a HSA account. And then paid out of pocket for all but the big surgeries, etc. People would be a lot smarter where and how they spend there money and it would put leverage on Doctors, Hospitals, and Insurance Companies to compete and provide better and more affordable service. This would also open people eyes to being more responsible for there own health.
6/4/2016 8:58pm Edited Date/Time 6/4/2016 8:59pm
Scr your outlook is a reasonable outlook. Based on people that will take accountability for themselves. I like your reasonings. But it doesn't hit the heart strings. Nobody wants to work hard anymore for Anything. Theyd rather fill an arena and scream and wave signs when candidates say "healthcare for all" three words that sound so pretty but are so ugly to even try to define.

The problem is you can't force people to take care of themselves. And you can't force them to be accountable and you can't force them to believe it's not a god given right for healthcare. But you can force everyone to pay a penalty tax.


I am considering opening a private practice one day with a buddy whose a doctor. You pay us up front January 1st say $3,000!" Cash. And you can come in and see us anytime for one year. We will assess, diagnose and prescribe medication. Lab work would be flat fee of $50 per visit. This would just be an outpatient family practice office. That gives them access to a doctor constantly but still doesn't cover them if they need to be admitted as an inpatient.

But the more government regulates I think having a personal doctor with a cash deal for services is where primary care will be going for those outside of Medicaid and Medicare. I'm not sure though. I don't even know if $3,000 is reasonable. Or would I need 5,000 to break even? 200 accounts at $3,000 is 500,000. But then I'd need employees. And provide healthcare and....oh boy. Atleast we got incentive to start a small business in America these days....maybe not lol. I've got a lot to learn. Haven't even scratched the surface of this problem....the people need fix this, not the government.
6/4/2016 9:01pm Edited Date/Time 6/4/2016 9:02pm
There are Federal interstate commerce laws that do not allow one state to ban another state's commerce from entering the state. Somehow this exemption for medical insurance that is absolutely terrible for consumer's is always overlooked by those making the rules.
Hut
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6/4/2016 9:35pm
Spartacus wrote:
American health in general REALLY sucks. Fat is the new normal. Business lobby government to let us eat crap and keep people in the dark about...
American health in general REALLY sucks. Fat is the new normal. Business lobby government to let us eat crap and keep people in the dark about food choice/health.

American health care underserves and is over priced.

Rx prices are the highest in the developed world. Again, the fox is hanging out with the guard dogs in Washington.

The entire discussion on affordable care was misguided. It should have been about health care costs, not who pays.

That said why the fuk is America the only developed country without health care? Because the leaches selling it want to make every damm cent they can no matter what and buy their way into having their way.

Ban lobbying. Period. No corporate donations to politicians. Boo fuking hoo for them.

Opinions from someone with 4 doctors in family.



This
SCR
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6/4/2016 10:39pm
kkawboy14 wrote:
Has Obamacare helped or hurt you? I provide group for my company and it keeps going thru the roof but it is easier to get good...
Has Obamacare helped or hurt you?

I provide group for my company and it keeps going thru the roof but it is easier to get good coverage
I forgot about the cash physicians or concierge doctors where you pay a yearly members hip or retainer lIke your talking about.. I was talking with my mom about this recently. Another good example of good ideas and options that come from the free market and the people that actually provide the services. Not buarocrats and political think tanks.
Motoxdoc
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Steamboat Springs, CO US
6/5/2016 12:33am
Scr your outlook is a reasonable outlook. Based on people that will take accountability for themselves. I like your reasonings. But it doesn't hit the heart...
Scr your outlook is a reasonable outlook. Based on people that will take accountability for themselves. I like your reasonings. But it doesn't hit the heart strings. Nobody wants to work hard anymore for Anything. Theyd rather fill an arena and scream and wave signs when candidates say "healthcare for all" three words that sound so pretty but are so ugly to even try to define.

The problem is you can't force people to take care of themselves. And you can't force them to be accountable and you can't force them to believe it's not a god given right for healthcare. But you can force everyone to pay a penalty tax.


I am considering opening a private practice one day with a buddy whose a doctor. You pay us up front January 1st say $3,000!" Cash. And you can come in and see us anytime for one year. We will assess, diagnose and prescribe medication. Lab work would be flat fee of $50 per visit. This would just be an outpatient family practice office. That gives them access to a doctor constantly but still doesn't cover them if they need to be admitted as an inpatient.

But the more government regulates I think having a personal doctor with a cash deal for services is where primary care will be going for those outside of Medicaid and Medicare. I'm not sure though. I don't even know if $3,000 is reasonable. Or would I need 5,000 to break even? 200 accounts at $3,000 is 500,000. But then I'd need employees. And provide healthcare and....oh boy. Atleast we got incentive to start a small business in America these days....maybe not lol. I've got a lot to learn. Haven't even scratched the surface of this problem....the people need fix this, not the government.
"Nobody wants to work hard anymore for Anything"?.....really?.....you base that on......what? Do you also think most unemployed people enjoy chillin out all day and not working?

So you're thinking of taking a lump sum of cash from prospective patients at the beginning of the year?.....maybe you could refer to it as a sort of "premium payment"......and for receiving that you would promise them....or maybe give them assurance....or lets just say you would "insure" them that they would get health care at a less expensive cost than if they didn't pay you at the beginning of the year. That sounds great! You ought to do that before anyone else thinks about it and the government steps in and requires you be bonded, licensed and regulated.Dry
kzizok
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6/5/2016 4:57am
coverage went from about $400 to about $1100.
kzizok
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6/5/2016 5:39am Edited Date/Time 6/5/2016 5:47am
Motoxdoc wrote:
"[b]Nobody[/b] wants to work hard anymore for [b]Anything[/b]"?.....really?.....you base that on......what? Do you also think most unemployed people enjoy chillin out all day and not working...
"Nobody wants to work hard anymore for Anything"?.....really?.....you base that on......what? Do you also think most unemployed people enjoy chillin out all day and not working?

So you're thinking of taking a lump sum of cash from prospective patients at the beginning of the year?.....maybe you could refer to it as a sort of "premium payment"......and for receiving that you would promise them....or maybe give them assurance....or lets just say you would "insure" them that they would get health care at a less expensive cost than if they didn't pay you at the beginning of the year. That sounds great! You ought to do that before anyone else thinks about it and the government steps in and requires you be bonded, licensed and regulated.Dry
There are quite a few of tthese cafeteria tyype plans out there now. They seem to work pretty well too.
motogrady
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WV US
6/5/2016 6:38am Edited Date/Time 6/5/2016 6:41am
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy.
But, you go there you have to include motocross racers also.
Guys don't have to ride, just as a fat woman doesn't need a rack of Bon bons.

No, greedy higher ups, greedy medicine manufacturers, greedy lawyers getting astronomical judgements which in turn cause astronomical greedy insurance rates, greedy medical schools and professors that restrict the numbers of those wanting to become doctors in the first place.

Slash all that, by law or deregulation.

That's a start.
6/5/2016 7:35am Edited Date/Time 6/5/2016 7:42am
Motoxdoc wrote:
"[b]Nobody[/b] wants to work hard anymore for [b]Anything[/b]"?.....really?.....you base that on......what? Do you also think most unemployed people enjoy chillin out all day and not working...
"Nobody wants to work hard anymore for Anything"?.....really?.....you base that on......what? Do you also think most unemployed people enjoy chillin out all day and not working?

So you're thinking of taking a lump sum of cash from prospective patients at the beginning of the year?.....maybe you could refer to it as a sort of "premium payment"......and for receiving that you would promise them....or maybe give them assurance....or lets just say you would "insure" them that they would get health care at a less expensive cost than if they didn't pay you at the beginning of the year. That sounds great! You ought to do that before anyone else thinks about it and the government steps in and requires you be bonded, licensed and regulated.Dry
Can't base it on anything. I'm sure coworkers call it as they see it differently. But I'm Just calling it how I see it. Maybe I see it all wrong. What really upsets me is when bad things happen to good people. Seems like more hard working people get screwed than someone who has no regard for their life or others.



I see my fiancé get called into the OR at all hours of the night to remove needles from heroin addicts arms. Who won't pay. That come back with another needle and infection two weeks later. That's he type of crap we see regularly.

If we can waste resources figuring out regulation for what won't be paid for....then why can't we figure out who actually could be able to work ?

I drive through the hood daily on my way home from work. Lots of people standing on the corner. Lots of people sitting outside in the project development. Are some of them available for work ? Could they be ? The IRS will knock your door down over taxes but there's no rules against work evasion...or atleast it's more lacks laqs lackadaisicall (sp) but again I might be seeing that wrong. Not being a smart ass either. Just voicing opinion.

The whole country is screwed. Not one person or idea can fix it. So I don't know doc. I'm sure you call it how you see it. But in your area what are you seeing ?
6/5/2016 7:37am Edited Date/Time 6/5/2016 7:43am
motogrady wrote:
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy. But, you go there you have to...
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy.
But, you go there you have to include motocross racers also.
Guys don't have to ride, just as a fat woman doesn't need a rack of Bon bons.

No, greedy higher ups, greedy medicine manufacturers, greedy lawyers getting astronomical judgements which in turn cause astronomical greedy insurance rates, greedy medical schools and professors that restrict the numbers of those wanting to become doctors in the first place.

Slash all that, by law or deregulation.

That's a start.
There are people who come in three times a week, get $5,000 work ups because they have mental issues, have no way of paying their bill, and we have to take their complaints seriously because we don't want to get sued and we can't turn anyone away for any reason unless they are being violent. They either have Medicaid and we make less and less money each time they come in or if they don't have Medicaid they just go into millions of dollars of debt. There is no other business that is required to see esomeone regardless of their ability to pay.

We can't trust these patients with any amount of pain medications because they will over dose if we give them too many pills, so we have to give them one days worth of pain medications and instruct them to follow up. They never follow up and come back as soon as they run out of medications.

It is a completely broken system and no politician is going to be able to fix it because they are too out of touch to realize what needs to be done.
APLMAN99
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Tualatin, OR US
Fantasy
6/5/2016 8:00am
motogrady wrote:
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy. But, you go there you have to...
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy.
But, you go there you have to include motocross racers also.
Guys don't have to ride, just as a fat woman doesn't need a rack of Bon bons.

No, greedy higher ups, greedy medicine manufacturers, greedy lawyers getting astronomical judgements which in turn cause astronomical greedy insurance rates, greedy medical schools and professors that restrict the numbers of those wanting to become doctors in the first place.

Slash all that, by law or deregulation.

That's a start.
There are people who come in three times a week, get $5,000 work ups because they have mental issues, have no way of paying their bill...
There are people who come in three times a week, get $5,000 work ups because they have mental issues, have no way of paying their bill, and we have to take their complaints seriously because we don't want to get sued and we can't turn anyone away for any reason unless they are being violent. They either have Medicaid and we make less and less money each time they come in or if they don't have Medicaid they just go into millions of dollars of debt. There is no other business that is required to see esomeone regardless of their ability to pay.

We can't trust these patients with any amount of pain medications because they will over dose if we give them too many pills, so we have to give them one days worth of pain medications and instruct them to follow up. They never follow up and come back as soon as they run out of medications.

It is a completely broken system and no politician is going to be able to fix it because they are too out of touch to realize what needs to be done.
If you have patients that are going "millions of dollars" into debt, then that illustrates one of the biggest issues we have. You should be able to see a doctor nearly daily for years and never get close to a million dollars in charges.

My wife works on the business side of the medical field, and to be honest her job shouldn't even need to exist but with all the levels of admin now it's a necessity. And the numbers that she talks about would be obscene even if you removed a couple of zeros from the end.
6/5/2016 8:30am Edited Date/Time 6/5/2016 8:33am
motogrady wrote:
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy. But, you go there you have to...
Well, I understand the frustration of seeing repeat patients that don't do the right things to keep themselves healthy.
But, you go there you have to include motocross racers also.
Guys don't have to ride, just as a fat woman doesn't need a rack of Bon bons.

No, greedy higher ups, greedy medicine manufacturers, greedy lawyers getting astronomical judgements which in turn cause astronomical greedy insurance rates, greedy medical schools and professors that restrict the numbers of those wanting to become doctors in the first place.

Slash all that, by law or deregulation.

That's a start.
There are people who come in three times a week, get $5,000 work ups because they have mental issues, have no way of paying their bill...
There are people who come in three times a week, get $5,000 work ups because they have mental issues, have no way of paying their bill, and we have to take their complaints seriously because we don't want to get sued and we can't turn anyone away for any reason unless they are being violent. They either have Medicaid and we make less and less money each time they come in or if they don't have Medicaid they just go into millions of dollars of debt. There is no other business that is required to see esomeone regardless of their ability to pay.

We can't trust these patients with any amount of pain medications because they will over dose if we give them too many pills, so we have to give them one days worth of pain medications and instruct them to follow up. They never follow up and come back as soon as they run out of medications.

It is a completely broken system and no politician is going to be able to fix it because they are too out of touch to realize what needs to be done.
APLMAN99 wrote:
If you have patients that are going "millions of dollars" into debt, then that illustrates one of the biggest issues we have. You should be able...
If you have patients that are going "millions of dollars" into debt, then that illustrates one of the biggest issues we have. You should be able to see a doctor nearly daily for years and never get close to a million dollars in charges.

My wife works on the business side of the medical field, and to be honest her job shouldn't even need to exist but with all the levels of admin now it's a necessity. And the numbers that she talks about would be obscene even if you removed a couple of zeros from the end.
Yes millions, there are three major health networks in St. Louis and one guy I am thinking of in particular visits ours at least twice a week and has been doing this for at least five years. There is no telling how often he visits the other two. I would tell you that I could count up his ER visits next time he come in, but you probably wouldn't like that. Smile

Why would you need to see a doctor nearly daily for years and how and why should that be affordable? In what other business do you somehow just have the right to receive services for free? The body can do amazing things. It doesn't need an old man in a white coat to keep it alive.
If you opened a restaurant and you had to give people food regardless of their ability to pay then what do you think would happen to the cost of your food for the people that had to pay the bill?
kzizok
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6/5/2016 9:02am Edited Date/Time 6/5/2016 9:14am
Heres a little nuggett:ER, I worked in used to have a couple come in severals times a week. The interesting part is they each lived on opposite side of OKC (land wise ione of the biggest in the country). Guess where the hospital was located? You guessed it, right smack dab in the middle. You can probably see where this gioing. Yep, each would call an ambulance (they didnt have car) at the same time. They both show up in the ER, sign an against medical advice form and go about their day. Used ambulance as their Taxi. They wouldnt call a taxi because they cost money. So they got free ambulance rides, for them. Dont think I didnt recognize that I was working to pay for all their shit in the system.
Sometimes, they would stay, so we had to admit to the ER. They next would order food. I cant make this shit up. Avg fee just step in ambulance , about $1500, if they stayed to be checked in, another $1500, not including anything else.About $3k per person,$6k total. Remember, those numbers are the bare minimum. If they wanted narcotics, they mention the two magic words, chest pain. Did I mention they do this several times a week? EMTLA law says no matter what, you have to see them. Where did common sense go? Sorry for the ramble.
6/5/2016 9:19am Edited Date/Time 6/5/2016 9:22am
Kzizok and chocolate, oh the crap we could laugh about around a table in the same room. This is stuff nobody talks about but it exists.

I have surgical icu experience, Float to medical and nuero as well. And pick up in pacu extra to pay for my wedding. Ha.

In every aspect of the hospital there is major fuckery going on. There are patients stuck in the icu because insurance won't pay for them to go to a long term acute care facility (LTAC) unless they're on a ventilator for 24 hours. They won't pay for them to stay in the icu either. So too sick to leave to a lower level of care, but not sick enough to go to a facikity designed to care for chronicly sick individuals. These patients beg us to keep them on the vent for 24 hours so the insurance will pay for them to go a LTAC. And it comes down to caregivers hands being tied. It's so hard to even provide great care to these people with all the leashes they put on us. I wish it were different. I don't know how to fix it, but I know it's broken.




I work for a major hospital system. We get patients from all over the world. From these other countries people rave and praise that their socialized medicine is absolutely awesome. So then why are Saudis, flying to America to get care ? Why are swedes telling me at the bedside socialized medicine is terrble....the quality isn't there so they have to fly to America...a city in Ohio of all places and be worked up for aggressive bowel treatments/ transplant procedures/ necessary procedures To have a shot at living a quality life.

IF ITS SO GREAT, Why don't these people stay there and use their socialized system that they're provided ?
kzizok
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6/5/2016 9:39am
kkawboy14 wrote:
Has Obamacare helped or hurt you? I provide group for my company and it keeps going thru the roof but it is easier to get good...
Has Obamacare helped or hurt you?

I provide group for my company and it keeps going thru the roof but it is easier to get good coverage
Its insane. Just a couple of minutes ago my nephew sent this and asked if its true:



6/5/2016 9:45am Edited Date/Time 6/5/2016 9:51am
It's true. Physician just have to write the order. 8 oz alcohol with meals tid.

If they're super sick or have the ability to become super sick you're not fixing the addiction, so to prevent withdrawal give them what they need. After they're more stable try to get them consulted with psych and into a rehab type of treatment. Withdrawal on top of sepsis or something systemic is a recipe for death. So another example of trying any means necessary to save people.

People that get into healthcare do so with good intentions and just get bogged down. But we still muscle through and hope and have faith in humanity. That's what keeps me going. If I can help one decent person for 80 that abuse it, I'm ok with it. But at some point the bubble will pop and there won't be any of us left.

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