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View Diary: Obamacare Application, Unveiled Today, Full of Win (202 comments)

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  •  Poor people will be required to go to a federal (4+ / 0-)

    "health clinic" because hospitals will reject them. Flat out reject. Federal clinics will have to care for the poor and uninsured and underinsured with the junk insurance.

    The chargemaster is the key to the kingdom. Hospitals make a killing... and NON-profits (think Catholic hospitals) earn more profit per year than their profit counterparts.

    Poor people pay 400% more for the exact same healthcare services that Medicare and Medicaid reduce down. Even insurance companies can't reduce rates from hospitals like Medicare can.

    And, hospitals will whine that they "write off" charity healthcare, but since they actually bill 400% more than they should... their write-downs are bullshit. Their so-called "charity care" is often less than 1% of their annual profit. Hospitals are often a city's most profitable business and the administrators some of the highest paid in the region... and not worth the salt plunked down for their service.

    And, hospital administrators are gearing up to get MORE HEAVY-HANDED IN COLLECTIONS from the uninsured and underinsured who are charged obscene amounts for healthcare.

    The CEOs of hospitals make obscene compensation packages... which includes and permits them to maintain ties to their pharmaceutical companies and other such things that milk our economy dry.

    The Hurricane Sandy bill is $60 billion. The US spent that much LAST WEEK on healthcare.

    The hospital industry makes the military industrial complex look like a piker. The MIC spent $1.53 billion on lobbying since 1998 while the healthcare industry spent $5.56 billion.

    Our deficit is driven by the healthcare-CEO complex.  

    A society grows great when old men plant trees in whose shade they know they shall never sit.

    by bronte17 on Tue Apr 30, 2013 at 09:40:25 PM PDT

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    •  "fedeal health clinic" sounds like "death panels" (25+ / 0-)

      Where exactly are these "clinics". Are they going to be built by FEMA by any chance?

      We knew that the private sector was still involved in delivery of health care and that is part of the problem with the ACA.

      That said, the hospitals are not going to be collecting from poor people, they'll be collecting from Medicaid as those people will now be covered under that program. If they aren't covered, then it'll be like it is now and the taxpayers and those with insurance will pick up the tab along  with the hospitals.

      There are other parts of the law that would also suggest that what you claim may not be how it will go in general.

      The politicians may be bought, and the system corrupt, but it is our duty to fix these things.

      by sebastianguy99 on Tue Apr 30, 2013 at 09:56:20 PM PDT

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      •  I agree-no such thing as a "federal health clinic" (26+ / 0-)

        I am an MD and no one has heard of such a thing. If no docs, then no clinics.

        However, if they did want to expand VA Clinics to more patients, would not be such a bad thing. Isn't it amazing we have federalized single-payer healthcare for our veterans and really no one complains.

        Seems these ACA forms have things off to a good next step.

        •  RNs trained in master's programs to run clinics (2+ / 0-)
          Recommended by:
          praenomen, CuriousBoston

          My cousin is doing this. He will eventually run a clinic on his own.

          And my info is from academic studies and reports.

          A society grows great when old men plant trees in whose shade they know they shall never sit.

          by bronte17 on Wed May 01, 2013 at 08:49:01 AM PDT

          [ Parent ]

          •  You are closer to the truth than you (0+ / 0-)

            can would be eye-opening if most people could hear what is being taught in medical classrooms at the moment. Even college professors are screaming at their students to wake up before it's too late...but they just don't get it.

            •  I'm sure you could repeat this info (3+ / 0-)
              Recommended by:
              Amayi, howarddream, sethtriggs

              without breaking any confidences. Please do.

              Let us all have the strength to see the humanity in our enemies, and the courage to let them see the humanity in ourselves.

              by Nowhere Man on Wed May 01, 2013 at 10:57:14 AM PDT

              [ Parent ]

              •  In general terms, they're telling students (0+ / 0-)

                that we're all getting royally screwed and if we don't start fighting back, then we're going to discover that we've been had, but it will be too late.

                Many of the professors are saying that they have become healthcare activists because of what they see happening in the medical field (especially to elderly people).

                But what is more amazing is that they are affirming the information that teacherken posted on this site when he said that students entering college now are unprepared for academic studies. They have literally been screaming at them that they don't have critical thinking skills. In other words, the conservatives have managed to dumb down America to the point that our students are in serious trouble. They won't be able to compete.

          •  Still need an MD involved somewhere (1+ / 0-)
            Recommended by:

            I think nurse practitioners and physician assistants are very useful for providing medical care, though there are limits.

            "Minute Clinics" or similar are fine for simple issues. However, anything more complicated needs MDs involvement.

      •  Community Health Centers and Free Clinics (20+ / 0-)

        have been around for forty years. In many cases they are privately funded using new markets tax cuts and neighborhood synergy allowing them to go to banks for loans which the banks can write off in return for the private non profits tax breaks.

        Hospital Free care pays the costs of poor people in a close approximation to universal comprehensive single payer. The costs are passed on by the Hospital to a combination of Medicaid, Insurance  and privately funded charities and philanthropies so that there is more than one payer but it is universal and comprehensive.

        Live Free or Die --- Investigate, Incarcerate

        by rktect on Wed May 01, 2013 at 12:58:57 AM PDT

        [ Parent ]

        •  Hospitals and the CEOs are not the Mister Nice Guy (2+ / 0-)
          Recommended by:
          praenomen, rktect

          that so many people imagine them to be.

          And Mayo Clinic itself ran a program and study which demonstrated that health care costs can be significantly reduced when the doctors and CEOs are NOT personally vested and affiliated with the capital equipment/pharmaceuticals/special hospital wings.

          That's a Texas thang down there in Houston to suck folks dry.

          A society grows great when old men plant trees in whose shade they know they shall never sit.

          by bronte17 on Wed May 01, 2013 at 08:53:46 AM PDT

          [ Parent ]

          •  I'm able to see both sides (0+ / 0-)

            Hospital administrators tend to be assholes more concerned with the bottom line than providing care, and doctors are often asked to give their research grants to the hospital in return for labs. Its the administrators job to identify the funding before agreeing to build a bone marrow transplant or cardiac catheterization, or infectious disease wing.

            Doctors then turn around and demand some pretty fancy lab equipment, autoclaves with their own steam generators and stainless steel piping to wash petrie dishes for example. That's the sort of thing which tends to make hospital healthcare expensive.

            There are also doctors who aren't internationally famous, who don't have their own research labs, who donate time to provide the services of a specialist to community health centers and there are lots of hospitals who allow CHC's to come to them for their lab work and diagnostics.

            As far as affordable healthcare and free care go, its awful nice to be too poor to afford insurance and get your cancer care paid for by a system that medical professionals put in place precisely to get around the insurance company parasites.

            Live Free or Die --- Investigate, Incarcerate

            by rktect on Wed May 01, 2013 at 03:31:13 PM PDT

            [ Parent ]

      •  you do know states are... (3+ / 0-)

        ...cutting medicade coverage left and right now.

        We Glory in war, in the shedding of human blood. What fools we are.

        by delver rootnose on Wed May 01, 2013 at 01:34:13 AM PDT

        [ Parent ]

      •  It is how civilized countries do things (1+ / 0-)
        Recommended by:

        healthcare administration largely centralized at the national level. Much simpler much fairer.

      •  My doctor's office is a "federal health clinic" (7+ / 0-)

        A large percentage of primary care practices are federally qualified health clinics. In rural areas and inner cities, almost all of them are.  

        You will be required to have a primary care physician.

        If you are poor, the offices that receive federal funding to subsidize care for poor patients are the federally qualified health clinics. Practices that chose not to participate in the FQHC program probably won't accept you, but you're unlikely to live in the tony zip code where such a practice is located, anyway.

        Someone is doing some serious "ooga booga" framing here. There's nothing scary about a federally qualified health clinic.

        •  Well then it is not your doctor's office is it? (0+ / 0-)

          This isn't about subsidies, The comment said that there were going to be "federal clinics", not clinics that rely in part on federal subsidies. There is a big difference as one is entirely publicly owned and the other is private but takes public funds.

          I too rely on a local clinic for my care and I'm sure federal money is part of how they stay in business. I am also quite aware of the difference between my clinic and where I went when I had insurance. They are not the same though they both have monies from the public purse.

          I hope we can agree that the public is not well served by misinformation not matter the source or motivation, if any.

          The politicians may be bought, and the system corrupt, but it is our duty to fix these things.

          by sebastianguy99 on Wed May 01, 2013 at 12:46:40 PM PDT

          [ Parent ]

          •  The comment was full of shit (1+ / 0-)
            Recommended by:

            The commenter to whom I replied was using fear-mongering language to describe exactly the kind of office in which my primary care physician works.  

            He has been working from the same office for more than a decade. He is the same doctor I have been going to during that time. A bit over a year ago, his office filled out some paperwork and added some administrative procedures, and voila(!) it is now a FQHC. There is literally no difference in the care I receive or the physician I use, but people in town who are currently uninsured will now be able to use his office and get subsidized insurance coverage.

    •  That hasn't been my experience (22+ / 0-)

      I'm 67 my wife will be 65 on May 3. We did go to a free clinic first that referred us to a hospital for CAT Scans and XRays which the Hospital covered under Free Care. The Initial bills for the Emergency Room, surgery, and recovery were covered under Free Care (Charity Care).

      Rather than poor people being charged obscene amounts, Hospitals pass the obscene amounts on to Medicare which passes them on to insurance companies who are subsidized to pick up the Free Care.

      Obama is now proposing to cut the subsidies since the Affordable Care Act in providing the 50 million new customers makes it more than adequately profitable for the insurance companies to write it off.

      We are now enrolled in SSI, Medicare and Maine Care aka Medicare, plus I have the VA. Her radiation and chemo treatments are covered by Medicare first and then by Maine Care. The Hospital administered the coverage using social workers to facilitate grants from cancer funds to pay for the chemo. Medicare A reimburses the Hospital costs. Medicare B reimburses the treatment costs, we don't have Medicare C. Medicare D is picked up by Maine Care with a $10 co-pay for a medication that costs thousands and generic drugs at $2.65.

      Live Free or Die --- Investigate, Incarcerate

      by rktect on Wed May 01, 2013 at 12:53:15 AM PDT

      [ Parent ]

      •  60% of all bankruptcies in the US are medical (2+ / 0-)
        Recommended by:
        praenomen, rktect


        For people who are not on Medicare, their healthcare expenses are 400 times what you pay. For no rhyme or reason. It's that "chargemaster" which the hospital financial offices use to bilk people out of money.

        And, if you can't pay, you do NOT get chemo. It's that simple. For the majority of people.

        A society grows great when old men plant trees in whose shade they know they shall never sit.

        by bronte17 on Wed May 01, 2013 at 08:59:53 AM PDT

        [ Parent ]

        •  Thanks to the healthcare reforms in Obamacare (1+ / 0-)
          Recommended by:

          it isn't going to be like that anymore.

          Live Free or Die --- Investigate, Incarcerate

          by rktect on Wed May 01, 2013 at 03:33:11 PM PDT

          [ Parent ]

          •  well... there is a lot of trepidation out there (1+ / 0-)
            Recommended by:

            from most of the players in our healthcare system.

            My two cents would say that poor people will get basic services that focuses on altering to a wellness lifestyle more than focusing on disease (not that it is a bad thing to do that).

            But, for those who already suffer horrible ill health from poor choices or simply poor environment, it will be too little too late.

            We're going to hand out bandaids for a long time to come. Health clinics just aren't going to cut it for many sick people. And a Harvard study has published the findings that back it up.

            And, many states have passed those damn "freedom of conscience" clauses that allow doctors and nurses and pharmacists to opt out of treating an ill person if that person "offends" some offset of their religious persecution complex.

            There are a lot of outs for providers to not treat folks if they don't feel like it.

            This country is totally dysfunctional.

            A society grows great when old men plant trees in whose shade they know they shall never sit.

            by bronte17 on Wed May 01, 2013 at 07:50:40 PM PDT

            [ Parent ]

            •  I'm poor and the services I get are comprehensive (1+ / 0-)
              Recommended by:

              My wife is receiving her hospitalization, radiation, chemo therapy and surgery free of charge, my VA care has included an operation on my gall bladder which included an ambilance ride to a hospital out of state and a weeks stay there in intensive care, regular CAT scans, X-Rays, colonoscopies, phlebotomy, gastro enterology, 2 annual checkups, optometry to include free glasses, audiology to include free hearing aids, a liver biopsy, schedule D drugs for $2.65, and schedule B drugs with a $10 co-pay. I'm leaving off a lot of stuff because the list is really long but we get phone calls from people working to keep us healthy almost on a daily basis.

              The Primary Care that you are talking about coming from Free Clinics, Free Care at hospitals, CHC's SSI disability, Medicaid and non governmental programs to include philanthropies and volunteers, vaccinations against flu and communicable diseases generally, diagnostics and treatment for chronic illness such as heart disease and diabetes has been around for forty years.

              Live Free or Die --- Investigate, Incarcerate

              by rktect on Thu May 02, 2013 at 03:17:25 AM PDT

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              •  They have been around for decades (0+ / 0-)

                yet for a supposedly "first world" nation, we have a horribly inefficient healthcare system that excludes tens of millions while it's simultaneously more expensive than any other in the world (we spend more than the other top 10 nations COMBINED).

                And a lot of that has more to do with churning the system to create superfluous layers and then skimming that cream off the top by too many middlemen while the actual healthcare delivery is suppressed or denied for millions.

                A society grows great when old men plant trees in whose shade they know they shall never sit.

                by bronte17 on Thu May 02, 2013 at 06:10:13 AM PDT

                [ Parent ]

    •  Human husbandry. One can only hope the (1+ / 0-)
      Recommended by:

      medical industrial complex causes less suffering than the military industrial complex.
      The results are questionable because the military hardware only hurts when it is used in warfare. Keeping the stuff in storage is just really boring.

      We organize governments to deliver services and prevent abuse.

      by hannah on Wed May 01, 2013 at 03:24:53 AM PDT

      [ Parent ]

      •  And that's really what happened with Iraq (2+ / 0-)
        Recommended by:
        praenomen, hannah

        The military just exploded out of its container. They chafed under the confines and couldn't wait to be turned loose to use their very expensive deadly toys.

        shrub epitomized the glorification of SWAT militaristic swaggering bling on that aircraft carrier.

        A society grows great when old men plant trees in whose shade they know they shall never sit.

        by bronte17 on Wed May 01, 2013 at 09:04:49 AM PDT

        [ Parent ]

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