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 And these are the people you want running your own healthcare system?

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Bighead
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The Other One
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PostSubject: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeTue Aug 25, 2009 9:00 am

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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 10:12 am

I spent several years without decent healthcare. Now, being disabled, I have Medicare. ANYTHING that lets you see your doctor is better than nothing.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 2:13 pm

CelticDragon wrote:
I spent several years without decent healthcare. Now, being disabled, I have Medicare. ANYTHING that lets you see your doctor is better than nothing.

Especially when the doctor mistakenly gives you the death sentence.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 2:42 pm

That happens even in private practices. That's the problem with having human beings give care, we're fallible. The whole letter mixup on the ALS diagnoses was due to a clerk typing in the wrong code. Besides, that's not "giving you the death sentence." That is a misdiagnosis. One can still seek a second opinion or take all options to treating the disease, rather than laying down and giving up.
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Ratzilla
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 6:31 pm

The difference between a misdiagnosis in a private practice and this is that here there were 1200 patients misdiagnosed all at the same time due to cookie cutter medicine.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 7:57 pm

CelticDragon wrote:
That happens even in private practices. That's the problem with having human beings give care, we're fallible. The whole letter mixup on the ALS diagnoses was due to a clerk typing in the wrong code. Besides, that's not "giving you the death sentence." That is a misdiagnosis. One can still seek a second opinion or take all options to treating the disease, rather than laying down and giving up.

Read the story again this time keeping in mind the group of patients and where they must get healthcare. Multiply that number by 100 million, then re-read it again.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 9:26 pm

It's a moot point now that Teddy has kicked the bucket. 'Healthcare Reform' will sail through the legislature on a wave of manufactured sentimentality... ya'll just watch.

Not that I care much one way or the other. But it'll be funny to hear the wailing and gnashing of teeth from the 'right'.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 9:39 pm

do you honestly believe it will sail thru? I think we should all be very worried.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 10:26 pm

Well, "sail" might be an exaggeration- I expect a big fight and plenty of political theater over the next few MONTHS. But this is something the Dems have wanted decades. They finally have the votes to do it (filibusters be damned- there are ways around those). The insurance industry and the pharmasutical industry, while putting up a valiant covert opposition, are ALREADY cutting deals. Top it all off with Saint Teddy's demise as an emotional rallying point- and I think that healthcare reform in SOME form will pass.

The Republicans blew their wad early- I just don't think they can sustain the level of hysteria that they managed to generate for a few weeks. The Democrats, on the other hand, have only started to organize their own astroturf campaign. They're putting together their own rallies, busing in union-people, organizing multiple special interest groups, conjuring up advocacy groups out of thin air, and using their campaign machine to get people stirred up. It worked last year, and I think it'll work again.

Like I said, I don't care a whole lot what they do. I have mediocre health insurance now, and I expect I'll have mediocre coverage afterwards. I DON'T think it's an efficient long-term solution... but the option of a "free market" or anything even remotely like it just isn't on the table. Socialism in America- in a number of areas- has produced mediocre results for GENERATIONS... this isn't anything new. I don't see any reason to think healthcare will be any different.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Aug 26, 2009 10:51 pm

I agree that the dems will call for a rally to push this through around Chappy K's death. If the dems didn't jump on the chance for a huge liberal pity party it would have Teddy spinning in his grave in shame.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 12:08 am

Bighead wrote:
The Republicans blew their wad early- I just don't think they can sustain the level of hysteria that they managed to generate for a few weeks. The Democrats, on the other hand, have only started to organize their own astroturf campaign. They're putting together their own rallies, busing in union-people, organizing multiple special interest groups, conjuring up advocacy groups out of thin air, and using their campaign machine to get people stirred up. It worked last year, and I think it'll work again.

I don't think so. The Dems have put fear in the retired, millions are out of work, and Republicans are ACTUALLY taking off work to dispute this.

I, as a person who would benefit from this bill, (ie. pays their own insurance and goes to the doctor rarely), oppose it. Why to you speculate that is?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 7:12 am

Quote :
Why to you speculate that is?

Because that's what your talk-radio idols tell you to do.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 7:38 am

nitromaxx98 wrote:
Bighead wrote:
The Republicans blew their wad early- I just don't think they can sustain the level of hysteria that they managed to generate for a few weeks. The Democrats, on the other hand, have only started to organize their own astroturf campaign. They're putting together their own rallies, busing in union-people, organizing multiple special interest groups, conjuring up advocacy groups out of thin air, and using their campaign machine to get people stirred up. It worked last year, and I think it'll work again.

The Dems have put fear in the retired,

I think you better lay off of the Kool-Aid Nitro. It is the Republicant's (Sarah Palin, Chuck Grasslie and a host of others) and their Talking Heads (Rush Limbaugh, Sean Hannity, Glen Beck) that have been spewing the "Soylent Green" bullshit lies with the #1-Death Panels for the sick and Elderly and #2 the Death Book for Veterans and #3-how all those on Medicare are going to have to give up their Doctors.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 8:08 am

Ratzilla wrote:
I agree that the dems will call for a rally to push this through around Chappy K's death. If the dems didn't jump on the chance for a huge liberal pity party it would have Teddy spinning in his grave in shame.

"Never let a good crisis go to waste." - Rahm Emanuel

Guess that goes for a timely death, too.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 8:18 am

From what I see - those "bullshit lies" are not lies. Seems that there is plenty of proof to back it all up. If they have their way, they won't have to worry about giving up their doctors on Medicare because there won't be any Medicare anymore.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 9:28 am

Bighead wrote:
Quote :
Why to you speculate that is?

Because that's what your talk-radio idols tell you to do.

Wrong.

C'mon, Bighead, you're a smart guy. Don't dissapoint me now.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 9:31 am

slider wrote:
I think you better lay off of the Kool-Aid Nitro. It is the Republicant's (Sarah Palin, Chuck Grasslie and a host of others) and their Talking Heads (Rush Limbaugh, Sean Hannity, Glen Beck) that have been spewing the "Soylent Green" bullshit lies with the #1-Death Panels for the sick and Elderly and #2 the Death Book for Veterans and #3-how all those on Medicare are going to have to give up their Doctors.

How do you keep from breaking your nose when Obama stops walking?
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nobodysbusiness wrote:
From what I see - those "bullshit lies" are not lies. Seems that there is plenty of proof to back it all up. If they have their way, they won't have to worry about giving up their doctors on Medicare because there won't be any Medicare anymore.

Medicare isn't going anywhere, another urban legend from the fear mongers!
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 3:36 pm

and what is your proof of that?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 5:35 pm

0bama said so.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 5:51 pm

If there is socialized medicine there is no longer a need for medicare. All would become lumped into the same cookie cutter system. Except the wealthy and the politicians of course.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 6:15 pm

Ratzilla wrote:
If there is socialized medicine there is no longer a need for medicare. All would become lumped into the same cookie cutter system. Except the wealthy and the politicians of course.

Medicare is Socialized Medicine dipshits, why do you think they had Ronnie Reagan doing the speech back when they were trying to pass it back in the 60's telling people they could tell their grandchildren about when we were still free? All the same lies the Republicant's are still spewing, and you know what, it still works pretty damn good and that is why the Seniors of this Country don't want any changes to their health care. But the ney-sayers are using that to scare the hell out them into believing it will be taken away. Prove to me where it says Medi-CAre will go away. I dare you!

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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 6:37 pm

You gotta take this argument in small doses, Slider- 'cause most of these people aren't even remotely interested in the truth. If they hear it from their Dear Leader Rush, then it MUST be true. A mere assertion by the right entertainer is 'proof' by their standards.

Nitro- I've been disappointing you for YEARS. Why would you expect me to stop now?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 6:53 pm

Medicare’s annual spending exceeded revenue brought in from taxes in 2008, forcing Medicare to begin spending its reserve funds. According to the Medicare Trustees, Medicare’s reserve will be empty by 2017, and Medicare will have to cut benefits or payment rates by 19% to balance its budget [1]. Since the projected date of Medicare’s bankruptcy has been brought forward many times [2], it’s likely that the actual date of bankruptcy may be as early as 2015.

This should come as no surprise to observers of US healthcare policy, since Medicare has limited funds, but nearly unlimited liabilities. Medicare will pay for almost any treatment that a licensed doctor provides, without regard to the effectiveness of that treatment, or its own ability to pay for that treatment.

In the past, politicians have paid for Medicare’s growth through borrowing. That route will be unavailable this time, as US government debt will exceed GDP by next year, and could be over 120% of GDP by 2017. Raising taxes will be difficult as well, since tax revenues will have to be increased just to pay for the existing debt! If Congress and the President fail to curb Medicare cost growth as part of health care reform, the cuts in 2017 will look a lot like California’s budget, where the state was forced to cut $16.1 Billion (18%) from its in state services across the board.

The current health care reform plans have introduced a variety of cuts in Medicare, which may reduce costs in the short term. But none of the plans under consideration address Medicare’s root problem: Medicare is not allowed to say NO. Rationing health care is not part of the current health care discussion, but it happens covertly today, and it will become the norm. If Medicare is to avoid insolvency, the government will have to decide when some procedures just aren’t worth doing. Seniors should be allowed to pay extra for those procedures, but Medicare will have to limit its responsibility. If you don’t believe me, look at California, where they finally learned that when the money’s gone, it’s gone.

[1] The Medicare Trustees’ Report Summary can be found at: http://www.ssa.gov/OACT/TRSUM/index.html

The fiscal situation referred to in this post refers specifically to the solvency of the Medicare Part A, the Hospital Insurance (HI) fund. Other parts of Medicare are in slightly better shape, but not by much. In 2017 the HI fund will have revenue for 81% of benefits, but in 2035 it will have revenue for only 50% of benefits.

[2] The Medicare Trustees note that the 2008 Report projected a Medicare HI Fund insolvency date of 2019 – it was brought forward 2 years this year. The solvency calculations also assume that Medicare will cut payments to medical providers based on a Deficit Reduction Act formula – but every year from 2003-2009, these cuts have been rolled back. The likely date of insolvency may move forward by a few more years as a result.



LINK
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 7:58 pm

According to your Republicant members of Congress, Medicare has been teetering on the edge of bankruptcy from the moment it was signed into law. You prook says it has enough money in 2015 or 2019, which is it?

HMMM I wonder if it'll still be solvent then and the dumbasses will still be bitching about the "Socialist Medicine" that Johnson put into motion being yet another "Socialist or Communist' program being shoved down the throat of the American People. Why do you think the Republicant's are working so hard to flat out lie to the Seniors in the country?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 8:35 pm

slider wrote:
Ratzilla wrote:
If there is socialized medicine there is no longer a need for medicare. All would become lumped into the same cookie cutter system. Except the wealthy and the politicians of course.

Medicare is Socialized Medicine dipshits

Well since you believe every reply must begin with an insult, may I suggest you are the mutant offspring of a Wichita crack whore and a retarded Rottweiler?

Now that that's done, the fact that Medicare is socialized medicine is the point. If everyone is using socialized medicine there would be no point in a separate program like Medicare. You ass baby of a diseased San Francisco drag queen.

Hope my insults were good enough to make the discussion proper. Smile
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 8:42 pm

I think you're mistaken, Ratzilla. If there are any human/rottweiller offspring here in Kansas, I'm pretty sure they'd be in Hutchinson.

LINK


And speaking of Wichita crack whores- we've got a pretty good crop this month.

Wichita Crack Whores
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One of em could have relocated.
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Man them hos are butt ugly. And these are the people you want running your own healthcare system? 733732 And check out the eyes on that Melivin guy. Wonder if seeing one of them hags naked caused his eyes bug out like that? LOL
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slider wrote:
According to your Republicant members of Congress, Medicare has been teetering on the edge of bankruptcy from the moment it was signed into law. You prook says it has enough money in 2015 or 2019, which is it?

HMMM I wonder if it'll still be solvent then and the dumbasses will still be bitching about the "Socialist Medicine" that Johnson put into motion being yet another "Socialist or Communist' program being shoved down the throat of the American People. Why do you think the Republicant's are working so hard to flat out lie to the Seniors in the country?

My bad, slider. I overestimated your ability to comprehend simple budget concepts. I'll try to find links that use smaller words..

How do you breathe in there?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 10:17 pm

Ratzilla, you are one sick Futhermucker, and no NB I am not going to apologize to the Forum for my langauge, that is simply calling a fracking spade a spade in plain english.

Now for calling my Mother a crack whore and my Father a retarded Rotweiler. I'd like to meet you in a dark alley, you would be begging on your Mother and Fathers honor to take those poorly chosen words back. That is not a threat, just a wish to make you show some respect towards the people you chose to drag thropugh the mud just to be a fracking prick. Did those comments make your little pencil thin pecker hard and squirt? Takes a real big man to attack someone's parent and in that matter.

Now for the "rules of this Forum" I see once again Ratzilla can get away with a sick, perverted and uncalled for remarks about someone's parents.

NB, why don't you put that 'saintly halo' of yours down for a just a little while and ban his sorry ass for a month. He sure as frack deserves it for his lack of any common sense and his personal attack on the honor of my dead Father and 84 year old Mother.

Ratzilla you are a total fracking asshole and a complete classless fracking prick and you can take your feeble apology if one every comes from and shove it up your ass!
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 10:32 pm

What is a Republicant?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 10:33 pm

and Ratzilla, knock it off. I know where you live.

All of you - behave and have a normal conversation/debate. I will throw the whole thread in the can.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 10:35 pm

For being thick skinned and throwing insults around like you do, you sure did take Ratz comments personally. He will be warned, and possibly banned, but as you have said before, suck it up and take it!! Why are you letting what some dude on the internet says bother you so much?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 11:20 pm

slider wrote:
I'd like to meet you in a dark alley, you would be begging on your Mother and Fathers honor to take those poorly chosen words back.

Not likely.

slider wrote:
Ratzilla you are a total fracking asshole and a complete classless fracking prick and you can take your feeble apology if one every comes from and shove it up your ass!

I had no intent of apologizing. Smile

You like to insult everyone on these forums, I just thought I'd make you feel at home. Guess you shouldn't start an insult contest if you're a minor leaguer.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeThu Aug 27, 2009 11:31 pm

nobodysbusiness wrote:
and Ratzilla, knock it off. I know where you live.

You gonna bring the whip? What a Face tongue
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:09 am

Ratzilla wrote:


You like to insult everyone on these forums.

He's never insulted me.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:25 am

Bighead wrote:
Ratzilla wrote:


You like to insult everyone on these forums.

He's never insulted me.

Probably because you havn't considered him worth bothering with. And recently you've both been taking leftist views of the topics. I happen to agree with both you and slider on several issues and don't think either of you are complete socialists. One difference between the two of you is that you don't think you have a one sided right to trash everyone else without anyone firing back. For some reason he does. In plain words, he has tantrums.
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slider
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:36 am

nobodysbusiness wrote:
For being thick skinned and throwing insults around like you do, you sure did take Ratz comments personally. He will be warned, and possibly banned, but as you have said before, suck it up and take it!! Why are you letting what some dude on the internet says bother you so much?

I have very thick skin but when it comes to insulting my Parents, especially calling my Mother a Crack Whore and my Father a Retard that is where the line is drawn.

Those two extremely rude and offensive statements by Ratzilla are a direct violation of your rules of conduct on theis Forum. They were a direct personal attack on me and my Parents. So grow some balls and enforce your Forum Rules!

Ratzilla must be setting at his keyboard stroking his massive two inch penis in celebration of his big accomplishment of showing the Forum just how big of a low life scum he acually is. But I'll bet the ranch you'll ban me and let Ratzilla and his school yard bullies just continue to get away with their flagrant abuse of your rules. You did it when Mikcc did the same thing to my Mother, inferring that he was sleeping with her several months ago. Once again there are special rules for some and the rest of the users get treated differently than the chosen few.

Just how would you feel if someone called your Mom a Whore and your Dad a retard? I'll bet the ranch you would have them gone in a heartbeat.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:48 am

no slider, I bet the ranch that I would laugh out loud, and let it go. The only reason Ratz made the comment he did, is to get under your skin and make you understand what it feels like. You are constantly making comments, like the ones above. How is it that you are also not in direct violation of the rules by calling all the other posters on this thread dipshits? If you would learn to keep your mouth shut sometimes half of these arguements wouldn't happen. I am all for a heated debate, especially on important topics like these, but when you make comments like you do - you are just begging to get jumped on.

It looks to me like you can sure dish it out but can't take it.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:51 am

oh and bottom line slider - this is MY FORUM and I will do what I want with it. If you don't like it, LEAVE!
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:58 am

slider, why don't you ask yourself why I would insult you so extremely. I don't insult the others in that rude of a fashion. If you'd politely debate instead of going into profanity laden tirades there'd be more sympathy towards you and I wouldn't torment you to that degree.

It is my nature to return an attack 10 times stronger with no mercy whatsoever. I also return kindness with a gentle manner that you could experience if you'd learn to calm down.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 12:58 am

slider wrote:
insulting my Parents, especially calling my Mother a Crack Whore and my Father a Retard

slider wrote:
Those two extremely rude and offensive statements by Ratzilla

ratzilla wrote:
may I suggest you are the mutant offspring of a Wichita crack whore and a retarded Rottweiler?

This is a question.

Ratzilla wrote:
You ass baby of a diseased San Francisco drag queen.

This is a statement.

slider wrote:
Ratzilla must be setting at his keyboard stroking his massive two inch penis in celebration

This is an assumption.

This is funny.. What a Face
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 1:06 am

nitromaxx98 wrote:
slider wrote:
Ratzilla must be setting at his keyboard stroking his massive two inch penis in celebration

This is an assumption.

This is funny.. What a Face

What's funny is that he calls two inch penises massive. Poor fella. Explains alot.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 1:15 am

Ratzilla wrote:
if you'd learn to calm down.

Probabally difficult to calm down when people in wheelchairs keep on taking all the close parking spots.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 1:41 am

nitromaxx98 wrote:
Ratzilla wrote:
if you'd learn to calm down.

Probabally difficult to calm down when people in wheelchairs keep on taking all the close parking spots.

Careful nitro. He'll want to take you in a dark alley and teach you a lesson too. Sure hope he knows an alley with handicapped parking so he won't hurt himself getting there.
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeFri Aug 28, 2009 5:50 am

And these are the people you want running your own healthcare system? 1974_eating_popcorn
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeMon Sep 07, 2009 8:46 pm

im not convinced "medicare" is the problem. seems to me if all the insurance companies and corporate for profit hospitals were taken from the equation it wouldnt be broke.

What that New York Times Magazine story missed about the Memorial Medical Center tragedy.
By Josh Levin
Posted Friday, Sept. 4, 2009, at 7:03 AM ET
(Continued from page 1)


Medicare's new rules created an economic incentive to build more LTCHs. Acute-care hospitals, now getting a fixed amount per patient, were eager to discharge the people they treated as soon as possible—the longer the stay, the more money the hospital would lose. LTCHs, which were reimbursed at higher levels, sprang up to take in that supply, becoming a repository for patients who were clogging up beds at acute-care facilities. CMS reported in 2005 that the standard payment rate for LTCHs was eight times greater than the rate for acute-care hospitals. In 2006, the director of the Center for Medicare Management said that LTCHs were "the highest paid hospitals in the Medicare program, with average Medicare margins of almost 12 percent."

For-profit hospital corporations, enticed by those huge margins, predictably swooped in. In the mid-1980s, Vencor (since renamed Kindred Healthcare) began putting together a chain of 60 facilities for patients on respirators. But LTCHs really took off with the advent of hospitals within hospitals. An HWH matches up an acute-care hospital with spare beds and a long-term-care hospital in need of patients. Put the two together, and you've got a perfect symbiosis: The big hospital gets a rent-paying tenant for its formerly unused space, and the LTCH saves the cost of building a free-standing facility and gets a steady provider of sick people.

The amount of LTCHs in the United States more than tripled from 1993 to 2005, with hospitals within hospitals growing at three times the rate of LTCHs overall. In 1995, there were 32 HWHs across America; seven years later, there were 132. According to CMS, there are nearly 400 LTCHs today, with 60 percent of those hospitals within hospitals. Those LTCHs are highly concentrated in a few states; as of 2004, one-third of all LTCH beds were in Massachusetts, Texas, and Louisiana. LifeCare Hospitals moved into the New Orleans market in 1994.

This expansion was all well and good for the hospitals, but it wasn't necessarily good for Medicare. A 2004 report by the Health and Human Services Office of Inspector General (PDF) revealed that HWHs were marketing themselves to potential hosts as a way to get around Medicare reimbursement restrictions for acute-care hospitals. What the hospitals saw as an efficiency could be viewed as Medicare fraud. Host hospitals had a financial motivation to dispense with non-revenue-generating patients as soon as possible, perhaps before they received the treatment mandated by Medicare's IPPS payments. Sending those patients along to the in-house LTCH would generate another Medicare check for a single episode of care. Bruce C. Vladeck, the administrator of the Medicare and Medicaid programs in the mid-1990s and now a health care consultant, says he was always aware of the two-payments-for-one-patient dilemma. He says the problem for the government was "to figure out whether Medicare is getting billed twice for two separate services. The HWH has been particularly problematic in that regard—you just take the patient up the elevator and you're generating another $8,000 Medicare bill."

http://www.slate.com/id/2227333/pagenum/2
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeMon Sep 07, 2009 9:18 pm

So who's going to pay for the doctors' educations after they mandate that doctors can't be profitable? And who's going to pay the malpractice premiums that the doctors can't afford, since the Democrats refuse to even talk about tort reform?

Translation: The best and brightest will choose a profession other than medicine. That will really be good for the nation's healthcare, huh?
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PostSubject: Re: And these are the people you want running your own healthcare system?   And these are the people you want running your own healthcare system? Icon_minitimeWed Sep 09, 2009 4:30 am

The Other One wrote:
So who's going to pay for the doctors' educations after they mandate that doctors can't be profitable? And who's going to pay the malpractice premiums that the doctors can't afford, since the Democrats refuse to even talk about tort reform?

Translation: The best and brightest will choose a profession other than medicine. That will really be good for the nation's healthcare, huh?

Is that why you went into the food services industry? Student loans and tort reform? good grief. you're kind of an alarmist aren't you?
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