Barb May <
bar...@nonofyourbusinessx.tv> wrote:
>Adam H. Kerman wrote:
>>Barb May <
bar...@nonofyourbusinessx.tv> wrote:
>>>Irish Mike wrote:
>>>>BTW, do you
>>>>think Obama should tell seniors that Obnamacare will cut $700
>>>>billion from their medical benefits? LOL.
>>>Mike doesn't know when he's lying.
>>>The $700 billion is a cut in the rate of increase, not a cut to
>>>existing benefits and it's cut from payments to providers, not
>>>benefits.
>>I know I'm being trolled here,
>Oh please. Don't flatter yourself.
You weren't trolling just me, but I'm the only one who bit.
>>but how do you cut payments without cutting benefits?
>1. By cutting "fraud, waste and abuse."
Hahahahahahahahahaha
If we cut waste, fraud, and abuse from the Pentagon budget, there might
be enough money to increase domestic civilian spending by 1/3, if
spent wisely, which it never is.
>2. Reducing payments to providers for specific treatments is not the
>same as cutting benefits.
So, you're just repeating back what you said without answering the question.
I didn't actually expect a decent answer, so you didn't disappoint.
Some hospitals face a situation in which they must keep surgeons on call
to provide emergency services, but they can't afford to keep surgeons
with the right specialty on call for common traumas treated on an
emergency basis.
That would be cardiovascular surgeons and neurosurgeons.
A patient with head and neck trauma is brought in for emergency surgery.
He's seen by a general surgeon, whose skills are adequate to keeping the
patient alive, but not good enough to avoid serious outcomes, and the
patient may survive with a poor quality of life. This is, in part, the
fault of insurance companies and especially Medicare/Medicaid, which
insurance companies tend to slavishly follow, so payments for a certain
type of surgery are inadequate to cover the actual cost of giving the
patient the treatment he needs. Therefore, the patient doesn't get
what he needs.
But keep denying that payment reductions aren't equivalent to
cutting benefits. Obamacare does fuckall for cutting the basic cost
of treatment, and really isn't intended to.
>3. Reducing planned increases in payments to providers are not "cuts."
Same comment, given that this is irrelevant in a system in which costs
aren't controlled.
>The down side to #2 & #3 is that more providers will refuse to accept
>Medicare patients, but some trade-offs will be necessary in order to
>achieve the cuts.
And when those providers are doctors? It's actually worth paying doctors
more so that patients receive adequate care, again, putting off as long
as possible hospitalization when inevitable.
>Obamacare actually increases healthcare coverage for seniors by
>eliminating the "donut hole"
That applied to drugs, nothing else. Seniors on Medicare supplements
weren't subject to the donut hole, and those for whom drugs were truly
unaffordable were on Medicaid. It rather shifts monies around among
plans seniors are typically on. Will it make the supplemental plans cheaper?
Possibly. Does it make any difference if the drugs are charged to a Medicare
versus a Medicaid plan? No.
>as well as out-of-pocket costs for annual wellness visits, some cancer
>screenings and other preventive services.
It's not at all clear that doctors, themselves, will be making more money
for these visits, given the way they are subject to charge limits, which
cuts the visits short.
Cancer screenings, well, that's money to hospitals, isn't it.
>Ryan's plan actually keeps the cuts but he uses the money for "deficit
>reduction" which, since his plan actually increases the deficit, means
>that he is really using the money to finance his tax cuts for the
>wealthy. And of course since he wants to eliminate Obamacare, he would
>be eliminating the donut hole coverage, wellness visits, cancer
>screenings, and other preventative services.
>>For instance, Obamacare chose winners and losers.
>>Hospitals were the huge winners. Doctors? The losers.
>The biggest winners are the insurance and pharma companies.
I don't see insurance companies as the winners, given that they'll be
forced to take patients as policyholders who will cost them real money.
Big drugs? Yeah, given that they still get out of the federal government
negotiating mass purchases, sigh.
>>Would a senior
>>prefer getting adequate care from his doctor so maybe he puts off
>>going to the hospital as long
>>as possible?
>Everyone would prefer that, including the uninsured. The question is,
>how best to pay for it without going broke.
No, the question is Why don't we reduce hospital payments and give more
money to doctors for clinic visits as that would save the system money
in the long run? Not to mention giving patients better outcomes...
But who cares. Patients don't have lobbies as powerful as the lobby for
big hospitals.
>>>Meanwhile Ryan's plan will replace Medicare with a voucher system
>>>that starts out inadequate and over time is reduced to almost
>>>nothing -- effectively eliminating Medicare.
>>I think Medicare and Social security pension should be means tested. I
>>think welfare should be given in the form of cash benefits, like the
>>old negative income tax suggested in the 1960s by Milton Friedman,
>>and not services. Let the poor chose which services to buy.
>>Government, with trillions of debt, is too stupid to tell poor people
>>how to manage their welfare payments.
>Government is not totally incompetent at providing benefits when
>politicians aren't involved.
I'm unfamiliar with how Congress can pass a law creating a program
without politicians being involved. This isn't France, in which Napolean
could impose a new code of law by fiat.
>Meanwhile, many poor people don't make good choices when you just hand
>them money. If you want to do that it'll have to be phased in slowly.
I like your "The poor are lazy and stupid" theory. When lots of powerful
people begin thinking that way, it leads to horrors like eugenics.
Yes, a few of them will gamble or take drugs, in lieu of buying food,
clothing and shelter. I'd rather assume that they are adults who'd like
to be part of the middle class, except for unemployment problems, and could
use a bit of cash till they get back on their feet.
I'd like to think that giving them cash will allow them to make their own
decisions and behave like normal consumers. For instance, with cash in
lieu of Section 8 vouchers, they'll demand better housing, instead of a
landlord charging market rent to the tenant plus a supplement from the
housing authority to provide housing in a building that's been inadequately
maintained for years. Cash in lieu of food stamps, they should have a
choice of grocery stores to shop in. Cash in lieu of Medicaid, they could
get better doctors and maybe buy their own health insurance. But let them
make decisions for themselves. Once they learn basic life lessons, maybe
they'll work their way into the middle class... and remain there.
This'll create massive unemployment among welfare bureaucrats and
social workers who aren't qualified for private sector jobs, but oh well.