Democratic primary watch

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Indy
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Re: Democratic primary watch

Post by Indy » Tue Mar 03, 2020 8:05 am

I voted for Warren.

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specialsauce
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Re: Democratic primary watch

Post by specialsauce » Tue Mar 03, 2020 10:00 am

Indy wrote:
Tue Mar 03, 2020 8:05 am
specialsauce wrote:
Mon Mar 02, 2020 8:47 pm
Nodack wrote:
Mon Mar 02, 2020 5:15 pm
specialsauce wrote:
Sun Mar 01, 2020 11:38 pm
Nodack wrote:
Sun Mar 01, 2020 10:34 pm


I don’t understand that, They are arguing different stances. Improve Obamacare? Go all in with Medicare for all and no private insurance? Medicare for all and private insurance? The goal is to cover all Americans and lower prices, not just take it over for power. That makes no sense to me. The Dems obviously don’t all agree and Republicans don’t want any part of reform other than neutering Obamacare. As soon as Republicans took out the mandatory part of Obamacare it became a failure.

Something as huge as health care for all Americans should be something all lawmakers from both sides should be working on together instead of just fighting and refusing to work together. That’s where we are though. My choice would be to fix Obamacare, not gut it but, I would be open to other options if it got the job done.
Saying “Medicare for all!!” Doesn’t fix the rising cost of healthcare.
No, it says we are going to have health care for all Americans. It doesn’t say anything about lowering or raising prices.

Lowering the costs is in the details.
There’s no details. Bernie hasn’t a clue how he’s going to pay for it all, let alone reduce costs. He can’t articulate a well thought out response whatsoever.
Most of paying for it is coming out of insurance company profits, drug company profiteering, and executive pay at these companies. But we do have to do something about malpractice insurance/tort reform if we want to get all the way there.

And I completely agree with your previous comment about physician-owned providers. I have an emergency physician friend here that has his compensation directly tied to how many tests he can order (and get his company reimbursed for). I was blown away when I learned that his how they are compensated.
We’re going off on a tangent here sorry but....
I would say that productivity based reimbursement is a bit of a double edged sword. There has to be an incentive for the physician who works hard and sees twice as many patients as his colleague. If you don’t reward hard work, it removes all motivation and you end up with longer wait times, people avoiding the more ill and thereby stressful patients. You can say it’s messed up and it’s human lives, sure- but if your work told you all of a sudden you have no means for promotions, your salary will remain the same whether you do great work or sit around on your phone all day- would you work as hard? I would think not, just human nature.

Do I see an abuse of the system? Maybe. Generally it’s not with ordering tests- I have never witnessed someone order a study that was grossly not indicated (that would generate us very minimal extra income if any at all, not to mention be completely irresponsible) but increasing the complexity of the patient’s presentation by giving IV fluids for example, or writing for a prescription (even if it’s Tylenol) may lead to higher reimbursement.

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Split T
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Re: Democratic primary watch

Post by Split T » Tue Mar 03, 2020 12:27 pm

I work for a healthcare organization that is working on switching from a pay per test model to a model that would charge a set rate for the year. I guess the idea is it incentivizes employees to keep the communities they serve in good health. I’m not sure all the details, but it’ll be interesting to see how it works.

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specialsauce
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Re: Democratic primary watch

Post by specialsauce » Tue Mar 03, 2020 12:52 pm

Split T wrote:
Tue Mar 03, 2020 12:27 pm
I work for a healthcare organization that is working on switching from a pay per test model to a model that would charge a set rate for the year. I guess the idea is it incentivizes employees to keep the communities they serve in good health. I’m not sure all the details, but it’ll be interesting to see how it works.
I could see how that could work as an outpatient primary care model (maybe). Doesn’t really seem applicable to emergency care much. That also doesn’t account for how sick a patient population is. Seeing sicker patients requires more resources, more time, and should be compensated accordingly at an individual level.

It would be equivalent to paying two mechanics the same amount annually at your shop- one who chooses to just change oil filters, and another that is left to replace transmissions. I don’t know much about cars but I can guess one is a hell of a lot more difficult and time consuming than the other, and it wouldn’t be fair to pay both mechanics the same amount.

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Split T
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Re: Democratic primary watch

Post by Split T » Tue Mar 03, 2020 1:45 pm

specialsauce wrote:
Tue Mar 03, 2020 12:52 pm
Split T wrote:
Tue Mar 03, 2020 12:27 pm
I work for a healthcare organization that is working on switching from a pay per test model to a model that would charge a set rate for the year. I guess the idea is it incentivizes employees to keep the communities they serve in good health. I’m not sure all the details, but it’ll be interesting to see how it works.
I could see how that could work as an outpatient primary care model (maybe). Doesn’t really seem applicable to emergency care much. That also doesn’t account for how sick a patient population is. Seeing sicker patients requires more resources, more time, and should be compensated accordingly at an individual level.

It would be equivalent to paying two mechanics the same amount annually at your shop- one who chooses to just change oil filters, and another that is left to replace transmissions. I don’t know much about cars but I can guess one is a hell of a lot more difficult and time consuming than the other, and it wouldn’t be fair to pay both mechanics the same amount.
Right, there are definitely some issues to work out. I don’t know exactly what their plans are there, but we’ll see. Definitely makes more sense in an outpatient setting right now.

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Indy
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Re: Democratic primary watch

Post by Indy » Tue Mar 03, 2020 2:16 pm

I think we can all agree that insurance companies should not be dictating how much care is worth/should cost.

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Indy
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Re: Democratic primary watch

Post by Indy » Tue Mar 03, 2020 2:16 pm

Full disclosure, I work for a large medical device company in the regulatory and quality function.

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Nodack
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Re: Democratic primary watch

Post by Nodack » Tue Mar 03, 2020 2:26 pm

Indy wrote:
Tue Mar 03, 2020 2:16 pm
I think we can all agree that insurance companies should not be dictating how much care is worth/should cost.
I wonder if Congress agrees. I bet a lot of them are paid handsomely by insurance companies to have a different opinion.

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Indy
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Re: Democratic primary watch

Post by Indy » Tue Mar 03, 2020 3:44 pm

Nodack wrote:
Tue Mar 03, 2020 2:26 pm
Indy wrote:
Tue Mar 03, 2020 2:16 pm
I think we can all agree that insurance companies should not be dictating how much care is worth/should cost.
I wonder if Congress agrees. I bet a lot of them are paid handsomely by insurance companies to have a different opinion.
They don't care because they get free coverage and have some of the best healthcare in the land.

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specialsauce
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Re: Democratic primary watch

Post by specialsauce » Tue Mar 03, 2020 4:39 pm

Indy wrote:
Tue Mar 03, 2020 3:44 pm
Nodack wrote:
Tue Mar 03, 2020 2:26 pm
Indy wrote:
Tue Mar 03, 2020 2:16 pm
I think we can all agree that insurance companies should not be dictating how much care is worth/should cost.
I wonder if Congress agrees. I bet a lot of them are paid handsomely by insurance companies to have a different opinion.
They don't care because they get free coverage and have some of the best healthcare in the land.
Agreed on both fronts.

There’s a lot wrong with healthcare. Coverage may expand under Democrats at the cost of increasing the already massive debt. The Republicans have offered no solution whatsoever. Neither party will fix the actual problems until lobbying power is reduced, there’s a crackdown on insurance companies and big pharma/corporate medical groups, and significant tort reform is passed. Everything else is lip service and political bullshit.

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Nodack
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Re: Democratic primary watch

Post by Nodack » Tue Mar 03, 2020 8:27 pm

Neither party will fix the actual problems until lobbying power is reduced
And that is NOT going to happen unless 50,000,000 people march on Washington.

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Cap
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Re: Democratic primary watch

Post by Cap » Tue Mar 03, 2020 10:50 pm

Nodack wrote:
Tue Mar 03, 2020 8:27 pm
Neither party will fix the actual problems until lobbying power is reduced
And that is NOT going to happen unless 50,000,000 people march on Washington.
And 50,000,000 people marching on Washington for this cause is NOT going to happen.
JJ will be better than KP when all is said and done [in 2020]. Mark it. — AIG, with Indy betting against

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Nodack
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Re: Democratic primary watch

Post by Nodack » Wed Mar 04, 2020 11:16 am

Exactly.

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Indy
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Re: Democratic primary watch

Post by Indy » Wed Mar 04, 2020 2:47 pm

It is hard to find 50M people that could afford to miss time from work for that. Did I read it correctly that there is no market in the US where you can work minimum wage and afford a 2 bed room apartment anymore?

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Mori Chu
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Re: Democratic primary watch

Post by Mori Chu » Wed Mar 04, 2020 8:29 pm

Biden really cleaned up on Super Tuesday. Bloomberg drops out. Seems like Warren will drop out, too (sniff). Is Biden going to run away with the nomination now? Amazing how fast candidates' fortunes can change. A week ago Bernie was the overwhelming front-runner, now his campaign will have to fight for its life.

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Nodack
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Re: Democratic primary watch

Post by Nodack » Wed Mar 04, 2020 8:56 pm

A week ago it looked like Pete might get in and Biden was done.

Obviously Sanders scares not only Republicans, but Democrats too. All the moderates simultaneously endorsed Biden before Super Tuesday.

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ShelC
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Re: Democratic primary watch

Post by ShelC » Thu Mar 05, 2020 6:06 am

Biden is this election cycle's Hillary so they're kicking everyone else out of the way. It's Joe's turn. Results will probably end up the same tho because I don't think Joe knows what year it is anymore.

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Nodack
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Re: Democratic primary watch

Post by Nodack » Thu Mar 05, 2020 9:42 am

Joe is a little slower. I am pretty sure he knows what year it is. His ability to reason is light years ahead of Trump imo. Biden will listen to advisors and make a decision based on that information and I trust he will do the right thing. Trump doesn’t listen to anyone but a few hosts on FOX News who praise him and then does what he thinks will help him the most anyway.

The Dems are all in it together. Even Sanders said last night that he and Biden are friends and that if either one of them gets the nomination that either one of them will support the others campaign.

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Indy
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Re: Democratic primary watch

Post by Indy » Thu Mar 05, 2020 9:44 am

Nodack wrote:
Thu Mar 05, 2020 9:42 am
Joe is a little slower. I am pretty sure he knows what year it is. His ability to reason is light years ahead of Trump imo. Biden will listen to advisors and make a decision based on that information and I trust he will do the right thing. Trump doesn’t listen to anyone but a few hosts on FOX News who praise him and then does what he thinks will help him the most anyway.

The Dems are all in it together. Even Sanders said last night that he and Biden are friends and that if either one of them gets the nomination that either one of them will support the others campaign.
He should tell that to his supporters.

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Indy
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Re: Democratic primary watch

Post by Indy » Thu Mar 05, 2020 9:45 am

ShelC wrote:
Thu Mar 05, 2020 6:06 am
Biden is this election cycle's Hillary so they're kicking everyone else out of the way. It's Joe's turn. Results will probably end up the same tho because I don't think Joe knows what year it is anymore.
who is kicking people out of the race beside the voters and the people not donating to the campaigns?

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