Miscellaneous And Off Topic Subjects

[froot loops]

Froot:

That was a worthwhile read from Vox. I agree with the political points of it for sure.

Personally, if I'm the Rs then I either don't touch healthcare or rip the band-aid off and go full-throttle. There are no half-measures because not matter what you do, if you touch it at all you own it (the Carville Doctrine). If you're going to touch it, you might as well go all in. You're going to get crushed no matter what you do. There is, literally, no successful political course one can plot when dealing with this issue.

Of those two choices, I'd try opt of the first. Ideally make it look like you tried something, but it couldn't get through. Hopefully 3 Senators defect in states that they can afford to do so.

You would think theoretically if they continue their quest jam it through fails in epic fashion, that would pave the way for some bipartisan compromise. There is more than a small minority in the GOP that like the ACA a lot more than they can publicly say. This bill just looks like a tax cut. It really has nothing that Trump promised. But it won't work in practice as that Vox article pointed out, working with the other side has become a fools errand if you want to stay in power.

[Wild Hoss]

Do you think the R's constituents will expect the R'a to actually govern at some point? Or can they continue to say "we can't do anything" even with total control of the gov?

The pogroms then turn inward, and really, have already begun to.

There will be plenty of blame for Democrats too, fret not.

[Da Geezer]

I know who you were referring to. I'm just wondering about Jeffs silence in the face of your personal attacks.

I am not, and have not, attacked Jeff during this whole recent discussion about the ACA and rinocare. In fact, I specifically asked him to comment on the matter a few days ago. Jeff changes his opinions when new facts present themselves, and he is not bashful in saying so. That's a good thing.

But one thing I do know. You, SLF, are not a lawyer. No fiduciary could possibly not know what the AMT is.

[Da Geezer]

good post on the Vox article, froot.

Talent, quoting Carville, is right. Anyone who touches health care loses.

[Jeff Buchanan]

Geezer is correct, if you contract a disease like Cancer, Heart Disease, Diabetes or anything that requires long term attention, just show up to your ER. They will take care of you.

Partly true .......

In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs.

https://www.cms.gov/regulations-and-guidance/legislation/emtala/

My experience with this in a rural ER I worked at was that fewer than 20% of in the door ER visits were evaluated and treated under EMTALA. Most of these were triage level 3 or above (1-5 with 5 being simple stuff like a cold). Indirectly, I was aware of only half of these being admitted. Most of them are stabilized and released.

As well, if the stay was over 3d in the hospital for EMTALA admits, that was rare. You don't get, in a hospital situation, long term treatment say, for example, a new diagnosis of CA. The patient admitted under EMTALA is going to get referred to a Oncologist who will accept indigent patients.

ALabamAlum may be able to speak to this more precisely but hospitals do get reimbursement from CMS I believe for indigent care so not all of the cost of this care is being assigned as overhead where it then becomes costs assigned elsewhere.

[iam416]

Do you think the R's constituents will expect the R'a to actually govern at some point? Or can they continue to say "we can't do anything" even with total control of the gov?

Rs will govern. The Executive is already doing so and there some things I quite like. Congress will pass bills on issues where they have the political high ground. Healthcare, however, is an area they're better off doing nothing.

[Da Geezer]

What do you guys think about Trump lowering the mileage target from 54.5 mpg? He claims it will help the automakers.

[Jeff Buchanan]

BTW ...... I've never perceived anything that Geezer has posted as an attack on me.

I do know that it is hard to keep posts about HC reform on point. There are so many aspects of it that to keep them in neat compartments is difficult.

[iam416]

I offer a much shorter, more focused healthcare opinion from one Kevin Williamson, who I believe Froot hates. However, I think he may actually agree with the central premise of the argument if not the noise: http://www.nationalreview.com/corner...aid-even-texas

[entropy]

Do you think the R's constituents will expect the R'a to actually govern at some point? Or can they continue to say "we can't do anything" even with total control of the gov?

Great question.


Sent from my iPhone using Tapatalk

[entropy]

Miscellaneous And Off Topic Subjects

What do you guys think about Trump lowering the mileage target from 54.5 mpg? He claims it will help the automakers.

The investments have already been made. Seems to be change for the sake of change. In other words "I'm doing something"


Sent from my iPhone using Tapatalk

[Whitley]

What do you guys think about Trump lowering the mileage target from 54.5 mpg? He claims it will help the automakers.

It is a mistake for the long term.

[froot loops]

I offer a much shorter, more focused healthcare opinion from one Kevin Williamson, who I believe Froot hates. However, I think he may actually agree with the central premise of the argument if not the noise: http://www.nationalreview.com/corner...aid-even-texas

Most of his stuff is straight polemic nonsense. I try not to hate anything, its actually the one word I really get on my kids about. I'd rather have them swear like a sailor than say they hate someone. That column was OK, it has some good observations in it, but I don't get what it has to do with mandates.

I'm sure he understands the reason for the individual mandate, but maybe not. He is making the case more for single payer than he realizes. Insurance is a third party mechanism to organize all the things that need to be covered. In his system it sounds like each state is making their own payments for each specific thing like hearing aids. Basically doing the job of the insurance company.

[iam416]

I think his use of mandate is unremarkable and extremely clear:

But if we are going to use government, then, by all means, let’s use government in the most honest, transparent, and straightforward way we can. Forget the insurance mandate and just write the check.

Rather than mandate insurance coverage, write the fucking check. We can debate all day long about whether the government should pay for it, but if you decide that it should, then don't fuck around with mandating insurance coverage -- be honest.

As for single-payer, I'm sure he's adamantly opposed, however my guess is that he'd much rather have the government come out and pay for it directly than run it through the insurance companies.

[AlabamAlum]

Jeff,

We get what's called a DSH payment for indigent. It traditionally covers 30% of the costs incurred.

Geezer,

Yes, you get treatment. As basic and as limited as we can get away with. We will deliver the baby, get you angioplasty for a STEMI (heart attack) and stop your bleeding from your cut or cast your broken bone, etc. chronic diseases, not so much.

SLF,

Most hospitals won't really raise prices for indigent care -at least for several years- as we can't really set our own prices any more. The government and insurers do. So, we write-off what we can to offset this. Some states, counties, and municipalities do have us included in their tax schemes for indigent care, too, so there is that.