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21 Oct 08 - 05:23 PM (#2472169) Subject: BS: Cathy the Coder/Fixing Health Care From: GUEST,mg Well, first of all I have tried to think of how you wouldn't need coders, regardless of the new system employed. I think at least transitionally they will be needed, for billing, for cost control, for medical records, for patient satisfication surveys etc. Now, a lot could be done with a bar coder and a scanner..the doctor does an appendectomy and her assistant scans the name of the operation, the medicines, the supplies, etc. and you have a good idea of cost. She spends 20 minutes post-op and there you can scan again. Can be done. You don't have what you need in medical records, which is some sort of human observation, so you get the gist of the patient. I don't know how this could be simplified, especially when she will probably see several doctors. Now, we can all submit ideas as to how to fix health care. I would add how to fix it so the transition is not worse than the cure, which it easily could be. It is like steering a huge freighter and it will not turn on a dime. I am with Edwards and probably others, probably Obama, who say let's leave what works in place for now and incorporate stuff from the bottom up. I would have many many clinics all over the place and I would have public health nurses and I would have school nurses in huge numbers. Oops..nursing shortage. I would immediately get huge numbers of people in the pipeline, and a problem is the shortage of nurse instructors. I would also get all sorts of health professionals and paraprofessionals starting to be trained right now. Many could be cross-trained perhaps. I would look at training for medics and I would try to duplicate that. I would look at the prison population and train them as at least paraprofessionals. I would look at nationwide certifications rather than state ones so Nancy the Nurse could cross state lines, if she can't already. Unlike many other people, here and elsewhere, I do not presume to pontificate about licensing requirements I don't know about. I wouldn't make health care free except to indigent people. There could be a sliding scale and people can and should pay somewhat to the extent of their ability. That would bring at least some revenue into the system. I would look at alternative medicine. Many conditions can be helped that way. I would train health facilitators..neighborhood people who would need very little training to follow up on people after surgery, to make sure they are taking their medicines, that they haven't fallen, that they are able to take care of themselves... I would look into these lifeline screenings that come to your church and see how good they are for $100 instead of thousands at the hospital. I would start screening people pretty soon. I would have mobile teams of health people who could conduct immumization clinics, move to disaster areas etc. The biggest problem is not that insurance is bad and mean or doctors are greedy..but we have invented ourselves into a situation where the treatment for an illness can cost more than what a person can make in a lifetime. So that has to be taken into account. Medications -- overprescribed at times and cost a whole lot. Certainly we can look at the overprescription. And people need more time to talk to health people..maybe not doctors..maybe a whole new profession..health educators..nurse educators, etc. 15 minutes of a rushed doctor's time is not going to get you more than a prescription problably. Need to look at entire lifestyle..diet, exercise, sunshine, fresh air, social support etc. If the public is paying, as they should, they also need some crime prevention in there...they should have to pay for cancer and heart attacks...but some stuff is self-inflicted. Drug use and all the crime it causes. I am not saying don't treat drug addicts, but certainly be out in the open about some of the problems. I don't think you can be too confidential about some of this stuff and enable the drug users further. Get it out in the open and let the chips fall where they may. I am not saying out them, but don't cover up the problem either. Now routinely patients are asked at least in some places about their drug use and it is in their charts. Fertility treatments....minor surgery yes. Vitamins and counseling yes. I don't know how much further I would go, but not to extreme measures, and I think there should be limits on the number of implants. Well, that is all I can think of for now. We need to be training many new nurses and physician assistants and all sorts of other specialties and we have to get used to the idea most of us are probably not going to see a doctor except for major problems, and we will be just fine. mg |
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21 Oct 08 - 05:50 PM (#2472202) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: bobad The vast and perhaps insurmountable obstacle to a "Medicare-for-all" system is Big Insurance and its success in buying politicians of all affiliations. Big Insurance stands to lose its $600B-a-year business model if the US were to truly provide universal healthcare, and you can be certain that they will expend whatever it takes to protect that stake. But the current set of proposals are exactly what insurers want, as they will entice or force Americans to continue to purchase usurious policies that bedevil providers with paperwork, cut patients off when neediest, and preserve the lifestyles to which Big Insurance has become accustomed. It's high time for US citizens -- and particularly the physicians guild -- to make it clear that nothing short of a single-party "Medicare-for-all" system will be acceptable. http://www.epimetrics.com/topics/one-page?page_id=453&topic=Commentary&page_topic_id=99 |
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21 Oct 08 - 06:23 PM (#2472225) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: PoppaGator A few years ago, a tumor was discovered in my neck, and I became a cancer statistic. Very fortunately, I had good health coverage through my employer that year. I went through a very harrowing and very dibilitating regime of simultaneous radiation and chemotherapy which left me completely non-functional for several months. In the end, the cancer was completely eradicated and I have survived pretty much "home-free," although the radiation (directed to the lower half of my skull) has left some lifelong aftereffects: damaged teeth and gums, limited saliva production, scar-tissue throat lining, and no thyroid function at all. The "list prices" for my daily treatments and other services were so astronomical as to be laughable. Blue Cross/Blue Shield took care of it all, thanks to my having been paying premiums, in the form of barely-noticeable payroll deductions. Of course, my employer had also been chipping in as well. Even so, I'm sure that the total premiums rendered in my name, during the entire period of my employment with the company, were significantly less than the total amount of all the bills. (Of course, the insurance companies do not pay the full list price, but still...) First of all, let me aknowledge that I was luckier than many in having the system work for me "as advertised." I know very well that not everyone has the same experience. Because that entire incident took place under the aegis of the established system, no one is going to accuse me of "accepting charity," and I can enjoy my renewed health with absolutely no qualms about whether I was able to get through that crisis without besmirching my credit rating and my financial "honor." Things are different now. With the arrival of Hurricane Katrina, I lost that job and the associated benefits. The company shut down briefly, resumed operations with a "skeleton crew" in a different city for a while, and eventually came back home. I'm back at work for them again, but this time on a contract basis, paid by the hour with no health insurance and no other benefits, and making considerably less money per week. When my wife and I need medical care now, we turn to the state free-care system, along with the many other "medically indigent" folks in our area. The waiting times and other such bullshit is more difficult than what I had experienced before in the "private sector," but I have every confidence that the actual medical care is absolutley OK. If this is any foreshadowing of a future "one-payer" system, I have no problem with it. What kind of galls me is the idea that some people would think I should be ashamed of having to resort to "welfare" or some such nonsense. When I had conventional coverage back in 2005, I had my life saved at very little out-of-pocket expense, and that was perfectly OK. When I need medical care now, in slightly different circumstances (I'm still working, I'm just not being compensated nearly as well), I'm going to feel just as guilt-free as before, even though the treatment will necessarily be financed in a different manner. |
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21 Oct 08 - 06:33 PM (#2472237) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: GUEST,mg I think almost everyone wants some sort of universal care...my biggest concern is the transition. If Terry the Magic Fairy could wave her magic wand and just make it happen, it would be great. It is not going to happen. I say build it from the ground up until it gets better than private care, with people trained from the beginning to realize they will be working in a public care system, and they could be trained in 2 to 4 years and some could come on board right now...and then people will transition in from private to public as either they see how good it is or they are hit with something catastrophic and have no choice. mg |
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21 Oct 08 - 07:05 PM (#2472259) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: GUEST,mg One thing I absolutely believe in and that is pain control. No one should be suffering, here or anywhere. Maybe their problems can't be fixed, but they should be painfree. And here we spend all this money in places trying to get farmers not to grow opium. Have them grow it, buy it, distribute it, set up secured hospices for those who want to abuse it, and stockpile it against whatever calamaties might befall us sooner or later. mg |
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21 Oct 08 - 07:18 PM (#2472267) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: McGrath of Harlow Getting sick isn't a matter of choice, so getting treatment shouldn't be a matter of payment. The bottom line principle agreed across the political spectrum in the UK is that health care has to be free at the point of use for everyone. For all it's faults, most of them related to failure to ensure thta that principal is applied consistently, the British National Health Service is a marvellous thing to have. There are other ways to organise universal health care, but however it is done, that principle is crucial. |
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21 Oct 08 - 07:33 PM (#2472284) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: GUEST,Justin U Oh don't talk to me about health care. I thought I was doing my civic duty until I saw a recent TV advert for blood donation, in which Sharon Osborne says " An anonymous blood donor saved my life." I really hope it wasn't me- I'm certainly never giving blood again. |
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21 Oct 08 - 07:39 PM (#2472295) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: Amos You, on the other hand, are a peculiarly subhuman example of the species, Justin. A |
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21 Oct 08 - 09:10 PM (#2472377) Subject: RE: BS: Cathy the Coder/Fixing Health Care From: Donuel studies have found that clergy, and not psychologists or other mental health experts, are the most common source of help sought in times of psychological distress. This explains why the evangelical loon across the street is not on medication It may also 'expalin' Palin. |