New Health Care reforms

Like most people who have had long-term conditions, I support the improvements in it. Right now, we are all already paying through the nose because of people whose options are A) go untreated or B) go to the ER for a chronic condition. When they can't pay, it comes out of taxes (local, state and federal). The changes should save about $1.3T in the next 20 years, so I am for it.

I hear lots of complaints of "Well I don't use it..." -- we ALL pay for things we don't use like local schools, and (wait for it) the very hospitals that get tons in tax money. So I don't see the difference there.

The medicaid program right now doesn't really work. I was scheduled for exploratory surgery to diagnose and treat a major problem and my insurance company dropped me. I was able to get on medicaid... right as my then-doctor dropped it due to changes in reimbursement policies.

So I never got my much-needed surgery, doctors still disagree about what I have, and I live in fear that the problem will come back and disable me yet again (as I've been assured it probably will). And I'm put in the position where I have to be "overly optimistic" about my medical status in grad school applications. It's sort-of controlled with medications (which I can't afford on my own, and have to wait months to get a new doctor to re-start taking it).

But for how long? It's hinged on me continuing to have hypogonadism that (spoiler alert) could come and go at any time. Severe, constant pain and nausea aren't exactly conducive to being productive at work. I've seen it basically destroy my business, delay my schooling a TON, and put me on general assistance for over a year. All of that cost the government more than actually treating my illness would have, and realistically I am one of the lucky ones.

So yes, I do support insurance policies based on medical science and I do support government-backed healthcare.

 

What gets me as a Floridian is the state instead of working on their end to expand the options for medical care and working with the planned changes, they are suing. I mean it can't ALL be on the Feds the states have to do their part to expand options. I can think of many ideas just off the top of my head:

1. Expand primary care doctors by fast tracking foreign doctors with proper educations ,GAAP accepted schools, to be doctors as GP's.

2. Expand nursing programs so they have nurses with bachelors degrees that can do more primary care activities backed by computer diagnostic programs and testing methods.

3. Reactivate earlier laws where any licensed doctor of medicine and expanded to nurse practitioners must do a certain number of hours of service say in this case under Medicaid, or lose their licenses. They would get reimbursed at Medicaid rates.

4. Add a small tax say ,on property, of 1% to pay for expanding Medicaid reimbursements.

5. Have a state board to negotiate prices for drugs, durable medical goods and services and set-up the state as the primary payer for Medicaid with provider networks as the delivery system. Something akin to many models in Europe.

There six ideas just on my own that states could do.

 

I wish I could get somebody to weight in on my previous statement. I know it's not a complete solution, but it seems that I'm the only person I know who sees the situation this way. I would like to know if anybody else sees my idea as workable or if it's fatally flawed in some way.

I strongly agree with statements one and two by thomaskolter. I'm not so sure about the others, but good thinking none the less. I'm not sure suing is anything but a political move to express discontent so they can say "we tried to do something" to the voters.

 

There are issues most of all the overall costs of drugs, medical education and malpractice costs plus the issue of all this affecting the pay of primarycare providers.

The new law is pushing for Nurse Practitioners and Primary Care Physicians Assistants to replace doctors since they cost half an average GP Physician would cost. And various options to have team medicine. But as long as an internist must pay a thrid of their income in malpractice insurance they can't compete plus ancillery costs.

Plus if you go after the system like that it would never have passed to many interests would have been at risk the new reform builds on the system we have already.

But the law is not bad I suggest get Landmark a book written by the staff of the Washington Post that covers the bill in simple language, I like it since it EXPLAINS the bill at every key point.

 

Thanks for the response! That's great that there is a book out there that explains the law. I suspect it may not be as bad as some would like us to believe, but I'm still leery of the whole thing honestly.

 

Landmark ,book, doesn't pull punches it explains the bad parts that might not work. But it does make it all readable and in simple language with charts and graphs. Its a good read and covers how it got past and in back a simplified form of the bill blow by blow in its technical terms.

But one area we have to consider is states have to do their part they license medical providers and can do a great deal to help this along. As can local juristictions if my city added a small tax on property it could go to setting up added funds and options here, when they can integrate it into the Federal programs. But I know one person that works, has epilepsy and attacks weekly forcing hospitalization and care. Their cost right now we estimate is $200,000 per year or more uncompensated since they are under Florida charity care law. With regular treatment and drugs that would drop to maybe $20,000 a year. Medicaid since her income is to high in our state and she works is not available under the new law she would be covered and cost taxpayers and the people that have to pay for her in their bills a good deal of money. This fact is alone one reason to consider this bill favorably how many others are out there that for lack of simple care could be saving everyone money.

But I will add this if this fails and the system really does start falling apart the government will HAVE TO take over big time and all these private market forces still at work might go away. Doctors, hospitals and the like might get paid directly by the government with serious cost containment and bargaining so right now the parties affected are better off supporting this and making it work. There next option offered may be no option at all.