Barry! How's That ObamaCare Thing Working?

[mrplunkey]

After reading that reply I suddenly have an urge to see how deep my bellybutton is.

BarryCare subsidies don't start until your bellybutton is 2.5" deep.

Test it out yourself -- just put that peener of yours in there and see if it fits.

 

[billfred]

That sort of happens now. Our existing health care system has self-organized into something that is flawed, but has some common-sense measures built into it.

Let's say I show-up to an emergency room and tell them I've got a little bit of clicking in my shoulder when I lift heavy. I'm uninsured, but think it would be just great if they'd refer me to Dr. Andrews down in Alabama, because he did such nice work on Drew Brees a few years ago.

That's never, ever, ever, never going to happen.

But if I go into the same emergency room with blood gushing out of my shoulder via my subclavian vein, they'll save my life and stabilize me -- even with zero insurance at all.

We really have two systems: A non-emergent and an emergent system. We don't have people dying in the streets (who don't have alternatives).

There is absolutely, no-doubt, 100% for sure people in dire financial circumstances who have chronic conditions who genuinely want them treated or even cured. But it's very difficult to separate that group from the 450lb Walmart crowd who thinks it's funny who can grow their bellybutton the deepest over the holidays. There are people who just don't care. Remember: 20% of Americans still smoke. What kind of rock would you have to live under to not know smoking is bad for you? But with their BarryCare card, they'll become walking, breathing ATM machines for a health care system designed to rack-up charges against patients with insurance.

The private sector might be able to sort-out the Helpless from the Clueless, but it's absolutely certain that the government won't be able to do it.

This thing is going to be a train wreck. We're 15% into the mess, at best.

Let me give you a Texas scenario to highlight again the fuckrdness of our current system. Old lady goes to hospital in Mexico - sick. They finally realize she has terminal brain cancer and tells her to go home and take care of business.

She instead cones to visit son in Texas who takes her to emergency room who come up with the same diagnosis EXCEPT we gothru extensive surgery and treatment with the same end result. And who pays for that??? You do thru local taxes and the next time you go to Dr and get charged 6x for your treatment.

 

[samoth]

But if I go into the same emergency room with blood gushing out of my shoulder via my subclavian vein, they'll save my life and stabilize me -- even with zero insurance at all.

There is absolutely, no-doubt, 100% for sure people in dire financial circumstances who have chronic conditions who genuinely want them treated or even cured.

I realize this is the way it is, but I never understood *why* they get products & service for free? Why don't we turn them away from what they can't afford, like we do for everyone else for everything else in the country? I mean, sure, give them some aspirin and a glass of gatoraid, but deny them the free $50k in medical services. We don't donate filet mignon & bespokes to food/clothes banks, we donate used hanes & cheap cans of shit.

 

[mrplunkey]

Let me give you a Texas scenario to highlight again the fuckrdness of our current system. Old lady goes to hospital in Mexico - sick. They finally realize she has terminal brain cancer and tells her to go home and take care of business.

She instead cones to visit son in Texas who takes her to emergency room who come up with the same diagnosis EXCEPT we gothru extensive surgery and treatment with the same end result. And who pays for that??? You do thru local taxes and the next time you go to Dr and get charged 6x for your treatment.

The foreign national issue is a twist. But let's assume we're dealing the American citizens or illegal aliens who will eventually be given BarryCare (it's inevitable).

That current-day scenario depends on one key thing -- how the hospital is compensated (or not compensated) for indigent care. The only duty an emergency room has is to provide the emergent portion of her care.

I live about 15 minutes away from a for-profit hospital staffed almost exclusively by private practice physicians. If she presented in their ED, she'd get the same treatment she received in Mexico -- hospice care. Those guys aren't going to get stuck with a terminal patient and no compensation.

I also live about 25 minutes away from a state-run level one trauma center with a huge academic medicine program. Most of their medical staff is employed. They have a contract with the state and get reimbursed on *all* underinsured/uninsured, as part of being a regional, academic, level-one trauma center. If she presented there, they'd think CHA-CHING! And get that meter running. There would be dozens (literally) of tests. Lots of imaging. Surgery for sure. Hell, she may even qualify for our new proton therapy treatments.

So what does BarryCare do? It gives every single provider that same special status. Every patient becomes a walking ATM. Just find a condition, rack-up a bunch of charges against it and give the exchange program the bill. It will drive up the medical losses of the exchanges, since average patient acuity will rise. But guess what? They love that. The 85% medical loss ratio works both ways. Sure, they can't spend more than 15% of their collected premiums on overhead and profit -- so how do you grow profits? You grow your medical loss ratio.

Healthcare has a huge problem already: Providers preying on people with good insurance and running-up the meter. End-of-life care is a particular problem. A well-insured patient can bring-in hundreds of thousands of dollars in profit on those last few weeks of life. BarryCare turns every patient into one of those ATMs.

 

[mrplunkey]

I realize this is the way it is, but I never understood *why* they get products & service for free? Why don't we turn them away from what they can't afford, like we do for everyone else for everything else in the country? I mean, sure, give them some aspirin and a glass of gatoraid, but deny them the free $50k in medical services. We don't donate filet mignon & bespokes to food/clothes banks, we donate used hanes & cheap cans of shit.

The current system does turn some people away. It doesn't turn-down emergent care at all and is only moderately effective at turning-down chronic conditions.

But the argument you are making is the old "is healthcare a right?" fight. I've yet to meet someone who could explain to me why it is a right, but food, clothes, housing, education and a guaranteed job isn't a right either. We'll treat your arthritis but let you starve to death? We'll feed you but not clothe you? We'll clothe you but you don't have a place to put the clothes? And what about education?

 

[-SD-]

Because its a goddamn right thats why

Quit asking questions and just accept that obama is so much smarter than all of us and knows whats best

 

[samoth]

The current system does turn some people away. It doesn't turn-down emergent care at all and is only moderately effective at turning-down chronic conditions.

That's my question: Why aren't the latter turned away? Why are they special and deserve free stuff?

But the argument you are making is the old "is healthcare a right?" fight. I've yet to meet someone who could explain to me why it is a right, but food, clothes, housing, education and a guaranteed job isn't a right either. We'll treat your arthritis but let you starve to death? We'll feed you but not clothe you? We'll clothe you but you don't have a place to put the clothes? And what about education?

"But where do we draw the line?!"

Did Scotus ever debate this? I have no idea what's a right any more.

 

[samoth]

Because its a goddamn right thats why

Citation? Aren't rights supposed to be written down somewhere? (Not rhetorical; I'm just not knowledgable on this stuff)

Quit asking questions and just accept that obama is so much smarter than all of us and knows whats best

Frankly, given his academic pedigree, I easily conceed that he's smarter than everyone on this board.

I can see the idealism in universal healthcare, but I don't know enough about the current system to even attempt an argument one way or the other. Plus there are financial/market ramifications that makes it relevant to my interests, even if by proxy.

 

[-SD-]

Citationings!!!!!!////111

 

[samoth]

Citationings!!!!!!////111

xkcd: Citogenesis