Health Care Reform Part III: The Implementation.

Discussion in 'Politics & Current Events' started by argentine soccer fan, Nov 14, 2013.

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  1. sedlie

    sedlie Member+

    Apr 5, 2011
    Is it mid-April already?!
     
  2. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    It's as though people were, you know, procrastinating. Which is odd because some on here denied that was possible.

    Benghazi anyone?
     
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  3. Naughtius Maximus

    Jul 10, 2001
    Shropshire
    Club:
    Chelsea FC
    Nat'l Team:
    England
    Well, that and also it seems the death panels have already started...

    http://www.nytimes.com/2014/04/18/b...t-could-influence-doctors-advice.html?hp&_r=0

    Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care.

    The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.

    “We understand that we doctors should be and are stewards of the larger society as well as of the patient in our examination room,” said Dr. Lowell E. Schnipper, the chairman of a task force on value in cancer care at the American Society of Clinical Oncology.

    In practical terms, new guidelines being developed by the medical groups could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment — at the end of life, for example — is too expensive. In the extreme, some critics have said that making treatment decisions based on cost is a form of rationing.
     
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  4. Naughtius Maximus

    Jul 10, 2001
    Shropshire
    Club:
    Chelsea FC
    Nat'l Team:
    England
    Aren't they changing it now because they wanted to improve the data collection to measure the effects of the new system?

    It's not like the stats won't be available before and after.
     
  5. Minnman

    Minnman Member+

    Feb 11, 2000
    Columbus, OH, USA
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    I doubt it. Changes of this nature take years to implement. I believe it's been reported that a change of this nature has been discussed for a decade; well before there was any hint of an ACA (or before Obama was president). My guess is they're doing it now because it took time this long to get around to doing it.

    This newer model will affect the way the insured are measured. But I also assume it will affect many other things. We're focusing on the health insurance side of things because, well, that's the current hyper-political topic.

    You're right that 'stats will be available' and plenty of other studies will be, and already being, done regarding the effects of this law.
     
  6. Pønch

    Pønch Saprissista

    Aug 23, 2006
    Donde siempre
    This IMHO is the right way to approach issues like how much money to spend on end of life treatments that might prolong a (less than enjoyable) life for a few months. Everything else being equal, I'd much rather let my descendants use that money elsewhere.
     
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  7. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    I saw this play out last year with the father of my daughter's boyfriend. He was terminally ill and spent the last 2 1/2 weeks of his life in an ICU. He had no healthcare directive and family refused to move him into a hospice situation. So hospital will have ended up billing Medicare for $$$. For what, precisely? So that the family could all pile into an ICU room and watch him die hooked up to all sorts of medical equipment.
     
  8. ElJefe

    ElJefe Moderator
    Staff Member

    Feb 16, 1999
    Colorful Colorado
    Club:
    FC Dallas
    Nat'l Team:
    United States
    Did you miss the part that the change was for 2013 onward?
     
  9. stanger

    stanger BigSoccer Supporter

    Nov 29, 2008
    Columbus
    Club:
    Columbus Crew
    Nat'l Team:
    United States
    You're a little late to the party.
     
  10. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia
    Interesting piece by Krugman..

    http://krugman.blogs.nytimes.com/2014/04/18/on-the-liberal-bias-of-facts/

    Chait’s answer, which I agree is part of the story, is that the liberal and conservative movements are not at all symmetric in their goals. Conservatives want smaller government as an end in itself; liberals don’t seek bigger government per se — they want government to achieve certain things, which is quite different. You’ll never see liberals boasting about raising the share of government spending in GDP the way conservatives talk proudly about bringing that share down. Because liberals want government to accomplish something, they want to know whether government programs are actually working; because conservatives don’t want the government doing anything except defense and law enforcement, they aren’t really interested in evidence about success or failure. True, they may seize on alleged evidence of failure to reinforce their case, but it’s about political strategy, not genuine interest in the facts.

    Well, surely another factor is the lack of a comprehensive liberal media environment comparable to the closed conservative universe. If you lean right, you can swaddle yourself 24/7 in Fox News and talk radio, never hearing anything that disturbs your preconceptions. (If you were getting your “news” from Fox, you were told that the hugely encouraging Rand survey was nothing but bad news for Obamacare.) If you lean left, you might watch MSNBC, but the allegedly liberal network at least tries to make a distinction between news and opinion — and if you watch in the morning, what you get is right-wing conspiracy theorizing more or less indistinguishable from Fox.

    /quote
     
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  11. Naughtius Maximus

    Jul 10, 2001
    Shropshire
    Club:
    Chelsea FC
    Nat'l Team:
    England
    What one might call 'fair and balanced' ;)
     
  12. Funkfoot

    Funkfoot Member+

    May 18, 2002
    New Orleans, LA
  13. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia
    From the link:

    Or "I was for it, before was against it". Way to go Piyush.
     
  14. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    I was thinking, "that doesn't make any sense." Then....

    For Jindal, this is about fighting anything Obama supports. It’s about Jindal’s ability to brag to tea party activists in Iowa that he hates Obamacare more than any other governor does. It’s about putting politics ahead of the health and welfare of Louisiana’s working poor.​


    He's not the first politician to sacrifice real people on the alter of his ambition, and he won't be the last, but this is pretty damning.
     
  15. superdave

    superdave Member+

    Jul 14, 1999
    VB, VA
    Club:
    DC United
    Nat'l Team:
    United States
    I'd be against the bill, too. If you start having voters decide all kinds of hot button issues, you get the worst aspects of California government.
     
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  16. ElJefe

    ElJefe Moderator
    Staff Member

    Feb 16, 1999
    Colorful Colorado
    Club:
    FC Dallas
    Nat'l Team:
    United States
    While I agree with you on the last sentence, I would point out that pretty much only California has the stupidly low requirements for getting this stuff on the ballot.

    That being said, when a state legislature votes to put something up for a public vote, unless they're mandated to do so by the state constitution, there's usually a lot of political cowardice involved.
     
  17. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    The bill last year to expand Medicaid - which would not have put the issue to an initiative ballot, but would have had the legislature voting - similarly got voted down in committee on a partisan vote.
     
  18. taosjohn

    taosjohn Member+

    Dec 23, 2004
    taos,nm
    While I understand that Jindal opposes Medicaid expansion for unreasonable reasons, I do not quite get how the death of this particular bill in committee is attributable to Jindal's ambitions or position? Surely the "nay votes" should take primary responsibility?

    And I'd also point out that Susana Martinez, Republican Governor of New Mexico, is at least getting lip service as a potential VP nominee despite expanding Medicaid without much protest-- can't see why it would be "make or break" for Jindal.
     
  19. M

    M Member+

    Feb 18, 2000
    Via Ventisette
    Jindal has actively campaigned against Medicaid expansion and indicated he would veto any such bill. This was an attempt to take the issue straight to the voters and avoid the veto.

    VP nominees don't have to win a primary contest.
     
  20. taosjohn

    taosjohn Member+

    Dec 23, 2004
    taos,nm

    1. Right, but the effort to bypass the veto process failed as well, and Jindal had nothing to do with that failure, as far as I can see? Presumably the Republicans on the committee felt they could kill it without having to pay any piper for it come general election...

    2. No, they don't, but presumably the party feels that there are general election votes to be gained by obstructing Obamacare. It is a somewhat odd message then to consider someone who accepted the ACA Medicaid arithmetic exactly as intended, without conflict.
     
  21. puttputtfc

    puttputtfc Member+

    Sep 7, 1999
    Cuts both ways you know.
     
  22. Funkfoot

    Funkfoot Member+

    May 18, 2002
    New Orleans, LA
    Louisiana has not been a big ballot initiative state; I think this was a desperation measure. In general I agree with you, but the worst aspects of California government are probably still better than Louisiana government.
     
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  23. ceezmad

    ceezmad Member+

    Mar 4, 2010
    Chicago
    Club:
    Chicago Red Stars
    Nat'l Team:
    United States
    Well elections have consequences.

    If Louisiana people want medicare expansion all they have to do is vote out people that oppose it.

    I will not hold my breath.
     
  24. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia
    Probably the 242,000 people eligible for the expansion want that to happen. But it is also very likely that the people that does not want that to happen (or that have been lead to believe that the expansion is a bad thing) will outnumber those that will vote for it.
     
  25. JohnR

    JohnR Member+

    Jun 23, 2000
    Chicago, IL
    The irony runs deep with that.
     
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