Bipartisan Healthcare Summit, Anyone? Bueller?

[edeevee]

I am surprised that a full day later no one on the Fence Post is talking about this.

For my part, I was impressed by the Republicans. I expected them to show up (or not) and spew nothing but soundbites all day. There was some of that, sure, but there were also some legitimate good ideas.

I really like the idea of fake patients to root out Medicare and Medicaid fraud. It seems like an idea that could work.

And the suggestion of setting mandates by state majority works for me too. BTW, in case you missed it, that's the idea that minimum standards of insurance coverage would become federal mandates for any health care service that 26 or more states require of their insurers. As example: Currently, 20 states require insurers to cover annual mammograms for all women age 40 and over -- less than 26 -- so that would NOT be a federal mandate. But 27 states require insurers to cover annual mammograms for all women age 50 and over or when required by a physician -- more than 26 -- so that WOULD be a federal mandate.

The one thing I did not like was the Republicans repeating over and over again that they wanted to start from scratch on the bill. Okay, we get it. Enough already. Besides, I think we all know that "moving slowly and incrementally" is GOP code for "stalling until we get the majority again", right?

I mean, if Republicans really wanted to implement health care reform, why didn't they? They had plenty of chances when they were the majority in both the House and Senate -- and W was in the White House.

From an article in Reason Magazine last fall:
"The passion you need to drive health care reform through Congress has not been present with Republicans," laments Gail Wilensky, who headed the agency that runs Medicare under President George H.W. Bush and advised both George W. Bush and John McCain. "Even liability reform—they couldn't get that through."

Stuart Butler, a veteran health care expert at the conservative Heritage Foundation in Washington, shares her frustration. When I asked him whether he blamed Republicans for not adopting sensible innovations when they held power, he replied, "Absolutely! They just don't get it. They just feel that it's not something they do, somehow. Republicans missed a tremendous opportunity."

Modify and improve on the health reform bills with Republican input?

Yes!

Move slowly and incrementally and trust that if Republicans regain majority they'll take care of it?

No effin' way I'm falling for that one again.

[LuciusBeebe]

Recent thoughts:

1. Democrats need to abandon the idea that they'll get Republican support. Its just not something that Republicans will support. Like trying to talk a vegetarian into trying your steak. Its just not going to happen. That's not to disparage the Republicans, in a way I admire the way they're sticking to what they believe.

2. I would like it if they called it "insurance reform" instead of health care reform. Health care will remain the same. You'll still see your doctor, you'll still get your treatment. The thing that will change is how the bill is paid.

[Copycatted]

I watched/listened to every minute of that days meeting that I could edeevee. I found it quite by-partisan too as I think you were saying.

Elected Officials are expected not to show their cards of taking care of the peoples light work/business and was going fine that way untill when what bummed me out I had only two TV channels that were covering the days event. And when one (CNN or FOX) would butt in and play their own so called cards as those in atendance were having their turn I often found both were butting in and found myself being disfranchised from how D.C. was trying to get it all on one page.

What I expect is this President as have most,if not all,is about to do an Executive Priviledge of the peoples light work/business.

[edeevee]

I watched/listened to every minute of that days meeting that I could edeevee. I found it quite by-partisan too as I think you were saying.

Elected Officials are expected not to show their cards of taking care of the peoples light work/business and was going fine that way untill when what bummed me out I had only two TV channels that were covering the days event. And when one (CNN or FOX) would butt in and play their own so called cards as those in atendance were having their turn I often found both were butting in and found myself being disfranchised from how D.C. was trying to get it all on one page.

What I expect is this President as have most,if not all,is about to do an Executive Priviledge of the peoples light work/business.

Hi Copycatted, I had to work the day of the summit so I didn't get to watch any of the coverage. All I had were the transcripts -- but I didn't get any of the editorializing or network propaganda either so maybe I got the better end of the deal

[edeevee]

I would like it if they called it \"insurance reform\" instead of health care reform. Health care will remain the same. You'll still see your doctor, you'll still get your treatment. The thing that will change is how the bill is paid.

I'm not so sure. I think if some of the proposed insurance reforms are enacted, they might actually change health care.

For example, if effective tort reform is passed then doctors might stop practicing defensive medicine -- patients won't be subjected to as many (probably) unecessary tests and procedures.

If doctors and institutions are rewarded more for prevention than disease management, a lot of people won't even get sick in the first place. Why not pay less than $500 a year for a weight management program that might keep fat ladies like me from needing knee surgery or having heart problems? Why not improve school lunches to fight childhood obesity? Or "weight" the food stamp program so that recipients get more bang for their benefits when they purchase healthy foods? Or make doctor's visits affordable so patients won't wait until their illness becomes life threatening before they seek care -- or use far more expensive emergency rooms to treat things like colds and ordinary illnesses?

And electronic records ... I know I've told my story before but, bear with me? My kid had a biopsy for cancer that was found to be malignant. His doctor made a mistake and referred him for a $10,000 test that is not accurate when performed shortly after surgery (the biopsy). If there were electronic records, the doctor who performed the test might have known he'd had the biopsy within that non-accurate period. If there had been electronic records, the radiologist might have recognized that the test was not accurate and might not have ordered $14,000 worth of radiology planning. And, instead of waiting a month to get the kind of care my son REALLY needed, he could have been treated before the cancer got even bigger and harder to treat.

I still thank God every day that one doctor took the time to read the whole record, decided maybe they were on the wrong track and referred us to a super specialist. Because of that, instead of receiving radiation would have raised his chances of developing a secondary cancer in just a few years, he was able to be treated surgically. He is alive and well almost three years later and we look forward with a lot of hope to a long and productive life for him.

So yeah, much of what we're talking about is really insurance reform -- but rethinking how and what we pay for can have a positive impact on how health care is delivered too.

[HoosierHelen]

As usual, very well said Edeevee!

[HoosierHelen]

The way I understand this, the reconciliation bill needs to be passed in the Senate to match word for word what the House bill contained. It will get much promised resistance from the Republicans and....so......the war has not been won. (Yet)

I sincerely do not wish to see anyone who is using Medicare to loose any of their benefits. We have so many citizens with pre-existing conditions and also families who are unable to afford the expensive rates that private insurance companies are charging them when their employers are not paying for health insurance. Healthcare reform is an obvious need for our citizens.

The costs are prohibitive for private insurance for most families if their workplace doesn't offer an insurance plan for their employees. During these difficult economic times, far too many families are doing without health insurance because they don't even have jobs. Anyone living with pre-exisiting conditions are simply out of luck unless they are independently wealthy.

For Republicans to deny the need for health care reform reflects their lack of concern for our middle and lower class citizens. IF they wanted to be constructive and be a part of the process of shaping the reform so that it represented their concerns, they would have contributed to the effort. Instead they stood firm as a party and simply said 'NO'.

The Republicans are still very capable of throwing this entire effort in the trash with how they manipulate the Senate reconciliation bill. I wish I could hear them contributing to ideas of improving the bill and cost cutting, rather than just simply saying 'NO'. How are they looking out for affordable health needs of our citizens with that attitude?? I sincerely believe they are part of the 'I've got mine club and you are on your own.' Private insurance companies have been pricing their coverage higher and higher every year and excluding more and more of the working class from affordable coverage.

Our employers cannot continue to offer insurance plans we have known in the past at the rate of increased prices being charged. How in the world the Republicans can be proud of their lack of concern and urgency of this bill says so much about where their values.

[matt_s]

The way I understand this, the reconciliation bill needs to be passed in the Senate to match word for word what the House bill contained. It will get much promised resistance from the Republicans and....so......the war has not been won. (Yet)

I sincerely do not wish to see anyone who is using Medicare to loose any of their benefits. We have so many citizens with pre-existing conditions and also families who are unable to afford the expensive rates that private insurance companies are charging them when their employers are not paying for health insurance. Healthcare reform is an obvious need for our citizens.

The costs are prohibitive for private insurance for most families if their workplace doesn't offer an insurance plan for their employees. During these difficult economic times, far too many families are doing without health insurance because they don't even have jobs. Anyone living with pre-exisiting conditions are simply out of luck unless they are independently wealthy.

For Republicans to deny the need for health care reform reflects their lack of concern for our middle and lower class citizens. IF they wanted to be constructive and be a part of the process of shaping the reform so that it represented their concerns, they would have contributed to the effort. Instead they stood firm as a party and simply said 'NO'.

The Republicans are still very capable of throwing this entire effort in the trash with how they manipulate the Senate reconciliation bill. I wish I could hear them contributing to ideas of improving the bill and cost cutting, rather than just simply saying 'NO'. How are they looking out for affordable health needs of our citizens with that attitude?? I sincerely believe they are part of the 'I've got mine club and you are on your own.' Private insurance companies have been pricing their coverage higher and higher every year and excluding more and more of the working class from affordable coverage.

Our employers cannot continue to offer insurance plans we have known in the past at the rate of increased prices being charged. How in the world the Republicans can be proud of their lack of concern and urgency of this bill says so much about where their values.

There is a pretty interesting article in the Evansville Courier Press: http://www.courierpress.com/news/201...plan-will-end/ with information on what this will mean for Hoosiers. It was also interesting to note that Indiana is one of the states considering suing the Federal Government in order to stop the reform from happening on Constitutional grounds. Virginia is another that I have seen do state that it might.

[Mr Douglas]

It's just occurred to me in reading all this-
The Amish are Socialists! They've been here ALL ALONG!
I'm calling Glenn Beck!

[evilkumquat]

I just don't get why conservatives are so focused on punishing those who abuse a system, they are willing to let those that need it suffer.

Here they're focusing on those who might try to commit Medicare fraud. Who frigging cares? Let's worry about getting everyone covered, THEN go back and refine the system. Besides, Medicare fraud is just another one of their diversionary tactics like tort reform. Limiting excessive lawsuits would take care of what? 2-3% of the total health care expenditures in this country (by some estimates)? Again, WHO CARES?

Well, besides incompetent doctors, of course.

But seriously. All the Conservatives suffer from this mania about punishing those who abuse the system and they would be more than willing to tear it down completely and not let ANYONE use it.

It's like Welfare. They always point to the tiny, insignificant number of people who abuse the system... those who by all accounts have no reason NOT to find a job... and ignore the vast, VAST majority who sincerely need a leg up.

Or capital punishment. They want to see people fry in the electric chair so bad that they're willing to overlook all the cases where innocent people were sentenced to die and by merest luck (or crusading liberals) were saved. It's more important (to them) that one guilty person suffer than several innocent people stay alive.

[HomeyG]

I have an idea. Let's take 1 Democrat, 1 Republican, 2 pencils, 2 sheets of paper, with President Obama furnishing the beer, lock'em up in a room and no potty breaks until they write a bill that we all would like.

[Mr Douglas]

I have an idea. Let's take 1 Democrat, 1 Republican, 2 pencils, 2 sheets of paper, with President Obama furnishing the beer, lock'em up in a room and no potty breaks until they write a bill that we all would like.

I will gladly provide the pencil and paper. Hell, I'll buy the beer. (If I quietly take out the lobbyists, will somebody create a credible and fool-proof diversion?)

AWWW.... Now I'm starting to sound just like one of them.

[john40]

I have an idea. Let's take 1 Democrat, 1 Republican, 2 pencils, 2 sheets of paper, with President Obama furnishing the beer, lock'em up in a room and no potty breaks until they write a bill that we all would like.

Who is going to buy the Depends?

[HoosierHelen]

At the recent Healthcare summit Senator Tom Coburn, an Oklahoma Republican who’s also a medical doctor, raised the issue at the top of the list for many lawmakers in his party: medical malpractice. Coburn said hundreds of billions of dollars are wasted each year because doctors order unnecessary tests for fear of lawsuits.

‘Risk-Averse’

“We are risk-averse to the tort system and the extortion system that’s out there today in health care,” Coburn said. He also raised the possibility of having “undercover patients” to root out fraud.

Later in this same summit debate, it was mentioned that any Dr. found guilty of fraud would NEVER have the opportunity to practice using the new health insurance guidelines proposed (acccording to how this was suggested by the Republican McConnel from Kentucky)?

Where I am going with this is that patients are different, we react to medicines differently, a treatment that works for one may not work for another. I would hate to think of my Dr. being afraid to order a test or try a procedure on me because if he does, I could be an undercover cop ready to pin him for an unnecessarily ordered test or procedure. The potential for abuse of this type of system is too large to ignore.

No way should my physican be treated like a common criminal where he is exposed to undercover agents trying to trip him up for ordering a test that a government official determines unnecessary. BTW...this is a REPUBLICAN proposing this intrusion between my medical treatment and my personal physician. I don't buy their act of 'less government is best'. They will impose ALL government possible on the common people and exclude their priviledged hand picked few. The older I get the less tolerant I grow of Republicans.


Here is the link to the most recent review article I was reading that referenced this proposal from Senator Tom Coburn:

http://www.bloomberg.com/apps/news?p...d=aH_ap64_IXWk

[hairypumper]

The big Republican lie that gets me is the one about illegals being covered under "the plan". Are they too stupid to realize illegals are already covered under the current plan? Or do they think we are that dumb?

[HoosierHelen]

Edeevee,

I had not read your comment about supporting the concept of undercover patients early this AM when I posted my thoughts on the same topic. The desire to limit fraud, I share with you. Interesting how that particular approach of undercover patients effected us each so differently. To me it struck me immediately as to how that approach could become politically motivated, if someone wanted to target a Dr. because they did not like them for whatever reason. There are so many political hoops a physican must jump through already just to be accepted into Medical School. Grades are not the deciding factor that some may believe them to be.

Limiting fraud I am very supportive of. I just believe this leaves our physicans vulnerable to withhold ordering tests they may need to order, because their priority now becomes outsmarting an undercover patient, rather than treating a patient.

[edeevee]

Edeevee,

I had not read your comment about supporting the concept of undercover patients early this AM when I posted my thoughts on the same topic. The desire to limit fraud, I share with you. Interesting how that particular approach of undercover patients effected us each so differently. To me it struck me immediately as to how that approach could become politically motivated, if someone wanted to target a Dr. because they did not like them for whatever reason. There are so many political hoops a physican must jump through already just to be accepted into Medical School. Grades are not the deciding factor that some may believe them to be.

Limiting fraud I am very supportive of. I just believe this leaves our physicans vulnerable to withhold ordering tests they may need to order, because their priority now becomes outsmarting an undercover patient, rather than treating a patient.

Helen, I guess this just proves that great minds don't ALWAYS think alike, lol. I used to audit medical charts for accuracy, as well as fraud. There are no guarantees that undercover patients wouldn't be used for political targeting but it's my experience that the government is pretty good at telling the difference between true fraud and doctors who are just practicing medicine to the best of their abilities.

Fraud would be something like this: A woman who has Medicare goes to the doctor for a cough. In the course of the exam, the doctor asks the woman if her coughing causes her to have problems with bladder control. The woman is a little embarrassed but she admits that, yes, ONCE, she coughed so hard that she had a little accident. The doctor diagnoses her with both bronchitis and urinary incontinence. He gives her a precription for an antibiotic and she leaves the office. The doctor then uses her Medicare number to bill for hundreds of dollars worth of incontinence supplies that the woman doesn't need and doesn't even recieve.

Practicing medicine would be something like this: A woman who has Medicare goes to the doctor for bronchitis. She complains that she coughs so hard that she loses control of her bladder. The doctor gives her an antibiotic and orders a chest x-ray. The x-ray comes back normal but the woman returns, again complaining about incontinence. The doctor orders additional tests but can't find any reason for her problem. He decides maybe the problem is related to medication that she's taking, but she NEEDS to take that medication, so she'll have to put up with the incontinence. The doctor counsels her about managing the incontinence and gives her a prescription for supplies.

See the difference? In one instance the doctor was focused on making money. In the other, he used good practices to try to root out a problem -- although most of the test he ordered didn't find anything wrong, they were not really "unecessary".

And that's just the sneaky kind of fraud. There are people out there that don't even ever see a patient but bill for thousands and thousands of dollars worth of visits, medications, medical equipement, tests and other procedures with the sole purpose of scamming the system.

The way I understand it, these undercover patients will be sent to providers who order extraordinary amounts of something -- not the average family doctor who's just trying to treat his (or her) patients.

[HoosierHelen]

It would seem to me that all of us have an interest in our physicans not charging our insurance, medicare, or medicaid for services not rendered. Anytime my insurance company sends a payment to my physican or hospital for care I have received, I receive a copy of how much they paid and what was paid for. I do review those copies. If I should see something listed as paid and I know I had not received that care, I certainly would call my insurance provider and inquire. In fact in the past I have done this, no fraud was involved, I just needed a clarification because I didn't understand the medical code.

A physican or medical clinic intentionally charging for services not rendered should of course be charged with fraud. We need checks and balances in all systems to keep everyone honest. If the only way our government is able to root out fraud in the medical system is by sending out undercover patients to Dr.'s offices, it seems extreme to me (and costly). Of course, we might be able to take some people off the unemployment system and pay them as government employees working undercover.

I can think of so many friends and relatives who have been treated for serious medical problems, became discouraged, they changed Dr.'s and a new Dr. took a different approach, did different testings, and many improved. Some changes did not make any difference, of course.

[LuciusBeebe]

If the only way our government is able to root out fraud in the medical system is by sending out undercover patients to Dr.'s offices, it seems extreme to me (and costly).

I think its a good idea. Most retail stores have undercover customers. "Secret shoppers", they were called for K-mart. Its a great way to see what's really going on. You can hide almost anything with paperwork. But an undercover patient can find out if doctors are trying to cure the patient or pad the bill.

[hairypumper]

My dad would get statements from his insurance and medicare. He would look for a check and not even take the time to see what the summary was for. He kept getting referred to so many specialists he didn't know who he was seeing when. They all prescribed him medicine, some without checking to see what he was already on. A Pharmacist saved his life by catching medicines that shouldn't be taken together. Do mail order prescriptions get the same scrutiny?