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.

[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.

[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?

[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.

[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]

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.

[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?

[HoosierHelen]

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?

That happened to a co-worker of mine a few years back. She wasn't using the same pharmacy for all of her meds, consequently, she landed in the hospital for a few days because of drug interaction between different Dr.'s prescriptions. She convinced me...keep all your prescriptions filled at ONE place. I don't know if mail order prescriptions get the same scrutiny or not?

Yesterday on NPR they had an interview with someone from the DEA that watches databases for people who Dr. shop. They go to multiple different Dr.'s for the purpose of getting multiple prescriptions for the same drugs. Frequently these are pain killers or anxiety drugs. They explained with the reporting systems in place now between pharmacies and the DEA, these people are exposed very quickly by the system. It is an illegal practice. Many Dr.'s are signing up for the service now also so they can screen these offenders before they write the prescriptions.

[wickedacoustic]

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.

"Bipartisan Healthcare" this doesn't seem like a Democratic topic at all! Just in your comments here I see you have taken your Dem. time to "SLAM" the Republican Party... how many times? Republicans want to start over so the whole Bipartisan anything can exsist!
Waiting around for the majority, this should not be too complicated after the left bring on more of their "SUMMITS". I just wish that the left would understand just make the "Hope and Change" happen and quit looking backwards blamming the previous administrations, or move out of the glass house before throwing stones. This could be one reason that your Bipartisan talks mean very little to so many!!

[Mr Douglas]

\\"Bipartisan Healthcare\\" this doesn't seem like a Democratic topic at all! Just in your comments here I see you have taken your Dem. time to \\"SLAM\\" the Republican Party... how many times? Republicans want to start over so the whole Bipartisan anything can exsist!
Waiting around for the majority, this should not be too complicated after the left bring on more of their \\"SUMMITS\\". I just wish that the left would understand just make the \\"Hope and Change\\" happen and quit looking backwards blamming the previous administrations, or move out of the glass house before throwing stones. This could be one reason that your Bipartisan talks mean very little to so many!!

There really isn't much of a left or right anymore. It's just a distraction. They're two sides of the same thing- corporatists. Google Mussolini.

[wickedacoustic]

There really isn't much of a left or right anymore. It's just a distraction. They're two sides of the same thing- corporatists. Google Mussolini.

I'm hearing you.....I just hope we get it together, otherwise we all suffer the same future will not matter left or right......."GOOGLE IT" they will tell you!

[Mr Douglas]

I'm hearing you...........\"GOOGLE IT\"

Your smiley implies I'm nuts?

[Mr Douglas]

I'm hearing you.....I just hope we get it together, otherwise we all suffer the same future will not matter left or right.......\"GOOGLE IT\" they will tell you!

"If we can't hang together, we'll surely hang separately"...........or something like that.

[wickedacoustic]

No not at all MrDouglas when selected I thought he (smilie) was pointing at his nose, with "Right on the nose" kind of stuff, but now I see it he is whistling, and spinning his finger......................No nuts intended! I appologize and will watch the smilie action.

[HoosierHelen]

\"Bipartisan Healthcare\" this doesn't seem like a Democratic topic at all! Just in your comments here I see you have taken your Dem. time to \"SLAM\" the Republican Party... how many times? Republicans want to start over so the whole Bipartisan anything can exsist!
Waiting around for the majority, this should not be too complicated after the left bring on more of their \"SUMMITS\". I just wish that the left would understand just make the \"Hope and Change\" happen and quit looking backwards blamming the previous administrations, or move out of the glass house before throwing stones. This could be one reason that your Bipartisan talks mean very little to so many!!

Wickedacoustic, I must respectfully disagree with you on this one. I do feel the dialog of this summit was constructive. Just as the dialog between Edeevee and LB and myself has been on here. All minds do not react in similar ways to the same facts. Discussing why we feel and think the way we do, is constructive.

I don't believe the left is looking backwards with their goals, however, one must recognize where we started from before we can recognize our progress. For the Republicans to recommend starting over from the beginning says to me that they weren't even giving serious consideration in the beginning to the first round of dialog on the health care reform issue. Were they expecting it to just die and go away....so they brushed the topic off their tables with the other crumbs they considered unimportant?

These representatives are being PAID to do their jobs. US citizens are reasonable to expect their healthcare needs to be affordable for all. The need does exist. Republicans did not seem to take this need seriously and now...one year later, they want to start over because they did not participate in the 1st year's plans and proposals??? The only word ever offered up from Republicans seemed to be 'NO' this first year. No reasonable new suggestions...no offers at all...simply....'NO'.

Hopefully they will get on board and take our citizens need seriously this time.