And so it begins.

[theeedude]

We wouldn't expect you to even find a single fault in Obamacare, hell I think you were giving it credit for the economy recovering. And god forbid something did go catastrophically wrong with one of it's policy changes you would just resort back to calling it a republican plan.

No one will confuse the modern day Republican party for an organization that has a plan for health care. You can rest easy on that one.

 

[Hayabusa Rider]

So first Obamacare was too complex, now it's too simplistic. Tomorrow this BS complaint will fall by the wayside as previous ones have, and it will be too complex again. And on and on.

Is that what I said? Nope. Obama is simplistic solution to a complex problem, that is health care. That means the problem of actual health care is far beyond anything Obamacare offers. This "solution" you defend isn't going to be the fix in all cases. Now I could be wrong, so I'll ask you. If there are two institutions which fail, one because it does not have the staff to do things properly, and the other which is just plain lazy, are the penalties the same? If no then good and I withdraw my complaint on this issue. On the other hand if the solution is to cut funding where more was needed in the first place, that's stupid. Shall we cut staffing and teachers in inner cities where scores tend to be lower than suburbs? That would be idiotic, and same thing here. Sometimes more resources are needed. Sometimes not. Sometimes people are trying to do the best with what they have and sometimes not. All you have to do is show where in this plan this is taken into account. That should't be hard, right?

 

[ivwshane]

This just the blatant hypocrisy. They almost always advocate more money to fix every problem except here because, well, we all know there is no wrong in Obama or his policies.

I agree. It's also funny to hear those on the right now taking this stance when they were opposed to something like giving aid to poor performing schools.

Hypocrisy indeed, on both sides

 

[IronWing]

I agree. It's also funny to hear those on the right now taking this stance as opposed to something like poor performing schools they were advocating for cutting their spending.

That's an entirely different agenda at work. The conservatives want to gut the public schools by any means possible and divert public school funds to their pet religious and/or for-profit charter schools.

 

[Matt1970]

No one will confuse the modern day Republican party for an organization that has a plan for health care. You can rest easy on that one.

Except for, you know, YOU.

There is a reason it's originally a Republican idea.

 

[Hayabusa Rider]

That's an entirely different agenda at work. The conservatives want to gut the public schools by any means possible and divert public school funds to their pet religious and/or for-profit charter schools.

Perhaps it's different, but in some ways not. No one can or will answer my question about how this works or when it applies (and when not). If it addresses my concerns then that's great. If it doesn't the motives don't matter. Stupid thought processes lead to harm, and that would be the bottom line.

Note I'm a supporter of good health care and education, not dumb.

 

[Blanky]

With each passing month I'm more convinced the US needs to put the insurance industry in front of a collective firing squad and adopt a Euro/Canadian model.

And this is from a guy who has "extremely good" insurance. Many of the proles who support the status quo don't realize what they are supporting.

 

[theeedude]

Except for, you know, YOU.

Which is why I said "modern day" Republican party. There was a time when the Republican party still had ideas.

 

[MongGrel]

Which is why I said "modern day" Republican party. There was a time when the Republican party still had ideas.

Agreed.

Long past.

 

[ivwshane]

That's an entirely different agenda at work. The conservatives want to gut the public schools by any means possible and divert public school funds to their pet religious and/or for-profit charter schools.

True but that wasn't the reasoning they used.

 

[cubby1223]

That's an entirely different agenda at work. The conservatives want to gut the public schools by any means possible and divert public school funds to their pet religious and/or for-profit charter schools.

Democrats also are gutting public schools in exchange for cheaper charter schools. Hi, I live near Chicago. Chicago is run by Democrats.

 

[cubby1223]

I think the conservative concern is the amount of power the government has to decide what is good and what is bad. What will continue and what will fail.

 

[IronWing]

Democrats also are gutting public schools in exchange for cheaper charter schools. Hi, I live near Chicago. Chicago is run by Democrats.

I said conservatives, not Reps. Dems and Reps are both conservative parties.

 

[theeedude]

Is that what I said? Nope. Obama is simplistic solution to a complex problem, that is health care. That means the problem of actual health care is far beyond anything Obamacare offers. This "solution" you defend isn't going to be the fix in all cases. Now I could be wrong, so I'll ask you. If there are two institutions which fail, one because it does not have the staff to do things properly, and the other which is just plain lazy, are the penalties the same? If no then good and I withdraw my complaint on this issue. On the other hand if the solution is to cut funding where more was needed in the first place, that's stupid. Shall we cut staffing and teachers in inner cities where scores tend to be lower than suburbs? That would be idiotic, and same thing here. Sometimes more resources are needed. Sometimes not. Sometimes people are trying to do the best with what they have and sometimes not. All you have to do is show where in this plan this is taken into account. That should't be hard, right?

If two institutions fail because they got dinged 1% Medicare reimbursement for unnecessarily killing or causing health harm to patients, my question would not be which one had a better excuse, but why they only got dinged 1%.
Also, if you are so concerned about hospitals closing, you focus should be directed to states not-expanding Medicaid and suing to stop their own citizens from getting subsidies on the Federal exchange. Now their hospitals could well be up the brown creek with no paddle.

 

[nickqt]

I said conservatives, not Reps. Dems and Reps are both conservative parties.

This.

Take the average Democratic party member from the US. Transport them to Canada. Or Britain. Or Continental Western/Central Europe. Place them in a party.

They'd fit into the conservative party just fine.

Which is why every time someone accuses a Democrat or Obama of being a communist or socialist, it's laughable and delusional.

I mean, sure, you can call Obama a socialist, but that means Nixon was a socialist and Ike was damn near a commie. Obama is a socially-liberal 70's era Republican. Of course today, that only allows membership in the Democratic party.

 

[IronWing]

I think the conservative concern is the amount of power the government has to decide what is good and what is bad. What will continue and what will fail.

When the taxpayers are footing the bill I think it is reasonable that the government make some attempt to get good value for the money spent. I suppose we could dump Medicare entirely and go back to letting the elderly forage for their own healthcare. It didn't work prior to Medicare but who knows, maybe the current market can accommodate the elderly now.

 

[Fern]

I have to say I'm amazed that conservatives are arguing for the government to pay the same (or even more!) to hospitals that deliver a poor product.

It's hard to imagine what the government could do other than impose some sort of financial penalty for bad performance. Hospital acquired infections are the very definition of waste in health care.

Nobody but you is arguing "for the government to pay the same (or even more!) to hospitals that deliver a poor product."

The real issue is whether this is the best way to combat the problem of infections.

I don't know the details of this rule, but what happens the (small) 1% reduction?

If the answer is nothing, doesn't that indicate the govt is then content to allow this problem continue as long as it keeps the 1%?

If that's the case, can it truly be said that this rule is about fixing the problem? Or, is it just one of several 'revenue' measures inserted to make Obamacare look better in the CBO cost projections. You know, like 1099's required for everybody for everything (thankfully repealed), the tax on medical equipment (WTH is that about?) and the tax on gold plated plans (the 'let's encourage less coverage while we're encouraging more coverage' thingy).

And are we to believe that this issue is not already covered by state and fed regulations? That until this 1% reduction was enacted no rules covered excessive infections? I don't believe that. I think we should just fix the already existing regulations.

Oh, looks like states DO alreay regulate this:

Some states issue their own penalties — California, for instance, levies fines as high as $100,000 per incident on hospitals that are repeat offenders.

Yup, starting to look more like a revenue measure than an honest attempt to fix the problem. Uncle Sugar wants his cut I suppose.

Oh look, the fed govt already doesn't have to pay for unnecessary costs such as avoidable complications from infections:

Since 2008, Medicare has refused to pay hospitals for the cost of treating patients who suffer avoidable complications.

The penalties come on top of other financial incentives Medicare has been placing on hospitals. This year, Medicare has already fined 2,610 hospitals for having too many patients return within a month of discharge.

http://kaiserhealthnews.org/news/me...ls-with-highest-rates-of-infections-injuries/

These are two existing financial penalties I found quickly. May well be more, such as higher insurance rates for the hospitals. Hey feds, keep trying the same thing over and over, maybe you'll get a different result, huh?

Looks like low hanging fruit alright - for Obamacare finances.

Fern

 

[Hayabusa Rider]

If two institutions fail because they got dinged 1% Medicare reimbursement for unnecessarily killing or causing health harm to patients, my question would not be which one had a better excuse, but why they only got dinged 1%.

Hey if inner city schools don't match the performance of the richest neighborhoods they deserve to have staffing cut. I mean if teachers are so lazy do away with most of them. That will make things right. Obviously all situations are equal, and it's just all numbers, not people who are important. It's weird how conservative so called liberals really can be. Stupid blanket statements about two different underlying causes are stupid.

What you did however is completely ignore reality in favor of 1% and that's probably because my concerns are correct. The plan probably doesn't have enough thought applied to it to do better than what my son would have come up with when he was six, or at least that the case if it doesn't know the difference in individual situations. Is it really that stupid?

Does it or does it not differentiate between causes and provide support when that is what is needed? Your response would be "Yes" or "No", not evasion of the question.

 

[Fern]

uhmm, it is risk adjusted.

Again, this has proven to be effective in the real world. It is literally the lowest hanging fruit we could possibly find in terms of eliminating wasteful spending. It's a no-brainer.

Some are disagreeing, or at least saying that the adjustment process needs a lot of work.

Medicare penalized 143 of 292 major teaching hospitals, the KHN analysis found.

“We know some of the procedures we do — heart transplants or resecting cancerous portions of the esophagus — are going to be just more prone to having some of these adverse events,” said Dr. Atul Grover, the chief public policy officer of the Association of American Medical Colleges. “To lump in all of those things that are very complex procedures with simple things like pneumonia or hip replacements may not be giving an accurate result.”

An analysis of the penalties that Dr. Ashish Jha, a professor at the Harvard School of Public Health, conducted for KHN found that penalties were assessed against 32 percent of the hospitals with the sickest patients. Only 12 percent of hospitals with the least complex cases were punished. Hospitals with the poorest patients were also more likely to be penalized, Jha found. A fourth of the nation’s publicly owned hospitals, which often are the safety net for poor, sick people, are being punished.

Hospitals complain that the new penalties are arbitrary, since there may be almost no difference between hospitals that are penalized and those that narrowly escape falling into the worst quarter.

“Hospitals may be penalized on things they are getting safer on, and that sends a fairly mixed message,” said Nancy Foster, a quality expert at the American Hospital Association.

Hospital officials also point out those that do the best job identifying infections in patients may end up looking worse than others. “How hard you look for something influences your results,” said Dr. Darrell Campbell Jr., chief medical officer at the University of Michigan Health System.

http://kaiserhealthnews.org/news/me...ls-with-highest-rates-of-infections-injuries/

So teaching hospitals, hospitals treating serious cases, and hospitals for the poor are being fined significantly more often than other hospitals? The 'adjusting' may need adjusting.

Still think this isn't really about fixing the problem of infections.

Fern

 

[theeedude]

Hey if inner city schools don't match the performance of the richest neighborhoods they deserve to have staffing cut. I mean if teachers are so lazy do away with most of them. That will make things right. Obviously all situations are equal, and it's just all numbers, not people who are important. It's weird how conservative so called liberals really can be. Stupid blanket statements about two different underlying causes are stupid.

What you did however is completely ignore reality in favor of 1% and that's probably because my concerns are correct. The plan probably doesn't have enough thought applied to it to do better than what my son would have come up with when he was six, or at least that the case if it doesn't know the difference in individual situations. Is it really that stupid?

Does it or does it not differentiate between causes and provide support when that is what is needed? Your response would be "Yes" or "No", not evasion of the question.

So you don't believe in accountability for hospitals, and think the government should not pay even 1% less for worse care.
Do you also pay exactly same for expired food likely to make you sick as you would for fresh food?

 

[Matt1970]

So you don't believe in accountability for hospitals, and think the government should not pay even 1% less for worse care.
Do you also pay exactly same for expired food likely to make you sick as you would for fresh food?

Nobody is saying they don't want accountability, but blindly going in and just financially penalizing hospitals without understanding the problem or what might fix it is asinine. That could very well make things worse in a lot of cases.

 

[theeedude]

Nobody is saying they don't want accountability, but blindly going in and just financially penalizing hospitals without understanding the problem or what might fix it is asinine. That could very well make things worse in a lot of cases.

So you want to pay same for high quality service as one that unnecessarily endangers your life, because not paying same for it could make the dangerous service even worse in the future?
Even though that paying exact same for dangerous service as high quality one removes any financial incentive to improve quality.
That's an interesting position, but I don't think the opposite one is asinine.

 

[bradly1101]

Hire more nurses, and these problems decrease.

Simple solution. More nurses = better care.

But, is better care really worth it?

That might mean slightly less profits for shareholders and administrators, and that's just a slippery slope to socialism, comrades.

True dat.

 

[Matt1970]

So you want to pay same for high quality service as one that unnecessarily endangers your life, because not paying same for it could make the dangerous service even worse in the future?
Even though that paying exact same for dangerous service as high quality one removes any financial incentive to improve quality.
That's an interesting position, but I don't think the opposite one is asinine.

I think you missed the whole point of why one would be endangering your life. If the very reason why that service is at higher risk is because of a lack of funds, how is financially penalizing them going to do anything but make things worse?

 

[theeedude]

I think you missed the whole point of why one would be endangering your life. If the very reason why that service is at higher risk is because of a lack of funds, how is financially penalizing them going to do anything but make things worse?

I get it, "to everyone by their need, from everyone by their ability."
It's interesting position for conservatives to take when opposing "Socialist Takeover of Medicine." But seeing how, day after day, Obamacare makes Republicans do backflips to oppose it, I can't say I am too surprised.