Huge changes to healthcare sneaking into the stimulus bill

[vi edit]

As somebody who has worked in an IS based position supporting clinical documentation and working directly with our own EMR product, I'm very curious as to what the government can magically do at a national level that even standalone hospitals haven't been able to accomplish. Many hosptials are a hodgepode network of independent applications shoestrung together with hopefully some semblence of HL7 and data warehousing available.

When you have an ED on one system, your ambulatory offices on another, surgery on a third, main house on a fourth, and any number of specialized areas on countless other applications being used it's VERY difficult to bring all that data back to one place.

We stuggle to get med rec's correct from floor to floor. Let alone from one health care network to another.

 

[Jack Ryan]

Originally posted by: Xavier434

Originally posted by: dphantom

Originally posted by: senseamp
People love to complain how Medicare will bankrupt us, but the very same people are up in arms if the government tries to implement any sort of cost containment on Medicare.
This is typical Republicanism, screw up governing, then pretend that government is the problem.

Not I. Cut medicare and SS all you want. Privatize all of it is absolutely fine with me. Let me keep my money and decide how I want to fund retirement and healthcare. I don't need some brainless moron in a D.C. office deciding for me.

And what happens to everyone (including you) during times like these where you have tons of people that planned wisely to retire using whatever they had, but had it all vanish within a couple months thanks to a bad time in the economy?

Part of the government's job is to preserve the common welfare of each and every one of it's citizens. That means they need a low risk trump card for preservation and that is going to cost money. Just because the government is letting you keep your taxes doesn't mean you have control of your money even in a 100% free market. The only difference is that you end up giving it to corporations to control it for you instead which is fine, but this country needs a back up plan if it intends to survive during hard times and that is the government's job.

In your opinion...

I disagree.

 

[Descartes]

Originally posted by: vi edit
As somebody who has worked in an IS based position supporting clinical documentation and working directly with our own EMR product, I'm very curious as to what the government can magically do at a national level that even standalone hospitals haven't been able to accomplish. Many hosptials are a hodgepode network of independent applications shoestrung together with hopefully some semblence of HL7 and data warehousing available.

I too am curious, especially with the snafus around some of the past attempts.

Thankfully, many of the more prominent systems at least support HL7 and most vendors also support HL7. Much of my work is related to the infrastructure needed to speak HL7 and integrate with all the systems. I would hope any national endeavor would include a centralization of information in this regard, and at the very least cut down on repetition among facilities. It's nonsense to go from a clinic to a hospital and have to regurgitate your entire history once again. That's only one issue.

Another is fraud. Cut out the fraud at the clinical level, confirm identity at the time of visit, allow doctors to capture their revenue and reduce costs. Fraud is huge not just with government policies, but also with companies that fund their own healthcare like Home Depot (not sure if they still do).

So, fraud + unification of information by imposing standards, not dissimilar to NPI can help capture a tremendous amount. I think Georgia alone had $300M in fraudulent claims last year. I might be wrong in that.

When you have an ED on one system, your ambulatory offices on another, surgery on a third, main house on a fourth, and any number of specialized areas on countless other applications being used it's VERY difficult to bring all that data back to one place.

Exactly. This is why eHR has so much potential, imo. I've seen successful integration between regional hospitals, clinics, etc. even on disparate systems like Siemens, Meditech, LSS, etc. HL7 helps, but there are many other ways of extracting information and automating workflow.

 

[theeedude]

Originally posted by: Jack Ryan

Originally posted by: Xavier434

Originally posted by: dphantom

Originally posted by: senseamp
People love to complain how Medicare will bankrupt us, but the very same people are up in arms if the government tries to implement any sort of cost containment on Medicare.
This is typical Republicanism, screw up governing, then pretend that government is the problem.

Not I. Cut medicare and SS all you want. Privatize all of it is absolutely fine with me. Let me keep my money and decide how I want to fund retirement and healthcare. I don't need some brainless moron in a D.C. office deciding for me.

And what happens to everyone (including you) during times like these where you have tons of people that planned wisely to retire using whatever they had, but had it all vanish within a couple months thanks to a bad time in the economy?

Part of the government's job is to preserve the common welfare of each and every one of it's citizens. That means they need a low risk trump card for preservation and that is going to cost money. Just because the government is letting you keep your taxes doesn't mean you have control of your money even in a 100% free market. The only difference is that you end up giving it to corporations to control it for you instead which is fine, but this country needs a back up plan if it intends to survive during hard times and that is the government's job.

In your opinion...

I disagree.

Good for you. Your side lost last election.

 

[fskimospy]

Originally posted by: Fern

The article provides a (pdf) link to the stimulus bill, and gives cites (page numbers) for it's claims. Why not check it out instead of speculating?

Edit: Forgot to mention - Oh yeah, d@mn, look more new stuff discovered buried in the +600 pages. Doesn't look to be related to 'stimulus' in any meaningful way.

Let's see so far the stimulus bill that's about "jobs" (according to Obama) also has (1) Individual welfare/unemployment, (2) welfare/support for states, (3) Education, (4) now we see health care reform. What else?

Fern

I definitely agree that people should go check it out instead of speculating. If they did that, this thread probably wouldn't exist.

The rest of your post is just baffling.

1.) Extended unemployment benefits are considered by a large number of researchers and economists to be directly stimulative as the money is quickly spent.

2.) Covering state budget shortfalls. As the budget for the state is already drawn up, normal appropriations prepared, and projects planned, the money sent to states can also be quickly spent. In addition, this prevents layoffs: ie. jobs.

3.) See #2

4.) See my original complaint about this thread. The opinion article its based on is wildly speculating. Or did you think that a bill that had health care modernization in it wouldn't have any provisions as to how the new system would be used?

 

[fskimospy]

Originally posted by: Jack Ryan

Originally posted by: Xavier434

And what happens to everyone (including you) during times like these where you have tons of people that planned wisely to retire using whatever they had, but had it all vanish within a couple months thanks to a bad time in the economy?

Part of the government's job is to preserve the common welfare of each and every one of it's citizens. That means they need a low risk trump card for preservation and that is going to cost money. Just because the government is letting you keep your taxes doesn't mean you have control of your money even in a 100% free market. The only difference is that you end up giving it to corporations to control it for you instead which is fine, but this country needs a back up plan if it intends to survive during hard times and that is the government's job.

In your opinion...

I disagree.

You should go read the preamble to the Constitution then. There's something about 'provide for the general welfare' in there.

 

[BoberFett]

Originally posted by: senseamp

Originally posted by: dphantom

Originally posted by: senseamp
Sounds like a first step toward universal health care. So far so good.

If it's from the government, it is almost certainly bad.

As opposed to same thing from the insurance company?

No, they're both bad. But only Democrat fools believe that government bureaucracy is better than corporate bureaucracy.

 

[Xavier434]

Originally posted by: eskimospy

Originally posted by: Jack Ryan

Originally posted by: Xavier434

And what happens to everyone (including you) during times like these where you have tons of people that planned wisely to retire using whatever they had, but had it all vanish within a couple months thanks to a bad time in the economy?

Part of the government's job is to preserve the common welfare of each and every one of it's citizens. That means they need a low risk trump card for preservation and that is going to cost money. Just because the government is letting you keep your taxes doesn't mean you have control of your money even in a 100% free market. The only difference is that you end up giving it to corporations to control it for you instead which is fine, but this country needs a back up plan if it intends to survive during hard times and that is the government's job.

In your opinion...

I disagree.

You should go read the preamble to the Constitution then. There's something about 'provide for the general welfare' in there.

Exactly. That is what I am referring to. The issue is that different people have different interpretations of that part of the Constitution, but generally I feel that it at least means that the government should provide to its people what the people are unable to provide for themselves well enough to keep the country from falling apart.

To me, that at least means having a trump card available to play during times like we are seeing now. That doesn't mean it will be painless and it doesn't mean that there is not more than one way to play that trump card but it needs to exist and that has nothing to do with any government party. It has everything to do with the US Government.

 

[PokerGuy]

Originally posted by: BoberFett

Originally posted by: senseamp

Originally posted by: dphantom

Originally posted by: senseamp
Sounds like a first step toward universal health care. So far so good.

If it's from the government, it is almost certainly bad.

As opposed to same thing from the insurance company?

No, they're both bad. But only Democrat fools believe that government bureaucracy is better than corporate bureaucracy.

... and with companies, if competition were properly allowed, you'd have the option to choose a different company. With a government run disaster system (which it certainly would be), you'd have no choice, and everyone in the country would be stuck with that disaster forever, since we can NEVER EVER get rid of giant government disaster institutions once they get created.

 

[Anubis]

Originally posted by: ironwing
While I don't support this legislation I also don't see it as a significant change from the current system where insurance company flunkies are providing direction, guidance, and generally backseat doctoring. The only thing that changes is who is calling the shots, an insurance company accountant or a govmint accountant.

it really isnt any different, and will just result in docs being paied even less then they deserve

 

[theeedude]

Originally posted by: PokerGuy

Originally posted by: BoberFett

Originally posted by: senseamp

Originally posted by: dphantom

Originally posted by: senseamp
Sounds like a first step toward universal health care. So far so good.

If it's from the government, it is almost certainly bad.

As opposed to same thing from the insurance company?

No, they're both bad. But only Democrat fools believe that government bureaucracy is better than corporate bureaucracy.

... and with companies, if competition were properly allowed, you'd have the option to choose a different company. With a government run disaster system (which it certainly would be), you'd have no choice, and everyone in the country would be stuck with that disaster forever, since we can NEVER EVER get rid of giant government disaster institutions once they get created.

Seniors have an option of using an insurer other than or in addition to medicare if you don't like medicare coverage.
As it stands now, the health care system disaster is not in civilized countries with universal healthcare, but in our multi payer system. But if Republicans want to be anti-medicare party they certainly have an option of taking that to the voters. They seemed to punt last time they were in power, and instead decided to expand the program.

 

[vi edit]

Originally posted by: Anubis

Originally posted by: ironwing
While I don't support this legislation I also don't see it as a significant change from the current system where insurance company flunkies are providing direction, guidance, and generally backseat doctoring. The only thing that changes is who is calling the shots, an insurance company accountant or a govmint accountant.

it really isnt any different, and will just result in docs being paied even less then they deserve

It's not just docs. It's basic repayments to a hosptial too. The state of IL is so far in the hole right now that it hasn't made a payment to hospitals for reimbursement since the beginning of January.

 

[Budmantom]

Originally posted by: Anubis

Originally posted by: ironwing
While I don't support this legislation I also don't see it as a significant change from the current system where insurance company flunkies are providing direction, guidance, and generally backseat doctoring. The only thing that changes is who is calling the shots, an insurance company accountant or a govmint accountant.

it really isnt any different, and will just result in docs being paied even less then they deserve

We have a shortage of doctors and if we see this UHC we will see a flood of patients, sounds like a great combination.

 

[BoberFett]

Originally posted by: senseamp

Good for you. Your side lost last election.

So you agree that losing an election means your opinion doesn't matter? And therefore you agree that Democrat opinion didn't matter during Bush's administration? And you therefore agree that everything Bush did was correct, because might makes right?

You're a Bush supporter.

 

[Fern]

Originally posted by: vi edit
As somebody who has worked in an IS based position supporting clinical documentation and working directly with our own EMR product, I'm very curious as to what the government can magically do at a national level that even standalone hospitals haven't been able to accomplish. Many hosptials are a hodgepode network of independent applications shoestrung together with hopefully some semblence of HL7 and data warehousing available.

When you have an ED on one system, your ambulatory offices on another, surgery on a third, main house on a fourth, and any number of specialized areas on countless other applications being used it's VERY difficult to bring all that data back to one place.

We stuggle to get med rec's correct from floor to floor. Let alone from one health care network to another.

Agreed.

The IRS, a goverment organization from day #1, has never been able to get their systems integrated & working.

How this is magically gonna happen to much larger national network of independant hospitals/care- givers is unrealistic.

Fern

 

[theeedude]

Originally posted by: BoberFett

Originally posted by: senseamp

Good for you. Your side lost last election.

So you agree that losing an election means your opinion doesn't matter? And therefore you agree that Democrat opinion didn't matter during Bush's administration? And you therefore agree that everything Bush did was correct, because might makes right?

You're a Bush supporter.

Your opinion also does not matter because it's full of logical fallacies, not just because your side lost the election.

 

[Fern]

Originally posted by: eskimospy
-snip-
1.) Extended unemployment benefits are considered by a large number of researchers and economists to be directly stimulative as the money is quickly spent.

2.) Covering state budget shortfalls. As the budget for the state is already drawn up, normal appropriations prepared, and projects planned, the money sent to states can also be quickly spent. In addition, this prevents layoffs: ie. jobs.

So now "welfare" type expenditures are really "stimulus"?

I don't believe I've seen anybody on the 'left' admit that something, anything, did NOT meet the definition of "stimulus" (at least not when Dems when are in power).

I understand those who feel a need for increased unemployemnt benefits and federal assistance ot states for increased Medicaid costs, I just disagree with the wholesale of justification and any and all expenditures under the guise of "stimulus".

Moreover it misses a very important point (IMO, at least) and one that has so far been absent in the discussion. Obama keeps saying this is about jobs - well let's inject the concept of 'best bang for the buck'. We don't have unlimited funds (contrary to their behavior), stimulus funds should be prioritized and focuses to projects/items that give us the best return of our $'s. I see zero effort towards that; in fact I see no recognition of the concept, nothing to indicate it's been taken into consideration at all.

Fern

 

[fskimospy]

Originally posted by: Fern

So now "welfare" type expenditures are really "stimulus"?

I don't believe I've seen anybody on the 'left' admit that something, anything, did NOT meet the definition of "stimulus" (at least not when Dems when are in power).

I understand those who feel a need for increased unemployemnt benefits and federal assistance ot states for increased Medicaid costs, I just disagree with the wholesale of justification and any and all expenditures under the guise of "stimulus".

Moreover it misses a very important point (IMO, at least) and one that has so far been absent in the discussion. Obama keeps saying this is about jobs - well let's inject the concept of 'best bang for the buck'. We don't have unlimited funds (contrary to their behavior), stimulus funds should be prioritized and focuses to projects/items that give us the best return of our $'s. I see zero effort towards that; in fact I see no recognition of the concept, nothing to indicate it's been taken into consideration at all.

Fern

As we've covered before, you simply have a different definition of what stimulus is. Unemployment benefit extension as economic stimulus is specifically backed up by research. (there are also studies that dispute it, but the Democrats certainly have a rational and verifiable basis for their opinion).

I'm not sure if you know the basis for this proposal, but yes the fundamental premise is that any kind of government spending is in fact stimulus, because it injects money into the system. Keynes is famously quoted as saying that in particularly disastrous economic times, the government should pay people to dig holes and fill them back up. You may disagree with this particular economic philosophy, but it's been explained several times at this point. Basically it appears you have a philosophical difference with the Democrats, one that isn't going to change for either one of you guys. Unfortunately for you, they won the election.

Nobody thinks we have unlimited funds, that's just a ridiculous statement on your part. They simply think that significant deficit spending is required to meet the economic difficulties we are facing. Bang for the buck is important, which is why the vast majority of the money is being spent on areas such as personal tax cuts and unemployment benefits (that the Democrats believe will inject large amounts of cash quickly into the economy), but another important aspect of it is that the stimulus be broad based enough to touch as many sectors of society and the economy as possible.

Long story short, you appear to have fundamental differences with the basic philosophy this is based on, as do many Republicans. Republicans have suffered catastrophic electoral losses over the last several years, and so on these fundamental debates you are going to lose. It doesn't mean that they will have no input (in fact, I'm surprised they've had as much as they have), but they won't be able to change the basic premise. I'm sorry, but that's how things work as elections have consequences.

 

[BoberFett]

Originally posted by: senseamp

Originally posted by: BoberFett

Originally posted by: senseamp

Good for you. Your side lost last election.

So you agree that losing an election means your opinion doesn't matter? And therefore you agree that Democrat opinion didn't matter during Bush's administration? And you therefore agree that everything Bush did was correct, because might makes right?

You're a Bush supporter.

Your opinion also does not matter because it's full of logical fallacies, not just because your side lost the election.

My side didn't lose. I don't have a side.

Try again, peabrain.

 

[palehorse]

All of this debate on the pros and cons of UHC is old news and practically irrelevant... I'd rather get to the bottom of the real issue here: That is, what the fuck are these items doing in drafts of the Stimulus Bill?!

Is it as Daschle suggested? Are they being jammed into a completely unrelated bill because "the issue is too important to be stalled by Senate protocol"? :Q

 

[PokerGuy]

Yes, they are specifically being snuck in because if they were subject to pulblic debate and public understanding of how they're getting screwed, the public would not support them.

 

[palehorse]

Originally posted by: PokerGuy
Yes, they are specifically being snuck in because if they were subject to pulblic debate and public understanding of how they're getting screwed, the public would not support them.

That may or may not be true... but, the real issue remains the fact that they're being "snuck in"...

 

[fskimospy]

Originally posted by: palehorse
All of this debate on the pros and cons of UHC is old news and practically irrelevant... I'd rather get to the bottom of the real issue here: That is, what the fuck are these items doing in drafts of the Stimulus Bill?!

Is it as Daschle suggested? Are they being jammed into a completely unrelated bill because "the issue is too important to be stalled by Senate protocol"? :Q

I answered this in my reply to Fern.

 

[theeedude]

Originally posted by: BoberFett

Originally posted by: senseamp

Originally posted by: BoberFett

Originally posted by: senseamp

Good for you. Your side lost last election.

So you agree that losing an election means your opinion doesn't matter? And therefore you agree that Democrat opinion didn't matter during Bush's administration? And you therefore agree that everything Bush did was correct, because might makes right?

You're a Bush supporter.

Your opinion also does not matter because it's full of logical fallacies, not just because your side lost the election.

My side didn't lose. I don't have a side.

Try again, peabrain.

If that is truly the case, which I don't believe it is but whatever, then your opinion doesn't matter only because it's full of logical fallacies, and not because your side lost.

 

[MovingTarget]

Originally posted by: Budmantom

Originally posted by: Anubis

Originally posted by: ironwing
While I don't support this legislation I also don't see it as a significant change from the current system where insurance company flunkies are providing direction, guidance, and generally backseat doctoring. The only thing that changes is who is calling the shots, an insurance company accountant or a govmint accountant.

it really isnt any different, and will just result in docs being paied even less then they deserve

We have a shortage of doctors and if we see this UHC we will see a flood of patients, sounds like a great combination.

We can always train more doctors. The number of people in the population needing to see one in this society is relatively constant barring some major outbreak. The difference is whether they forgo care because of finances. There are many universities that would love to have a medical school. I say screw the AMA on this one. We need to drastically ramp up the number of medical professionals we have as UHC seems to be more and more like an inevitability considering the current clusterfvck. Better be prepared. If the catastrophe you cite happens, we should've seen it coming.