You cant filabuster the repeal of Obamacare?

[Hayabusa Rider]

I'm not aware of any of these nations. There are parliamentary systems but those not only don't require cooperation but the party in power actually exercises TOTAL control over the government, unlike here. I actually think that's a feature, not a bug, as split sovereignty is a horrible idea, but it's there.

Coalitions and votes of confidence may be something you dislike, but I think some accountability is proper. BTW a monopoly on power was seen as a threat and gridlock may be a feature, not a bug to keep things from moving one way or the other to a great degree.

 

[Doc Savage Fan]

Very few people thought the ACA was perfect, but it was GOP obstructionism that prevented any improvements being made to it.

Just curious...exactly what ACA improvements did Republicans block?

 

[fskimospy]

Coalitions and votes of confidence may be something you dislike, but I think some accountability is proper. BTW a monopoly on power was seen as a threat and gridlock may be a feature, not a bug to keep things from moving one way or the other to a great degree.

I don't have a problem with coalitions and votes of confidence, I'm just telling you that in a parliamentary system the party in power has absolute, total control, unlike ours. There isn't even the ability in most cases for individual acts of courage and bravery that defy the party's will. (in a lot of countries if an MP votes against the party he can simply be replaced with one who won't) If you're talking about other nations requiring compromise they actually require much less of it than ours does.

 

[soundforbjt]

I've gone into painful detail too many times so I'll do an abbreviated version.

Health care revolves around one person, the patient and treating ailments, then maintaining health. That's it. The patient matters and all other considerations are secondary.

It's a simple premise which has absolutely no simple solutions, but there are ways we can go about making radical changes in "business as usual". Foremost is doing away with the idea of "cost containment" being most important. Yes costs are a major factor, however what has been missing in the discussion is how the patient does. If we improve the process in specific ways we can provide a more immediate and better treatment which automatically decreases costs. Yes investment will be needed but the rewards in health improvement and processes offsets that.

1) Remove politicians as much as possible. Do this by tasking professional associations in all aspects related to care to select those known for ability and high standards of ethics. This would be many providers, actuaries, IT people, public health advocates. No politicians.

2) Task this independent group who works full time and is compensated and funded, to make an apolitical assessment of the current situation.

3) Develop competing scenarios and test them. Refine as needed and see what really happens in the test "market"

4) Work to build a dynamic system which is not weighed down by bureaucracy. This needs to be reform based on merit.

5) Present all findings to Congress and the public concurrently. No closed door meetings.

6) Let Congress debate but not discard or add without the Body replying first in a most public way.

7) Implement and modify as optimal care dictates.

I'll tackle one facet of care which can make broad beneficial improvements.

Here is how things are. We do not have a unified health care system and addressing this is a major concern. We are a large and disparate population with many needs, not all alike. One size fits all makes no sense. But we can provide some unification. Let's have a "Mednet", which would be online records of every patient, accessed by providers by multiple biometric measures. Get some of the snoops and people in academia to come up with an encryption standard higher than what we currently use. Some marvelous minds out there. Use them.

So what? Why is this a big thing? Here's a "secret". The most important thing for providers to do their jobs properly is a complete and up to date medical history. This cannot be overemphasized.

A real world everyday example. A patient comes to an ER and presents with symptoms which are not easily determined initially. Due to location, hours or whatever the medical history is incomplete or inaccurate. You cannot depend a patient for accuracy. So patient gets a test. $. Test inclusive. Patient admitted for observation and further testing $$$. Patient treated and the process completed. $$$$$

Or.

Patient presents at ER. Full accurate medical history comes up. Oh had that test. Oh takes this med. Oh this problem was recognized and therapy adjustments need to be made.

Which is better for all parties involved? The second. Fewer resources needed of all kinds to get it right.

Doesn't happen much, right? Every. Single. Day, and too often.

But something not so obvious. Currently the data collection we have is limited by spotty knowledge and lack of infrastructure.

Put this in place and great stuff happens. We even have a model for illustrative purposes, VAERS.

That is a vaccination reporting system which exists because of vaxxer ignorance for the most part, but it is a wonderful thing to have in any case. We can analyse and know things. We can discover what we never knew existed, because it provides knowledge and knowledge is power to make positive change.

So strip personally identifiable information from profiles and datamine therapies to determine what works and when and vice versa. See if something works, but at times not then dig further for causation. Whoa, it looks like some meds provide benefit that wasn't even guessed at. We have concrete evidence we would have missed.

It happens all the time already but at a snail's pace.

Better outcomes
Lower costs overall
New therapies, improvement in current treatments and becoming aware of things for good or ill we havent even thought about.

One tiny facet of care and see what it can bring.

Usually someone comes in with Republican this or Democrat that and how trying to do such things is a fantasy, shut up and do what my overlords tell you.

Can't get into all that. This is too serious for the ignorant to run.

Thank you for the explanation, I agree on many points you made.

 

[ivwshane]

Thank you for the explanation, I agree on many points you made.

The ACA also did many of the things he suggested. One of its focuses was on the actual results of care and comparative effectiveness research (CER), which was the very thing hayabusa was talking about. He, like most Americans are totally clueless as to what the ACA did and how it works outside of insurance exchanges.

https://aspe.hhs.gov/meeting-aca-mandate-build-data-capacity

 

[Hayabusa Rider]

The ACA also did many of the things he suggested. One of its focuses was on the actual results of care and comparative effectiveness research (CER), which was the very thing hayabusa was talking about. He, like most Americans are totally clueless as to what the ACA did and how it works outside of insurance exchanges.

https://aspe.hhs.gov/meeting-aca-mandate-build-data-capacity

The ACA had some primitive and poorly supported initiatives. Credit for that. Congrats. You've begun to address a 0.01% of the issues.

So where is this system after all these years? I'd be keen to see the national prototype, or any results.

So I gave a specific solution to many problems with a major innovation. Your turn to identify a specific issue and resolve it in a specific (note specific) way that benefits the patient without referring to any legislation. Show us what you understand.

 

[ivwshane]

The ACA had some primitive and poorly supported initiatives. Credit for that. Congrats. You've begun to address a 0.01% of the issues.

So where is this system after all these years? I'd be keen to see the national prototype, or any results.

So I gave a specific solution to many problems with a major innovation. Your turn to identify a specific issue and resolve it in a specific (note specific) way that benefits the patient without referring to any legislation. Show us what you understand.

You can shove your goal posts up your ass since they seem to follow your every move anyway.

Do your own research guy, I provided you with info you were clueless about, show us how facts and reality matter to you and look into what was posted yourself.

 

[Hayabusa Rider]

You can shove your goal posts up your ass since they seem to follow your every move anyway.

Do your own research guy, I provided you with info you were clueless about, show us how facts and reality matter to you and look into what was posted yourself.

I did my research. I provided a concrete example how vast improvements can be made. You are full of opinions so show us how qualified to pass judgement.

Thought so. We know.

 

[JEDI]

While you were sleeping, at 1 a.m., the Republican Senate voted 51 - 48:
1. To end coverage for preexisting conditions, veterans benefits, and aid to rural hospitals.
2. To remove discrimination protection for women in healthcare.
3. Against the provision allowing children to remain on their parent's insurance till the age of 26.

if true, how did this get past a filibuster?

 

[ivwshane]

I did my research. I provided a concrete example how vast improvements can be made. You are full of opinions so show us how qualified to pass judgement.

Thought so. We know.

No, you posted what you thought should happen and then when I showed you the ACA was doing just that you then moved the goal posts and said it wasn't good enough. Now show your work and show how its not good enough.

 

[Hayabusa Rider]

No, you posted what you thought should happen and then when I showed you the ACA was doing just that you then moved the goal posts and said it wasn't good enough. Now show your work and show how its not good enough.

Huh, I nothing about a unified and universal system to do what I said. Three million dollars spent on that? Wow thats a sincere effort right there.

Hey about having a safety net. We could have maybe 5 million for that. Solves that problem.

Windowdressing.

 

[Meghan54]

Cool....your ER example, esp. the second part, is what a typical MD's office visit should be. And that's not how an ER is used, either. ER's don't adjust therapies, meds, etc. That's not their purpose...at all.

And to harken back to another point from earlier, Obamacare certainly did have the mechanisms in place in the original legislation to pay for the unexpected costs ins. co's. would face, thereby preventing the massive premium increases that did happen when the Republican controlled House refused to fund said payment mechanisms. It's rather easy to cause a failure of a project when you refuse to fund various aspects of said project, as the Repubs in fact did.

I've gone into painful detail too many times so I'll do an abbreviated version.

Health care revolves around one person, the patient and treating ailments, then maintaining health. That's it. The patient matters and all other considerations are secondary.

It's a simple premise which has absolutely no simple solutions, but there are ways we can go about making radical changes in "business as usual". Foremost is doing away with the idea of "cost containment" being most important. Yes costs are a major factor, however what has been missing in the discussion is how the patient does. If we improve the process in specific ways we can provide a more immediate and better treatment which automatically decreases costs. Yes investment will be needed but the rewards in health improvement and processes offsets that.

1) Remove politicians as much as possible. Do this by tasking professional associations in all aspects related to care to select those known for ability and high standards of ethics. This would be many providers, actuaries, IT people, public health advocates. No politicians.

2) Task this independent group who works full time and is compensated and funded, to make an apolitical assessment of the current situation.

3) Develop competing scenarios and test them. Refine as needed and see what really happens in the test "market"

4) Work to build a dynamic system which is not weighed down by bureaucracy. This needs to be reform based on merit.

5) Present all findings to Congress and the public concurrently. No closed door meetings.

6) Let Congress debate but not discard or add without the Body replying first in a most public way.

7) Implement and modify as optimal care dictates.

I'll tackle one facet of care which can make broad beneficial improvements.

Here is how things are. We do not have a unified health care system and addressing this is a major concern. We are a large and disparate population with many needs, not all alike. One size fits all makes no sense. But we can provide some unification. Let's have a "Mednet", which would be online records of every patient, accessed by providers by multiple biometric measures. Get some of the snoops and people in academia to come up with an encryption standard higher than what we currently use. Some marvelous minds out there. Use them.

So what? Why is this a big thing? Here's a "secret". The most important thing for providers to do their jobs properly is a complete and up to date medical history. This cannot be overemphasized.

A real world everyday example. A patient comes to an ER and presents with symptoms which are not easily determined initially. Due to location, hours or whatever the medical history is incomplete or inaccurate. You cannot depend a patient for accuracy. So patient gets a test. $. Test inclusive. Patient admitted for observation and further testing $$$. Patient treated and the process completed. $$$$$

Or.

Patient presents at ER. Full accurate medical history comes up. Oh had that test. Oh takes this med. Oh this problem was recognized and therapy adjustments need to be made.

Which is better for all parties involved? The second. Fewer resources needed of all kinds to get it right.

Doesn't happen much, right? Every. Single. Day, and too often.

But something not so obvious. Currently the data collection we have is limited by spotty knowledge and lack of infrastructure.

Put this in place and great stuff happens. We even have a model for illustrative purposes, VAERS.

That is a vaccination reporting system which exists because of vaxxer ignorance for the most part, but it is a wonderful thing to have in any case. We can analyse and know things. We can discover what we never knew existed, because it provides knowledge and knowledge is power to make positive change.

So strip personally identifiable information from profiles and datamine therapies to determine what works and when and vice versa. See if something works, but at times not then dig further for causation. Whoa, it looks like some meds provide benefit that wasn't even guessed at. We have concrete evidence we would have missed.

It happens all the time already but at a snail's pace.

Better outcomes
Lower costs overall
New therapies, improvement in current treatments and becoming aware of things for good or ill we havent even thought about.

One tiny facet of care and see what it can bring.

Usually someone comes in with Republican this or Democrat that and how trying to do such things is a fantasy, shut up and do what my overlords tell you.

Can't get into all that. This is too serious for the ignorant to run.

 

[Hayabusa Rider]

Cool....your ER example, esp. the second part, is what a typical MD's office visit should be. And that's not how an ER is used, either. ER's don't adjust therapies, meds, etc. That's not their purpose...at all.

And to harken back to another point from earlier, Obamacare certainly did have the mechanisms in place in the original legislation to pay for the unexpected costs ins. co's. would face, thereby preventing the massive premium increases that did happen when the Republican controlled House refused to fund said payment mechanisms. It's rather easy to cause a failure of a project when you refuse to fund various aspects of said project, as the Repubs in fact did.

I was typing through the whole thing a bit fast. What I meant is that instead of admitting adjustments could be made, but as you say the patients physician would make changes unless is was a "snowbird" kind of situation where patient and provider weren't near at the time. As far as Repblicans I don't expect much from them. As you know care is a very complex subject and when people who haven't a real understanding are tasked with many many things it is difficult with the best of intentions, and that's without partisan factors entering into it.

 

[highland145]

And to harken back to another point from earlier, Obamacare certainly did have the mechanisms in place in the original legislation to pay for the unexpected costs ins. co's. would face, thereby preventing the massive premium increases that did happen when the Republican controlled House refused to fund said payment mechanisms. It's rather easy to cause a failure of a project when you refuse to fund various aspects of said project, as the Repubs in fact did.

Intentional ignorance.