Obamacare “repeal”

[ny_quant]

А где-нибудь в ЖЖ уже обсуждают какой это прекрасный план и как Трамп быстро выполнит очередное предвыборное обещание? Кстати, уважуха консерваторам которые против.

Comments

[nefedor.livejournal.com]

Setting the charity cases aside, are you saying that people who can't pay for the service don't need this service?

That is something I can hardly agree with. Yes, people can be lazy, stupid, reckless, whatever, they can make mistakes leading to such situations when they have broken something and don't have money to cover the fix. And despite their laziness and stupidity, they do need the service. Saying otherwise look inhumane to me. I'd advocate helping those people, maybe not most effective and expensive way, but helping.

[tandem-bike.livejournal.com]

believe me, if they NEED it, they are helped.

if they say Oh, i don't go to see a doctor because i don't have$100 for a visit - - they don't need a doctor.

[nefedor.livejournal.com]

Another real life example.

My friend. Excellent programmer, I consider him my teacher. Family, two girls, house near NYC, nice job, wife never worked.

Suddenly out of the blue something happens to him: he became irritated and obsessive, sitting at the computer at nights, not sleeping for several days, lost his job and with it the insurance, couldn't get himself together to find another, stopped going to interviews couple of years ago. Money depleted, debt, house in foreclosure, etc.

He had a family history of depressions and schizophrenia, most likely this is the reason. Wife works but can't produce enough to support everybody.

Does he need help?

[tandem-bike.livejournal.com]

he does, but what is your point?

[nefedor.livejournal.com]

The point is that if you take the group of people who needs help and the group of people who are helped or eligible for help - these are different groups. It's possible to be in first but not in second. Which is sort of scary because life is unpredictable so one can't be sure he or she won't get into such predicament.

[tandem-bike.livejournal.com]

well, these people will always exist. those who need help but cannot quite get access. The important thing is to minimize this group, not to eliminate it. because the latter is not possible in ANY medical system.

[nefedor.livejournal.com]

The argument from the left is that such people won't exist with their socialist system. (At the cost of spending more than they can or gov control). But I see things the similar way you described, so I'd probably just agree here.

[tandem-bike.livejournal.com]

i am glad you agree. but the right and the left view of the delivery of medical care - those views are equally idiotic and lunatic. as are their other political views.

Arbat and Jerkov are twins separated at birth. with equally hateful demagogy and a total lack of knowledge of anything they speak of, with some rare exceptions in the case of the former.

extreme left and extreme right are to be avoided at al cost.

[nefedor.livejournal.com]

And again I agree with the general point (though I have never read Arbat so I don't know how he fits the profile).

[tandem-bike.livejournal.com]

easily. take Jerkov, turn him inside out, make him smarter and a bit more honest - here is Arbat.

[nefedor.livejournal.com]

:)

[yucca.livejournal.com]

This is an odd idea. Is it so hard to imagine a person who has a once-in-a-while heart pain, or suspiciously looking mole, or weird stomach pain who is postponing a visit to the doctor until they have extra $100...which might not happen for a while. Or a pregnant woman who goes to the hospital only when it's time for her to give birth? Or a woman who doesn't spend money for a mammogram until she has an advanced stage cancer?

[tandem-bike.livejournal.com]

you threw too many scenarios at me, all with a different "weight" and sense.


perhaps you overestimate the 100 doll thing, Yucca. we have "self-pay" patients. had a lot in prev. place you know. they pay $100 out of pocket. upfront. to see me who costs closer to 400-500 per 1-hr visit.

$100 is a bag of groceries. it is not that much. responsible people will pay it. indigents do not need it - they will be seen for free.

the buck stops and the problem starts when i need to admit that person - for 5 days, to a tune of 22K or more.

that's when we ask for charity care.

[yucca.livejournal.com]

And I'm not so convinced about $100, after S. received $500-1000 bills for specialist visits (we have high deductible). Self-pay patients may be able to negotiate but it's not like this is widely advertised, and remember we're probably talking about people who are not highly educated. Throw in some tests and it suddenly starts to look a lot more than $100. So they think they might not really "need" it, the problem will eventually go away, whatever.

[tandem-bike.livejournal.com]

you are funny. i am TELLING you that self-pay is $100 upfront for a 4th level specialist visit, and you re "not so convinced"? it's.. like, a fact. sorry. a F.A.C.T. :-)

and i did mention what happens with "tests". YES, they need to be approved for charity care before i admit them or they will wind up with a 20-30 K bill.

and please, save me from this patronizing "they are not so educating so they don't worry as much about your health" thing. 1. it is a common left intellectual mistake to equate "noneducated" with "dumb and ignorant". and 2. it is a common left intellectual mistake to think that truly dumb and ignorant don't care about their health uniformly - some do, some don't. just like in your social class, and those people have advocates, which you really don't have ( and don't need, thanks heavens).

[yucca.livejournal.com]

Are you telling me a fact about your practice or about a universal rule that we could use ourselves instead of paying $500 later?

And don't tell me about uneducated people, I work in an organization that is dedicated to helping them and yes, many cannot understand simple instructions, have hard time using the internet, whatever. Not all, of course. Doesn't matter they don't worry about their health, but that's unrelated to education, I know highly educated people who avoid going to see a doctor as long as possible. I imagine it would be even worse if that involved significant expense.

[tandem-bike.livejournal.com]

well, you do sound uppity as shit, sorry :-)

like i said, the indigent actually get access to care.

as to 100 instead of 500 - an INTERESTING q.

i would not be surprised if you were to declare "I am self-pay", a university clinic would sat "just bring 100 doll cash".

no a private or HMO - i doubt that would happen. but i worked only in Unis.

my mom though - nearly 40 years of practice in the US, 36 of them in private practice - she would barter, she would treat for free, she had scaled down for those without money. now D's dad could not do that, he worked for a private CLINIC, so they made the rules. he told me they served EVERYBODY. but it is a small clinic in a small western town. Mayo clinic - you cannot literally walk in until you guarantee payment one way or another. the famous . Mayo is a not a good model, for the future of medicine. it is boutique, and fairly greedy at that. i say as an insider :-)

[ny-quant.livejournal.com]

// Mayo clinic - you cannot literally walk in until you guarantee payment one way or another

Exactly! As I was trying to explain to Yan but he won't listen.

[yankel.livejournal.com]

"Exactly! As I was trying to explain to Yan but he won't listen."

Что я не слышу? :) Я где то утверждал, что Mayo Clinic принимает бедных? Частная клиника вообще никого не обязана принимать.

Всех-всех принимают ERs в госпиталях. Это - закон.
Плюс, существуют различные клиники для бедных, временный медикеит и т.д
То о чем писала Молли, и то о чем я писал, когда рассказывал, как лечили мою мать.
Для незастрахованных есть и был до Обамакера доступ к услугам системы здравоохранения.
Я вам дал ссылки на сайты, где можно найти клиники для бедных.
Я честно не понимаю, как я еще могу доказать, что человека без денег будут лечить?

Ну, хотите, скажите в каком районе живет бойфренд вашей дочери и мы поищем клиники там.

[yucca.livejournal.com]

Just had to note in passing, that I get a lecture for saying people who are not highly educated may have trouble negotiating a complicated medical pricing system, but in your other post expressions like "она бы тогда плодилась дома", "oрдa нелегaльнoй свoлoчи", "В ближайших 2-3-4 поколениях они будут потенциальной угрозой твоему потомству", "вякает, что Америка ее родная страна" are obviously perfectly OK. Whether it's an ideological or stylistic bias or both, I'm not sure, but I'm done trying to comply.

[tandem-bike.livejournal.com]

please do no quote my friends out of context. you make them sound horrible.

[yucca.livejournal.com]

I mean "Doesn't mean", of course.

[yucca.livejournal.com]

Also, of course, the numbers themselves defy reason. Looking at the details, the doctor himself bills one amount, high but reasonable, and then the hospital bills several times more. WTF? There were no tests, no special rooms or equipment, just a checkup with some simple instruments. If the doctor had just rented a regular office (like my dad just had an eye surgery in some dingy building in a questionable neighborhood, but the doctor was great...) would it have been cheaper? Or is there something I don't get here?

[tandem-bike.livejournal.com]

that is a completely unrelated issue. and that is THE CRUCIAL ISSUE which neither idiotic ACA nor its nor less idiotic replacement addressed.

[yucca.livejournal.com]

of course