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

[tandem-bike.livejournal.com]

well, that did not happen in the VA system! it really is an exemplary socialist medicine outfit, with the pros and the cons.

[nefedor.livejournal.com]

Here I can't comment because I lack the knowledge. I believe you, of course, and wonder how could they keep it this way.

[tandem-bike.livejournal.com]

well, do you want me to tell you about it? it is simple. everything is run M.A.S.H. style, with the same absurdity at times. teh resources are capped, and when an expensive drug is needed, a vet may hear sorry, sir, not on the formulary. there are some exceptions. you want to see THIS doctor but you cannot, you see whomever they gave you. you want to see the same doctor every time but no way, you will see a different resident staffed by different attendings. you want a motorized wheelchair but "VA no longer pays for those"". etc.

and - a HUGE reliance on volunteers for all kinds of tasks.

[nefedor.livejournal.com]

The main question here is about capped resources. How are they capped - by whom? Who can influence on that cap? Can it be influenced democratically - by majority vote?

[tandem-bike.livejournal.com]

now, here i cannot answer because i don't know. what i do know - democracy has no place there.

i suspect some admins and medical directors get together nad decide to add ( can happen!) or cut a service.

for example, when a new device is introduces, the technical acquisitions committee will meet and discuss its need for teh VA population, consider the cost, the benefits, the PR etc. and provide the servic e- or not.

or - the same people probably convene and decide that it is too cost-ineffective and tough on schedulers to have "personal" doctors for the vets, so anybody will be scheduled into anyone's next availble without regard to whom they saw for the last 10 years.

as a result - sometimes teh patients suffer, sometimes they benefit. it balances out.

[nefedor.livejournal.com]

Yes, I suspect the same. Then this is why VA is not implementable on the national level: we do have democratic means to influence the caps.

[tandem-bike.livejournal.com]

hate to say it, but that's why the end is near.

we need to cap malpractice to 200,000 unless there are "special considerations", which are rare ( i could gieve you examples but no need), cut the MD salaries ( ouch but yes), prodice TWICE more local MDs, import TWICE more pakistani and indian MDs, destroy entitlement plans while building a socialist universal plan, the open the free market to new paradgims of medical insurance.

why am i not advising the president?? i would volunteer signamax first, though.

[nefedor.livejournal.com]

Totally agree - the end is near exactly because of that.

>> cap malpractice to 200,000

I'm making, say, 500K a year. Suppose, some surgeon did a lousy job on me and I've lost ability to work. And he/insurance owes me only 6 month of my pay? Hmmm...
I'm not saying hard no to that, but it looks somewhat unfavorable...

>> produce TWICE more local MDs, import TWICE more pakistani and indian MDs

Would that mean quality drop or not?

[tandem-bike.livejournal.com]

1. life is not fair
2. yes, a quality drop


:-)

i mean both

[ny-quant.livejournal.com]

Clearly, reliance on volunteers won't work on the national level.

[nefedor.livejournal.com]

Well, I'm not sure if they rely on them that hard. There is volunteering everywhere. But even if this is an issue, I still think the cap on pay has larger influence.